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Introduction
My main research interest is epidemiological approaches to identify risk factors for type 1 diabetes with the long term goal of identifying preventive interventions. I also do related work on celiac disease risk factors, as well as epidemiology of complications of type 1 diabetes and descriptive epidemiology of type 2 diabetes
Skills and Expertise
Publications
Publications (259)
Aim: To clarify whether SARS-CoV-2 infection or vaccination contribute to risk of type 1 diabetes or more severe diabetes onset in children and young adults.
Methods: We analysed cohorts of population-wide registries of young individuals from Norway (N=1,986,970) and Sweden (N=2,100,188). We used regression models to estimate adjusted rate ratios (...
Aims/hypothesis
The aim of this study was to investigate whether higher dietary intake of marine n -3 fatty acids during pregnancy is associated with a lower risk of type 1 diabetes in children.
Methods
The Danish National Birth Cohort (DNBC) and the Norwegian Mother, Father and Child Cohort Study (MoBa) together include 153,843 mother–child pairs...
Background
Socioeconomic status in the risk of developing type 1 diabetes seems inconsistent. We investigated whether risk of childhood-onset type 1 diabetes differed by parental education or occupation in a nationwide cohort.
Methods
This cohort study included all children born in Norway from 1974 to 2013. In individually linked data from nationw...
Objectives
Infections in early childhood have been associated with risk of celiac disease (CD) and type 1 diabetes (T1D). We investigated whether this is driven by susceptibility genes for autoimmune disease by comparing infection frequency by genetic susceptibility variants for CD or T1D.
Methods
We genotyped 373 controls and 384 children who dev...
Background: Long-chain marine omega-3 fatty acids (eicosapentaenoic acid; EPA and docosahexaenoic acid; DHA) have anti-inflammatory effects. Dietary intake of EPA and DHA in pregnancy was associated with lower offspring risk of asthma in a randomized trial, and lower risk of type 1 diabetes in the offspring in retrospective observational studies.
A...
Type 1 diabetes is an autoimmune disease that affects 0.1 to nearly 1% of the population, dependent on the country, with its highest incidence around 10–15 years of age. The incidence has increased over time, approximately doubling over the past 2–3 decades. The incidence varies across the world, with the highest among populations of (Northern) Eur...
Aims:
Studies of social inequality and risk of developing type 1 diabetes are inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socioeconomic status or parental occupation and risk of type 1 diabetes in children.
Methods:
We searched for publications between January 1, 197...
Maternal antibiotic use during pregnancy has been linked to asthma risk in children, but the role of underlying infections remains unclear. We investigated the association of maternal antibiotic use and infections during pregnancy with offspring risk of asthma. We used two population-based cohorts: the Norwegian Mother, Father and Child Cohort Stud...
Background Socioeconomic status in the risk of developing type 1 diabetes seems inconsistent. We investigated whether risk of childhood-onset type 1 diabetes differed by parental education or occupation in a nationwide cohort. Methods This cohort study included all children born in Norway from 1974 to 2013. In individually linked data from nationwi...
Aims
Studies of social inequality in risk of type 1 diabetes seems inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socioeconomic status or parental occupation and risk of type 1 diabetes in children.
Methods
We searched for publications between January 1, 1970, and Novembe...
Background
We aimed to study the cumulative incidence and risk factors (sex, age, calendar year of diabetes onset, country of origin and educational level) of acute myocardial infarction (AMI) in subjects with type 1 diabetes and matched controls.
Methods
A nationwide cohort of subjects with type 1 diabetes diagnosed at age < 15 years in Norway du...
Purpose
To investigate incidence of end-stage renal disease (ESRD), and the association of education and coronary heart disease (CHD) with ESRD, in subjects throughout Norway followed from the diagnosis of childhood-onset type 1 diabetes.
Methods
All new onset cases of type 1 diabetes 1973–2016 were followed for CHD and ESRD in nation-wide registr...
Aims:
We investigated the current extent of undiagnosed diabetes and prediabetes and their associated cardiovascular risk profile in a population-based study.
Methods:
All residents aged ≥20 years in the Nord-Trøndelag region, Norway were invited to the HUNT4 Survey in 2017-2019, and 54% attended. Diagnosed diabetes was self-reported, and in tho...
Background
Maternal diabetes is a well-known risk factor for pregnancy complications. Possible links between long-term maternal blood sugar in the normal range and pregnancy complications are less well described.
Methods
We assayed glycated haemoglobin (HbA1c) in blood samples collected around the 18th week of pregnancy for 2937 singleton pregnanc...
