饮食铁摄入与遗传性铁过载的相互作用：TEDDY 研究中胰岛自身免疫和 1 型糖尿病进展的风险。
Interaction Between Dietary Iron Intake and Genetically Determined Iron Overload: Risk of Islet Autoimmunity and Progression to Type 1 Diabetes in the TEDDY Study.
机构信息
1Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
2Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Herlev, Denmark.
出版信息
Diabetes Care. 2023 May 1;46(5):1014-1018. doi: 10.2337/dc22-1359.
OBJECTIVE
To examine whether iron intake and genetically determined iron overload interact in predisposing to the development of childhood islet autoimmunity (IA) and type 1 diabetes (T1D).
RESEARCH DESIGN AND METHODS
In The Environmental Determinants of Diabetes in the Young (TEDDY) study, 7,770 genetically high-risk children were followed from birth until the development of IA and progression to T1D. Exposures included energy-adjusted iron intake in the first 3 years of life and a genetic risk score (GRS) for increased circulating iron.
RESULTS
We found a U-shaped association between iron intake and risk of GAD antibody as the first autoantibody. In children with GRS ≥2 iron risk alleles, high iron intake was associated with an increased risk of IA, with insulin as first autoantibody (adjusted hazard ratio 1.71 [95% CI 1.14; 2.58]) compared with moderate iron intake.
CONCLUSIONS
Iron intake may alter the risk of IA in children with high-risk HLA haplogenotypes.
目的
研究铁摄入量和遗传性铁过载是否相互作用，从而导致儿童胰岛自身免疫（IA）和 1 型糖尿病（T1D）的发生。
研究设计和方法
在青少年糖尿病的环境决定因素（TEDDY）研究中，对 7770 名遗传高风险的儿童从出生开始进行随访，直至发生 IA 并进展为 T1D。暴露因素包括生命最初 3 年的能量校正铁摄入量和循环铁增加的遗传风险评分（GRS）。
结果
我们发现铁摄入量与谷氨酸脱羧酶抗体（GAD 抗体）作为第一个自身抗体的风险之间存在 U 形关联。在 GRS≥2 个铁风险等位基因的儿童中，与中等铁摄入量相比，高铁摄入量与 IA 的发生风险增加相关，以胰岛素作为第一个自身抗体（校正后的危险比 1.71 [95%CI 1.14；2.58]）。
结论
铁摄入量可能会改变具有高危 HLA 单倍型的儿童发生 IA 的风险。
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