Drash A L, Cho N, Tajima N, Rewers M, Laporte R
Indian J Pediatr. 1989 Nov-Dec;56 Suppl 1:S15-32. doi: 10.1007/BF02776460.
Epidemiologic studies are providing important new insights into the etiology and clinical course of IDDM as well as providing critically needed data on the magnitude of the problem in different parts of the world. The development of national IDDM registries have documented extraordinary differences in diabetes incidence and prevalence, with the highest incidence figures in Finland (greater than 30/100,000/yr) and the lowest in the Orient with Korea reporting incidence rates below 1 and Japan between 1.0-2.4/100,000/yr. The great geographic variation in expression of diabetes in childhood is strongly supportive of environmental factors playing a major role in the etiology of disease. Our studies document a linear correlation between IDDM incidence and distance from the equator and a similar but inverse correlation with mean annual environmental temperature. Other workers find a direct correlation with dairy product consumption. Factors that may play a role in beta cell damage include viral infections, environmental toxins, nutrients and stress factors. Because of the low incidence of IDDM among children living in Asia it is most important to expand the current national registries in the Asian countries and begin a careful study of the environmental differences within Asian countries as well as comparison of studies between countries with very high incidence rates and those with the lowest rates.
流行病学研究正在为胰岛素依赖型糖尿病（IDDM）的病因和临床病程提供重要的新见解，同时也在提供关于世界各地该问题严重程度急需的数据。国家IDDM登记处的发展记录了糖尿病发病率和患病率的巨大差异，芬兰的发病率最高（每年超过30/10万），而东方国家发病率最低，韩国报告的发病率低于1/10万，日本为每年1.0 - 2.4/10万。儿童糖尿病表现的巨大地理差异有力地支持了环境因素在疾病病因中起主要作用的观点。我们的研究记录了IDDM发病率与离赤道距离之间的线性关系，以及与年平均环境温度类似但相反的关系。其他研究人员发现与乳制品消费存在直接关联。可能在β细胞损伤中起作用的因素包括病毒感染、环境毒素、营养物质和压力因素。由于亚洲儿童中IDDM的发病率较低，因此最重要的是扩大亚洲国家现有的国家登记处，并开始仔细研究亚洲国家内部的环境差异，以及比较高发病率国家和最低发病率国家之间的研究。
