Diabetes care · 2026
A Secular Increase in the Incidence of Islet Autoimmunity Among Colorado Children With Moderate-Risk HLA Genotypes.
СтатьяНазвание и аннотация: Перевод в очереди
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Hohsfield Kirk R, Dong Fran, Waugh Kathleen, Steck Andrea K, Buckner Teresa, Johnson Randi K, Carry Patrick M, Frohnert Brigitte, Rewers Marian, Norris Jill M
Аннотация
OBJECTIVE: We investigated islet autoimmunity (IA) incidence trends among Colorado children born 1993-2010 in Diabetes Autoimmunity Study in the Young (DAISY) and The Environmental Determinants of Diabetes in the Young (TEDDY) and whether HLA genotype or early-life environmental exposures contributed to observed increases.
RESEARCH DESIGN AND METHODS: We analyzed the risk of IA among 2,734 Colorado children representing three birth cohorts (BCs): BC1 (1993-1998), BC2 (1999-August 2004), and BC3 (September 2004-2010). Cox models evaluated IA by BC, with time-varying coefficients, BC-HLA interaction, and stratification by type 1 diabetes family history. Mediation analyses examined age at gluten introduction, weight-for-age Z-score, and maternal smoking.
RESULTS: IA increased across BC1-BC3 (7.0%, 10.7%, and 12.7%). At age 1 year, moderate-risk HLA participants in BC2 and BC3 had, respectively, 2.57 and 6.19 times the IA risk of BC1. By age 5 years, effects attenuated. No selected environmental exposures mediated the increased incidence.
CONCLUSIONS: IA increased among Colorado children born 1993-2010, with the strongest effects among moderate-risk HLA genotypes in later BCs.
RESEARCH DESIGN AND METHODS: We analyzed the risk of IA among 2,734 Colorado children representing three birth cohorts (BCs): BC1 (1993-1998), BC2 (1999-August 2004), and BC3 (September 2004-2010). Cox models evaluated IA by BC, with time-varying coefficients, BC-HLA interaction, and stratification by type 1 diabetes family history. Mediation analyses examined age at gluten introduction, weight-for-age Z-score, and maternal smoking.
RESULTS: IA increased across BC1-BC3 (7.0%, 10.7%, and 12.7%). At age 1 year, moderate-risk HLA participants in BC2 and BC3 had, respectively, 2.57 and 6.19 times the IA risk of BC1. By age 5 years, effects attenuated. No selected environmental exposures mediated the increased incidence.
CONCLUSIONS: IA increased among Colorado children born 1993-2010, with the strongest effects among moderate-risk HLA genotypes in later BCs.