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Association of antibiotics exposure within the first 2 years after birth with subsequent childhood type 1 diabetes

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Abstract

Purpose

Antibiotics prescription in early life can cause dysbiosis, an imbalance of gut microbiota. We aimed to reveal the relationship between antibiotics exposure during the first 2 years after birth and type 1 diabetes risk in children under 8 years of age using a nationally representative data from South Korea.

Methods

The final study population consisted of 63,434 children from the National Health Insurance Service (NHIS) database from 2008 to 2015. The primary exposure of interest was antibiotics prescription in first 2 years after birth. The analysis was conducted with cumulative defined daily dose (cDDD; 0–29, 30–59, ≥ 60 cDDD), the number of antibiotics classes (0–3, 4, ≥5 classes), and age at first antibiotics prescription (0–119, 120–239, ≥ 240 days). Age, sex, household income, and overweight were considered as potential confounding covariates.

Results

Compared to those within the less than 30 cDDD, other groups that were prescribed more antibiotics did not have a significant difference in diabetes risk (aHR 0.86, 95% CI 0.37–2.02 in ≥ 60 cDDD). The number of antibiotics classes and age at first antibiotics prescriptions were also not associated with the risk of type 1 diabetes. The development of diabetes was not related to the cDDD, the number of antibiotics classes, and age at first antibiotics prescription according to subgroup analysis which was stratified by overweight.

Conclusions

Antibiotics exposure within the first 2 years of life was not associated with subsequent diabetes risk. Future studies using a larger number of long-term follow-up data are needed.

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Data availability

This study used the NHIS database (NHIS-2020-2-072).

Code availability

SAS Enterprise Guide 7.1 (SAS Institute, Cary, NC, USA) was used to conduct all statistical analyzes.

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Author contributions

S.M.P. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: D.H.L., S.G.C., S.M.P. Acquisition of data: D.H.L., J.Y.C., S.M.P. Analysis and interpretation of data: D.H.L., S.G.C., J.Y.C., Y.J.P., S.M.P. Drafting of the manuscript: D.H.L., S.G.C., S.M.P. Critical revision of the manuscript: J.H.K., S.M.P. Statistical analysis: D.H.L., S.G.C., J.Y.C., Y.J.P. Administrative, technical, or material support: J.Y.C., S.G.C., S.M.P.

Funding

This research was supported by the Basic Science Research Program by the National Research Foundation of Korea (grant number: 2017R1D1A1B03033721).

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Authors and Affiliations

  1. Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea

    Dahye Lee

  2. Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, South Korea

    Seulggie Choi, Jooyoung Chang & Sang Min Park

  3. Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea

    Young Jun Park & Sang Min Park

  4. Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea

    Jae Hyun Kim

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  1. Dahye Lee
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Corresponding author

Correspondence to Sang Min Park.

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The authors declare no competing interests.

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The Ministry of Health and Welfare and National Research Foundation of Korea had no role in the design and conduct of the study, the collection, management, analysis, and interpretation of the data, or the preparation, review, or approval of the manuscript, and decision to submit for publication.

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The requirement for informed consent was waived as the NHIS data is anonymized according to strict confidentiality guidelines prior to distribution.

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This study was approved by the Seoul National University Hospital Institutional Review Board (IRB number: E-1904-003-1021).

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Lee, D., Choi, S., Chang, J. et al. Association of antibiotics exposure within the first 2 years after birth with subsequent childhood type 1 diabetes. Endocrine 77, 21–29 (2022). https://doi.org/10.1007/s12020-022-03042-7

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