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Diabetes. 2016 Jul;65(7):1988-95. doi: 10.2337/db15-1180. Epub 2016 Mar 18.

Growth and Risk for Islet Autoimmunity and Progression to Type 1 Diabetes in Early Childhood: The Environmental Determinants of Diabetes in the Young Study.

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Department of Clinical Sciences, Lund University, Malmö, Sweden
Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL.
Department of Pediatrics, University of Florida, Gainesville, FL.
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
Pacific Northwest Diabetes Research Institute, Seattle, WA.
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA.
Department of Pediatrics, Turku University Hospital, Turku, Finland.
Department of Pediatrics, Turku University Hospital, Turku, Finland Departments of Physiology and Pediatrics, University of Turku, Turku, Finland.
Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V., Neuherberg, Germany.
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO.


Increased growth in early childhood has been suggested to increase the risk of type 1 diabetes. This study explored the relationship between weight or height and development of persistent islet autoimmunity and progression to type 1 diabetes during the first 4 years of life in 7,468 children at genetic risk for type 1 diabetes followed in Finland, Germany, Sweden, and the U.S. Growth data collected every third month were used to estimate individual growth curves by mixed models. Cox proportional hazards models were used to evaluate body size and risk of islet autoimmunity and type 1 diabetes. In the overall cohort, development of islet autoimmunity (n = 575) was related to weight z scores at 12 months (hazard ratio [HR] 1.16 per 1.14 kg in males or per 1.02 kg in females, 95% CI 1.06-1.27, P < 0.001, false discovery rate [FDR] = 0.008) but not at 24 or 36 months. A similar relationship was seen between weight z scores and development of multiple islet autoantibodies (1 year: HR 1.21, 95% CI 1.08-1.35, P = 0.001, FDR = 0.008; 2 years: HR 1.18, 95% CI 1.06-1.32, P = 0.004, FDR = 0.02). No association was found between weight or height and type 1 diabetes (n = 169). In conclusion, greater weight in the first years of life was associated with an increased risk of islet autoimmunity.

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