Telethon Kids Institute, The University of Western Australia, Subiaco, Australia.
Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Australia.
Pediatr Diabetes. 2018 Jun;19(4):690-692. doi: 10.1111/pedi.12636. Epub 2018 Jan 4.
To determine the incidence of childhood type 1 diabetes mellitus (T1D) in Western Australia from 2011 to 2016, and to examine the temporal trends between 1985 and 2016.
An observational cohort study was undertaken of all children newly diagnosed with T1D aged 0 to 14 years in Western Australia from 1985 to 2016. Cases were identified from the Western Australian Children's Diabetes Database, a population-based diabetes register previously estimated to be >99% complete. Annual age-standardized and age- and sex-specific incidence rates were calculated and the Joinpoint Regression Program used to identify any significant changes in trends over the study period.
A total of 2499 cases were included (1272 boys, 1227 girls). The overall mean annual incidence was 19.1/100 000 person years (95% confidence interval, CI: 18.3-19.8), with no significant difference found between boys and girls. The mean annual incidence of 12.1/100 000 person years (95% CI: 11.1-13.1) in 0 to 4-years was significantly lower than that observed in 5 to 9 (21.6/100 000 [95% CI: 20.2-23.0]) and 10 to 14 (23.5/100 000 [95% CI: 22.1-25.0]) years. Joinpoint regression analysis identified a significant change in the temporal trend occurring in 2003. From 1985 to 2003, the incidence increased on an average of 3.3% per year (95% CI: 1.9-4.7). However, from 2003 to 2016, no significant change in the temporal trend occurred (-0.6% per year [95% CI: -2.4-1.2]).
This study provides evidence for a possible plateauing in the incidence of childhood T1D in Western Australia, following a peak in 2003. Ongoing monitoring of the incidence will be essential to determine how temporal trends continue to evolve.
确定 2011 年至 2016 年西澳大利亚州儿童 1 型糖尿病（T1D）的发病率，并研究 1985 年至 2016 年期间的时间趋势。
对 1985 年至 2016 年期间在西澳大利亚州新诊断为 T1D 的 0 至 14 岁儿童进行了一项观察性队列研究。病例是从西澳大利亚儿童糖尿病数据库中确定的，该数据库是一个人群糖尿病登记处，此前估计其完整性>99%。计算了每年年龄标准化和年龄及性别特异性发病率，并使用 Joinpoint 回归程序确定研究期间趋势是否发生任何显著变化。
共纳入 2499 例（男 1272 例，女 1227 例）。总平均年发病率为 19.1/100000 人年（95%置信区间，CI：18.3-19.8），男女性别之间无显著差异。0 至 4 岁的 12.1/100000 人年（95%CI：11.1-13.1）的平均年发病率明显低于 5 至 9 岁（21.6/100000 [95%CI：20.2-23.0]）和 10 至 14 岁（23.5/100000 [95%CI：22.1-25.0]）的发病率。Joinpoint 回归分析发现，2003 年发生了时间趋势的显著变化。1985 年至 2003 年期间，发病率平均每年增加 3.3%（95%CI：1.9-4.7）。然而，2003 年至 2016 年期间，时间趋势未发生显著变化（每年减少 0.6%[95%CI：-2.4-1.2]）。
本研究为西澳大利亚州儿童 1 型糖尿病发病率在 2003 年达到峰值后可能出现平台期提供了证据。对发病率的持续监测对于确定时间趋势如何继续演变至关重要。
