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Association between childhood obesity and subsequent Type 1 diabetes: a systematic review and meta-analysis
K C Verbeeten1, C E Elks, D Daneman
1Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Insights
Childhood obesity is linked to a higher risk of developing Type 1 diabetes. Preventing obesity may help reduce Type 1 diabetes incidence.
Area of Science:
- Endocrinology
- Pediatrics
- Epidemiology
Background:
- Childhood obesity is a growing public health concern.
- Type 1 diabetes is a chronic autoimmune condition affecting children.
- The relationship between childhood obesity and Type 1 diabetes risk requires further investigation.
Purpose of the Study:
- To systematically review and synthesize existing research on the association between childhood obesity and the risk of developing Type 1 diabetes.
- To evaluate the strength and consistency of evidence linking childhood obesity to subsequent Type 1 diabetes.
Main Methods:
- A systematic search of the PubMed database was conducted.
- Studies included used childhood obesity metrics (BMI, %weight-for-height) as exposure and Type 1 diabetes as outcome.
- Inclusion criteria required obesity assessment to precede Type 1 diabetes diagnosis.
Main Results:
- Nine studies (8 case-control, 1 cohort) involving 2658 cases were analyzed.
- Seven studies found a significant association between childhood obesity and increased Type 1 diabetes risk.
- Meta-analyses indicated a pooled odds ratio of 2.03 for categorical obesity and 1.25 per standard deviation increase in BMI for Type 1 diabetes risk.
Conclusions:
- Evidence supports an association between childhood obesity and an elevated risk of subsequent Type 1 diabetes.
- Potential causal mechanisms linking obesity and Type 1 diabetes are being explored.
- Preventing childhood obesity may offer an additional benefit of reducing Type 1 diabetes incidence.
Aims:
To review and synthesize the published evidence on the possible association between childhood obesity and the subsequent risk of Type 1 diabetes.
Methods:
The PubMed database was systematically searched for studies using childhood obesity, BMI or %weight-for-height as the exposure variable and subsequent Type 1 diabetes as the outcome. Studies were only included if assessment of obesity preceded the diagnosis of Type 1 diabetes.
Results:
Eight case-control studies and one cohort study were included, comprising a total of 2658 cases. Of these nine studies, seven reported a significant association between childhood obesity, BMI or %weight-for-height and increased risk for Type 1 diabetes. Meta-analysis of the four studies that reported childhood obesity as a categorical exposure produced a pooled odds ratio of 2.03 (95% CI 1.46-2.80) for subsequent Type 1 diabetes; however, in those studies, age at obesity assessment varied from age 1 to 12 years. A dose-response relationship was supported by a continuous association between childhood BMI and subsequent Type 1 diabetes in a meta-analysis of five studies (pooled odds ratio 1.25 (95%CI 1.04-1.51) per 1 sd higher BMI).
Conclusion:
There is overall evidence for an association between childhood obesity, or higher BMI, and increased risk of subsequent Type 1 diabetes. Several theories have been proposed for a causal relationship. Reduction in Type 1 diabetes should be considered as a potential additional benefit of preventing childhood obesity.
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