registers

寄存器
  • 文章类型: Journal Article
    闭塞性下肢动脉疾病(LEAD)的患病率正在全球范围内上升,而欧洲流行病学数据却很少。我们报告了1996年至2018年丹麦LEAD修复的发病率和死亡率,对开放主动脉-髂动脉分层,开放外围,和血管内修复。
    一项涵盖1996年至2018年的丹麦人口登记册前瞻性数据的全国性队列研究。合并症采用Charlson的合并症指数(CCI)进行评估。通过多变量泊松和Cox回归估计发病率(IR)和死亡率(MRR),分别。
    我们确定了41,438名独特的患者正在接受46,236例首次通过主动脉-liac进行LEAD修复(n=5213),外周手术(n=18,665)或经皮经腔血管成形术(PTA,n=22,358)。从1996年到2018年,初级血运重建的年龄和性别标准化IR从每100,000人年71.8降至50.2(IRR,0.70;95%CI,0.66-0.75)。从1996年到2010年,PTA的IR增加了2.5倍,所有三种修复技术在2010年后均呈下降趋势。IR下降是由于跛行导致的LEAD修复减少所致,以及80岁以下的人,而80岁以上人群的IR增加(p交互作用<0.001)。男性铅修复更频繁(IRR女性vs男性,0.78;95%CI,0.77-0.80),这在日历时间上是一致的(p相互作用=0.41)。开放/手术修复后,粗死亡率下降,并在PTA之后增加,但与研究期的开始和结束相比,这三种技术的调整后死亡率都有降低的趋势(MRRaorto,0.71;95%CI,0.54-0.93vsMRR外围设备,0.76;95%CI,0.69-0.83vsMRRPTA,0.96;95%CI,0.86-1.07)。年龄增长和CCI,男性,吸烟,和与死亡率增加相关的护理依赖。
    从1996年到2018年,丹麦的LEAD修复发生率下降,尤其是在80岁以下的人群中,主要是由于跛行的血运重建减少。开放手术后调整后的死亡率下降,但在PTA之后似乎没有改变。
    UNASSIGNED: The prevalence of occlusive lower extremity artery disease (LEAD) is rising worldwide while European epidemiology data are scarce. We report incidence and mortality of LEAD repair in Denmark from 1996 through 2018, stratified on open aorto-iliac, open peripheral, and endovascular repair.
    UNASSIGNED: A nationwide cohort study of prospective data from population-based Danish registers covering 1996 to 2018. Comorbidity was assessed by Charlson\'s Comorbidity Index (CCI). Incidence rate (IR) ratios and mortality rate ratios (MRR) were estimated by multivariable Poisson and Cox regression, respectively.
    UNASSIGNED: We identified 41,438 unique patients undergoing 46,236 incident first-time LEAD repairs by either aorto-iliac- (n=5213), peripheral surgery (n=18,665) or percutaneous transluminal angioplasty (PTA, n=22,358). From 1996 to 2018, the age- and sex-standardized IR for primary revascularization declined from 71.8 to 50.2 per 100,000 person-years (IRR, 0.70; 95% CI, 0.66-0.75). Following a 2.5-fold IR increase of PTA from 1996 to 2010, all three repair techniques showed a declining trend after 2010. The declining IR was driven by decreasing LEAD repair due to claudication, and by persons aged below 80 years, while the IR increased in persons aged above 80 years (p interaction<0.001). LEAD repair was more frequent in men (IRRfemale vs male, 0.78; 95% CI, 0.77-0.80), which was consistent over calendar time (p interaction=0.41). Crude mortality decreased following open/surgical repair, and increased following PTA, but all three techniques trended towards lower adjusted mortality comparing the start and the end of the study period (MRRaorto-iliac, 0.71; 95% CI, 0.54-0.93 vs MRRperipheral, 0.76; 95% CI, 0.69-0.83 vs MRRPTA, 0.96; 95% CI, 0.86-1.07). Increasing age and CCI, male sex, smoking, and care dependency associated with increased mortality.
