Childhood Diabetes Registry of Saxony Working Group
High birth weights but not excessive weight gain prior to manifestation are related to earlier onset of diabetes in childhood: ‘accelerator hypothesis’ revisited
Article first published online: 18 DEC 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 15, Issue 6, pages 428–435, September 2014
How to Cite
High birth weights but not excessive weight gain prior to manifestation are related to earlier onset of diabetes in childhood: ‘accelerator hypothesis’ revisited., , , , , , , .
- Issue published online: 26 AUG 2014
- Article first published online: 18 DEC 2013
- Manuscript Accepted: 6 NOV 2013
- Manuscript Revised: 7 OCT 2013
- Manuscript Received: 31 JUL 2013
- Medical Faculty of the University of Leipzig
- Kompetenznetz Adipositas, Berlin
- LIFE, Research Center
- DFG, KFO (Bonn-Bad Godesberg), Germany. Grant Numbers: B11, B15
- accelerator hypothesis;
- body mass index;
- type 1 diabetes mellitus;
- weight gain
Aim of this study was to test Wilkin's ‘accelerator hypothesis’: whether excessive weight gain accelerates the onset of type 1 diabetes.
Subjects and methods
Anthropometric birth data of 1117 children who developed diabetes between 1988 and April 2013 were compared with those of a sex, age, and gestational age matched, contemporary regional control group (n = 54 344). Cases were divided into three manifestation groups (G1:0–4.9 yr, G2:5–9.9 yr, and G3: 10–20 yr). Furthermore, growth data of 540 children with diabetes were compared with controls (n = 134 249) in pre-, peri-, and post-onset intervals (interval: 1–6). Also, correlation of age at onset and body mass index (BMI) standard deviation score (SDS) at this point of time were examined.
Cases had significantly higher SDSs for birth weight when compared with controls (boys: p = 0.007, girls: p = 0.002). Children with early manifestation had the highest mean of birth weight SDS (G1>G2>G3), (p = 0.22, adjusted r2 = 0.001). BMI SDS trend curves of cases are slightly higher compared with those of the healthy controls. This was only significant in years after diagnosis (interval 6, p < 0.000). Cases did not show excessive weight gain in any of the examined intervals before the onset of diagnosis (interval 1–3). One year after diagnosis, we found an inverse correlation between age at diagnosis and BMI SDS at diabetes manifestation. The youngest children at diagnosis (G1) had the lowest BMI SDS at manifestation and vice versa (G1<G2<G3, p = 0.06).
Our data do not support the ‘accelerator hypothesis’. There was no sign of excessive weight gain before manifestation. Discrepant results from other studies could be due to non-age-adjusted controls.