Caesarean section and risk of type 1 diabetes.

Autor: Singh T; Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany., Weiss A; Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany., Vehik K; Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Krischer J; Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Rewers M; Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA., Toppari J; Department of Pediatrics, Turku University Hospital, Turku, Finland.; Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland.; Centre for Population Health Research, University of Turku, Turku, Finland., Lernmark Å; Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmo, Sweden., Hagopian W; Pacific Northwest Research Institute, Seattle, WA, USA., Akolkar B; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA., Bonifacio E; Technische Universität Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany.; Paul Langerhans Institute Dresden of Helmholtz Munich, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.; Institute for Diabetes and Obesity, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany., Ziegler AG; Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.; Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.; Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany., Winkler C; Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany. christiane.winkler@helmholtz-munich.de.; Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany. christiane.winkler@helmholtz-munich.de.
Jazyk: angličtina
Zdroj: Diabetologia [Diabetologia] 2024 Aug; Vol. 67 (8), pp. 1582-1587. Date of Electronic Publication: 2024 May 31.
DOI: 10.1007/s00125-024-06176-7
Abstrakt: Aims/hypothesis: Delivery by Caesarean section continues to rise globally and has been associated with the risk of developing type 1 diabetes and the rate of progression from pre-symptomatic stage 1 or 2 type 1 diabetes to symptomatic stage 3 disease. The aim of this study was to examine the association between Caesarean delivery and progression to stage 3 type 1 diabetes in children with pre-symptomatic early-stage type 1 diabetes.
Methods: Caesarean section was examined in 8135 children from the TEDDY study who had an increased genetic risk for type 1 diabetes and were followed from birth for the development of islet autoantibodies and type 1 diabetes.
Results: The likelihood of delivery by Caesarean section was higher in children born to mothers with type 1 diabetes (adjusted OR 4.61, 95% CI 3.60, 5.90, p<0.0001), in non-singleton births (adjusted OR 4.35, 95% CI 3.21, 5.88, p<0.0001), in premature births (adjusted OR 1.91, 95% CI 1.53, 2.39, p<0.0001), in children born in the USA (adjusted OR 2.71, 95% CI 2.43, 3.02, p<0.0001) and in children born to older mothers (age group >28-33 years: adjusted OR 1.19, 95% CI 1.04, 1.35, p=0.01; age group >33 years: adjusted OR 1.80, 95% CI 1.58, 2.06, p<0.0001). Caesarean section was not associated with an increased risk of developing pre-symptomatic early-stage type 1 diabetes (risk by age 10 years 5.7% [95% CI 4.6%, 6.7%] for Caesarean delivery vs 6.6% [95% CI 6.0%, 7.3%] for vaginal delivery, p=0.07). Delivery by Caesarean section was associated with a modestly increased rate of progression to stage 3 type 1 diabetes in children who had developed multiple islet autoantibody-positive pre-symptomatic early-stage type 1 diabetes (adjusted HR 1.36, 95% CI 1.03, 1.79, p=0.02). No interaction was observed between Caesarean section and non-HLA SNPs conferring susceptibility for type 1 diabetes.
Conclusions/interpretation: Caesarean section increased the rate of progression to stage 3 type 1 diabetes in children with pre-symptomatic early-stage type 1 diabetes.
Data Availability: Data from the TEDDY study ( https://doi.org/10.58020/y3jk-x087 ) reported here will be made available for request at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository (NIDDK-CR) Resources for Research (R4R) ( https://repository.niddk.nih.gov/ ).
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: