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School performance and educational achievement in children exposed to maternal cancer in utero 母体在子宫内罹患癌症的儿童的学习成绩和教育成就
Pub Date : 2024-04-08 DOI: 10.1136/jech-2023-221753
Iben Katinka Greiber, Jakob Hansen Viuff, Mona Aarenstrup Karlsen, Øjvind Lidegaard, Anders Preztmann Mikkelsen, Cristel Sørensen Hjortshøj, Lone Storgaard, Lene Mellemkjær
Background In utero exposure to maternal cancer and cancer treatment might influence the child’s cognitive development. This study investigated if exposure to maternal cancer during fetal life impacted school performance and educational achievement as adults. Methods This nationwide retrospective cohort study identified all live-born children in Denmark between January 1978 and December 2013. Exposure was defined as maternal cancer diagnosis during pregnancy. Four partly overlapping birth cohorts were constructed depending on the outcome of interest: (1) receiving special educational support for birth years 2001–2013; (2) grade point average (GPA) at the final exams after 10th grade for 1986–2003; (3) educational achievement at 20 years for 1978–1998; and (4) education at 30 years for 1978–1988. Logistic and linear models were adjusted for birth year, maternal age, maternal education and maternal death. Results The estimated probability of receiving special educational support was similar in the exposed group and the reference (adjusted OR 0.96; 95% CI 0.46 to 1.77, non-significant). The GPA did not statistically differ (0.13 grade points; 95% CI −0.18 to 0.45, non-significant). The achieved educational levels were similar for the exposed group and the reference at 20 years, with an adjusted OR of 1.07 (95% CI 0.82 to 1.40) for low versus medium educational level, and at 30 years with an adjusted OR of 0.73 (95% CI 0.35 to 1.50) for low versus high educational level and of 1.07 (95% CI 0.66 to 1.72) for medium versus high educational level. Conclusion Our findings did not indicate poorer performance in compulsory school nor impairment of adult educational achievement after exposure to maternal cancer in utero. No data are available. Data are available from Statistics Denmark () and Danish Health Data Authority (). The corresponding author had full access to the included data.
背景 母体在子宫内接触癌症和接受癌症治疗可能会影响儿童的认知发展。本研究调查了在胎儿时期接触母体癌症是否会影响孩子成年后的学习成绩和教育成就。方法 这项全国性的回顾性队列研究对 1978 年 1 月至 2013 年 12 月期间丹麦所有活产儿童进行了鉴定。母体在怀孕期间被诊断患有癌症即为接触癌症。根据所关注的结果构建了四个部分重叠的出生队列:(1)2001-2013 年出生年份中接受特殊教育支持的情况;(2)1986-2003 年 10 年级后期末考试的平均学分绩点(GPA);(3)1978-1998 年 20 岁时的教育成就;以及(4)1978-1988 年 30 岁时的教育情况。逻辑模型和线性模型根据出生年份、产妇年龄、产妇教育程度和产妇死亡情况进行了调整。结果 在暴露组和参照组中,接受特殊教育支持的估计概率相似(调整后 OR 为 0.96;95% CI 为 0.46 至 1.77,不显著)。平均学分绩点没有统计学差异(0.13 个等级分;95% CI -0.18-0.45,无显著性差异)。暴露组和参照组在 20 岁时达到的教育水平相似,低教育水平与中等教育水平的调整 OR 值为 1.07(95% CI 0.82 至 1.40),30 岁时低教育水平与高教育水平的调整 OR 值为 0.73(95% CI 0.35 至 1.50),中等教育水平与高教育水平的调整 OR 值为 1.07(95% CI 0.66 至 1.72)。结论 我们的研究结果表明,母体在子宫内罹患癌症后,其义务教育阶段的学习成绩不会变差,也不会影响其成年后的教育成就。没有数据。数据来源于丹麦统计局()和丹麦卫生数据管理局()。通讯作者可完全访问所包含的数据。
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引用次数: 0
Causal associations of antioxidants with Alzheimer’s disease and cognitive function: a Mendelian randomisation study 抗氧化剂与阿尔茨海默病和认知功能的因果关系:孟德尔随机研究
Pub Date : 2024-04-08 DOI: 10.1136/jech-2023-221184
Jiao Wang, Yingyue Huang, Chunhua Bei, Huiling Yang, Zihong Lin, Lin Xu
