Zucker I, et al. 1263-P. Presented at: American Diabetes Association Scientific Sessions; June 3-7, 2022; New Orleans (hybrid meeting).
Twig does not report any relevant financial disclosures. See the study for the relevant financial disclosures from all other authors.
NEW ORLEANS — Adolescents’ Risk of Development type 1 diabetes increased with increasing BMI, according to data presented at the American Diabetes Association Scientific Sessions and published simultaneously in Diabetology.
“There were previous reports of the association between obesity and type 1 diabetes in previous cohorts that mainly included children,” Gilad Twig, MD, PhD, a resident of the internal medicine department at Sheba Medical Center in Tel Aviv, Israel, told Healio. “We were somewhat surprised to see that the association persisted in adolescents who were perfectly healthy – apart from abnormal weight – with no apparent risk factors for type 1 diabetes†
Twig and colleagues conducted a retrospective cohort study of adolescents aged 16 to 19 who underwent a medical examination prior to military service in Israel from January 1996 to December 2016. Data from participants were linked to the Israel National Diabetes Registry. BMI was calculated using height and weight measured at baseline. The participants were placed in age- and gender-matched percentiles based on CDC criteria. Participants in the 85th to 94th percentile of BMI were considered overweight and obesity was defined as the 95th percentile or higher.
There were 834,050 men and 592,312 women in the study. Over a median follow-up of 11.2 years, there were 777 cases of type 1 diabetes spanning 15,819,750 person-years, with an incidence of 4.9 cases per 100,000 person-years.
The risk of type 1 diabetes gradually increased with higher BMI. In multivariable analysis, adolescents in the 75th to 84th percentile of BMI (adjusted HR = 1.41; 95% CI, 1.11-1.78), overweight (aHR = 1.54; 95% CI, 1.23 -1.94) and obese (aHR = 2.05; 95% CI, 1.58-2.66) had an increased risk of type 1 diabetes compared to those in the fifth to 49th percentiles of BMI.
“For obese adolescents, the risk of type 1 diabetes was about double,” Twig said. “It is important to remember that in our study we grouped all obese people into the group, regardless of the severity of the obesity. Therefore, it is likely that for adolescents with more severe forms of obesity, the actual risk of developing type diabetes 1 is even greater.”
Each 5 unit increase in BMI was associated with a 35% increase in the risk of developing type 1 diabetes (aHR = 1.35; 95% CI, 1.24-1.47) and each 1 standard deviation increase in BMI increased the risk of developing type 1 diabetes by 25% (aHR = 1.25; 95% CI, 1.17-1.32).
Twig said future research is planned to identify more risk factors for type 1 diabetes in the same cohort.
“In particular, we intend to better identify the characteristics of adolescents in whom being overweight may play a greater role in the development of type 1 diabetes,” Twig said.
- Zucker I, et al. Diabetology† 2022;doi:10.1007/s00125-022-05722-5.
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