Infant anthropometry, early life infection, and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study
Ponsonby, AL and Pezic, A and Cochrane, J and Cameron, FJ and Pascoe, M and Kemp, A and Dwyer, T, Infant anthropometry, early life infection, and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study, Pediatric Diabetes, 12, (4) pp. 313-321. ISSN 1399-543X (2011) [Refereed Article]
Background: Higher birthweight is associated with increased type 1 diabetes
mellitus (T1DM) risk, but the contribution of higher adiposity or lean mass is
unclear. In this Tasmanian infant cohort, early upper respiratory infection has
been associated with higher asthma risk.
Patients and methods: Eligible infants represented one-fifth of live births in
Tasmania, 19881995. Hospital interview data (day 6) were obtained on
96.3% (10 628/11 040), home (5 wk) visit data (38 d) on 92.9% (9876/10 628) of
those, then a phone (12 wk) interview (87 d). Tricep and subscapular skinfold
measures and upper arm circumference were recorded at the first two
interviews. T1DM cases (n = 26) arising from the age of 16 or under in
Tasmania from 1988 to 2006 were ascertained.
Results: Higher birthweight [adjusted odds ratio (AOR) 2.82 (95% CI
1.316.09)], lean mid-upper arm circumference [AOR 1.76 (95% CI
1.162.66)], not skinfold measures, were associated with T1DM risk. Children
with an early upper respiratory tract infection by 5-wk visit [AOR 2.74 (95%
CI 1.196.32)] or ear infection by 12-wk interview [AOR 3.44 (95% CI
1.0011.79)] were also at higher risk. Putative markers of altered microbial
exposure such as resident density were not associated with T1DM risk but the
effect of increasing birth order on T1DM risk differed for older (AOR 0.41,
p = 0.02) than young mother (AOR 2.45, p = 0.01); difference in effect,
p = 0.001.
Conclusion: In this cohort, early upper respiratory tract infection was
associated with T1DM risk, as had been previously found for asthma,
consistent with immunoinflammatory upregulation. Using the detailed
anthropometric measures available, the link between higher birthweight and
T1DM did not appear to reflect increased adiposity.