Background Circulating antioxidants are associated with a lower risk of Alzheimer’s disease (AD) in observational studies, suggesting potential target areas for intervention. However, whether the associations are causal remains unclear. Here, we studied the causality between antioxidants and AD or cognitive function using two-sample Mendelian randomisation (MR). Methods Single nucleotide polymorphisms strongly (p<5×10−8) associated with antioxidants (vitamin A, vitamin C, zinc, selenium, β-carotene and urate) and outcomes (AD, cognitive performance and reaction time) were obtained from the largest and most recent genome-wide association studies (GWAS). MR inverse variance weighting (IVW) and MR pleiotropy residual sum and outlier test (MR-PRESSO) were used for data analysis. Results Higher genetically determined selenium level was associated with 5% higher risk of AD (OR 1.047, 95% CI 1.005 to 1.091, p=0.028) using IVW. Higher genetically determined urate level was associated with worse cognitive performance (β=−0.026, 95% CI −0.044 to −0.008, p=0.005) using MR-PRESSO. No association between the other antioxidants and AD, cognitive performance and reaction time was found. Similar results were found in the sensitivity analyses. Conclusion Our results suggest that lifelong exposure to higher selenium may be associated with a higher risk of AD, and higher urate levels could be associated with worse cognitive performance. Further analyses using larger GWAS of antioxidants are warranted to confirm these observations. Our results suggest that caution is needed in the interpretation of traditional observational evidence on the neuroprotective effects of antioxidants. Data are available in a public, open access repository. The data sets for MR analysis of this article are available from published genome-wide association studies: , , , , , , , , , .
背景 在观察性研究中,循环中的抗氧化剂与阿尔茨海默病(AD)的低风险相关,这表明可能存在干预的目标领域。然而,这种关联是否是因果关系仍不清楚。在此,我们采用双样本孟德尔随机法(MR)研究了抗氧化剂与阿尔茨海默病或认知功能之间的因果关系。方法 单核苷酸多态性强(p, , , , , , , , , , .
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引用次数: 0
Intersectional inequalities in paediatric infectious diseases: a national cohort study in Sweden 儿科传染病的交叉不平等:瑞典全国队列研究
Pub Date : 2024-04-08 DOI: 10.1136/jech-2023-220593
Samuel Videholm, Sven Arne Silfverdal, Per E Gustafsson
Background It is well known that socially deprived children are more likely to be hospitalised for infections. Less is known about how different social disadvantages interact. Therefore, we examine intersectional inequalities in overall, upper respiratory, lower respiratory, enteric and genitourinary infections in the first 5 years of life. Methods We conducted a population-based retrospective cohort study of Swedish children born between 1998 and 2015. Inequalities were examined using analysis of individual heterogeneity and discriminatory accuracy as the analytical framework. A variable with 60 intersectional strata was created by combining information on maternal education, household income, sex/gender and maternal migration status. We estimated the incidence rates of infectious disease hospitalisation for each intersectional strata and the associations between intersectional strata and infectious disease hospitalisations using logistic regression models. We furthermore quantified the discriminatory ability of the intersectional strata with respect to infectious disease hospitalisation. Results The study included 1785 588 children and 318 080 hospital admissions. The highest overall incidence of hospitalisations for infections was found in boys born to low-educated mothers who lived in families with the lowest household income. The overall incidence of infections was unrelated to household income in children born to highly educated mothers. The ability of the intersectional strata to discriminate between children with and without infections was poor. Conclusion We found that inequalities in paediatric infectious diseases were shaped by the intersections of different social disadvantages. These inequalities should be addressed by public health policies that reach all children. Data may be obtained from a third party and are not publicly available. We used pseudo-anonymised register data obtained from third parties. It includes sensitive information and some access restrictions may apply. Interested researchers need to obtain data directly from the National Board of Health and Welfare in Sweden (socialstyrelsen@socialstyrelsen.se) and from Statistics Sweden (scb@scb.se).
