Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Klinfarmlab, Vita Stråket 11, Sahlgrenska University Hospital, S-413 45, Gothenburg, Sweden.
Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
Diabetologia. 2020 Jun;63(6):1141-1150. doi: 10.1007/s00125-020-05121-8. Epub 2020 Mar 23.
AIMS/HYPOTHESIS: The association between pubertal timing and type 2 diabetes, independent of prepubertal BMI, is not fully understood. The aim of the present study was to evaluate the association between pubertal timing and risk of adult type 2 diabetes, independent of prepubertal BMI, in Swedish men.
We included 30,697 men who had data for BMI at age 8 and 20 years and age at Peak Height Velocity (PHV), an objective assessment of pubertal timing, available from the BMI Epidemiology Study Gothenburg (BEST Gothenburg), Sweden. Information on type 2 diabetes (n = 1851) was retrieved from the Swedish National Patient Register. HRs and 95% CIs were estimated by Cox regression analysis. We observed violations of the assumption of proportional hazards for the association between age at PHV and the risk of type 2 diabetes and therefore split the follow-up period at the median age of type 2 diabetes diagnosis (57.2 years of age) to define early (≤57.2 years) and late (>57.2 years) type 2 diabetes diagnosis.
Age at PHV was inversely associated with both early (HR 1.28 per year decrease in age at PHV, 95% CI 1.21, 1.36) and late (HR 1.13, 95% CI 1.06, 1.19) type 2 diabetes. After adjustment for childhood BMI, the associations between age at PHV and both early (HR 1.24, 95% CI 1.17, 1.31) and late (HR 1.11, 95% CI 1.05, 1.17) type 2 diabetes were similar. Moreover, early age at PHV predicted insulin treatment of type 2 diabetes (OR 1.25 per year decrease in age at PHV, 95% CI 1.17, 1.33). Assuming a higher risk among those with an age at PHV below the median, the population attributable factor indicates that 15% fewer of the diagnosed individuals would have developed type 2 diabetes had they not reached puberty early.
CONCLUSIONS/INTERPRETATION: These findings indicate that early puberty may be a novel independent risk factor for type 2 diabetes.
目的/假设：青春期开始时间与 2 型糖尿病之间的关联，独立于青春期前的 BMI，目前还不完全清楚。本研究的目的是评估青春期开始时间与成年 2 型糖尿病风险之间的关联，独立于青春期前的 BMI，在瑞典男性中进行评估。
我们纳入了 30697 名男性，他们的数据包括 8 岁和 20 岁时的 BMI 以及来自瑞典哥德堡 BMI 流行病学研究（BEST Gothenburg）的青春期开始时间的客观评估-高峰生长速度（PHV）。2 型糖尿病的信息（n=1851）来自瑞典国家患者登记处。使用 Cox 回归分析估计 HR 和 95%CI。我们观察到 PHV 年龄与 2 型糖尿病风险之间的比例风险假设违反，因此将随访期在 2 型糖尿病诊断中位年龄（57.2 岁）处分割，以定义早期（≤57.2 岁）和晚期（>57.2 岁）2 型糖尿病诊断。
PHV 年龄与早期（每减少 PHV 年龄 1.28 岁，95%CI 1.21,1.36）和晚期（HR 1.13，95%CI 1.06,1.19）2 型糖尿病均呈负相关。在调整儿童 BMI 后，PHV 年龄与早期（HR 1.24，95%CI 1.17,1.31）和晚期（HR 1.11，95%CI 1.05,1.17）2 型糖尿病之间的关联相似。此外，早期 PHV 预测 2 型糖尿病的胰岛素治疗（每减少 PHV 年龄 1 年，OR 1.25，95%CI 1.17,1.33）。假设 PHV 年龄低于中位数的人群风险更高，人群归因分数表明，如果这些人没有提前进入青春期，那么将有 15%更少的确诊个体会发展为 2 型糖尿病。
结论/解释：这些发现表明，青春期提前可能是 2 型糖尿病的一个新的独立危险因素。
