Refereed journal article or data article (A1)

Increased HLA class II risk is associated with a more aggressive presentation of clinical type 1 diabetes

List of AuthorsKieleväinen Vilma, Turtinen Maaret, Luopajärvi Kristiina, Härkönen Taina, Ilonen Jorma, Knip Mikael; Finnish Pediatric Diabetes Register

PublisherJohn Wiley and Sons Inc

Publication year2023

JournalActa Paediatrica

Journal name in sourceActa Paediatrica, International Journal of Paediatrics

Volume number112

Issue number3

Start page522

End page528




Self-archived copy’s web address


Aim: To determine the association of HLA class II risk with the demographic and clinical characteristics of type 1 diabetes at diagnosis.

Methods: We conducted a register-based retrospective cohort study of 4993 Finnish children (2169 girls) - diagnosed with type 1 diabetes under the age of 15 years in 2003-2016. The participants were divided into six risk groups based on their HLA DR/DQ genotype. Demographic characteristics, family history of type 1 diabetes and metabolic markers at the time of diagnosis were compared between the groups.

Results: In total, 4056/4993 children (81.2%) carried an HLA genotype associated with an increased risk of type 1 diabetes (risk groups 3-5), whereas 937/4993 children (18.8%) carried a HLA genotype conferring no or decreased disease risk. Children with higher HLA risk were younger at diagnosis (p < 0.001) and had a shorter duration of classical symptoms before diagnosis (p = 0.016). Subjects in the high-risk group were more likely to have a family member affected by type 1 diabetes when compared to those in the neutral risk group (11.5% vs. 8.8%, p = 0.05).

Conclusion: Children with stronger HLA disease susceptibility are younger at their disease manifestation and have a shorter period of symptoms before diagnosis, suggesting that the HLA class II genes are associated with a more aggressive disease presentation.

Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.

Last updated on 2023-28-03 at 16:56