Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway Department of Nutrition, University of Oslo, Oslo, Norway
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Diabetes Care. 2015 Feb;38(2):257-63. doi: 10.2337/dc14-1130. Epub 2014 Nov 24.
We aimed to study the association of breast-feeding duration and age at the introduction of solid foods with the risk of islet autoimmunity and type 1 diabetes in genetically susceptible children.
Newborns were recruited from the Norwegian general population during 2001-2007. After genetic screening of nearly 50,000 newborns, 908 children with the high-risk HLA genotype were followed up with blood samples and questionnaires at age 3, 6, 9, and 12 months and then annually. Complete infant diet data were available for 726 children.
Any breast-feeding for 12 months or longer predicted a decreased risk of developing type 1 diabetes compared with any breast-feeding for less than 12 months before and after adjusting for having a first-degree relative with type 1 diabetes, vitamin D supplementation, maternal education, sex, and delivery type (hazard ratio 0.37 [95% CI 0.15-0.93]). Any breast-feeding for 12 months or longer was not associated with islet autoimmunity but predicted a lower risk of progression from islet autoimmunity to type 1 diabetes (hazard ratio 0.35 [95% CI 0.13-0.94]). Duration of full breast-feeding was not significantly associated with the risk of islet autoimmunity or type 1 diabetes nor was age at introduction of solid foods or breast-feeding at the time of introduction of any solid foods.
These results suggest that breast-feeding for 12 months or longer predict a lower risk of progression from islet autoimmunity to type 1 diabetes among genetically predisposed children.
我们旨在研究母乳喂养持续时间和固体食物引入年龄与遗传易感儿童胰岛自身免疫和 1 型糖尿病风险的相关性。
2001-2007 年期间,我们从挪威普通人群中招募了新生儿。在对近 50,000 名新生儿进行基因筛查后,908 名具有高危 HLA 基因型的儿童在 3、6、9 和 12 个月以及之后每年进行血液样本和问卷调查。726 名儿童的完整婴儿饮食数据可用于研究。
与母乳喂养少于 12 个月相比,任何 12 个月或更长时间的母乳喂养都预示着发生 1 型糖尿病的风险降低,在调整一级亲属患有 1 型糖尿病、维生素 D 补充、母亲教育、性别和分娩类型后(风险比 0.37 [95%CI 0.15-0.93])。任何 12 个月或更长时间的母乳喂养与胰岛自身免疫无关,但预示着从胰岛自身免疫到 1 型糖尿病的进展风险降低(风险比 0.35 [95%CI 0.13-0.94])。全母乳喂养的持续时间与胰岛自身免疫或 1 型糖尿病的风险无显著相关性,固体食物引入的年龄或引入任何固体食物时的母乳喂养也与两者无相关性。
这些结果表明,母乳喂养 12 个月或更长时间可预测遗传易感儿童从胰岛自身免疫到 1 型糖尿病的进展风险降低。