Prevalence and Incidence Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980-2012
Prevalence and Incidence Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980-2012
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DOI：
10.1001/jama.2014.11494
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发表时间：
2014-09-24
影响因子：
120.7
通讯作者：
Gregg, Edward W.
中科院分区：
文献类型：
--
作者：
Geiss, Linda S.;Wang, Jing;Gregg, Edward W.
重要性虽然近几十年来美国糖尿病的患病率和发病率有所增加，但没有研究系统地研究诊断糖尿病患病率和发病率的长期全国趋势。目的研究诊断糖尿病患病率和发病率的长期趋势，以确定是否有加速或减速的时期。我们分析了1980-2012年来自国家健康访谈调查（NHIS）的664969名年龄在20至79岁之间的成年人的数据，以估计总体平民、非机构化美国人口和人口统计学亚组的发病率和患病率。（年龄组、性别、种族/民族、主要结果和指标：糖尿病患病率和发病率的年百分比变化（APC）结果在20世纪80年代，年龄校正的糖尿病患病率和发病率的APC没有显著变化，但在1990-2008年期间，每一个都急剧增加，然后在2008-2012年期间趋于平稳，没有显著变化。1990年每100人的患病率为3.5（95% CI，3.2 - 3.9），2008年为7.9（95% CI，7.4 - 8.3），2012年为8.3（95% CI，7.9 - 8.7）。1990年每1000人的发病率为3.2（95% CI，2.2 - 4.1），2008年为8.8（95% CI，7.4 - 10.3），2012年为7.1（95% CI，6.1 - 8.2）。[图表]许多人口亚群的趋势与这些总体趋势相似。然而，非西班牙裔黑人和西班牙裔成年人的发病率继续增加（对于相互作用，非西班牙裔黑人成年人P = .03，西班牙裔成年人P =.01），其发病率显著高于非西班牙裔白色成年人。此外，与高中以上教育程度的成年人相比，高中以下教育程度的成年人患病率增加率更高（对于交互，<高中P = .006，高中P < .001）结论和相关性对1980年至2012年全国代表性数据的分析表明，2012年糖尿病的发病率和患病率翻了一番。1990年至2008年，2008年至2012年之间进入平稳期。然而，在包括非西班牙裔黑人和西班牙裔亚群以及高中或以下教育程度的人群在内的亚群中，糖尿病的患病率或发病率似乎持续增加。
IMPORTANCE Although the prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes.OBJECTIVE To examine long-term trends in the prevalence and incidence of diagnosed diabetes to determine whether there have been periods of acceleration or deceleration in rates.DESIGN, SETTING, AND PARTICIPANTS We analyzed 1980-2012 data for 664 969 adults aged 20 to 79 years from the National Health Interview Survey (NHIS) to estimate incidence and prevalence rates for the overall civilian, noninstitutionalized, US population and by demographic subgroups (age group, sex, race/ethnicity, and educational level).MAIN OUTCOMES AND MEASURES The annual percentage change (APC) in rates of the prevalence and incidence of diagnosed diabetes (type 1 and type 2 combined).RESULTS The APC for age-adjusted prevalence and incidence of diagnosed diabetes did not change significantly during the 1980s, but each increased sharply each year during 1990-2008 before leveling off with no significant change during 2008-2012. The prevalence per 100 persons was 3.5 (95% CI, 3.2 to 3.9) in 1990, 7.9 (95% CI, 7.4 to 8.3) in 2008, and 8.3 (95% CI, 7.9 to 8.7) in 2012. The incidence per 1000 persons was 3.2 (95% CI, 2.2 to 4.1) in 1990, 8.8 (95% CI, 7.4 to 10.3) in 2008, and 7.1 (95% CI, 6.1 to 8.2) in 2012.[GRAPHICS]Trends in many demographic subpopulations were similar to these overall trends. However, incidence rates among non-Hispanic black and Hispanic adults continued to increase (for interaction, P = .03 for non-Hispanic black adults and P =.01 for Hispanic adults) at rates significantly greater than for non-Hispanic white adults. In addition, the rate of increase in prevalence was higher for adults who had a high school education or less compared with those who had more than a high school education (for interaction, P = .006 for < high school and P < .001 for high school).CONCLUSIONS AND RELEVANCE Analyses of nationally representative data from 1980 to 2012 suggest a doubling of the incidence and prevalence of diabetes during 1990-2008, and a plateauing between 2008 and 2012. However, there appear to be continued increases in the prevalence or incidence of diabetes among subgroups, including non-Hispanic black and Hispanic subpopulations and those with a high school education or less.