The Contribution of BMI to a Young Child’s Risk of Islet Autoimmunity Is Dependent on HLA-DR4-DQ8 Without HLA-DR3-DQ2
Authors' conclusion
The contribution of BMI to risk of IA during early childhood is dependent on the HLA-DR-DQ genotype more so than the first-appearing IA phenotype.
Study context
- Population
- Children at risk for islet autoimmunity (IA) with at least three BMI measurements in the The Environmental Determinants of Diabetes in the Young (TEDDY) study7,724 children identified
- Participants
- 7,724 / 6,396 / 4,732
- Exposure
- BMI z score and change in BMI vs risk of islet autoimmunity (IA) by age period
- Infancyn = 7,724
- Early childhoodn = 6,396
- Pubertyn = 4,732
- Outcome
- Risk of IA (IAA-first, GADA-first and IA overall) by BMI z score
Methodological detailsjoint modeling of longitudinal BMI and time-to-event IA
- Joint modeling of longitudinal BMI and time-to-event IA
Main finding
As reported in the abstract
Infant's BMI z score not associated with IA risk before 18 months of age (n = 185)
HR 1.03
95% CI 0.88, 1.19
Child's BMI and increased risk of IA from 1.5 to 8.5 years of age (n = 470)
HR 1.20
95% CI 1.04, 1.32
Child's BMI and increased risk of IA from 8.5 to 15 years of age (n = 209)
HR 1.27
95% CI 1.09, 1.49
Observational data: associations, not effects.
Further findings
Interaction with first-appearing IA phenotypes
- No interactions with first-appearing IA phenotypes were observed
High BMI z score (SD >0.5) from age 9 months and IA in early childhood by HLA genotype
- Increased IA risk specifically with HLA-DR4/4 or HLA-DR4/8, not HLA-DR3/3 or HLA-DR3/4; HLA ∗ BMI interaction
- P < 0.005
Original publication
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