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智利儿童 2006 至 2014 年 1 型糖尿病事件病例的强制报告:一项基于人群的研究。

Mandatory notifications of type 1 diabetes incident cases in Chilean children, 2006 to 2014: A population-based study.

机构信息

Division of Pediatrics, Pontificia Universidad Católica de Chile School of Medicine, Santiago, Chile.

Pediatric Endocrinology Unit, Universidad de Los Andes, Santiago, Chile.

出版信息

Pediatr Diabetes. 2020 Feb;21(1):48-52. doi: 10.1111/pedi.12937. Epub 2019 Nov 11.

Abstract

UNLABELLED

Type 1 diabetes mellitus (T1D) incidence in children varies across regions and countries, showing a continuous rise globally. Chile has mandatory T1D notification and guaranteed access to diagnosis and treatment since 2005, providing a strong model to evaluate T1D epidemiology.

OBJECTIVE

To determine T1D incidence in Chilean population under 20 years between 2006 and 2014.

METHODS

We reviewed mandatory notifications of T1D in Chile's public health system.

RESULTS

A total of 4153 T1D cases in population under 20 years were notified from 2006 to 2014. Median age was 14 years and 51% were male. The average annual T1D incidence was 12 per 100 000 population, with an increase from 10.2 in 2006 to 13.8 in 2014 (β 0.5 95% confidence interval [CI] 0.4-0.7, P < .001). A significantly increasing linear trend of T1D incidence was observed in groups of 0 to 4 years (β 0.33, 95% CI 0.06-0.59, P = .02), 5 to 9 years (β 0.68 95% CI 0.27-1.10, P = .006), and 10 to 14 (β 0.94, 95% CI 0.67-1.20, P < .001), but increase was less pronounced in the oldest children aged between 15 and 19 years (β 0.22, 95% CI -0.03 to 0.44, P = .052). The lowest regional T1D incidence was observed in the Araucanía region, which has the highest rate of indigenous population.

CONCLUSION

Incidence rates of T1D in Chile, evaluated through a mandatory notification program, are rapidly increasing in children and adolescents. If increasing trends persist, Chile will reach T1D incidence rates of Western developed countries in the next decade.

摘要

背景

1 型糖尿病(T1D)在儿童中的发病率因地区和国家而异,在全球范围内呈持续上升趋势。智利自 2005 年起实行 T1D 强制报告制度,并保证儿童能获得诊断和治疗,为评估 T1D 流行病学提供了有力的模型。

目的

确定 2006 年至 2014 年期间智利 20 岁以下人群中 T1D 的发病率。

方法

我们查阅了智利公共卫生系统中 T1D 的强制报告。

结果

2006 年至 2014 年期间,4153 例 20 岁以下人群确诊 T1D。中位年龄为 14 岁,51%为男性。T1D 的年平均发病率为每 100000 人 12 例,发病率从 2006 年的 10.2 例增加到 2014 年的 13.8 例(β0.5,95%置信区间[CI]0.4-0.7,P<0.001)。0 至 4 岁(β0.33,95%CI0.06-0.59,P=0.02)、5 至 9 岁(β0.68,95%CI0.27-1.10,P=0.006)和 10 至 14 岁(β0.94,95%CI0.67-1.20,P<0.001)组 T1D 发病率呈显著线性上升趋势,但年龄较大的 15 至 19 岁儿童上升幅度较小(β0.22,95%CI-0.03 至 0.44,P=0.052)。发病率最低的地区是 Araucanía 地区,该地区原住民比例最高。

结论

通过强制报告计划评估,智利儿童和青少年 T1D 的发病率正在迅速上升。如果上升趋势持续下去,智利将在未来十年达到西发达国家的 T1D 发病率。

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