Center for the Scientific and Clinical Study of Endocrinology, Ministry of Health, Tashkent, Uzbekistan.
International Diabetes Federation Life for a Child Program, Glebe, Australia.
Pediatr Diabetes. 2018 Feb;19(1):158-165. doi: 10.1111/pedi.12495. Epub 2017 Jan 17.
We aimed to determine the incidence, prevalence and mortality of type 1 diabetes (T1D) in Uzbekistan in children <15 years old.
In a prospective study from 1998 to 2014 the primary ascertainment of incidence, prevalence and mortality, and cause of death was via data collected by endocrinology dispensaries in Uzbekistan's 14 administrative divisions. A second data collection for 2008-2010 from a national audit in 2011 was used to determine age structure.
Over 1998-2014 T1D prevalence roughly doubled (7.8 to 15.3/100,000 population aged <15 years, P = .10), following a doubling of incidence (1.5 to 3.1/100 000 < 15 years), a 5.6% annualized increase, P = .001), with a fall in mortality per 1000 patient years (24.5 to 2.0, P = .001). There was a female preponderance, with a male:female ratio of 0.89 in 2008-2010. In every year, T1D incidence was highest in the 10-14.99 year age-group, although the proportion of diagnoses under 5 years of age increased from 6.0% of total diagnoses in 1998-2002, to 13.4% in 2008-2010. Peak age of onset in 2008-2010 was 13 years. Notable regional variation was evident, with incidence being highest in Tashkent-City (P = .005). The most common cause of death was chronic renal failure-responsible for 31 deaths in children <15 years during the study period.
Our results provide the first long-term epidemiological data for T1D in Uzbekistan and the region. Uzbekistan is country of low but rising T1D incidence and prevalence, and falling mortality. Attention to improving clinical care is warranted, to reduce long-term complications.
本研究旨在确定乌兹别克斯坦＜15 岁儿童 1 型糖尿病（T1D）的发病率、患病率和死亡率。
本前瞻性研究于 1998 年至 2014 年开展，主要通过乌兹别克斯坦 14 个行政区内分泌诊所收集的数据确定发病率、患病率和死亡率以及死亡原因。2011 年对 2008-2010 年进行了第二次全国审计数据收集，以确定年龄结构。
1998-2014 年期间，T1D 患病率翻了一番（＜15 岁人群中为 7.8/100000 至 15.3/100000，P=0.10），发病率也翻了一番（＜15 岁人群中为 1.5/100000 至 3.1/100000，年增长率为 5.6%，P=0.001），每 1000 名患者年的死亡率下降（24.5 至 2.0，P=0.001）。女性发病率高于男性，男女比例为 2008-2010 年的 0.89。在每年中，10-14.99 岁年龄组的 T1D 发病率最高，尽管＜5 岁的诊断比例从 1998-2002 年的总诊断数的 6.0%增加到 2008-2010 年的 13.4%。2008-2010 年发病高峰年龄为 13 岁。明显的区域差异，塔什干市发病率最高（P=0.005）。儿童＜15 岁期间，死亡的最常见原因是慢性肾衰竭，共有 31 例。
本研究提供了乌兹别克斯坦及该地区 T1D 的首个长期流行病学数据。乌兹别克斯坦的 T1D 发病率和患病率呈上升趋势，但死亡率呈下降趋势，属于低发病率和低患病率国家。需要注意提高临床护理水平，以减少长期并发症。
