Obesity in late adolescence and incident type 1 diabetes in young adulthood

• Published in: Diabetologia 2022-09, Vol.65 (9), p.1473-1482
• Main Authors: Zucker, Inbar, Zloof, Yair, Bardugo, Aya, Tsur, Avishai M., Lutski, Miri, Cohen, Yaron, Cukierman-Yaffe, Tali, Minsky, Noga, Derazne, Estela, Tzur, Dorit, Melzer Cohen, Cheli, Pinhas-Hamiel, Orit, Chodick, Gabriel, Raz, Itamar, Afek, Arnon, Gerstein, Hertzel C., Tirosh, Amir, Twig, Gilad
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Adolescents; Adult; Body Mass Index; Body weight; Child; Child development; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - epidemiology; Epidemiology; Health risks; Human Physiology; Humans; Incidence; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Obesity - complications; Overweight; Overweight - complications; Pathogenesis; Risk Factors; Teenagers; Young Adult; Young adults
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-022-05722-5

Aims/hypothesis Studies in children have reported an association between increased BMI and risk for developing type 1 diabetes, but evidence in late adolescence is limited. We studied the association between BMI in late adolescence and incident type 1 diabetes in young adulthood. Methods All Israeli adolescents, ages 16–19 years, undergoing medical evaluation in preparation for mandatory military conscription between January 1996 and December 2016 were included for analysis unless they had a history of dysglycaemia. Data were linked with information about adult onset of type 1 diabetes in the Israeli National Diabetes Registry. Weight and height were measured at study entry. Cox proportional models were applied, with BMI being analysed both as a categorical and as a continuous variable. Results There were 777 incident cases of type 1 diabetes during 15,819,750 person-years (mean age at diagnosis 25.2±3.9 years). BMI was associated with incident type 1 diabetes. In a multivariable model adjusted for age, sex and sociodemographic variables, the HRs for type 1 diabetes were 1.05 (95% CI 0.87, 1.27) for the 50th–74th BMI percentiles, 1.41 (95% CI 1.11, 1.78) for the 75th–84th BMI percentiles, 1.54 (95% CI 1.23, 1.94) for adolescents who were overweight (85th–94th percentiles), and 2.05 (95% CI 1.58, 2.66) for adolescents with obesity (≥95th percentile) (reference group: 5th–49th BMI percentiles). One increment in BMI SD was associated with a 25% greater risk for incidence of type 1 diabetes (HR 1.25, 95% CI 1.17, 1.32). Conclusions Excessively high BMI in otherwise healthy adolescents is associated with increased risk for incident type 1 diabetes in early adulthood. Graphical abstract