OBJECTIVE -In retrospective studies, a number of disparate environmental factors (including experiences of serious life events) have been proposed as trigger mechanisms for type 1 diabetes or the autoimmune process behind the disease. Psychosocial stress in families may affect children negatively due to a link to hormonal levels and nervous signals that in turn influence both insulin sensitivity/insulin need and the immune system. Our aim was to investigate whether psychological stress, measured as psychosocial strain in families, is associated with diabetesrelated autoimmunity during infancy.RESEARCH DESIGN AND METHODS -The first 4,400 consecutive 1-year-old children from a large prospective population-based project participated in the study. Parents completed questionnaires at birth and at 1 year, including various measures of psychosocial stress (e.g., parenting stress) and sociodemographic background. Blood samples drawn from the children at 1 year were analyzed for type 1 diabetes-associated autoantibodies toward tyrosine phosphatase and GAD. Antibodies toward tetanus toxoid were used as non-diabetes-related control antibodies. RESULTS -Psychosocial factors, i.e., high parenting stress (odds ratio 1.8 [95% CI 1.2-2.9], P Ͻ 0.01), experiences of a serious life event (2.3 [1.3-4.0], P Ͻ 0.01), foreign origin of the mother (2.1 [1.3-3.3], P Ͻ 0.001), and low paternal education (1.6 [1.1-2.3], P Ͻ 0.01) were associated with diabetes-related autoimmunity in the child, independent of family history of diabetes.CONCLUSIONS -Psychological stress, measured as psychosocial strain in the family, seems to be involved in the induction, or progression, of diabetes-related autoimmunity in the child during the 1st year of life.
Diabetes Care 28:290 -295, 2005