Chong Jia W, Craig Maria E, Cameron Fergus J, Clarke Caroline F, Rodda Christine P, Donath Susan M, Werther George A
Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia.
Pediatr Diabetes. 2007 Apr;8(2):67-73. doi: 10.1111/j.1399-5448.2007.00229.x.
The objectives of the study were to (i) determine the incidence of type 1 diabetes mellitus (T1DM) in children aged <15 yr in Victoria, Australia, from 1999 to 2002 and (ii) to analyze trends in incidence over this period.
Prospective population-based incidence study. The primary source of case ascertainment was from the Australasian Paediatric Endocrine Group (APEG) Victorian diabetes register. The secondary source was the National Diabetes Register (NDR), which ascertains cases from the National Diabetes Service Scheme (NDSS), a Commonwealth government initiative, where patients register to receive diabetes supplies at a subsidized price.
Age-standardized incidence, trends in incidence by age, sex and year, and variation in incidence by region, season, and socioeconomic status.
Case ascertainment was 99.1% complete using the capture-recapture method. The mean annual age-standardized incidence was 19.3 per 100 000 person years from 1999 to 2002. On average, incidence increased by 9.3% per year, with a greater relative increase in the 0-4 yr age-group (p = 0.037). No gender bias in incidence was found, but the increase in females was statistically significant (13.6% per year, 95% confidence interval 3.7-24.3). Variation in geographical distribution and seasonal onset of incidence was not statistically significant.
The marked increase in the incidence of T1DM in Victoria is greater than that recently described in other Australia states and developed nations. The etiology of this rise is unclear, while the increased caseload has major implications for diabetes health care providers for current and future resource allocation.
本研究的目的是:(i)确定1999年至2002年澳大利亚维多利亚州15岁以下儿童1型糖尿病(T1DM)的发病率,以及(ii)分析该时期发病率的趋势。
基于人群的前瞻性发病率研究。病例确定的主要来源是澳大拉西亚儿科内分泌组(APEG)维多利亚糖尿病登记册。次要来源是国家糖尿病登记册(NDR),它从国家糖尿病服务计划(NDSS)确定病例,NDSS是联邦政府的一项举措,患者在此登记以补贴价格领取糖尿病用品。
年龄标准化发病率、发病率随年龄、性别和年份的趋势,以及发病率在地区、季节和社会经济地位方面的差异。
采用捕获-再捕获方法,病例确定的完成率为99.1%。1999年至2002年,平均年龄标准化发病率为每10万人年19.3例。平均而言,发病率每年增加9.3%,0至4岁年龄组的相对增幅更大(p = 0.037)。未发现发病率存在性别差异,但女性发病率的增加具有统计学意义(每年13.6%,95%置信区间3.7 - 24.3)。发病率的地理分布和季节性发病差异无统计学意义。
维多利亚州T1DM发病率的显著上升高于澳大利亚其他州和发达国家最近描述的情况。这种上升的病因尚不清楚,而病例数的增加对糖尿病医疗服务提供者当前和未来的资源分配具有重大影响。