The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study
(2024) In Journal of the Endocrine Society 8(7).- 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... (More)
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.
(Less)
- author
- organization
- publishing date
- 2024-05-23
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of the Endocrine Society
- volume
- 8
- issue
- 7
- article number
- bvae103
- publisher
- Oxford University Press
- external identifiers
-
- pmid:38867880
- ISSN
- 2472-1972
- DOI
- 10.1210/jendso/bvae103
- project
- The Environmental Determinants of Diabetes in the Young (TEDDY).
- language
- English
- LU publication?
- yes
- additional info
- © The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.
- id
- 48857c52-2d41-4031-9561-da1bc0cb4f40
- date added to LUP
- 2024-06-15 18:05:41
- date last changed
- 2024-06-17 08:59:37
@article{48857c52-2d41-4031-9561-da1bc0cb4f40, abstract = {{<p>CONTEXT: The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty.</p><p>OBJECTIVE: We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes.</p><p>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.</p><p>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; <br> 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; <br> 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.<br> </p><p>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.</p>}}, author = {{Warncke, Katharina and Tamura, Roy and Schatz, Desmond A and Veijola, Riitta and Steck, Andrea K and Akolkar, Beena and Hagopian, William and Krischer, Jeffrey P and Lernmark, Åke and Rewers, Marian J and Toppari, Jorma and McIndoe, Richard and Ziegler, Anette-G and Vehik, Kendra and Haller, Michael J and Elding Larsson, Helena}}, issn = {{2472-1972}}, language = {{eng}}, month = {{05}}, number = {{7}}, publisher = {{Oxford University Press}}, series = {{Journal of the Endocrine Society}}, title = {{The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study}}, url = {{http://dx.doi.org/10.1210/jendso/bvae103}}, doi = {{10.1210/jendso/bvae103}}, volume = {{8}}, year = {{2024}}, }