Analysis of 20 years of prospective registration of childhood onset diabetes - time trends and birth cohort effects
Analysis of 20 years of prospective registration of childhood onset diabetes - time trends and birth cohort effects
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DOI：
10.1080/080352500750027628
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发表时间：
2000-10-01
期刊：
影响因子：
3.8
通讯作者：
Mustonen, L
中科院分区：
文献类型：
--
作者：
Dahlquist, G;Mustonen, L
自1977年7月1日以来，瑞典儿童糖尿病登记处一直在记录全国范围内儿童发病糖尿病的所有病例，并具有高水平的确定性。本报告描述和分析了1978年1月1日至1997年12月31日期间发生的8358例儿童发病病例。平均年发病率为26.4/10万儿童/年（1978年）。21.1 1997年：31.9）。随着时间的推移，有一个显着的对数线性增加，平均每年增加1.7%。最陡峭的平均增长是在年轻发病病例中（2.5%），最陡峭的年增长率（6.3%）在过去10年期间在这个年龄组中看到。明确显示了向更年轻发病年龄的转变，因为与前10年观察期相比，最后一个观察期的发病年龄更小。随着时间的推移，男女之间以及冬季和夏季的增加情况相似。在分析所涵盖的六个完整出生队列时，我们没有发现趋势的明显变化。出生队列（1978-82年）发病5年显示出时间变异性，但没有明显的趋势。将出生队列的累积发病率与母乳喂养频率相关联的生态学分析显示无显著相关性。一个具有统计学意义的对数线性关联被发现的官方估计国内生产总值调整类似的价格水平（p = 0.002）。结论：儿童期发病的糖尿病的发病率迅速增加，在瑞典与转向年轻的年龄组，但没有出生队列的趋势。环境风险因素是间接的，而不是引发的，与国内生产总值的相关性可能表明与财富相关的风险因素，如高增长率，一个已知的儿童糖尿病的风险因素。
The Swedish Childhood Diabetes Registry has been recording all cases of childhood onset diabetes nationwide, with a high level of ascertainment, since 1 July 1977. The present report describes and analyses the 8358 childhood onset cases occurring between 1 January 1978 and 31 December 1997. The mean annual incidence was 26.4/100000 children per year (1978. 21.1 and 1997: 31.9). There was a significant log-linear increase over time, with a mean annual increase of 1.7%. The steepest mean increase was seen among the young onset cases (2.5%) and the steepest yearly increase (6.3%) was seen in this age group during the last 10-y period. A shift towards a younger age at onset was clearly indicated, as the age at onset was less during the last compared with the first 10-y period of observation. The increase over time was similar between the sexes and during winter and summer. When analysing the six full birth cohorts covered, we found no clear-cut shift in the trend. Birth cohorts (1978-82) up to 5 y of onset showed a time variability but no clear trend over time. Ecological analyses associating cumulative incidence by birth cohort to breastfeeding frequency showed no significant association. A statistically significant log-linear association was found to the official estimate of gross domestic product adjusted for similar price levels (p = 0.002).Conclusion: The incidence of childhood onset diabetes is rapidly increasing in Sweden with a shift towards the younger age groups but with no trend in birth cohorts. Precipitating rather than initiating environmental risk factors are suggested, and the correlation to gross domestic product may suggest risk factors associated with wealth-such as a high growth rate, a known risk factor for childhood diabetes.