The incidence of type 1 diabetes in the age group 0-39 years has not increased in Antwerp (Belgium) between 1989 and 2000 - Evidence for earlier disease manifestation
The incidence of type 1 diabetes in the age group 0-39 years has not increased in Antwerp (Belgium) between 1989 and 2000 - Evidence for earlier disease manifestation
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DOI：
10.2337/diacare.25.5.840
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发表时间：
2002-05-01
期刊：
影响因子：
16.2
通讯作者：
Gorus, FK
中科院分区：
文献类型：
--
作者：
Weets, I;De Leeuw, IH;Gorus, FK
目的——观察到全球儿童 I 型糖尿病的发病率有所增加。由于在不同国家，大多数新发 1 型糖尿病患者是在成年后被诊断出来的，因此我们调查了儿童中这种疾病发病率的上升是否反映了全球糖尿病发病率的增加，还是临床表现向更早的转变。 研究设计和方法 - 在安特卫普地区对 40 岁之前出现的 I 型糖尿病发病率进行了为期 12 年（1989-2000 年）的前瞻性测量。通过捕获-再捕获方法评估确定的完整性。通过泊松回归分析研究期间的发病率趋势。 结果 - 40 岁之前诊断的 1 型糖尿病发病率在 12 年期间保持稳定，平均每年每 100,000 人中有 9.9 例。 15 岁以下两性的发病率相似，但成年发病的男性明显过多，特别是在 20 岁之后，导致 15 岁以下的男女比例为 0.9，而 15 岁以后为 1.6（P = 0.001）。在 12 年的观察期内，15 岁以下的发病率呈显着增加趋势，而 15 岁至 40 岁之间的发病率则呈下降趋势（P = 0.025）。 15 岁以下的发病率每年平均增加 1.8%，5 岁以下的发病率平均每年增加 5.0%（P = 0.06）。 结论 - 我们的结果表明，在比利时，儿童 1 型糖尿病（尤其是 5 岁以下儿童）发病率的增加并非归因于全球发病率的增加，而是归因于早期的临床表现。结果表明，环境因素可能会优先加速年轻糖尿病易感受试者的亚临床疾病进程。
OBJECTIVE - A worldwide increase in the incidence of childhood type I diabetes has been observed. Because in various countries the majority of new type 1 diabetic patients are diagnosed in adulthood, we investigated whether the rising incidence of this disorder in children reflects a global increase in the incidence of diabetes or a shift toward earlier clinical presentation.RESEARCH DESIGN AND METHODS - The incidence of type I diabetes presenting before age 40 years was prospectively measured in the Antwerp district over a 12-year period (1989-2000). The completeness of ascertainment was evaluated by the capture-recapture method. Trends in incidence during the study period were analyzed by Poisson regression.RESULTS - The incidence of type 1 diabetes diagnosed before age 40 years remained constant over the 12-year period, averaging 9.9 cases per 100,000 individuals per year. The incidence was similar in both sexes tinder age 15 years, but a marked male excess was noted for adult-onset disease, in particular after age 20 years, resulting in a male-to-female ratio of 0.9 under age 15 years vs. 1.6 thereafter (P = 0.001). During the 12-year observation period, there was a significant tendency toward increasing incidence under age 15 years at the expense of a decreasing incidence between ages 15 and 40 years (P = 0.025). The annual increase in incidence averaged 1.8% under age 15 years and 5.0% under age 5 years (P = 0.06).CONCLUSIONS - Our results indicate that in Belgium, the increasing incidence of childhood type 1 diabetes-especially for children under age 5 years-is not attributable to a global increase in disease incidence, but rather to earlier clinical manifestation. The results suggest that an environmental factor may preferentially accelerate the subclinical disease process in young diabetes-prone subjects.