Am J Epidemiol. 2014 Feb 15;179(4):492-8. doi: 10.1093/aje/kwt308. Epub 2014 Jan 8.
In this study, we examined temporal changes in the incidence of primary biliary cirrhosis (PBC) and investigated associations between PBC incidence and sociodemographic factors and spatial clustering. We included 982 patients aged ≥40 years from North East England with incident PBC diagnosed during 1987-2003. Age-standardized incidence rates with 95% confidence intervals were calculated. Negative binomial regression was used to analyze incidence and socioeconomic deprivation. Clustering analysis was performed using point process methods, testing the null hypothesis that disease risk does not vary spatially and that PBC cases occur independently. The age-standardized incidence rate was 53.50 per million persons per year (95% confidence interval: 48.65, 58.35) in 1987-1994 and 45.09 per million persons per year (95% confidence interval: 41.10, 49.07) in 1995-2003. Risk of PBC increased in areas with higher levels of socioeconomic deprivation (P = 0.035). More specifically, risk increased in areas with higher levels of overcrowded homes (P = 0.040), higher levels of households without cars (P < 0.001), and higher levels of non-owner-occupied homes (P < 0.001). Overall, there was evidence of spatial clustering (P = 0.001). The findings confirm that overall incidence of PBC did not rise over time, but sociodemographic variations suggest that certain aspects of deprivation are involved in its etiology.
在这项研究中，我们考察了原发性胆汁性肝硬化（PBC）发病率的时间变化，并调查了 PBC 发病率与社会人口因素之间的关联和空间聚集。我们纳入了来自英格兰东北部的 982 名年龄≥40 岁的患者，这些患者在 1987-2003 年期间被诊断为原发性胆汁性肝硬化。计算了年龄标准化发病率及其 95%置信区间。使用负二项回归分析发病率和社会经济剥夺。使用点过程方法进行聚类分析，检验疾病风险在空间上没有差异且 PBC 病例独立发生的零假设。1987-1994 年的年龄标准化发病率为 53.50/百万人年（95%置信区间：48.65，58.35），1995-2003 年的年龄标准化发病率为 45.09/百万人年（95%置信区间：41.10，49.07）。在社会经济剥夺程度较高的地区，PBC 的发病风险增加（P=0.035）。更具体地说，在住房过度拥挤程度较高的地区（P=0.040）、没有汽车的家庭比例较高的地区（P<0.001）和非自住房屋比例较高的地区（P<0.001），风险增加。总体而言，存在空间聚集的证据（P=0.001）。这些发现证实，PBC 的总体发病率并未随时间升高，但社会人口统计学的差异表明，某些方面的贫困与该病的病因有关。
