Girls’ risk of developing type 1 diabetes drops significantly after the age 10 while the risk for boys remains the same, researchers have said.
In addition, type 1 diabetes risk is markedly higher in boys with a single autoantibody than girls with a single autoantibody.
This implies that sex could be associated with autoantibody development, making sex an important consideration when it comes to calculating the risk of someone developing type 1 diabetes.
In autoimmune diseases including type 1 diabetes, autoantibodies are produced by the body’s immune system and attack other proteins.
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In type 1 diabetes, male sex is a risk factor, unlike other autoimmune diseases.
This has led to the thinking that either immune, metabolic, or other differences between male and female sex may play a part in the risk or progression of type 1 diabetes.
The authors said: “The risk of type 1 diabetes is significantly higher in males than females when presenting with a single autoantibody. Risk is similar between males and females in childhood, with the risk diverging at age 10. Risk in females then dramatically decreases, whereas risk is sustained in males.”
“Speaking about the difference in risk between boys and girls, the authors go on to say: “We don’t know, and this is an interesting area where more research is needed.
“The change in risk at around the age of 10 raises the hypothesis that puberty-related hormones may play a role.”
They went on: “We found the biggest differences in risk of type 1 diabetes in individuals who had not progressed to stage 1 type 1 diabetes, with a similar rate and risk of progression in those who were stage 1 and stage 2 type 1 diabetes.
“Therefore, it seems most likely that explaining the mechanism of sex differences may help us understand underlying pathogenesis of type 1 diabetes and potential intervention targets, more than affecting how we screen, diagnose and intervene.”
The study involved researchers assessing 235,765 relatives of people with type 1 diabetes, using modelling to predict the five-year risk of type 1 diabetes for males and females.
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Five-year risk of progression to type 1 diabetes in those with single autoantibodies was significantly higher in males – 21% compared to 14% in females.
The study authors reported a significant drop in five-year type 1 diabetes risk in females when screened, and autoantibody positive, after the age of 10, compared to before the age of 10.
For males, there was a steady decline in five-year type 1 diabetes risk as age at screening increases.
The research, led by Erin L. Templeman and Dr Richard Oram from University of Exeter Medical School, will be presented in Madrid next month at the Annual Meeting of the European Association for Study of Diabetes.
