Effects of Gluten Intake on Risk of Celiac Disease: A Case-Control Study on a Swedish Birth Cohort
Effects of Gluten Intake on Risk of Celiac Disease: A Case-Control Study on a Swedish Birth Cohort
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DOI：
10.1016/j.cgh.2015.09.030
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发表时间：
2016-03-01
影响因子：
12.6
通讯作者：
Agardh, Daniel
中科院分区：
文献类型：
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作者：
Aronsson, Carin Andren;Lee, Hye-Seung;Agardh, Daniel
背景与目的：早期营养可能影响乳糜泻的风险。我们调查了直到2岁的饮食中的麸质量是否增加了乳糜泻的风险。方法：我们进行了一项1-3巢式病例对照研究，146例，导致436例病例对照对匹配的性别，出生年份，和HLA基因型产生的瑞典儿童乳糜泻的遗传风险。每年对新生儿进行组织转氨酶自身抗体（tTGA）筛查。如果tTGA检测呈阳性，则从每3个月采集的冷冻血清样品中确定血清转化的时间点。通过肠活检证实了腹腔疾病。谷蛋白摄入量是根据在9、12、18和24个月大时收集的3天食物记录计算的。优势比（OR）通过条件Logistic regulation.Results计算：母乳喂养的持续时间（中位数，32周）和年龄在第一次介绍谷蛋白（中位数，22周）之间没有显着差异的情况下和tTGA阴性对照。在tTGA血清转换前的随访中，病例报告的谷蛋白摄入量大于对照组（OR，1.28; 95%置信区间[CI]，1.13-1.46; P = .0002）。与对照组相比，在上三分之一组（即>5.0 g/d）中，在tTGA血清转换检测呈阳性之前，发现比对照组更多的病例（OR，2.65; 95% CI，1.70-4.13; P < .0001）。这一发现在DR 3-DQ 2纯合子儿童中相似（OR，3.19; 95% CI，1.61-6.30; P = .001），DR 3-DQ 2杂合子（OR，2.24; 95%CI，1.08-4.62; P = .030），对于未携带DR 3-DQ 2的儿童，结论：在遗传易感儿童中，2岁之前摄入麸质的量使乳糜泻的风险增加至少2倍。这些发现可能会被考虑到未来的婴儿喂养建议。
BACKGROUND & AIMS: Early nutrition may affect the risk of celiac disease. We investigated whether amount of gluten in diet until 2 years of age increases risk for celiac disease.METHODS: We performed a 1-to-3 nested case-control study of 146 cases, resulting in 436 case-control pairs matched for sex, birth year, and HLA genotype generated from Swedish children at genetic risk for celiac disease. Newborns were annually screened for tissue transglutaminase autoantibodies (tTGA). If tested tTGA positive, time point of seroconversion was determined from frozen serum samples taken every 3 months. Celiac disease was confirmed by intestinal biopsies. Gluten intake was calculated from 3-day food records collected at ages 9, 12, 18 and 24 months. Odds ratios (OR) were calculated through conditional logistic regression.RESULTS: Breastfeeding duration (median, 32 wk) and age at first introduction to gluten (median, 22 wk) did not differ between cases and tTGA-negative controls. At the visit before tTGA seroconversion, cases reported a larger intake of gluten than controls (OR, 1.28; 95% confidence interval [CI], 1.13-1.46; P = .0002). More cases than controls were found in the upper third tertile (ie, >5.0 g/d) before they tested positive for tTGA seroconversion than controls (OR, 2.65; 95% CI, 1.70-4.13; P < .0001). This finding was similar in children homozygous for DR3-DQ2 (OR, 3.19; 95% CI, 1.61-6.30; P = .001), heterozygous for DR3-DQ2 (OR, 2.24; 95% CI, 1.08-4.62; P = .030), and for children not carrying DR3-DQ2 (OR, 2.43; 95% CI, 0.90-6.54; P = .079).CONCLUSIONS: The amount of gluten consumed until 2 years of age increases the risk of celiac disease at least 2-fold in genetically susceptible children. These findings may be taken into account for future infant feeding recommendations.