Ethnic differences in progression of islet autoimmunity and type 1 diabetes in relatives at risk.

Diabetologia 2018 09 21;61(9):2043-2053. Epub 2018 Jun 21.

Section of Diabetes and Endocrinology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin St, Suite 10.20, Houston, TX, 77030, USA.

Aims/hypothesis: We hypothesised that progression of islet autoimmunity and type 1 diabetes mellitus differs among races/ethnicities in at-risk individuals.

Methods: In this study, we analysed the data from the Type 1 Diabetes TrialNet Pathway to Prevention Study. We studied 4873 non-diabetic, autoantibody-positive relatives of individuals with type 1 diabetes followed prospectively (11% Hispanic, 80.9% non-Hispanic white [NHW], 2.9% non-Hispanic black [NHB] and 5.2% non-Hispanic other [NHO]). Primary outcomes were time from single autoantibody positivity confirmation to multiple autoantibody positivity, and time from multiple autoantibody positivity to type 1 diabetes mellitus diagnosis.

Results: Conversion from single to multiple autoantibody positivity was less common in Hispanic individuals than in NHW individuals (HR 0.66 [95% CI 0.46, 0.96], p = 0.028) adjusting for autoantibody type, age, sex, Diabetes Prevention Trial Type 1 Risk Score and HLA-DR3-DQ2/DR4-DQ8 genotype. In participants who screened positive for multiple autoantibodies (n = 2834), time to type 1 diabetes did not differ by race/ethnicity overall (p = 0.91). In children who were <12 years old when multiple autoantibody positivity was determined, being overweight/obese had differential effects by ethnicity: type 1 diabetes risk was increased by 36% in NHW children (HR 1.36 [95% CI 1.04, 1.77], p = 0.024) and was nearly quadrupled in Hispanic children (HR 3.8 [95% CI 1.6, 9.1], p = 0.0026). We did not observe this interaction in participants who were ≥12 years old at determination of autoantibody positivity, although this group size was limited. No significant differential risks were observed between individuals of NHB and NHW ethnicity.

Conclusions/interpretation: The risk and rate of progression of islet autoimmunity were lower in Hispanic compared with NHW at-risk individuals, while significant differences in the development of type 1 diabetes were limited to children <12 years old and were modified by BMI.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00125-018-4660-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611550PMC
September 2018
24 Reads

Publication Analysis

Top Keywords

type diabetes
24
autoantibody positivity
16
multiple autoantibody
12
type
8
diabetes mellitus
8
islet autoimmunity
8
autoimmunity type
8
progression islet
8
diabetes
7
autoantibody
5
primary outcomes
4
risk score
4
[nho] primary
4
multiple
4
outcomes time
4
time single
4
positivity confirmation
4
single autoantibody
4
positivity
4
non-hispanic [nho]
4

Altmetric Statistics

References

(Supplied by CrossRef)

RA Insel et al.
Diabetes Care 2015

AG Ziegler et al.
JAMA 2013

JM Sosenko et al.
Diabetes Care 2008

EJ Mayer-Davis et al.
N Engl J Med 2017

E Barinas-Mitchell et al.
Diabetes 2004

MH Black et al.
Pediatr Diabetes 2013

EC Gay et al.
Diabetes Care 1989

JN Kostraba et al.
Diabetes Care 1992

IM Libman et al.
Diabetes Care 2003

G Morahan et al.
Current Opinion in Endocrinology, Diabetes, and Obesity 2012

M Tosur et al.
Curr Diabetes Rev 2018

Similar Publications