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Weight gain in early life predicts risk of islet autoimmunity in children with a first degree relative with type 1 diabetes.
In a prospective birth cohort study infants were followed, who had a first-degree relative with type 1 diabetes, to investigate the relationship between early growth and infant feeding, and the risk of islet autoimmunity.
Infants with a first degree relative with type 1 diabetes were identified during the pregnancy. Dietary intake was recorded prospectively to determine duration of breast feeding and age at introduction of cows milk protein, cereals, meat, fruit and vegetables. At 6 monthly reviews, length (or height) and weight, antibodies to insulin, glutamic acid decarboxylase 65, the tyrosine phosphatase-like insulinoma antigen, IA2, and tissue transglutaminase were measured. Islet autoimmunity was defined as persistent elevation of one or more islet antibodies at consecutive 6 monthly intervals, including the most recent measure, and was the primary outcome measure.
Follow-up of 548 infants for 5.7 (3.2) years identified 46 children with islet autoimmunity. Weight z-score and BMI z-score were continuous predictors of risk of islet autoimmunity [adjusted hazard ratio (95% CI) 1.43 (1.10-1.84) p=0.007; 1.29 (1.01-1.67) p=0.04 respectively]. Risk of islet autoimmunity was greater in subjects with weight z-score > 0 than 0 over time [adjusted hazard ratio (95% CI) 2.61 (1.26 – 5.44), p=0.01]. Weight z-score and BMI z-score at 2 years, and change in weight z-score between birth and 2 years, but not dietary intake, also predicted risk of islet autoimmunity.
Conclusion: Weight gain in early life predicts risk of islet autoimmunity in children with a first degree relative with type 1 diabetes.
Diabetes Care Publish Ahead of Print online, October 3, 2008,DOI: 10.2337/dc08-0821
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FACT:
Every 10 seconds a person dies from diabetes-related causes. Every 10 seconds two people develop diabetes. In many countries in Asia, the Middle East, Oceania and the Caribbean, diabetes affects 12 to 20% of the adult population. Seven of the 10 countries with the highest number of people living with diabetes are in the developing world.
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