Infant anthropometry, early life infection, and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study

Authors

  • Anne-Louise Ponsonby,

    Corresponding author
    1. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
    2. Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia
    3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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  • Angela Pezic,

    1. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • Jennifer Cochrane,

    1. Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia
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  • Fergus J Cameron,

    1. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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  • Mark Pascoe,

    1. Department of Paediatrics and Child Health, University of Tasmania, Hobart, Tasmania, Australia
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  • Andrew Kemp,

    1. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • Terence Dwyer

    1. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
    2. Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia
    3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Prof. Anne-Louise Ponsonby, Environmental and Genetic Epidemiology Research Group, Infection, Immunity and Environment Theme, Murdoch Childrens Research Institute, Royal Childrens Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
Tel: +61 3 8341 6372;
fax: +61 3 9345 6000;
e-mail: anne-louise.ponsonby@mcri.edu.au

Abstract

Ponsonby A-L, Pezic A, Cochrane J, Cameron FJ, Pascoe M, Kemp A, Dwyer T. Infant anthropometry, early life infection and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study.

Background: Higher birthweight is associated with increased type 1 diabetes mellitus (T1DM) risk, but the contribution of higher adiposity or lean mass is unclear. In this Tasmanian infant cohort, early upper respiratory infection has been associated with higher asthma risk.

Patients and methods: Eligible infants represented one-fifth of live births in Tasmania, 1988–1995. Hospital interview data (day 6) were obtained on 96.3% (10 628/11 040), home (5 wk) visit data (38 d) on 92.9% (9876/10 628) of those, then a phone (12 wk) interview (87 d). Tricep and subscapular skinfold measures and upper arm circumference were recorded at the first two interviews. T1DM cases (n = 26) arising from the age of 16 or under in Tasmania from 1988 to 2006 were ascertained.

Results: Higher birthweight [adjusted odds ratio (AOR) 2.82 (95% CI 1.31–6.09)], lean mid-upper arm circumference [AOR 1.76 (95% CI 1.16–2.66)], not skinfold measures, were associated with T1DM risk. Children with an early upper respiratory tract infection by 5-wk visit [AOR 2.74 (95% CI 1.19–6.32)] or ear infection by 12-wk interview [AOR 3.44 (95% CI 1.00–11.79)] were also at higher risk. Putative markers of altered microbial exposure such as resident density were not associated with T1DM risk but the effect of increasing birth order on T1DM risk differed for older (AOR 0.41, p = 0.02) than young mother (AOR 2.45, p = 0.01); difference in effect, p = 0.001.

Conclusion: In this cohort, early upper respiratory tract infection was associated with T1DM risk, as had been previously found for asthma, consistent with immunoinflammatory upregulation. Using the detailed anthropometric measures available, the link between higher birthweight and T1DM did not appear to reflect increased adiposity.

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