Excess BMI in Childhood: A Modifiable Risk Factor for Type 1 Diabetes Development?

Diabetes Care. 2017 May;40(5):698-701. doi: 10.2337/dc16-2331. Epub 2017 Feb 15.


Objective: We aimed to determine the effect of elevated BMI over time on the progression to type 1 diabetes in youth.

Research design and methods: We studied 1,117 children in the TrialNet Pathway to Prevention cohort (autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI above the 85th age- and sex-adjusted percentile generated a cumulative excess BMI (ceBMI) index. Recursive partitioning and multivariate analyses yielded sex- and age-specific ceBMI thresholds for greatest type 1 diabetes risk.

Results: Higher ceBMI conferred significantly greater risk of progressing to type 1 diabetes. The increased diabetes risk occurred at lower ceBMI values in children <12 years of age compared with older subjects and in females versus males.

Conclusions: Elevated BMI is associated with increased risk of diabetes progression in pediatric autoantibody-positive relatives, but the effect varies by sex and age.

MeSH terms

  • Adolescent
  • Age Factors
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / etiology*
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Pediatric Obesity / complications*
  • Risk Factors
  • Sex Factors