Pediatric type 1 diabetes, islet autoimmunity associated with changes in weight, height
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Children may be more likely to develop islet autoimmunity and then type 2 diabetes if they gain weight more quickly during infancy and early childhood and if they become taller faster in early childhood, according to findings published in Diabetes Care.
“There is still no clear picture of if and how the whole growth trajectory in early life is associated with the development of islet autoimmunity and type 1 diabetes. This is mainly due to the lack of growth data in infancy and the lack of complex modeling techniques for longitudinal growth data in early life,” Xiang Liu, PhD, associate professor at the Health Informatics Institute of the Morsani College of Medicine at the University of South Florida in Tampa, Florida, and colleagues wrote. “By modeling the entire growth trajectory, the growth patterns can be easily identified and help pinpoint the timing of a potential disturbance or exposure.”
Liu and colleagues used data from 7,522 children who took part in the Environmental Determinants of Diabetes in the Young (TEDDY) study. The researchers measured weight and height at 3-month intervals across 9 years of median follow-up time and identified islet autoimmunity and type 1 diabetes via blood samples.
Based on this analysis, the researchers found that islet autoimmunity occurred in 10.1% of the cohort while type 1 diabetes occurred in 3.9%.
There was a 9% increase in the risk for islet autoimmunity for every annual increase in weight of 1 kg among those with the “higher rate of weight gain in infancy” (HR = 1.09; 95% CI, 1.02-1.17). A 15% increase in the risk for GADA-first islet autoimmunity was observed for every annual increase in weight of 1 kg among those with the “higher rate of weight gain in infancy” (HR = 1.15; 95% CI, 1.04-1.28). The researchers noted that there was a positive association between birth weight and autoimmunity risk (HR = 1.19; 95% CI, 1.02-1.41).
During infancy there was a 21% reduction in the risk for progressing from islet autoimmunity to type 1 diabetes for every annual rise of 1 cm in height among those who grew taller more slowly (HR = 0.79; 95% CI, 0.7-0.9). There was also a 24% reduction in risk for every month longer it took to progress from autoimmunity to type 1 diabetes (HR = 0.76; 95% CI, 0.58-0.99). In contrast, the risk was 48% higher for every annual rise of 1 cm in height among those who got taller more quickly (HR = 1.48; 95% CI, 1.22-1.79).
In regard to weight gain in early childhood, the researchers wrote that for those with GAD islet autoantibodies, there were positive associations between islet autoimmunity to type 1 diabetes risk and birth weight (HR = 2.04; 95% CI, 1.03-4.04) as well as weight growth rate (HR = 2.57; 95% CI, 1.34-4.91).
“Our findings showed that overall weight and height are associated with islet autoimmunity and progression to type 1 diabetes at different phases in early growth, and this effect was more pronounced in those who developed GADA as a first appearing autoantibody,” the researchers wrote. “The pattern of infancy growth, phase transition and childhood growth may serve as a surrogate of perinatal programming, similar to catch-up growth. Identifying the distinct growth patterns and age of transition from one growth phase to another may provide a rough time period to assess environmental triggers and other viable biomarkers associated with the type 1 diabetes prodrome.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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