Excess BMI in Childhood: A Modifiable Risk Factor for Type 1 Diabetes Development?

• Published in: Diabetes care Vol. 40; no. 5; pp. 698 - 701
• Main Authors: Ferrara, Christine Therese, Geyer, Susan Michelle, Liu, Yuk-Fun, Evans-Molina, Carmella, Libman, Ingrid M., Besser, Rachel, Becker, Dorothy J., Rodriguez, Henry, Moran, Antoinette, Gitelman, Stephen E., Redondo, Maria J.
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.05.2017
• Subjects: Adolescent; Age; Age Factors; Body mass; Body Mass Index; Child; Child, Preschool; Childhood; Children; Children & youth; Childrens health; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - etiology; Female; Females; Health risks; Humans; Male; Males; Multivariate Analysis; Novel Communications in Diabetes; Pediatric Obesity - complications; Pediatrics; Research design; Risk assessment; Risk Factors; Sex; Sex Factors; Thresholds
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc16-2331

We aimed to determine the effect of elevated BMI over time on the progression to type 1 diabetes in youth. We studied 1,117 children in the TrialNet Pathway to Prevention cohort (autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI above the 85th age- and sex-adjusted percentile generated a cumulative excess BMI (ceBMI) index. Recursive partitioning and multivariate analyses yielded sex- and age-specific ceBMI thresholds for greatest type 1 diabetes risk. Higher ceBMI conferred significantly greater risk of progressing to type 1 diabetes. The increased diabetes risk occurred at lower ceBMI values in children <12 years of age compared with older subjects and in females versus males. Elevated BMI is associated with increased risk of diabetes progression in pediatric autoantibody-positive relatives, but the effect varies by sex and age.