{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:15:10Z","timestamp":1784128510417,"version":"3.55.0"},"reference-count":16,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2024-0451_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Type 1 diabetes mellitus (T1D) is a heterogeneous condition. We aimed to study the associations between age and sex with clinical characteristics at the onset of pediatric T1D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0451_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A secondary analysis was conducted on data collected retrospectively from 706 children newly diagnosed with T1D at a large tertiary hospital in southeastern USA. Age (stratified across three cohorts from 0.84 to 18.08 years), sex, and their interaction were compared for associations with clinical characteristics of T1D at presentation by multivariable regression analyses and pairwise comparisons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0451_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Within the participants (mean age 9.71 (SD 4.10), 48.3\u202f% female, 21.0\u202f% Hispanic, 15.3\u202f% non-Hispanic black and 58.7\u202f% non-Hispanic white), children under 6 years had higher glucose (p&lt;0.001), lower hemoglobin A<jats:sub>1c<\/jats:sub> (HbA<jats:sub>1c<\/jats:sub>) (p&lt;0.001), and lower C-peptide (p&lt;0.001) than the older age groups. Diabetic ketoacidosis (DKA) was more prevalent in the youngest (p=0.005) and the intermediate-aged cohorts (p=0.005), compared to the oldest group. Among the children with DKA, bicarbonate was lower in the youngest (p&lt;0.001) and middle cohorts (p=0.013), compared to the oldest group. Younger age was associated with higher prevalence of insulin autoantibodies (IAA; p&lt;0.001) and IA-2 autoantibodies (IA-2A; p=0.006). Males had higher glucose (p=0.001), but lower HbA<jats:sub>1c<\/jats:sub> (p=0.003), lower C-peptide (p&lt;0.001), and lower GAD autoantibody (GADA) prevalence (p=0.001) than females. There was no significant interaction between age and sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0451_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In children with new onset T1D, younger age and male sex were associated with findings suggestive of more rapid and aggressive T1D preclinical course, including poorer beta-cell function, and distinct islet autoantibody profiles.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2024-0451","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T18:52:29Z","timestamp":1732733549000},"page":"22-28","source":"Crossref","is-referenced-by-count":2,"title":["Age and sex mark clinical differences in the presentation of pediatric type 1 diabetes mellitus"],"prefix":"10.1515","volume":"38","author":[{"given":"Esha A.","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofan","family":"Huang","sequence":"additional","affiliation":[{"name":"3989 Institute for Clinical and Translational Research, Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horacio J.","family":"Velasquez","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khushboo","family":"Golani","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro F.","family":"Siller","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles G.","family":"Minard","sequence":"additional","affiliation":[{"name":"3989 Institute for Clinical and Translational Research, Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Tosur","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"},{"name":"Children\u2019s Nutrition Research Center, USDA\/ARS , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-4645","authenticated-orcid":false,"given":"Maria J.","family":"Redondo","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology , Texas Children\u2019s Hospital , Houston , TX , USA"},{"name":"3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2025011004321640544_j_jpem-2024-0451_ref_001","doi-asserted-by":"crossref","unstructured":"ElSayed, NA, Aleppo, G, Bannuru, RR, Bruemmer, D, Collins, BS, Ekhlaspour, L, et al.. 2. Diagnosis and classification of diabetes: standards of care in diabetes-2024. Diabetes Care 2024;47:S20\u201342. https:\/\/doi.org\/10.2337\/dc24-s002.","DOI":"10.2337\/dc24-S002"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_002","doi-asserted-by":"crossref","unstructured":"Gale, EA, Gillespie, KM. Diabetes and gender. Diabetologia 2001;44:3\u201315. https:\/\/doi.org\/10.1007\/s001250051573.","DOI":"10.1007\/s001250051573"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_003","doi-asserted-by":"crossref","unstructured":"Mohammad, HA, Farghaly, HS, Metwalley, KA, Monazea, EM, Abd El-Hafeez, HA. Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt. Indian J Endocrinol Metab 2012;16:796\u2013802. https:\/\/doi.org\/10.4103\/2230-8210.100679.","DOI":"10.4103\/2230-8210.100679"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_004","doi-asserted-by":"crossref","unstructured":"Bosi, E, Boulware, DC, Becker, DJ, Buckner, JH, Geyer, S, Gottlieb, PA, et al.. Impact of age and antibody type on progression from single to multiple autoantibodies in type 1 diabetes relatives. J Clin Endocrinol Metab 2017;102:2881\u20136. https:\/\/doi.org\/10.1210\/jc.2017-00569.","DOI":"10.1210\/jc.2017-00569"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_005","doi-asserted-by":"crossref","unstructured":"Jacobsen, LM, Bocchino, L, Evans-Molina, C, DiMeglio, L, Goland, R, Wilson, DM, et al.. The risk of progression to type 1 diabetes is highly variable in individuals with multiple autoantibodies following screening. Diabetologia 2020;63:588\u201396. https:\/\/doi.org\/10.1007\/s00125-019-05047-w.","DOI":"10.1007\/s00125-019-05047-w"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_006","doi-asserted-by":"crossref","unstructured":"Leete, P, Willcox, A, Krogvold, L, Dahl-J\u00f8rgensen, K, Foulis, AK, Richardson, SJ, et al.. Differential insulitic profiles determine the extent of \u03b2-cell destruction and the age at onset of type 1 diabetes. Diabetes 2016;65:1362\u20139. https:\/\/doi.org\/10.2337\/db15-1615.","DOI":"10.2337\/db15-1615"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_007","doi-asserted-by":"crossref","unstructured":"Battaglia, M, Ahmed, S, Anderson, MS, Atkinson, MA, Becker, D, Bingley, PJ, et al.. Introducing the endotype concept to address the challenge of disease heterogeneity in type 1 diabetes. Diabetes Care 2020;43:5\u201312. https:\/\/doi.org\/10.2337\/dc19-0880.","DOI":"10.2337\/dc19-0880"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_008","doi-asserted-by":"crossref","unstructured":"Redondo, MJ, Morgan, NG. Heterogeneity and endotypes in type 1 diabetes mellitus. Nat Rev Endocrinol 2023;19:542\u201354. https:\/\/doi.org\/10.1038\/s41574-023-00853-0.","DOI":"10.1038\/s41574-023-00853-0"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_009","doi-asserted-by":"crossref","unstructured":"You, W, Yang, J, Liu, Y, Wang, W, Zhu, L, Wang, W, et al.. Fulminant type 1 diabetes mellitus: two case reports. Medicine 2019;98:e14319. https:\/\/doi.org\/10.1097\/md.0000000000014319.","DOI":"10.1097\/MD.0000000000014319"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_010","doi-asserted-by":"crossref","unstructured":"Krischer, JP, Cuthbertson, DD, Greenbaum, C. Male sex increases the risk of autoimmunity but not type 1 diabetes. Diabetes Care 2004;27:1985\u201390. https:\/\/doi.org\/10.2337\/diacare.27.8.1985.","DOI":"10.2337\/diacare.27.8.1985"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_011","doi-asserted-by":"crossref","unstructured":"Vehik, K, Bonifacio, E, Lernmark, \u00c5, Yu, L, Williams, A, Schatz, D, et al.. Hierarchical order of distinct autoantibody spreading and progression to type 1 diabetes in the TEDDY study. Diabetes Care 2020;43:2066\u201373. https:\/\/doi.org\/10.2337\/dc19-2547.","DOI":"10.2337\/figshare.12302405"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_012","doi-asserted-by":"crossref","unstructured":"Decochez, K, De Leeuw, IH, Keymeulen, B, Mathieu, C, Rottiers, R, Weets, I, et al.. IA-2 autoantibodies predict impending type I diabetes in siblings of patients. Diabetologia 2002;45:1658\u201366. https:\/\/doi.org\/10.1007\/s00125-002-0949-8.","DOI":"10.1007\/s00125-002-0949-8"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_013","doi-asserted-by":"crossref","unstructured":"So, M, O\u2019Rourke, C, Ylescupidez, A, Bahnson, HT, Steck, AK, Wentworth, JM, et al.. Characterising the age-dependent effects of risk factors on type 1 diabetes progression. Diabetologia 2022;65:684\u201394. https:\/\/doi.org\/10.1007\/s00125-021-05647-5.","DOI":"10.1007\/s00125-021-05647-5"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_014","doi-asserted-by":"crossref","unstructured":"Tojjar, J, Cervin, M, Hedlund, E, Brahimi, Q, Forsander, G, Elding, LH, et al.. Sex differences in age of diagnosis, HLA genotype, and autoantibody profile in children with type 1 diabetes. Diabetes Care 2023;46:1993\u20136. https:\/\/doi.org\/10.2337\/dc23-0124.","DOI":"10.2337\/dc23-0124"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_015","doi-asserted-by":"crossref","unstructured":"Flores, MGV, Islam, H, Puttagunta, SM, Islam, R, Kundu, S, Jha, SB, et al.. Association between type 1 diabetes mellitus and celiac disease: autoimmune disorders with a shared genetic background. Cureus 2022;14:e22912. https:\/\/doi.org\/10.7759\/cureus.22912.","DOI":"10.7759\/cureus.22912"},{"key":"2025011004321640544_j_jpem-2024-0451_ref_016","doi-asserted-by":"crossref","unstructured":"Conrad, N, Misra, S, Verbakel, JY, Verbeke, G, Molenberghs, G, Taylor, PN, et al.. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet 2023;401:1878\u201390. https:\/\/doi.org\/10.1016\/s0140-6736(23)00457-9.","DOI":"10.1016\/S0140-6736(23)00457-9"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2024-0451\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2024-0451\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T04:35:26Z","timestamp":1736483726000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2024-0451\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,11,25]]},"published-print":{"date-parts":[[2025,1,29]]}},"alternative-id":["10.1515\/jpem-2024-0451"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2024-0451","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,28]]}}}