Maternal antibiotic use during pregnancy has been linked to asthma risk in children, but the role of underlying infections remains unclear. We investigated the association of maternal antibiotic use and infections during pregnancy with offspring risk of asthma. We used two population-based cohorts: the Norwegian Mother, Father and Child Cohort Stud...
Introduction
We aimed to investigate whether the proportion of undiagnosed diabetes varies by socioeconomic status and healthcare consumption, in a Norwegian population screened with glycated hemoglobin (HbA 1c ).
Research design and methods
In this cohort study, we studied age-standardized diabetes prevalence using data from men and women aged 40...
Background and aim
Genetic markers are established as predictive of type 1 diabetes, but unknown early life environment is believed to be involved. Umbilical cord blood may reflect perinatal metabolism and exposures. We studied whether selected polar metabolites in cord blood contribute to prediction of type 1 diabetes.
Methods
Using a targeted UH...
LINKED CONTENT
This article is linked to Størdal et al and Sundqvist et al papers. To view these articles, visit https://doi.org/10.1111/apt.16361 and https://doi.org/10.1111/apt.16348
Background and aim
Genetic markers are established as predictive of type 1 diabetes, but unknown early life environment is believed to be involved. Umbilical cord blood may reflect perinatal metabolism and exposures. We studied whether selected polar metabolites in cord blood contribute to prediction of type 1 diabetes.
Methods
Using a targeted UHP...
Objective:
To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes.
Research design and methods:
A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973-1982. The...
Background:
Coeliac disease is an immune-mediated intestinal disease characterised by lifelong intolerance to dietary gluten in genetically predisposed individuals. Microbial factors including infections or bacterial microbiota have long been suspected to be involved in the aetiology, but the scientific literature on the topic is scattered and het...
Introduction:
To test whether parechovirus and anellovirus, frequent enteric viruses, were associated with subsequent celiac disease (CD). We hypothesized that children who later developed CD would have increased frequency of parechovirus infections before transglutaminase 2 (TG2) antibody development. Anellovirus testing was exploratory, as a pot...
Maternal diet can influence the developing immune system of the offspring. We hypothesized that maternal fibre and gluten intake during pregnancy were associated with the risk of celiac disease in the child. In the Norwegian Mother, Father and Child Cohort Study (MoBa, n = 85,898) higher maternal fibre intake (median 29.5 g/day) was associated with...
Objectives:
To determine the association between childhood growth prior to the development of celiac disease (CD) and CD autoimmunity (CDA) identified by periodic serological screening.
Study design:
The Diabetes Autoimmunity Study in the Young cohort includes 1979 genetically at-risk children from Denver, Colorado, with annual growth measuremen...
Objectives:
During pregnancy, small quantities of maternal cells are naturally transmitted to the fetus. This transmission, termed maternal microchimerism (MMc), has been implicated in autoimmune diseases but its potential role is unclear. We aimed to investigate if MMc at birth predicted childhood celiac disease (CD) risk, a common immune-mediate...
Importance: Celiac disease is an increasingly common immune-mediated disorder. The potential role of infections in celiac disease development is not well characterized.
Objective: To test whether two frequent enteric viruses, parechovirus and anellovirus, were associated with subsequent celiac disease. Our a priori hypothesis was that children who...
Background
The relationship between maternal gluten intake in pregnancy, offspring intake in childhood, and offspring risk of type 1 diabetes has not been examined jointly in any studies. Our aim was to study the relationship between maternal and child intake of gluten and risk of type 1 diabetes in children.
Methods and findings
We included 86,30...
Epidemiological data on pediatric type 1 diabetes (T1D), mainly incidence, have become increasingly available since the second half of the 20th century. Comparative incidence data across populations were only obtained since the 1980s. The 2019 IDF Atlas provides T1D incidence, prevalence and mortality estimates for children < 15 years for all 211 c...
Type 1 diabetes is a chronic, immune-mediated disease characterised by the destruction of insulin-producing cells. Standardised registry data show that type 1 diabetes incidence has increased 3-4% over the past three decades, supporting the role of environmental factors. Although several factors have been associated with type 1 diabetes, none of th...
Background:
There is limited evidence linking type 2 diabetes (T2D) to influenza-related complications.
Objectives:
To test a set of research questions relating to pandemic influenza vaccination, hospitalization and mortality in people with and without T2D.
Methods:
In this population-based cohort study, we linked individual-level data from se...
Microbiomes are vast communities of microorganisms and viruses that populate all natural ecosystems. Viruses have been considered to be the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared with that...
