Dabelea D, Hanson R L, Bennett P H, Roumain J, Knowler W C, Pettitt D J
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85014, USA.
Diabetologia. 1998 Aug;41(8):904-10. doi: 10.1007/s001250051006.
Until recently, Type II diabetes was considered rare in children. The disease is, however, increasing among children in populations with high rates of Type II diabetes in adults. The prevalence of Type II diabetes was determined in 5274 Pima Indian children between 1967 and 1996 in three 10-year time periods, for age groups 5-9, 10-14 and 15-19 years. Diabetes was diagnosed using World Health Organisation criteria, based on an oral glucose tolerance test. The prevalence of diabetes increased over time in children aged 10 years and over: in boys from 0 % in 1967-1976 to 1.4% in 1987-1996 in the 10-14 year old age group, and from 2.43% to 3.78% for age group 15-19 and in girls from 0.72 % in 1967-1976 to 2.88 % in 1987-1996 in the 10-14 year old age group, and from 2.73 % to 5.31 % for age group 15-19 years. Along with the increase in the prevalence of Type II diabetes (p < 0.0001), there was an increase in weight (calculated as percentage of relative weight, p < 0.0001), and in frequency of exposure to diabetes in utero (p < 0.0001). The increasing weight and increasing frequency of exposure to diabetes in utero accounted for most of the increase in diabetes prevalence in Pima Indian children over the past 30 years. Type II diabetes is now a common disease in American Indian children aged 10 or more years and has increased dramatically over time, along with increasing weight. A vicious cycle related to an increase in the frequency of exposure to diabetes in utero appears to be an important feature of this epidemic.
直到最近，II型糖尿病在儿童中还被认为很罕见。然而，在成年人中II型糖尿病发病率较高的人群中，儿童患这种疾病的人数正在增加。1967年至1996年期间，分三个10年时间段，对5274名皮马印第安儿童（年龄在5 - 9岁、10 - 14岁和15 - 19岁）的II型糖尿病患病率进行了测定。根据世界卫生组织的标准，通过口服葡萄糖耐量试验来诊断糖尿病。10岁及以上儿童的糖尿病患病率随时间增加：在10 - 14岁年龄组中，男孩从1967 - 1976年的0%增至1987 - 1996年的1.4%，15 - 19岁年龄组从2.43%增至3.78%；女孩在10 - 14岁年龄组中从1967 - 1976年的0.72%增至1987 - 1996年的2.88%，15 - 19岁年龄组从2.73%增至5.31%。随着II型糖尿病患病率的增加（p < 0.0001），体重（以相对体重百分比计算，p < 0.0001）以及子宫内接触糖尿病的频率也有所增加（p < 0.0001）。在过去30年里，体重增加和子宫内接触糖尿病频率增加是皮马印第安儿童糖尿病患病率增加的主要原因。II型糖尿病现在是10岁及以上美国印第安儿童中的常见疾病，并且随着体重增加，其发病率随时间急剧上升。子宫内接触糖尿病频率增加相关的恶性循环似乎是这一流行病的一个重要特征。
