TY  - JOUR
AB  - BACKGROUND: Smoking is a risk factor for cardiovascular complications and can promote a severe course of COVID-19 infection. The aim of this study was to compare smoking habits of young people with diabetes with the general population. METHODS: We analyzed smoking behavior in the Diabetes Prospective Follow-up Registry (DPV) cohort (type 1 (T1D) and type 2 diabetes (T2D) from Germany and T1D from Austria aged 14-24 years) and compared it to data from the German survey on smoking behavior (DEBRA study) of the general population. Data were aggregated per year and patient for 2016-2023. Logistic regression models adjusted for gender and migration background were calculated stratified by age groups (14-17; 18-24 years), taking repeated measurements into account. Smoking behavior between T1D and T2D or between Germany and Austria was compared with similar regression models. RESULTS: Thirty-four thousand two hundred seventy-five patients from the DPV cohort were included in data analysis. The overall proportion of people who smoked was lower in DPV than in the general population (13.4% vs. 24.0%), with the exception of young adults with T2D at the beginning of the pandemic (36.7% vs. 33.4%). For T1D, there was a significant upward trend in the number of patients who smoked in the group of 14-17 years (2.86%, CI 1.21-4.55 per year, p < 0.001) and also in the group of 18-24 years (4.94 per year, CI 1.37-8.63; p < 0.01) between 2016 and 2023. The proportion of smokers and the number of smoked cigarettes was higher in Austria than in Germany (10.7% vs. 8.0%; OR with 95%-CI 1.38 [1.22-1.56], p < 0.001; and 7.5 [6.8-8.1] vs. 5.9 [5.7-6.0] cigarettes/day, p < 0.001) and in T2D than T1D (11.0% vs. 7.9%; OR 1.44 [1.23-1.68], p < 0.001 and 8.0 [7.2-8.8] vs. 5.9 [5.7-6.1] cigarettes/day, p < 0.001). CONCLUSION: The reported proportion of smokers among young people with diabetes was lower than in the general population. Only young adults with T2D temporarily smoked more than the general population at the beginning of the pandemic. This could be explained by stress, but also by a changed daily structure during the lockdown.
AU  - Warncke, K.
AU  - Hofer, S.E.*
AU  - von Sengbusch, S.*
AU  - Ermer, U.*
AU  - Niemeyer, M.*
AU  - Lemmer, A.*
AU  - Hilgard, D.*
AU  - Welters, A.*
AU  - Holl, R.W.*
AU  - Eckert, A.J.*
C1  - 73781
C2  - 57217
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Did smoking behavior change in adolescents and young adults with and without diabetes during the COVID-19 pandemic? A cohort study from the DPV registry.
JO  - BMC Pediatr.
VL  - 25
IS  - 1
PB  - Bmc
PY  - 2025
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - BACKGROUND: Long-term survival after premature birth is significantly determined by development of morbidities, primarily affecting the cardio-respiratory or central nervous system. Existing studies are limited to pairwise morbidity associations, thereby lacking a holistic understanding of morbidity co-occurrence and respective risk profiles. METHODS: Our study, for the first time, aimed at delineating and characterizing morbidity profiles at near-term age and investigated the most prevalent morbidities in preterm infants: bronchopulmonary dysplasia (BPD), pulmonary hypertension (PH), mild cardiac defects, perinatal brain pathology and retinopathy of prematurity (ROP). For analysis, we employed two independent, prospective cohorts, comprising a total of 530 very preterm infants: AIRR ("Attention to Infants at Respiratory Risks") and NEuroSIS ("Neonatal European Study of Inhaled Steroids"). Using a data-driven strategy, we successfully characterized morbidity profiles of preterm infants in a stepwise approach and (1) quantified pairwise morbidity correlations, (2) assessed the discriminatory power of BPD (complemented by imaging-based structural and functional lung phenotyping) in relation to these morbidities, (3) investigated collective co-occurrence patterns, and (4) identified infant subgroups who share similar morbidity profiles using machine learning techniques. RESULTS: First, we showed that, in line with pathophysiologic understanding, BPD and ROP have the highest pairwise correlation, followed by BPD and PH as well as BPD and mild cardiac defects. Second, we revealed that BPD exhibits only limited capacity in discriminating morbidity occurrence, despite its prevalence and clinical indication as a driver of comorbidities. Further, we demonstrated that structural and functional lung phenotyping did not exhibit higher association with morbidity severity than BPD. Lastly, we identified patient clusters that share similar morbidity patterns using machine learning in AIRR (n=6 clusters) and NEuroSIS (n=8 clusters). CONCLUSIONS: By capturing correlations as well as more complex morbidity relations, we provided a comprehensive characterization of morbidity profiles at discharge, linked to shared disease pathophysiology. Future studies could benefit from identifying risk profiles to thereby develop personalized monitoring strategies. TRIAL REGISTRATION: AIRR: DRKS.de, DRKS00004600, 28/01/2013. NEuroSIS: ClinicalTrials.gov, NCT01035190, 18/12/2009.
