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. 2018 Aug;55(8):797-804.
doi: 10.1007/s00592-018-1150-y. Epub 2018 May 12.

Influence of early-life parental severe life events on the risk of type 1 diabetes in children: the DiPiS study

Markus Lundgren  1   2 , Katarina Ellström  3 , Helena Elding Larsson  3   4 ; DiPiS study group
Collaborators, Affiliations

Influence of early-life parental severe life events on the risk of type 1 diabetes in children: the DiPiS study

Markus Lundgren et al. Acta Diabetol. 2018 Aug.

Abstract

Aims: Stress and severe life events (SLEs) modify autoimmune disease susceptibility. Here, we aimed to establish if SLEs reported by parents during the first 2 years of life influence the risk of developing type 1 diabetes (T1D) using data from the prospective Diabetes Prediction in Skåne (DiPiS) study.

Methods: Prospective questionnaire data recorded at 2 months (n = 23,187) and 2 years of age (n = 3784) from the DiPiS cohort of children were included in the analysis. SLEs were analyzed both by groups and as a combined variable. A Cox proportional hazards model was used to calculate hazard ratios (HRs) for T1D diagnosis for the total cohort and for the HLA-DQ2/8 high-risk population. Affected first-degree relatives, HLA-DQ risk group, paternal education level, and parents' country of birth were included as covariates.

Results: There was a significantly increased risk of T1D in children with SLEs occurring during the child's first 2 years of life for both the total cohort (HR 1.67; 95% CI 1.1, 2.7; p = 0.03) and the DQ2/8 cohort (HR 2.2; 95% CI 1.1, 4.2; p = 0.018). Subgroup analysis of events related to unemployment, divorce, or family conflict showed a significant hazard for these events occurring both during and after pregnancy in the DQ2/8 cohort (HR 2.17; 95% CI 1.1, 4.3; p = 0.03 and HR 4.98; 95% CI 2.3, 11; p < 0.001, respectively) and after pregnancy in the total cohort (multiple regression HR 2.07; 95% CI 1.01, 4.2; p = 0.047).

Conclusions: Children of parents experiencing an SLE during the child's first 2 years of life were at increased risk of T1D. Further studies including those measuring immune and stress-related biomarkers are necessary to validate the findings.

Keywords: Diabetes mellitus; Pediatrics; Prospective studies; Psychological; Stress; Type 1.

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Conflict of interest statement

Conflict of interest

The authors declare that there are no conflicts of interest.

Statement of human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Statement of informed consent

Informed consent was obtained from all patients for being included in the study.

Figures

Fig. 1
Fig. 1
Study inclusion flow chart
Fig. 2
Fig. 2
Kaplan–Meier curves of SLEs after pregnancy for the total cohort. Survival probability is plotted on the y-axis; note that this axis does not start at zero. Log-rank test: χ2 (1, n = 23,187) = 3.7, p = 0.055. Gray line: not exposed to event; black line: exposed to event
Fig. 3
Fig. 3
Kaplan–Meier curves of SLEs after pregnancy for the DQ2/8 cohort. Survival probability is plotted on the y-axis; note that this axis does not start at zero. Log-rank test: χ2 (1, n = 865) = 5.8, p = 0.016. Gray line: not exposed to life event; black line: exposed to event
See this image and copyright information in PMC

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