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1977 - 1986年英格兰北部儿童胰岛素依赖型糖尿病与物质匮乏状况

Insulin dependent diabetes in childhood and material deprivation in northern England, 1977-86.

作者信息

Crow Y J, Alberti K G, Parkin J M

机构信息

Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne.

出版信息

BMJ. 1991 Jul 20;303(6795):158-60. doi: 10.1136/bmj.303.6795.158.

Abstract

OBJECTIVE

To determine the incidence of insulin dependent diabetes in the Northern region of England in children less than 16 years old in the period 1977 to 1986 and to relate the incidence data to an index of deprivation.

DESIGN

Retrospective analysis of hospital case records identified from the regional health authority's computer; validation of the primary source with hospital clinic registers and community paediatric registers.

SETTING

Northern region, excluding South Cumbria District Health Authority (659,300 children under 16 in 1981).

PATIENTS

All children diagnosed with insulin dependent diabetes before the age of 16 and resident in the region at time of diagnosis.

MAIN OUTCOME MEASURES

Incidence rates for the 10 year period and analysis of incidence rates within categories of deprivation.

RESULTS

919 incident cases were identified. The validation procedure covered 54% of all cases identified and gave 95% completeness of ascertainment. The average annual incidence over the 10 year period was 14.8/100,000 for girls and 13.4/100,000 for boys. The annual incidence for the most and least deprived areas of the region was 18.7/100,000 (95% confidence interval 16.2 to 21.5) for boys and 7/100,000 (5.6 to 8.8) for girls. There was a highly significant trend (p less than 0.001) of decreasing incidence with decreasing level of deprivation.

CONCLUSIONS

In the north of England the incidence of childhood diabetes is related to material deprivation.

摘要

目的

确定1977年至1986年期间英格兰北部16岁以下儿童胰岛素依赖型糖尿病的发病率,并将发病率数据与贫困指数相关联。

设计

对从地区卫生当局计算机中识别出的医院病例记录进行回顾性分析;用医院诊所登记册和社区儿科登记册对原始资料进行验证。

地点

北部地区,不包括南坎布里亚区卫生局(1981年有659300名16岁以下儿童)。

患者

所有16岁之前被诊断为胰岛素依赖型糖尿病且诊断时居住在该地区的儿童。

主要观察指标

10年期间的发病率以及贫困类别内发病率的分析。

结果

共识别出919例新发病例。验证程序涵盖了所有识别出病例的54%,确定率达到95%。10年期间女孩的年均发病率为14.8/10万,男孩为13.4/10万。该地区最贫困和最不贫困地区男孩的年发病率分别为18.7/10万(95%置信区间16.2至21.5)和女孩为7/10万(5.6至8.8)。随着贫困程度降低,发病率呈极显著下降趋势(p<0.001)。

结论

在英格兰北部,儿童糖尿病的发病率与物质贫困有关。

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Evidence for increasing prevalence of diabetes mellitus in childhood.儿童期糖尿病患病率上升的证据。
Br Med J (Clin Res Ed). 1983 Jun 11;286(6381):1855-7. doi: 10.1136/bmj.286.6381.1855.

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