Abstract: Objective To analyze the disease burden of type 1 diabetes(T1DM) among Chinese children and adolescents from 1990 to 2019, and to predict its future trend, so as to provide reference for the prevention and control of disease burden caused by T1DM in children and adolescents. Methods Data on the incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs) attributed to T1DM among individuals aged under 20 years from 1990 to 2019 were retrieved from the 2019 Global Burden of Disease (GBD) database.Joinpoint regression analysis was used to examine the trends in these parameters.Furthermore, Grey Prediction Model GM(1,1) was utilized to forecast the disease burden for the upcoming 20 years. Results In 2019, the incidence rate, the prevalence rate and the mortality rate of T1DM among children and adolescents in China was 5.22/10⁵, 49.17/10⁵, and 0.07/10⁵, respectively, and the DALY rate was 7.82/10⁵, which were all lower than the global average.In 2019, the incidence and mortality rates of T1DM among male children and adolescents in China were higher than those of females, while the DALYs rate was lower than that of females.Notably, within the age group of 5 - 9 years old, the incidence rate for T1DM was the highest at 7.30/10⁵, and the mortality rate was highest among children under 1 year old, reaching 0.33/10⁵.The Joinpoint regression model revealed an upward trend in the incidence and prevalence rates of T1DM among children and adolescents in China from 1990 to 2019, with average annual percentage changes (AAPC) of 1.44% and 1.05%, respectively.Conversely, the mortality rate and DALY rate exhibited a significantly decreasing trend (P<0.05), with AAPCs of -4.30% and -3.45%, respectively.The forecasted outcomes indicated a notable increase in the incidence and prevalence rates of T1DM among Chinese children and adolescents from 2020 to 2039. Conclusions The incidence and prevalence rates of T1DM among children and adolescents in China have shown an upward trend from 1990 to 2019.It is essential to continue implementing proactive preventive measures to alleviate the disease burden.

Key words: type 1 diabetes mellitus, disease burden, predictive model, children and adolescents

摘要： 目的 分析1990—2019 年中国儿童青少年1型糖尿病疾病负担并对其未来的变化趋势进行预测,为预防和控制儿童青少年因1型糖尿病所致的疾病负担提供参考依据。方法 利用2019年全球疾病负担(GBD)数据库提取1990—2019年20岁以下儿童青少年归因于1型糖尿病的发病率、患病率、死亡率及伤残调整寿命年(DALYs)率,采用Joinpoint回归模型分析其变化趋势,通过灰色预测模型GM(1,1)预测未来20年的疾病负担。结果 2019年,中国儿童青少年1型糖尿病发病率5.22/10⁵,患病率49.17/10⁵,死亡率0.07/10⁵, DALY率7.82/10⁵,均低于全球平均水平。2019年,中国男性儿童青少年1型糖尿病疾病发病率、死亡率均高于女性,而DALY率低于女性,其中5~9岁年龄组儿童青少年1型糖尿病疾病发病率最高,为7.30/10⁵,＜1岁年龄组死亡率最高,为0.33/10⁵。Joinpoint回归模型结果显示,1990—2019年发病率、患病率呈现上升趋势,平均年度变化百分比(AAPC)分别为1.44%、1.05%,而死亡率和DALY率呈现降低趋势,AAPC分别为-4.30%和-3.45%,差异均有统计学意义(P<0.05)。预测结果表明,2020—2039年中国儿童青少年1型糖尿病发病率和患病率均呈显著上升趋势。结论 1990—2019年中国儿童青少年1型糖尿病发病率和患病率呈上升趋势,应继续采取积极的预防措施以减轻疾病负担。

关键词: 1型糖尿病, 疾病负担, 模型预测, 儿童青少年