    UNASSIGNED: The incidence rate of LEAD repair decreased in Denmark from 1996 to 2018, especially in persons younger than 80 years, and primarily due to reduced revascularization for claudication. Adjusted mortality rates decreased following open surgery, but seemed unaltered following PTA.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:杜兴氏肌营养不良症(DMD)是一种进行性遗传性疾病,患病率为每3,600-6,000名男性出生1名。患有DMD的个体通常在4-7岁时被诊断;中位生存期为30年。它们需要多学科护理,个人援助,往往是特殊教育。
    目的:目的是评估丹麦DMD的疾病负担。这包括发病率,患病率,使用医疗保健服务,劳动力市场参与,教育成果,以及由于DMD引起的总体可占成本。还调查了对最近的亲戚(兄弟姐妹和父母)的影响。
    方法:使用全面的丹麦国家卫生和行政登记册来评估患有DMD的个体和五年前的近亲的疾病负担,在DMD诊断后长达20年。包括1994-2021年患有DMD的个人(和亲戚)。将所有结果与来自丹麦人群的没有疾病的匹配对照组进行比较。
    结果:确定了213名DMD患者。他们在学校的成绩较低,与对照组相比,他们需要更多的特殊教育,更多的医疗保健和家庭护理。在11年的小学期间,特殊教育的额外费用总计为180,900欧元。他们在18至30岁之间的年平均生产力损失为20,200欧元。DMD诊断后20年的额外医疗费用估计为1,524,000欧元。如果患有DMD的人活到30岁,额外费用总额为2,365,800欧元。
    结论:使用国家注册数据,这项研究提供了关于DMD疾病负担的详细结果,包括对近亲的影响。在20年的医疗费用中,增加了60次住院和200次门诊接触,还有家庭护理和特殊教育的费用,随着疾病的进展而增加。
    UNASSIGNED: Duchenne Muscular Dystrophy (DMD) is a progressive genetic disease with a prevalence of 1 per 3,600-6,000 male births. Individuals with DMD are typically diagnosed at age 4-7 years; median survival is 30 years. They require multidisciplinary care, personal assistance, and often special education.
    UNASSIGNED: The aim was to assess the burden of disease in DMD in Denmark. This includes incidence, prevalence, use of healthcare services, labour market participation, educational outcomes, and overall attributable costs due to DMD. Impact on the closest relatives (siblings and parents) was also investigated.
    UNASSIGNED: The comprehensive Danish national health and administrative registers were used to assess the burden of disease following individuals with DMD and closest relatives from five years before, and up to 20 years after DMD diagnosis. Individuals with DMD (and relatives) from 1994-2021 were included. All outcomes were compared to matched control groups without the disease drawn from the Danish population.
    UNASSIGNED: 213 unique individuals with DMD were identified. They had lower grades in school, required more special education and more healthcare and home care compared to their control group. The extra costs of special education summed to EUR 180,900 over the course of 11 years elementary school. They had an annual average productivity loss of EUR 20,200 between the age of 18 to 30. The extra healthcare costs of DMD in the 20 years after diagnosis were estimated to EUR 1,524,000. If an individual with DMD lives to be 30, total extra costs sum to EUR 2,365,800.
    UNASSIGNED: Using national register data this study presented detailed results on the burden of disease of DMD, including impact on closest relatives. With 60 additional hospital admissions and 200 extra outpatient contacts in 20 years healthcare costs, but also costs of home care and special education, increases as disease progresses.
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  • 文章类型: Journal Article
    背景:心血管疾病(CVDs)在老年人中普遍存在,但很少有研究关注心血管疾病药物在过渡到法定退休后的发展模式。因此,我们旨在确定退休后CVD药物的轨迹,和他们的社会人口统计学,工作和健康相关的决定因素。
    方法:我们使用了赫尔辛基市前雇员的完整登记数据,芬兰。所有在2000-2013年达到法定退休的人,有五年的随访数据(n=6,505,73%的女性),包括在内。使用芬兰社会保险机构报销登记簿中的数据,通过基于组的轨迹建模来确定CVD药物的轨迹。社会人口统计学,使用多项逻辑回归分析了轨迹组成员的工作和健康相关决定因素.
