Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland.
J Nutr. 2024 Nov;154(11):3465-3474. doi: 10.1016/j.tjnut.2024.09.018. Epub 2024 Sep 21.
Prospective longitudinal evidence considering the entire childhood food consumption in relation to the development of islet autoimmunity (IA or) type 1 diabetes is lacking.
We studied the associations of consumption of various foods and their combinations with IA and type 1 diabetes risk.
Children with genetic susceptibility to type 1 diabetes born in 1996-2004 were followed from birth up to ≤6 y of age in the prospective birth cohort type 1 diabetes prediction and prevention study (n = 5674). Exposure variables included 34 food groups covering the entire diet based on repeated 3-d food records at ages 3 mo to 6 y. Endpoints were islet cell antibodies plus biochemical IA (n = 247), multiple biochemical IA (n = 206), and type 1 diabetes (n = 94). We analyzed associations between longitudinally observed foods and risk of IA/type 1 diabetes using a Bayesian approach to joint models in 1-food and multi-food models adjusted for energy intake, sex, human leukocyte antigen genotype, and familial diabetes.
The final multi-food model for islet cell antibodies plus biochemical IA included oats [hazard ratio (HR): 1.09; 95% credible interval (CI): 1.04, 1.14], banana (HR: 1.07; 95% CI: 1.03, 1.11), and cruciferous vegetables (HR: 0.83; 95% CI: 0.73, 0.94). The final model for multiple biochemical IA included, in addition to the above-mentioned foods, fermented dairy (HR: 1.42; 95% CI: 1.12, 1.78) and wheat (HR: 1.10; 95% CI: 1.03, 1.18). The final multi-food model for type 1 diabetes included rye (HR: 1.27; 95% CI: 1.07, 1.50), oats (HR: 1.15; 95% CI: 1.03, 1.26), fruits (HR: 1.05; 95% CI: 1.01, 1.09), and berries (HR: 0.67; 95% CI: 0.50, 0.93).
Higher consumption of oats, gluten-containing cereals, and fruits was associated with increased that of cruciferous vegetables with decreased risk of several type 1 diabetes-related endpoints when considering all the foods in combination. Further etiological and mechanistic studies are warranted.
缺乏前瞻性纵向研究来评估整个儿童期食物摄入与胰岛自身免疫（IA 或）1 型糖尿病发展之间的关系。
我们研究了各种食物及其组合的摄入与 IA 和 1 型糖尿病风险之间的关联。
1996-2004 年间出生的具有 1 型糖尿病遗传易感性的儿童，在前瞻性出生队列 1 型糖尿病预测和预防研究中从出生开始进行随访，直至≤6 岁（n=5674）。暴露变量包括基于 3 个月至 6 岁时重复的 3 天食物记录的 34 种食物组，涵盖了整个饮食。终点为胰岛细胞抗体加生化 IA（n=247）、多个生化 IA（n=206）和 1 型糖尿病（n=94）。我们使用联合模型的贝叶斯方法分析了纵向观察到的食物与 IA/1 型糖尿病风险之间的关系，该模型调整了能量摄入、性别、人类白细胞抗原基因型和家族性糖尿病。
胰岛细胞抗体加生化 IA 的最终多食物模型包括燕麦（HR：1.09；95%可信区间（CI）：1.04，1.14）、香蕉（HR：1.07；95% CI：1.03，1.11）和十字花科蔬菜（HR：0.83；95% CI：0.73，0.94）。多个生化 IA 的最终模型除了上述食物外，还包括发酵乳制品（HR：1.42；95% CI：1.12，1.78）和小麦（HR：1.10；95% CI：1.03，1.18）。1 型糖尿病的最终多食物模型包括黑麦（HR：1.27；95% CI：1.07，1.50）、燕麦（HR：1.15；95% CI：1.03，1.26）、水果（HR：1.05；95% CI：1.01，1.09）和浆果（HR：0.67；95% CI：0.50，0.93）。
当考虑所有食物的组合时，更高的燕麦、含麸质谷物和水果的摄入量与十字花科蔬菜的摄入量增加有关，而与几种与 1 型糖尿病相关的终点的风险降低有关。需要进一步进行病因学和机制研究。
