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Licensed Unlicensed Requires Authentication Published by De Gruyter December 16, 2015

Exposure to sunshine early in life prevented development of type 1 diabetes in Danish boys

  • Ramune Jacobsen EMAIL logo , Peder Frederiksen and Berit L. Heitmann
An erratum for this article can be found here:


Background: We aimed to assess the association between exposure to sunshine during gestation and the risk of type 1 diabetes (T1D) in Danish children.

Methods: The study population included 331,623 individuals born in Denmark from 1983 to 1988; 886 (0.26%) developed T1D by the age of 15 years. The values of sunshine hours were obtained from the Danish Meteorological Institute. Gestational exposure to sunshine was calculated by summing recorded monthly sunshine hours during the full 9 months prior to the month of birth. The linear variable then was split into two categories separated by the median value.

Results and Conclusions: Cox regression models showed that more sunshine during the third gestational trimester was associated with lower hazards (HR) of T1D at age 5–9 years in males: HR (95% CI): 0.60 (0.43–0.84), p=0.003. Our results should be considered in the context of evidence-based recommendations to the public about skin protection from the sun.

Corresponding author: Ramune Jacobsen, PhD, Research Unit for Dietary Studies, The Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark, Phone: +45 30691692; and Institute of Preventive Medicine, Frederiksberg Hospital, Frederiksberg, Denmark


1. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet 2014;383:69–82.10.1007/978-1-4614-1028-7_4Search in Google Scholar

2. Kiess W, Gorski T, Penke M, Klamt S, Kapellen TM. Diabetes mellitus in children and adolescents – a global epidemic which has become neglected. J Pediatr Endocrinol Metab 2015;28:247–50.10.1515/jpem-2015-0900Search in Google Scholar PubMed

3. Svensson J, Carstensen B, Molbak A, Christau B, Mortensen HB, Nerup J, et al. Increased risk of childhood type 1 diabetes in children born after 1985. Diabetes Care 2002;25:2197–201.10.2337/diacare.25.12.2197Search in Google Scholar PubMed

4. Svensson J, Lyngaae-Jorgensen A, Carstensen B, Simonsen LB, Mortensen HB. Long-term trends in the incidence of type 1 diabetes in Denmark: the seasonal variation changes over time. Pediatr Diabetes 2009;10:248–54.10.1111/j.1399-5448.2008.00483.xSearch in Google Scholar PubMed

5. Laron Z. Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus. Am J Med Genet 2002;115:4–7.10.1002/ajmg.10338Search in Google Scholar PubMed

6. Mohr SB, Garland CF, Gorham ED, Garland FC. The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia 2008;51:1391–8.10.1007/s00125-008-1061-5Search in Google Scholar PubMed

7. Badenhoop K, Kahles H, Penna-Martinez M. Vitamin D, immune tolerance, and prevention of type 1 diabetes. Curr Diab Rep 2012;12:635–42.10.1007/s11892-012-0322-3Search in Google Scholar PubMed

8. Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Curr Opin Pharmacol 2010;10:482–96.10.1016/j.coph.2010.04.001Search in Google Scholar PubMed

9. Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child 2008;93:512–7.10.1136/adc.2007.128579Search in Google Scholar PubMed

10. Holick MF. Vitamin D: a d-lightful solution for health. J Investig Med 2011;59:872–80.10.2310/JIM.0b013e318214ea2dSearch in Google Scholar PubMed PubMed Central

11. Jacobsen R, Hypponen E, Sorensen TI, Vaag AA, Heitmann BL. Gestational and early infancy exposure to margarine fortified with vitamin D through a National Danish Programme and the risk of type 1 diabetes: the D-Tect study. PLoS One 2015;10:e0128631.10.1371/journal.pone.0128631Search in Google Scholar

12. Pedersen CB. The Danish civil registration system. Scand J Public Health 2011;39(7 Suppl):22–5.10.1177/1403494810387965Search in Google Scholar

13. Cappelen J. Denmark – DMI Historical Climate Data Collection 1768-2011 with Danish Abstracts: Technical Report, Copenhagen: DMI, Ministry of Climate and Energy, 2012.Search in Google Scholar

14. Ramagopalan SV, Heger A, Berlanga AJ, Maugeri NJ, Lincoln MR, Burrell A, et al. A ChIP-seq defined genome-wide map of vitamin D receptor binding: associations with disease and evolution. Genome Res 2010;20:1352–60.10.1101/gr.107920.110Search in Google Scholar