背景众所周知,社会处境不利的儿童更有可能因感染而住院。但人们对不同的社会不利条件如何相互作用却知之甚少。因此,我们研究了儿童出生后 5 年内在总体感染、上呼吸道感染、下呼吸道感染、肠道感染和泌尿生殖系统感染方面的交叉不平等现象。方法 我们对 1998 年至 2015 年间出生的瑞典儿童进行了一项基于人群的回顾性队列研究。研究采用个体异质性和判别准确性分析作为分析框架,对不平等现象进行了研究。通过综合母亲教育程度、家庭收入、性别和母亲移民身份等信息,创建了一个包含 60 个交叉层的变量。我们使用逻辑回归模型估算了每个交叉层的传染病住院率以及交叉层与传染病住院率之间的关联。此外,我们还量化了交叉阶层对传染病住院率的判别能力。结果 研究共纳入 1785 588 名儿童和 318 080 例住院病例。低学历母亲所生的男孩因感染住院的总体发病率最高,他们生活在家庭收入最低的家庭。在高学历母亲所生的儿童中,感染的总体发生率与家庭收入无关。交叉分层区分感染和未感染儿童的能力较差。结论 我们发现,儿科传染病的不平等是由不同的社会不利因素交叉造成的。这些不平等现象应通过惠及所有儿童的公共卫生政策来解决。数据可能来自第三方,且不对外公开。我们使用了从第三方获得的伪匿名登记数据。其中包括敏感信息,可能会有一些访问限制。感兴趣的研究人员需要直接从瑞典国家卫生与福利委员会(socialstyrelsen@socialstyrelsen.se)和瑞典统计局(scb@scb.se)获取数据。
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引用次数: 0
Impact of informal caregiving on depressive symptoms among a national cohort of men 非正式护理对全国男性队列中抑郁症状的影响
Pub Date : 2024-04-07 DOI: 10.1136/jech-2023-221814
Tania L King, Peter P Vitaliano, Humaira Maheen, Yamna Taouk
Background There is evidence that unpaid caregiving can have negative effects on the mental health of female caregivers; however, evidence of impacts on male caregivers is limited. This study addressed this gap by examining associations between becoming a caregiver and depressive symptoms among men. Methods We used data from waves 1–2 (2013, 2016) of the Longitudinal Study of Australian Male Health (Ten to Men). Effects of incident caregiving on depressive symptoms were estimated using augmented inverse probability treatment weighting, with adjustment for potential confounders. Incident caregiving was assessed as a binary variable (became a caregiver vs not), and depressive symptoms were measured using the Patient Health Questionnaire (moderate to severe depressive symptoms; yes, no). Main analysis was prospective, drawing on wave 1 (caregiving) and wave 2 (depressive symptoms), and sensitivity analyses modelled cross-sectional associations. Results In the main analysis, incident caregiving in wave 1 was associated with depressive symptoms in the subsequent wave, with an average treatment effect of 0.11 (95% CI 0.06, 0.17) and equating to a risk ratio of 2.03 (95% CI 1.55, 2.51). Associations were robust to several sensitivity analyses, with cross-sectional associations supporting the main prospective analyses. Conclusion These results provide evidence of the association between caregiving and depressive symptoms among male caregivers. This has important implications for policy and support programmes. As we seek to shift caregiving responsibilities toward a more gender-equal distribution of care, policy must recognise that, like female caregivers, male caregivers also experience mental health impacts related to their caregiving role. Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from Dataverse, managed by the Australian Data Archive. Restrictions apply to the availability of these data, and interested users may apply for data from .
背景 有证据表明,无偿照料会对女性照料者的心理健康产生负面影响;然而,对男性照料者产生影响的证据却很有限。本研究通过考察男性成为照顾者与抑郁症状之间的关联来填补这一空白。方法 我们使用了澳大利亚男性健康纵向研究(Ten to Men)第 1-2 波(2013 年、2016 年)的数据。采用增强反概率处理加权法估算了事件性照料对抑郁症状的影响,并对潜在混杂因素进行了调整。护理事件以二元变量(成为护理者与未成为护理者)进行评估,抑郁症状采用患者健康问卷(中度至重度抑郁症状;是,否)进行测量。主要分析为前瞻性分析,以第一波(护理)和第二波(抑郁症状)为基础,敏感性分析则以横截面关联为模型。结果 在主要分析中,第一阶段的护理事件与随后阶段的抑郁症状相关,平均治疗效果为 0.11 (95% CI 0.06, 0.17),风险比为 2.03 (95% CI 1.55, 2.51)。几种敏感性分析结果显示,这些关联是稳健的,横断面关联支持主要的前瞻性分析结果。结论 这些结果提供了男性护理者中护理与抑郁症状之间关联的证据。这对政策和支持计划具有重要意义。在我们寻求将护理责任转向更平等的性别分配时,政策必须认识到,与女性护理者一样,男性护理者也会受到与他们的护理角色相关的心理健康影响。数据可能来自第三方,不对外公开。支持本研究结果的数据可从澳大利亚数据档案馆管理的 Dataverse 获取。这些数据的可用性受到限制,有兴趣的用户可向 .
