Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt
Abstract
:1. Introduction
2. Subjects and Methods
2.1. Study Tools
2.2. Data Entry and Analysis
3. Results
3.1. Description of the Study Sample
3.2. Maternal and Environmental Factors Occurring during Pregnancy
3.3. Natal and Neonatal Factors
3.4. Feeding Practices in the First Year of Life
3.5. Childhood Environmental Factors
4. Discussion
5. Conclusions
Acknowledgment
Author Contributions
Conflicts of Interest
References
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Variables | Cases n = 204 | Controls n = 204 |
---|---|---|
Sex | ||
Male | 100 (49.0%) | 100 (49.0%) |
Female | 104 (51.0%) | 104 (51.0%) |
Age (years) | ||
6–9 | 116 (56.86%) | 116 (56.86%) |
10–16 | 88 (43.14%) | 88 (43.14%) |
Age at diagnosis of T1DM (years) | 7.94 ± 3.39 | - |
Duration of T1DM (years) | 6.36 ± 4.46 | - |
Maternal Factors | aOR (95% CI) |
---|---|
Residence (rural vs. urban) | 1.56 (1.02–2.50) |
Family income (insufficient vs. sufficient) | 2.37 (1.41–3.99) |
Mother’s age (>35 years vs. <35 years) | 8.53 (1.87–38.97) |
Family member smoking (positive history vs. negative) | 1.01 (0.85–1.89) |
Family history of type 1 DM (positive history vs. negative) | 2.48 (1.23–34.72) |
Consanguinity (positive history vs. negative) | 2.01 (1.32–4.78) |
History of maternal diseases/exposures during pregnancy | |
Pre-eclampsia (positive vs. negative) | 1.83 (0.26–7.83) |
Gestational DM (positive vs. negative) | 0.98 (0.38–2.52) |
Maternal infection (positive vs. negative) | 2.89 (1.02–10.76) |
Antepartum hemorrhage (positive vs. negative) | 1.21 (0.43–3.40) |
Over weight gain during pregnancy (positive vs. negative) | 2.94 (1.10–8.95) |
Antibiotic intake during pregnancy (positive vs. negative) | 2.45 (0.59–10.98) |
Antihypertensive intake during pregnancy (positive vs. negative) | 1.50 (0.26–8.62) |
Antiemetic intake during pregnancy (positive vs. negative) | 0.93 (0.43–2.15) |
Natal and Neonatal Factors | aOR (95% CI) |
---|---|
Place of delivery (hospital vs. home) | 0.15 (0.08–0.31) |
Mod of delivery (cesarean vs. vaginal) | 2.81 (1.59–4.95) |
Duration of pregnancy (preterm vs. full-term) | 4.60 (1.21–17.49) |
Birth weight (Kg) | |
Birth weight (2.5–3.0 vs. <2.5) | 0.77 (0.30–2.01) |
Birth weight (>3 vs. <2.5) | 0.94 (0.34–2.62) |
Birth order | |
Birth order (second vs. first) | 2.16 (1.21–3.85) |
Birth order (third or more vs. first) | 2.00 (1.05–3.80) |
History of neonatal jaundice (positive vs. negative) | 5.62 (2.98–10.62) |
History of neonatal infection (positive vs. negative) | 0.34 (0.07–1.68) |
History of neonatal respiratory distress (positive vs. negative) | 0.43 (0.09–1.56) |
Feeding Practice | aOR (95% CI) |
---|---|
Breast feeding (>6 months vs. <6 months) | 0.10 (0.07–0.48) |
History of introduction of cow’s milk in first year of life (positive vs. negative) | 6.37 (3.23–12.58) |
History of vitamin D Supplementation in first year of life (positive vs. negative) | 0.14 (0.08–0.24) |
Onset of weaning (less than five months vs. more than five months) | 1.25 (0.24–1.71) |
Childhood Environmental Factors | aOR (95% CI) |
---|---|
Childhood infection (positive history vs. negative) | |
Rubella | 1.02 (0.01–86.72) |
Measles | 7.89 (0.49–127.14) |
Varicella | 4.62 (0.59–13.42) |
Mumps | 3.65 (0.56–20.53) |
Allergy (positive history vs. negative) | |
Eczema | 1.88 (0.61–5.74) |
Rhinitis and conjunctivitis | 1.39 (0.45–4.29) |
Bronchial asthma | 1.33 (0.38–4.71) |
Diet (positive history vs. negative) | |
Frequent intake of preserved meat (>4 times/week) | 0.59 (0.36–1.95) |
Frequent intake of sweets (high) | 3.35 (1.95–5.76) |
Frequent intake of meat (>4 times/week) | 1.25 (0.52–3.01) |
Frequent Intake of fish (>4 times/week) | 3.66 (0.77–17.35) |
Frequent Intake of vegetables (>4 times/week) | 0.24 (0.09–0.70) |
Moving home (positive history vs. negative) | 1.75 (0.11–27.10) |
Physical activity (high vs. low) | 0.18 (0.13–0.25) |
Factors | β | S.E. | aOR (95% CI) |
---|---|---|---|
Residence (rural vs. urban) | 0.79 | 0.36 | 2.03 (1.30–4.25) |
Parental history of T1DM (positive history vs. negative) | 3.90 | 2.54 | 9.03 (1.02–85.32) |
Mod Of Delivery (cesarean vs. vaginal) | 0.75 | 0.43 | 2.13 (1.09–5.03) |
Breast feeding (>6 months vs. <6 months) | −1.46 | 0.39 | 0.23 (0.11–0.50) |
Introduction of cows milk in first year of life (positive vs. negative) | 2.99 | 0.42 | 19.94 (8.73–45.53) |
Vitamin D Supplementation in first year of life (positive vs. negative) | −2.16 | 0.37 | 0.11 (0.05–0.24) |
Physical Activity (high vs. low) | −2.90 | 0.44 | 0.05 (0.02–0.12) |
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Awadalla, N.J.; Hegazy, A.A.; Abd El-Salam, M.; Elhady, M. Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt. Int. J. Environ. Res. Public Health 2017, 14, 615. https://doi.org/10.3390/ijerph14060615
Awadalla NJ, Hegazy AA, Abd El-Salam M, Elhady M. Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt. International Journal of Environmental Research and Public Health. 2017; 14(6):615. https://doi.org/10.3390/ijerph14060615
Chicago/Turabian StyleAwadalla, Nabil J., Amal A. Hegazy, Manal Abd El-Salam, and Marwa Elhady. 2017. "Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt" International Journal of Environmental Research and Public Health 14, no. 6: 615. https://doi.org/10.3390/ijerph14060615
APA StyleAwadalla, N. J., Hegazy, A. A., Abd El-Salam, M., & Elhady, M. (2017). Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt. International Journal of Environmental Research and Public Health, 14(6), 615. https://doi.org/10.3390/ijerph14060615