Abstract

BACKGROUND:

Data on the relationship between Th2-biased atopic disorders and Th1-biased autoimmune diseases such as type 1 diabetes are conflicting. Many studies have not defined the time sequence of disease appearance, and few have investigated the role of candidate risk factors.

OBJECTIVE:

The objective was to investigate whether the presence of parents' report of physician-diagnosed atopic disorders is lower among cases of type 1 diabetes before diagnosis, as compared with population-based control subjects, and whether this may be explained by candidate risk factors such as day-care attendance, breastfeeding habits, and perinatal factors.

METHODS:

We designed a population-based case-control study in Norway with 545 cases of childhood-onset type 1 diabetes and 1668 control subjects. Families were contacted by mail, and they completed a questionnaire on physician-diagnosed atopic eczema, allergic rhino-conjunctivitis and asthma, and other relevant factors. Data on birth order, maternal age at delivery, birth weight, gestational age, pre-eclampsia, and caesarean section were obtained from the Medical Birth Registry of Norway by record linkage.

RESULTS:

Atopic eczema was inversely associated with risk of type 1 diabetes, odds ratio=0.55 (95% confidence interval 0.35-0.87) after adjustment for age, sex, maternal education, day-care attendance, duration of exclusive breastfeeding, and perinatal factors. Allergic rhino-conjunctivitis and asthma were not significantly associated with type 1 diabetes.

CONCLUSIONS:

Atopic eczema was associated with a lower risk of type 1 diabetes, independent of a number of candidate risk factors, suggesting that it may confer partial protection against type 1 diabetes.