Early-Life Factors Associated With Adult-Onset Type 1 Diabetes: A Swedish Nationwide Cohort and Family-Based Study

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Care Pub Date : 2024-07-24 DOI:10.2337/dc24-0896
Coralie Amadou, Yuxia Wei, Maria Feychting, Sofia Carlsson
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Abstract

OBJECTIVE Childhood-onset type 1 diabetes (T1D) is associated with perinatal factors, but data related to adult-onset T1D are scarce. This study aimed at investigating the association between early-life factors and adult-onset T1D in a Swedish nationwide cohort and family-based study. RESEARCH DESIGN AND METHODS We included 1,813,415 individuals aged ≥18 years, born in Sweden 1983 to 2002, followed until 2020. T1D diagnosis (n = 3,283) was identified from the National Diabetes, Patient and Prescribed Drugs Registers, and perinatal exposures were obtained from the Medical Birth Register. We performed Cox proportional hazard (hazard ratio [95% CI]) regression with mutual adjustment for perinatal exposures, sex, birth year, and parental sociodemographic background and history of diabetes. We also compared T1D risks among siblings’ groups identified from the Multiple Generation Register. RESULTS The incidence rate of adult-onset T1D was 18.8 per 100,000 person-years. Year of birth (1.06 [1.01–1.10], per five additional years) and history of maternal (4.10 [3.09–5.43]) and paternal (6.24 [5.10–7.64]) T1D were associated with a higher incidence of adult-onset T1D, whereas female sex (0.69 [0.64–0.74]) and having parents born outside Sweden were associated with a lower incidence. Regarding perinatal exposures, only non–full-term birth (<39 weeks vs. ≥39 weeks) was associated with a higher incidence of adult-onset T1D (1.12 [1.04–1.22]). The sibling cohort results were consistent with the full cohort analysis. CONCLUSIONS Perinatal factors seem to play a minor role in the development of adult-onset T1D compared with childhood-onset T1D, suggesting that triggers or accelerators of autoimmunity occurring later in life are more significant.
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与成年 1 型糖尿病相关的早期生活因素:瑞典全国队列和家庭研究
目的 儿童期发病的 1 型糖尿病(T1D)与围产期因素有关,但成年期发病的 1 型糖尿病相关数据却很少。本研究旨在通过一项瑞典全国性队列和家庭研究,调查早期生活因素与成年后发病的 T1D 之间的关系。研究设计和方法 我们纳入了 1,813,415 名年龄≥18 岁、1983 年至 2002 年出生在瑞典的个体,并跟踪调查至 2020 年。T1D诊断(n = 3,283)来自全国糖尿病、患者和处方药登记册,围产期暴露来自出生医学登记册。我们对围产期暴露、性别、出生年份、父母的社会人口背景和糖尿病史进行了Cox比例危险(危险比[95% CI])回归,并进行了相互调整。我们还比较了多代登记册中确定的兄弟姐妹群体的 T1D 风险。结果 成人型 T1D 的发病率为每 10 万人年 18.8 例。出生年份(1.06 [1.01-1.10],每增加 5 年)、母系(4.10 [3.09-5.43])和父系(6.24 [5.10-7.64])T1D 病史与成人型 T1D 的高发病率有关,而女性(0.69 [0.64-0.74])和父母在瑞典以外出生则与低发病率有关。在围产期暴露方面,只有非足月产(<39周与≥39周)与成人发病率较高有关(1.12 [1.04-1.22])。同胞队列结果与全队列分析结果一致。结论 与儿童期发病的 T1D 相比,围产期因素在成人期发病的 T1D 中似乎作用较小,这表明晚期发生的自身免疫诱因或加速因素更为重要。
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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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