Dataset Information

Excess BMI Accelerates Islet Autoimmunity in Older Children and Adolescents.

ABSTRACT:

Objective

Sustained excess BMI increases the risk of type 1 diabetes (T1D) in autoantibody-positive relatives without diabetes of patients. We tested whether elevated BMI also accelerates the progression of islet autoimmunity before T1D diagnosis.

Research design and methods

We studied 706 single autoantibody-positive pediatric TrialNet participants (ages 1.6-18.6 years at baseline). Cumulative excess BMI (ceBMI) was calculated for each participant based on longitudinally accumulated BMI ?85th age- and sex-adjusted percentile. Recursive partitioning analysis and multivariable modeling defined the age cut point differentiating the risk for progression to multiple positive autoantibodies.

Results

At baseline, 175 children (25%) had a BMI ?85th percentile. ceBMI range was -9.2 to 15.6 kg/m² (median -1.91), with ceBMI ?0 kg/m² corresponding to persistently elevated BMI ?85th percentile. Younger age increased the progression to multiple autoantibodies, with age cutoff of 9 years defined by recursive partitioning analysis. Although ceBMI was not significantly associated with progression from single to multiple autoantibodies overall, there was an interaction with ceBMI ?0 kg/m², age, and HLA (P = 0.009). Among children ?9 years old without HLA DR3-DQ2 and DR4-DQ8, ceBMI ?0 kg/m² increased the rate of progression from single to multiple positive autoantibodies (hazard ratio 7.32, P = 0.004) and conferred a risk similar to that in those with T1D-associated HLA haplotypes. In participants <9 years old, the effect of ceBMI on progression to multiple autoantibodies was not significant regardless of HLA type.

Conclusions

These data support that elevated BMI may exacerbate islet autoimmunity prior to clinical T1D, particularly in children with lower risk based on age and HLA. Interventions to maintain normal BMI may prevent or delay the progression of islet autoimmunity.

SUBMITTER: Ferrara-Cook C

PROVIDER: S-EPMC7035590 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Excess BMI Accelerates Islet Autoimmunity in Older Children and Adolescents.

Ferrara-Cook Christine C Geyer Susan Michelle SM Evans-Molina Carmella C Libman Ingrid M IM Becker Dorothy J DJ Gitelman Stephen E SE Redondo Maria Jose MJ

Diabetes care 20200114 3

<h4>Objective</h4>Sustained excess BMI increases the risk of type 1 diabetes (T1D) in autoantibody-positive relatives without diabetes of patients. We tested whether elevated BMI also accelerates the progression of islet autoimmunity before T1D diagnosis.<h4>Research design and methods</h4>We studied 706 single autoantibody-positive pediatric TrialNet participants (ages 1.6-18.6 years at baseline). Cumulative excess BMI (ceBMI) was calculated for each participant based on longitudinally accumula ...[more]

PMID: 31937610

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Dataset Information

Excess BMI Accelerates Islet Autoimmunity in Older Children and Adolescents.

Objective

Research design and methods

Results

Conclusions

Publications

Excess BMI Accelerates Islet Autoimmunity in Older Children and Adolescents.

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