Early Infant Feeding and Risk of Developing Type 1 Diabetes-Associated Autoantibodies

摘要: ContextDietary factors modifying type 1 diabetes mellitus (DM) risk have been proposed, but little is known if they trigger the islet autoimmunity that precedes clinical disease.ObjectiveTo determine whether breastfeeding duration, food supplementation, or age at introduction of gluten-containing foods influences developing islet autoantibodies.Design and SettingProspective natural history cohort study conducted from 1989 to 2003 in inpatient/outpatient clinics in Germany.ParticipantsThe BABYDIAB follows newborn children parents with DM. Eligibility requirements were met 1610 children. Blood samples obtained at birth, age 9 months, 2, 5, 8 years. Dropout rate was 14.4% by 5 years. Breastfeeding data obtained prospective questionnaires (91% complete), supplementation family interview (72% for 80% gluten introduction).Main Outcome MeasureDevelopment autoantibodies (insulin, glutamic acid decarboxylase, or IA-2 antibodies) 2 consecutive blood samples.ResultsLife-table autoantibody frequency 5.8% (SE, 0.6%) Reduced total or exclusive duration did not significantly increase developing autoantibodies. Food supplementation with before 3 however, associated with significantly increased (adjusted hazard ratio, 4.0; 95% confidence interval, 1.4-11.5; P = .01 vs children who received only breast milk until months). Four 17 children who months developed autoantibodies (life-table 5-year risk, 24%; SE, 10%). All 4 had high-risk DRB1*03/04,DQB1*0302 genotype. Early exposure increase risk of celiac disease–associated Children who first after 6 risks for disease autoantibodies.ConclusionEnsuring compliance infant feeding guidelines a possible way to reduce development DM