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Warncke, K. ; Tamura, R.* ; Schatz, D.A.* ; Veijola, R.* ; Steck, A.K.* ; Akolkar, B.* ; Hagopian, W.* ; Krischer, J.P.* ; Lernmark, Å.* ; Rewers, M.J.* ; Toppari, J.* ; McIndoe, R.* ; Ziegler, A.-G. ; Vehik, K.* ; Haller, M.J.* ; Elding Larsson, H.*

The influence of pubertal development on autoantibody appearance and progression to type 1 diabetes in the TEDDY Study.

J. Endocr. Soc. 8:bvae103 (2024)

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CONTEXT: The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty. OBJECTIVE: We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes. METHODS: The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios. RESULTS: Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes. CONCLUSION: Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Diabetes ; Insulin Resistance ; Type 1 Diabetes ; β-cell; Insulin-resistance; Environmental Determinants; Self-assessment; Young Teddy; Children; Risk; Age; Maturation; Onset

ISSN (print) / ISBN 2472-1972

e-ISSN 2472-1972

Journal Journal of the Endocrine Society

Quellenangaben Volume: 8, Issue: 7, Article Number: bvae103

Publisher Endocrine Society

Publishing Place 2055 L St Nw, Suite 600, Washington, Dc 20036 Usa

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Diabetes Research (IDF)

Grants Barbara Davis Center for Childhood Diabetes
Colorado Clinical Center: Marian Rewers, MD
University of Colorado
National Institute of Diabetes and Digestive and Kidney Diseases