Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
PLoS Med. 2020 Mar 2;17(3):e1003032. doi: 10.1371/journal.pmed.1003032. eCollection 2020 Mar.
The relationship between maternal gluten intake in pregnancy, offspring intake in childhood, and offspring risk of type 1 diabetes has not been examined jointly in any studies. Our aim was to study the relationship between maternal and child intake of gluten and risk of type 1 diabetes in children.
We included 86,306 children in an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), with recruitment from 1999 to 2008 and with follow-up time to April 15, 2018. We used registration of type 1 diabetes in the Norwegian childhood diabetes registry as the outcome. We used Cox proportional hazard regression to estimate hazard ratios (HRs) for the mother's intake of gluten up to week 22 of pregnancy and offspring gluten intake when the child was 18 months old. The average time followed was 12.3 years (0.70-16.0). A total of 346 children (0.4%) children were diagnosed with type 1 diabetes, resulting in an incidence rate of 32.6/100,000 person-years. Mean gluten intake per day was 13.6 g for mothers and 8.8 g for children. There was no association between the mother's intake of gluten in pregnancy and offspring type 1 diabetes, with an adjusted HR (aHR) of 1.02 (95% confidence interval [CI] 0.73-1.43, p = 0.91) for each 10-g-per-day increment. There was an association between offspring intake of gluten and a higher risk of type 1 diabetes, with an aHR of 1.46 (95% CI 1.06-2.01, p = 0.02) for each 10-g-per-day increment. Among the limitations are the likely imprecision in estimation of gluten intake and that we only had information regarding gluten intake at 2 time points in early life.
Our results show that, while the mother's intake of gluten in pregnancy was not associated with type 1 diabetes, a higher intake of gluten by the child at an early age may give a higher risk of type 1 diabetes.
在任何研究中，尚未联合研究孕妇麸质摄入量、儿童时期摄入情况以及儿童 1 型糖尿病风险之间的关系。我们的目的是研究母亲和儿童麸质摄入量与儿童 1 型糖尿病风险之间的关系。
我们纳入了一项观察性全国队列研究，即挪威母亲和儿童队列研究（MoBa）中的 86306 名儿童，该研究于 1999 年至 2008 年招募，并随访至 2018 年 4 月 15 日。我们将挪威儿童糖尿病登记处登记的 1 型糖尿病作为结局。我们使用 Cox 比例风险回归估计母亲妊娠第 22 周的麸质摄入量以及儿童 18 个月时的麸质摄入量与孩子患 1 型糖尿病风险的比值比（HR）。平均随访时间为 12.3 年（0.70-16.0）。共有 346 名儿童（0.4%）被诊断为 1 型糖尿病，发病率为 32.6/100000 人年。母亲每日平均摄入的麸质为 13.6 克，儿童为 8.8 克。母亲妊娠期间摄入的麸质与子女患 1 型糖尿病之间无关联，调整后的 HR（aHR）为 1.02（95%CI 0.73-1.43，p=0.91），每增加 10 克/天。儿童摄入的麸质与 1 型糖尿病风险增加相关，aHR 为 1.46（95%CI 1.06-2.01，p=0.02），每增加 10 克/天。研究的局限性包括麸质摄入量的估计可能不精确，以及我们仅在生命早期的两个时间点获得了有关麸质摄入量的信息。
我们的结果表明，尽管母亲妊娠期间摄入的麸质与 1 型糖尿病无关，但儿童在早期摄入更多的麸质可能会增加患 1 型糖尿病的风险。
