Incidence and trend of type 1 diabetes and the underlying environmental determinants

Summary A wealth of epidemiological studies concerning the distribution of type 1 diabetes (T1D) around the world have pointed to the appreciable variation in the incidence of T1D among disparate age groups, ethnicities, and geographical locations. On the whole, the incidence of childhood T1D has be...

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Veröffentlicht in:Diabetes/metabolism research and reviews 2019-01, Vol.35 (1), p.e3075-n/a
Hauptverfasser: Xia, Ying, Xie, Zhiguo, Huang, Gan, Zhou, Zhiguang
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Xie, Zhiguo
Huang, Gan
Zhou, Zhiguang
description Summary A wealth of epidemiological studies concerning the distribution of type 1 diabetes (T1D) around the world have pointed to the appreciable variation in the incidence of T1D among disparate age groups, ethnicities, and geographical locations. On the whole, the incidence of childhood T1D has been on the rise, and a plausible inverse relationship between the initial incidence rate and the following annual increase in incidence has been raised. Countries that used to exhibit lower incidences tend to have steep annual increase whereas those with already‐established high incidences are more likely to show a modest increase or even stabilization in T1D incidence. Environmental agents considered responsible for the current evolving pattern of T1D incidence will be detailed, mainly including the increasing prevalence of childhood obesity, viral infections in a chronic manner, maternal‐child interaction such as breastfeeding, and latitude‐ultraviolet B‐vitamin D pathway. Certain rationale has been put forward in an attempt to explain the potential association between environmental agents and development of T1D. For instance, accelerator hypothesis regards insulin resistance as the promoter of earlier disease onset in obese children whereas the negative correlation of microbial infections in background populations with incidence of T1D represents the basic component of the hygiene hypothesis. Further investigations are still warranted to verify these theories across multiple ethnic groups and to identify additional contributors to the variation in T1D incidence.
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On the whole, the incidence of childhood T1D has been on the rise, and a plausible inverse relationship between the initial incidence rate and the following annual increase in incidence has been raised. Countries that used to exhibit lower incidences tend to have steep annual increase whereas those with already‐established high incidences are more likely to show a modest increase or even stabilization in T1D incidence. Environmental agents considered responsible for the current evolving pattern of T1D incidence will be detailed, mainly including the increasing prevalence of childhood obesity, viral infections in a chronic manner, maternal‐child interaction such as breastfeeding, and latitude‐ultraviolet B‐vitamin D pathway. Certain rationale has been put forward in an attempt to explain the potential association between environmental agents and development of T1D. For instance, accelerator hypothesis regards insulin resistance as the promoter of earlier disease onset in obese children whereas the negative correlation of microbial infections in background populations with incidence of T1D represents the basic component of the hygiene hypothesis. 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subjects Breast feeding
breastfeeding
Breastfeeding & lactation
Children
Diabetes
Diabetes mellitus
Diabetes mellitus (insulin dependent)
Hypotheses
incidence
Insulin
Minority & ethnic groups
Obesity
type 1 diabetes
viral infection
Vitamin D
title Incidence and trend of type 1 diabetes and the underlying environmental determinants
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