Article révisé par les pairs
Résumé : Background: The age at clinical onset of type 1 diabetes is decreasing. Preliminary Belgian data suggested that this anticipation occurred preferentially in boys. We investigated whether this gender-specific anticipation could be confirmed over a 15-year observation period. Methods: In Antwerp, we studied incidence trends between 1989 and 2003 in 746 type 1 diabetic patients under age 40. For 2928 antibody-positive patients diagnosed nationwide during the same period, age at diagnosis was analysed according to gender and calendar year. Results: In Antwerp, the incidence of type 1 diabetes under age 15 increased significantly with time from 10.9/100000/year in 1989-1993 to 15.8/100000/year in 1999-2003 (p = 0.008). The rising incidence in children was largely restricted to boys under age 10 where the incidence more than doubled during the 15-year period (6.8/100000/year in 1989-1993 vs 17.2/100000/year in 1999-2003; p < 0.001). Such an increase was not found in girls under age 10 (p = 0.54). This selective trend toward younger age at diagnosis in boys was confirmed in the larger group of Belgian patients where the median age at diagnosis decreased in boys - but not in girls - from 20 years in 1989-1993 to 15 years in 1999-2003 (p < 0.001). Conclusions: Over a 15-year observation period, a selective anticipation of clinical onset of type 1 diabetes was found in boys but not in girls. This suggests that an environmental factor may preferentially accelerate the subclinical disease process in young boys. Copyright © 2007 John Wiley & Sons, Ltd.

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