Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA.
Health Place. 2010 May;16(3):547-56. doi: 10.1016/j.healthplace.2009.12.015. Epub 2010 Jan 15.
We evaluated geographic variation in type 1 and type 2 diabetes mellitus (T1DM, T2DM) in four regions of the United States. Data on 807 incident T1DM cases diabetes and 313 T2DM cases occurring in 2002-03 in South Carolina (SC) and Colorado (CO), 5 counties in Washington (WA), and an 8 county region around Cincinnati, Ohio (OH) among youth aged 10-19 years were obtained from the SEARCH for Diabetes in Youth Study. Geographic patterns were evaluated in a Bayesian framework. Incidence rates differed between the study regions, even within race/ethnic groups. Significant small-area variation within study region was observed for T1DM and T2DM. Evidence for joint spatial correlation between T1DM and T2DM was present at the county level for SC (r(SC)=0.31) and CO non-Hispanic Whites (r(CO)=0.40) and CO Hispanics (r(CO)=0.72). At the tract level, no evidence for meaningful joint spatial correlation was observed (r(SC)=-0.02; r(CO)=-0.02; r(OH)=0.03; and r(WA=)0.09). Our study provides evidence for the presence of both regional and small area, localized variation in type 1 and type 2 incidence among youth aged 10-19 years in the United States.
我们评估了美国四个地区 1 型和 2 型糖尿病（T1DM、T2DM）的地理差异。2002-03 年，南卡罗来纳州（SC）和科罗拉多州（CO）、华盛顿州的 5 个县以及俄亥俄州辛辛那提附近的 8 个县共 807 例 1 型糖尿病（T1DM）和 313 例 2 型糖尿病（T2DM）患者的发病数据来源于青少年糖尿病研究（SEARCH for Diabetes in Youth Study）。我们在贝叶斯框架下评估了地理模式。即使在种族/民族群体内部，各研究地区的发病率也存在差异。在研究区域内观察到 T1DM 和 T2DM 存在显著的小区域差异。在 SC（r(SC)=0.31）和 CO 非西班牙裔白人（r(CO)=0.40）以及 CO 西班牙裔（r(CO)=0.72），T1DM 和 T2DM 之间存在联合空间相关性的证据。在县一级，在 SC（r(SC)=-0.02）、CO（r(CO)=-0.02）、OH（r(OH)=0.03）和 WA（r(WA)=0.09），没有观察到有意义的联合空间相关性的证据。本研究提供了证据表明，在美国，10-19 岁青少年的 1 型和 2 型糖尿病发病率存在区域性和小区域的本地化差异。
