TY - JOUR
T1 - Distinct growth phases in early life associated with the risk of type 1 diabetes
T2 - The teddy study
AU - TEDDY study group
AU - Liu, Xiang
AU - Vehik, Kendra
AU - Huang, Yangxin
AU - Larsson, Helena Elding
AU - Toppari, Jorma
AU - Ziegler, Anette G.
AU - She, Jin Xiong
AU - Rewers, Marian
AU - Hagopian, William A.
AU - Akolkar, Beena
AU - Krischer, Jeffrey P.
N1 - Funding Information:
Acknowledgments. The authors thank Sarah Austin-Gonzalez with the Health Informatics Institute at the University of South Florida (Tampa, FL) for assistance with preparing the figures. Funding. The TEDDY study is funded by National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, JDRF, and Centers for Disease Control and Prevention grants U01-DK-63829, U01-DK-63861, U01-DK-63821, U01-DK-63865, U01-DK-63863, U01-DK-63836, U01-DK-63790, UC4-DK-63829, UC4-DK-63861, UC4-DK-63821, UC4-DK-63865, UC4-DK-63863, UC4-DK-63836, UC4-DK-95300, UC4-DK-100238, UC4-DK-106955, UC4-DK-112243, and UC4-DK-117483 and contract number HHSN267200700014C. This work is supported in part by the National Institutes of Health/National Center for Advancing Translational Sciences Clinical and Translational Science Awards to the University of Florida (UL1-TR-000064) and the University of Colorado (UL1-TR-001082). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. All authors attest to meeting International Committee of Medical Journal Editors uniform requirements for authorship by making substantial contributions to conception and design of this manuscript; acquisition, analysis, and interpretation of the data; drafting or revising the manuscript for intellectual content; and giving final approval of the published version. X.L. proposed and performed the analysis, interpreted the results, and wrote the manuscript. K.V. provided input on the interpretation of the results and reviewed and edited the manuscript. Y.H. performed the analysis and reviewed and edited the manuscript. H.E.L. reviewed and edited the manuscript. J.T., A.G.Z., J.-X.S., M.R., W.A.H., B.A., and J.P.K.
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - OBJECTIVE This study investigates two-phase growth patterns in early life and their association with development of islet autoimmunity (IA) and type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study followed 7,522 genetically high-risk children in Sweden, Finland, Germany, and the U.S. from birth for a median of 9.0 years (interquartile range 5.7–10.6) with available growth data. Of these, 761 (10.1%) children developed IA and 290 (3.9%) children were diagnosed with T1D. Bayesian two-phase piecewise linear mixed models with a random change point were used to estimate children’s individual growth trajectories. Cox proportional hazards models were used to assess the effects of associated growth parameters on the risks of IA and progression to T1D. RESULTS A higher rate of weight gain in infancy was associated with increased IA risk (hazard ratio [HR] 1.09 [95% CI 1.02, 1.17] per 1 kg/year). A height growth pattern with a lower rate in infancy (HR 0.79 [95% CI 0.70, 0.90] per 1 cm/year), higher rate in early childhood (HR 1.48 [95% CI 1.22, 1.79] per 1 cm/year), and younger age at the phase transition (HR 0.76 [95% CI 0.58, 0.99] per 1 month) was associated with increased risk of progression from IA to T1D. A higher rate of weight gain in early childhood was associated with increased risk of progression from IA to T1D (HR 2.57 [95% CI 1.34, 4.91] per 1 kg/year) in children with first-appearing GAD autoantibody only. CONCLUSIONS Growth patterns in early life better clarify how specific growth phases are associated with the development of T1D.
AB - OBJECTIVE This study investigates two-phase growth patterns in early life and their association with development of islet autoimmunity (IA) and type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study followed 7,522 genetically high-risk children in Sweden, Finland, Germany, and the U.S. from birth for a median of 9.0 years (interquartile range 5.7–10.6) with available growth data. Of these, 761 (10.1%) children developed IA and 290 (3.9%) children were diagnosed with T1D. Bayesian two-phase piecewise linear mixed models with a random change point were used to estimate children’s individual growth trajectories. Cox proportional hazards models were used to assess the effects of associated growth parameters on the risks of IA and progression to T1D. RESULTS A higher rate of weight gain in infancy was associated with increased IA risk (hazard ratio [HR] 1.09 [95% CI 1.02, 1.17] per 1 kg/year). A height growth pattern with a lower rate in infancy (HR 0.79 [95% CI 0.70, 0.90] per 1 cm/year), higher rate in early childhood (HR 1.48 [95% CI 1.22, 1.79] per 1 cm/year), and younger age at the phase transition (HR 0.76 [95% CI 0.58, 0.99] per 1 month) was associated with increased risk of progression from IA to T1D. A higher rate of weight gain in early childhood was associated with increased risk of progression from IA to T1D (HR 2.57 [95% CI 1.34, 4.91] per 1 kg/year) in children with first-appearing GAD autoantibody only. CONCLUSIONS Growth patterns in early life better clarify how specific growth phases are associated with the development of T1D.
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U2 - 10.2337/dc19-1670
DO - 10.2337/dc19-1670
M3 - Article
C2 - 31896601
AN - SCOPUS:85081144972
SN - 0149-5992
VL - 43
SP - 556
EP - 562
JO - Diabetes Care
JF - Diabetes Care
IS - 3
ER -
