Aspects of Sex Differences in Type 1 Diabetes
Författare
Summary, in English
Abstract:
Background Type 1 diabetes (T1D) is one of the most common childhood autoimmune diseases, with rising incidence worldwide with a male predominance. The etiology behind the disease is mostly unknown and it is essential to understand the factors that impact its development to prevent the disease and personalize the treatment. This thesis aims to examine sex-specific differences in T1D, explore the prevalence of parental diabetes, and the impact of parental diabetes on childhood obesity, as well as the influence of parental diabetes heredity on the clinical profiles of children with T1D.
Methods: Study I examined the relationship between parental diabetes status and childhood obesity risk among 12-year-olds with data obtained from a cross-sectional multicenter national screening study for celiac disease in 11,050 healthy 12-year-old children (The ETICS study). Questionnaires were used to obtain data regarding parental diabetes and Socioeconomic Status, and the children got their height and weight measured by a nurse. Study II investigated sex-specific differences in the clinical and immunological characteristics of children with newly diagnosed T1D, with a T1D population obtained from the nationwide Better Diabetes Diagnosis (BDD) study, an ongoing cohort study including almost all newly diagnosed Swedish patients with diabetes since 2005, where 3,977 children with T1D were included. Study III explored the prevalence of parental diabetes among children with newly diagnosed T1D and examined the potential differences in clinical characteristics based on diabetes heredity. The same population with T1D was used as in Study II, and data from Study I were used as healthy age- matched controls.
Results: Study I findings indicated that only boys with parents affected by T1D had an elevated risk of overweight compared to sex-matched peers without parental T1D. Both girls and boys, with parents with type 2 diabetes (T2D) had an elevated risk of overweight compared to sex-matched peers without parental T2D regardless of the socioeconomic status. Study II showed notable sex differences in the characteristics at the time of T1D diagnosis. Girls demonstrated earlier onset of symptoms and had a higher likelihood of testing positive for various autoantibodies, particularly glutamic acid decarboxylase autoantibodies (GADA). Meanwhile, boys had a higher likelihood of testing positive for Insulin Autoantibodies (IAA). Sex-specific differences in HLA risk factors were also apparent among children under 9 years of age. Study III showed an increased prevalence of parental diabetes (T1D and T2D), in children with T1D compared to healthy controls and that heredity for T1D correlates with younger age at diagnosis and lower HbA1c, while heredity for T2D was associated with a higher risk of being overweight or obese.
Conclusion: This thesis offers insights into the heterogeneity of T1D and the relationship between sex, parental diabetes status, obesity risk, and clinical markers that impact T1D in children. These findings may have implications for new screening strategies when developing tailored preventive interventions and optimizing disease management approaches to improve outcomes in the T1D population.
Background Type 1 diabetes (T1D) is one of the most common childhood autoimmune diseases, with rising incidence worldwide with a male predominance. The etiology behind the disease is mostly unknown and it is essential to understand the factors that impact its development to prevent the disease and personalize the treatment. This thesis aims to examine sex-specific differences in T1D, explore the prevalence of parental diabetes, and the impact of parental diabetes on childhood obesity, as well as the influence of parental diabetes heredity on the clinical profiles of children with T1D.
Methods: Study I examined the relationship between parental diabetes status and childhood obesity risk among 12-year-olds with data obtained from a cross-sectional multicenter national screening study for celiac disease in 11,050 healthy 12-year-old children (The ETICS study). Questionnaires were used to obtain data regarding parental diabetes and Socioeconomic Status, and the children got their height and weight measured by a nurse. Study II investigated sex-specific differences in the clinical and immunological characteristics of children with newly diagnosed T1D, with a T1D population obtained from the nationwide Better Diabetes Diagnosis (BDD) study, an ongoing cohort study including almost all newly diagnosed Swedish patients with diabetes since 2005, where 3,977 children with T1D were included. Study III explored the prevalence of parental diabetes among children with newly diagnosed T1D and examined the potential differences in clinical characteristics based on diabetes heredity. The same population with T1D was used as in Study II, and data from Study I were used as healthy age- matched controls.
Results: Study I findings indicated that only boys with parents affected by T1D had an elevated risk of overweight compared to sex-matched peers without parental T1D. Both girls and boys, with parents with type 2 diabetes (T2D) had an elevated risk of overweight compared to sex-matched peers without parental T2D regardless of the socioeconomic status. Study II showed notable sex differences in the characteristics at the time of T1D diagnosis. Girls demonstrated earlier onset of symptoms and had a higher likelihood of testing positive for various autoantibodies, particularly glutamic acid decarboxylase autoantibodies (GADA). Meanwhile, boys had a higher likelihood of testing positive for Insulin Autoantibodies (IAA). Sex-specific differences in HLA risk factors were also apparent among children under 9 years of age. Study III showed an increased prevalence of parental diabetes (T1D and T2D), in children with T1D compared to healthy controls and that heredity for T1D correlates with younger age at diagnosis and lower HbA1c, while heredity for T2D was associated with a higher risk of being overweight or obese.
Conclusion: This thesis offers insights into the heterogeneity of T1D and the relationship between sex, parental diabetes status, obesity risk, and clinical markers that impact T1D in children. These findings may have implications for new screening strategies when developing tailored preventive interventions and optimizing disease management approaches to improve outcomes in the T1D population.
Publiceringsår
2024
Språk
Engelska
Publikation/Tidskrift/Serie
Lund University, Faculty of Medicine Doctoral Dissertation Series
Issue
2024:72
Fulltext
Dokumenttyp
Doktorsavhandling
Förlag
Lund University, Faculty of Medicine
Ämne
- Endocrinology and Diabetes
- Pediatrics
Nyckelord
- type 1 diabetes (T1D)
- Sex Differences
- Autoimmunity
- Genetics
- Childhood obesity
- Autoantibodies to glulamic acid decarboxylase (GAD)
- Autoantibodies
- HLA‐DQ
Status
Published
Handledare
- Annelie Carlsson
- Matti Cervin
- Fredrik Norström
ISBN/ISSN/Övrigt
- ISSN: 1652-8220
- ISBN: 978-91-8021-566-4
Försvarsdatum
22 maj 2024
Försvarstid
13:00
Försvarsplats
Belfragesalen, BMC D15, Klinikgatan 32 i Lund. Join by Zoom: https://lu-se.zoom.us/j/62109366500?pwd=eEdnRGtzNEJPQkZvTUQ3M0FHZVRTUT09
Opponent
- Sofia Carlsson (Associate professor, PhD)