A high linear growth is associated with an increased risk of childhood diabetes mellitus

Abstract

Summary. Insulin release and growth are intimately connected. The aim of the present study was to investigate height and weight in diabetic children from birth to onset of Type 1 (insulin-dependent) diabetes mellitus compared to that in referent children. Data on height and weight were collected from mailed questionnaires and from growth records obtained from the child health clinics and schools in 337 recentonset diabetic children, 0-14 years old, and from 517 age-, sex-, and geographically matched referent children. A total of 9002 paired height and weight observations were collected. The anthropometric development of the children was expressed as standard deviation scores using the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC) growth reference material. On the average, the diabetic children were consistently taller than the referent children, a finding more pronounced among the boys. The diabetic boys were significantly taller from 7 to i years before the clinical onset of the disease, regardless of age at onset. A similar tendency was found for the girls. When mean height from 5 to 1 years before onset was used as a possible risk factor for diabetes, a linearly increasing trend in the odds ratio was found for diabetes in boys (odds ratio = 1.0; 1.57; 2.46 for height standard deviation score values < 0; 0-1 and > 1, respectively;p = 0.002 for trend). A similar, but statistically not significant, tendency was found for girls (odds ratio = 1.0; 1.44; 1.43). As regards height increment from birth similar trends in odds ratios were found. Weight-for-height was similar among diabetic and referent children of both sexes. We conclude that diabetic boys tend to be taller and grow faster than referent boys for several years preceding the disease. A similar, but not statistically significant tendency was found among diabetic girls. Our findings indicate that rapid linear growth is a risk factor for Type I diabetes in childhood, and may be either a promoter of Type i diabetes or else a marker of a physiological mechanism that affects both growth and the pathogenesis of Type 1 diabetes.

Children developing type 1 diabetes before 6 years of age have increased linear growth independent of HLA genotypes

“…Increased height and linear growth in childhood have been reported to be a risk factor for diabetes [17][18][19]. In the present study we failed to confirm an increased height based on SDS in children developing diabetes.…”

“…Retrospective studies of children with diabetes have reported increased linear growth up to 7 years before onset of disease [17] as well as increased height and weight standard deviation scores (SDS) from 1 month of age [18] and increased growth in length between 1 and 3 years of age [19,20]. The authors of the latter study corrected growth for mid-parental height (MPH), which is known to correlate with both birthweight and birth length [21], and with postnatal growth of the child [21,22].…”

A high weight gain early in life is associated with an increased risk of Type 1 (insulin-dependent) diabetes mellitus

“…The diffeIence was seen at 3 months of age and was statistically significant at 6, 9, 18 and 30 months. Similar results were seen in the study by Baum et al [10] while our findings are somewhat different from those of Blom et al [11] who did not show any difference in weight for age between diabetic and referent children from birth to clinical onset of Type 1 diabetes. They found however that boys who developed diabetes were consistently taller than referent boys from birth.…”

“…Baum et al [10] compared diabetic and nondiabetic children regarding weight gain during the first year of life and found that children who develop Type 1 diabetes are heavier at certain stages in infancy. Blom et al [11] concluded from an incident case referent study that children (especially boys) who later develop diabetes tend to be slightly but consistently taller, although not heavier, than matched referent children from early childhood up to the year of clinical onset of Type 1 diabetes.…”

Diabetes-associated HLA genotypes affect birthweight in the general population

“…These include viral infections [39][40][41], dietary factors (cow's milk, nitrosamines, high protein intake) [42,43], neonatal jaundice and ABO incompatibility [44], neonatal respiratory disease [44], early supplementary milk-based feeding, short time of breast-feeding [42,45] and stress events such as severe life events [42,46,47]. Several studies have found that children who later develop diabetes have a higher BW than controls, and also have an increased linear growth in childhood [15,16,42,48,49]. Our finding that HLA genetic factors, which are associated with susceptibility for type 1 diabetes, are related to intrauterine growth might in fact contribute to the increased BW in type 1 diabetes children.…”