Central obesity in school‐aged children increases the likelihood of developing paediatric autoimmune diseases

Abstract

Background: The incidences of both paediatric obesity and autoimmune diseases have been increasing, but their relationship with one another is unclear.Objective: To determine whether obesity or particular dietary patterns in schoolaged children are potential risk factors for autoimmune diseases during adolescence.Methods: This matched case-control study included 525 children, followed up from a median age of 11.3 to 16.7 years. Of them, 105 children received primary autoimmune diagnoses (diabetes, thyroiditis, arthritis, or inflammatory bowel diseases) after baseline and generated the case group. Four children with matching age, sex, and residential area generated the control group of 420 children. At baseline, age-and sex-specific body mass index categories were acquired and waist-to-height ratio (WHTR) was calculated. Central obesity was present when WHTR ≥0.5. Dietary patterns were analysed using a food frequency questionnaire (FFQ).Results: School-aged children with central obesity were 2.11 (OR, 95% CI 1.11-3.98) times more likely to develop autoimmune diseases before age of 19 years than those without central obesity. Being overweight was not related to the onset of these diseases (OR 1.60, 95% CI 0.89-2.87, nor were dietary patterns. Conclusion:Central obesity in school-aged children was related to the development of autoimmune diseases, while being overweight and dietary patterns were not. K E Y W O R D S autoimmune thyroiditis (AIT), dietary patterns, eating habits, inflammatory bowel diseases (IBD), juvenile idiopathic arthritis (JIA), type 1 diabetes (DM) 1 | INTRODUCTION Autoimmune diseases are a group of complex immunological disorders, in which the immune system erroneously interprets normal tissues as foreign, generating unwanted attacks, and inflammations in different organs. This study focuses on four autoimmune diseases with partially to represent autoimmune diseases in individuals between the age of 11 and 19 years in general: type 1 diabetes (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD). These diseases were chosen due to their potentially overlapping genetic pathways. In addition, their pathogeneses resemble each other, showing T-cell organ infiltrations with intermittent inflammations, yet without specific triggering factors. Pancreatic T-cell infiltration leads to depleted insulin secretion, hyperglycaemia, and eventually DM; thyroid gland infiltration leads to reduced thyroid hormone function and hypothyroidism seen in AIT;

Low maternal education increases the risk of Type 1 Diabetes, but not other autoimmune diseases: a mediating role of childhood BMI and exposure to serious life events

“…Type 1 Diabetes also has a strong association with overweight and obesity while the association with other autoimmune diseases is less clear although some studies indicates that obesity increases the risk of MS, SLE, RA, IBD and Psoriasis 28 , while the risk of some autoimmune diseases including Celiac disease is decreased in obese individuals 29 . In children, obesity seems to increase the risk of Type 1 Diabetes and IBD more than JIA and Hypothyroidism 30 . The theoretical explanation for the association between Type 1 Diabetes and higher BMI could be the importance of beta-cell stress in disease development of Type 1 Diabetes.…”

Not Only Metabolic Complications of Childhood Obesity

“…Interestingly, central obesity in school-aged children emerged as a risk factor for the development of autoimmune diseases, including type 1 diabetes, autoimmune thyroiditis, juvenile idiopathic arthritis, and inflammatory bowel disease in the adolescent period [ 166 ].…”

Pre-Diagnostic Saliva Microbiota of School-Aged Children Who Developed Type 1 Diabetes or Inflammatory Bowel Diseases

“…Saliva microbiota composition may also be influenced by oral hygiene and health, stages of dentition, and dietary patterns-especially by the consumption of sugary products [25]. While the dietary patterns and sugary product consumption of children in the Fin-HIT cohort who developed autoimmune diseases have been reported to be similar to those of those who did not develop these diseases [26], we lacked detailed information on the children's overall oral health as a potential confounder. Nevertheless, our earlier findings from a Fin-HIT subsample (n = 617) presented a good oral health: 66% of the children had no history of cavitated caries lesions in permanent teeth, and only minor differences in the saliva microbiota were observed between children with and without dental caries [27].…”