Lund-Blix Nicolai A, Dydensborg Sander Stine, Størdal Ketil, Nybo Andersen Anne-Marie, Rønningen Kjersti S, Joner Geir, Skrivarhaug Torild, Njølstad Pål R, Husby Steffen, Stene Lars C
Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Diabetes Care. 2017 Jul;40(7):920-927. doi: 10.2337/dc17-0016. Epub 2017 May 9.
Our aim was to study the relation between the duration of full and any breastfeeding and risk of type 1 diabetes.
We included two population-based cohorts of children followed from birth (1996-2009) to 2014 (Denmark) or 2015 (Norway). We analyzed data from a total of 155,392 children participating in the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC). Parents reported infant dietary practices when their child was 6 and 18 months old. The outcome was clinical type 1 diabetes, ascertained from nationwide childhood diabetes registries. Hazard ratios (HRs) were estimated using Cox regression.
Type 1 diabetes was identified in 504 children during follow-up, and the incidence of type 1 diabetes per 100,000 person-years was 30.5 in the Norwegian cohort and 23.5 in the Danish cohort. Children who were never breastfed had a twofold increased risk of type 1 diabetes compared with those who were breastfed (HR 2.29 [95% CI 1.14-4.61] for no breastfeeding vs. any breastfeeding for ≥12 months). Among those who were breastfed, however, the incidence of type 1 diabetes was independent of duration of both full breastfeeding (HR per month 0.99 [95% CI 0.97-1.01]) and any breastfeeding (0.97 [0.92-1.03]).
Suggestive evidence supports the contention that breastfeeding reduces the risk of type 1 diabetes. Among those who were breastfed, however, no evidence indicated that prolonging full or any breastfeeding was associated with a reduced risk of type 1 diabetes.
我们的目的是研究纯母乳喂养及任何形式母乳喂养的持续时间与1型糖尿病风险之间的关系。
我们纳入了两个基于人群的队列研究，研究对象为从出生（1996 - 2009年）至2014年（丹麦）或2015年（挪威）进行随访的儿童。我们分析了总共155392名参与挪威母婴队列研究（MoBa）和丹麦国家出生队列（DNBC）的儿童的数据。父母在孩子6个月和18个月大时报告婴儿的饮食情况。研究结果为临床1型糖尿病，通过全国儿童糖尿病登记处确定。使用Cox回归估计风险比（HRs）。
随访期间，504名儿童被确诊为1型糖尿病，挪威队列中每10万人年的1型糖尿病发病率为30.5，丹麦队列中为23.5。从未接受母乳喂养的儿童患1型糖尿病的风险是接受母乳喂养儿童的两倍（未母乳喂养与母乳喂养≥12个月相比，HR为2.29 [95%CI 1.14 - 4.61]）。然而，在接受母乳喂养的儿童中，1型糖尿病的发病率与纯母乳喂养的持续时间（每月HR为0.99 [95%CI 0.97 - 1.01]）和任何形式母乳喂养的持续时间（0.97 [0.92 - 1.03]）均无关。
有提示性证据支持母乳喂养可降低1型糖尿病风险这一观点。然而，在接受母乳喂养的儿童中，没有证据表明延长纯母乳喂养或任何形式母乳喂养的时间与降低1型糖尿病风险有关。
