Mauny F, Grandmottet M, Lestradet C, Guitard J, Crenn D, Floret N, Olivier-Koehret M, Viel J F
Department of Public Health, Epidemiology and Biostatistics Unit, Faculty of Medicine, Besançon, France.
Eur J Epidemiol. 2005;20(4):325-9. doi: 10.1007/s10654-005-0329-z.
AIMS/HYPOTHESIS: A study was conducted by the Franche-Comté Regional Association of Private Practitioners (Union Régionale des Médecins Libéraux de Franche-Comté) to assess trends in childhood-onset Type 1 diabetes in this administrative region of France, between 1980 and 1998.
Cases of childhood-onset Type 1 diabetes (aged 0-14 years) were retrospectively recorded with the help of general practitioners, private specialists and hospitals in the Franche-Comté and surrounding administrative regions. Incidence rates and trends during the period were analysed using Poisson regression.
During the 19-year study period, 308 cases of childhood-onset Type 1 diabetes were identified. The level of case ascertainment was estimated to be 80.6% (95% CI: 74.7, 87.4). The male-to-female sex ratio was 1.03. The World standardised incidence rate was 6.90/100,000. The incidence rate was 6.03 (95% CI: 4.76, 7.53) for children aged 0 to 4 years, 6.45 (95% CI: 5.23, 7.88) for children aged 5-9 years and 8.56 (95% CI: 7.18, 10.13) for those aged 10-14 years. The annual increase rate was 4.9%, continuous and regular, without any deviation. This trend did not differ according to gender or age group.
CONCLUSION/INTERPRETATION: These results confirm that the incidence and the increase rate in childhood Type 1 diabetes in France are average compared to in other European countries over an extended period of time. Furthermore, the regular and linear increase in incidence supports the hypothesis of causal environmental factors diffusing over time. The complementary data provided also illustrate the role that private practitioners may play by their implication in epidemiology and public health.
目的/假设：法国弗朗什-孔泰地区私人执业医师协会（Franche-Comté Regional Association of Private Practitioners，Union Régionale des Médecins Libéraux de Franche-Comté）开展了一项研究，以评估1980年至1998年期间法国该行政区儿童期1型糖尿病的发病趋势。
借助弗朗什-孔泰及周边行政区的全科医生、私人专科医生和医院，对儿童期1型糖尿病（0至14岁）病例进行回顾性记录。使用泊松回归分析该期间的发病率及趋势。
在19年的研究期内，共确诊308例儿童期1型糖尿病病例。病例确诊水平估计为80.6%（95%置信区间：74.7, 87.4）。男女比例为1.03。世界标准化发病率为6.90/10万。0至4岁儿童的发病率为6.03（95%置信区间：4.76, 7.53），5至9岁儿童为6.45（95%置信区间：5.23, 7.88），10至14岁儿童为8.56（95%置信区间：7.18, 10.13）。年增长率为4.9%，持续且规律，无任何偏差。该趋势在性别或年龄组之间无差异。
结论/解读：这些结果证实，在较长一段时间内，法国儿童期1型糖尿病的发病率和增长率与其他欧洲国家相比处于平均水平。此外，发病率的持续线性增长支持了因果环境因素随时间扩散的假设。所提供的补充数据也说明了私人执业医师在流行病学和公共卫生中的参与可能发挥的作用。