OBJECTIVE: To examine the association between maternal and child gluten intake and risk of type 1 diabetes in children.
DESIGN: Pregnancy cohort
SETTING: Population-based, nation-wide study in Norway
PARTICIPANTS: 86,306 children in The Norwegian Mother and Child Cohort Study born from 1999 through 2009, followed to April 15, 2018.
MAIN OUTCOME MEA...
Ecological observations suggest an inverse relationship between smoking in pregnancy and celiac disease (CD) in offspring. While individual-level analyses have been inconsistent, they have mostly lacked statistical power or refined assessments of exposure. To examine the association between pregnancy-related smoking and CD in the offspring, as well...
Objectives:
Celiac disease (CD) may occur in genetically predisposed individuals exposed to gluten, but it is unclear whether the amount of gluten influences the risk of disease. We aimed at determining whether the amount of gluten intake at age 18 months predicted later risk of CD.
Methods:
In an observational nationwide cohort study, the Norwe...
( BMJ . 2018;361:k2477)
Pregnant women commonly have low vitamin D levels, and this might be a causal factor in the development of gestational hypertension and preeclampsia. Previous meta-analyses have suggested an association between a low 25-hydroxyvitamin D concentration and an increased risk of preeclampsia, but these results may be biased. One...
Background:
Maternal microchimerism (MMc), the transmission of small quantities of maternal cells to the fetus, is relatively common and persistent. MMc has been detected with increased frequency in the circulation and pancreas of type 1 diabetes (T1D) patients. We investigated for the first time whether MMc levels at birth predict future T1D risk...
Objectives:
To determine the association between the amount of gluten intake in childhood and later celiac disease (CD), for which data are currently scarce.
Methods:
The prospective Diabetes Autoimmunity Study in the Young cohort includes 1875 at-risk children with annual estimates of gluten intake (grams/d) from age 1 year. From 1993 through J...
Objective:
To study the association of gluten intake with development of islet autoimmunity and progression to type 1 diabetes.
Research design and methods:
The Diabetes Autoimmunity Study in the Young (DAISY) follows children with an increased risk of type 1 diabetes. Blood samples were collected at 9, 15, and 24 months of age, and annually the...
Objective
To determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease.
Design
Case-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016.
Setting
Norwegian population.
Participants
Children carrying the HLA...
Objective:
Circumstantial evidence links 25-hydroxy vitamin D [25(OH)D], vitamin D-binding protein (DBP), vitamin D-associated genes, and type 1 diabetes (T1D), but no studies have jointly analyzed these. We aimed to investigate whether DBP levels during pregnancy or at birth were associated with offspring T1D and whether vitamin D pathway genetic...
Microbiomes are vast communities of microbes and viruses that populate all natural ecosystems. Viruses have been considered the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared to other environments...
Objectives:
Direct genotyping of adenovirus or enterovirus from clinical material using polymerase chain reaction (PCR) followed by Sanger sequencing is often difficult due to the presence of multiple virus types in a sample, or due to varying efficacy of PCR amplifying the capsid gene on the background of foreign nucleic acids. Here we present a...
Aims/hypothesis:
This study aimed to examine recent time trends in the incidence and prevalence of type 2 diabetes in Norway.
Methods:
In this Norwegian nationwide cohort study, we linked data from national registries with prospectively collected data on diabetes medication and diabetes diagnoses for all residents in Norway aged 30 to 89 years (...
(Abstracted from BMJ 2018;361:k2167)
Observational studies have found that women with lower levels of 25-hydroxyvitamin D are at greater risk of preeclampsia. Although some small trials of vitamin D supplementation in pregnancy have suggested a potential benefit of supplementation, a recent meta-analysis found no impact on preeclampsia from vitamin...
Aims/hypothesis:
Case reports have linked influenza infections to the development of type 1 diabetes. We investigated whether pandemic and seasonal influenza infections were associated with subsequent increased risk of type 1 diabetes.
Methods:
In this population-based registry study, we linked individual-level data from national health registri...
Background:
A few prospective studies suggest an association between maternal smoking during pregnancy and lower risk of type 1 diabetes. However, the role of unmeasured confounding and misclassification remains unclear.
Methods:
We comprehensively evaluated whether maternal smoking in pregnancy predicts lower risk of childhood-onset type 1 diab...
Web appendix: Supplementary material
Objective:
To use mendelian randomisation to investigate whether 25-hydroxyvitamin D concentration has a causal effect on gestational hypertension or pre-eclampsia.
Design:
One and two sample mendelian randomisation analyses.
