加拿大青年队列中青少年 2 型糖尿病的发病率和患病率趋势：2002-2013 年。
Incidence and prevalence trends of youth-onset type 2 diabetes in a cohort of Canadian youth: 2002-2013.
机构信息
Department of Pediatrics, University of British Columbia, Vancouver, Canada.
MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
出版信息
Pediatr Diabetes. 2018 Jun;19(4):630-636. doi: 10.1111/pedi.12631. Epub 2017 Dec 27.
OBJECTIVE
Youth-onset type 2 diabetes is an emerging disease. We estimated incidence and prevalence trends of youth-onset type 2 diabetes between 2002 and 2013 in the Canadian province of British Columbia.
METHODS
This population-based cohort study used a validated diabetes case-finding definition and algorithm to differentiate type 2 from type 1 diabetes to identify youth <20 years with type 2 diabetes within linked population-based administrative data. Age-standardized incidence and prevalence were calculated. JoinPoint regression and double exponential smooth modeling were used.
RESULTS
From 2002/2003 to 2012/2013, the incidence of youth-onset type 2 diabetes increased from 3.45 (95% confidence interval, CI: 2.43, 4.80) to 5.16 (95% CI: 3.86, 6.78)/100 000. The annual percent change (APC) in incidence was 3.74 (95% CI: 1.61, 5.92; P = 0.003) overall, while it was 5.94 (95% CI: 1.84, 10.20; P = 0.009) and 0.53 (95% CI: -5.04, 6.43; P = 0.837) in females and males, respectively. The prevalence increased from 0.009% (95% CI: 0.007, 0.011) in 2002/2003 to 0.021% (95% CI: 0.018, 0.024) in 2012/2013 with an APC of 7.89 (95% CI: 6.41, 9.40; P < 0.0001). In females, it increased from 0.012% (95% CI: 0.009, 0.015) to 0.027% (95% CI: 0.023, 0.032) and in males from 0.007% (95% CI: 0.005, 0.009) to 0.015% (95% CI: 0.012, 0.019). By 2030, we forecast a prevalence of 0.046% (95% CI: 0.043, 0.048).
CONCLUSIONS
Youth-onset type 2 diabetes is increasing with higher rates in females vs males. If these rates continue, in 2030, the number of cases will increase by 5-fold. These data are needed to set priorities for diabetes prevention in youth.
目的
青少年 2 型糖尿病是一种新兴疾病。我们评估了 2002 年至 2013 年期间加拿大不列颠哥伦比亚省青少年 2 型糖尿病的发病率和流行趋势。
方法
本基于人群的队列研究使用了经过验证的糖尿病病例发现定义和算法，将 2 型糖尿病与 1 型糖尿病区分开来，以确定在相关的基于人群的行政数据中年龄<20 岁的患有 2 型糖尿病的青少年。计算了年龄标准化的发病率和患病率。采用 JoinPoint 回归和双指数平滑模型进行分析。
结果
从 2002/2003 年到 2012/2013 年，青少年 2 型糖尿病的发病率从 3.45（95%置信区间：2.43，4.80）增加到 5.16（95%置信区间：3.86，6.78）/100000。发病率的年变化百分比（APC）总体为 3.74（95%置信区间：1.61，5.92；P=0.003），而女性和男性的 APC 分别为 5.94（95%置信区间：1.84，10.20；P=0.009）和 0.53（95%置信区间：-5.04，6.43；P=0.837）。患病率从 2002/2003 年的 0.009%（95%置信区间：0.007，0.011）增加到 2012/2013 年的 0.021%（95%置信区间：0.018，0.024），APC 为 7.89（95%置信区间：6.41，9.40；P<0.0001）。在女性中，患病率从 0.012%（95%置信区间：0.009，0.015）增加到 0.027%（95%置信区间：0.023，0.032），而在男性中从 0.007%（95%置信区间：0.005，0.009）增加到 0.015%（95%置信区间：0.012，0.019）。到 2030 年，我们预测患病率为 0.046%（95%置信区间：0.043，0.048）。
结论
青少年 2 型糖尿病的发病率正在上升，女性的发病率高于男性。如果这些比率继续下去，到 2030 年，病例数将增加 5 倍。这些数据是制定青少年糖尿病预防计划的必要依据。
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