Long-Term or Recurrent Antibiotic Use in Early Life and the Risk of Type 2 Diabetes: A Population-Based Prospective Cohort and a Case–Control Study
Zijun Li and Qiangsheng He contributed equally to this study as the first authors.
Funding: This work was supported by Gansu Province Endocrine Disease Clinical Medical Research Center, 20JR10FA667, the Major Project of the National Social Science Fund of China: Research on the Theoretical System, International Experience and Chinese Path of Evidence-based Social Science, Grant 19ZDA142.
ABSTRACT
Background
Antibiotics in childhood are commonly used and have been linked to gut microbiome dysbiosis and metabolic disorders. However, direct evidence regarding the association between long-term or recurrent antibiotic use (LRAU) during early life and diabetes was scarce. We performed this study to investigate this association in two population-based studies.
Methods
We undertook a prospective analysis encompassing 147 010 participants from the UK Biobank. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of self-reported LRAU during early life on diabetes risk. We also conducted a case–control study within the Chinese population, in which 263 diabetes cases and 526 controls were matched for age and living location. Odds ratios (ORs) and 95% CI were was calculated using logistic regression models.
Results
We identified 4314 incident cases of type 2 diabetes over 1 840 944 person-years of follow-up in the UK Biobank. LRAU during early life was associated with a 26% higher risk of diabetes after accounting for putative risk factors (HR, 1.26; 95% CI, 1.16–1.37) in the UK biobank. We observed a more evident association between LRAU and an elevated risk of diabetes in the case–control study (OR, 3.32; 95% CI, 2.06–5.38). The primary finding was robust to several subgroup analyses and sensitivity analyses.
Conclusions
LRAU during early life may increase the risk of type 2 diabetes. Caution should be exercised when prescribing long-term or recurrent antibiotics to children and adolescents.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
Reasonable requests to access the data from the Chinese Metabolic Management Center used in this study may be sent to the corresponding authors. Data from UK Biobank are available on application at www.ukbiobank.ac.uk/register-apply.