AU  - Ciora, O.A.*
AU  - Seegmüller, T.*
AU  - Fischer, J.S.*
AU  - Wirth, T.*
AU  - Häfner, F.
AU  - Stöcklein, S.
AU  - Flemmer, A.W.*
AU  - Förster, K.
AU  - Kindt, A.*
AU  - Bassler, D.*
AU  - Poets, C.F.*
AU  - Ahmidi, N.*
AU  - Hilgendorff, A.
C1  - 70497
C2  - 55638
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Delineating morbidity patterns in preterm infants at near-term age using a data-driven approach.
JO  - BMC Pediatr.
VL  - 24
IS  - 1
PB  - Bmc
PY  - 2024
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - BACKGROUND: Offspring of mothers with gestational diabetes mellitus (GDM) have an increased risk of neonatal complications like birth trauma due to macrosomia or postnatal hypoglycemia, as well as long-term metabolic sequelae. Neonatal body composition may be a sensitive marker of metabolic effects on the fetus caused by suboptimal glycemic control during pregnancy. OBJECTIVE: To determine body composition in offspring of mothers with GDM compared to a reference cohort of healthy term neonates and to assess whether increased body fat would be associated with postnatal hypoglycemia. METHODS: This prospective, observational, cross-sectional study included 311 full-term, singleton infants born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. Results are indicated as median (1st Quartile - 3rd Quartile). RESULTS: Of 311 infants, 40 (12.9%) were born to mothers with GDM. Birth weight standard deviation scores (SDS) (0.24 vs. - 0.07, p = 0.04), fat mass (370 g vs. 333 g, p = 0.02) as well as fat mass/total body mass (BF%; 11.4% vs. 10.8%, p = 0.03) were significantly higher in infants following maternal GDM than in controls. In GDM offspring, anthropometric parameters, fat mass or BF% did not differ between infants with or without postnatal hypoglycemia. In this cohort, SDS for birth weight, fat mass, fat free mass, BF% or postnatal hypoglycemia were not associated with maternal blood glucose levels measured at an oral glucose tolerance test. CONCLUSIONS: SDS for birth weight, neonatal fat mass, and BF% were significantly higher in newborns following maternal GDM. In these infants born to mothers with GDM, body composition did not differ between those with or without postnatal hypoglycemia.
AU  - Wiechers, C.*
AU  - Balles, L.S.*
AU  - Kirchhof, S.*
AU  - Weber, R.*
AU  - Avellina, V.*
AU  - Pauluschke-Fröhlich, J.*
AU  - Hallschmid, M.
AU  - Fritsche, L.
AU  - Preissl, H.
AU  - Fritsche, A.
AU  - Poets, C.F.*
AU  - Franz, A.R.*
C1  - 61442
C2  - 50251
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Body composition in term offspring after maternal gestational diabetes does not predict postnatal hypoglycemia.
JO  - BMC Pediatr.
VL  - 21
IS  - 1
PB  - Bmc
PY  - 2021
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - Background During pregnancy, a variety of factors can influence fetal growth and development. Intrauterine growth may impact on later life and health. Neonatal body composition may be a more sensitive marker for the intrauterine environment than established anthropometric parameters at birth. Methods To study neonatal body composition determined by air displacement plethysmography in healthy, term singletons as national reference data, and to establish factors impacting on neonatal body composition in this population. This prospective cross-sectional observational study included 271 healthy, full-term, singletons born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. Results Median (Q1, Q2) fat mass / total body mass (BF%) in German singletons was 10.8% (7.7-13.4) and fat free mass (FFM) 2843 g (2606-3099). Female infants had significantly increased BF% compared to male infants (11.2% (8.7-14.0) vs. 9.6% (7.2-12.1)). On multiple regression analysis, BF% and fat mass increased with female gender, maternal pre-pregnancy body mass index, non-smoking mother and parity, whereas FFM increased with male gender and increasing gestational age at birth. Gestational weight gain category, birth mode, and postnatal age at measurement were not associated with BF%, FFM or fat mass. Conclusions We generated BF% and FFM centiles for healthy, term, singletons born in Germany; these are similar to those found in other European countries. Infant body composition at birth was associated with modifiable (pre-pregnancy body mass index, smoking), and given factors (gender, gestational age at birth, parity).
AU  - Wiechers, C.*
AU  - Kirchhof, S.*
AU  - Balles, L.*
AU  - Avelina, V.*
AU  - Weber, R.*
AU  - Maas, C.*
AU  - Pauluschke-Fröhlich, J.*
AU  - Hallschmid, M.