Setting:
Two European pregnancy cohorts (Avon Longitudinal Study of Parents and Children, and Generation R Study), and...
Iron overload due to environmental or genetic causes have been associated diabetes. We hypothesized that prenatal iron exposure is associated with higher risk of childhood type 1 diabetes. In the Norwegian Mother and Child cohort study (n = 94,209 pregnancies, n = 373 developed type 1 diabetes) the incidence of type 1 diabetes was higher in childre...
Background:
Infections in early life have been linked to type 1 diabetes (T1D) risk, but no previous study has comprehensively analysed exposure to antibiotics, acetaminophen and infections during pregnancy and early childhood in relation to offspring risk of T1D.
Methods:
Participants in the Norwegian Mother and Child Cohort Study (n = 114 215...
Background: Few studies have examined gluten intake as a risk factor for islet autoimmunity (IA) and type 1 diabetes (T1D). Our aim was to study the association of gluten intake with development of IA and progression to T1D, accounting for HLA genotype.
Methods: The Diabetes Autoimmunity Study in the Young (DAISY) follows children with an increased...
Background:
Our objective was to examine the associations of parental body mass index (BMI) and maternal gestational weight gain with childhood-onset type 1 diabetes. Comparing the associations of maternal and paternal BMI with type 1 diabetes in the offspring will provide further insight into the role of unmeasured confounding by characteristics...
Problem:
Previous studies have suggested that immune perturbations during pregnancy can affect offspring type 1 diabetes (T1D) risk. We aimed to identify immunological markers that could predict offspring T1D or that were linked to T1D risk factors.
Method of study:
We quantified selected circulating immunological markers in mid-pregnancy (inter...
Studies on vitamin D status during pregnancy and risk of type 1 diabetes (T1D) lack consistency, and are limited by small sample sizes or single measures of 25-hydroxyvitamin D (25(OH)D). We investigated whether average maternal 25(OH)D plasma concentrations during pregnancy are associated with risk of childhood T1D. In a case-cohort design, we ide...
Objectives: Influenza has been linked to autoimmune conditions, but its relationship to subsequent celiac disease (CD) is unknown. Our primary aim was to determine the risk of CD after influenza. A secondary analysis examined the risk of CD following pandemic influenza vaccination.
Methods: This nationwide register-based cohort study included 2,637...
Objective:
End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aimed to estimate the cumulative incidence of ESRD in individuals with childhood-onset type 1 diabetes followed for up to 42 years.
Research design and methods:
Data were based on the nationwide, population-based Norwegian Childhood Diabetes...
Supplemental Digital Content is available in the text.
Objective
Several genetic polymorphisms determine vitamin D status. We aimed to estimate the strength of association of established 25-hydroyxvitamin D (25OHD) associated variants in the mother and in the fetus, with 25OHD concentration in newborn umbilical cord plasma.
Methods
We randomly selected 578 mother and child dyads from the prospective N...
Background
Low concentration of 25-hydroxyvitamin D during pregnancy may be associated with offspring autoimmune disorders. Little is known about environmental triggers except gluten for celiac disease, a common immune-mediated disorder where seasonality of birth has been reported as a risk factor. We therefore aimed to test whether low maternal an...
Objective:
Our aim was to study the relation between the duration of full and any breastfeeding and risk of type 1 diabetes.
Research design and methods:
We included two population-based cohorts of children followed from birth (1996-2009) to 2014 (Denmark) or 2015 (Norway). We analyzed data from a total of 155,392 children participating in the N...
Background:
Breastfeeding may protect against infections, but its optimal duration remains controversial. We aimed to study the association of the duration of full and any breastfeeding with infections the first 18 months of life.
Methods:
The Norwegian Mother and Child study (MoBa) is a prospective birth cohort which recruited expecting mothers...
Type 1 diabetes can occur at any age but the incidence peaks around puberty. The incidence in children varies drastically between populations. Type 1 diabetes has a strong genetic component and familial clustering. However, only a minority of carriers of the susceptibility genes develop type 1 diabetes. During the 1970s–2010s, the incidence of type...
Capsule summary:
This first investigation of multiple biomarkers reflecting cellular and humoral immune activation in mid-pregnancy or at birth do not support concerns that the prenatal systemic immune response influences celiac disease development in children.
Objective:
To study long-term mortality, causes of death, and end-stage renal disease (ESRD) in people diagnosed with type 1 diabetes at age 15-29 years.
Research design and methods:
This nationwide, population-based cohort with type 1 diabetes diagnosed during 1978-1982 (n = 719) was followed from diagnosis until death, emigration, or September...