Distinct Growth Phases in Early Life Associated With the Risk of Type 1 Diabetes: The TEDDY Study
- 2 January 2020
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 43 (3), 556-562
- https://doi.org/10.2337/dc19-1670
Abstract
OBJECTIVE This study investigates two-phase growth patterns in early life and their association with development of islet autoimmunity (IA) and type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study followed 7,522 genetically high-risk children in Sweden, Finland, Germany, and the U.S. from birth for a median of 9.0 years (interquartile range 5.7–10.6) with available growth data. Of these, 761 (10.1%) children developed IA and 290 (3.9%) children were diagnosed with T1D. Bayesian two-phase piecewise linear mixed models with a random change point were used to estimate children’s individual growth trajectories. Cox proportional hazards models were used to assess the effects of associated growth parameters on the risks of IA and progression to T1D. RESULTS A higher rate of weight gain in infancy was associated with increased IA risk (hazard ratio [HR] 1.09 [95% CI 1.02, 1.17] per 1 kg/year). A height growth pattern with a lower rate in infancy (HR 0.79 [95% CI 0.70, 0.90] per 1 cm/year), higher rate in early childhood (HR 1.48 [95% CI 1.22, 1.79] per 1 cm/year), and younger age at the phase transition (HR 0.76 [95% CI 0.58, 0.99] per 1 month) was associated with increased risk of progression from IA to T1D. A higher rate of weight gain in early childhood was associated with increased risk of progression from IA to T1D (HR 2.57 [95% CI 1.34, 4.91] per 1 kg/year) in children with first-appearing GAD autoantibody only. CONCLUSIONS Growth patterns in early life better clarify how specific growth phases are associated with the development of T1D.Keywords
Funding Information
- National Institute of Diabetes and Digestive and Kidney Diseases (U01-DK-63829, U01-DK-63861, U01-DK-63821, U01-DK-63865, U01-DK-63863, U01-DK-63836, U01-DK-63790, UC4-DK-63829, UC4-DK-63861, UC4-DK-63821, UC4-DK-63865, UC4-DK-63863, UC4-DK-63836, UC4-DK-95300, UC4-DK-100238, UC4-DK-106955, UC4-DK-112243, UC4-DK-117483, HHSN267200700014C)
- National Institutes of Health/National Center for Advancing Translational Sciences (UL1-TR-000064, UL1-TR-001082)
This publication has 33 references indexed in Scilit:
- The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY studyDiabetologia, 2015
- The changing epidemiology of type 1 diabetes: why is it going through the roof?Diabetes/Metabolism Research and Reviews, 2010
- Height growth velocity, islet autoimmunity and type 1 diabetes development: the Diabetes Autoimmunity Study in the YoungDiabetologia, 2009
- Weight Gain in Early Life Predicts Risk of Islet Autoimmunity in Children With a First-Degree Relative With Type 1 DiabetesDiabetes Care, 2009
- Children developing type 1 diabetes before 6 years of age have increased linear growth independent of HLA genotypesDiabetologia, 2008
- Can we slow the rising incidence of childhood-onset autoimmune diabetes? The overload hypothesisDiabetologia, 2005
- Environmental Triggers and Determinants of Type 1 DiabetesDiabetes, 2005
- Rapid Early Growth Is Associated With Increased Risk of Childhood Type 1 Diabetes in Various European PopulationsDiabetes Care, 2002
- The accelerator hypothesis: weight gain as the missing link between Type I and Type II diabetesDiabetologia, 2001
- Association between infant growth before onset of juvenile type-1 diabetes and autoantibodies to IA-2The Lancet, 2000