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引用次数: 0
Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain 城市公园对糖尿病患病率中社会经济不平等现象的调节作用:西班牙马德里市横断面人口研究
Pub Date : 2024-03-07 DOI: 10.1136/jech-2023-221198
Elena Plans-Beriso, Pedro Gullon, Mario Fontan-Vela, Manuel Franco, Beatriz Perez-Gomez, Marina Pollan, Isabel Cura-Gonzalez, Usama Bilal
Background Evidence has shown contradicting results on how the density of urban green spaces may reduce socioeconomic inequalities in type 2 diabetes ( equigenic hypothesis ). The aim of this study is to test whether socioeconomic inequalities in diabetes prevalence are modified by park density. Methods We designed a population-wide cross-sectional study of all adults registered in the primary healthcare centres in the city of Madrid, Spain (n=1 305 050). We obtained georeferenced individual-level data from the Primary Care Electronic Health Records, and census-tract level data on socioeconomic status (SES) and park density. We modelled diabetes prevalence using robust Poisson regression models adjusted by age, country of origin, population density and including an interaction term with park density, stratified by gender. We used this model to estimate the Relative Index of Inequality (RII) at different park density levels. Findings We found an overall RII of 2.90 (95% CI 2.78 to 3.02) and 4.50 (95% CI 4.28 to 4.74) in men and women, respectively, meaning that the prevalence of diabetes was three to four and a half times higher in low SES compared with high SES areas. These inequalities were wider in areas with higher park density for both men and women, with a significant interaction only for women (p=0.008). Interpretation We found an inverse association between SES and diabetes prevalence in both men and women, with wider inequalities in areas with more parks. Future works should study the mechanisms of these findings, to facilitate the understanding of contextual factors that may mitigate diabetes inequalities. Data may be obtained from a third party and are not publicly available. Data are not publicly available as it contains information from Electronic Medical Records. Upon reasonable request to the Heart Healthy Hoods project, data could be available for researchers.
背景 有证据表明,城市绿地的密度可能会减少 2 型糖尿病的社会经济不平等(等原假说),但结果却相互矛盾。本研究旨在检验社会经济不平等现象是否会因公园密度而改变。方法 我们设计了一项全人口横断面研究,对象是在西班牙马德里市初级医疗保健中心登记的所有成年人(n=1 305 050)。我们从初级保健电子健康记录中获得了地理参照的个人数据,以及有关社会经济地位(SES)和公园密度的普查区数据。我们使用稳健的泊松回归模型对糖尿病患病率进行建模,该模型根据年龄、原籍国、人口密度进行调整,并包含一个与公园密度的交互项,按性别进行分层。我们利用该模型估算了不同公园密度水平下的相对不平等指数(RII)。结果 我们发现,男性和女性的总体相对不平等指数分别为 2.90(95% CI 2.78 至 3.02)和 4.50(95% CI 4.28 至 4.74),这意味着与高社会经济地位地区相比,低社会经济地位地区的糖尿病患病率要高出三到四倍半。在公园密度较高的地区,男性和女性的不平等现象更为严重,只有女性的不平等现象具有显著的交互作用(p=0.008)。解释 我们发现,在男性和女性中,社会经济地位与糖尿病发病率之间存在反比关系,在公园较多的地区,不平等现象更为严重。未来的工作应研究这些发现的机制,以促进对可能减轻糖尿病不平等的环境因素的理解。数据可能来自第三方,不对外公开。由于数据包含来自电子病历的信息,因此不对外公开。在向 "心脏健康罩 "项目提出合理要求后,研究人员可获得相关数据。
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引用次数: 0
Correction: Predictive value of metabolic profiling in cardiovascular risk scores: analysis of 75 000 adults in UK Biobank 更正:代谢分析在心血管风险评分中的预测价值:对英国生物库中 75000 名成年人的分析
Pub Date : 2024-03-01 DOI: 10.1136/jech-2023-220801corr1
BMJ Publishing Group Ltd
Jin D, Trichia E, Islam N, et al. Predictive value of metabolic profiling in cardiovascular risk scores: analysis of 75 000 adults …
Jin D、Trichia E、Islam N 等人.代谢特征描述在心血管风险评分中的预测价值:对 75 000 名成人的分析...
