Centre for Public Health and UKCRC Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK.
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Diabetologia. 2019 Mar;62(3):408-417. doi: 10.1007/s00125-018-4763-3. Epub 2018 Nov 28.
AIMS/HYPOTHESIS: Against a background of a near-universally increasing incidence of childhood type 1 diabetes, recent reports from some countries suggest a slowing in this increase. Occasional reports also describe cyclical variations in incidence, with periodicities of between 4 and 6 years. METHODS: Age/sex-standardised incidence rates for the 0- to 14-year-old age group are reported for 26 European centres (representing 22 countries) that have registered newly diagnosed individuals in geographically defined regions for up to 25 years during the period 1989-2013. Poisson regression was used to estimate rates of increase and test for cyclical patterns. Joinpoint regression software was used to fit segmented log-linear relationships to incidence trends. RESULTS: Significant increases in incidence were noted in all but two small centres, with a maximum rate of increase of 6.6% per annum in a Polish centre. Several centres in high-incidence countries showed reducing rates of increase in more recent years. Despite this, a pooled analysis across all centres revealed a 3.4% (95% CI 2.8%, 3.9%) per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004-2008 period. Rates of increase were similar in boys and girls in the 0- to 4-year-old age group (3.7% and 3.7% per annum, respectively) and in the 5- to 9-year-old age group (3.4% and 3.7% per annum, respectively), but were higher in boys than girls in the 10- to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant 4 year periodicity was detected in four centres, with three centres showing that the most recent peak in fitted rates occurred in 2012. CONCLUSIONS/INTERPRETATION: Despite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20 years in Europe. Although four centres showed support for a cyclical pattern of incidence with a 4 year periodicity, no plausible explanation for this can be given.
目的/假设：在儿童 1 型糖尿病发病率普遍上升的背景下，最近一些国家的报告表明这种上升速度有所放缓。偶尔也有报告描述了发病率的周期性变化，其周期性为 4 至 6 年。
方法：报告了 26 个欧洲中心（代表 22 个国家）的 0 至 14 岁年龄组的年龄/性别标准化发病率，这些中心在 1989 年至 2013 年期间，在地理定义区域内登记了长达 25 年的新诊断个体。使用泊松回归估计增长率并检验周期性模式。使用 Joinpoint 回归软件拟合分段对数线性关系以分析发病趋势。
结果：除了两个较小的中心外，所有中心的发病率均呈显著上升趋势，其中一个波兰中心的最高增长率为每年 6.6%。一些高发病率国家的几个中心近年来的增长率呈下降趋势。尽管如此，对所有中心的汇总分析显示，发病率每年增加 3.4%（95%CI 2.8%，3.9%），尽管 2004-2008 年期间的增长率有所下降。0-4 岁年龄组男孩和女孩的增长率相似（分别为每年 3.7%和 3.7%），5-9 岁年龄组男孩和女孩的增长率也相似（分别为每年 3.4%和 3.7%），但 10-14 岁年龄组男孩的增长率高于女孩（分别为每年 3.3%和 2.6%）。四个中心检测到明显的 4 年周期性，其中三个中心显示拟合率的最近峰值出现在 2012 年。
结论/解释：尽管一些高风险国家的增长率有所下降，但中心的汇总估计仍显示发病率每年增加 3.4%，这表明欧洲的发病率大约每 20 年翻一番。尽管四个中心支持发病率呈 4 年周期性变化的模式，但无法对此给出合理的解释。
Epidemiol Prev. 2013
Diabetologia. 2001-10
Srp Arh Celok Lek. 2016
Children (Basel). 2025-8-19
Front Endocrinol (Lausanne). 2025-7-29
Genes (Basel). 2025-6-28
Diabetes Obes Metab. 2025-6-19
Int J Mol Sci. 2025-5-11
Diabetologia. 2018-6-22
Diabet Med. 2018-3-24
Pediatr Diabetes. 2017-8-31
N Engl J Med. 2017-4-13
Phys Life Rev. 2016-12
Zotero 插件