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芬兰、瑞典及美国加利福尼亚州斯坦福市新冠疫情封锁期间5岁以下男童1型糖尿病风险增加——一项多中心观察性研究

Increased Risk of Type 1 Diabetes in Boys Under the Age of 5 Years During COVID-19 Lockdowns in Finland, Sweden and Stanford, CA, USA-An Observational Multicenter Study.

作者信息

Tall Susanna, Prahalad Priya, Adiels Martin, Rosengren Annika, Virtanen Suvi M, Maahs David M, Knip Mikael

机构信息

Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Population Department, Finnish Institute for Health and Welfare, Helsinki, Finland.

出版信息

Diabetes Metab Res Rev. 2025 Sep;41(6):e70084. doi: 10.1002/dmrr.70084.

Abstract

AIMS

The COVID-19 pandemic has been associated with an increased incidence of type 1 diabetes. Changes in the type 1 diabetes incidences in countries like Sweden where very mild COVID-19 pandemic related measures were applied have not been established so far. We analysed the incidence of type 1 diabetes during the COVID-19 lockdown and before the lockdown in Sweden, Finland and Stanford, CA, USA.

MATERIALS AND METHODS

Type 1 diabetes incidence rates during the first 18 months of the SARS-CoV-2 pandemic (3/2020-8/2021) were compared to a period before the pandemic (three corresponding 18-month terms 2014-2019) in Sweden, Finland and Stanford.

RESULTS

In Sweden, type 1 diabetes incidence increased by 5% (IRR 1.05; 95% CI = 0.98-1.12; p = 0.18, N = 4458), in Finland by 17% (IRR 1.17; 95% CI = 1.07-1.27; p < 0.001, N = 2881) and in Stanford by 10% (IRR = 1.10; 95% CI = 0.91-1.34; p = 0.34, N = 531) during the lockdown compared to the time before lockdown. In boys under 5 years of age, the incidence increased significantly in all regions: Sweden (IRR 1.21; 95% CI = 1.00-1.46; p = 0.05, N = 521), Finland (IRR = 1.33; 95% Cl = 1.06-1.67, p = 0.02, N = 363) and Stanford CA, USA (IRR = 2.07"; 95% Cl = 1.06-4.02, p = 0.03, N = 37).

CONCLUSIONS

Lockdowns during the COVID-19 pandemic may have untoward consequences such as an increased risk of type 1 diabetes in young children, boys in particular. The hygiene hypothesis may explain this finding.

摘要

目的

2019冠状病毒病(COVID-19)大流行与1型糖尿病发病率上升有关。在瑞典等实施了非常温和的COVID-19相关措施的国家,1型糖尿病发病率的变化迄今尚未明确。我们分析了瑞典、芬兰和美国加利福尼亚州斯坦福在COVID-19封锁期间及封锁前1型糖尿病的发病率。

材料与方法

将严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行的前18个月(2020年3月至2021年8月)期间的1型糖尿病发病率与瑞典、芬兰和斯坦福大流行前的一个时期(2014 - 2019年三个相应的18个月时间段)进行比较。

结果

与封锁前相比,在封锁期间,瑞典1型糖尿病发病率增加了5%(发病率比值比[IRR]1.05;95%置信区间[CI]=0.98 - 1.12;p = 0.18,N = 4458),芬兰增加了17%(IRR 1.17;95% CI = 1.07 - 1.27;p < 0.001,N = 2881),斯坦福增加了10%(IRR = 1.10;95% CI = 0.91 - 1.34;p = 0.34,N = 531)。在5岁以下男孩中,所有地区的发病率均显著上升:瑞典(IRR 1.21;95% CI = 1.00 - 1.46;p = 0.05,N = 521),芬兰(IRR = 1.33;95% CI = 1.06 - 1.67,p = 0.02,N = 363),以及美国加利福尼亚州斯坦福(IRR = 2.07;95% CI = 1.06 - 4.02,p = 0.03,N = 37)。

结论

COVID-19大流行期间的封锁可能会产生不良后果,如幼儿尤其是男孩患1型糖尿病的风险增加。卫生假说可能解释这一发现。

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