Geographic variation in mortality among individuals with youth-onset diabetes mellitus across the world
Geographic variation in mortality among individuals with youth-onset diabetes mellitus across the world
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DOI：
10.1007/s001250050665
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发表时间：
1997-02-01
期刊：
影响因子：
8.2
通讯作者：
Tajima, N
中科院分区：
文献类型：
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作者：
Matsushima, M;LaPorte, RE;Tajima, N
本研究的目的是评估全球青年胰岛素依赖型糖尿病（IDDM）患者死亡率的地理差异。该研究基于目前可获得的IDDM发病率和死亡率数据。0-24岁年龄组糖尿病死亡率数据来自世界卫生组织（世卫组织）统计数据。将死亡率除以从世卫组织钻石项目获得的IDDM发病率，根据IDDM的发生频率对死亡率进行调整。发达国家和东欧人口之间的死亡率存在10倍以上的地理差异。死亡率最高的地区位于日本、东欧和俄罗斯。与IDDM相关的结果最好的地区是北欧、中欧和加拿大。一项生态学研究表明，发病率调整死亡率（估计病死率）与IDDM发病率本身（Spearman相关系数= -0.45）以及婴儿死亡率和出生时预期寿命之间存在关系。这些数据表明，即使在发达国家，青年发病糖尿病患者的死亡率也可能存在巨大的地理差异。必须指出的是，这些超额死亡是可以预防的。生态学研究还表明，死亡率的差异可能部分与整体和糖尿病相关的护理有关。
The aim of this study was to evaluate the geographic variation in mortality among individuals with youth-onset insulin-dependent diabetes mellitus (IDDM) across the world. The study was based on the currently available IDDM incidence and mortality data. Mortality data for diabetes in the 0-24 year age group were obtained from World Health Organization (WHO) statistics. The mortality rates were adjusted for the frequency of occurrence of IDDM by dividing the mortality rates by the IDDM incidence rates which were obtained from the WHO DiaMond project. There was a more than 10-fold geographic variation in mortality between the developed countries and Eastern European populations. The areas with the highest mortality rates were located in Japan, Eastern Europe and Russia. The areas having the best outcome associated with IDDM were Northern Europe, Central Europe, and Canada. An ecological study demonstrated a relationship between the incidence-adjusted mortality (estimated case-fatality) with IDDM incidence itself (Spearman's correlation coefficient = -0.45) as well as infant mortality and life expectancy at birth. These data demonstrated the possibility of an enormous geographic variation in mortality of youth-onset diabetic patients even in developed countries. It is important to note that these excess deaths are potentially preventable. The ecological study also suggested that the mortality differences may be in part related to overall and diabetes related care.