1型糖尿病风险增加儿童的ω-3多不饱和脂肪酸摄入量与胰岛自身免疫
Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes.
作者信息
Norris Jill M, Yin Xiang, Lamb Molly M, Barriga Katherine, Seifert Jennifer, Hoffman Michelle, Orton Heather D, Barón Anna E, Clare-Salzler Michael, Chase H Peter, Szabo Nancy J, Erlich Henry, Eisenbarth George S, Rewers Marian
机构信息
Department of Preventive Medicine and Biostatistics, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA.
出版信息
JAMA. 2007 Sep 26;298(12):1420-8. doi: 10.1001/jama.298.12.1420.
CONTEXT
Cod liver oil supplements in infancy have been associated with a decreased risk of type 1 diabetes mellitus in a retrospective study.
OBJECTIVE
To examine whether intakes of omega-3 and omega-6 fatty acids are associated with the development of islet autoimmunity (IA) in children.
DESIGN, SETTING, AND PARTICIPANTS: A longitudinal, observational study, the Diabetes Autoimmunity Study in the Young (DAISY), conducted in Denver, Colorado, between January 1994 and November 2006, of 1770 children at increased risk for type 1 diabetes, defined as either possession of a high diabetes risk HLA genotype or having a sibling or parent with type 1 diabetes. The mean age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. A case-cohort study (N = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (as a percentage of total lipids) was examined.
MAIN OUTCOME MEASURE
Risk of IA, defined as being positive for insulin, glutamic acid decarboxylase, or insulinoma-associated antigen-2 autoantibodies on 2 consecutive visits and still autoantibody positive or having diabetes at last follow-up visit.
RESULTS
Fifty-eight children developed IA. Adjusting for HLA genotype, family history of type 1 diabetes, caloric intake, and omega-6 fatty acid intake, omega-3 fatty acid intake was inversely associated with risk of IA (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.21-0.96; P = .04). The association was strengthened when the definition of the outcome was limited to those positive for 2 or more autoantibodies (HR, 0.23; 95% CI, 0.09-0.58; P = .002). In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was also inversely associated with IA risk (HR, 0.63; 95% CI, 0.41-0.96; P = .03).
CONCLUSION
Dietary intake of omega-3 fatty acids is associated with reduced risk of IA in children at increased genetic risk for type 1 diabetes.
背景
一项回顾性研究表明，婴儿期补充鳕鱼肝油与1型糖尿病风险降低有关。
目的
研究ω-3和ω-6脂肪酸的摄入量是否与儿童胰岛自身免疫（IA）的发生有关。
设计、地点和参与者：一项纵向观察性研究，即青少年糖尿病自身免疫研究（DAISY），于1994年1月至2006年11月在科罗拉多州丹佛市对1770名1型糖尿病风险增加的儿童进行，这些儿童被定义为具有高糖尿病风险的HLA基因型，或有患1型糖尿病的兄弟姐妹或父母。随访时的平均年龄为6.2岁。从1岁开始，根据报告的多不饱和脂肪酸饮食摄入量评估胰岛自身免疫情况。还进行了一项病例队列研究（N = 244），研究红细胞膜中多不饱和脂肪酸含量（占总脂质的百分比）与IA风险的关系。
主要观察指标
IA风险，定义为连续两次就诊时胰岛素、谷氨酸脱羧酶或胰岛素瘤相关抗原-2自身抗体呈阳性，且在最后一次随访时仍为自身抗体阳性或患有糖尿病。
结果
58名儿童发生了IA。在调整了HLA基因型、1型糖尿病家族史、热量摄入和ω-6脂肪酸摄入量后，ω-3脂肪酸摄入量与IA风险呈负相关（风险比[HR]，0.45；95%置信区间[CI]，0.21 - 0.96；P = 0.04）。当将结局定义限制为两种或更多自身抗体呈阳性的患者时，这种关联得到加强（HR，0.23；95% CI，0.09 - 0.58；P = 0.002）。在病例队列研究中，红细胞膜中ω-3脂肪酸含量也与IA风险呈负相关（HR，0.63；95% CI，0.41 - 0.96；P = 0.03）。
结论
对于1型糖尿病遗传风险增加的儿童，饮食中摄入ω-3脂肪酸与IA风险降低有关。
Zotero 插件