Physical Activity and the Development of Islet Autoimmunity and Type 1 Diabetes in 5- to 15-Year-Old Children Followed in the TEDDY Study
Xiang Liu, Suzanne Bennett Johnson, Kristian Lynch, Kerry Cordan, Russell R. Pate, Martha Butterworth, Åke Lernmark, William Hagopian, Marian J. Rewers, Richard McIndoe, Jorma Toppari, Anette‐G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Jimin Yang, The TEDDY Study Group, Marian Rewers, Kimberly Bautista, Judith Baxter, Daniel Felipe-Morales, Brigitte I. Frohnert, Marisa Stahl, Isabel Flores Garcia, Patricia Gesualdo, Sierra Hays, Michelle Hoffman, Rachel Karban, Edwin Liu, Leila Loaiza, Jill Norris, Holly O’Donnell, Loana Thorndahl, Andrea K. Steck, Kathleen Waugh, Jorma Toppari, Olli Simell, Annika Adamsson, Suvi Ahonen, Iris Erlund, Sirpa Anttila, Leena Hakola, Anne Hekkala, Tiia Honkanen, Heikki Hyöty, Jorma Ilonen, Sanna Jokipuu, Taru Karjalainen, Leena Eklund Karlsson, Jukka Kero, Jaakko J. Koskenniemi, Miia Kähönen, Mikael Knip, Minna-Liisa Koivikko, Katja Kokkonen, Merja Koskinen, Mirva Koreasalo, Kalle Kurppa, Salla Kuusela, Jarita Kytölä, Jutta E. Laiho, Tiina Latva-aho, Siiri Leisku, Laura Leppänen, Katri Lindfors, Maria Lönnrot, Elina Mäntymäki, Markus Mattila, Maija E. Miettinen, Teija Mykkänen, Tiina Niininen, Sari Niinistö, Noora Nurminen, Sami Oikarinen, Hanna-Leena Oinas, Paula Ollikainen, Zhian Othmani, Sirpa Pohjola, Solja Raja-Hanhela, Jenna Rautanen, Anne Riikonen, Minna Romo, Juulia Rönkä, Nelli Rönkä, Satu Simell, Päivi Tossavainen, Mari Vähä-Mäkilä, Eeva Varjonen, Riitta Veijola, Irene Viinikangas, Silja Vilmi, Suvi Μ. Virtanen, Richard McIndoe, Desmond Schatz, Diane Hopkins, Michael J. Haller, Risa Bernard, Melissa Gardiner, Ashok Sharma, Laura M. Jacobsen, Jennifer Hosford
Abstract
OBJECTIVE: This study investigated physical activity and its association with the development of islet autoimmunity and type 1 diabetes in genetically at-risk children aged 5-15 years. RESEARCH DESIGN AND METHODS: As part of the longitudinal Environmental Determinants of Diabetes in the Young (TEDDY) study, annual assessment of activity using accelerometry was conducted from age 5 years. Time-to-event analyses using Cox proportional hazard models were used to assess the association between time spent in moderate to vigorous physical activity per day and the appearance of one or several autoantibodies and progression to type 1 diabetes in three risk groups: 1) 3,869 islet autoantibody (IA)-negative children, of whom 157 became single IA positive; 2) 302 single IA-positive children, of whom 73 became multiple IA positive; and 3) 294 multiple IA-positive children, of whom 148 developed type 1 diabetes. RESULTS: No significant association was found in risk group 1 or risk group 2. A significant association was seen in risk group 3 (hazard ratio 0.920 [95% CI 0.856, 0.988] per 10-min increase; P = 0.021), particularly when glutamate decarboxylase autoantibody was the first autoantibody (hazard ratio 0.883 [95% CI 0.783, 0.996] per 10-min increase; P = 0.043). CONCLUSIONS: More daily minutes spent in moderate to vigorous physical activity was associated with a reduced risk of progression to type 1 diabetes in children aged 5-15 years who had developed multiple IAs.