Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
Am J Epidemiol. 2018 Jan 1;187(1):34-44. doi: 10.1093/aje/kwx191.
Breastfeeding, age at introduction of foods, and food diversity in infancy were studied for associations with advanced islet autoimmunity and type 1 diabetes. During 1996--2004, a total of 5,915 newborns with human leukocyte antigen-conferred susceptibility to type 1 diabetes were enrolled in the prospective Finnish Type 1 Diabetes Prediction and Prevention Nutrition Study. Children were assessed at intervals of 3-12 months for the appearance of 4 types of islet autoantibodies and type 1 diabetes up to the age of 15 years. Survival models indicated the 3 variables of interest were not associated with advanced islet autoimmunity or type 1 diabetes in the cohort. Early introduction of solid foods was associated with increased risk of advanced islet autoimmunity in children up to age 3 years (for <3 months vs. >4 months, hazard ratio = 2.33, 95% confidence interval: 1.39, 3.91; for 3-4 months vs. >4 months, hazard ratio = 2.18; 95% confidence interval: 1.38, 3.47) but not in longer follow-up (P for interaction = 0.046). Similar results were observed for age at introduction of roots, cereals, egg, and meat relative to risk of advanced islet autoimmunity. No consistent, long-term associations between infant feeding and advanced islet autoimmunity or type 1 diabetes were observed.
研究了母乳喂养、食物引入年龄和婴儿期食物多样性与胰岛自身免疫和 1 型糖尿病的相关性。1996 年至 2004 年，前瞻性芬兰 1 型糖尿病预测和预防营养研究共纳入了 5915 名具有 1 型糖尿病易感性的人类白细胞抗原新生儿。每隔 3-12 个月评估儿童是否出现 4 种胰岛自身抗体和 1 型糖尿病，直至 15 岁。生存模型表明，队列中这 3 个感兴趣的变量与晚期胰岛自身免疫或 1 型糖尿病无关。早期引入固体食物与 3 岁以下儿童晚期胰岛自身免疫风险增加有关（<3 个月与>4 个月相比，危险比=2.33，95%置信区间：1.39，3.91；3-4 个月与>4 个月相比，危险比=2.18；95%置信区间：1.38，3.47），但在更长的随访中无此相关性（P 交互=0.046）。引入根茎类食物、谷物、蛋和肉的年龄与晚期胰岛自身免疫风险之间也存在类似的关系。未观察到婴儿喂养与晚期胰岛自身免疫或 1 型糖尿病之间存在一致的长期相关性。
