Matsuura Nobuo, Yokomichi Hiroshi, Ito Yoshiya, Suzuki Shigeru, Mochizuki Mie
Department of Reproductive and Developmental Medicine, Graduate School of Medicine, Hokkaido University, 7 Nishi, 15 Kita, Kita-ku, City of Sapporo, Hokkaido Japan.
Department of Epidemiology and Environmental Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi Japan.
Diabetol Int. 2024 Jan 24;15(2):262-269. doi: 10.1007/s13340-023-00688-0. eCollection 2024 Apr.
To examine the mortality rate and causes of death in childhood-onset type 1 diabetes in Japan.
For a median 36.7 years, we followed 391 patients under the age of 15 years who developed type 1 diabetes between 1959 and 1996. We calculated the mortality rate per 100,000 person-years and the standardised mortality ratio (SMR) according to risk factors.
The mortality rates and SMRs were 823 and 8.8 with onset during 1959-1979, 370 and 5.9 with onset during 1980-1989, and 133 and 3.2 with onset during 1990-1996, respectively. The mortality rates and SMRs were 359 and 8.4 in men, and 235 and 6.0 in women. Mortality rates and SMRs were 452 and 7.3 in patients with diabetes onset before puberty and 514 and 6.3 in patients with onset after puberty. The main causes of death with shorter disease duration were sudden death, accident/suicide, and acute diabetic complications. With a more than 30-year disease duration, the main causes of death were end-stage renal disease and cardiovascular disease.
This cohort study revealed a decrease in the mortality rate between 1959-1979 and 1990-1996 in patients with childhood-onset type 1 diabetes in Japan. Patients with onset after puberty had a higher mortality rate than those with onset before puberty.
研究日本儿童期发病的1型糖尿病的死亡率及死亡原因。
在36.7年的时间里，我们对1959年至1996年间发病时年龄在15岁以下的391例1型糖尿病患者进行了随访。我们计算了每10万人年的死亡率以及根据风险因素得出的标准化死亡率（SMR）。
1959 - 1979年发病患者的死亡率和SMR分别为823和8.8，1980 - 1989年发病患者为370和5.9，1990 - 1996年发病患者为133和3.2。男性的死亡率和SMR分别为359和8.4，女性为235和6.0。青春期前发病的糖尿病患者死亡率和SMR分别为452和7.3，青春期后发病患者为514和6.3。病程较短时的主要死亡原因是猝死、意外/自杀和急性糖尿病并发症。病程超过30年时，主要死亡原因是终末期肾病和心血管疾病。
这项队列研究显示，日本儿童期发病的1型糖尿病患者在1959 - 1979年至1990 - 1996年间死亡率有所下降。青春期后发病的患者死亡率高于青春期前发病的患者。
