Manuwald Ulf, Heinke Peter, Salzsieder Eckhard, Hegewald Janice, Schoffer Olaf, Kugler Joachim, Kapellen Thomas M, Kiess Wieland, Rothe Ulrike
Health Sciences, Public Health, Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.
Institute of Diabetes "Gerhardt Katsch" Karlsburg, Karlsburg, Germany.
PLoS One. 2017 Sep 7;12(9):e0183665. doi: 10.1371/journal.pone.0183665. eCollection 2017.
The aim of this study was to analyze the incidence rates of type 1 diabetes in Saxony before and after the German reunification.
The study examined two registries: one until 1990 and one since 1999. Only patients under 15 years of age with type 1 diabetes and living in Saxony were included in the study. Standardized incidence rates were described based on direct age standardization procedures using the Standard European Population for each calendar year between the observation periods 1982-1989 and 1999-2014. Age was grouped into three classes: 0-4, 5-9 and 10-14 years of age. Incidence data were presented as age-standardized incidence rates per 100,000 person-years (PY) with 95% confidence intervals [CI]. Joinpoint regression was used for trend analyses and Poisson regression was used to adjust for the effects of age and sex on the incidence.
A total number of 2,092 incident cases of type 1 diabetes (1,109 males; 983 females) were included. The age-standardized incidence rates of type 1 diabetes per 100,000 PY was 7.9 [95%CI 6.8; 8.9] in the period from 1982-1989 and 20.1 [95%CI 14.0; 26.1] in the period from 1999-2014. The yearly increase in incidence over the entire time period (1982-2014) was 4.3% according to the average annual percent change (AAPC) method, and estimated to be 4.4% [95% CI 4.0; 4.8%] using a Poisson regression model adjusting for sex and age group.
In this study, a significantly increasing incidence of type 1 diabetes was observed after reunification. In future studies it would be interesting to follow up on the question of which environmental and lifestyle factors could be causing the increasing type 1 diabetes incidence.
本研究旨在分析德国统一前后萨克森州1型糖尿病的发病率。
该研究考察了两个登记处：一个截至1990年，另一个自1999年起。研究仅纳入了15岁以下、居住在萨克森州且患有1型糖尿病的患者。基于直接年龄标准化程序，使用标准欧洲人口对1982 - 1989年和1999 - 2014年观察期内的每个日历年描述标准化发病率。年龄分为三个组：0 - 4岁、5 - 9岁和10 - 14岁。发病率数据以每10万人年（PY）的年龄标准化发病率表示，并带有95%置信区间[CI]。采用连接点回归进行趋势分析，采用泊松回归调整年龄和性别对发病率的影响。
共纳入2092例1型糖尿病新发病例（男性1109例；女性983例）。1982 - 1989年期间，每10万PY的1型糖尿病年龄标准化发病率为7.9 [95%CI 6.8；8.9]，1999 - 2014年期间为20.1 [95%CI 14.0；26.1]。根据平均年度百分比变化（AAPC）方法，整个时间段（1982 - 2014年）发病率的年增长率为4.3%，使用调整了性别和年龄组的泊松回归模型估计为4.4% [95%CI 4.0；4.8%]。
在本研究中，统一后观察到显著增加的1型糖尿病发病率。在未来研究中，跟进哪些环境和生活方式因素可能导致1型糖尿病发病率上升这一问题将很有趣。