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引用次数: 0
Correction: How to create healthier places: a multi-disciplinary qualitative study exploring the complex system of urban development decision-making 更正:如何创造更健康的场所:探索城市发展决策复杂系统的多学科定性研究
Pub Date : 2024-03-01 DOI: 10.1136/jech-2023-ssmabstracts.15corr1
BMJ Publishing Group Ltd
Gouais AL. How to create healthier places: a …
Gouais AL.如何创造更健康的场所:...
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引用次数: 0
Modeling chronic disease risk across equity factors using a population-based prediction model: the Chronic Disease Population Risk Tool (CDPoRT) 利用基于人口的预测模型:慢性病人口风险工具(CDPoRT),建立跨公平因素的慢性病风险模型
Pub Date : 2024-02-21 DOI: 10.1136/jech-2023-221080
Kitty Chen, Kathy Kornas, Laura C Rosella
Background Predicting chronic disease incidence at a population level can help inform overall future chronic disease burden and opportunities for prevention. This study aimed to estimate the future burden of chronic disease in Ontario, Canada, using a population-level risk prediction algorithm and model interventions for equity-deserving groups who experience barriers to services and resources due to disadvantages and discrimination. Methods The validated Chronic Disease Population Risk Tool (CDPoRT) estimates the 10-year risk and incidence of major chronic diseases. CDPoRT was applied to data from the 2017/2018 Canadian Community Health Survey to predict baseline 10-year chronic disease estimates to 2027/2028 in the adult population of Ontario, Canada, and among equity-deserving groups. CDPoRT was used to model prevention scenarios of 2% and 5% risk reductions over 10 years targeting high-risk equity-deserving groups. Results Baseline chronic disease risk was highest among those with less than secondary school education (37.5%), severe food insecurity (19.5%), low income (21.2%) and extreme workplace stress (15.0%). CDPoRT predicted 1.42 million new chronic disease cases in Ontario from 2017/2018 to 2027/2028. Reducing chronic disease risk by 5% prevented 1500 cases among those with less than secondary school education, prevented 14 900 cases among those with low household income and prevented 2800 cases among food-insecure populations. Large reductions of 57 100 cases were found by applying a 5% risk reduction in individuals with quite a bit workplace stress. Conclusion Considerable reduction in chronic disease cases was predicted across equity-defined scenarios, suggesting the need for prevention strategies that consider upstream determinants affecting chronic disease risk. Data are available in a public, open access repository. Canadian Community Health Survey Public Use Microdata File is publicly available in an open-access repository ().
背景预测人口层面的慢性病发病率有助于了解未来慢性病的总体负担和预防机会。本研究旨在利用人口层面的风险预测算法估算加拿大安大略省未来的慢性病负担,并为因不利条件和歧视而在获得服务和资源方面遇到障碍的需要公平的群体建立干预模型。方法 经过验证的慢性病人口风险工具(CDPoRT)可估算主要慢性病的 10 年风险和发病率。将 CDPoRT 应用于 2017/2018 年加拿大社区健康调查的数据,以预测加拿大安大略省成年人口中到 2027/2028 年的 10 年慢性病基线估计值,以及需要公平的群体中的慢性病估计值。CDPoRT 被用于模拟在 10 年内降低 2% 和 5% 风险的预防方案,目标群体是高风险的应享公平待遇群体。结果 中学以下教育程度(37.5%)、严重食物无保障(19.5%)、低收入(21.2%)和极端工作压力(15.0%)人群的基线慢性病风险最高。CDPoRT预测,从2017/2018年到2027/2028年,安大略省将新增142万慢性病病例。将慢性病风险降低 5%,可预防中学以下教育程度人群中的 1500 例病例,预防家庭收入低人群中的 14 900 例病例,预防食品无保障人群中的 2800 例病例。在工作压力较大的人群中,将风险降低 5%,可大幅减少 57 100 例病例。结论 预计在公平定义的各种情况下,慢性病病例会大幅减少,这表明需要制定考虑到影响慢性病风险的上游决定因素的预防战略。数据可在公开、开放的资料库中查阅。加拿大社区健康调查公共使用微数据文件可在开放存取资料库()中公开获取。
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引用次数: 0
How to conduct methodologically rigorous epidemiological studies of the Chinese Famine of 1959–1961 如何对 1959-1961 年中国饥荒进行方法严谨的流行病学研究
Pub Date : 2024-02-01 DOI: 10.1136/jech-2023-221875
Chunyu Liu, Zi Lian, Chihua Li
