Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012.
Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012.
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DOI：
10.1056/nejmoa1610187
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发表时间：
2017-04-13
期刊：
影响因子：
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通讯作者：
SEARCH for Diabetes in Youth Study
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文献类型：
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作者：
Mayer-Davis EJ;Lawrence JM;Dabelea D;Divers J;Isom S;Dolan L;Imperatore G;Linder B;Marcovina S;Pettitt DJ;Pihoker C;Saydah S;Wagenknecht L;SEARCH for Diabetes in Youth Study
1型糖尿病和2型糖尿病的诊断在青少年中提出了大量的临床和公共卫生负担。2001-2009年期间，这些疾病的流行率有所上升，但缺乏关于最近发病率趋势的数据。我们在美国的五个研究中心确定了1型和2型糖尿病病例。分母（每年490万年轻人）来自美国人口普查或健康计划成员计数。在计算了2002-2012年期间的年发病率后，我们使用具有2年移动平均值的广义自回归移动平均模型分析了趋势。共确定了11，245名1型糖尿病（0至19岁）和2846名2型糖尿病（10至19岁）青年。1型糖尿病的总体未调整估计发病率每年增加1.4%（从2002-2003年的每10万青年每年19.5例增加到2011-2012年的每10万青年每年21.7例，P = 0.03）。在调整后的成对比较中，西班牙裔的年增长率高于非西班牙裔白人（4.2%对1.2%，P<0.001）。2型糖尿病的总体未校正发病率每年增加7.1%（从2002-2003年的每10万青年每年9.0例增加到2011-2012年的每10万青年每年12.5例，P<0.001，种族或种族、性别和年龄亚组的趋势）。调整后的成对比较显示，非西班牙裔白人2型糖尿病发病率的相对年增长率（0.6%）低于非西班牙裔黑人，亚洲人或太平洋岛民和美洲原住民（所有比较P<0.05），西班牙裔美国人的年增长率与美洲原住民之间存在显著差异。（3.1% vs. 8.9%，P = 0.01）。调整年龄、性别、种族或民族后，1型糖尿病发病率的相对年增长率为1.8%（P<0.001），2型糖尿病发病率的相对年增长率为4.8%（P<0.001）。在2002-2012年期间，青年中1型和2型糖尿病的发病率显著增加，特别是在少数种族和族裔群体的青年中。（由国家糖尿病、消化和肾脏疾病研究所以及疾病控制和预防中心资助。
Diagnoses of type 1 and type 2 diabetes in youths present a substantial clinical and public health burden. The prevalence of these diseases increased in the 2001–2009 period, but data on recent incidence trends are lacking. We ascertained cases of type 1 and type 2 diabetes mellitus at five study centers in the United States. Denominators (4.9 million youths annually) were obtained from the U.S. Census or health-plan member counts. After the calculation of annual incidence rates for the 2002–2012 period, we analyzed trends using generalized autoregressive moving-average models with 2-year moving averages. A total of 11,245 youths with type 1 diabetes (0 to 19 years of age) and 2846 with type 2 diabetes (10 to 19 years of age) were identified. Overall unadjusted estimated incidence rates of type 1 diabetes increased by 1.4% annually (from 19.5 cases per 100,000 youths per year in 2002–2003 to 21.7 cases per 100,000 youths per year in 2011–2012, P = 0.03). In adjusted pairwise comparisons, the annual rate of increase was greater among Hispanics than among non-Hispanic whites (4.2% vs. 1.2%, P<0.001). Overall unadjusted incidence rates of type 2 diabetes increased by 7.1% annually (from 9.0 cases per 100,000 youths per year in 2002–2003 to 12.5 cases per 100,000 youths per year in 2011–2012, P<0.001 for trend across race or ethnic group, sex, and age subgroups). Adjusted pairwise comparisons showed that the relative annual increase in the incidence of type 2 diabetes among non-Hispanic whites (0.6%) was lower than that among non-Hispanic blacks, Asians or Pacific Islanders, and Native Americans (P<0.05 for all comparisons) and that the annual rate of increase among Hispanics differed significantly from that among Native Americans (3.1% vs. 8.9%, P = 0.01). After adjustment for age, sex, and race or ethnic group, the relative annual increase in the incidence of type 1 diabetes was 1.8% (P<0.001) and that of type 2 diabetes was 4.8% (P<0.001). The incidences of both type 1 and type 2 diabetes among youths increased significantly in the 2002–2012 period, particularly among youths of minority racial and ethnic groups. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the Centers for Disease Control and Prevention.)