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Children developing type 1 diabetes before 6 years of age have increased linear growth independent of HLA genotypes
H Elding Larsson1, G Hansson, A Carlsson
1Department of Clinical Sciences, Malmö-Paediatrics, University Hospital MAS, Ing. 72 Hus 91, Plan 10, SE-205 02, Malmö, Sweden. helena.larsson@med.lu.se
Insights
Children who develop type 1 diabetes show increased birth length and height gain in early life, particularly those with specific human leukocyte antigen (HLA) genotypes. These growth patterns may indicate early diabetes risk.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Type 1 diabetes risk is linked to high birth weight and accelerated childhood growth.
- Human leukocyte antigen (HLA) genotypes associated with type 1 diabetes may influence relative birth weight.
Purpose of the Study:
- To investigate if children who later develop type 1 diabetes exhibit increased birth size (weight/length), height development, or body mass index (BMI) in the first 18 months.
- To determine if these growth parameters correlate with HLA genotypes or mid-parental height (MPH).
Main Methods:
- A case-control study involving 58 children with type 1 diabetes and 155 controls.
- Data collected included birthweight, birth length, weight, and height.
- Participants were matched for HLA status or not, within the Diabetes Prediction in Skåne study.
Main Results:
- Children who developed type 1 diabetes had increased birth length standard deviation scores (SDS) corrected for MPH, especially compared to non-HLA-matched controls.
- These children also showed significantly greater height gain between 0 and 18 months.
- Diabetic children were taller (MPH-corrected) from 6 to 18 months, but BMI was not significantly different.
Conclusions:
- Birth length SDS is associated with HLA-related type 1 diabetes risk.
- While high-risk HLA may influence prenatal growth, other factors contribute to increased postnatal linear growth in children who develop type 1 diabetes.
- Early growth patterns, particularly height, may serve as potential indicators for type 1 diabetes risk.
Aims/Hypothesis:
High birthweight and increased childhood growth are risk factors for type 1 diabetes. Relative birthweight is associated with HLA genotypes that confer a high risk of diabetes. Our aims were to test whether young children prior to clinical onset of type 1 diabetes have increased: (1) birthweight or birth length standard deviation scores (SDS); (2) height development SDS; or (3) BMI SDS during first 18 months of life and whether these parameters are related to HLA genotypes or mid-parental height (MPH).
Methods:
Birthweight, birth length, weight and height were obtained from 58 type 1 diabetes children and 155 controls matched for HLA or not in the Diabetes Prediction in Skåne study.
Results:
Birth length SDS corrected for MPH was increased in children developing diabetes compared with all (p < 0.048) and with non-HLA- (p < 0.050) but not with HLA-matched controls. Children developing diabetes had increased height gain at 0 to 18 months of age (p < 0.005). Diabetic children were significantly taller from 6 to 18 months of age when correcting for MPH compared with non-HLA-matched as well as HLA-matched controls, but BMI was not increased.
Conclusions/Interpretation:
Birth length SDS was associated with diabetes risk HLA. When corrected for MPH, children developing diabetes were taller at birth than non-HLA- but not taller than HLA-matched controls. Diabetic children had increased MPH-corrected height up to 18 months of age compared with both HLA- and non-HLA-matched controls. High-risk HLA affects prenatal growth, but other factors may explain the increased postnatal linear growth in children developing diabetes.
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