ArticleDiabetologia2016
The relationship between BMI and insulin resistance and progression from single to multiple autoantibody positivity and type 1 diabetes among TrialNet Pathway to Prevention participants.
Article in Diabetologia, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- High BMI and the risk for incident type 1 Diabetes Mellitus: a systematic review and meta-analysis of aggregated cohort studies.Cardiovascular diabetology · 2023Pooled it
- Changing epidemiology of immune-mediated inflammatory diseases in immigrants: A systematic review of population-based studies.Journal of autoimmunity · 2019Pooled it
- Effects of vitamin D supplementation on metabolic factors, serum omentin-1, and anthropometric indices in middle-aged women with prediabetes: a double-blind randomized controlled trial.Nutrition & diabetes · 2025Trial
- The interaction of vitamin D supplementation with Omentin-1 gene polymorphism on metabolic factors and anthropometric indices in women with prediabetes: a study protocol for a double-blind randomized controlled trial.BMC complementary medicine and therapies · 2025Trial
- Lifestyle and environmental risk factors for adult-onset autoimmune diabetes: current evidence and future directions.Diabetologia · 2026Review
- Single Autoantibody Positivity in Pediatric Type 1 Diabetes: Serological Profiles, Clinical Trajectories and Implications for Early Disease Monitoring-A Case Series of Seven Patients.Life (Basel, Switzerland) · 2026Article
- Impact of Body Size on Preclinical Type 1 Diabetes Development and Progression.Diabetes care · 2026Review
- Evaluation of body mass index, waist-to-hip ratio, and waist-to-height ratio as predictors of insulin resistance in Syrian adult women: A cross-sectional study.The Journal of international medical research · 2026Article
- New and emerging therapies in type 1 diabetes mellitus.The Journal of clinical investigation · 2026Review
- Article
- Neonatal and Birth Risk Factors for Type 1 Diabetes Mellitus: Prediction Using an Artificial Neural Network.Life (Basel, Switzerland) · 2025Article
- Metabolic Phenotype of Stage 1 and Stage 2 Type 1 Diabetes Using Modeling of β Cell Function.The Journal of clinical endocrinology and metabolism · 2025Article
- Type 1 diabetes presenting in adults: Trends, diagnostic challenges and unique features.Diabetes, obesity & metabolism · 2025Review
- Association Between Estimated Glucose Disposal Rate and Stroke in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.Journal of the American Heart Association · 2025Article
- Large-scale analysis highlights obesity as a risk factor for chronic, non-communicable inflammatory diseases.Frontiers in endocrinology · 2025Article
- Time to reframe the disease staging system for type 1 diabetes.The lancet. Diabetes & endocrinology · 2024Review
- Beyond Stages: Predicting Individual Time Dependent Risk for Type 1 Diabetes.The Journal of clinical endocrinology and metabolism · 2024Article
- Positive Correlation between BMI and Left Ventricle and Atrium Inside Diameter Size in Chinese Type 2 Diabetes Patients with Left Ventricular and Atrial Enlargement.Reviews in cardiovascular medicine · 2024Article
- HOMA-IR and the Matsuda Index as predictors of progression to type 1 diabetes in autoantibody-positive relatives.Diabetologia · 2024Article
- Review
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
aims/hypothesisThe incidence of type 1 diabetes is increasing at a rate of 3-5% per year. Genetics cannot fully account for this trend, suggesting an influence of environmental factors. The accelerator hypothesis proposes an effect of metabolic factors on type 1 diabetes risk. To test this in the TrialNet Pathway to Prevention (PTP) cohort, we analysed the influence of BMI, weight status and insulin resistance on progression from single to multiple islet autoantibodies (Aab) and progression from normoglycaemia to diabetes.
methodsHOMA1-IR was used to estimate insulin resistance in Aab-positive PTP participants. Cox proportional hazards models were used to evaluate the effects of BMI, BMI percentile (BMI%), weight status and HOMA1-IR on the progression of autoimmunity or the development of diabetes.
resultsData from 1,310 single and 1,897 multiple Aab-positive PTP participants were included. We found no significant relationships between BMI, BMI%, weight status or HOMA1-IR and the progression from one to multiple Aabs. Similarly, among all Aab-positive participants, no significant relationships were found between BMI, weight status or HOMA1-IR and progression to diabetes. Diabetes risk was modestly increased with increasing BMI% among the entire cohort, in obese participants 13-20 years of age and with increasing HOMA1-IR in adult Aab-positive participants. CONCLUSIONS/
interpretationAnalysis of the accelerator hypothesis in the TrialNet PTP cohort does not suggest a broad influence of metabolic variables on diabetes risk. Efforts to identify other potentially modifiable environmental factors should continue.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.