AU  - Preissl, H.
AU  - Fritsche, A.
AU  - Poets, C.F.*
AU  - Franz, A.R.*
C1  - 57636
C2  - 47873
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Neonatal body composition: Crossectional study in healthy term singletons in Germany.
JO  - BMC Pediatr.
VL  - 19
IS  - 1
PB  - Bmc
PY  - 2019
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - BACKGROUND: Feeding breast milk is associated with reduced morbidity and mortality, as well as improved neurodevelopmental outcome but does not meet the high nutritional requirements of preterm infants. Both plasma and urinary urea concentrations represent amino acid oxidation and low concentrations may indicate insufficient protein supply. This study assesses the effect of different levels of enteral protein on plasma and urinary urea concentrations and determines if the urinary urea-creatinine ratio provides reliable information about the protein status of preterm infants. METHODS: Sixty preterm infants (birthweight < 1500 g; gestational age < 32 weeks) were enrolled in a randomized controlled trial and assigned to either a lower-protein group (median protein intake 3.7 g/kg/d) or a higher-protein group (median protein intake 4,3 g/kg/d). Half the patients in the higher-protein group received standardized supplementation with a supplement adding 1.8 g protein/100 ml milk, the other half received individual supplementation depending on the respective mother's milk macronutrient content. Plasma urea concentration was determined in two scheduled blood samples (BS1; BS2); urinary urea and creatinine concentrations in weekly spot urine samples. RESULTS: The higher-protein group showed higher plasma urea concentrations in both BS1 and BS2 and a higher urinary urea-creatinine-ratio in week 3 and 5-7 compared to the lower-protein group. In addition, a highly positive correlation between plasma urea concentrations and the urinary urea-creatinine-ratio (p < 0.0001) and between actual protein intake and plasma urea concentrations and the urinary urea-creatinine-ratio (both p < 0.0001) was shown. CONCLUSIONS: The urinary urea-creatinine-ratio, just like plasma urea concentrations, may help to estimate actual protein supply, absorption and oxidation in preterm infants and, additionally, can be determined non-invasively. Further investigations are needed to determine reliable cut-off values of urinary urea concentrations to ensure appropriate protein intake. TRIAL REGISTRATION: Clinicaltrials.gov; NCT01773902 registered 15 January 2013, retrospectively registered.  
AU  - Mathes, M.*
AU  - Maas, C.*
AU  - Bleeker, C.*
AU  - Vek, J.*
AU  - Bernhard, W.*
AU  - Peter, A.
AU  - Poets, C.F.*
AU  - Franz, A.R.*
C1  - 53565
C2  - 44753
TI  - Effect of increased enteral protein intake on plasma and urinary urea concentrations in preterm infants born at < 32 weeks gestation and < 1500 g birth weight enrolled in a randomized controlled trial - a secondary analysis.
JO  - BMC Pediatr.
VL  - 18
IS  - 1
PY  - 2018
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - BACKGROUND: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. METHODS: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. RESULTS: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). CONCLUSIONS: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
AU  - Lundgren, M.*
AU  - Steed, L.J.*
AU  - Tamura, R.*
AU  - Jonsdottir, B.*
AU  - Gesualdo, P.*
AU  - Crouch, C.*
AU  - Sjöberg, M.*
AU  - Hansson, G.K.*
AU  - Hagopian, W.A.*
AU  - TEDDY Study Group (Ziegler, A.-G.)
AU  - Rewers, M.J.*
AU  - Lernmark, A.*
AU  - Toppari, J.*
AU  - She, J.X.*
AU  - Akolkar, B.*
AU  - Krischer, J.P.*
AU  - Haller, M.J.*
AU  - Elding Larsson, H.*
C1  - 51144
C2  - 43049
TI  - Analgesic antipyretic use among young children in the TEDDY study: No association with islet autoimmunity.
JO  - BMC Pediatr.
