Bai Patricia, Barkmeier Andrew J, Hodge David O, Mohney Brian G
Alix School of Medicine, Mayo Clinic, Phoenix, AZ, USA.
Department of Ophthalmology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.
Acta Diabetol. 2024 Dec;61(12):1511-1516. doi: 10.1007/s00592-024-02314-0. Epub 2024 Jun 7.
Although the literature on childhood diabetes has traditionally focused on Type 1 diabetes (T1D), youth-onset Type 2 diabetes (T2D) and its associated morbidities have become increasingly prevalent. This study reports on the incidence and demographics of a population-based cohort of children diagnosed with diabetes over a 50-year period.
Medical records of patients < 22 years diagnosed with diabetes from January 1, 1970, through December 31, 2019, were retrospectively reviewed using the Rochester Epidemiology Project, a database of clinics and hospitals in Olmsted County, Minnesota.
Of 606 children diagnosed with diabetes, 519 (85.6%) were diagnosed with T1D at a mean age of 10.9 ± 5.3 years. 87 (14.4%) were diagnosed with T2D at a mean age of 17.4 ± 3.4 years. The incidence of T2D increased 23-fold (p < 0.001) over the five-decade period (5 per 100,000 children/year) while T1D remained stable (26 per 100,000 children/year; p = 0.08). The mean body mass index at T2D diagnosis (35.5 kg/m ± 10.4) was significantly higher than in T1D (18.9 kg/m ± 4.6 [95% CI for difference 14.2-19.0]; p < 0.0001). Sixty-nine percent of children diagnosed with T2D were female, and the hazard ratio of developing diabetic retinopathy in females with T2D compared to males was 6.83 (95% CI 1.53-30.44; p = 0.012).
The incidence of youth-onset T2D increased significantly over the 50-year period while the incidence of T1D remained stable. A higher proportion of females were diagnosed with youth-onset T2D. Females with T2D were more than six times likelier to develop diabetic retinopathy than males.
尽管关于儿童糖尿病的文献传统上主要关注1型糖尿病（T1D），但青少年发病的2型糖尿病（T2D）及其相关并发症的发病率日益升高。本研究报告了一个基于人群的队列中50年间被诊断为糖尿病的儿童的发病率和人口统计学特征。
利用罗切斯特流行病学项目回顾性分析了1970年1月1日至2019年12月31日期间诊断为糖尿病的22岁以下患者的病历，该项目是明尼苏达州奥尔姆斯特德县的诊所和医院数据库。
在606名被诊断为糖尿病的儿童中，519名（85.6%）被诊断为T1D，平均年龄为10.9±5.3岁。87名（14.4%）被诊断为T2D，平均年龄为17.4±3.4岁。在这50年期间，T2D的发病率增加了23倍（p<0.001）（每10万名儿童/年5例），而T1D保持稳定（每10万名儿童/年26例；p=0.08）。T2D诊断时的平均体重指数（35.5kg/m±10.4）显著高于T1D（18.9kg/m±4.6[差异的95%置信区间为14.2-19.0]；p<0.0001）。69%被诊断为T2D的儿童为女性，与男性相比，T2D女性患糖尿病视网膜病变的风险比为6.83（95%置信区间1.53-30.44；p=0.012）。
在这50年期间，青少年发病的T2D发病率显著增加，而T1D发病率保持稳定。更高比例的女性被诊断为青少年发病的T2D。T2D女性患糖尿病视网膜病变的可能性是男性的六倍多。
