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Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Faculty of Health Sciences.
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2015 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 58, no 6, 1188-1197 p.Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis The aim of this study was to prospectively investigate whether psychological stress during childhood may be a risk factor for manifest type 1 diabetes. Methods The All Babies In Southeast Sweden (ABIS) study invited all families with babies born between 1 October 1997 and 30 September 1999 in southeast Sweden to participate. Our study subsample includes 10,495 participants in at least one of the data collections at 2-3, 5-6, 8 and 10-13 years of age not yet diagnosed with type 1 diabetes at inclusion; 58 children were subsequently diagnosed. Age at diagnosis was obtained from the national register SweDiabKids in 2012. Family psychological stress was measured via questionnaires given to the parents assessing serious life events, parenting stress, parental worries and the parents social support. Results Childhood experience of a serious life event was associated with a higher risk of future diagnosis of type 1 diabetes (HR 3.0 [95% CI 1.6, 5.6], p = 0.001) after adjusting for heredity of type 1 diabetes and age at entry into the study. The result was still valid when controlling for heredity of type 2 diabetes, size for gestational age, the parents education level and whether the mother worked at least 50% of full time before the childs birth (HR 2.8 [95% CI 1.5, 5.4], p = 0.002), and also when childhood BMI was added to the model (HR 5.0 [95% CI 2.3, 10.7], p less than 0.001). Conclusions/interpretation This first prospective study concluded that experience of a serious life event in childhood may be a risk factor for manifest type 1 diabetes.

Place, publisher, year, edition, pages
Springer Verlag (Germany) , 2015. Vol. 58, no 6, 1188-1197 p.
Keyword [en]
Longitudinal studies; Prospective studies; Psychological stress; Risk factors; Stressful events; Type 1 diabetes mellitus
National Category
Clinical Medicine Basic Medicine
Identifiers
URN: urn:nbn:se:liu:diva-118842DOI: 10.1007/s00125-015-3555-2ISI: 000353893000008PubMedID: 25870022OAI: oai:DiVA.org:liu-118842DiVA: diva2:818159
Note

Funding Agencies|Swedish Research Council [K2005-72X-11242-11A, K2008-69X-20826-01-4]; Swedish Child Diabetes Foundation (Barndiabetesfonden); JDRF Wallenberg Foundation [K 98-99D-12813-01A]; Medical Research Council of Southeast Sweden (FORSS); Swedish Council for Working Life and Social Research [FAS2004-1775]

Available from: 2015-06-08 Created: 2015-06-04 Last updated: 2016-04-01
In thesis
1. Stress in childhood and the risk of type 1 diabetes
Open this publication in new window or tab >>Stress in childhood and the risk of type 1 diabetes
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: It is still unknown why children develop type 1 diabetes (T1D), although both genetic predisposition and environmental factors seems to be involved. Stress has been suggested as one environmental factor contributing to the development of T1D since the stress hormones may increase the need for insulin or increase insulin resistance. The family is important for the child’s emotional security, development, and regulation of emotions, hence stress among the parent’s may influence the child’s experiences of stress and coping with stressors.

Aim: The aim of the current thesis was to evaluate self--‐assessment measurements of psychological stress in the family and to investigate if psychological stress in the family is involved in the development of childhood T1D.

Methods: The All Babies in Southeast Sweden (ABIS) study is a prospective cohort study following children born in southeast Sweden between 1997 and 1999. All parents of children born in the region, approximately 21600 were asked to participate. In total, questionnaire data has been obtained from n=16142 (response rate approximately 75%) in some of the six data--‐collections and between 15845 (73%) and 4022 (19%) at each data collection. Psychological stress in the family was measured by questionnaires assessing: Serious life events experienced by the child and the parent, parenting stress, parental dissatisfaction, parental worries, the parent’s adult attachment, and the parents’ social support. Identification of cases with T1D was done through the national register SweDiabKids. At Dec the 31st 2012 had in total 104 (0,64%) children been diagnosed with T1D. Diabetes--‐cases included in the study samples was n=42 and n=58.

Results: Parenting stress, parental worries, and size of social support were judged as reliable measurements assessing different aspects of psychological stress in the family, as well as they were all associated to children’s mental health in early adolescence. A serious life event experienced in childhood (measured by checklist at age 5--‐6, 8 and 10--‐ 14 years) was associated with an increase in risk for manifest T1D up to 13--‐15 years of age. None of the variables measuring psychological stress among parents were found to associate with risk of T1D.

Conclusions: In addition to a checklist assessing serious life events experienced by the child is self--‐assessment measurements of parenting stress, parental worries and the parent’s social support be useful in large--‐scale studies as proxies for psychological stress of the child. The current study is the first unbiased prospective study that can confirm an association between the experience of a serious life event and increased risk of T1D. The result was independent of the child’s BMI and the parents’ educational level. Our results gives us strong reason to believe that psychological stress caused by serious life events can play a part in the immunological process leading to the onset of T1D.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 94 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1475
National Category
Public Health, Global Health, Social Medicine and Epidemiology Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121066 (URN)10.3384/diss.diva-121066 (DOI)978-91-7685-973-5 (print) (ISBN)
Public defence
2015-09-25, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
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Available from: 2015-09-04 Created: 2015-09-04 Last updated: 2016-04-01Bibliographically approved

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Nygren, MariaCarstensen, JohnKoch, FelixLudvigsson, JohnnyFrostell, Anneli
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