加那利群岛糖尿病相关终末期肾病发病率极高。基于估计的危险人群分析。

Disproportionately high incidence of diabetes-related end-stage renal disease in the Canary Islands. An analysis based on estimated population at risk.

机构信息

Nephrology Section, Hospital Universitario de Canarias, Santa Cruz de Tenerife, La Laguna, Spain.

出版信息

Nephrol Dial Transplant. 2010 Jul;25(7):2283-8. doi: 10.1093/ndt/gfp761. Epub 2010 Jan 11.

DOI:10.1093/ndt/gfp761

PMID:20064954

Abstract

BACKGROUND

An exceptionally high incidence of diabetes-related end-stage renal disease (DM-ESRD) has been reported in the Canary Islands. This phenomenon was attributed to an increased prevalence of diabetes in this community. We compared the incidence of DM-ESRD in the Canary Islands with the rest of Spain among the estimated number of individuals at risk (people with diabetes in the population).

METHODS

The population-at-risk was calculated using census population figures and estimates of self-reported diabetes prevalence from the Spanish National Health Survey in the years 2003 and 2006. The incidence of DM-ESRD for the same years was obtained through Spanish regional registries. The independent effect of age, community of residence and calendar year was estimated with a Poisson regression model. Age-standardized acceptance rate ratios were calculated for each community.

RESULTS

Overall DM-ESRD incidence in the Canary Islands population-at-risk was 1209.9 per million population (pmp) in 2003 and 1477.3 pmp in 2006. Rates for the remaining Spanish regions ranged from 177.3-984.9 pmp. The incidence was higher in the Canary Islands across all age groups, but was most striking for patients > or =75 years. Diabetes prevalence in the general population was greater in the two youngest age strata and diminished from 75 years on in the Canary Islands, in comparison with other areas of Spain. Using a cluster of three communities with the lowest incidence as a reference, the relative risk of DM-ESRD in the Canary Islands population-at-risk was 3.88 [95% confidence interval (CI): 3.07-4.89]. Age-standardized acceptance ratios (95% CI) in the Canary Islands were 2.21 (1.85-2.61) in 2003 and 2.73 (2.34-3.17) in 2006.

CONCLUSIONS

Individuals with diabetes in the Canary Islands present a disproportionately high incidence of ESRD. Diabetic Canary inhabitants are exposed to the disease for a longer time and therefore, may be more vulnerable to the development of chronic diabetes complications, including ESRD.

摘要

背景

加那利群岛报告了极高的糖尿病相关终末期肾病（DM-ESRD）发病率。这一现象归因于该社区糖尿病患病率的增加。我们比较了加那利群岛和西班牙其他地区在估计的风险人群（人群中患有糖尿病的人）中 DM-ESRD 的发病率。

方法

使用人口普查人口数据和 2003 年和 2006 年西班牙国家健康调查中自我报告的糖尿病患病率估计值计算风险人群。同年的 DM-ESRD 发病率通过西班牙区域登记处获得。使用泊松回归模型估计年龄、居住社区和日历年份的独立影响。为每个社区计算了年龄标准化接受率比。

结果

2003 年和 2006 年，加那利群岛风险人群的总体 DM-ESRD 发病率分别为每百万人口 1209.9 人（pmp）和 1477.3 pmp。其余西班牙地区的发病率范围为 177.3-984.9 pmp。所有年龄组的发病率在加那利群岛都较高，但在≥75 岁的患者中最为明显。一般人群中糖尿病的患病率在两个最年轻的年龄组中较高，而在加那利群岛中从 75 岁开始下降，与西班牙其他地区相比。使用发病率最低的三个社区集群作为参考，加那利群岛风险人群的 DM-ESRD 相对风险为 3.88 [95%置信区间（CI）：3.07-4.89]。2003 年加那利群岛的年龄标准化接受率比（95%CI）为 2.21（1.85-2.61），2006 年为 2.73（2.34-3.17）。