Childhood type 1 diabetes: an environment-wide association study across England

Area of Science:

• Environmental Epidemiology
• Public Health
• Pediatric Endocrinology

Background:

• Type 1 diabetes is an autoimmune disease impacting approximately 400,000 individuals in the UK.
• Environmental factors are suspected to trigger type 1 diabetes in genetically susceptible individuals.
• Understanding these environmental triggers is crucial for prevention and intervention strategies.

Purpose of the Study:

• To investigate associations between a wide array of environmental factors and childhood type 1 diabetes incidence in England.
• To generate hypotheses regarding potential environmental triggers for type 1 diabetes.
• To utilize an agnostic, ecological environment-wide association study (EnWAS) approach.

Main Methods:

• Ecological study design at the local authority district (LAD) level.
• Utilized a national dataset of 13,948 children (0-9 years) diagnosed with type 1 diabetes from 2000-2011.
• Assessed associations using Poisson regression, disease mapping, and ecological regression with 53 demographic and environmental variables.

Main Results:

• Fifteen of 53 factors showed significant associations with type 1 diabetes incidence after multiple testing adjustments.
• Inverse associations were observed with air pollutants (particulate matter, NO2, NOx, CO).
• Significant associations were also found with lead in soil, radon, outdoor light at night, overcrowding, population density, ethnicity, Index of Multiple Deprivation, and radon potential.

Conclusions:

• The study identified numerous demographic and environmental factors associated with childhood type 1 diabetes in England.
• Findings suggest a complex interplay between the environment and type 1 diabetes development.
• Further research is warranted to confirm these associations and elucidate causal pathways.