Space-time clustering analyses of type 1 diabetes in children from north-east England: support for an infectious aetiology?
Space-time clustering analyses of type 1 diabetes in children from north-east England: support for an infectious aetiology?
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DOI：
10.1186/1476-069x-8-s1-s14
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发表时间：
2009-01-01
影响因子：
6
通讯作者：
Cheetham, Tim D.
中科院分区：
文献类型：
--
作者：
McNally, Richard J. Q.;Pollock, Raymond;Cheetham, Tim D.
背景：儿童1型糖尿病的病因尚不明确。最近的一些研究提出了一种感染性病因。据推测，可能涉及感染因子。支持这一假设可以提供一个发现的时空集群。本研究的目的是：（i）确定英格兰东北部儿童糖尿病病例是否存在时空聚集性;（ii）由于诊断时的年龄;（iii）性别之间;（iv）居住人口密度水平之间，检验时空聚集性的差异。方法：我们研究了1990-2007年期间0-14岁儿童中确诊的1型糖尿病的发病率。所有病例均居住在英格兰东北部的特定地理区域（诺森伯兰、泰恩河畔纽卡斯尔和北泰恩赛德）。我们应用了基于K函数的二阶过程来测试全局聚类。地点是诊断时的居住地址。使用最近邻阈值重复测试，以允许可变的种群密度，为每次分析提供主要结果。性别之间和人口密度水平之间的差异进行了assessed.Results：我们分析了457例1型糖尿病。总体而言，有轻微显着的证据，全球时空聚类（P = 0.089）。在包含至少一名女性的病例对之间存在统计学显著聚类（P = 0.017），但在包含至少一名男性的病例对之间不存在统计学显著聚类（P = 0.190）。此外，在包含至少一个来自人口更稠密地区的病例对之间存在显著的聚集性（P = 0.044），但在包含至少一个来自人口较少地区的病例对中，（P = 0.226）。虽然分析只发现了在北半球诊断的1型糖尿病病例的全球时空聚集的轻微显著证据，在英格兰东部，有两个值得注意的发现。第一，有证据显示女性之间有聚集现象，第二，聚集现象仅限于人口稠密地区的病例。这些发现与感染因子的可能病因学参与一致。
Background: The aetiology of type 1 diabetes in children is uncertain. A number of recent studies have suggested an infectious aetiology. It has been postulated that an infectious agent may be involved. Support for this hypothesis may be provided by a finding of space-time clustering. The aims of this study were: (i) to determine whether there was space-time clustering in cases of childhood diabetes from north-east England; and to test for differences in space-time clustering: (ii) due to age at diagnosis; (iii) between the sexes and (iv) between levels of residential population density.Methods: We studied incidence of type 1 diabetes diagnosed in children aged 0-14 years and diagnosed during the period 1990-2007. All cases were resident in a defined geographical region of north-east England (Northumberland, Newcastle upon Tyne and North Tyneside). We applied a second-order procedure based on K-functions to test for global clustering. Locations were residential addresses at time of diagnosis. Tests were repeated using nearest neighbour thresholds to allow for variable population density, providing the primary result for each analysis. Differences between sexes and between levels of population density were assessed.Results: We analysed 457 cases of type 1 diabetes. Overall, there was marginally significant evidence of global space-time clustering (P = 0.089). There was statistically significant clustering amongst pairs of cases that contained at least one female (P = 0.017), but not amongst pairs of cases that contained at least one male (P = 0.190). Furthermore, there was significant clustering amongst pairs of cases that contained at least one from a more densely populated area (P = 0.044), but not amongst pairs of cases that contained at least one from a less densely populated area (P = 0.226).Conclusion: Although the analyses have only found marginally significant evidence of global space-time clustering for cases of type 1 diabetes diagnosed in north-east England, there were two notable findings. First, there was evidence of clustering amongst females and secondly clustering was confined to cases from more densely populated areas. These findings are consistent with a possible aetiological involvement of an infectious agent.