幼児期におけるシリアルへの最初の曝露のタイミングと小島型自己免疫のリスク
Jill M Norris1, Katherine Barriga, Georgeanna Klingensmith
1Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver 80262, USA. jill.norris@uchsc.edu
JAMA
|October 2, 2003
まとめ
乳幼児期に穀物を早期にまたは遅れて摂取すると,遺伝的に1型糖尿病に罹患する傾向のある小島型自己免疫 (IA) のリスクが増加します. このリスクを軽減するために,穀物導入の最適なタイミングは4〜6ヶ月間かもしれません.
科学分野:
- 小児内分泌学について
- 免疫学 免疫学とは
- 栄養科学とは,栄養科学である.
背景:
- 乳児の食事による曝露は1型糖尿病 (DM) の発症と一貫していない.
- 早期の食事要因を理解することは,敏感な子供の自己免疫疾患の予防に不可欠です.
研究 の 目的:
- 乳幼児のシリアル導入のタイミングとアイレット自己免疫 (IA) の発症との関連を調べる.
- 1型糖尿病のリスクに関連して,食事による曝露の潜在的な重要なウィンドウを特定する.
主な方法:
- 1994年から2002年にかけて,高リスクの乳児1183人 (HLA遺伝子型または家族歴によって定義される) を対象とした将来の出生コホート研究.
- 9歳まで定期的に実施される自己抗体スクリーニング (インスリン,GAD,IA-2).
- 島根自己免疫 (IA) は,持続的な自己抗体陽性または糖尿病診断によって定義されます.
主要な成果:
- 0〜3ヶ月 (HR,4.32) と7ヶ月以上 (HR,5.36) の間のシリアルの初期被曝は,4〜6ヶ月と比較してIAの危険を大幅に増加させた.
- HLA-DRB1*03/04,DQB8陽性児の早期 (0~3ヶ月) と遅い (7ヶ月以上) の穀物曝露では,かなり高いIAリスクが示された (HRsはそれぞれ5.55と12.53).
結論:
- 幼児期に穀物の導入のための特別な"機会の窓"が存在することがあります.
- この窓の外で穀物を導入すると,遺伝的に感受性の高い子供にIAのリスクが増加し,食事介入の重要な期間を示唆します.
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