Analgesic antipyretic use among young children in the TEDDY study: No association with islet autoimmunity

for the TEDDY Study Group

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.

Original languageEnglish (US)
Article number127
JournalBMC pediatrics
Volume17
Issue number1
DOIs
StatePublished - May 16 2017

Fingerprint

Antipyretics
Autoimmunity
Analgesics
Acetaminophen
Anti-Inflammatory Agents
Fever
Finland
Sweden
Germany
Pharmaceutical Preparations
Infection
Proportional Hazards Models
Autoantibodies
Homeostasis
Cohort Studies
Logistic Models
Prospective Studies
Glucose
Incidence

Keywords

  • Analgesics
  • Islet autoimmunity
  • Prospective studies
  • Type 1 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity. / for the TEDDY Study Group.

In: BMC pediatrics, Vol. 17, No. 1, 127, 16.05.2017.

Research output: Contribution to journalArticle

@article{132fd56ca7cd4f8ab067191e260575a0,
title = "Analgesic antipyretic use among young children in the TEDDY study: No association with islet autoimmunity",
abstract = "Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7{\%}) and Sweden (94.8{\%}) compared to Finland (78.1{\%}) and Germany (80.2{\%}). First-born children were more commonly given acetaminophen (OR 1.26; 95{\%} CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95{\%} CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4{\%}; 26.3{\%} of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95{\%} CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95{\%} CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.",
keywords = "Analgesics, Islet autoimmunity, Prospective studies, Type 1 diabetes",
author = "{for the TEDDY Study Group} and Markus Lundgren and Steed, {Leigh Johnson} and Roy Tamura and Berglind Jonsdottir and Patricia Gesualdo and Claire Crouch and Maija Sj{\"o}berg and Gertie Hansson and Hagopian, {William A.} and Ziegler, {Anette G.} and Rewers, {Marian J.} and {\AA}ke Lernmark and Jorma Toppari and She, {Jin Xiong} and Beena Akolkar and Jin-Xiong She and Haller, {Michael J.} and {Elding Larsson}, Helena and Kimberly Bautista and Judith Baxter and Ruth Bedoy and Daniel Felipe-Morales and Kimberly Driscoll and Frohnert, {Brigitte I.} and Michelle Hoffman and Rachel Karban and Edwin Liu and Jill Norris and Adela Samper-Imaz and Andrea Steck and Kathleen Waugh and Hali Wright and Simell, {Olli G.} and Annika Adamsson and Suvi Ahonen and Heikki Hy{\"o}ty and Jorma Ilonen and Sanna Jokipuu and Tiina Kallio and Leena Karlsson and Miia K{\"a}h{\"o}nen and Mikael Knip and Lea Kovanen and Mirva Koreasalo and Kalle Kurppa and Tiina Latvaaho and Maria L{\"o}nnrot and Elina M{\"a}ntym{\"a}ki and McIndoe, {Richard A} and Sharma, {Ashok Kumar}",
year = "2017",
month = "5",
day = "16",
doi = "10.1186/s12887-017-0884-y",
language = "English (US)",
volume = "17",
journal = "BMC Pediatrics",
issn = "1471-2431",
publisher = "BioMed Central",
number = "1",

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TY - JOUR

T1 - Analgesic antipyretic use among young children in the TEDDY study

T2 - No association with islet autoimmunity

AU - for the TEDDY Study Group

AU - Lundgren, Markus

AU - Steed, Leigh Johnson

AU - Tamura, Roy

AU - Jonsdottir, Berglind

AU - Gesualdo, Patricia

AU - Crouch, Claire

AU - Sjöberg, Maija

AU - Hansson, Gertie

AU - Hagopian, William A.

AU - Ziegler, Anette G.

AU - Rewers, Marian J.

AU - Lernmark, Åke

AU - Toppari, Jorma

AU - She, Jin Xiong

AU - Akolkar, Beena

AU - She, Jin-Xiong

AU - Haller, Michael J.

AU - Elding Larsson, Helena

AU - Bautista, Kimberly

AU - Baxter, Judith

AU - Bedoy, Ruth

AU - Felipe-Morales, Daniel

AU - Driscoll, Kimberly

AU - Frohnert, Brigitte I.

AU - Hoffman, Michelle

AU - Karban, Rachel

AU - Liu, Edwin

AU - Norris, Jill

AU - Samper-Imaz, Adela

AU - Steck, Andrea

AU - Waugh, Kathleen

AU - Wright, Hali

AU - Simell, Olli G.

AU - Adamsson, Annika

AU - Ahonen, Suvi

AU - Hyöty, Heikki

AU - Ilonen, Jorma

AU - Jokipuu, Sanna

AU - Kallio, Tiina

AU - Karlsson, Leena

AU - Kähönen, Miia

AU - Knip, Mikael

AU - Kovanen, Lea

AU - Koreasalo, Mirva

AU - Kurppa, Kalle

AU - Latvaaho, Tiina

AU - Lönnrot, Maria

AU - Mäntymäki, Elina

AU - McIndoe, Richard A

AU - Sharma, Ashok Kumar

PY - 2017/5/16

Y1 - 2017/5/16

N2 - Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.

AB - Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.

KW - Analgesics

KW - Islet autoimmunity

KW - Prospective studies

KW - Type 1 diabetes

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U2 - 10.1186/s12887-017-0884-y

DO - 10.1186/s12887-017-0884-y

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