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. 2022 Nov 18;22(1):284.
doi: 10.1186/s12902-022-01197-y.

Use of antibiotics and risk of type 2 diabetes, overweight and obesity: the Cardiovascular Risk in Young Finns Study and the national FINRISK study

Joel Nuotio  1   2   3   4 , Teemu Niiranen  5   6   7 , Tomi T Laitinen  8   9   10 , Jessica Miller  9   11 , Matthew A Sabin  9   11   12 , Aki S Havulinna  5   13 , Jorma S A Viikari  6   7 , Tapani Rönnemaa  6   7 , Nina Hutri-Kähönen  14 , Tomi P Laitinen  15 , Päivi Tossavainen  16 , Veikko Salomaa  5 , Olli T Raitakari  8   17 , David P Burgner  9   11 , Markus Juonala  9   6   7
Affiliations

Use of antibiotics and risk of type 2 diabetes, overweight and obesity: the Cardiovascular Risk in Young Finns Study and the national FINRISK study

Joel Nuotio et al. BMC Endocr Disord. .

Abstract

Purpose: To investigate whether exposure to systemic antibiotics influences the risk of developing type 2 diabetes and overweight/obesity.

Methods: The study sample comprised 2209 (110 with incident diabetes) participants from the population-based Cardiovascular Risk in Young Finns Study (YFS) aged 24-39 years in 2001. The exposure was national linked register data on purchased antibiotic courses between 1993 and 2001. Clinical examinations including BMI were conducted in 2001, 2007 and 2011. Participants with prevalent diabetes in 2001 were excluded. Data on type 2 diabetes was also obtained from two national registers until 2017. Data from four population-based National FINRISK studies were used for replication (N = 24,674, 1866 with incident diabetes).

Results: Prior antibiotic exposure (> 5 versus 0-1 antibiotic courses) was associated with subsequent type 2 diabetes in both YFS (OR 2.29; 95%CI 1.33-3.96) and FINRISK (HR 1.73; 95%CI 1.51-1.99). An increased risk for type 2 diabetes was observed in YFS (OR 1.043; 95%CI 1.013-1.074) and FINRISK (HR 1.022; 95%CI 1.016-1.029) per course. Exposure to antibiotics increased the risk of overweight/obesity (BMI > 25 kg/m2) after a 10-year follow-up in YFS (OR 1.043; 95%CI 1.019-1.068) and in FINRISK (OR 1.023; 95%CI 1.018-1.029) at baseline per antibiotic course. Adjustments for confounders from early life in YFS and at baseline in FINRISK, including BMI, socioeconomic status, smoking, insulin, blood pressure, and physical activity, did not appreciably alter the findings.

Conclusion: Our results show that exposure to antibiotics was associated with increased risk for future type 2 diabetes and overweight/obesity and support judicious antibiotic prescribing.

Keywords: Antibiotics; Obesity; Type 2 diabetes.

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Conflict of interest statement

None. VS has consulted for Novo Nordisk and Sanofi and received honoraria from these companies. He also has ongoing research collaboration with Bayer Ag. (All unrelated to the present study).

Figures

Fig. 1
Fig. 1
Incidence of Type 2 diabetes from baseline to 2017 according to prior antibiotic medication exposure quartiles (data from 1993 to baseline) in the Young Finns Study and the National Finrisk Study. P for trend was calculated 1) using a logistic regression model adjusted for age, sex, childhood family income, parental smoking and early life (age 6 to 24 years) body mass index, insulin, systolic blood pressure, and physical activity in YFS and 2) using a Cox regression model adjusted for age, sex, study cohort, income, smoking, systolic blood pressure, physical activity in FINRISK
Fig. 2
Fig. 2
Body mass index according to prior antibiotic medication exposure (quartiles, data from 1993 to baseline) in the Young Finns Study and the National FINRISK Study. P for trend was calculated using a linear regression model adjusted for 1) age, sex, childhood family income, parental smoking and early life (age 6 to 24 years) body mass index, insulin, systolic blood pressure, and physical activity in YFS and 2) age, sex, study cohort, income, smoking, systolic blood pressure, physical activity in FINRISK. Body mass index measured at baseline (1997, 2002, 2007 or 2012) in FINRISK and at the most recent follow-up (2011) in YFS
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