A1 Refereed original research article in a scientific journal
The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study
Authors: Warncke, Katharina; Tamura, Roy; Schatz, Desmond A; Veijola, Riitta; Steck, Andrea K; Akolkar, Beena; Hagopian, William; Krischer, Jeffrey P; Lernmark, Åke; Rewers, Marian J; Toppari, Jorma; McIndoe, Richard; Ziegler, Anette-G; Vehik, Kendra; Haller, Michael J; Elding Larsson, Helena
Publisher: Oxford University Press
Publication year: 2024
Journal: Journal of the Endocrine Society
Journal name in source: Journal of the Endocrine Society
Journal acronym: J Endocr Soc
Article number: bvae103
Volume: 8
Issue: 7
eISSN: 2472-1972
DOI: https://doi.org/10.1210/jendso/bvae103
Web address : https://doi.org/10.1210/jendso/bvae103
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/456982997
Context: The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty.
Objective: We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes.
Methods: The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios.
Results: Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes.
Conclusion: Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.
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Funding information in the publication:
The TEDDY Study is funded by U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63865, U01 DK63863, U01 DK63836, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63865, UC4 DK63863, UC4 DK63836, UC4 DK95300, UC4 DK100238, UC4 DK106955, UC4 DK112243, UC4 DK117483, U01 DK124166, U01 DK128847, and Contract No. HHSN267200700014C from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), Centers for Disease Control and Prevention (CDC), and JDRF. This work is supported in part by the National Institutes of Health (NIH)/NCATS Clinical and Translational Science Awards to the University of Florida (UL1 TR000064) and the University of Colorado (UL1 TR002535). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