    结果:区分了CVD药物的六个轨迹:“恒定低”(35%),“后期增长”(6%),“提前增加”(5%),“恒定高”(39%),“高而递减”(8%),和“低且递减”(7%)。大多数(74%)的退休人员属于“恒定低”和“恒定高”类别。较低的职业阶层和退休前疾病缺勤的增加与“恒定高”轨迹有关。Further,那些受教育程度较低的人更容易处于“早期增长”的轨道。
    结论:社会经济地位较低或退休前疾病缺勤人数较多的个人可能被认为风险较高,并可能从早期干预中受益。例如,生活方式干预和针对工作条件的干预,或更频繁的监测。
    Cardiovascular diseases (CVDs) are prevalent in older people, but few studies focus on developmental patterns in CVD medication directly after transition to statutory retirement. We thus aimed to identify trajectories of CVD medication after retirement, and their sociodemographic, work and health-related determinants.
    We used complete register data of former employees of the City of Helsinki, Finland. All who reached their statutory retirement in 2000-2013, with five-year follow-up data (n = 6,505, 73% women), were included. Trajectories of CVD medication were identified with group-based trajectory modelling using data from Finnish Social Insurance Institution\'s reimbursement register. Sociodemographic, work and health-related determinants of trajectory group membership were analysed using multinomial logistic regression.
    Six trajectories of CVD medication were distinguished: \"constant low\" (35%), \"late increase\" (6%), \"early increase\" (5%), \"constant high\" (39%), \"high and decreasing \" (8%), and \"low and decreasing\" (7%). The majority (74%) of the retirees fell into the \"constant low\" and \"constant high\" categories. Lower occupational class and increased pre-retirement sickness absence were associated with the \"constant high\" trajectory. Further, those with lower educational attainment were more prone to be in the \"early increase\" trajectory.
    Individuals in lower socioeconomic positions or with a higher number of pre-retirement sickness absence may be considered at higher risk and might benefit from early interventions, e.g. lifestyle interventions and interventions targeting working conditions, or more frequent monitoring.
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  • 文章类型: Journal Article
    我们概述了丹麦可获得的全国环境数据及其与个人记录的关联潜力,旨在促进有关当地周围环境对人类健康的潜在影响的研究。
    丹麦的研究人员有独特的机会进行大规模的基于人口的研究,将整个丹麦人口视为一个大,基于全国完整的人口和卫生登记的开放和动态队列。到目前为止,这一领域的大多数研究都利用个人和家庭层面的信息来研究疾病在家庭中的聚集,合并症,的风险,和预后后,疾病发作,和疾病风险的社会梯度。将时间和空间上的环境数据与个人联系起来,为研究社会健康影响提供了新的可能性,建筑和物理环境。
    我们描述了个体与其当地周围环境之间可能的联系,以建立暴露组-即个人在其生命历程中的总环境暴露。
    丹麦目前可用的全国纵向环境数据构成了宝贵的全球稀有资产,可以帮助探索暴露对人类健康的影响。
    UNASSIGNED: We provide an overview of nationwide environmental data available for Denmark and its linkage potentials to individual-level records with the aim of promoting research on the potential impact of the local surrounding environment on human health.
    UNASSIGNED: Researchers in Denmark have unique opportunities for conducting large population-based studies treating the entire Danish population as one big, open and dynamic cohort based on nationally complete population and health registries. So far, most research in this area has utilised individual- and family-level information to study the clustering of disease in families, comorbidities, risk of, and prognosis after, disease onset, and social gradients in disease risk. Linking environmental data in time and space to individuals enables novel possibilities for studying the health effects of the social, built and physical environment.
    UNASSIGNED: We describe the possible linkage between individuals and their local surrounding environment to establish the exposome - that is, the total environmental exposure of an individual over their life course.
    UNASSIGNED: The currently available nationwide longitudinal environmental data in Denmark constitutes a valuable and globally rare asset that can help explore the impact of the exposome on human health.
