Accumulation of childhood adversities and type 1 diabetes risk: a register-based cohort study of all children born in Denmark between 1980 and 2015

Bengtsson, Jessica; Byberg, Stine; Carstensen, Bendix; Stavola, Bianca L De; Svensson, Jannet; Jørgensen, Marit E.; Rod, Naja Hulvej

doi:10.1093/ije/dyaa138

Cited by 9 publications

(9 citation statements)

References 36 publications

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“…Including those with type 1 diabetes could have led to weakening of the association between ACEs and diabetes in our study as ACEs are not likely to be associated with type 1 diabetes. 61 However, onset of type 1 diabetes is rare in adults. The current analysis only included those with age of onset of diabetes after 18 years, and diabetes is therefore likely to predominantly be type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore

et al. 2021

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ObjectivesSeveral studies have linked diabetes mellitus to adverse childhood experiences (ACEs). While a number of studies have examined the association between ACEs and diabetes in Western populations, few have done it in Asian populations. The current study aimed to examine (1) the association between ACEs and diabetes, including the association after age stratification, and (2) the association of comorbid depression, resource use and health-related quality of life (HRQoL) among those with diabetes and ACEs in Singapore.SettingsParticipants were surveyed in their homes or any other preferred venue of their choice.Participants6126 individuals aged 18 years and above were randomly selected among Singapore residents.DesignCross-sectional nationwide epidemiological study.ResultsExposure to any ACE was not associated with increased odds of diabetes; however, those who had experienced parental separation, death or divorce of a parent had higher odds of diabetes. In addition, we observed significant interaction between age and ACEs in relation to odds of diabetes. ACEs were significantly associated with higher odds of diabetes mainly in the younger age group. The prevalence of major depressive disorder was significantly higher among those with diabetes and ACEs than those with diabetes alone (3.7% and 0.3% respectively).ConclusionsEfforts to promote regular exercise and healthy lifestyles both in the population and among those with diabetes must continue for the prevention and management of diabetes. The findings emphasise the need to create more awareness of both the prevalence and impact of ACEs among those treating chronic diseases.

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Section: Discussionmentioning

confidence: 99%

Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore

et al. 2021

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“…Parental employment status (both parents working, only father, only mother or neither), use of public versus private hospital were reported by Begum et al in South Australia, showing a slightly but significantly higher risk associated with higher socioeconomic status. In a Danish study, family poverty (5.5% of cohort), parental long-term unemployment (25% of cohort) was not significantly associated with childhood-onset type 1 diabetes (21).…”

Section: Resultsmentioning

confidence: 95%

Is socioeconomic status associated with risk of childhood type 1 diabetes? A comprehensive review

Ruiz

Stene

2022

Preprint

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AimsStudies of social inequality in risk of type 1 diabetes seems inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socioeconomic status or parental occupation and risk of type 1 diabetes in children.MethodsWe searched for publications between January 1, 1970, and November 30, 2021. We focused on the most recent and/or informative publication in case of multiple publications from the same data source and referred to these as primary studies.ResultsOur search identified 69 publications with relevant data. We identified eight primary cohort studies with individual-level data, which we considered the highest quality of evidence. Furthermore, we identified 13 primary case-control studies and 14 semi-ecological studies with area-level socioeconomic status variables which provide weaker quality of evidence. Four of eight primary cohort studies contained data on maternal education, showing non-linear associations with type 1 diabetes that were not consistent across studies. There were no consistent patterns on the association of parental occupation and childhood-onset type 1 diabetes.ConclusionsThere is a need for more high-quality studies, but the existing literature does not suggest a major and consistent role of socioeconomic status in the risk of type 1 diabetes.Novelty statement“What is already known?”- Socioeconomic status has been associated with a variety of exposures, but the influence on type 1 diabetes risk is unclear.“What this study has found?”- Our searches identified eight high-quality and several lower quality studies, mostly using socioeconomic status as a confounder. There was no consistent association between socioeconomic status and risk of childhood type 1 diabetes. No conclusions could be drawn for specific parental occupations.“What are the implications of the study?”-While there is a need for more high-quality studies, the existing literature does not suggest a major and consistent role of socioeconomic status in the risk of type 1 diabetes.

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“…To address challenges of ACEs score as described in introduction, we fitted a model including all ACEs simultaneously similar to some previous research [ 28 , 29 ], and then predicted hazard ratios according to the count of ACEs in a continuous scale [42] , retaining the information of severity in ordinal ACEs. Given that ACEs are likely clustered and co-occurring, estimated risks for each ACE may provide limited information on their own [ 43 , 44 ], while estimates for the overall effect of ACEs may be more reliable due to their smaller standard errors.…”

Section: Discussionmentioning

confidence: 99%

“…We identified potential confounders from existing studies [ 22 , 29 , 35 ], and a direct acyclic diagram (supplementary file 1, figure S1). Sex, age in years, and ethnicity (white, non-white) were derived from phase 1.…”

Section: Methodsmentioning

confidence: 99%

“…A major advantage of an ACE score is that it permits the examination of dose-response associations, as well as defining the total exposure to ACEs in a simple manner. On the other hand, an approach that recognises different effect sizes in a simultaneously adjusted model [ 28 , 29 ] tackles some of the challenges of ACE scores [ 27 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

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Adverse childhood experiences and incident coronary heart disease: a counterfactual analysis in the Whitehall II prospective cohort study

Akasaki

Nicholas

Abell

et al. 2021

American Journal of Preventive Cardiology

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Objectives Adverse childhood experience is thought to be associated with risk of coronary heart disease, but it is not clear which experiences are cardiotoxic, and whether risk increases with the accumulation of adverse childhood experiences. Methods Participants were 5149 adults (72.6% men) in the Whitehall II cohort study. Parental death was recorded at phase 1 (median age in years 44.3), and 13 other adverse childhood experiences at phase 5 (55.3). We applied Cox proportional hazards regression with person-time from phase 5 to examine associations of adverse childhood experiences with incident coronary heart disease. We predicted hazard ratios according to count of the experiences, and examined dose-response effect. We finally estimated reduction of coronary heart disease in a hypothetical scenario, the absence of adverse childhood experiences. Results Among study participants, 62.9% had at least one adversity, with “financial problems” having the highest prevalence (26.1%). There were 509 first episodes of coronary heart disease during an average 12.9 years follow-up. Among 14 adverse childhood experiences in a multiply adjusted model, “parental unemployment” showed the highest hazard of coronary heart disease incidence (hazard ratio; 95% confidence interval: 1.53; 1.16 to 2.02). No dose-response effect was observed (constant for proportionality in hazard ratio: 1.05, 0.99 to 1.11). Based on the estimates of final model, in the absence of childhood adversities, we estimated a 6.0% reduction in coronary heart disease (0.94; 0.87 to 1.01), but the confidence interval includes one. Conclusion Although individual adverse childhood experiences show some association with coronary heart disease, there is no clear relationship with the number of adverse experiences. Further research is required to quantify effects of multiple and combinations of adverse childhood experiences considering timing, duration, and severity.

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Accumulation of childhood adversities and type 1 diabetes risk: a register-based cohort study of all children born in Denmark between 1980 and 2015

Cited by 9 publications

References 36 publications

Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore

Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore

Is socioeconomic status associated with risk of childhood type 1 diabetes? A comprehensive review

Adverse childhood experiences and incident coronary heart disease: a counterfactual analysis in the Whitehall II prospective cohort study

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