title: Excess BMI in Childhood: A Modifiable Risk Factor for Type 1 Diabetes Development?
abstract: We aimed to determine the effect of elevated BMI over time on the progression to type 1 diabetes in youth.
  
  
  
  We studied 1,117 children in the TrialNet Pathway to Prevention cohort (autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI above the 85th age- and sex-adjusted percentile generated a cumulative excess BMI (ceBMI) index. Recursive partitioning and multivariate analyses yielded sex- and age-specific ceBMI thresholds for greatest type 1 diabetes risk.
  
  
  
  Higher ceBMI conferred significantly greater risk of progressing to type 1 diabetes. The increased diabetes risk occurred at lower ceBMI values in children <12 years of age compared with older subjects and in females versus males.
  
  
  
  Elevated BMI is associated with increased risk of diabetes progression in pediatric autoantibody-positive relatives, but the effect varies by sex and age.
authors.affiliation: University of California, San Francisco, San Francisco, CA christine.ferrara@ucsf.edu.
authors.forename: Christine Therese
authors.initials: CT
authors.lastname: Ferrara
authors.affiliation: University of South Florida, Tampa, FL.
authors.forename: Susan Michelle
authors.identifier: 0000-0003-0008-7751
authors.initials: SM
authors.lastname: Geyer
authors.affiliation: King's College London, London, U.K.
authors.forename: Yuk-Fun
authors.initials: YF
authors.lastname: Liu
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Carmella
authors.initials: C
authors.lastname: Evans-Molina
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Libman
authors.affiliation: Oxford University Hospitals NHS Foundation Trust, Oxford, U.K.
authors.forename: Rachel
authors.initials: R
authors.lastname: Besser
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Becker
authors.affiliation: University of South Florida, Tampa, FL.
authors.forename: Henry
authors.initials: H
authors.lastname: Rodriguez
authors.affiliation: Department of Pediatric Endocrinology, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Moran
authors.affiliation: University of California, San Francisco, San Francisco, CA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gitelman
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Redondo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D063766:Pediatric Obesity / Q000150:complications*; D012307:Risk Factors; D012737:Sex Factors