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  • 文章类型: Journal Article
    自然存在的放射性物质(NORM)有助于工人辐射暴露产生的剂量,不同工作和环境条件下的公共和非人类生物群。在EURATOMHorizon2020RadoNorm项目中,正在进行工作,以确定欧洲国家的NORM暴露情况和情景,并收集与辐射防护相关的定性和定量数据。获得的数据将有助于更好地了解涉及NORM的活动范围,放射性核素行为和相关的辐射暴露,并将提供相关科学的见解,实践和监管挑战。上述NORM项目工作的第一项活动是开发用于识别NORM暴露情况的分层方法和支持统一数据收集的补充工具。而NORM鉴定方法在Michalik等人中给出。,2023年,在本文中,提供了NORM数据收集工具的主要详细信息,并将其公开提供。这些工具是MicrosoftExcel表单中的一系列NORM寄存器,已全面设计,以帮助(a)确定辐射防护在特定暴露情况下的主要NORM问题,(B)获得所涉及材料的概述(即,原材料,产品,副产品,残留物,流出物),c)收集关于NORM的定性和定量数据,和(d)描述多种危险暴露情况,并采取进一步措施,为工人制定综合风险和暴露剂量评估,公共和非人类生物群。此外,NORM寄存器确保以支持和补充NORM流程的有效管理和监管控制的方式对NORM情况进行标准化和统一的表征,产品和废物,以及世界各地对自然辐射的相关暴露。
    Naturally occurring radioactive materials (NORM) contribute to the dose arising from radiation exposure for workers, public and non-human biota in different working and environmental conditions. Within the EURATOM Horizon 2020 RadoNorm project, work is ongoing to identify NORM exposure situations and scenarios in European countries and to collect qualitative and quantitative data of relevance for radiation protection. The data obtained will contribute to improved understanding of the extent of activities involving NORM, radionuclide behaviours and the associated radiation exposure, and will provide an insight into related scientific, practical and regulatory challenges. The development of a tiered methodology for identification of NORM exposure situations and complementary tools to support uniform data collection were the first activities in the mentioned project NORM work. While NORM identification methodology is given in Michalik et al., 2023, in this paper, the main details of tools for NORM data collection are presented and they are made publicly available. The tools are a series of NORM registers in Microsoft Excel form, that have been comprehensively designed to help (a) identify the main NORM issues of radiation protection concern at given exposure situations, (b) gain an overview of materials involved (i.e., raw materials, products, by-products, residues, effluents), c) collect qualitative and quantitative data on NORM, and (d) characterise multiple hazards exposure scenarios and make further steps towards development of an integrated risk and exposure dose assessment for workers, public and non-human biota. Furthermore, the NORM registers ensure standardised and unified characterisation of NORM situations in a manner that supports and complements the effective management and regulatory control of NORM processes, products and wastes, and related exposures to natural radiation worldwide.
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  • 文章类型: Journal Article
    韵律特征是挪威方言变异的一些最突出的特征。因此,难怪当挪威儿童将代码转换为类似首都方言的东西时,护卫者和学者首先认识到韵律系统的转换(此后东挪威语城市,UEN)在角色扮演中。专注于词汇音调重音系统,本文调查了北挪威儿童参与同伴社会角色扮演的自发言语。通过调查从自发同伴游戏语料库中提取的F0轮廓,并将它们与引出的基线参考轮廓进行比较,本文提出了儿童在角色扮演中未能在化合物中应用与UEN一致的目标音调口音的情况,尽管音调口音的产生在其他方面似乎是语音目标,例如UEN。换句话说,他们按照UEN语音学表演,但不是UEN形态语音。
    Prosodic features are some of the most salient features of dialect variation in Norway. It is therefore no wonder that the switch in prosodic systems is what is first recognized by caretakers and scholars when Norwegian children code-switch to something resembling the dialect of the capital (henceforth Urban East Norwegian, UEN) in role-play. With a focus on the system of lexical tonal accents, this paper investigates the spontaneous speech of North Norwegian children engaging in peer social role-play. By investigating F0 contours extracted from a corpus of spontaneous peer play, and comparing them with elicited baseline reference contours, this paper makes the case that children fail to apply the target tonal accent consistent with UEN in compounds in role-play, although the production of tonal accents otherwise seems to be phonetically target like UEN. Put in other words, they perform in accordance with UEN phonetics, but not UEN morpho-phonology.
