National Institute for Health and Welfare, Dept of Chronic Disease Prevention, Diabetes Prevention Unit, Helsinki, Finland.
Diabet Med. 2009 Jul;26(7):673-8. doi: 10.1111/j.1464-5491.2009.02743.x.
To determine if there is a worldwide seasonal pattern in the clinical onset of Type 1 diabetes.
Analysis of the seasonality in diagnosis of Type 1 diabetes was based on the incidence data in 0- to 14-year-old children collected by the World Health Organization Diabetes Mondiale (WHO DiaMond) Project over the period 1990-1999. One hundred and five centres from 53 countries worldwide provided enough data for the seasonality analysis. The incidence seasonality patterns were also determined for age- and sex-specific groups.
Forty-two out of 105 centres exhibited significant seasonality in the incidence of Type 1 diabetes (P < 0.05). The existence of significant seasonal patterns correlated with higher level of incidence and of the average yearly counts. The correlation disappeared after adjustment for latitude. Twenty-eight of those centres had peaks in October to January and 33 had troughs in June to August. Two out of the four centres with significant seasonality in the southern hemisphere demonstrated a different pattern with a peak in July to September and a trough in January to March.
The seasonality of the incidence of Type 1 diabetes mellitus in children under 15 years of age is a real phenomenon, as was reported previously and as is now demonstrated by this large standardized study. The seasonality pattern appears to be dependent on the geographical position, at least as far as the northern/southern hemisphere dichotomy is concerned. However, more data are needed on the populations living below the 30th parallel north in order to complete the picture.
确定 1 型糖尿病的临床发病是否存在全球季节性模式。
根据世界卫生组织糖尿病项目(WHO DiaMond)1990-1999 年期间收集的 0-14 岁儿童 1 型糖尿病发病率数据,分析 1 型糖尿病发病的季节性。全球 53 个国家的 105 个中心提供了足够的数据进行季节性分析。还确定了年龄和性别特定组的发病季节性模式。
在 105 个中心中,有 42 个中心(P < 0.05)的 1 型糖尿病发病率存在显著季节性。存在显著季节性模式与更高的发病率和平均年计数相关。调整纬度后,相关性消失。其中 28 个中心发病高峰在 10 月至 1 月,33 个中心发病低谷在 6 月至 8 月。南半球的 4 个具有显著季节性的中心中有 2 个显示出不同的模式,高峰在 7 月至 9 月,低谷在 1 月至 3 月。
15 岁以下儿童 1 型糖尿病发病率的季节性是一个真实的现象,正如以前报道的那样,现在通过这项大型标准化研究也得到了证明。季节性模式似乎取决于地理位置,至少就南北半球二分法而言是这样。然而,需要更多关于生活在北纬 30 度以下的人群的数据,以完善这一图景。