| Cesarean section and interferon-induced helicase gene polymorphisms combine to increase childhood type 1 diabetes risk. | |
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MedLine Citation:
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PMID: 22110093 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE The incidence of type 1 diabetes is increasing. Delivery by cesarean section is also more prevalent, and it is suggested that cesarean section is associated with type 1 diabetes risk. We examine associations between cesarean delivery, islet autoimmunity and type 1 diabetes, and genes involved in type 1 diabetes susceptibility. RESEARCH DESIGN AND METHODS Cesarean section was examined as a risk factor in 1,650 children born to a parent with type 1 diabetes and followed from birth for the development of islet autoantibodies and type 1 diabetes. RESULTS Children delivered by cesarean section (n = 495) had more than twofold higher risk for type 1 diabetes than children born by vaginal delivery (hazard ratio [HR] 2.5; 95% CI 1.4-4.3; P = 0.001). Cesarean section did not increase the risk for islet autoantibodies (P = 0.6) but was associated with a faster progression to diabetes after the appearance of autoimmunity (P = 0.015). Cesarean section-associated risk was independent of potential confounder variables (adjusted HR 2.7;1.5-5.0; P = 0.001) and observed in children with and without high-risk HLA genotypes. Interestingly, cesarean section appeared to interact with immune response genes, including CD25 and in particular the interferon-induced helicase 1 gene, where increased risk for type 1 diabetes was only seen in children who were delivered by cesarean section and had type 1 diabetes-susceptible IFIH1 genotypes (12-year risk, 9.1 vs. <3% for all other combinations; P < 0.0001). CONCLUSIONS These findings suggest that type 1 diabetes risk modification by cesarean section may be linked to viral responses in the preclinical autoantibody-positive disease phase. |
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Authors:
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Ezio Bonifacio; Katharina Warncke; Christiane Winkler; Maike Wallner; Anette-G Ziegler |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes Volume: 60 ISSN: 1939-327X ISO Abbreviation: Diabetes Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372763 Medline TA: Diabetes Country: United States |
Other Details:
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Languages: eng Pagination: 3300-6 Citation Subset: AIM; IM |
Affiliation:
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Corresponding author: Anette-G. Ziegler, anette-g.ziegler@helmholtz-muenchen.de. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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