Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
Department of Biology, Faculty of Science, University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark.
Nutrients. 2023 Oct 11;15(20):4333. doi: 10.3390/nu15204333.
The incidence of type 1 diabetes mellitus in children is considerably increasing in western countries. Thus, identification of the environmental determinants involved could ultimately lead to disease prevention. Here, we aimed to systematically review (PROSPERO ID: CRD42022362522) the current evidence of the association between maternal dietary factors during gestation and the risk of developing type 1 diabetes and/or islet autoimmunity (IA) in murine and human offspring.
In accordance with PRISMA guidelines, the present systematic review searched PubMed and Scopus ( = 343) for different combinations of MeSH terms, such as type 1 diabetes, diet, islet autoimmunity, prenatal, nutrient, gluten, gliadin, vitamin, milk, and fibers.
We found that the most investigated dietary factors in the present literature were gluten, dietary advanced glycosylated end products (dAGEs), vitamin D, fatty acids, and iron. The results concerning prenatal exposure to a gluten-free environment showed a consistently protective effect on the development of IA. Prenatal exposures to vitamin D and certain fatty acids appeared to protect against the development of IA, whereas in utero iron and fat exposures correlated with increased risks of IA.
We conclude that a definite association is not established for most factors investigated as the literature represents a heterogeneous pool of data, although fetal exposures to some maternal dietary components, such as gluten, show consistent associations with increased risks of IA. We suggest that human prospective dietary intervention studies in both cohort and clinical settings are crucial to better evaluate critical and protective prenatal exposures from the maternal diet during pregnancy.
在西方国家，儿童 1 型糖尿病的发病率显著增加。因此，确定所涉及的环境决定因素最终可能导致疾病预防。在这里，我们旨在系统地回顾（PROSPERO ID：CRD42022362522）目前关于妊娠期间母体饮食因素与 1 型糖尿病和/或胰岛自身免疫（IA）风险之间关联的证据，在鼠类和人类后代中。
根据 PRISMA 指南，本系统评价在 PubMed 和 Scopus 上搜索了不同的 MeSH 术语组合，如 1 型糖尿病、饮食、胰岛自身免疫、产前、营养、麸质、麦醇溶蛋白、维生素、牛奶和纤维。
我们发现，目前文献中研究最多的饮食因素是麸质、膳食晚期糖基化终产物（dAGEs）、维生素 D、脂肪酸和铁。关于产前暴露于无麸质环境的研究结果表明，对 IA 的发展具有一致的保护作用。产前暴露于维生素 D 和某些脂肪酸似乎可以预防 IA 的发生，而宫内铁和脂肪暴露与 IA 风险增加相关。
我们得出的结论是，由于文献代表了一组异质的数据，因此大多数被调查的因素并没有建立明确的相关性，尽管胎儿暴露于某些母体饮食成分，如麸质，与增加的 IA 风险存在一致的关联。我们建议，在队列和临床环境中进行前瞻性人类饮食干预研究对于更好地评估怀孕期间母体饮食的关键和保护产前暴露至关重要。
