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

Research output: Contribution to journalArticle

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.

Details

Authors
  • Leigh Johnson Steed
  • Roy N. Tamura
  • Patricia Gesualdo
  • Claire Cowen Crouch
  • Maija Sjöberg
  • Gertie Hansson
  • William A. Hagopian
  • Anette-G Ziegler
  • Marian J. Rewers
  • Jorma Toppari
  • Jin-Xiong She
  • Beena Akolkar
  • Jeffrey P. Krischer
  • Michael J. Haller
  • Kimberly Bautista
  • Judith Baxter
  • Ruth Bedoy
  • Daniel Felipe-Morales
  • Kimberly Driscoll
  • Brigitte I. Frohnert
  • Michelle Hoffman
  • Rachel Karban
  • Edwin Liu
  • Jill Norris
  • Adela Samper-Imaz
  • Andrea K Steck
  • Kathleen Waugh
  • Hali Wright
  • Olli G. Simell
  • Annika Adamsson
  • Suvi Ahonen
  • Heikki Hyöty
  • Jorma Ilonen
  • Sanna Jokipuu
  • Tiina Kallio
  • Leena Karlsson
  • Miia Kähönen
  • Mikael Knip
  • Lea Kovanen
  • Mirva Koreasalo
  • Kalle Kurppa
  • Tiina Latvaaho
  • Maria Lönnrot
  • Elina Mäntymäki
  • Katja Multasuo
  • Juha Mykkänen
  • Tiina Niininen
  • Sari Niinistö
  • Mia Nyblom
  • Petra Rajala
  • Jenna Rautanen
  • Anne Riikonen
  • Mika Riikonen
  • Jenni Rouhiainen
  • Minna Romo
  • Tuula Simell
  • Ville Simell
  • Aino Stenius
  • Maria Leppänen
  • Sini Vainionpää
  • Eeva Varjonen
  • Riitta Veijola
  • Suvi M Virtanen
  • Mari Vähä-Mäkilä
  • Mari Åkerlund
  • Katri Lindfors
  • Desmond Schatz
  • Diane Hopkins
  • Jamie Thomas
  • Janey Adams
  • Katherine Silvis
  • Melissa Gardiner
  • Richard McIndoe
  • Ashok Sharma
  • Joshua W Williams
  • Gabriela Young
  • Stephen W. Anderson
  • Laura Mary Jacobsen
  • Andreas Beyerlein
  • Ezio Bonifacio
  • Michael Hummel
  • Sandra Hummel
  • Kristina Foterek
  • Nicole Janz
  • Mathilde Kersting
  • Annette Knopff
  • Sibylle Koletzko
  • Claudia Peplow
  • Roswith Roth
  • Marlon Scholz
  • Joanna Stock
  • Katharina Warncke
  • Lorena Wendel
  • Christiane Winkler
  • Maria Ask
  • Jenny Bremer
  • Ulla Marie Carlsson
  • Lina Fransson
  • Thomas Gard
  • Joanna Gerardsson
  • Rasmus Bennet
  • Monica Hansen
  • Susanne Hyberg
  • Fredrik Johansen
  • Marielle Lindström
  • Maria Månsson-Martinez
  • Maria Markan
  • Jessica Melin
  • Zeliha Mestan
  • Karin Ottosson
  • Kobra Rahmati
  • Anita Ramelius
  • Sara Sibthorpe
  • Ulrica Swartling
  • Evelyn Tekum Amboh
  • Carina Törn
  • Anne Wallin
  • Åsa Wimar
  • Sofie Åberg
  • Killian Michael Killian
  • Jennifer Skidmore
  • Josephine Carson
  • Maria Dalzell
  • Kayleen Dunson
  • Rachel Hervey
  • Corbin Johnson
  • Rachel Lyons
  • Arlene Meyer
  • Denise Mulenga
  • Alexander Tarr
  • Morgan Uland
  • John Willis
  • Dorothy Becker
  • Margaret Franciscus
  • Mary Ellen
  • Mary Ellen Dalmagro Elias Smith
  • Ashi Daftary
  • Mary Beth Klein
  • Chrystal Yates
  • Michael Abbondondolo
  • Sarah Austin-Gonzalez
  • Maryouri Avendano
  • Sandra Baethke
  • Rasheedah Brown
  • Brant R. Burkhardt
  • Martha Butterworth
  • Joanna Clasen
  • David Cuthbertson
  • Eberhard Christopher Eberhard
  • Steven W. Fiske
  • Dena Garcia
  • Jennifer Garmeson
  • Veena Gowda
  • Kathleen Heyman
  • Francisco Perez Laras
  • Hye-Seung Lee
  • Shu Liu
  • Xiang Liu
  • Kristian Lynch
  • Jamie Malloy
  • Cristina McCarthy
  • Steven Meulemans
  • Hemang Parikh
  • Chris Shaffer
  • Laura Smith
  • Susan Smith
  • Noah Sulman
  • Ulla Uusitalo
  • Kendra Vehik
  • Ponni Vijayakandipan
  • Keith Wood
  • Jimin Yang
  • R. D. Lori Ballard
  • David Hadley
  • Wendy Mcleod
  • Liping Yu
  • Dongmei Miao
  • Polly J Bingley
  • Alistair Williams
  • Kyla Chandler
  • Saba Rokni
  • Claire L. Williams
  • Rebecca Wyatt
  • Gifty George
  • Sian Grace
  • Henry Erlich
  • Steven J. Mack
  • Anna Lisa Fear
  • Sandra Ke
  • Niveen Mulholland
  • Stephen Rich
  • Wei-Min Chen
  • Suna Onengut-Gumuscu
  • Emily Farber
  • Rebecca Roche Pickin
  • Jordan Davis
  • Dan Gallo
  • Jessica Bonnie
  • Paul Campolieto
  • Kasia Bourcier
  • Thomas Briese
  • Suzanne Bennett Johnson
  • Eric W Triplett
Organisations
External organisations
  • Augusta University
  • University of South Florida
  • University of Colorado
  • Pacific Northwest Diabetes Research Institute
  • University of Turku
  • Klinikum rechts der Isar
  • National Institute of Diabetes and Digestive and Kidney Diseases
  • Florida Museum Natural History
  • Turku University Hospital
  • University of Tampere
  • Tampere University Hospital
  • National Institute for Health and Welfare
  • University of Eastern Finland
  • University of Oulu
  • Oulu University Hospital
  • Pediatric Endocrine Associates PC
  • Dresden University of Technology
  • Research institute of Child Nutrition
  • World Orthopaedic Concern
  • Children's Hospital of Pittsburgh of UPMC
  • University of Bristol
  • Children's Hospital Oakland Research Institute
  • University of Virginia
  • National Institute of Allergy and Infectious Diseases
  • Columbia University
  • Florida State University
  • Lund University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes

Keywords

  • Analgesics, Islet autoimmunity, Prospective studies, Type 1 diabetes
Original languageEnglish
Article number127
JournalBMC Pediatrics
Volume17
Issue number1
Publication statusPublished - 2017 May 16
Publication categoryResearch
Peer-reviewedYes

Related research output

Markus Lundgren, 2017, Lund: Lund University, Faculty of Medicine. 110 p.

Research output: ThesisDoctoral Thesis (compilation)

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