Mayer-Davis Elizabeth J, Dabelea Dana, Lamichhane Archana Pande, D'Agostino Ralph B, Liese Angela D, Thomas Joan, McKeown Robert E, Hamman Richard F
Center for Research in Nutrition and Health Disparities and Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina 29208, USA.
Diabetes Care. 2008 Mar;31(3):470-5. doi: 10.2337/dc07-1321. Epub 2007 Dec 10.
To evaluate the hypothesis that breast-feeding is associated with reduced type 2 diabetes among African-American, Hispanic, and non-Hispanic white youth, mediated in part by current weight status.
The SEARCH Case-Control Study, an ancillary study to SEARCH for Diabetes in Youth, was conducted in two of six SEARCH clinical sites. Eighty youth with type 2 diabetes aged 10-21 years were included. Nondiabetic control participants were recruited from primary care provider offices (n = 167). Breast-feeding information was recalled by biological mothers.
Prevalence (%) of breast-feeding (any duration) was lower among youth with type 2 diabetes than among control subjects (19.5 vs. 27.1 for African Americans, 50.0 vs. 83.8 for Hispanics, and 39.1 vs. 77.6 for non-Hispanic whites). The overall crude odds ratio for the association of breast-feeding (ever versus never) and type 2 diabetes was 0.26 (95% CI 0.15-0.46). Results were similar by race/ethnic group (P value for interaction = 0.17). The odds ratio for the association after adjusting for 12 potential confounders was 0.43 (0.19-0.99). When current BMI z-score was added to the model, the odds ratio was attenuated (0.82 [0.30-2.30]), suggesting possible mediation through current childhood weight status. Analyses that incorporated duration of breast-feeding, adjusted for potential confounders, provided evidence for dose response (test for trend, P value <0.0001), even after inclusion of BMI z-score.
Breast-feeding appears to be protective against development of type 2 diabetes in youth, mediated in part by current weight status in childhood.
评估母乳喂养与非裔美国、西班牙裔和非西班牙裔白人青少年2型糖尿病发病率降低相关这一假设，且部分是由当前体重状况介导的。
SEARCH病例对照研究是青少年糖尿病SEARCH研究的一项辅助研究，在SEARCH六个临床站点中的两个进行。纳入了80名年龄在10 - 21岁的2型糖尿病青少年。非糖尿病对照参与者从初级保健提供者办公室招募（n = 167）。母乳喂养信息由亲生母亲回忆。
2型糖尿病青少年中母乳喂养（任何持续时间）的患病率（%）低于对照受试者（非裔美国人中分别为19.5%对27.1%，西班牙裔中为50.0%对83.8%，非西班牙裔白人中为39.1%对77.6%）。母乳喂养（曾经与从未）与2型糖尿病关联的总体粗比值比为0.26（95%CI 0.15 - 0.46）。按种族/族裔分组结果相似（交互作用P值 = 0.17）。在调整12个潜在混杂因素后的关联比值比为0.43（0.19 - 0.99）。当将当前BMI z评分添加到模型中时，比值比减弱（0.82 [0.30 - 2.30]），表明可能通过当前儿童体重状况介导。纳入母乳喂养持续时间并调整潜在混杂因素的分析提供了剂量反应的证据（趋势检验，P值<0.0001），即使在纳入BMI z评分之后。
母乳喂养似乎对青少年2型糖尿病的发生具有保护作用，部分是由儿童期当前体重状况介导的。
