Early-childhood body mass index and its association with the COVID-19 pandemic, containment measures and islet autoimmunity in children with increased risk for type 1 diabetes.

COVID-19 Childhood BMI Islet autoimmunity Stringency index Type 1 diabetes

Journal

Diabetologia
ISSN: 1432-0428
Titre abrégé: Diabetologia
Pays: Germany
ID NLM: 0006777

Informations de publication

Date de publication:
12 Jan 2024
Historique:
received: 14 08 2023
accepted: 14 11 2023
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 12 1 2024
Statut: aheadofprint

Résumé

The aim of this study was to determine whether BMI in early childhood was affected by the COVID-19 pandemic and containment measures, and whether it was associated with the risk for islet autoimmunity. Between February 2018 and May 2023, data on BMI and islet autoimmunity were collected from 1050 children enrolled in the Primary Oral Insulin Trial, aged from 4.0 months to 5.5 years of age. The start of the COVID-19 pandemic was defined as 18 March 2020, and a stringency index was used to assess the stringency of containment measures. Islet autoimmunity was defined as either the development of persistent confirmed multiple islet autoantibodies, or the development of one or more islet autoantibodies and type 1 diabetes. Multivariate linear mixed-effect, linear and logistic regression methods were applied to assess the effect of the COVID-19 pandemic and the stringency index on early-childhood BMI measurements (BMI as a time-varying variable, BMI at 9 months of age and overweight risk at 9 months of age), and Cox proportional hazard models were used to assess the effect of BMI measurements on islet autoimmunity risk. The COVID-19 pandemic was associated with increased time-varying BMI (β = 0.39; 95% CI 0.30, 0.47) and overweight risk at 9 months (β = 0.44; 95% CI 0.03, 0.84). During the COVID-19 pandemic, a higher stringency index was positively associated with time-varying BMI (β = 0.02; 95% CI 0.00, 0.04 per 10 units increase), BMI at 9 months (β = 0.13; 95% CI 0.01, 0.25) and overweight risk at 9 months (β = 0.23; 95% CI 0.03, 0.43). A higher age-corrected BMI and overweight risk at 9 months were associated with increased risk for developing islet autoimmunity up to 5.5 years of age (HR 1.16; 95% CI 1.01, 1.32 and HR 1.68, 95% CI 1.00, 2.82, respectively). Early-childhood BMI increased during the COVID-19 pandemic, and was influenced by the level of restrictions during the pandemic. Controlling for the COVID-19 pandemic, elevated BMI during early childhood was associated with increased risk for childhood islet autoimmunity in children with genetic susceptibility to type 1 diabetes.

Identifiants

pubmed: 38214711
doi: 10.1007/s00125-023-06079-z
pii: 10.1007/s00125-023-06079-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Wellcome Trust
ID : [107212/Z/15/Z]
Pays : United Kingdom

Informations de copyright

© 2024. The Author(s).

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Auteurs

Sandra Hummel (S)

Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany. sandra.hummel@helmholtz-munich.de.
Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany. sandra.hummel@helmholtz-munich.de.
School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany. sandra.hummel@helmholtz-munich.de.

Sarah Rosenberger (S)

Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität München, Munich, Germany.
Pettenkofer School of Public Health, Munich, Germany.

Thekla von dem Berge (T)

Kinder- und Jugendkrankenhaus auf der Bult, Hannover, Germany.

Rachel E J Besser (REJ)

Centre for Human Genetics, JDRF/Wellcome Diabetes and Inflammation Laboratory, Nuffield Department of Medicine, NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.

Kristina Casteels (K)

Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.

Angela Hommel (A)

Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany.
Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.

Olga Kordonouri (O)

Kinder- und Jugendkrankenhaus auf der Bult, Hannover, Germany.

Helena Elding Larsson (H)

Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Department of Paediatrics, Skane University Hospital, Malmö/Lund, Sweden.

Markus Lundgren (M)

Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden.

Benjamin A Marcus (BA)

School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Mariusz Oltarzewski (M)

Department of Paediatric Diabetology and Paediatrics, The Children's Clinical Hospital Józef Polikarp Brudziński, Warsaw, Poland.
Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.

Anne Rochtus (A)

Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.

Agnieszka Szypowska (A)

Department of Paediatric Diabetology and Paediatrics, The Children's Clinical Hospital Józef Polikarp Brudziński, Warsaw, Poland.
Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.

John A Todd (JA)

Centre for Human Genetics, JDRF/Wellcome Diabetes and Inflammation Laboratory, Nuffield Department of Medicine, NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.

Andreas Weiss (A)

Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.

Christiane Winkler (C)

Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.

Ezio Bonifacio (E)

Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany.
Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.

Anette-G Ziegler (AG)

Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Classifications MeSH