The important use of famines as human laboratories to study long-term health effects has become widely recognised over the past decades. To date, over 300 epidemiological studies of the Chinese Famine of 1959–1961 have been published, and there is a fast-growing interest in examining its intergenerational impacts.1 However, many of them had major limitations in analytical methods. In light of the study by Hu and colleagues,2 we discussed some overlooked methodological issues and alternative strategies to conduct rigorous Chinese famine studies. A frequently discussed limitation of Chinese famine studies is that many of …
过去几十年来,将饥荒作为人类实验室来研究长期健康影响的重要性已得到广泛认可。迄今为止,有关 1959-1961 年中国大饥荒的流行病学研究已发表 300 多篇,人们对研究其代际影响的兴趣与日俱增。1 然而,许多研究在分析方法上存在很大的局限性。根据 Hu 及其同事的研究,2 我们讨论了一些被忽视的方法问题,以及开展严谨的中国饥荒研究的替代策略。中国饥荒研究中一个经常被讨论的局限性是,许多中国饥荒研究在方法上存在缺陷。
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引用次数: 0
Parental education and occupation in relation to childhood type 1 diabetes: nationwide cohort study 父母教育和职业与儿童 1 型糖尿病的关系:全国性队列研究
Pub Date : 2024-02-01 DOI: 10.1136/jech-2023-220693
Paz Lopez-Doriga Ruiz, German Tapia, Inger J. Bakken, Siri E. Håberg, Hanne L Gulseth, Torild Skrivarhaug, Geir Joner, Lars C Stene
Socioeconomic status in the risk of developing type 1 diabetes seems inconsistent. We investigated whether risk of childhood-onset type 1 diabetes differed by parental education or occupation in a nationwide cohort. Methods This cohort study included all children born in Norway from 1974 to 2013. In individually linked data from nationwide population registries following children born in Norway up to 15 years of age, we identified 4647 with newly diagnosed type 1 diabetes during 15 381 923 person-years of follow-up. Results Children of mothers with a master’s degree had lower risk of type 1 diabetes than children of mothers with completed upper secondary education only (adjusted incidence rate ratio, aIRR=0.82 95% CI: 0.70 to 0.95). There was no difference between upper secondary and lower secondary maternal education (aIRR=0.98, 95% CI: 0.89 to 1.08). Paternal education was not significantly associated with type 1 diabetes, lower secondary compared with upper secondary aIRR 0.96 (0.88–1.05) and master compared with upper secondary aIRR 0.93 (0.83–1.05). While maternal elementary occupation was associated with a lower risk of type 1 diabetes, specific maternal or paternal occupations were not. Conclusions Our results suggested inverse U-shaped associations between maternal socioeconomic status and risk of type 1 diabetes. Non-linear associations may be part of the reason why previous literature has been inconsistent. Data may be obtained from a third party and are not publicly available. Norwegian data protection legislation and Act on medical andhealth research do not allow individual level patient data to be shared by the authors. However, all data are accessible to authorised researchers after ethical approval andapplication to the registries via , and the Norwegian Childhood Diabetes Registry.
社会经济地位对 1 型糖尿病发病风险的影响似乎并不一致。我们在一个全国性队列中调查了儿童期发病的1型糖尿病风险是否因父母的教育或职业而异。方法 这项队列研究包括1974年至2013年期间在挪威出生的所有儿童。我们从全国人口登记处的单独链接数据中,对挪威出生至15岁的儿童进行了随访,在15 381 923人年的随访期间,我们发现了4647名新诊断出的1型糖尿病患者。结果 母亲拥有硕士学位的儿童罹患1型糖尿病的风险低于母亲仅完成高中教育的儿童(调整后发病率比,aIRR=0.82 95% CI:0.70至0.95)。高中和初中母亲教育程度之间没有差异(aIRR=0.98,95% CI:0.89 至 1.08)。父亲的教育程度与 1 型糖尿病的关系不大,初中与高中相比 aIRR 为 0.96(0.88-1.05),硕士与高中相比 aIRR 为 0.93(0.83-1.05)。虽然母亲的初级职业与较低的 1 型糖尿病风险相关,但母亲或父亲的特定职业却与之无关。结论 我们的研究结果表明,母亲的社会经济地位与罹患 1 型糖尿病的风险呈反 U 型关系。非线性关联可能是以往文献不一致的部分原因。数据可能来自第三方,不对外公开。挪威数据保护法和医疗与健康研究法不允许作者共享个人层面的患者数据。不过,所有数据在经过伦理批准并通过挪威儿童糖尿病登记处(Norwegian Childhood Diabetes Registry)向登记处提出申请后,经授权的研究人员均可查阅。
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