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Perinatal and childhood risk factors for early-onset type 1 diabetes: a population-based case-control study in Taiwan
Hsin-Yu Lee1, Chin-Li Lu2, Hua-Fen Chen3
11 Department and Graduate Institute of Public Health, College of Medical, National Cheng-Kung University, Tainan, Taiwan.
Insights
Childhood infections and Caesarean sections are linked to higher type 1 diabetes (T1D) risk. Modifiable perinatal factors may influence T1D incidence in young children.
Area of Science:
- Pediatrics
- Endocrinology
- Epidemiology
Background:
- Increasing incidence of childhood type 1 diabetes (T1D).
- Suspected contribution of perinatal and childhood factors to T1D trends.
Purpose of the Study:
- Investigate relationships between perinatal/childhood risk factors and T1D incidence in children under 10.
- Identify key risk factors for early-onset T1D.
Main Methods:
- Nested case-control study design.
- Utilized claim data from 1,478,573 live births in Taiwan (2000-2005).
- Analyzed 632 T1D cases and 10 matched controls per case using conditional logistic regression.
Main Results:
- Childhood infection significantly increased T1D risk (OR=1.46).
- Maternal factors: younger mothers (<25 yrs), Caesarean section (CS), and gestational diabetes mellitus (GDM) were associated with higher T1D risk.
- Paternal factors: older fathers (>30 yrs) and paternal diabetes (T1D or T2D) increased offspring T1D risk.
Conclusions:
- Childhood infections and Caesarean sections are modifiable perinatal factors potentially predisposing to T1D.
- Early identification of these risk factors may aid in T1D prevention strategies.
Background:
Certain factors originating from the perinatal and childhood periods are suspected of contributing to the recent increasing trend of childhood type 1 diabetes (T1D) incidence. This study sought to investigate the relationships between various perinatal and childhood risk factors and T1D incidence in young children (<10 years).
Methods:
We used a nested case-control design based on 1,478,573 live births born in 2000-05 in Taiwan. Cases were 632 incident cases of T1D between 2000 and 2008. Ten matched controls for each case were randomly selected. Information on various perinatal risk factors was also identified from claim data. Multiple conditional logistic regression was employed to estimate odds ratio (OR) and 95 confidence interval (CI) of T1D.
Results:
Childhood infection was significantly associated with an increased risk of T1D (OR = 1.46, 95% CI = 1.23-1.73). Increased risk of T1D was also noted in children born to younger mothers (<25 years) (OR = 1.94, 95% CI = 1.34-2.81), older fathers (>30 years) (OR = 1.56 (95% CI = 1.16-2.10) to 1.57 (95% CI = 1.19-2.05), mothers with Caesarean section (CS) (OR = 2.35, 95% CI = 1.52-3.64), and mothers with gestational diabetes mellitus (OR = 4.36, 95% CI = 2.76-7.77). Fathers with T1D (OR = 7.36, 95% CI = 1.02-57.21) or type 2 diabetes (OR = 1.54, 95% CI = 1.04-2.26) were observed to substantially increase the risk of offspring T1D.
Conclusions:
Certain modifiable perinatal factors such as infection and CS may predispose incidence of T1D in young children.
