Incidence of type 1 diabetes and distance from the sea : a descriptive epidemiological study

Abstract

Background: Increasingly, environmental factors are being shown to play a role in the etiology of type 1 diabetes (T1D). One geographical feature that exerts a major effect on climate but whose relationship with T1D incidence has not been studied is distance from the sea. This study investigated any possible relationship between distance from the sea and the incidence of T1D. Methods: Spearman correlation analysis was performed to investigate the relationship between the incidence of T1D (determined using data from the DiaMond Project) and distance from the sea. This was followed by multivariate analyses to adjust for potential cofounders. Results: A significant negative association was found between T1D incidence and shortest distance from sea (r = −0.251, P = 0.01235), mean hours of sunshine (r = −0.325, P = 0.002), and mean temperature (r = −0.224, P = 0.046), and a positive association was found between T1D incidence and latitude (r = 0.434, P = 0.0001). Multivariate analysis (generalized linear model) showed that both distance from the sea and latitude were independently associated with the incidence of T1D. The association of distance from sea and the incidence of T1D remained significant even after adjusting for mean temperature (P = 0.002) and mean hours of sunshine (P = 0.005). Conclusions: The data show that there is a negative correlation between distance from the sea and the incidence of T1D, which was independent of latitude, mean temperature, and mean hours of sunshine. This suggests that environmental factors associated with climatic conditions may influence the risk of T1D.