Haynes A, Bower C, Bulsara M K, Jones T W, Davis E A
Department of Endocrinology and Diabetes, Princess Margaret Hospital, and Centre for Child Health Research, The University of Western Australia, Telethon Institute of Child Health Research, Subiaco, Perth, Western Australia.
Diabetologia. 2004 May;47(5):866-70. doi: 10.1007/s00125-004-1385-8. Epub 2004 Apr 17.
AIMS/HYPOTHESIS: Our aim was to determine the incidence of Type 1 diabetes in children who were 0 to 14 years of age in Western Australia from 1985 to 2002, and to analyse the trends in incidence rate over the same period.
Primary case ascertainment was from a prospective population-based diabetes register that was established in 1987, and secondary case ascertainment was from the Western Australia Hospital Morbidity Data System. Denominator data were obtained from the Australian Bureau of Statistics. Poisson regression was used to analyse the incidence rates by calendar year, sex and age at diagnosis.
There was a total of 1144 cases (560 boys, 584 girls). Using the capture-recapture method, case ascertainment was estimated to be 99.8% complete. The mean age standardised incidence from 1985 to 2002 was 16.5 per 100,000 person years (95% CI 14.7-18.2), ranging from 11.3 per 100,000 in 1985 to 23.2 per 100,000 in 2002. The incidence increased on average by 3.1% (95% CI 1.9%-4.2%) a year over the period ( p<0.001). No significant difference was found between boys and girls. A significant increase in incidence was found in all age groups, with no disproportionate increase found in the 0 to 4-year-olds.
CONCLUSIONS/INTERPRETATION: The incidence of childhood-onset Type 1 diabetes in Western Australia has increased significantly over the past 18 years and shows no signs of abating. In contrast to other studies, a higher rate of increase was not found in the youngest children.
目的/假设:我们的目的是确定1985年至2002年西澳大利亚州0至14岁儿童1型糖尿病的发病率,并分析同期发病率的变化趋势。
主要病例确诊来自于1987年建立的基于人群的前瞻性糖尿病登记册,次要病例确诊来自西澳大利亚医院发病率数据系统。分母数据来自澳大利亚统计局。采用泊松回归分析按诊断年份、性别和年龄划分的发病率。
共有1144例病例(560名男孩,584名女孩)。采用捕获-再捕获法,估计病例确诊率为99.8%。1985年至2002年的平均年龄标准化发病率为每10万人年16.5例(95%置信区间14.7-18.2),范围从1985年的每10万人11.3例到2002年的每10万人23.2例。在此期间,发病率平均每年上升3.1%(95%置信区间1.9%-4.2%)(p<0.001)。未发现男孩和女孩之间存在显著差异。所有年龄组的发病率均显著上升,0至4岁儿童未发现不成比例的上升。
结论/解读:在过去18年中,西澳大利亚州儿童期1型糖尿病的发病率显著上升,且没有下降的迹象。与其他研究不同的是,最小年龄组儿童的发病率没有更高的上升率。