0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Infant Growth and Risk of Childhood-Onset Type 1 Diabetes in Children From 2 Scandinavian Birth Cohorts Online Only

Maria C. Magnus, PhD1; Sjurdur F. Olsen, MD, PhD2; Charlotta Granström, MSc2; Geir Joner, MD, PhD3,4; Torild Skrivarhaug, MD, PhD4; Jannet Svensson, MD, PhD5; Jesper Johannesen, MD, PhD5; Pål Njølstad, MD, PhD6,7; Per Magnus, MD, PhD8; Ketil Størdal, MD, PhD1,9; Lars C. Stene, PhD1
[+] Author Affiliations
1Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
2Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
3Institute of Clinical Medicine, University of Oslo, Oslo, Norway
4Department of Pediatrics, Oslo University Hospital, Oslo, Norway
5Department of Pediatrics, Copenhagen University Hospital, Herlev, Denmark
6Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
7KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
8Institute Management and Staff, Norwegian Institute of Public Health, Oslo, Norway
9Department of Pediatrics, Ostfold Hospital Trust, Fredrikstad, Norway
JAMA Pediatr. 2015;169(12):e153759. doi:10.1001/jamapediatrics.2015.3759.
Text Size: A A A
Published online

Importance  Type 1 diabetes mellitus is one of the most common chronic diseases with onset in childhood, but environmental risk factors have not been convincingly established.

Objective  To test whether increased growth during the first year of life is associated with higher risk of childhood-onset type 1 diabetes.

Design, Setting, and Participants  This is a cohort study using information from 2 population-based cohort studies in Norway and Denmark, the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC), of children born between February 1998 and July 2009. The current study was conducted between November 2014 and June 2015.

Exposures  Change in weight and length from birth to age 12 months.

Main Outcomes and Measures  Unadjusted and adjusted hazard ratios (HRs) of type 1 diabetes, classified based on nationwide childhood diabetes registers, obtained using Cox proportional hazards regression.

Results  A total of 99 832 children were included in the study, with 59 221 in MoBa (51.2% boys and 48.8% girls; mean age at end of follow-up, 8.6 years [range, 4.6-14.2 years]) and 40 611 in DNBC (50.6% boys and 49.4% girls; mean age at end of follow-up, 13.0 years [range, 10.4-15.7 years]). The incidence rate of type 1 diabetes from age 12 months to the end of follow-up was 25 cases per 100 000 person-years in DNBC and 31 cases per 100 000 person-years in MoBa. The change in weight from birth to 12 months was positively associated with type 1 diabetes (pooled unadjusted HR = 1.24 per 1-SD increase; 95% CI, 1.11-1.39; pooled adjusted HR = 1.24 per 1-SD increase; 95% CI, 1.09-1.41). There was no significant association between length increase from birth to 12 months and type 1 diabetes (pooled unadjusted HR = 1.06 per 1-SD increase; 95% CI, 0.93-1.22; pooled adjusted HR = 1.06 per 1-SD increase; 95% CI, 0.86-1.32). The associations were similar in both sexes.

Conclusions and Relevance  This is the first prospective population-based study, to our knowledge, providing evidence that weight increase during the first year of life is positively associated with type 1 diabetes. This supports the early environmental origins of type 1 diabetes.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Place holder to copy figure label and caption
Figure.
Formation of the Analysis Sample

A, Children in the Norwegian Mother and Child Cohort Study (MoBa). In MoBa, a total of 2545 children were excluded because they were stillborn, were aborted, or had unknown birth outcome, and 3842 live-born children were excluded because they were from multiple births. B, Children in the Danish National Birth Cohort (DNBC). In DNBC, a total of 6303 children were excluded because they were stillborn, were aborted, or had unknown birth outcome, and 4163 live-born children were excluded because they were from multiple births.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

1,139 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Diabetes, Foot Ulcer

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Clarifying Your Question

brightcove.createExperiences();