An association between high bilirubin levels at birth and a higher risk for developing type 1 diabetes has been previously suggested. Now, a large study has further confirmed the association.

According to the Centers for Disease Control and Prevention:

Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. During pregnancy, the mother’s liver removes bilirubin for the baby, but after birth the baby’s liver must remove the bilirubin. In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice.

Previous research has suggested that jaundice at birth may be associated with a small increase in type 1 diabetes risk, but data has been inconsistent between different investigations.

This month, a new research study published in the journal Paediatrics and International Child Health evaluated the relationship further.

Study Design

Researchers in Taiwan assessed data from the National Health Insurance Research Database (between 2001 and 2005). Data from a total of 23,784 newborns who were diagnosed with elevated bilirubin levels was compared against data from 47,568 newborns with normal bilirubin levels. The study authors described that the control cohort was “frequency-matched to the hyperbilirubinemia group by gender, age, parental occupation and urbanization.” The researchers set out to determine whether elevated bilirubin levels at birth were associated with higher odds of developing type 1 diabetes during childhood.

Study Outcomes

The study revealed that:

Newborns with high bilirubin levels were significantly more likely to develop type 1 diabetes during childhood

Those with high bilirubin levels were significantly more likely to develop type 1 diabetes earlier in life

Subjects with high bilirubin levels at birth “had a 66% increased risk of developing type 1 diabetes”

Females were more likely to develop type 1 diabetes than males

Those with “perinatal complications and neonatal infections” were also at increased risk for a subsequent type 1 diabetes diagnosis

Conclusions

Altogether, the results demonstrate that “neonatal hyperbilirubinemia is associated with a subsequently increased risk of childhood-onset type 1 diabetes.”

However, the findings cannot determine a causal relationship. Other factors that increase the risk of high bilirubin levels, such as pre-term delivery, may be related to the association, and may also also be directly associated with type 1 diabetes risk. Mixed data concerning the effects of phototherapy for jaundice as it relates to type 1 diabetes risk further confound the interpretations. Furthermore, additional validation using international cohorts is warranted.

Read more about Intensive management, type 1 diabetes risk factors, type 1 diabetes study.