Article

DPV Scientific Initiative of Germany and Austria, The ‘accelerator hypothesis': relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus

University Children's Hospital, University of Erlangen-Nuremberg, Loschgestr.15, 91054, Erlangen, Germany.
Diabetologia (Impact Factor: 6.88). 01/2006; 48(12):2501-4. DOI: 10.1007/s00125-005-0033-2
Source: PubMed

ABSTRACT The aim of this study was to investigate whether either increased weight or BMI are associated with the earlier manifestation of type 1 diabetes mellitus in children.
We evaluated anthropometric measurements in a large cohort of 9,248 patients of European extraction who were diagnosed in the years 1990-2003 in 116 pediatric clinics throughout Germany and Austria.
Patients were divided into four groups according to age (0-4.9 years, 5-9.9 years, 10-14.9 years and 15-20 years). Significantly higher standard deviation scores (SDSs) for weight and BMI at diabetes onset were found for both boys and girls in the three younger age groups (up to 14.9 years of age) compared with the reference population (p<0.00001). In addition, the BMI SDS and the weight SDS were significantly higher in the 0-4.9-years age group than in all other groups (p<0.00001), and BMI SDS at onset gradually decreased with increasing age at manifestation (p<0.0001). Over the >10-year study period, there was a continuous rise in the weight-SDS and the BMI-SDS in the cohort (p<0.0001), especially in the 5-9.9-years and the 10-14.9-years age groups. Multivariate analysis revealed a significant influence of male sex and of year of manifestation on BMI SDS (p<0.0001) and demonstrated a negative association between the patients' BMI SDS and age at diagnosis, with a mean annual decrease in BMI SDS of -0.0248 (95% CI -0.0294 to -0.0202, p<0.0001).
A higher BMI was associated with a younger age at diabetes onset. Increased weight gain could therefore be a risk factor for the early manifestation of type 1 diabetes.

Download full-text

Full-text

Available from: Reinhard Holl, Aug 11, 2014
0 Followers
 · 
106 Views
  • Source
    • "). This hypothesis is heavily debated, with evidence emerging on both sides (Dabelea et al. 2006; Knerr et al. 2005). A comprehensive review and criticism of the accelerator hypothesis was recently published (Fourlanos et al., 2008; Gale 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated geographic variation in type 1 and type 2 diabetes mellitus (T1DM, T2DM) in four regions of the United States. Data on 807 incident T1DM cases diabetes and 313 T2DM cases occurring in 2002-03 in South Carolina (SC) and Colorado (CO), 5 counties in Washington (WA), and an 8 county region around Cincinnati, Ohio (OH) among youth aged 10-19 years were obtained from the SEARCH for Diabetes in Youth Study. Geographic patterns were evaluated in a Bayesian framework. Incidence rates differed between the study regions, even within race/ethnic groups. Significant small-area variation within study region was observed for T1DM and T2DM. Evidence for joint spatial correlation between T1DM and T2DM was present at the county level for SC (r(SC)=0.31) and CO non-Hispanic Whites (r(CO)=0.40) and CO Hispanics (r(CO)=0.72). At the tract level, no evidence for meaningful joint spatial correlation was observed (r(SC)=-0.02; r(CO)=-0.02; r(OH)=0.03; and r(WA=)0.09). Our study provides evidence for the presence of both regional and small area, localized variation in type 1 and type 2 incidence among youth aged 10-19 years in the United States.
    Health & Place 05/2010; 16(3):547-56. DOI:10.1016/j.healthplace.2009.12.015 · 2.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Les dépôts amyloïdes représentent l'altération la plus typique des îlots pancréatiques chez les personnes atteintes de diabète de type 2 (non-insulino-dépendant) et chez les chats diabétiques. Après avoir rappelé les définitions et les classifications du diabète sucré et de l'amyloïdose, les mécanismes de formation des dépôts amyloïdes dans le pancréas à partir de l'amyline (ou Insular Amyloid PolyPepide) sont exposés. Après présentation des différentes étiologies du diabète sucré, l'implication de l'amyloïdose est envisagée dans chaque mécanisme physiologique et ses possibles altérations conduisant au développement de cette affection. Les conséquences de ces observations sur la population des chats diabétiques sont évoquées. La dernière partie aborde la démarche diagnostique du diabète sucré chez le chat et intègre dans la démarche thérapeutique classique la possibilité de prévention des dépôts amyloïdes.
  • Source
Show more