Department of Diabetes and Endocrinology, Women's and Children's Hospital and Discipline of Paediatrics, University of Adelaide, Adelaide, Australia.
Diabetes Care. 2009 Jan;32(1):94-9. doi: 10.2337/dc08-0821. Epub 2008 Oct 3.
In a prospective birth cohort study, we followed infants who had a first-degree relative with type 1 diabetes to investigate the relationship between early growth and infant feeding and the risk of islet autoimmunity.
Infants with a first-degree relative with type 1 diabetes were identified during their mother's pregnancy. Dietary intake was recorded prospectively to determine duration of breast-feeding and age at introduction of cow's milk protein, cereals, meat, fruit, and vegetables. At 6-month reviews, length (or height) and weight, antibodies to insulin, GAD65, the tyrosine phosphatase-like insulinoma antigen, and tissue transglutaminase were measured. Islet autoimmunity was defined as persistent elevation of one or more islet antibodies at consecutive 6-month intervals, including the most recent measure, and was the primary outcome measure.
Follow-up of 548 subjects for 5.7 +/- 3.2 years identified 46 children with islet autoimmunity. Weight z score and BMI z score were continuous predictors of risk of islet autoimmunity (adjusted hazard ratios 1.43 [95% CI 1.10-1.84], P = 0.007, and 1.29 [1.01-1.67], P = 0.04, respectively). The risk of islet autoimmunity was greater in subjects with weight z score >0 than in those with weight z score < or =0 over time (2.61 [1.26-5.44], P = 0.01). Weight z score and BMI z score at 2 years and change in weight z score between birth and 2 years, but not dietary intake, also predicted risk of islet autoimmunity.
Weight gain in early life predicts risk of islet autoimmunity in children with a first-degree relative with type 1 diabetes.
在一项前瞻性出生队列研究中，我们对一级亲属患有 1 型糖尿病的婴儿进行了随访，以研究早期生长和婴儿喂养与胰岛自身免疫风险之间的关系。
在母亲怀孕期间确定一级亲属患有 1 型糖尿病的婴儿。前瞻性记录饮食摄入量，以确定母乳喂养的持续时间以及引入牛奶蛋白、谷物、肉类、水果和蔬菜的年龄。在 6 个月的复查中，测量长度（或身高）和体重、胰岛素、GAD65、酪氨酸磷酸酶样胰岛素瘤抗原和组织转谷氨酰胺酶的抗体。胰岛自身免疫定义为在连续 6 个月的间隔内（包括最近一次测量）持续升高一种或多种胰岛抗体，是主要的结局测量指标。
对 548 名受试者进行了 5.7 +/- 3.2 年的随访，发现 46 名儿童患有胰岛自身免疫。体重 z 评分和 BMI z 评分是胰岛自身免疫风险的连续预测指标（调整后的危险比分别为 1.43 [95% CI 1.10-1.84]，P = 0.007 和 1.29 [1.01-1.67]，P = 0.04）。体重 z 评分>0 的受试者比体重 z 评分<或=0 的受试者随时间推移发生胰岛自身免疫的风险更大（2.61 [1.26-5.44]，P = 0.01）。2 岁时的体重 z 评分和 BMI z 评分以及出生到 2 岁之间体重 z 评分的变化，而不是饮食摄入，也预测了胰岛自身免疫的风险。
婴儿期的体重增加预测了一级亲属患有 1 型糖尿病的儿童发生胰岛自身免疫的风险。
