Weight Gain in Early Life Predicts Risk of Islet Autoimmuity in Children With a First-Degree Relative With Type 1 Diabetes
Weight Gain in Early Life Predicts Risk of Islet Autoimmuity in Children With a First-Degree Relative With Type 1 Diabetes
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DOI：
10.2337/dc08-0821
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发表时间：
2009-01-01
期刊：
影响因子：
16.2
通讯作者：
Colman, Peter G.
中科院分区：
文献类型：
--
作者：
Couper, Jennifer J.;Beresford, Sarah;Colman, Peter G.
目的：在一项前瞻性的Hirth队列研究中，我们跟踪调查了患有1型糖尿病的一级亲属的婴儿，以调查早期生长和婴儿喂养之间的关系以及胰岛自身免疫的风险。研究设计和方法--有一级亲属患有1型糖尿病的婴儿在他们母亲怀孕期间被确定。前瞻性地记录饮食摄入量，以确定母乳喂养的持续时间和引入牛奶蛋白、谷类食品、肉类、水果和蔬菜的年龄。在6个月的回顾中，测量了针对胰岛素、GAD65、酪氨酸磷酸酶样胰岛素瘤抗原和组织转谷氨酰胺酶的长度(或身高)和体重抗体。胰岛自身免疫被定义为连续6个月间隔内一个或多个胰岛抗体的持续升高，包括最近的测量，是主要的结果衡量标准。结果：对548名受试者进行了5.7+/-3.2年的随访，发现46名儿童患有胰岛自身免疫。体重17分和体重指数z分是胰岛自身免疫调整危险比的连续预测因子，分别为1.43[95%CI1.10~1.84]，P=0.007和1.29[1.01~1.67]，P=0.04。体重z分数为0的受试者发生胰岛自身免疫的风险高于体重z分数为0的受试者。
OBJECTIVE - In a prospective hirth cohort study, we followed infants who had a first-degree relative with type 1 diabetes to investigate the relationship between early growth and infant feeding and the risk of islet autoimmunity.RESEARCH DESIGN AND METHODS - Infants with a first-degree relative with type 1 diabetes were identified during their mother's pregnancy. Dietary intake was recorded prospectively to determine duration of breast-feeding and age at introduction of cow's milk protein, cereals, meat, fruit, and vegetables. At 6-month reviews, length (or height) and weight antibodies to insulin, GAD65, the tyrosine phosphatase-like insulinoma antigen, and tissue transglutaminase were measured. Islet autoimmunity was defined as persistent elevation of one or more islet antibodies at consecutive 6-month intervals, including the most recent measure, and was the primary outcome measure.RESULTS - Follow-up of 548 subjects for 5.7 +/- 3.2 years identified 46 children with islet autoimmunity. Weight 17 score and BMI z score were continuous predictors of risk of islet autoimmunity adjusted hazard ratios 1.43 [95% CI 1.10-1.84], P = 0.007, and 1.29 [ 1.01-1.67], P=0.04, respectively). The risk of islet autoimmunity was greater in subjects with weight z score >0 than in those with weight z score