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Dietary iron intake in the first 4 months of infancy and the development of type 1 diabetes: a pilot study
Ambika P Ashraf1, Nancy B Eason, Edmond K Kabagambe
1Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, The Children's Hospital, University of Alabama at Birmingham, USA. AAshraf@peds.uab.edu.
Insights
High iron intake in early infancy is linked to a greater risk of developing type 1 diabetes (T1DM). Further research is needed to confirm if iron is a direct cause or merely a marker of other risk factors.
Area of Science:
- Pediatric Endocrinology
- Nutritional Epidemiology
- Immunology
Background:
- Type 1 diabetes (T1DM) is an autoimmune condition with increasing incidence in children.
- Early life nutrition is a potential modifiable factor influencing T1DM risk.
- The role of specific nutrients, such as iron, in T1DM pathogenesis remains under investigation.
Purpose of the Study:
- To examine the association between early-life iron intake and the risk of developing T1DM in children.
- To determine if higher iron consumption during the first four months of life is correlated with T1DM development.
Main Methods:
- A case-control study involving 128 children with T1DM and 67 control subjects, all under 10 years old.
- Data collected via questionnaires on infant feeding practices in the first 4 months of life.
- Conditional logistic regression analysis was employed, including analyses restricted to cases with sibling controls.
Main Results:
- Median total iron intake in the first 4 months was significantly higher in T1DM cases (1159 mg) compared to controls (466 mg) (P < 0.001).
- Each one standard deviation increase in iron intake was associated with a 2.01-fold increased odds of T1DM in the overall sample.
- A similar association was observed in the sibling-controlled analysis, with a 2.26-fold increased odds for T1DM per SD increase in iron intake.
Conclusions:
- This pilot study suggests a potential association between high iron intake in early infancy and an increased risk of T1DM.
- The findings highlight the need for further investigation to ascertain whether iron intake is a causal factor or a marker for other T1DM risk factors.
Aims:
To investigate the impact of iron intake on the development of type 1 diabetes (T1DM).
Methods:
Case-control study with self-administered questionnaire among families of children with T1DM who were less than 10 years old at the time of the survey and developed diabetes between age 1 and 6 years. Data on the types of infant feeding in the first 4 months of life was collected from parents of children with T1DM (n = 128) and controls (n = 67) <10 years old. Because some cases had sibling controls, we used conditional logistic regression models to analyze the data in two ways. First we performed a case-control analysis of all 128 cases and 67 controls. Next, we performed a case-control analysis restricted to cases (n = 59) that had a sibling without diabetes (n = 59). Total iron intake was modeled as one standard deviation (SD) increase in iron intake. The SD for iron intake was 540 mg in the total sample and 539 mg in the restricted sample as defined above.
Results:
The median (min, max) total iron intake in the first 4 months of life was 1159 (50, 2399) mg in T1DM cases and 466 (50, 1224) mg among controls (P < 0.001). For each one standard deviation increase in iron intake, the odds ratio (95% confidence interval) for type 1 diabetes was 2.01 (1.183, 3.41) among all participants (128 cases and 67 controls) while it was 2.26 (1.27, 4.03) in a restricted sample of T1 D cases with a control sibling (59 cases and 59 controls) in models adjusted for birth weight, age at the time of the survey, and birth order.
Conclusion:
In this pilot study, high iron intake in the first 4 months of infancy is associated with T1DM. Whether iron intake is causal or a marker of another risk factor warrants further investigation.
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