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  • 文章类型: Journal Article
    背景:由于缺乏有关流产和人工流产的数据,现有数据可能低估了产前抗精神病药物暴露的潜在致畸作用。
    目的:根据终止妊娠的信息提供综合分析,流产,死产,和活产。
    方法:我们在丹麦进行了一项基于人群的队列研究,研究对象为临床公认的单胎妊娠,并于2008年至2017年进行了妊娠早期扫描。我们比较了在妊娠早期暴露于抗精神病药物的妊娠与未暴露妊娠中发生重大畸形的风险。在二级分析中,本研究与妊娠前使用抗精神病药物但未在妊娠期间使用抗精神病药物的女性(停药者)进行了比较.我们使用加权对数二项回归来估计混杂控制的调整患病率比(PR)和倾向评分精细分层。我们进行了四次敏感性分析,包括兄弟姐妹控制的分析。
    结果:在503,158例怀孕中,1,252(0.2%)是在妊娠早期服用抗精神病药处方的妇女。主要畸形出现在7.3%的抗精神病药物暴露妊娠中,5.1%的未暴露妊娠,和6.0%的中止妊娠者。与未暴露妊娠相比,暴露妊娠的校正PR为1.23(95%CI:1.01-1.50)。在同胞分析中,PR与中断剂和1.08(0.47-2.49)相比降低至1.14(0.88-1.48)。心脏畸形也观察到了类似的发现。类和个体抗精神病药的结果一致,并在四个敏感性分析中保持稳健。
    结论:我们的研究结果表明,孕早期抗精神病药物暴露的总体致畸作用有限或没有。对于个体抗精神病药,基于极少数情况的估计,有足够样本量的进一步研究是必要的.
    Existing data may underestimate the potential teratogenic effects of prenatal antipsychotic exposure because of lacking data on miscarriages and induced abortions.
    This study aimed to present a comprehensive analysis based on information on pregnancies ending in termination, miscarriage, stillbirth, and live birth.
    We conducted a population-based cohort study in Denmark of clinically recognized singleton pregnancies with the first-trimester scan performed from 2008 to 2017. We compared the risk of major malformations between pregnancies exposed to antipsychotics in the first trimester and unexposed pregnancies. In secondary analyses, the comparison was made with pregnancies of women who used antipsychotics before but not during pregnancy (discontinuers). We used weighted log-binomial regression to estimate adjusted prevalence ratios and propensity score fine stratifications for confounding control. We performed 4 sensitivity analyses, including a sibling-controlled analysis.
    Of the 503,158 pregnancies, 1252 (0.2%) were of women who filled an antipsychotic prescription in the first trimester. Major malformations were present in 7.3% of antipsychotic-exposed pregnancies, 5.1% of unexposed pregnancies, and 6.0% of discontinuers\' pregnancies. The adjusted prevalence ratio was 1.23 (95% confidence interval, 1.01-1.50) among exposed pregnancies compared with unexposed pregnancies. The prevalence ratio was attenuated to 1.14 (95% confidence interval, 0.88-1.48) compared with discontinuers and 1.08 (95% confidence interval, 0.47-2.49) in the sibling analysis. Similar findings were observed with cardiac malformations. Results were consistent for classes and individual antipsychotics, and remained robust across the 4 sensitivity analyses.
    Our findings suggest limited or no overall teratogenic effect of first-trimester antipsychotic exposure. For individual antipsychotics, with estimations based on very few cases, further studies with sufficient sample sizes are warranted.
