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波兰儿童 1 型糖尿病发病率 24 年趋势更新显示呈正弦模式且持续增加。

Updated 24-year trend of Type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase.

机构信息

Clinical Hospital No 1, Zabrze.

Silesian University of Technology, Gliwice.

出版信息

Diabet Med. 2017 Sep;34(9):1252-1258. doi: 10.1111/dme.13345. Epub 2017 Mar 19.

Abstract

AIMS

To present the incidence trend for Type 1 diabetes in Polish children aged 0-14 years, updated using data collected during 2005-2012, and assess the reliability of the predictive model constructed previously using the 1989-2004 database.

METHODS

Children aged < 15 years with newly diagnosed Type 1 diabetes are recorded prospectively (EURODIAB criteria) in several regional registers in Poland. Age- and gender-standardized incidence rates for Type 1 diabetes were calculated per 100 000 persons/year. Incidence rates were analysed in terms of the dependency on age, gender, geographical region and population density. Incidence rate trends over time were modelled using generalized linear models.

RESULTS

The mean standardized incidence for 1989-2012 was 12.72 per 100 000 persons/year [95% confidence interval (CI), 11.35 to 14.21]. Over the 24-year observation period, the incidence increased from 5.36 to 22.74 per 100 000 persons/year. The lowest incidence rate was in children aged 0-4 years (8.35, 95% CI 7.27 to 9.57 per 100 000 persons/year). There was no difference between genders, or urban and rural regions. Incidence rates were higher in northern compared with southern Poland [14.04 (95% CI 12.59 to 15.63) vs. 11.94 (95% CI 10.62 to 13.39) per 100 000 persons/year]. The new data corrected the earlier predictive model by changing the estimates of some factors related to patient age, gender and their interactions with the remaining factors. The incidence rate shows periodic 5.33-year fluctuations. The periodicity component allows for a more accurate prediction of the incidence rate over time.

CONCLUSIONS

This cohort study reveals a sustained increase in Type 1 diabetes incidence in Polish children aged 0-14 years with regular, sinusoidal fluctuations and a slight levelling off in past few years. It is of concern that are the highest increases in incidence are found in children aged 0-4 years.

摘要

目的

展示波兰 0-14 岁儿童 1 型糖尿病的发病趋势,该数据使用 2005-2012 年期间收集的数据进行更新,并评估之前使用 1989-2004 年数据库构建的预测模型的可靠性。

方法

使用几个波兰地区登记处前瞻性地记录年龄<15 岁的新诊断 1 型糖尿病儿童(EURODIAB 标准)。每 100000 人/年计算 1 型糖尿病的年龄和性别标准化发病率。发病率按年龄、性别、地理位置和人口密度进行分析。使用广义线性模型分析随时间变化的发病率趋势。

结果

1989-2012 年的平均标准化发病率为 12.72/100000 人/年(95%置信区间(CI)为 11.35-14.21)。在 24 年的观察期内,发病率从 5.36 上升至 22.74/100000 人/年。发病率最低的是 0-4 岁儿童(8.35,95%CI 为 7.27-9.57/100000 人/年)。男女之间或城乡之间无差异。与波兰南部相比,波兰北部的发病率较高[14.04(95%CI 为 12.59-15.63)与 11.94(95%CI 为 10.62-13.39)/100000 人/年]。新数据通过改变与患者年龄、性别相关的一些因素以及它们与其余因素的相互作用的估计值,纠正了早期的预测模型。发病率呈现出 5.33 年的周期性波动。周期性成分可以更准确地预测随时间变化的发病率。

结论

这项队列研究揭示了波兰 0-14 岁儿童 1 型糖尿病发病率持续上升,呈规则的正弦波动,近年来略有平稳。令人担忧的是,发病率最高的是 0-4 岁儿童。

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