JCEM:原子弹爆炸幸存者的糖尿病发病率如何?

2022-01-17 MedSci原创 MedSci原创

在原子弹爆炸幸存者中,发现辐射与糖尿病发病率相关。结果与城市和ATB年龄不一致,这可能表明辐射与糖尿病的关联可能存在混淆因素。

在日本,自二战以来,随着生活方式和环境因素的变化,糖尿病的患病率显着增加。 糖尿病现已成为一个重大的公共卫生问题和包括心血管疾病在内的各种疾病和病症的重要危险因素。最近的流行病学研究表明,接受高治疗剂量辐射的儿童癌症幸存者患糖尿病的风险增加,尤其是全身或腹部癌症。然而,低至中剂量(<4Gy)辐射对糖尿病发生风险的影响仍然未知。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员旨在探究辐射对原子弹(A-bomb)幸存者糖尿病发病率的影响,以及剂量反应是否受到其他因素的影响,包括城市、性别和轰炸时(ATB)的年龄。

从1969年到2015年,研究人员通过两年一次的临床检查观察到9131名基线时没有糖尿病的参与者。Cox比例风险模型用于估计风险比(HR)以评估糖尿病发病率的剂量反应。

在研究期间,研究人员共确定了1417例糖尿病病例。总体粗略发病率为7.01人/1000人/年。辐射剂量与糖尿病发病率显著相关性,这一效应随城市和ATB的年龄变化而变化。对于广岛ATB的10岁和30岁个体,胰腺辐射剂量为1Gy时,糖尿病的HR分别为1.47(95%CI为1.31-1.66)和1.13(95%CI为0.97-1.31)。然而,在长崎地区,这些年龄段没有观察到显著的辐射剂量反应。ATB较为年轻的患者辐射剂量相应HR较高,年龄每增加1岁就会降低1%。

由此可见,在原子弹爆炸幸存者中,发现辐射与糖尿病发病率相关。结果与城市和ATB年龄不一致,这可能表明辐射与糖尿病的关联可能存在混淆因素。

 

原始出处:

Yoshimi Tatsukawa.et al.Incidence of Diabetes in the Atomic Bomb Survivors: 1969-2015.JCEM.2021.https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgab902/6464273

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    2022-08-29 achengzhao
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    2022-11-22 仁者大医
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    2022-01-17 小小医者

    这个研究神

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