The role of age and excess body mass index in progression to type 1 diabetes in at-risk adults

Ferrara, CT; Geyer, SM; Evans-Molina, C; Libman, IM; Becker, DJ; Wentworth, JM; Moran, A; Gitelman, SE; Redondo, MJ; Type 1 Diabetes TrialNet Study Group,

Author(s): Ferrara, CT; Geyer, SM; Evans-Molina, C; Libman, IM; Becker, DJ; Wentworth, JM; Moran, A; Gitelman, SE; Redondo, MJ; Type 1 Diabetes TrialNet Study Group,;
Details: Publication Year 2017-12-01,Volume 102,Issue #12,Page 4596-4603
Journal Title: Journal of Clinical Endocrinology & Metabolism
Publication Type: Journal Article
Abstract: Background: Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. Objective: To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Research Design and Methods: Longitudinally accumulated BMI >25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values >/=0 kg/m2 and >/=5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. Results: In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of >35 years that reduced risk for type 1 diabetes. In men age >35 years and women age <35 years, sustained obesity (ceBMI >/=5 kg/m2) increased the risk for type 1 diabetes. Conclusions: Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology.
Publisher: Endocrine Society
Research Division(s): Population Health And Immunity
PubMed ID: 29092051
Publisher's Version: https://doi.org/10.1210/jc.2017-01490
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2018-02-14 04:25:22

Last Modified: 2018-02-14 04:29:05