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

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

Free PMC article

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

Christine Therese Ferrara et al. Diabetes Care. .
Free PMC article


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.


Figure 1
Figure 1
Effect of ceBMI on type 1 diabetes risk comparing traditional overweight/obese ceBMI definitions to age- and sex-specific ceBMI diabetes risk thresholds. Proportion type 1 diabetes–free pediatric subjects of the PTP cohort according to age (≥12 vs. <12 years old) and sex strata (males vs. females). A, C, E, and G: Assessment of overweight/obese threshold based on the 85th percentile for age- and sex-adjusted BMI. Dotted lines indicate ceBMI ≥0 (overweight/obese); solid gray indicates ceBMI <0 (nonoverweight/obese). B, D, F, and H: Assessment of ceBMI diabetes risk thresholds identified by recursive partitioning. Dotted lines indicate greater than or equal to age- and sex-specific ceBMI diabetes risk threshold; solid gray indicates less than age- and sex-specific ceBMI diabetes risk threshold. All models adjusted for antibody number (single vs. multiple).

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