The Swedish childhood diabetes study ? results from a nine year case register and a one year case-referent study indicating that Type 1 (insulin-dependent) diabetes mellitus is associated with both Type 2 (non-insulin-dependent) diabetes mellitus and autoimmune disorders

Dahlquist, Gisela; Blom, L.; Tuvemo, Torsten; Nyström, Lennarth; Sandström, Anita; Wall, Stig

doi:10.1007/bf00265396

Cited by 156 publications

(139 citation statements)

References 28 publications

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“…For each child two age-, sex-, and geographically-matched referent children were traced through the official Swedish population register. The collection of data by questionnaires has recently been described in detail [15,16].…”

Section: Methodsmentioning

confidence: 99%

“…Large-scale longitudinal studies describing the growth pattern in diabetic children during the period from birth until the clinical onset of diabetes are lacking. In Sweden, the growth development of all children is recorded at child health clinics and school health care units, and all children who develop diabetes before the age of 15 years are reported to the Swedish Childhood Diabetes Register [15,16]. Using this register, a nationwide incident paratively few in late pre-school and school age, the anthropometric measurements early in life dominated in the present study.…”

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confidence: 99%

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

1992

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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.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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

1992

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“…The results of this study have been analysed in blocks, based on a conceptual model [2] and using standard epidemiological methods with internal standardizations. An increased risk of developing Type 1 diabetes in childhood was indicated by the following factors: 1) Reported presence of insulintreated as well as non-insulin-treated diabetes, thyroid and rheumatic disease among relatives [3]. 2) Maternal age over 40 years, low maternal education and a short duration of breast-feeding [2].…”

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confidence: 99%

“…(2) To examine possible interactions between the risk determinants. (3) To analyse whether the predictive model will differ in different age groups. (4) To ascertain which of the risk determinants were important for the age at onset of the disease.…”

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confidence: 99%

The Swedish childhood diabetes study ? a multivariate analysis of risk determinants for diabetes in different age groups

1991

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Summary.In a nationwide incident case-referent study stepwise univariate analysis has revealed several risk determinants for childhood diabetes mellitus. In a multivariate analysis we have determined the set of risk determinants that would independently predict childhood Type i (insulindependent) diabetes. Possible interactions between the risk determinants and differences in risk profiles with different ages at onset were also examined. Reported familial insulintreated and non-insulin-treated diabetes were significant risk factors in all age groups, as was also a low frequency of milk intake. The frequency of infections and a high intake of foods rich in nitrosamine tended to interact (OR 11.8,p = 0.053) indicating a synergistic effect. A Cox regression analysis revealed that stressful life events during the last year was the only variable that tended to affect the age at onset (p = 0.055). This indicated that psychological stress may rather precipitate than induce Type i diabetes. A short breast-feeding duration (OR = 3.81), and an increased body height (OR = 3.82) contributed significantly to the predictive model in only the youngest age group (0-4 years). An increased frequency of infections in the year preceding onset (OR = 2.15) and no vaccination against measles (OR = 3.33) contributed significantly to the model only in the age group 5-9 years. Various nutrients had different impacts on the risk of developing Type 1 diabetes in different age groups. It is concluded that in the genetically susceptible child, risk factors which are associated with eating habits, frequency of infections, vaccination status, growth pattern and severe psychological stress affect the risk of developing diabetes independently of each other. The set of risk determinants varies with the age at onset. A high frequency of infections and a high frequency of nitrosamine-rich food intake seem to have a synergistic effect on the risk of developing diabetes in childhood.

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“…For patients o7 years, a control was selected among patients being treated at the hospital for reasons other than T1D (n ¼ 53). 27 Better diabetes diagnosis (BDD) study. A total of 2700 incident diabetes patients o18 years at diagnosis were collected between 2005 and 2009 from 40 pediatric clinics in Sweden for the BDD study.…”

Section: Swedish Childhood Study (Sv2)mentioning

confidence: 99%

Age-dependent variation of genotypes in MHC II transactivator gene (CIITA) in controls and association to type 1 diabetes

et al. 2012

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The major histocompatibility complex class II transactivator (CIITA) gene (16p13) has been reported to associate with susceptibility to multiple sclerosis, rheumatoid arthritis and myocardial infarction, recently also to celiac disease at genome-wide level. However, attempts to replicate association have been inconclusive. Previously, we have observed linkage to the CIITA region in Scandinavian type 1 diabetes (T1D) families. Here we analyze five Swedish T1D cohorts and a combined control material from previous studies of CIITA. We investigate how the genotype distribution within the CIITA gene varies depending on age, and the association to T1D. Unexpectedly, we find a significant difference in the genotype distribution for markers in CIITA (rs11074932, P ¼ 4 Â 10 À 5 and rs3087456, P ¼ 0.05) with respect to age, in the collected control material. This observation is replicated in an independent cohort material of about 2000 individuals (P ¼ 0.006, P ¼ 0.007). We also detect association to T1D for both markers, rs11074932 (P ¼ 0.004) and rs3087456 (P ¼ 0.001), after adjusting for age at sampling. The association remains independent of the adjacent T1D risk gene CLEC16A. Our results indicate an age-dependent variation in CIITA allele frequencies, a finding of relevance for the contrasting outcomes of previously published association studies.

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The Swedish childhood diabetes study ? results from a nine year case register and a one year case-referent study indicating that Type 1 (insulin-dependent) diabetes mellitus is associated with both Type 2 (non-insulin-dependent) diabetes mellitus and autoimmune disorders

Cited by 156 publications

References 28 publications

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

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

The Swedish childhood diabetes study ? a multivariate analysis of risk determinants for diabetes in different age groups

Age-dependent variation of genotypes in MHC II transactivator gene (CIITA) in controls and association to type 1 diabetes

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