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

Warncke, Katharina ; Tamura, Roy ; Schatz, Desmond A ; Veijola, Riitta LU ; Steck, Andrea K ; Akolkar, Beena ; Hagopian, William ; Krischer, Jeffrey P ; Lernmark, Åke LU orcid and Rewers, Marian J , et al. (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.

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organization
publishing date
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 &lt; .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}},
}