Association of environmental markers with childhood type 1 diabetes mellitus revealed by a long questionnaire on early life exposures and lifestyle in a case-control study.
BACKGROUND
The incidence of childhood type 1 diabetes (T1D) incidence is rising in many countries, supposedly because of changing environmental factors, which are yet largely unknown. The purpose of the study was to unravel environmental markers associated with T1D.


METHODS
Cases were children with T1D from the French Isis-Diab cohort. Controls were schoolmates or friends of the patients. Parents were asked to fill a 845-item questionnaire investigating the child's environment before diagnosis. The analysis took into account the matching between cases and controls. A second analysis used propensity score methods.


RESULTS
We found a negative association of several lifestyle variables, gastroenteritis episodes, dental hygiene, hazelnut cocoa spread consumption, wasp and bee stings with T1D, consumption of vegetables from a farm and death of a pet by old age.


CONCLUSIONS
The found statistical association of new environmental markers with T1D calls for replication in other cohorts and investigation of new environmental areas.


BACKGROUND
Clinical-Trial.gov NCT02212522 . Registered August 6, 2014.
Sorbonne Universités, UPMC Univ Paris 06, CNRS, Paris, France. felix.balazard@inserm.fr.|INSERM U1169, Hôpital Bicêtre, Université Paris-Sud, Kremlin-Bicêtre, France. felix.balazard@inserm.fr.
F
http://orcid.org/0000-0003-3336-0128
F
Balazard
INSERM U1169, Hôpital Bicêtre, Université Paris-Sud, Kremlin-Bicêtre, France.|Department of pediatric endocrinology, Hôpital Bicêtre, Kremlin-Bicêtre, France.
S
S
Le Fur
INSERM U1169, Hôpital Bicêtre, Université Paris-Sud, Kremlin-Bicêtre, France.
S
S
Valtat
INSERM U1169, Hôpital Bicêtre, Université Paris-Sud, Kremlin-Bicêtre, France.
A J
AJ
Valleron
INSERM U1169, Hôpital Bicêtre, Université Paris-Sud, Kremlin-Bicêtre, France.|Department of pediatric endocrinology, Hôpital Bicêtre, Kremlin-Bicêtre, France.
P
P
Bougnères
Dominique
D
Thevenieau
Corinne Fourmy
CF
Chatel
Rachel
R
Desailloud
Hélène
H
Bony-Trifunovic
Pierre-Henri
PH
Ducluzeau
Régis
R
Coutant
Sophie
S
Caudrelier
Armelle
A
Pambou
Emmanuelle
E
Dubosclard
Florence
F
Joubert
Philippe
P
Jan
Estelle
E
Marcoux
Anne-Marie
AM
Bertrand
Brigitte
B
Mignot
Alfred
A
Penformis
Chantal
C
Stuckens
Régis
R
Piquemal
Pascal
P
Barat
Vincent
V
Rigalleau
Chantal
C
Stheneur
Sylviane
S
Fournier
Véronique
V
Kerlan
Chantal
C
Metz
Anne
A
Fargeot-Espaliat
Yves
Y
Reznic
Frédérique
F
Olivier
Iva
I
Gueorguieva
Arnaud
A
Monier
Catherine
C
Radet
Vincent
V
Gajdos
Daniel
D
Terral
Christine
C
Vervel
Djamel
D
Bendifallah
Candace Ben
CB
Signor
Daniel
D
Dervaux
Abdelkader
A
Benmahammed
Guy-André
GA
Loeuille
Françoise
F
Popelard
Agnès
A
Guillou
Pierre-Yves
PY
Benhamou
Jamil
J
Khoury
Jean-Pierre
JP
Brossier
Joachim
J
Bassil
Sylvaine
S
Clavel
Bernard
B
Le Luyer
Pierre
P
Bougnères
Françoise
F
Labay
Isabelle
I
Guemas
Jacques
J
Weill
Jean-Pierre
JP
Cappoen
Sylvie
S
Nadalon
Anne
A
Lienhardt-Roussie
Anne
A
Paoli
Claudie
C
Kerouedan
Edwige
E
Yollin
Marc
M
Nicolino
Gilbert
G
Simonin
Jacques
J
Cohen
Catherine
C
Atlan
Agnès
A
Tamboura
Hervé
H
Dubourg
Marie-Laure
ML
Pignol
Philippe
P
Talon
Stéphanie
S
Jellimann
Lucy
L
Chaillous
Sabine
S
Baron
Marie-Noëlle
MN
Bortoluzzi
Elisabeth
E
Baechler
Randa
R
Salet
Ariane
A
Zelinsky-Gurung
Fabienne
F
Dallavale
Etienne
E
Larger
Marie
M
Laloi-Michelin
Jean-François
JF
Gautier
Bénédicte
B
Guérin
Laure
L
Oilleau
Laetitia
L
Pantalone
Céline
C
Lukas
Isabelle
I
Guilhem
Marc
M
De Kerdanet
Marie-Claire
MC
Wielickzo
Mélanie
M
Priou-Guesdon
Odile
O
Richard
François
F
Kurtz
Norbert
N
Laisney
Déborah
D
Ancelle
Guilhem
G
Parlier
Catherine
C
Boniface
Dominique Paris
DP
Bockel
Denis
D
Dufillot
Berthe
B
Razafimahefa
Pierre
P
Gourdy
Pierre
P
Lecomte
Myriam
M
Pepin-Donat
Marie-Emmanuelle
ME
Combes-Moukhovsky
Brigitte
B
Zymmermann
Marina
M
Raoulx
Anne Gourdin Et Catherine
AG
Dumont
Case–control; Data-driven; Environment; Epidemiology; Type 1 diabetes
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