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母亲妊娠晚期的食物摄入与后代胰岛自身免疫和 1 型糖尿病的风险。

Maternal food consumption during late pregnancy and offspring risk of islet autoimmunity and type 1 diabetes.

机构信息

Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

出版信息

Diabetologia. 2021 Jul;64(7):1604-1612. doi: 10.1007/s00125-021-05446-y. Epub 2021 Mar 30.

Abstract

AIMS/HYPOTHESIS: We aimed to investigate the association between maternal consumption of gluten-containing foods and other selected foods during late pregnancy and offspring risk of islet autoimmunity (IA) and type 1 diabetes in The Environmental Determinants of Diabetes in the Young (TEDDY) study.

METHODS

The TEDDY study recruited children at high genetic risk for type 1 diabetes at birth, and prospectively follows them for the development of IA and type 1 diabetes (n = 8556). A questionnaire on the mother's diet in late pregnancy was completed by 3-4 months postpartum. The maternal daily intake was estimated from a food frequency questionnaire for eight food groups: gluten-containing foods, non-gluten cereals, fresh milk, sour milk, cheese products, soy products, lean/medium-fat fish and fatty fish. For each food, we described the distribution of maternal intake among the four participating countries in the TEDDY study and tested the association of tertile of maternal food consumption with risk of IA and type 1 diabetes using forward selection time-to-event Cox regression.

RESULTS

By 28 February 2019, 791 cases of IA and 328 cases of type 1 diabetes developed in TEDDY. There was no association between maternal late-pregnancy consumption of gluten-containing foods or any of the other selected foods and risk of IA, type 1 diabetes, insulin autoantibody-first IA or GAD autoantibody-first IA (all p ≥ 0.01). Maternal gluten-containing food consumption in late pregnancy was higher in Sweden (242 g/day), Germany (247 g/day) and Finland (221 g/day) than in the USA (199 g/day) (pairwise p < 0.05).

CONCLUSIONS/INTERPRETATION: Maternal food consumption during late pregnancy was not associated with offspring risk for IA or type 1 diabetes.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00279318.

摘要

目的/假设:我们旨在研究孕妇在妊娠晚期摄入含麸质食物和其他选定食物与后代发生胰岛自身免疫(IA)和 1 型糖尿病的风险之间的关系,该研究是在儿童 1 型糖尿病环境决定因素研究(TEDDY)中进行的。

方法

TEDDY 研究在出生时招募了具有 1 型糖尿病高遗传风险的儿童,并前瞻性地跟踪他们发生 IA 和 1 型糖尿病的情况(n=8556)。在产后 3-4 个月时,通过问卷调查了解母亲在妊娠晚期的饮食情况。通过食物频率问卷估计母亲在妊娠晚期对 8 种食物组的每日摄入量:含麸质食物、非麸质谷物、新鲜牛奶、酸奶、奶酪产品、豆制品、瘦/中脂肪鱼和高脂肪鱼。对于每种食物,我们描述了 TEDDY 研究中四个参与国家的母亲摄入量分布,并使用向前选择时间事件 Cox 回归检验母亲食物摄入三分位与 IA 和 1 型糖尿病风险的关系。

结果

截至 2019 年 2 月 28 日,TEDDY 中发生了 791 例 IA 和 328 例 1 型糖尿病。孕妇在妊娠晚期摄入含麸质食物或其他任何选定食物与 IA、1 型糖尿病、胰岛素自身抗体阳性 IA 或谷氨酸脱羧酶自身抗体阳性 IA 的风险均无关联(所有 p≥0.01)。与美国相比,瑞典(242 克/天)、德国(247 克/天)和芬兰(221 克/天)的孕妇在妊娠晚期摄入的含麸质食物更多(两两比较 p<0.05)。

结论/解释:孕妇在妊娠晚期的饮食与后代发生 IA 或 1 型糖尿病的风险无关。

试验注册

ClinicalTrials.gov NCT00279318。

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