婴儿期初始谷物暴露的时间和小岛自身免疫的风险
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
概括
婴儿期早期或晚期进食谷物会增加1型糖尿病遗传倾向的儿童发生小岛自身免疫 (IA) 的风险. 谷物引入的最佳时间可能在4-6个月之间,以减轻这种风险.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 免疫学 免疫学 免疫学
- 营养科学 营养科学
背景情况:
- 婴儿饮食暴露与1型糖尿病 (DM) 的发展有着不一致的联系.
- 了解早期的饮食因素对于预防易患儿童自身免疫性疾病至关重要.
研究的目的:
- 调查婴儿谷物引入时间和小岛自身免疫 (IA) 开始之间的关联.
- 确定与1型糖尿病风险相关的饮食暴露的潜在关键窗口.
主要方法:
- 从1994年至2002年对1183名高风险婴儿 (按HLA基因型或家族病史定义) 的前性出生队列研究.
- 自体抗体查 (胰岛素,GAD,IA-2) 定期进行,直到9岁.
- 岛屿自身免疫 (IA) 通过持续的自身抗体阳性或糖尿病诊断来定义.
主要成果:
- 在0-3个月 (HR,4.32) 和7个多个月 (HR,5.36) 之间的初始谷物暴露显著增加了IA危险,而不是4-6个月.
- 在HLA-DRB1*03/04,DQB8阳性儿童中,早期 (0-3个月) 和晚期 (7个月以上) 的谷物暴露显示出明显更高的IA风险 (HRs分别为5.55和12.53).
结论:
- 在婴儿时期引入谷物可能存在特定的"机会窗口".
- 在这个窗口之外引入谷物会增加遗传敏感儿童的IA风险,这表明饮食干预的关键时期.
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