Matsuura N, Fukuda K, Okuno A, Harada S, Fukushima N, Koike A, Ito Y, Hotsubo T
Department of Pediatrics, Kitasato University, Sagamihara, Japan.
Diabetes Care. 1998 Oct;21(10):1632-6. doi: 10.2337/diacare.21.10.1632.
To identify the incidence of IDDM with regard to sex, age, family history of diabetes, season, and 5-year period of childhood IDDM among children ages 0-14 years from a population-based epidemiological study in Hokkaido, Japan, from 1973 to 1992.
Registration of all new IDDM cases in Hokkaido was conducted by the Childhood IDDM Hokkaido Registry Study Group from 1973 to 1992. The cases were selected from among 1) patients who were admitted to the member hospitals of the study group, 2) patients who answered a questionnaire distributed to hospitals and diabetic clinics throughout Hokkaido, and 3) patients whose cases were recorded in free-treatment medical records of urban and rural districts. The case ascertainment rate was estimated to be 100%. Differences in incidence with regard to sex, age, family history of diabetes, season, and year period were analyzed by the Poisson regression analysis by GENMOD.
During the 20-year period studied, 396 cases (181 boys, 215 girls) of abrupt-onset IDDM were registered. Statistically significant differences in annual incidence were found according to sex (female), age (8-14 years), history (having no diabetes in family), season (spring), and 5-year period.
This is the first population-based, long-term epidemiological study of childhood IDDM from Japan. We observed a significantly higher annual incidence (per 100,000/year) of IDDM in female subjects (1.81), older age-groups (2.25 for 8-14 years), subjects with no family history of diabetes (1.26), diabetes onset in the spring (2.20), and an increased trend over the 20 years. In addition, the heterogeneity of IDDM among Japanese children needs to be elucidated.
通过一项基于人群的流行病学研究，确定1973年至1992年日本北海道0至14岁儿童中，胰岛素依赖型糖尿病（IDDM）在性别、年龄、糖尿病家族史、季节以及儿童期IDDM的5年时间段方面的发病率。
北海道儿童IDDM登记研究组在1973年至1992年对北海道所有新的IDDM病例进行了登记。病例选自以下几类：1）研究组成员医院收治的患者；2）对北海道各地医院和糖尿病诊所发放的问卷做出答复的患者；3）城乡地区免费治疗病历中记录有病例的患者。病例确诊率估计为100%。通过GENMOD的泊松回归分析，分析了性别、年龄、糖尿病家族史、季节和年份方面发病率的差异。
在研究的20年期间，登记了396例（181名男孩，215名女孩）急性起病的IDDM病例。根据性别（女性）、年龄（8至14岁）、家族史（家族中无糖尿病）、季节（春季）和5年时间段，发现年发病率存在统计学上的显著差异。
这是日本首次基于人群的儿童IDDM长期流行病学研究。我们观察到女性受试者（1.81/10万/年）、年龄较大组（8至14岁为2.25/10万/年）、无糖尿病家族史的受试者（1.26/10万/年）、春季发病的糖尿病（2.20/10万/年）的IDDM年发病率显著较高，并且在这20年中呈上升趋势。此外，日本儿童中IDDM的异质性需要阐明。
