Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study.
Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study.
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DOI：
10.1186/s12916-017-0958-6
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发表时间：
2017-11-08
期刊：
影响因子：
9.3
通讯作者：
Lee JM
中科院分区：
文献类型：
--
作者：
Rogers MAM;Kim C;Banerjee T;Lee JM
虽然美国有最多的儿童患有1型糖尿病，但对成人发病的疾病知之甚少。本研究利用全国范围内的数据，比较青年（0-19岁）与成人（20-64岁）1型糖尿病的发病率。在这项纵向研究中，使用了Clinformatics® Data Mart数据库，其中包含来自6100万商业保险美国人（2001-2015年）的信息。按年龄组、性别、人口普查部门和诊断年份计算发病率和精确泊松95%置信区间。通过负二项回归评估率随时间的变化。总体而言，队列中有32，476人患上1型糖尿病。10-14岁青年的发病率最高（45.5例/100，000人-年）;然而，由于成年期比儿童期跨越更长的时间，成年人的新发病例数多于青年人（n = 19，174例成人; n = 13，302例青年）。男性的优势在10岁时就很明显，并在整个成年期持续存在。男性与女性的发病率比值为1.32（95% CI 1.30-1.35）。青年1型糖尿病发病率从2001年到2015年每年增加1.9%（95%CI 1.1-2.7%; P < 0.001），但不同地区之间存在差异。增长最快的是东南中部（3.8%/年; 95% CI 2.0-5.6%; P < 0.001）和山区（3.1%/年; 95% CI 1.6-4.6%; P < 0.001）。东北中部（2.7%/年; P = 0.010）、南大西洋（2.4%/年; P < 0.001）和西北中部（2.4%/年; P < 0.001）也有增加。然而，在成人中，发病率从2001年至2015年下降（-1.3%/年; 95%CI-2.3%至-0.4%; P = 0.007）。在1月、7月和8月，青年和成年人的确诊病例比例更高。在美国，1型糖尿病（0-64岁）的新发病例数估计为每年64，000例（青年27，000例，成人37，000例）。在美国，每年发生的1型糖尿病新发病例比以前认识到的要多。青年而非成年人发病率的增加表明，青年发病的诱因可能不同于成年发病的诱因。本文的在线版本（10.1186/s12916-017-0958-6）包含补充材料，可供授权用户使用。
While the United States has the largest number of children with type 1 diabetes mellitus, less is known regarding adult-onset disease. The present study utilizes nationwide data to compare the incidence of type 1 diabetes in youth (0–19 years) to that of adults (20–64 years). In this longitudinal study, the Clinformatics® Data Mart Database was used, which contains information from 61 million commercially insured Americans (years 2001–2015). Incidence rates and exact Poisson 95% confidence intervals were calculated by age group, sex, census division, and year of diagnosis. Changes in rates over time were assessed by negative binomial regression. Overall, there were 32,476 individuals who developed type 1 diabetes in the cohort. The incidence rate was greatest in youth aged 10–14 years (45.5 cases/100,000 person-years); however, because adulthood spans over a longer period than childhood, there was a greater number of new cases in adults than in youth (n = 19,174 adults; n = 13,302 youth). Predominance in males was evident by age 10 and persisted throughout adulthood. The male to female incidence rate ratio was 1.32 (95% CI 1.30–1.35). The incidence rate of type 1 diabetes in youth increased by 1.9% annually from 2001 to 2015 (95% CI 1.1–2.7%; P < 0.001), but there was variation across regions. The greatest increases were in the East South Central (3.8%/year; 95% CI 2.0–5.6%; P < 0.001) and Mountain divisions (3.1%/year; 95% CI 1.6–4.6%; P < 0.001). There were also increases in the East North Central (2.7%/year; P = 0.010), South Atlantic (2.4%/year; P < 0.001), and West North Central divisions (2.4%/year; P < 0.001). In adults, however, the incidence decreased from 2001 to 2015 (−1.3%/year; 95% CI −2.3% to −0.4%; P = 0.007). Greater percentages of cases were diagnosed in January, July, and August for both youth and adults. The number of new cases of type 1 diabetes (ages 0–64 years) in the United States is estimated at 64,000 annually (27,000 cases in youth and 37,000 cases in adults). There are more new cases of type 1 diabetes occurring annually in the United States than previously recognized. The increase in incidence rates in youth, but not adults, suggests that the precipitating factors of youth-onset disease may differ from those of adult-onset disease. The online version of this article (10.1186/s12916-017-0958-6) contains supplementary material, which is available to authorized users.
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影响因子：
16.2
作者：
Chiang JL;Kirkman MS;Laffel LM;Peters AL;Type 1 Diabetes Sourcebook Authors
通讯作者：
Type 1 Diabetes Sourcebook Authors
影响因子：
16.2
作者：
Bruno, G;Runzo, C;Pagano, G
通讯作者：
Pagano, G
影响因子：
2.9
作者：
Usher-Smith JA;Thompson MJ;Zhu H;Sharp SJ;Walter FM
通讯作者：
Walter FM
影响因子：
7.7
作者：
Bruno G;Maule M;Biggeri A;Ledda A;Mannu C;Merletti F;Songini M;Sardinian Group for Diabetes Epidemiology
通讯作者：
Sardinian Group for Diabetes Epidemiology
影响因子：
16.2
作者：
Hawa MI;Kolb H;Schloot N;Beyan H;Paschou SA;Buzzetti R;Mauricio D;De Leiva A;Yderstraede K;Beck-Neilsen H;Tuomilehto J;Sarti C;Thivolet C;Hadden D;Hunter S;Schernthaner G;Scherbaum WA;Williams R;Brophy S;Pozzilli P;Leslie RD;Action LADA consortium
通讯作者：
Action LADA consortium