Helen Phelan1,2, Nicole C Foster3, Anke Schwandt4,5, Jennifer J Couper6,7, Steven Willi8, Peter Kroschwald9, Timothy W Jones10, Mengdi Wu3, Claudia Steigleder-Schweiger11, Maria E Craig12,13,14, David M Maahs15,16, Nicole Prinz4,5. 1. John Hunter Children's Hospital, Newcastle, Australia. 2. University of Sydney, Sydney, Australia. 3. JAEB Centre for Health Research, Tampa, Florida, USA. 4. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 5. German Center for Diabetes Research (DZD), Munich-, Neuherberg, Germany. 6. Women's and Children's Hospital, Adelaide, Australia. 7. Robinson Research Institute, The University of Adelaide, Adelaide, Australia. 8. Diabetes Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 9. Department of Pediatrics and Adolescent Medicine, Ruppiner Clinics, Neuruppin, Germany. 10. Department of Diabetes and Endocrinology, Princess Margaret Hospital and Telethon Kids Institute, Perth, Australia. 11. Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. 12. Children's Hospital at Westmead, Sydney, Australia. 13. University of New South Wales, Sydney, Australia. 14. Charles Perkins Centre Westmead, University of Sydney, Australia. 15. Lucile Salter Packard Children's Hospital and Stanford University Medical Center, Palo Alto, California, USA. 16. Stanford University, Stanford, California, USA.
Abstract
BACKGROUND: BMI fluctuations during puberty are common. Data on individual change in BMI from childhood to young adulthood are limited in youth with type 1 diabetes. OBJECTIVES: To compare longitudinal trajectories of body mass index z score (BMIz) from childhood to adolescence across three registries spanning five countries. METHODS: Data sources: T1DX (USA), DPV (Germany/Austria/Luxembourg) and ADDN (Australia). The analysis included 11,513 youth with type 1 diabetes, duration >1 year, at least one BMI measure at baseline (age 8-10 years) and >5 aggregated BMI measures by year of age during follow-up until age 17 years. BMIz was calculated based on WHO charts. Latent class growth modelling was used to identify subgroups following a similar trajectory of BMIz over time. RESULTS: Five distinct trajectories of BMIz were present in the T1DX and ADDN cohorts, while six trajectories were identified in the DPV cohort. Boys followed more often a low/near-normal pattern while elevated BMIz curves were more likely in girls (ADDN; DPV). For T1DX cohort, no sex differences were observed. Comparing the reference group (BMIz ~0) with the other groups during puberty, higher BMIz was significantly associated with older age at T1D onset, racial/ethnic minority and elevated HbA1c (all p<0.05). CONCLUSION: This multinational study presents unique BMIz trajectories in youth with T1D across three continents. The prevalence of overweight and the longitudinal persistence of overweight support the need for close monitoring of weight and nutrition in this population. The international and individual differences likely result from diverse genetic, environmental and therapeutic factors.
BACKGROUND: BMI fluctuations during puberty are common. Data on individual change in BMI from childhood to young adulthood are limited in youth with type 1 diabetes. OBJECTIVES: To compare longitudinal trajectories of body mass index z score (BMIz) from childhood to adolescence across three registries spanning five countries. METHODS: Data sources: T1DX (USA), DPV (Germany/Austria/Luxembourg) and ADDN (Australia). The analysis included 11,513 youth with type 1 diabetes, duration >1 year, at least one BMI measure at baseline (age 8-10 years) and >5 aggregated BMI measures by year of age during follow-up until age 17 years. BMIz was calculated based on WHO charts. Latent class growth modelling was used to identify subgroups following a similar trajectory of BMIz over time. RESULTS: Five distinct trajectories of BMIz were present in the T1DX and ADDN cohorts, while six trajectories were identified in the DPV cohort. Boys followed more often a low/near-normal pattern while elevated BMIz curves were more likely in girls (ADDN; DPV). For T1DX cohort, no sex differences were observed. Comparing the reference group (BMIz ~0) with the other groups during puberty, higher BMIz was significantly associated with older age at T1D onset, racial/ethnic minority and elevated HbA1c (all p<0.05). CONCLUSION: This multinational study presents unique BMIz trajectories in youth with T1D across three continents. The prevalence of overweight and the longitudinal persistence of overweight support the need for close monitoring of weight and nutrition in this population. The international and individual differences likely result from diverse genetic, environmental and therapeutic factors.
Authors: Jennifer L Sherr; Anke Schwandt; Helen Phelan; Mark A Clements; Reinhard W Holl; Paul Z Benitez-Aguirre; Kellee M Miller; Joachim Woelfle; Thomas Dover; David M Maahs; Elke Fröhlich-Reiterer; Maria E Craig Journal: Pediatrics Date: 2021-08 Impact factor: 9.703