Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies

Show simple item record Cardwell, Chris R. Stene, Lars C. Joner, Geir Bulsara, Max K. Cinek, Ondrej Rosenbauer, Joachim Ludvigsson, Johnny Svensson, Jannet Goldacre, Michael J. Waldhoer, Thomas Jarosz-Chobot, Przemyslawa Gimeno, Suely Godoy Agostinho [UNIFESP] Chuang, Lee-Ming Roberts, Christine L. Parslow, Roger C. Wadsworth, Emma J. K. Chetwynd, Amanda Brigis, Girts Urbonaite, Brone Sipetic, Sandra Schober, Edith Devoti, Gabriele Ionescu-Tirgoviste, Constantin Beaufort, Carine E. de Stoyanov, Denka Buschard, Karsten Radon, Katja Glatthaar, Christopher Patterson, Chris C. 2016-01-24T14:06:19Z 2016-01-24T14:06:19Z 2011-04-01
dc.identifier.citation International Journal of Epidemiology. Oxford: Oxford Univ Press, v. 40, n. 2, p. 363-374, 2011.
dc.identifier.issn 0300-5771
dc.description.abstract Background the incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies.Methods Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity.Results Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR = 0.90 95% confidence interval (CI) 0.83-0.98; P = 0.02] but this association varied markedly between studies (I(2) = 67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children < 5 years of age (n = 25 studies, maternal age adjusted OR = 0.84 95% CI 0.75, 0.93; I(2) = 23%).Conclusion Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged < 5 years. This finding could reflect increased exposure to infections in early life in later born children. en
dc.description.sponsorship Czech Republic Ministry of Education
dc.description.sponsorship Department of Health of Taiwan
dc.description.sponsorship Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorship Swedish Child Diabetes Foundation
dc.description.sponsorship NHS National Coordinating Centre for Research Capacity Development UK
dc.description.sponsorship Australian National Health and Medical Research Council (NHMRC)
dc.description.sponsorship Research Council of Norway
dc.description.sponsorship German Research Foundation
dc.description.sponsorship Ministry for Science and Technological Development of Serbia
dc.description.sponsorship European Commission Health Information Strand
dc.description.sponsorship Diabetes UK
dc.description.sponsorship Northern Ireland Department of Health and Social Services
dc.format.extent 363-374
dc.language.iso eng
dc.publisher Oxford Univ Press
dc.relation.ispartof International Journal of Epidemiology
dc.rights Acesso aberto
dc.subject Diabetes mellitus en
dc.subject type 1 en
dc.subject epidemiology en
dc.subject birth order en
dc.subject meta-analysis en
dc.title Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies en
dc.type Artigo
dc.contributor.institution Queens Univ Belfast
dc.contributor.institution Norwegian Inst Publ Hlth
dc.contributor.institution Oslo Univ Hosp
dc.contributor.institution Univ Oslo
dc.contributor.institution Univ Western Australia
dc.contributor.institution Univ Notre Dame
dc.contributor.institution Charles Univ Prague
dc.contributor.institution Univ Dusseldorf
dc.contributor.institution Linkoping Univ
dc.contributor.institution Glostrup Univ Hosp
dc.contributor.institution Univ Oxford
dc.contributor.institution Med Univ Vienna
dc.contributor.institution Med Univ Silesia
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Natl Taiwan Univ Hosp
dc.contributor.institution Univ Sydney
dc.contributor.institution Univ Leeds
dc.contributor.institution Cardiff Univ
dc.contributor.institution Univ Lancaster
dc.contributor.institution Riga Stradins Univ
dc.contributor.institution Kaunas Univ Med
dc.contributor.institution Univ Belgrade
dc.contributor.institution Univ Lecce
dc.contributor.institution N Paulescu Inst Diabet
