Fronczak Carolyn M, Barón Anna E, Chase H Peter, Ross Colleen, Brady Heather L, Hoffman Michelle, Eisenbarth George S, Rewers Marian, Norris Jill M
Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Diabetes Care. 2003 Dec;26(12):3237-42. doi: 10.2337/diacare.26.12.3237.
The goal of this study was to examine whether maternal dietary intake of vitamin D, omega-3 fatty acids, and omega-6 fatty acids during pregnancy is associated with the appearance of islet autoimmunity (IA) in offspring.
The Diabetes Autoimmunity Study in the Young (DAISY) is recruiting at birth and following children at increased risk for type 1 diabetes, as determined by HLA-DR genotype or by family history of type 1 diabetes. A total of 233 mothers of newly recruited DAISY subjects were asked to recall their intake of food and nutritional supplements during the third trimester of pregnancy using the Willett food frequency questionnaire. Children were followed for an average of 4 years (range 0.8-7.3 years) for the appearance of insulin, GAD(65), and IA-2 autoantibodies. Sixteen children developed at least one autoantibody during this period. Unadjusted and adjusted hazard ratios (HRs) for the development of IA were estimated with survival analysis using a Weibull distribution.
Maternal intake of vitamin D via food was significantly associated with a decreased risk of IA appearance in offspring, independent of HLA genotype, family history of type 1 diabetes, presence of gestational diabetes mellitus, and ethnicity (adjusted HR = 0.37; 95% CI 0.17-0.78). Vitamin D intake via supplements, omega-3 fatty acids, and omega-6 fatty acids intake during pregnancy were not associated with appearance of IA in offspring.
Our findings suggest that maternal intake of vitamin D through food during pregnancy may have a protective effect on the appearance of IA in offspring.
本研究的目的是检验孕期母亲饮食中维生素D、ω-3脂肪酸和ω-6脂肪酸的摄入量是否与后代胰岛自身免疫（IA）的出现有关。
青少年糖尿病自身免疫研究（DAISY）在婴儿出生时招募HLA-DR基因型或1型糖尿病家族史确定为1型糖尿病风险增加的儿童并进行随访。共有233名新招募的DAISY受试者的母亲被要求使用威尔特食物频率问卷回忆她们在妊娠晚期的食物和营养补充剂摄入量。对儿童进行平均4年（范围0.8 - 7.3年）的随访，观察胰岛素、GAD（65）和IA - 2自身抗体的出现情况。在此期间，16名儿童出现了至少一种自身抗体。使用威布尔分布通过生存分析估计IA发生的未调整和调整后的风险比（HRs）。
母亲通过食物摄入维生素D与后代IA出现风险降低显著相关，独立于HLA基因型、1型糖尿病家族史、妊娠期糖尿病的存在和种族（调整后的HR = 0.37；95% CI 0.17 - 0.78）。孕期通过补充剂摄入维生素D、ω-3脂肪酸和ω-6脂肪酸的摄入量与后代IA的出现无关。
我们的研究结果表明，孕期母亲通过食物摄入维生素D可能对后代IA的出现具有保护作用。
