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食物消费与 HLA 易感性 1 型糖尿病患儿早期β细胞自身免疫:巢式病例对照设计。

Food consumption and advanced β cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes: a nested case-control design.

机构信息

Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.

出版信息

Am J Clin Nutr. 2012 Feb;95(2):471-8. doi: 10.3945/ajcn.111.018879. Epub 2012 Jan 11.

Abstract

BACKGROUND

Evidence for the role of food consumption during childhood in the development of β cell autoimmunity is scarce and fragmentary.

OBJECTIVE

We set out to study the associations of longitudinal food consumption in children with the development of advanced β cell autoimmunity.

DESIGN

Children with advanced β cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case.

RESULTS

In the main food groups, only intakes of cow-milk products (OR: 1.05; 95% CI: 1.00, 1.10) and fruit and berry juices (OR: 1.09; 95% CI: 1.02, 1.12) were significantly, although marginally, associated with advanced β cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced β cell autoimmunity.

CONCLUSION

Intakes of cow milk and fruit and berry juices could be related to the development of advanced β cell autoimmunity. This trial was registered at clinicaltrials.gov as number NCT00223613.

摘要

背景

儿童时期食物摄入与β细胞自身免疫发展之间关系的证据有限且零散。

目的

我们旨在研究儿童时期食物摄入的纵向变化与晚期β细胞自身免疫发展之间的相关性。

设计

从 1996 年至 2004 年出生的、具有 HLA-DQB1 易感性的 6069 名婴儿前瞻性出生队列中,确定了具有晚期β细胞自身免疫(即胰岛细胞抗体重复阳性)的儿童(n=232),以及至少其他 3 种分析抗体之一阳性或临床 1 型糖尿病。随访时间最长为 11 岁。家庭和日托人员完成了为期 3 天的食物记录。每 3-12 个月测量一次糖尿病相关自身抗体和饮食。为每个病例随机选择了 4 名在出生日期、性别、地区和遗传风险方面相匹配的对照者。

结果

在主要食物组中,只有牛奶制品的摄入量(OR:1.05;95%CI:1.00,1.10)和水果和浆果汁(OR:1.09;95%CI:1.02,1.12)与晚期β细胞自身免疫呈显著(尽管是边缘性)相关。新鲜奶制品和基于牛奶的婴儿配方奶的消费与该终点相关,而酸奶制品和奶酪的消费则没有证据表明与该终点相关。所有奶制品中的脂肪和新鲜奶制品中的蛋白质的摄入量与晚期β细胞自身免疫的风险相关。

结论

牛奶和水果、浆果汁的摄入量可能与晚期β细胞自身免疫的发展有关。本试验在 clinicaltrials.gov 上注册为 NCT00223613 号。

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