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First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study

Author:
  • Sandra Hummel
  • Andreas Beyerlein
  • Roy N. Tamura
  • Ulla Uusitalo
  • Carin Andŕen Aronsson
  • Jimin Yang
  • Anne Riikonen
  • Ake Lernmark
  • Marian J. Rewers
  • William A. Hagopian
  • Jin-Xiong She
  • Olli G. Simell
  • Jorma Toppari
  • Anette-G Ziegler
  • Beena Akolkar
  • Jeffrey P. Krischer
  • Suvi M Virtanen
  • Jill M Norris
Publishing year: 2017-03-01
Language: English
Pages: 398-404
Publication/Series: Diabetes Care
Volume: 40
Issue: 3
Document type: Journal article
Publisher: American Diabetes Association

Abstract english

OBJECTIVE Studies on the introduction of infant formulas and its effect on the risk of islet autoimmunity and type 1 diabetes (T1D) have yielded inconsistent results. We investigated whether the introduction of formula based on hydrolyzed cow'smilk as the first formula is associated with reduced islet autoimmunity risk in a large prospective cohort. RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively monitors 8,676 children at increased genetic risk for T1D. Autoantibodies to insulin, GAD65, and IA2 were measured regularly to define islet autoimmunity. Information on formula feeding was collected by questionnaires at 3 months of age. RESULTS In survival analyses, after adjustment for family history with T1D, HLA genotype, sex, country, delivery mode, breast-feeding 3 months, and seasonality of birth, we observed no significant association with islet autoimmunity in infants who received extensively hydrolyzed compared with nonhydrolyzed cow'smilk-based formula as the first formula during the first 3 months (adjusted hazard ratio 1.38 [95% CI 0.95; 2.01]), and a significantly increased risk for extensively hydrolyzed formula introduced during the first 7 days (adjusted hazard ratio 1.57 [1.04; 2.38]). Using a partially hydrolyzed or other formula as the first formula, or no formula, was not associated with islet autoimmunity risk. CONCLUSIONS These results add to the existing evidence that islet autoimmunity risk is not reduced, and may be increased, by using hydrolyzed compared with nonhydrolyzed cow's milk-based infant formula as the first formula in infants at increased genetic risk for T1D .

Keywords

  • Pediatrics
  • Endocrinology and Diabetes

Other

Published
  • Diabetes and Celiac Unit
  • ISSN: 0149-5992
E-mail: ake [dot] lernmark [at] med [dot] lu [dot] se

Principal investigator

Diabetes and Celiac Unit

+46 40 39 19 01

+46 70 616 47 79

60:11:015

Jan Waldenströms gata 35, Malmö

33

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00