|
|
|
| Trend in incidence of diabetes and age-period-cohort analysis among children and adolescents in Huzhou City from 2006 to 2025 |
| LI Haihua1, YE Yong1, YUAN Rui2, YUN Jingyi2, WANG Haobo3, FU Yuxin3
|
1. Huzhou Central Hospital, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang 313000, China;
2. Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang 313000, China;
3. Huzhou University, Huzhou, Zhejiang 313000, China |
|
|
|
|
Abstract Objective To investigate the trend of diabetes incidence among children and adolescents in Huzhou City, Zhejiang Province from 2006 to 2025, and to analyze the age, period, and cohort effects, so as to provide insights into the prevention and control of diabetes among children and adolescents. Methods Data on diabetes cases aged 0-19 years in Huzhou City from 2006 to 2025 were collected through the Chronic Disease Surveillance and Management System of Huzhou Center for Disease Control and Prevention. The standardized incidence was calculated using the age composition of the standard population from the Sixth National Population Census in 2010. The average annual percentage change (AAPC) was used to analyze the trend in incidence. An age-period-cohort model was used to analyze the effects of age, period, and birth cohort. Results A total of 913 diabetes cases aged 0-19 years were reported in Huzhou City from 2006 to 2025. The crude incidence and standardized incidence were 11.03/105 and 4.33/105, respectively, both showing upward trends (AAPC=13.307% and 13.226%, both P<0.05). There were 339 cases of type 1 diabetes mellitus (T1DM), with crude and standardized incidence of 3.83/105 and 0.62/105, respectively, showing upward trends (AAPC=9.944% and 10.442%, both P<0.05). There were 548 cases of type 2 diabetes mellitus (T2DM), with crude and standardized incidence of 6.20/105 and 1.97/105, respectively, showing upward trends (AAPC=14.920% and 14.213%, both P<0.05). Age-period-cohort model analysis showed that the risk of T1DM initially increased and then decreased with age, with the highest risk in the 5-<10 years age group (RR=9.189, 95%CI: 4.871-13.684). The risk of T2DM increased with age, with the highest risk in the 15-19 years age group (RR=17.316, 95%CI: 14.477-20.225). Using the period 2011-2015 as the reference group, the risk of T1DM showed an upward trend over time, with the highest risk in 2021-2025 (RR=1.474, 95%CI: 1.027-2.114). There were no statistically significant differences in incidence risk across other periods compared to 2011-2015 (all P>0.05). Using the 2006-2010 birth cohort as the reference group, the risks of both T1DM and T2DM showed upward trends with later birth cohorts. The highest risk of T1DM was observed in the 2021-2025 birth cohort (RR=2.881, 95%CI: 1.528-5.429), while the highest risk of T2DM was observed in the 2011-2016 birth cohort (RR=1.610, 95%CI: 1.081-2.397). Conclusions The incidence of diabetes among children and adolescents in Huzhou City showed an upward trend from 2006 to 2025, with T1DM being most prevalent among children aged 5-<10 years and T2DM among adolescents aged 15-19 years. The incidence risks of both T1DM and T2DM increased with later birth years.
|
|
Received: 03 September 2025
Revised: 03 March 2026
Published: 23 March 2026
|
|
|
|
|
|
[1] 中华医学会糖尿病学分会,中华医学会感染病学分会,中华医学会组织修复与再生分会.中国糖尿病足防治指南(2019版)(Ⅳ)[J].中华糖尿病杂志,2019,11(5):316-327.
[2] 朱铭强,董关萍.儿童糖尿病的诊断与管理[J].中华全科医师杂志,2023,22(7):671-676.
[3] 中华医学会儿科学分会内分泌遗传代谢学组,中华儿科杂志编辑委员会.中国儿童1型糖尿病标准化诊断与治疗专家共识(2020版)[J].中华儿科杂志,2020,58(6):447-454.
[4] 中华医学会儿科学分会内分泌遗传代谢学组,中国医师协会青春期健康与医学专业委员会.儿童2型糖尿病诊治指南(2025)[J].中华儿科杂志,2025,63(2):131-137.
[5] WU W,ZHANG J W,LI Y X,et al.Population-based prevalence of self-reported pediatric diabetes and screening for undiagnosed type 2 diabetes in Chinese children in years 2017-2019,a cross-sectional study[J/OL].Lancet Reg Health West Pac,2024,52[2026-03-03].https://doi.org/10.1016/j.lanwpc.2024.101206.
[6] TODAY STUDY GROUP,ZEITLER P,HIRST K,et al.A clinical trial to maintain glycemic control in youth with type 2 diabetes[J].N Engl J Med,2012,366(24):2247-2256.
[7] DABELEA D,STAFFORD J M,MAYER-DAVIS E J,et al.Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood[J].JAMA,2017,317(8):825-835.
[8] LAWRENCE J M,DIVERS J,ISOM S,et al.Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US,2001-2017[J].JAMA,2021,326(8):717-727.
[9] 薛喆,王思嘉,卢兰兰,等.2011—2021年宁波市儿童青少年糖尿病发病趋势[J].预防医学,2024,36(9):750-754.
[10] 赵冬,胡大一.普及健康生活方式是儿童青少年和中青年人群心血管病预防的首要策略[J].中华心血管病杂志,2022,50(12):1135-1137.
[11] DÜNDARİ,AKıNCıA,ÇAMTOSUN E,et al.Type 1 diabetes incidence trends in a cohort of Turkish children and youth[J].Turk Arch Pediatr,2023,58(5):539-545.
[12] VOJISLAV C,NATASA R,MILICA P,et al.Incidence trend of type 1 diabetes mellitus in Serbia[J/OL].BMC Endocr Disord,2020,20(1)[2026-03-03].https://doi.org/10.1186/s12902-020-0504-y.
[13] NORRIS J M,JOHNSON R K,STENE L C.Type 1 diabetes-early life origins and changing epidemiology[J].Lancet Diabetes Endocrinol,2020,8(3):226-238.
[14] 中华医学会糖尿病学分会,中国医师协会内分泌代谢科医师分会,中华医学会内分泌学分会,等.中国1型糖尿病诊治指南(2021版)[J].中华糖尿病杂志,2022,14(11):1143-1250.
[15] YI Y Y,GUO C,ZHENG Y L,et al.Life course associations between ambient fine particulate matter and the prevalence of prediabetes and diabetes:a longitudinal cohort study in Taiwan and Hong Kong[J].Diabetes Care,2025,48(1):93-100.
[16] 闫孝永,张林,丁玲,等.从最新临床实践共识指南及临床研究看儿童和青少年2型糖尿病诊治进展[J].中华糖尿病杂志,2023,15(12):1190-1195.
[17] 陈海苗,马岩,刘明奇,等.儿童期肥胖与2型糖尿病、冠心病的孟德尔随机化研究[J].预防医学,2025,37(3):307-311.
[18] LUK A,WILD SH,JONES S,et al.Early-onset type 2 diabetes:the next major diabetes transition[J].Lancet,2025,405(10497):2313-2326. |
|
|
|