15. Holick MF, Grant WB. Vitamin D status and ill health. Lancet Diabetes Endocrinol 2014;2:273–4.10.1016/S2213-8587(14)70044-0Search in Google Scholar

16. Hollis BW, Wagner CL. Nutritional vitamin D status during pregnancy: reasons for concern. Can Med Assoc J 2006;174:1287–90.10.1503/cmaj.060149Search in Google Scholar PubMed PubMed Central

17. Barker DJ. In utero programming of chronic disease. Clin Sci (Lond) 1998;95:115–28.10.1042/CS19980019Search in Google Scholar

18. Rothwell PM, Staines A, Smail P, Wadsworth E, McKinney P. Seasonality of birth of patients with childhood diabetes in Britain. Br Med J 1996;312:1456–7.10.1136/bmj.312.7044.1456Search in Google Scholar PubMed PubMed Central

19. Samuelsson U, Johansson C, Ludvigsson J. Month of birth and risk of developing insulin dependent diabetes in south east Sweden. Arch Dis Child 1999;81:143–6.10.1136/adc.81.2.143Search in Google Scholar PubMed PubMed Central

20. Hart PH, Gorman S, Finlay-Jones JJ. Modulation of the immune system by UV radiation: more than just the effects of vitamin D? Nat Rev Immunol 2011;11:584–96.10.1038/nri3045Search in Google Scholar PubMed

21. Kimlin MG. Geographic location and vitamin D synthesis. Mol Aspects Med 2008;29:453–61.10.1016/j.mam.2008.08.005Search in Google Scholar PubMed

22. Thuesen B, Husemoen L, Fenger M, Jakobsen J, Schwarz P, Toft U, et al. Determinants of vitamin D status in a general population of Danish adults. Bone 2012;50:605–10.10.1016/j.bone.2011.12.016Search in Google Scholar PubMed

23. Hypponen E, Power C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 2007;85:860–8.10.1093/ajcn/85.3.860Search in Google Scholar PubMed

24. McGrath JJ, Eyles DW, Pedersen CB, Anderson C, Ko P, Burne TH, et al. Neonatal vitamin D status and risk of schizophrenia: a population-based case-control study. Arch Gen Psychiatry 2010;67:889–94.10.1001/archgenpsychiatry.2010.110Search in Google Scholar PubMed

25. Jongbloet PH, Groenewoud HM, Hirasing RA, Van BS. Seasonality of birth in patients with childhood diabetes in The Netherlands. Diabetes Care 1998;21:190–1.10.2337/diacare.21.1.190Search in Google Scholar PubMed

26. McKinney PA. Seasonality of birth in patients with childhood Type I diabetes in 19 European regions. Diabetologia 2001;44(Suppl 3): B67–B74.10.1007/PL00002957Search in Google Scholar PubMed

27. Jongbloet PH. Over-ripeness ovopathy: a challenging hypothesis for sex ratio modulation. Hum Reprod 2004;19:769–74.10.1093/humrep/deh136Search in Google Scholar PubMed

28. Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, et al. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129–40.10.1017/S0950268806007175Search in Google Scholar PubMed PubMed Central

29. Bach JF, Chatenoud L. The hygiene hypothesis: an explanation for the increased frequency of insulin-dependent diabetes. Cold Spring Harb Perspect Med 2012;2:a007799.10.1101/cshperspect.a007799Search in Google Scholar PubMed PubMed Central

30. Stene LC, Rewers M. Immunology in the clinic review series; focus on type 1 diabetes and viruses: the enterovirus link to type 1 diabetes: critical review of human studies. Clin Exp Immunol 2012;168:12–23.10.1111/j.1365-2249.2011.04555.xSearch in Google Scholar PubMed PubMed Central

31. Svensson J, Carstensen B, Mortensen HB, Borch-Johnsen K. Early childhood risk factors associated with type 1 diabetes–is gender important? Eur J Epidemiol 2005;20:429–34.10.1007/s10654-005-0878-1Search in Google Scholar PubMed

32. Holt PG, Jones CA. The development of the immune system during pregnancy and early life. Allergy 2000;55:688–97.10.1034/j.1398-9995.2000.00118.xSearch in Google Scholar PubMed

Received: 2015-10-2
Accepted: 2015-11-2
Published Online: 2015-12-16
Published in Print: 2016-4-1

©2016 by De Gruyter

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