儿童期发病的1型糖尿病缓慢进展亚型作为终末期肾病的高危因素：日本的一项队列研究

Slowly progressive subtype of childhood-onset type 1 diabetes as a high-risk factor for end-stage renal disease: A cohort study in Japan.

作者信息

Yokomichi Hiroshi, Mochizuki Mie, Suzuki Shigeru, Ito Yoshiya, Hotsubo Tomoyuki, Matsuura Nobuo

机构信息

Department of Epidemiology and Environmental Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.

Department of Paediatrics, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan; Department of Paediatrics, NHO Kofu National Hospital, 11-35 Tenjincho, Kofu, Yamanashi, Japan.

出版信息

J Diabetes Complications. 2025 Jan;39(1):108922. doi: 10.1016/j.jdiacomp.2024.108922. Epub 2024 Nov 28.

DOI:10.1016/j.jdiacomp.2024.108922

PMID:39616658

Abstract

AIM

To compare the incidence of end-stage renal disease (ESRD) between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.

METHODS

This cohort study enrolled all 521 patients with childhood-onset type 1 diabetes with the year of onset from 1959 to 1996 in Hokkaido Prefecture, Japan. We calculated the ESRD incidence rate per 100,000 person-years by sex, onset year, onset age, and type 1 diabetes subtype (slowly progressive or acute-onset). We also constructed a Kaplan-Meier curve for ESRD by these risk factors.

RESULTS

The data of 391 patients were gathered, among whom 66 developed ESRD. The ESRD incidence rate per 100,000 person-years was 525 among all patients; 538 and 503 among women (n = 235) and men (n = 156); 893, 413, and 225 for onset year of 1959-1979 (n = 107), 1980-1989 (n = 201), and 1990-1996 (n = 83); 420 and 715 for onset before (n = 243) and after (n = 148) puberty; and 1388 and 432 for the slowly progressive (n = 41) and acute-onset (n = 350) subtypes, respectively. The Kaplan-Meier curve also indicated a significantly higher incidence of ESRD in slowly progressive than in acute-onset type 1 diabetes.

CONCLUSION

The incidence of ESRD was higher in slowly progressive than acute-onset type 1 diabetes.

摘要

目的

比较缓慢进展型1型糖尿病和急性起病型1型糖尿病终末期肾病（ESRD）的发病率。

方法

这项队列研究纳入了日本北海道地区1959年至1996年发病的所有521例儿童期起病的1型糖尿病患者。我们按性别、发病年份、发病年龄和1型糖尿病亚型（缓慢进展型或急性起病型）计算了每10万人年的ESRD发病率。我们还根据这些危险因素构建了ESRD的Kaplan-Meier曲线。

结果

收集了391例患者的数据，其中66例发生了ESRD。所有患者每10万人年的ESRD发病率为525；女性（n = 235）和男性（n = 156）分别为538和503；1959 - 1979年发病（n = 107）、1980 - 1989年发病（n = 201）和1990 - 1996年发病（n = 83）的发病率分别为893、413和225；青春期前（n = 243）和青春期后（n = 148）发病的发病率分别为420和715；缓慢进展型（n = 41）和急性起病型（n = 350）亚型的发病率分别为1388和432。Kaplan-Meier曲线也表明，缓慢进展型1型糖尿病的ESRD发病率显著高于急性起病型。