Excess Mortality in an Inception Cohort of Childhood Diabetes Diagnosed 1990–2010

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
S. Lain, Lindsay Stevens, Maria E. Craig, Alicia J. Jenkins, Kirstine J. Bell, Alison Pryke, K. Donaghue, Natasha Nassar
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Abstract

Objective. Evaluate the mortality risk of childhood-onset type 1 diabetes compared to the general population. Research Design and Methods. The study population, identified from the Australasian Paediatric Endocrinology Group diabetes register, was diagnosed with type 1 diabetes at age < 16 in New South Wales (NSW), Australia, from 1990 to 2010. The register was linked to National Death Index registrations to ascertain timing and cause of death up to 31/12/2022. Risk factors for mortality were assessed using multivariable Cox regression models and observed mortality rate compared to “expected” rates in the Australian general population using indirect-standardized mortality ratios (SMR), overall and by sex and age at diagnosis. Diabetes-related cause of death categories were identified. Results. Of 5,417 children diagnosed with type 1 diabetes, 157 subsequently died, with all-cause mortality of 1.37/1,000 person years. Increased mortality risk was associated with living in most disadvantaged areas (aHR 1.81 (1.05, 3.11)) but not living in a rural area. Overall SMR was 2.83 (95% CI 2.40, 3.33) with females having higher SMR than males (4.18 vs. 2.19). Most common causes of death recorded were acute diabetes complications (26%), including diabetes ketoacidosis, accident/misadventure (21%), and chronic diabetes complications (15%). Alcohol and/or drug use contributed to 17% of deaths. Conclusion. Compared to the general population, higher risk of mortality in people with type 1 diabetes was associated with female sex and living in area of socioeconomic disadvantage. Education about minimizing risk-taking behaviors should be communicated to young adults with type 1 diabetes.
1990-2010 年诊断的儿童糖尿病初始队列中的超额死亡率
目标:评估儿童期发病的 1 型糖尿病患者与普通人群相比的死亡风险。评估儿童期发病的 1 型糖尿病患者与普通人群相比的死亡风险。研究设计与方法。研究对象来自澳大拉西亚儿科内分泌学组糖尿病登记册,均为1990年至2010年期间在澳大利亚新南威尔士州(NSW)被诊断为小于16岁的1型糖尿病患者。该登记册与国家死亡指数登记相链接,以确定截至 2022 年 12 月 31 日的死亡时间和原因。使用多变量 Cox 回归模型评估了死亡风险因素,并使用间接标准化死亡率 (SMR) 将观察到的死亡率与澳大利亚普通人群的 "预期 "死亡率进行了比较,包括总体死亡率以及按性别和诊断时年龄划分的死亡率。确定了与糖尿病相关的死因类别。结果。在 5417 名确诊为 1 型糖尿病的儿童中,有 157 人随后死亡,全因死亡率为 1.37/1,000 人年。死亡风险的增加与居住在最贫困地区有关(aHR 1.81 (1.05, 3.11)),但与居住在农村地区无关。总体 SMR 为 2.83(95% CI 2.40,3.33),女性的 SMR 比男性高(4.18 对 2.19)。最常见的死亡原因是急性糖尿病并发症(26%),包括糖尿病酮症酸中毒、意外/不幸(21%)和慢性糖尿病并发症(15%)。酗酒和/或吸毒导致的死亡占 17%。结论与普通人群相比,1型糖尿病患者的死亡风险较高与女性性别和生活在社会经济条件较差的地区有关。应向年轻的1型糖尿病成人患者宣传尽量减少冒险行为的教育。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
期刊介绍: ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/​Abstracted: Web of Science SCIE Scopus CAS INSPEC Portico
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