Spatial and temporal variation in type 1 diabetes incidence in Western Australia from 1991 to 2010: Increased risk at higher latitudes and over time

Abstract Aims/hypothesis Among white European children developing type 1 diabetes, the otherwise common HLA haplotype DR15-DQ6 is rare, and highly protective. Adult-onset type 1 diabetes is now known to represent more overall cases than childhood onset, but it is not known whether DR15-DQ6 is protective in older-adult-onset type 1 diabetes. We sought to quantify DR15-DQ6 protection against type 1 diabetes as age of onset increased. Methods In two independent cohorts we assessed the proportion of type 1 diabetes cases presenting through the first 50 years of life with DR15-DQ6, compared with population controls. In the After Diabetes Diagnosis Research Support System-2 (ADDRESS-2) cohort (n = 1458) clinician-diagnosed type 1 diabetes was confirmed by positivity for one or more islet-specific autoantibodies. In UK Biobank (n = 2502), we estimated type 1 diabetes incidence rates relative to baseline HLA risk for each HLA group using Poisson regression. Analyses were restricted to white Europeans and were performed in three groups according to age at type 1 diabetes onset: 0–18 years, 19–30 years and 31–50 years. Results DR15-DQ6 was protective against type 1 diabetes through to age 50 years (OR < 1 for each age group, all p < 0.001). The following ORs for type 1 diabetes, relative to a neutral HLA genotype, were observed in ADDRESS-2: age 5–18 years OR 0.16 (95% CI 0.08, 0.31); age 19–30 years OR 0.10 (0.04, 0.23); and age 31–50 years OR 0.37 (0.21, 0.68). DR15-DQ6 also remained highly protective at all ages in UK Biobank. Without DR15-DQ6, the presence of major type 1 diabetes high-risk haplotype (either DR3-DQ2 or DR4-DQ8) was associated with increased risk of type 1 diabetes. Conclusions/interpretation HLA DR15-DQ6 confers dominant protection from type 1 diabetes across the first five decades of life. Graphical abstract

Download Full-text

Plasma micronutrients are associated with dietary intake and environmental tobacco smoke exposure in a paediatric population

Public Health Nutrition ◽

10.1017/s1368980007662296 ◽

2007 ◽

Vol 10 (7) ◽

pp. 712-718 ◽

Cited By ~ 23

Author(s):

Heather Brady ◽

Molly M Lamb ◽

Ronald J Sokol ◽

Colleen A Ross ◽

Jennifer A Seifert ◽

...

Keyword(s):

Type 1 Diabetes ◽

Dietary Intake ◽

Environmental Tobacco Smoke ◽

Tobacco Smoke ◽

Human Leukocyte ◽

Primary Objective ◽

Tobacco Smoke Exposure ◽

Increased Risk ◽

Over Time

AbstractBackgroundWhile adult populations have been well described in terms of nutritional status, such as the concentration of nutrient biomarkers, little work has been done in healthy paediatric populations.ObjectiveThe primary objective of this analysis was to explore the determinants of plasma micronutrients in a group of healthy infants and children.DesignThe Diabetes Autoimmunity Study in the Young (DAISY) has enrolled 1433 newborns at increased risk for type 1 diabetes in Denver, Colorado. A representative random sample of 257 children from the DAISY cohort between the ages of 9 months and 8 years with a total of 815 clinic visits over time was used in this analysis. Annual dietary intake was assessed over time with Willett food-frequency questionnaires that were validated in this population. Environmental tobacco smoke (ETS) was assessed using a validated survey. Plasma samples were tested for vitamins, carotenoids and total lipids. Predictors of plasma micronutrients were evaluated using mixed models for longitudinal data, while adjusting for age, human leukocyte antigen genotype, type 1 diabetes family history and other potential confounders and covariates.ResultsIncreased micronutrient intake was associated with increased levels of their respective plasma nutrient, with the exception of γ-tocopherol. Independent of dietary intake, levels of α- and β-carotene and β-cryptoxanthin were significantly lower, and γ-tocopherol was significantly higher, in children who were exposed to ETS.ConclusionDietary intake predicts plasma micronutrient levels. Exposure to ETS potentially could have negative health effects in this young population.

