Vitamin D levels at birth and risk of type 1 diabetes in childhood: a case-control study
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Published on: July 5, 2022
Francesco Cadario1,2, Silvia Savastio1,2, Veronica Pagliardini3
1Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
Insights
Vitamin D levels at birth were not linked to type 1 diabetes risk in children up to age 10. However, lower vitamin D in migrant newborns showed a higher risk, suggesting a potential ethnic modifier effect.
Area of Science:
- Pediatric Endocrinology
- Nutritional Immunology
- Public Health
Background:
- Type 1 diabetes (T1D) is an autoimmune disease with increasing incidence globally.
- Vitamin D is a crucial immunomodulator, and its role in T1D pathogenesis is under investigation.
- Neonatal vitamin D status may influence T1D risk, particularly in diverse populations.
Purpose of the Study:
- To investigate the association between cord blood vitamin D levels and the risk of developing T1D in children up to 10 years of age.
- To explore whether ethnic background modifies the relationship between neonatal vitamin D and T1D risk.
Main Methods:
- A case-control study utilizing linked Piedmont Diabetes Registry and Newborn Screening data.
- Inclusion of 67 children with T1D onset by age 10 and 236 matched controls.
- Measurement of 25-hydroxyvitamin D3 from neonatal blood spots using tandem mass spectrometry.
Main Results:
- No significant association was found between vitamin D levels at birth and overall T1D risk (OR=0.78, 95% CI 0.56-1.10).
- Vitamin D levels were significantly lower in migrant newborns compared to Italian newborns (p < 0.0001).
- A significant interaction between vitamin D and migrant status was observed (p = 0.04). Migrant newborns with low vitamin D (< 2.14 ng/ml) had a 14-fold increased T1D risk (OR=14.02), while no association was seen in Italian newborns.
Conclusions:
- Neonatal vitamin D sufficiency does not appear to be a major determinant of T1D risk in the general population up to age 10.
- A significantly elevated T1D risk was observed in migrant newborns with low vitamin D levels at birth.
- These findings suggest a potential role for vitamin D supplementation in specific high-risk ethnic subgroups, warranting further investigation.
Aims:
To assess whether vitamin D levels at birth were associated with risk of having type 1 diabetes up to 10 years of age and the potential modifier effect of ethnic group.
Methods:
The Piedmont Diabetes Registry and the Newborn Screening Regional data were linked to identify cases (n = 67 incident children aged ≤10 years at diabetes onset, 2002-2012) and up to five controls (n = 236) matched for birthday and ethnic group. Cards with neonatal blood spot were used and 25-hydroxyvitamin D(3) assessed with tandem mass spectroscopy.
Results:
In conditional logistic regression, OR for unit increment of log vitamin D was 0.78 (95 % CI 0.56-1.10). Vitamin D was significantly lower in migrant than in Italian control newborn babies (p < 0.0001), and interaction between vitamin D and migrant status was statistically significant (p = 0.04). Compared to migrant newborns babies with vitamin D ≥ 2.14 ng/ml, migrants with lower levels had an OR of 14.02 (1.76-111.70), whereas no association was evident in Italians.
Conclusions:
Our case-control study within the Piedmont Diabetes Registry showed no association between vitamin D levels at birth and risk of having type 1 diabetes up to 10 years of age, apart from the subgroup of migrant babies, which might have clinical implications if confirmed.
