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Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data |
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| Authors: | C. R. Cardwell L. C. Stene G. Joner E. A. Davis O. Cinek J. Rosenbauer J. Ludvigsson C. Castell J. Svensson M. J. Goldacre T. Waldhoer J. Polanska S. G. A. Gimeno L.-M. Chuang R. C. Parslow E. J. K. Wadsworth A. Chetwynd P. Pozzilli G. Brigis B. Urbonaitė S. Šipetić E. Schober C. Ionescu-Tirgoviste C. E. de Beaufort D. Stoyanov K. Buschard C. C. Patterson |
| Affiliation: | 1. Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK 2. Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway 3. Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway 4. Faculty of Medicine, University of Oslo, Oslo, Norway 5. Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia 6. The 2nd Medical School, Charles University, Prague, Czech Republic 7. Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Institute at Duesseldorf University, Duesseldorf, Germany 8. Department of Paediatrics and Diabetes Research Centre, Linkoping University, Linkoping, Sweden 9. Department of Health, Advisory Committee on Diabetes in Catalonia, Barcelona, Spain 10. Pediatric Department, Glostrup University Hospital, Glostrup, Denmark 11. Department of Public Health, Oxford University, Oxford, UK 12. Department of Epidemiology, Medical University of Vienna, Vienna, Austria 13. Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland 14. Preventive Medicine Department, Federal University of S?o Paulo, S?o Paulo, Brazil 15. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 16. Paediatric Epidemiology Group, University of Leeds, Leeds, UK 17. Centre for Occupational and Health Psychology, Cardiff University, Cardiff, UK 18. Mathematics and Statistics Department, Lancaster University, Lancaster, UK 19. University Campus Bio-Medico, Rome, Italy 20. Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia 21. Institute of Endocrinology, Kaunas University of Medicine, Kaunas, Lithuania 22. Institute of Epidemiology, School of Medicine, Belgrade University, Belgrade, Serbia 23. Department of Paediatrics, Medical University of Vienna, Vienna, Austria 24. Nutrition and Metabolic Diseases Clinic, N. Paulescu Institute of Diabetes, Bucharest, Romania 25. Clinique Pédiatrique, Luxembourg, Luxembourg 26. Children’s Diabetic Centre, Sofia, Bulgaria 27. Bartholin Instituttet, Rigshospitalet, Copenhagen, Denmark |
| Abstract: | Aims/hypothesisWe investigated whether children who are heavier at birth have an increased risk of type 1 diabetes.MethodsRelevant studies published before February 2009 were identified from literature searches using MEDLINE, Web of Science and EMBASE. Authors of all studies containing relevant data were contacted and asked to provide individual patient data or conduct pre-specified analyses. Risk estimates of type 1 diabetes by category of birthweight were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were then used to derive combined ORs and investigate heterogeneity between studies.ResultsData were available for 29 predominantly European studies (five cohort, 24 case–control studies), including 12,807 cases of type 1 diabetes. Overall, studies consistently demonstrated that children with birthweight from 3.5 to 4 kg had an increased risk of diabetes of 6% (OR 1.06 [95% CI 1.01–1.11]; p?=?0.02) and children with birthweight over 4 kg had an increased risk of 10% (OR 1.10 [95% CI 1.04–1.19]; p?=?0.003), compared with children weighing 3.0 to 3.5 kg at birth. This corresponded to a linear increase in diabetes risk of 3% per 500 g increase in birthweight (OR 1.03 [95% CI 1.00–1.06]; p?=?0.03). Adjustments for potential confounders such as gestational age, maternal age, birth order, Caesarean section, breastfeeding and maternal diabetes had little effect on these findings.Conclusions/interpretationChildren who are heavier at birth have a significant and consistent, but relatively small increase in risk of type 1 diabetes. |
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