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Secular trends of body mass index in N orth I ndian children with T ype 1 diabetes do not support the A ccelerator H ypothesis
Author(s) -
Dayal Devi,
Samprathi Madhusudan,
Jayaraman Dhaarani,
Kohat Dilesh,
Bhalla Anil Kumar
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12941
Subject(s) - body mass index , context (archaeology) , diabetes mellitus , obesity , medicine , anthropometry , childhood obesity , type 2 diabetes , endocrinology , demography , biology , overweight , paleontology , sociology
Summary Objective The accelerator hypothesis, which proposes a link between T ype 1 diabetes ( T 1 D ) and T ype 2 diabetes ( T 2 D ) through weight‐related insulin resistance, remains untested in developing countries with increasing rates of childhood obesity and T 1 D , and different ethnicities. We aimed to test the accelerator hypothesis in the context of a significant increase in T 1 D at our centre. Design and methods Medical records of children diagnosed with T 1 D between J anuary 2005 and D ecember 2014 were retrospectively reviewed. The body mass index ( BMI ) standard deviation scores ( SDS s) were calculated using height and weight measurements recorded 1–2 months after diagnosis of T 1 D and compared with age‐matched anthropometric data. The rate of change in BMI SDS s over time was calculated. Analysis of BMI data was undertaken for the three age categories: <5, 5 to <10 and >10 years. Results The mean age at diagnosis of 467 children with T 1 D was 7·27 ± 0·32 years and showed no change over the study period. There was a yearly increase of 14·11% in patient numbers; this increase was similar in the three age categories (22·7%, 17·0%, 16·3%, respectively, P = 1·0). Comparison of patient numbers between the two time periods of 5 years each showed a marked increase during 2010–2014 (148 vs 319, % increase 115·5%). The mean BMI SDS s at diagnosis in the three age categories were similar ( P = 1·0) and showed a yearly change of −0·36; the mean change in the three age categories was also similar (−0·35, −0·27, −0·46, respectively, P = 1·0). No correlation was found between age at diagnosis and BMI SDS s (correlation coefficient 0·010, P = 0·82). The mean BMI SDS in patients was significantly lower compared to controls (−0·54 vs −0·02, P = 0·001). Conclusion There was no association between BMI SDS and age at diagnosis in children with new onset T 1 D . Further studies are needed to test whether the accelerator hypothesis is relevant in developing countries.