Download Full-text

Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: evidence of non-uniformity over time in rates of increase

Diabetologia ◽

10.1007/s00125-012-2571-8 ◽

2012 ◽

Vol 55 (8) ◽

pp. 2142-2147 ◽

Cited By ~ 272

Author(s):

C. C. Patterson ◽

E. Gyürüs ◽

J. Rosenbauer ◽

O. Cinek ◽

A. Neu ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetes Incidence ◽

Childhood Type 1 Diabetes ◽

Childhood Type ◽

Over Time

Download Full-text

Prevalence of coexisting autoimmune thyroidal diseases in coeliac disease is decreasing

United European Gastroenterology Journal ◽

10.1177/2050640619899225 ◽

2020 ◽

Vol 8 (2) ◽

pp. 148-156 ◽

Cited By ~ 1

Author(s):

Patricia Dominguez Castro ◽

Grace Harkin ◽

Mary Hussey ◽

Brian Christopher ◽

Clifford Kiat ◽

...

Keyword(s):

Type 1 Diabetes ◽

General Population ◽

Autoimmune Diseases ◽

Coeliac Disease ◽

Immune Mediated ◽

Population Type ◽

Increased Risk ◽

General Populations ◽

Over Time

Background Coeliac disease (CD) is associated with an increased risk of other immune-mediated conditions. Aim: To investigate the prevalence of coexistent immune-mediated diseases in CD patients, and changes in the prevalence of autoimmune thyroidal diseases over the last 50 years. Methods Medical record data were collected retrospectively from 749 CD patients in Ireland. Prevalence of autoimmune diseases was compared with previously published results from general populations. Patients were divided into four groups based on the year of diagnosis to analyse changes in the prevalence of autoimmune thyroidal disease over time. Results Median age at the time of CD diagnosis was 56 years (range 18–91 years). A total of 233 (31.1%) patients had a coexistent immune-mediated condition (IMC). Autoimmune thyroidal diseases were seen in 149 (19.9%) patients, hypothyroidism in 110 (14.7%), type 1 diabetes in 27 (3.6%), psoriasis in 20 (2.7%), inflammatory bowel disease in 14 (1.9%) and rheumatoid arthritis in 12 (1.6%). All conditions were more common in CD patients than in the general population. Type 1 diabetes was diagnosed mainly before CD, whereas there was no such trend in other conditions. Autoimmune thyroidal diseases became less common in female CD patients over time. Conclusions Prevalence of autoimmune diseases is increased in adult CD patients compared with the general population. However, concomitant autoimmune thyroidal diseases became less common over time in women.

Download Full-text

The Role of Age and Excess Body Mass Index in Progression to Type 1 Diabetes in At-Risk Adults

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-01490 ◽

2017 ◽

Vol 102 (12) ◽

pp. 4596-4603

Author(s):

Christine T Ferrara ◽

Susan M Geyer ◽

Carmella Evans-Molina ◽

Ingrid M Libman ◽

Dorothy J Becker ◽

...

Keyword(s):

Body Mass Index ◽

Type 1 Diabetes ◽

Body Mass ◽

Protective Factor ◽

Diabetes Incidence ◽

Increased Risk ◽

Diabetes Progression ◽

The Impact

Abstract Background Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. Objective To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Research Design and Methods Longitudinally accumulated BMI >25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values ≥0 kg/m2 and ≥5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. Results In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of >35 years that reduced risk for type 1 diabetes. In men age >35 years and women age <35 years, sustained obesity (ceBMI ≥5 kg/m2) increased the risk for type 1 diabetes. Conclusions Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology.

Download Full-text