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  • 文章类型: Journal Article
    目的:跌倒相关损伤是帕金森病(PD)患者的主要健康问题。我们比较了患有和不患有PD的人的头部损伤和创伤性脑损伤(TBI)的发生率和伤后死亡率。
    方法:这项基于注册的研究是在FINPARK队列中进行的,其中包括1996-2015年在芬兰被诊断为PD的22,189人。我们排除了以前头部受伤的人,将20,514人留在PD。对于每个有PD的人,根据年龄确定了1-7名没有PD和先前头部受伤的匹配者,性别,和居住。Cox比例风险模型用于估计头部损伤的风险比。使用逻辑回归模型比较死亡率。
    结果:患有PD的人所有头部受伤的风险为2.16倍(95%置信区间[CI]=2.06-2.26),TBI的风险为1.97倍(95%CI=1.84-2.10)。性别,和合并症。患有PD的人在任何类型的颅脑损伤后的1年死亡率都较高(调整后的比值比[aOR]=1.44,95%CI=1.28-1.62),TBI(aOR=1.33,95%CI=1.14-1.57),或非TBI颅脑损伤(aOR=1.72,95%CI=1.42-2.07)比没有PD的人。PD患者在TBI后6个月和非TBI损伤后1个月观察到较高的死亡风险。患有PD和头部受伤的人的1年死亡率也高于患有PD和没有头部受伤的人。
    结论:患有PD的人比没有PD的人有更高的头部损伤风险和更高的伤后死亡率。
    Fall-related injuries are a major health concern among people with Parkinson disease (PD). We compared the incidence and postinjury mortality of head injuries and traumatic brain injury (TBI) among persons with and without PD.
    This register-based study was conducted on the FINPARK cohort, which includes 22,189 persons who were diagnosed with PD in Finland during 1996-2015. We excluded persons with a previous head injury, leaving 20,514 persons with PD. For each person with PD, 1-7 matching persons without PD and previous head injury were identified with respect to age, sex, and residence. The Cox proportional hazard model was used to estimate hazard ratios for head injury. A logistic regression model was used to compare mortality.
    Persons with PD had 2.16-fold (95% confidence interval [CI] = 2.06-2.26) risk of all head injuries and 1.97-fold (95% CI = 1.84-2.10) risk of TBI after adjustment for age, sex, and comorbidities. Persons with PD had higher 1-year mortality after any type of head injury (adjusted odds ratio [aOR] = 1.44, 95% CI = 1.28-1.62), TBI (aOR = 1.33, 95% CI = 1.14-1.57), or non-TBI head injury (aOR = 1.72, 95% CI = 1.42-2.07) than persons without PD. The higher risk of mortality was observed 6 months after TBI and 1 month after non-TBI injury in persons with PD. Persons with PD and head injury also had higher 1-year mortality than persons with PD and without head injury.
    Persons with PD have a higher risk of head injury and higher postinjury mortality than persons without PD.
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  • 文章类型: Journal Article
    背景:孕妇妊娠期高血压疾病(HDP)已被认为有助于后代心血管疾病的发展,但经验证据仍然不一致。这项研究旨在评估从儿童到成年早期,母亲整体和特定类型的HDP与后代糖尿病的关系。
    方法:使用丹麦国家健康登记册,这项研究共纳入了1978年至2018年在丹麦出生的2,448,753人.孕产妇HDP包括慢性高血压,妊娠期高血压,和先兆子痫.感兴趣的结果是后代的糖尿病(包括1型,2型和妊娠期糖尿病)。后代的随访始于出生,并在首次诊断为糖尿病时结束,从丹麦移民,死亡,或时间于2018年12月31日结束,以先到者为准。Cox比例风险回归用于评估从出生到年轻成年(长达41岁)的后代中母体HDP与糖尿病(包括1型,2型和妊娠期糖尿病)之间的关联的风险比(HRs)和95%置信区间(CI)。以后代的年龄为时间尺度。
    结果:在长达41年(中位数:19.3年)的随访中,患有HDP的母亲所生的1247个后代和没有HDP的母亲所生的23,645个后代被诊断患有糖尿病。与没有HDP的母亲所生的后代相比,患有HDP的母亲所生的人患整体糖尿病的风险增加(HR=1.27,95%CI=1.20-1.34),以及2型糖尿病(HR=1.57,95%CI=1.38-1.78)和妊娠糖尿病(HR=1.37,95%CI=1.25-1.49)。我们没有观察到1型糖尿病的风险明显增加(HR=1.08,95%CI=0.98-1.18)。妊娠期高血压(HR=1.37,95%CI=1.00-1.88)或先兆子痫(HR=1.62,95%CI=1.41-1.87)的母亲的后代患2型糖尿病的风险更高。重度先兆子痫的相关性最强,2型糖尿病风险为2倍(HR=2.00,95%CI=1.42-2.82)。孕妇HDP与1型糖尿病之间的关联没有达到统计学意义。妊娠高血压除外(HR=1.41,95CI=1.17-1.71)。此外,我们发现,有任何亚型母亲HDP的母亲所生的后代患妊娠期糖尿病的风险更高,和相应的慢性高血压的HR(95CIs),妊娠期高血压,子痫前期为1.60(1.06-2.41),1.29(1.04-1.59),和1.38(1.24-1.53),分别。我们还观察到,患有HDP和共病糖尿病的母亲的后代之间的关联比单独患有HDP或糖尿病的母亲的后代更强(HR=4.64,95CI=3.85-5.60)。