dc.contributor.institution Pediat Clin
dc.contributor.institution Childrens Diabet Ctr
dc.contributor.institution Rigshosp
dc.contributor.institution Hosp LMU Munich
dc.contributor.institution Sir Charles Gairdner Hosp
dc.description.affiliation Queens Univ Belfast, Ctr Publ Hlth, Sch Med Dent & Biomed Sci, Belfast BT12 6BJ, Antrim, North Ireland
dc.description.affiliation Norwegian Inst Publ Hlth, Div Epidemiol, Oslo, Norway
dc.description.affiliation Oslo Univ Hosp, Oslo Diabet Res Ctr, Oslo, Norway
dc.description.affiliation Univ Oslo, Inst Hlth Management & Hlth Econ, Oslo, Norway
dc.description.affiliation Univ Western Australia, Telethon Inst Child Hlth Res, Ctr Child Hlth Res, Perth, WA 6009, Australia
dc.description.affiliation Univ Notre Dame, Inst Hlth & Rehabil Res, Fremantle, Australia
dc.description.affiliation Charles Univ Prague, Sch Med 2, Prague, Czech Republic
dc.description.affiliation Univ Dusseldorf, Leibniz Inst, Inst Biometr & Epidemiol, German Diabet Ctr, Dusseldorf, Germany
dc.description.affiliation Linkoping Univ, Dept Paediat, Linkoping, Sweden
dc.description.affiliation Linkoping Univ, Diabet Res Ctr, Linkoping, Sweden
dc.description.affiliation Glostrup Univ Hosp, Dept Pediat, Glostrup, Denmark
dc.description.affiliation Univ Oxford, Dept Publ Hlth, Oxford, England
dc.description.affiliation Med Univ Vienna, Dept Epidemiol, Vienna, Austria
dc.description.affiliation Med Univ Silesia, Dept Pediat Endocrinol & Diabet, Katowice, Poland
dc.description.affiliation Universidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil
dc.description.affiliation Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
dc.description.affiliation Univ Sydney, Kolling Inst Med Res, Sydney, NSW 2006, Australia
dc.description.affiliation Univ Leeds, Paediat Epidemiol Grp, Leeds, W Yorkshire, England
dc.description.affiliation Cardiff Univ, Ctr Occupat & Hlth Psychol, Cardiff, S Glam, Wales
dc.description.affiliation Univ Lancaster, Dept Math & Stat, Lancaster, England
dc.description.affiliation Riga Stradins Univ, Dept Publ Hlth & Epidemiol, Riga, Latvia
dc.description.affiliation Kaunas Univ Med, Inst Endocrinol, Kaunas, Lithuania
dc.description.affiliation Univ Belgrade, Sch Med, Inst Epidemiol, Belgrade, Serbia
dc.description.affiliation Med Univ Vienna, Dept Paediat, Vienna, Austria
dc.description.affiliation Univ Lecce, Dept Social Sci & Commun, I-73100 Lecce, Italy
dc.description.affiliation N Paulescu Inst Diabet, Nutr & Metab Dis Clin, Bucharest, Romania
dc.description.affiliation Pediat Clin, Luxembourg, Luxembourg
dc.description.affiliation Childrens Diabet Ctr, Sofia, Bulgaria
dc.description.affiliation Rigshosp, Bartholin Inst, DK-2100 Copenhagen, Denmark
dc.description.affiliation Hosp LMU Munich, Inst Occupat & Environm Med, Munich, Germany
dc.description.affiliation Hosp LMU Munich, Outpatient Clin Occupat & Environm Med, Munich, Germany
dc.description.affiliation Sir Charles Gairdner Hosp, Perth, WA, Australia
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil
dc.description.sponsorshipID Czech Republic Ministry of Education: MSM 0021620814
dc.description.sponsorshipID Department of Health of Taiwan: DOH 90-TD1028
dc.description.sponsorshipID FAPESP: 94/0943-0
dc.description.sponsorshipID Australian National Health and Medical Research Council (NHMRC): 457302
dc.description.sponsorshipID German Research Foundation: HE 234/1-1
dc.description.sponsorshipID Ministry for Science and Technological Development of Serbia: 145084
dc.description.sponsorshipID European Commission Health Information Strand: 2007115
dc.identifier.doi 10.1093/ije/dyq207
dc.description.source Web of Science
dc.identifier.wos WOS:000289165800015


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