VL  - 17
IS  - 1
PY  - 2017
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - Background: Early childhood environmental exposures, possibly infections, may be responsible for triggering islet autoimmunity and progression to type 1 diabetes (T1D). The Environmental Determinants of Diabetes in the Young (TEDDY) follows children with increased HLA-related genetic risk for future T1D. TEDDY asks parents to prospectively record the child's infections using a diary book. The present paper shows how these large amounts of partially structured data were reduced into quantitative data-sets and further categorized into system-specific infectious disease episodes. The numbers and frequencies of acute infections and infectious episodes are shown. Methods: Study subjects (n = 3463) included children who had attended study visits every three months from age 3 months to 4 years, without missing two or more consecutive visits during the follow-up. Parents recorded illnesses prospectively in a TEDDY Book at home. The data were entered into the study database during study visits using ICD-10 codes by a research nurse. TEDDY investigators grouped ICD-10 codes and fever reports into infectious disease entities and further arranged them into four main categories of infectious episodes: respiratory, gastrointestinal, other, and unknown febrile episodes. Incidence rate of infections was modeled as function of gender, HLA-DQ genetic risk group and study center using the Poisson regression. Results: A total of 113,884 ICD-10 code reports for infectious diseases recorded in the database were reduced to 71,578 infectious episodes, including 74.0% respiratory, 13.1% gastrointestinal, 5.7% other infectious episodes and 7.2% febrile episodes. Respiratory and gastrointestinal infectious episodes were more frequent during winter. Infectious episode rates peaked at 6 months and began declining after 18 months of age. The overall infectious episode rate was 5.2 episodes per person-year and varied significantly by country of residence, sex and HLA genotype. Conclusions: The data reduction and categorization process developed by TEDDY enables analysis of single infectious agents as well as larger arrays of infectious agents or clinical disease entities. The preliminary descriptive analyses of the incidence of infections among TEDDY participants younger than 4 years fits well with general knowledge of infectious disease epidemiology. This protocol can be used as a template in forthcoming time-dependent TEDDY analyses and in other epidemiological studies.
AU  - Lönnrot, M.*
AU  - Lynch, K.*
AU  - Larsson, H.E.*
AU  - Lernmark, A.*
AU  - Rewers, M.*
AU  - Hagopian, W.*
AU  - She, J.*
AU  - Simell, O.*
AU  - Ziegler, A.-G.
AU  - Akolkar, B.*
AU  - Krischer, J.*
AU  - Hyoty, H.*
AU  - TEDDY Study Group (Beyerlein, A.
AU  - Hummel, M.
AU  - Hummel, S.
AU  - Knopff, A.
AU  - Peplow, C.
AU  - Roth, R.
AU  - Schenkel, J.
AU  - Stock, J.
AU  - Strauss, E.
AU  - Warncke, K.
AU  - Winkler, C.)
C1  - 44396
C2  - 36913
CY  - London
TI  - A method for reporting and classifying acute infectious diseases in a prospective study of young children: TEDDY.
JO  - BMC Pediatr.
VL  - 15
IS  - 1
PB  - Biomed Central Ltd
PY  - 2015
SN  - 1471-2431
ER  - 

TY  - JOUR
AB  - BackgroundVitamin D is well recognized for its role in skeletal health and its involvement in the modulation of the immune system. In the literature, controversial results are reported for atopic diseases. Thus, we investigated the association between vitamin D status and the prevalence of atopic diseases.MethodsSerum 25-hydroxy-vitamin D (25(OH)D) concentrations were measured in a sample of 2815 10-years old children from two German birth cohort studies. Self-reported physician-diagnosed eczema, hay fever or allergic rhinitis, and asthma were used as outcome variables as well as specific IgE positivity against common allergens. We applied logistic regression models, deriving adjusted odds ratio estimates (aOR) and 95% confidence intervals (CI).ResultsFor asthma and hay fever or allergic rhinitis, no associations existed with serum 25(OH)D concentrations. We observed a significant positive relationship between serum 25(OH)D levels and eczema at age 10 (aOR¿=¿1.09, CI¿=¿1.01-1.17, per 10 nmol/l increase in serum 25(OH)D levels) and for the lifetime prevalence of eczema (aOR¿=¿1.05, CI¿=¿1.01-1.09). Specific IgE positivity for food allergens (aOR¿=¿1.07, CI¿=¿1.02-1.11) and aeroallergens (aOR¿=¿1.05, CI¿=¿1.01-1.08) at age 10, as well as lifetime prevalence, was significantly related to the vitamin D status.ConclusionIn this study we found no indication that higher blood 25(OH)D levels are associated with decreased risk for any of the atopic outcomes in children. However, we observed a positive association of serum 25(OH)D concentrations with eczema and detectable specific IgE. Due to the given limitations of our study, the clinical relevance of these findings needs further clarification.
AU  - Wawro, N.
AU  - Heinrich, J.
AU  - Thiering, E.
AU  - Kratzsch, J.*
AU  - Schaaf, B.*
AU  - Hoffmann, B.*
AU  - Lehmann, I.*
AU  - Bauer, C.P.*
AU  - Koletzko, S.*
AU  - von Berg, A.*
AU  - Berdel, D.*
AU  - Linseisen, J.
C1  - 42972
C2  - 35902
TI  - Serum 25(OH)D concentrations and atopic diseases at age 10: Results from the GINIplus and LISAplus birth cohort studies.
JO  - BMC Pediatr.
VL  - 14
IS  - 1
PY  - 2014
SN  - 1471-2431
ER  -