    结论:患有HDP的母亲的后代,尤其是患有糖尿病的母亲,在他们生命后期患糖尿病的风险增加。我们的研究结果表明,应将及时有效地预防育龄妇女的HDP作为几代人的糖尿病预防和控制策略。
    Maternal hypertensive disorders during pregnancy (HDP) have been suggested to contribute to the development of offspring cardiovascular disease later in life, but empirical evidence remains inconsistent. This study was aimed to assess the association of maternal overall and type-specific HDPs with diabetes in offspring from childhood to early adulthood.
    Using Danish national health registers, a total of 2,448,753 individuals born in Denmark from 1978 to 2018 were included in this study. Maternal HDP included chronic hypertension, gestational hypertension, and preeclampsia. The outcome of interest was diabetes in offspring (including type 1, type 2, and gestational diabetes). The follow-up of offspring started at birth and ended at the first diagnosis of diabetes, emigration from Denmark, death, or time end on 31 December 2018, whichever came first. Cox proportional hazards regression was used to evaluate the hazard ratios (HRs) with 95% confidence intervals (CIs) of the association between maternal HDP and diabetes (including type 1, type 2, and gestational diabetes) in offspring from birth to young adulthood (up to 41 years), with the offspring\'s age as the time scale.
    During a follow-up of up to 41 (median: 19.3) years, 1247 offspring born to mothers with HDP and 23,645 offspring born to mothers without HDP were diagnosed with diabetes. Compared with offspring born to mothers without HDP, those born to mothers with HDP had an increased risk for overall diabetes (HR=1.27, 95% CI=1.20-1.34), as well as for type 2 diabetes (HR=1.57, 95% CI=1.38-1.78) and gestational diabetes (HR=1.37, 95% CI=1.25-1.49). We did not observe obvious increased risk for type 1 diabetes (HR=1.08, 95% CI=0.98-1.18). Offspring of mothers with gestational hypertension (HR=1.37, 95% CI=1.00-1.88) or preeclampsia (HR=1.62, 95% CI=1.41-1.87) had higher risks of type 2 diabetes. The strongest association was observed for severe preeclampsia, with a 2-fold risk of type 2 diabetes (HR=2.00, 95% CI=1.42-2.82). The association between maternal HDP and type 1 diabetes did not reach statistical significance, except for maternal gestational hypertension (HR=1.41, 95%CI=1.17-1.71). In addition, we found that offspring born to mothers with any subtypes of maternal HDP had higher risk of gestational diabetes, and the corresponding HRs (95%CIs) for chronic hypertension, gestational hypertension, and preeclampsia were 1.60 (1.06-2.41), 1.29 (1.04-1.59), and 1.38 (1.24-1.53), respectively. We also observed stronger associations among offspring of mothers with HDP and comorbid diabetes (HR=4.64, 95%CI=3.85-5.60) than offspring of mothers with HDP or diabetes alone.
    Offspring of mothers with HDP, especially mothers with comorbid diabetes, had an increased risk of diabetes later in their life. Our findings suggest that timely and effective prevention of HDP in women of childbearing age should be taken into consideration as diabetes prevention and control strategies for their generations.
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