Pettitt D J, Forman M R, Hanson R L, Knowler W C, Bennett P H
Diabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85014, USA.
Lancet. 1997 Jul 19;350(9072):166-8. doi: 10.1016/S0140-6736(96)12103-6.
Early exposure to cow's milk has been implicated in the occurrence of insulin-dependent diabetes mellitus but there is little information about infant-feeding practices and subsequent non-insulin-dependent diabetes mellitus (NIDDM). We examined the association between breastfeeding and NIDDM in a population with a high prevalence of this disorder, the Pima Indians.
Glucose-tolerance status was obtained from a 75 g oral glucose-tolerance test. A standard questionnaire given to mothers was used to classify infant-feeding practices for the first 2 months of life into three groups; exclusively breastfed, some breastfeeding, or exclusively bottlefed. The association between the three infant-feeding groups and NIDDM was analysed by multiple logistic regression.
Data were available for 720 Pima Indians aged between 10 and 39 years. 325 people who were exclusively bottlefed had significantly higher age-adjusted and sex-adjusted mean relative weights (146%) than 144 people who were exclusively breastfed (140%) or 251 people who had some breastfeeding (139%) (p = 0.019). People who were exclusively breastfed had significantly lower rates of NIDDM than those who were exclusively bottlefed in all age-groups (age 10-19, 0 of 56 vs 6 [3.6%] of 165; age 20-29, 5 [8.6%] of 58 vs 17 [14.7%] of 116]; age 30-39, 6 [20.0%] of 30 vs 13 [29.6%] of 44). The odds ratio for NIDDM in exclusively breastfed people, compared with those exclusively bottlefed, was 0.41 (95% CI 0.18-0.93) adjusted for age, sex, birthdate, parental diabetes, and birthweight.
Exclusive breastfeeding for the first 2 months of life is associated with a significantly lower rate of NIDDM in Pima indians. The increase in prevalence of diabetes in some populations may be due to the concomitant decrease in breastfeeding.
早期接触牛奶被认为与胰岛素依赖型糖尿病的发生有关，但关于婴儿喂养方式与随后的非胰岛素依赖型糖尿病（NIDDM）的信息却很少。我们在这种疾病高发的皮马印第安人群体中研究了母乳喂养与NIDDM之间的关联。
通过75克口服葡萄糖耐量试验获得葡萄糖耐量状态。向母亲发放的一份标准问卷用于将出生后头2个月的婴儿喂养方式分为三组：纯母乳喂养、部分母乳喂养或纯人工喂养。通过多元逻辑回归分析这三组婴儿喂养方式与NIDDM之间的关联。
有720名年龄在10至39岁之间的皮马印第安人的数据可供分析。纯人工喂养的325人经年龄和性别调整后的平均相对体重（146%）显著高于纯母乳喂养的144人（140%）或部分母乳喂养的251人（139%）（p = 0.019）。在所有年龄组中，纯母乳喂养的人患NIDDM的比例显著低于纯人工喂养的人（10 - 19岁组，56人中有0人患病，165人中有6人患病[3.6%]；20 - 29岁组，58人中有5人患病[8.6%]，116人中有17人患病[14.7%]；30 - 39岁组，30人中有6人患病[20.0%]，44人中有13人患病[29.6%]）。在对年龄、性别、出生日期、父母患糖尿病情况和出生体重进行调整后，纯母乳喂养的人患NIDDM的比值比为0.41（95%可信区间0.18 - 0.93），与纯人工喂养的人相比。
在皮马印第安人中，出生后头2个月纯母乳喂养与NIDDM的发生率显著降低有关。一些人群中糖尿病患病率的增加可能归因于母乳喂养的同时减少。
