2002 年至 2022 年德国北莱茵-威斯特法伦州儿童和青少年 1 型和 2 型糖尿病发病率趋势。

Trends in the incidence of type 1 diabetes and type 2 diabetes in children and adolescents in North Rhine-Westphalia, Germany, from 2002 to 2022.

机构信息

Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.

出版信息

Diabetes Metab. 2024 Sep;50(5):101567. doi: 10.1016/j.diabet.2024.101567. Epub 2024 Jul 31.

DOI:10.1016/j.diabet.2024.101567

PMID:39095014

Abstract

AIMS

The objective of this study was to assess overall and segmented trends in the incidence of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents younger than 20 years, from 2002 to 2022.

METHODS

This study used registry data on physician-diagnosed T1DM or T2DM from primary and secondary sources, covering the German federal state of North Rhine-Westphalia with 18 million inhabitants. The ages at T1DM and T2DM onset ranged from 0 to 19 and 10-19 years, respectively. The main outcomes were direct age- and/or sex-standardized incidence rates per 100,000 person-years (PYs) and trends estimated as annual percentage changes (APCs), both with 95 % confidence intervals. The segmented trends for subperiods were based on joinpoint regression models.

RESULTS

From 2002-2022, 17,470 and 819 persons had incident T1DM and T2DM, respectively. The total number of PYs was 73,743,982 for T1DM and 39,210,453 for T2DM, with a mean coverage rate of 98 % for T1DM and 90 % for T2DM. The standardized T1DM incidence increased from 17.6 [16.3;18.9} in 2002 to 33.2 [31.3;35.1] in 2022, with an APC of 2.7 % [2.3 %;3.1 %]. The standardized T2DM incidence increased from 1.3 [0.8;1.7] in 2002 to 2.8 [2.0;3.6] in 2022, with an APC of 6.4 % [4.9 %;8.0 %]. There were four different segmented trends for T1DM and T2DM, with the incidence peaking in 2021 and subsequently declining.

CONCLUSIONS

The incidence rates of T1DM and T2DM have increased over the past 20 years, with a wave-like pattern during the Covid-19 pandemic.

摘要

目的

本研究旨在评估 2002 年至 2022 年期间，20 岁以下儿童和青少年中 1 型糖尿病（T1DM）和 2 型糖尿病（T2DM）的总发病率和分段趋势。

方法

本研究使用了来自初级和二级来源的登记数据，涵盖了拥有 1800 万居民的德国北莱茵-威斯特法伦州的医生诊断为 T1DM 或 T2DM 的病例。T1DM 和 T2DM 的发病年龄分别为 0 至 19 岁和 10 至 19 岁。主要结局是每 10 万人年（PY）的直接年龄和/或性别标准化发病率（每 10 万人年）和趋势，分别用 95%置信区间表示的年百分比变化（APC）。亚时段的分段趋势基于连接点回归模型。

结果

2002 年至 2022 年期间，分别有 17470 人和 819 人患有 T1DM 和 T2DM。T1DM 的总 PY 数为 73743982，T2DM 为 39210453，T1DM 的平均覆盖率为 98%，T2DM 为 90%。标准化 T1DM 发病率从 2002 年的 17.6[16.3；18.9}增加到 2022 年的 33.2[31.3；35.1]，APC 为 2.7%[2.3%；3.1%]。标准化 T2DM 发病率从 2002 年的 1.3[0.8；1.7]增加到 2022 年的 2.8[2.0；3.6]，APC 为 6.4%[4.9%；8.0%]。T1DM 和 T2DM 有四种不同的分段趋势，发病率在 2021 年达到峰值，随后下降。