The Bartholin Institute, Rigshospitalet, Copenhagen, Denmark.
Department of Pediatrics, Hans Christian Andersen Children's hospital, Odense, Denmark.
Pediatr Diabetes. 2018 Mar;19(2):265-270. doi: 10.1111/pedi.12568. Epub 2017 Sep 22.
The incidence of type 1 diabetes (T1D) is increasing, and obesity may be a contributing factor by increasing the risk and accelerating the onset. We investigated the relation between childhood body mass index z-scores (BMIz) and the later risk of T1D, including association with age at onset of T1D. The study included 238 cases and 10 147 controls selected from the Copenhagen School Health Record Register (CSHRR). Cases of T1D were identified in the Danish Registry of Childhood and Adolescent Diabetes and 2 regional studies and linked to CSHRR. Using conditional logistic regression models, the association of childhood prediagnostic BMIz at 7 and 13 years of age and changes between these ages with subsequent risk (odds ratio, OR) of T1D was estimated. A greater BMIz at 7 and 13 years of age was associated with increased risk of T1D with OR of 1.23 (confidence interval, CI 1.09-1.37; P = .0001) and 1.20 (CI 1.04-1.40; P = .016), respectively. The risk was increased by upward changes in z-scores from birth to 7 years (OR=1.21, P = .003) and from 7 to 13 years of age (OR=1.95, P = .023), but in the latter age interval also by a decline in BMIz (OR = 1.91, P = .034). There were no associations between BMIz at 7 and 13 years of age and the age of onset (P = .34 and P = .42, respectively). Increased BMIz is associated with a moderate increase in risk of T1D, but with no relation to age at onset within the analyzed age range. Increased BMIz over time is unlikely to explain the rising incidence of T1D.
1 型糖尿病（T1D）的发病率正在上升，肥胖可能是一个促成因素，因为它会增加风险并加速发病。我们研究了儿童体重指数 z 分数（BMIz）与 T1D 风险的关系，包括与 T1D 发病年龄的关系。该研究包括从哥本哈根学校健康记录登记处（CSHRR）中选择的 238 例病例和 10147 例对照。T1D 病例在丹麦儿童和青少年糖尿病登记处以及 2 个区域研究中确定，并与 CSHRR 相关联。使用条件逻辑回归模型，估计了儿童在 7 岁和 13 岁时的预测前 BMIz 以及这些年龄之间的变化与随后 T1D 风险（比值比，OR）的关系。7 岁和 13 岁时 BMIz 较高与 T1D 风险增加相关，OR 分别为 1.23（95%置信区间，CI 1.09-1.37；P =.0001）和 1.20（CI 1.04-1.40；P =.016）。从出生到 7 岁（OR=1.21，P =.003）和从 7 岁到 13 岁（OR=1.95，P =.023）时 z 分数的升高与风险增加有关，但在后一个年龄区间，BMIz 的下降也与风险增加有关（OR=1.91，P =.034）。BMIz 在 7 岁和 13 岁时与发病年龄之间没有关联（P =.34 和 P =.42）。BMIz 随时间的增加与 T1D 的风险中度增加相关，但在所分析的年龄范围内与发病年龄无关。BMIz 的增加不太可能解释 T1D 发病率的上升。
