Yang Jimin, Tamura Roy N, Aronsson Carin A, Uusitalo Ulla M, Lernmark Åke, Rewers Marian, Hagopian William A, She Jin-Xiong, Toppari Jorma, Ziegler Anette G, Akolkar Beena, Krischer Jeffrey P, Norris Jill M, Virtanen Suvi M, Agardh Daniel
1Health Informatics Institute,Morsani College of Medicine,University of South Florida,Tampa,FL 33612,USA.
2The Diabetes and Celiac Disease Unit,Department of Clinical Sciences,Lund University,20502 Malmö,Sweden.
Br J Nutr. 2017 Feb;117(3):466-472. doi: 10.1017/S0007114517000332. Epub 2017 Mar 2.
Perinatal exposure to nutrients and dietary components may affect the risk for coeliac disease (CD). We investigated the association between maternal use of vitamin D, n-3 fatty acids (FA) and Fe supplements during pregnancy and risk for CD autoimmunity (CDA) and CD in the offspring. Children at increased genetic risk were prospectively followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study. CDA was defined as having persistently positive tissue transglutaminase autoantibodies (tTGA). Diagnosis of CD was either biopsy-confirmed or considered likely if having persistently elevated levels of tTGA>100 AU. Of 6627 enrolled children, 1136 developed CDA at a median 3·1 years of age (range 0·9-10) and 409 developed CD at a median 3·9 years of age (range 1·2-11). Use of supplements containing vitamin D, n-3 FA and Fe was recalled by 66, 17 and 94 % of mothers, respectively, at 3-4 months postpartum. The mean cumulative intake over the entire pregnancy was 2014 μg vitamin D (sd 2045 μg), 111 g n-3 FA (sd 303 g) and 8806 mg Fe (sd 7017 mg). After adjusting for country, child's human leucocyte antigen genotype, sex, family history of CD, any breast-feeding duration and household crowding, Cox's proportional hazard ratios did not suggest a statistically significant association between the intake of vitamin D, n-3 FA or Fe, and risk for CDA or CD. Dietary supplementation during pregnancy may help boost nutrient intake, but it is not likely to modify the risk for the disease in the offspring.
围产期接触营养素和膳食成分可能会影响患乳糜泻(CD)的风险。我们调查了孕期母亲使用维生素D、n-3脂肪酸(FA)和铁补充剂与后代患CD自身免疫(CDA)和CD的风险之间的关联。在“青少年糖尿病环境决定因素”(TEDDY)研究中,对遗传风险增加的儿童从出生起进行前瞻性随访。CDA被定义为组织转谷氨酰胺酶自身抗体(tTGA)持续呈阳性。CD的诊断要么通过活检确诊,要么如果tTGA水平持续升高>100 AU则被认为可能。在6627名登记儿童中,1136名在中位年龄3.1岁(范围0.9 - 10岁)时患CDA,409名在中位年龄3.9岁(范围1.2 - 11岁)时患CD。产后3 - 4个月时,分别有66%、17%和94%的母亲回忆起使用过含维生素D、n-3 FA和铁的补充剂。整个孕期的平均累积摄入量为维生素D 2014μg(标准差2045μg)、n-3 FA 111g(标准差303g)和铁8806mg(标准差7017mg)。在对国家、儿童的人类白细胞抗原基因型、性别、CD家族史、任何母乳喂养持续时间和家庭拥挤程度进行调整后,Cox比例风险比未显示维生素D、n-3 FA或铁的摄入量与CDA或CD风险之间存在统计学上的显著关联。孕期膳食补充可能有助于提高营养素摄入量,但不太可能改变后代患该病的风险。