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法国儿童甲亢的流行病学:一项全国性基于人群的研究。

Epidemiology of Childhood Hyperthyroidism in France: A Nationwide Population-Based Study.

机构信息

Santé publique France, Environmental Health Direction, Saint-Maurice, France.

Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Universitaire Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France.

出版信息

J Clin Endocrinol Metab. 2018 Aug 1;103(8):2980-2987. doi: 10.1210/jc.2018-00273.

Abstract

CONTEXT

Hyperthyroidism affects all age groups, but epidemiological data for children are scarce.

OBJECTIVE

To perform a nationwide epidemiological survey of hyperthyroidism in children and adolescents.

DESIGN

A cross-sectional descriptive study.

SETTING

Identification of entries corresponding to reimbursements for antithyroid drugs in the French national insurance database.

PARTICIPANTS

All cases of childhood hyperthyroidism (6 months to 17 years of age) in 2015.

MAIN OUTCOME MEASURES

National incidence rate estimated with a nonlinear Poisson model and spatial distribution of cases.

RESULTS

A total of 670 cases of childhood hyperthyroidism were identified. Twenty patients (3%) had associated autoimmune or genetic disease, with type 1 diabetes and Down syndrome the most frequent. The annual incidence for 2015 was 4.58/100,000 person-years (95% CI 3.00 to 6.99/100,000). Incidence increased with age, in both sexes. This increase accelerated after the age of 8 in girls and 10 in boys and was stronger in girls. About 10% of patients were affected before the age of 5 years (sex ratio 1.43). There was an interaction between age and sex, the effect of being female increasing with age: girls were 3.2 times more likely to be affected than boys in the 10 to 14 years age group and 5.7 times more likely to be affected in the 15 to 17 years age group. No conclusions about spatial pattern emerged.

CONCLUSION

These findings shed light on the incidence of hyperthyroidism and the impact of sex on this incidence during childhood and adolescence. The observed incidence was higher than expected from the results published for earlier studies in Northern European countries.

摘要

背景

甲状腺功能亢进症可影响所有年龄段,但儿童的流行病学数据较少。

目的

对儿童和青少年甲状腺功能亢进症进行全国性的流行病学调查。

设计

横断面描述性研究。

设置

在法国国家保险数据库中确定与抗甲状腺药物报销相对应的条目。

参与者

2015 年所有儿童甲状腺功能亢进症(6 个月至 17 岁)病例。

主要观察指标

用非线性泊松模型估计全国发病率和病例的空间分布。

结果

共发现 670 例儿童甲状腺功能亢进症。20 例(3%)患者存在自身免疫或遗传疾病,其中最常见的是 1 型糖尿病和唐氏综合征。2015 年的年发病率为 4.58/100000 人年(95%CI 3.00 至 6.99/100000)。发病率随年龄增长而增加,且在两性中均如此。在女孩中,这种增加在 8 岁以后加速,在男孩中在 10 岁以后加速,且在女孩中更为明显。约 10%的患者在 5 岁前发病(性别比 1.43)。年龄和性别之间存在交互作用,女性的影响随年龄增加而增加:在 10 至 14 岁年龄组中,女孩患该病的可能性是男孩的 3.2 倍,在 15 至 17 岁年龄组中,女孩患该病的可能性是男孩的 5.7 倍。未得出空间模式的结论。

结论

这些发现阐明了儿童和青少年甲状腺功能亢进症的发病率以及性别对发病率的影响。观察到的发病率高于北欧国家早期研究的结果预期。

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