幼児の早期栄養と1型糖尿病に関連する自己抗体を発症するリスク
Anette-G Ziegler1, Sandra Schmid, Doris Huber
1Diabetes Research Institute and Hospital München-Schwabing, Munich, Germany. anziegler@lrz.uni-muenchen.de
JAMA
|October 2, 2003
まとめ
乳児の3ヶ月前にグルテンを早期に導入すると,第1型糖尿病 (DM) の前駆体であるアイレットの自己抗体のリスクが著しく増加する可能性があります. 幼児の栄養に関するガイドラインを遵守することで,このリスクを軽減することができます.
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:
- 1型糖尿病 (DM) の発症は複雑で,食事要因が潜在的にアイレットの自己免疫に影響を与える可能性があります.
- 幼児の早期の栄養摂取が,アイレットの自己免疫を誘発する役割は不明である.
研究 の 目的:
- 島の自己抗体発現に対する授乳期間,栄養補助食品,グルテン摂取年齢の影響を調査する.
- タイプ1のDMリスクに影響を与える可能性のある,乳幼児の栄養の変更可能な要因を特定する.
主な方法:
- ドイツで1型DMの両親から生まれた1610人の子どもを対象とした前向きなコホート研究 (BABYDIAB).
- 授乳,サプリメント摂取,グルテン摂取に関するデータをアンケートやインタビューで収集した.
- 8歳までのシリアル血液サンプル採取により,アイレットの自己抗体 (インスリン,GAD,IA-2) の発達をモニターした.
主要な成果:
- 5歳までに小島原抗体の発生率は5.8%であった.
- 3ヶ月未満のグルテンを含む食品を導入すると,小島原抗体のリスクが著しく増加します (aHR=4.0).
- 授乳期間,またはグルテン導入の遅延 (6ヶ月後) と自己抗体発現との間に有意な関連性が見つかりませんでした.
結論:
- 3ヶ月未満のグルテンの早期導入は,遺伝的に感受性の高い乳児の島原抗体発達の重要なリスク因子です.
- グルテンの導入を遅らせ,現在の乳児の栄養ガイドラインを遵守することは,1型DMの自己抗体リスクを減らすための戦略かもしれません.
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