Bruno G, Merletti F, De Salvia A, Lezo A, Arcari R, Pagano G
Department of Internal Medicine, University of Turin, Italy.
Diabet Med. 1997 Nov;14(11):964-9. doi: 10.1002/(SICI)1096-9136(199711)14:11<964::AID-DIA493>3.0.CO;2-P.
To document the incidence of IDDM in the Province of Turin (Italy) in the 8-year period 1984-91 in children (0-14 years) and young adults (15-29 years), in relation to age, sex, monthly-seasonal variability, calendar year and urban/rural area, (all newly diagnosed cases (502) were ascertained through primary and secondary data sources and completeness of ascertainment estimated with the two sample capture-recapture method (99% in childhood and 95% in young adults). The independent effect of age, sex, calendar year, and urban/rural area was estimated with a Poisson regression model. Age-specific incidence rates were 8.42/100,000 (95% CI 7.37-9.62) and 6.72/100,000 (95% CI 5.96-7.58), respectively, in the age groups 0-14 and 15-29 years. Sex differences were evident in young adults, with an almost 1.5-fold increased risk in men (8.37/100,000, 95% CI 7.21-9.71 vs 5.00/100,000, CI 4.09-6.10). Seasonal trend was evident in childhood. Predictors of incidence rates were age, place of residence and interaction between sex and age; no temporal trend was detected. No significant differences were found in the two age-groups with respect to glycaemia, glycosuria, ketonuria, and fasting C-peptide levels. In conclusion, this study shows sex differences in IDDM risk in young adults; 55% of incident cases occurring in young adults; an independent contribution of urban/rural differences to IDDM risk; no temporal trend in 1984-91; a seasonal pattern of incidence in children; no significant differences in clinical presentation between age groups.
为记录1984年至1991年8年间意大利都灵省0至14岁儿童及15至29岁青年成人中胰岛素依赖型糖尿病(IDDM)的发病率,分析其与年龄、性别、月度-季节变化、日历年及城乡地区的关系,(所有新诊断病例(502例)通过一级和二级数据来源确定,并采用双样本捕获-再捕获法估计确诊完整性(儿童期为99%,青年成人为95%)。采用泊松回归模型估计年龄、性别、日历年及城乡地区的独立影响。0至14岁和15至29岁年龄组的年龄别发病率分别为8.42/10万(95%可信区间7.37 - 9.62)和6.72/10万(95%可信区间5.96 - 7.58)。青年成人中性别差异明显,男性患病风险几乎增加1.5倍(8.37/10万,95%可信区间7.21 - 9.71对5.00/10万,可信区间4.09 - 6.10)。儿童期有明显的季节性趋势。发病率的预测因素为年龄、居住地以及性别与年龄的交互作用;未检测到时间趋势。两个年龄组在血糖、糖尿、酮尿及空腹C肽水平方面未发现显著差异。总之,本研究显示青年成人中IDDM风险存在性别差异;55%的新发病例发生在青年成人中;城乡差异对IDDM风险有独立影响;1984年至1991年无时间趋势;儿童发病率呈季节性模式;各年龄组临床表现无显著差异。