Infant Growth and Risk of Childhood-Onset Type 1 Diabetes in Children From 2 Scandinavian Birth Cohorts

TY - JOUR

T1 - Infant Growth and Risk of Childhood-Onset Type 1 Diabetes in Children From 2 Scandinavian Birth Cohorts

AU - Magnus, Maria C

AU - Olsen, Sjurdur F

AU - Granström, Charlotta

AU - Joner, Geir

AU - Skrivarhaug, Torild

AU - Svensson, Jannet

AU - Johannesen, Jesper

AU - Njølstad, Pål

AU - Magnus, Per

AU - Størdal, Ketil

AU - Stene, Lars C

PY - 2015/12

Y1 - 2015/12

N2 - IMPORTANCE: Type 1 diabetes mellitus is one of the most common chronic diseases with onset in childhood, but environmental risk factors have not been convincingly established.OBJECTIVE: To test whether increased growth during the first year of life is associated with higher risk of childhood-onset type 1 diabetes.DESIGN, SETTING, AND PARTICIPANTS: This is a cohort study using information from 2 population-based cohort studies in Norway and Denmark, the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC), of children born between February 1998 and July 2009. The current study was conducted between November 2014 and June 2015.EXPOSURES: Change in weight and length from birth to age 12 months.MAIN OUTCOMES AND MEASURES: Unadjusted and adjusted hazard ratios (HRs) of type 1 diabetes, classified based on nationwide childhood diabetes registers, obtained using Cox proportional hazards regression.RESULTS: A total of 99,832 children were included in the study, with 59,221 in MoBa (51.2% boys and 48.8% girls; mean age at end of follow-up, 8.6 years [range, 4.6-14.2 years]) and 40,611 in DNBC (50.6% boys and 49.4% girls; mean age at end of follow-up, 13.0 years [range, 10.4-15.7 years]). The incidence rate of type 1 diabetes from age 12 months to the end of follow-up was 25 cases per 100,000 person-years in DNBC and 31 cases per 100,000 person-years in MoBa. The change in weight from birth to 12 months was positively associated with type 1 diabetes (pooled unadjusted HR = 1.24 per 1-SD increase; 95% CI, 1.11-1.39; pooled adjusted HR = 1.24 per 1-SD increase; 95% CI, 1.09-1.41). There was no significant association between length increase from birth to 12 months and type 1 diabetes (pooled unadjusted HR = 1.06 per 1-SD increase; 95% CI, 0.93-1.22; pooled adjusted HR = 1.06 per 1-SD increase; 95% CI, 0.86-1.32). The associations were similar in both sexes.CONCLUSIONS AND RELEVANCE: This is the first prospective population-based study, to our knowledge, providing evidence that weight increase during the first year of life is positively associated with type 1 diabetes. This supports the early environmental origins of type 1 diabetes.

AB - IMPORTANCE: Type 1 diabetes mellitus is one of the most common chronic diseases with onset in childhood, but environmental risk factors have not been convincingly established.OBJECTIVE: To test whether increased growth during the first year of life is associated with higher risk of childhood-onset type 1 diabetes.DESIGN, SETTING, AND PARTICIPANTS: This is a cohort study using information from 2 population-based cohort studies in Norway and Denmark, the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC), of children born between February 1998 and July 2009. The current study was conducted between November 2014 and June 2015.EXPOSURES: Change in weight and length from birth to age 12 months.MAIN OUTCOMES AND MEASURES: Unadjusted and adjusted hazard ratios (HRs) of type 1 diabetes, classified based on nationwide childhood diabetes registers, obtained using Cox proportional hazards regression.RESULTS: A total of 99,832 children were included in the study, with 59,221 in MoBa (51.2% boys and 48.8% girls; mean age at end of follow-up, 8.6 years [range, 4.6-14.2 years]) and 40,611 in DNBC (50.6% boys and 49.4% girls; mean age at end of follow-up, 13.0 years [range, 10.4-15.7 years]). The incidence rate of type 1 diabetes from age 12 months to the end of follow-up was 25 cases per 100,000 person-years in DNBC and 31 cases per 100,000 person-years in MoBa. The change in weight from birth to 12 months was positively associated with type 1 diabetes (pooled unadjusted HR = 1.24 per 1-SD increase; 95% CI, 1.11-1.39; pooled adjusted HR = 1.24 per 1-SD increase; 95% CI, 1.09-1.41). There was no significant association between length increase from birth to 12 months and type 1 diabetes (pooled unadjusted HR = 1.06 per 1-SD increase; 95% CI, 0.93-1.22; pooled adjusted HR = 1.06 per 1-SD increase; 95% CI, 0.86-1.32). The associations were similar in both sexes.CONCLUSIONS AND RELEVANCE: This is the first prospective population-based study, to our knowledge, providing evidence that weight increase during the first year of life is positively associated with type 1 diabetes. This supports the early environmental origins of type 1 diabetes.

KW - Adolescent

KW - Body Height

KW - Body Weight

KW - Child

KW - Child Development

KW - Child, Preschool

KW - Cohort Studies

KW - Denmark

KW - Diabetes Mellitus, Type 1

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Infant

KW - Male

KW - Norway

KW - Proportional Hazards Models

KW - Risk Factors

KW - Weight Gain

U2 - 10.1001/jamapediatrics.2015.3759

DO - 10.1001/jamapediatrics.2015.3759

M3 - Journal article

C2 - 26642117

SN - 2168-6203

VL - 169

JO - JAMA Pediatrics

JF - JAMA Pediatrics

IS - 12

M1 - e153759

ER -