%0 Journal Article
%T The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study.
%A Warncke K
%A Tamura R
%A Schatz DA
%A Veijola R
%A Steck AK
%A Akolkar B
%A Hagopian W
%A Krischer JP
%A Lernmark Å
%A Rewers MJ
%A Toppari J
%A McIndoe R
%A Ziegler AG
%A Vehik K
%A Haller MJ
%A Elding Larsson H
%J J Endocr Soc
%V 8
%N 7
%D 2024 May 23
%M 38867880
暂无%R 10.1210/jendso/bvae103
%X <B>UNASSIGNED: </B>The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty.<BR><B>UNASSIGNED: </B>We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes.<BR><B>UNASSIGNED: </B>The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios.<BR><B>UNASSIGNED: </B>Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes.<BR><B>UNASSIGNED: </B>Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.