TY  - JOUR
A1  - Tanoey, Justine
A1  - Baechle, Christina
A1  - Brenner, Hermann
A1  - Deckert, Andreas
A1  - Fricke, Julia
A1  - Günther, Kathrin
A1  - Karch, André
A1  - Keil, Thomas
A1  - Kluttig, Alexander
A1  - Leitzmann, Michael
A1  - Mikolajczyk, Rafael
A1  - Obi, Nadia
A1  - Pischon, Tobias
A1  - Schikowski, Tamara
A1  - Schipf, Sabine M.
A1  - Schulze, Matthias B.
A1  - Sedlmeier, Anja
A1  - Moreno Velásquez, Ilais
A1  - Weber, Katharina S.
A1  - Völzke, Henry
A1  - Ahrens, Wolfgang
A1  - Gastell, Sylvia
A1  - Holleczek, Bernd
A1  - Jöckel, Karl-Heinz
A1  - Katzke, Verena
A1  - Lieb, Wolfgang
A1  - Michels, Karin B.
A1  - Schmidt, Börge
A1  - Teismann, Henning
A1  - Becher, Heiko
T1  - Birth order, Caesarean section, or daycare attendance in relation to child- and adult-onset type 1 diabetes: results from the German National Cohort
JF  - International Journal of Environmental Research and Public Health
N2  - (1) Background: Global incidence of type 1 diabetes (T1D) is rising and nearly half occurred in adults. However, it is unclear if certain early-life childhood T1D risk factors were also associated with adult-onset T1D. This study aimed to assess associations between birth order, delivery mode or daycare attendance and type 1 diabetes (T1D) risk in a population-based cohort and whether these were similar for childhood- and adult-onset T1D (cut-off age 15); (2) Methods: Data were obtained from the German National Cohort (NAKO Gesundheitsstudie) baseline assessment. Self-reported diabetes was classified as T1D if: diagnosis age ≤ 40 years and has been receiving insulin treatment since less than one year after diagnosis. Cox regression was applied for T1D risk analysis; (3) Results: Analyses included 101,411 participants (100 childhood- and 271 adult-onset T1D cases). Compared to “only-children”, HRs for second- or later-born individuals were 0.70 (95% CI = 0.50–0.96) and 0.65 (95% CI = 0.45–0.94), respectively, regardless of parental diabetes, migration background, birth year and perinatal factors. In further analyses, higher birth order reduced T1D risk in children and adults born in recent decades. Caesarean section and daycare attendance showed no clear associations with T1D risk; (4) Conclusions: Birth order should be considered in both children and adults’ T1D risk assessment for early detection.
KW  - perinatal
KW  - adult-onset
KW  - late-onset
KW  - autoimmune
KW  - delivery mode
KW  - sex
KW  - offspring
KW  - NAKO
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-286216
SN  - 1660-4601
VL  - 19
IS  - 17
ER  - 
TY  - JOUR
A1  - Lenders, Malte
A1  - Weidemann, Frank
A1  - Kurschat, Christine
A1  - Canaan-Kühl, Sima
A1  - Duning, Thomas
A1  - Stypmann, Jörg
A1  - Schmitz, Boris
A1  - Reiermann, Stefanie
A1  - Krämer, Johannes
A1  - Blaschke, Daniela
A1  - Wanner, Christoph
A1  - Brand, Stefan-Martin
A1  - Brand, Eva
T1  - Alpha-Galactosidase A p.A143T, a non-Fabry disease-causing variant
JF  - Orphanet Journal of Rare Diseases
N2  - Background
Fabry disease (FD) is an X-linked multisystemic disorder with a heterogeneous phenotype. Especially atypical or late-onset type 2 phenotypes present a therapeutical dilemma.

Methods
To determine the clinical impact of the alpha-Galactosidase A (GLA) p.A143T/ c.427G > A variation, we retrospectively analyzed 25 p.A143T patients in comparison to 58 FD patients with other missense mutations.

Results
p.A143T patients suffering from stroke/ transient ischemic attacks had slightly decreased residual GLA activities, and/or increased lyso-Gb3 levels, suspecting FD. However, most male p.A143T patients presented with significant residual GLA activity (~50 % of reference), which was associated with normal lyso-Gb3 levels. Additionally, p.A143T patients showed less severe FD-typical symptoms and absent FD-typical renal and cardiac involvement in comparison to FD patients with other missense mutations. Two tested female p.A143T patients with stroke/TIA did not show skewed X chromosome inactivation. No accumulation of neurologic events in family members of p.A143T patients with stroke/transient ischemic attacks was observed.

Conclusions
We conclude that GLA p.A143T seems to be most likely a neutral variant or a possible modifier instead of a disease-causing mutation. Therefore, we suggest that p.A143T patients with stroke/transient ischemic attacks of unknown etiology should be further evaluated, since the diagnosis of FD is not probable and subsequent ERT or chaperone treatment should not be an unreflected option.
KW  - Fabry disease
KW  - genotype
KW  - lyso-Gb3
KW  - variant of unknown significance
KW  - GLA mutation
KW  - late-onset
KW  - stroke
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-166559
VL  - 11
IS  - 54
ER  -