Jin Feng, Xie Limin, Wang Guocheng, Pan Yu, Wang Cuijia, Li Wei
Department of Genetics and Reproductive Medicine, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China.
Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.
Front Endocrinol (Lausanne). 2025 Jul 29;16:1638187. doi: 10.3389/fendo.2025.1638187. eCollection 2025.
This study investigates the epidemiological trends of childhood type 1 diabetes (T1D) in China and establishes predictive models to estimate future disease burden.
Temporal trend analyses were performed using data from the Global Burden of Disease (GBD) database, stratified by age and sex. Joinpoint regression analysis was applied to evaluate changes in incidence and mortality rates from 1990 to 2021, complemented by autoregressive integrated moving average (ARIMA) and exponential smoothing state space (ETS) models to project disease trends through 2040.
The results indicate a rising trend in the incidence of childhood T1D among Chinese children aged 0-14 years, alongside an overall decline in mortality, reflecting an epidemiological pattern characterized by low incidence yet non-negligible mortality. Notably, infants < 1 year of age have shown increasing mortality rates in recent years. Projections indicate that both incidence and mortality in this age group will continue to increase through 2040. Additionally, incidence among children 1 year of age also expected to persist on an upward trajectory. Sex-based disparities were evident, with girls bearing a higher disease burden than boys, as indicated by elevated incidence, mortality and underdiagnosis rates.
These findings necessitate enhanced public health and clinical management strategies for childhood T1D in China, specifically targeting underdiagnosis reduction, incidence rate stabilization, and mortality rate improvement.
本研究调查中国儿童1型糖尿病（T1D）的流行病学趋势，并建立预测模型以估计未来的疾病负担。
使用全球疾病负担（GBD）数据库的数据进行时间趋势分析，按年龄和性别分层。应用Joinpoint回归分析评估1990年至2021年发病率和死亡率的变化，并辅以自回归积分移动平均（ARIMA）和指数平滑状态空间（ETS）模型预测到2040年的疾病趋势。
结果表明，中国0至14岁儿童中儿童T1D的发病率呈上升趋势，同时死亡率总体下降，反映出一种低发病率但死亡率不可忽视的流行病学模式。值得注意的是，近年来1岁以下婴儿的死亡率有所上升。预测表明，到2040年，该年龄组的发病率和死亡率都将继续上升。此外，1岁儿童的发病率预计也将持续上升。基于性别的差异很明显，女孩的疾病负担高于男孩，发病率、死亡率和诊断不足率均有所上升。
这些发现需要加强中国儿童T1D的公共卫生和临床管理策略，特别是针对减少诊断不足、稳定发病率和提高死亡率。
