Maaret Turtinen1,2, Taina Härkönen1,2, Anna Parkkola1,2, Jorma Ilonen3,4, Mikael Knip1,2,5,6. 1. Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 2. Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. 3. Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland. 4. Department of Clinical Microbiology, Turku University Hospital, Turku, Finland. 5. Folkhälsan Research Center, Helsinki, Finland. 6. Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland.
Abstract
OBJECTIVE: The present study tested the hypothesis that girls have a more aggressive disease process than boys at the diagnosis of type 1 diabetes (T1D). METHODS: Demographic and clinical characteristics, the humoral autoantibody profile, and the genetic risk assessed by the presence of human leukocyte antigen DR-DQ haplotypes were analyzed in terms of sex in 4993 children and adolescents diagnosed with T1D between January 2003 and December 2016. RESULTS: A clear male preponderance (56.6%) was observed in our cohort and boys were significantly older than girls at clinical diagnosis (mean 8.3 vs 7.7 years, P < .001). Age-adjusted analyses showed a poorer metabolic decompensation in girls than boys at diagnosis. Boys tested more often positive for autoantibodies against insulin autoantibodies (P = .008), islet antigen-2 autoantibodies (P = .033), and zinc transporter 8 autoantibodies (P = .027), whereas girls had a higher frequency of glutamic acid decarboxylase autoantibodies (GADA) (P < .001) and higher GADA (P < .001) and islet cell antibody titers (P = .001). We did not find any significant differences in the genetic risk profile between girls and boys. CONCLUSIONS: Our data show that the metabolic derangement is more severe in girls already at diagnosis of T1D and this finding is independent of age. The immunologic aggressiveness of the disease is more variable as the predominance of different autoantibodies varies between sexes with a higher frequency of GADA in girls, while the 3 other biochemical autoantibodies were more common in boys.
OBJECTIVE: The present study tested the hypothesis that girls have a more aggressive disease process than boys at the diagnosis of type 1 diabetes (T1D). METHODS: Demographic and clinical characteristics, the humoral autoantibody profile, and the genetic risk assessed by the presence of human leukocyte antigen DR-DQ haplotypes were analyzed in terms of sex in 4993 children and adolescents diagnosed with T1D between January 2003 and December 2016. RESULTS: A clear male preponderance (56.6%) was observed in our cohort and boys were significantly older than girls at clinical diagnosis (mean 8.3 vs 7.7 years, P < .001). Age-adjusted analyses showed a poorer metabolic decompensation in girls than boys at diagnosis. Boys tested more often positive for autoantibodies against insulin autoantibodies (P = .008), islet antigen-2 autoantibodies (P = .033), and zinc transporter 8 autoantibodies (P = .027), whereas girls had a higher frequency of glutamic acid decarboxylase autoantibodies (GADA) (P < .001) and higher GADA (P < .001) and islet cell antibody titers (P = .001). We did not find any significant differences in the genetic risk profile between girls and boys. CONCLUSIONS: Our data show that the metabolic derangement is more severe in girls already at diagnosis of T1D and this finding is independent of age. The immunologic aggressiveness of the disease is more variable as the predominance of different autoantibodies varies between sexes with a higher frequency of GADA in girls, while the 3 other biochemical autoantibodies were more common in boys.
Authors: Hugo Segerer; Michael Wurm; Julia M Grimsmann; Beate Karges; Andreas Neu; Marina Sindichakis; Katharina Warncke; Axel Dost; Reinhard W Holl Journal: Dtsch Arztebl Int Date: 2021-06-04 Impact factor: 5.594
Authors: Danièle Pacaud; Anita M Nucci; David Cuthbertson; Dorothy J Becker; Suvi M Virtanen; Johnny Ludvigsson; Jorma Ilonen; Mikael Knip Journal: Diabetologia Date: 2020-10-07 Impact factor: 10.122