The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study

Abstract Context The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty. Objective We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes. Methods The relationships between puberty, islet autoimmunity, and progression to ty...

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Veröffentlicht in:Journal of the Endocrine Society Jg. 8; H. 7; S. bvae103
Hauptverfasser: Warncke, Katharina, Tamura, Roy, Schatz, Desmond A, Veijola, Riitta, Steck, Andrea K, Akolkar, Beena, Hagopian, William, Krischer, Jeffrey P, Lernmark, Åke, Rewers, Marian J, Toppari, Jorma, McIndoe, Richard, Ziegler, Anette-G, Vehik, Kendra, Haller, Michael J, Elding Larsson, Helena
Format: Journal Article
Sprache:Englisch
Veröffentlicht: US Oxford University Press 01.07.2024
Schlagworte:
Autoantibodies
Clinical
Clinical Medicine
Development and progression
Diabetes
Endocrinology and Diabetes
Endokrinologi och diabetes
Health aspects
Islands of Langerhans
Klinisk medicin
Medical and Health Sciences
Medicin och hälsovetenskap
Pediatric research
Physiological aspects
Puberty
Type 1 diabetes
Germany
type 1 diabetes
β-cell
diabetes
insulin resistance
ISSN:2472-1972, 2472-1972
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Zusammenfassung:Abstract Context The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty. Objective We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes. Methods The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios. Results Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes. Conclusion Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.
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M.J.H. and H.E.L. contributed equally to the article as joint last authors.
ISSN:2472-1972
2472-1972
DOI:10.1210/jendso/bvae103