Katherine Silvis1, Carin A Aronsson2, Xiang Liu3, Ulla Uusitalo3, Jimin Yang3, Roy Tamura3, Åke Lernmark2, Marian Rewers4, William Hagopian5, Jin-Xiong She1, Olli Simell6, Jorma Toppari7, Anette Ziegler8,9,10, Beena Akolkar11, Jeffrey Krischer3, Suvi M Virtanen12,13,14, Jill M Norris15. 1. Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, Georgia. 2. Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmo, Sweden. 3. Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida. 4. Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado. 5. Pacific Northwest Diabetes Research Institute, Seattle, Washington. 6. Department of Pediatrics, Turku University Hospital, Turku, Finland. 7. Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland. 8. Institute of Diabetes Research, Helmholtz Zentrum München, Neuherberg, Germany. 9. Forachergruppe Diabetes e.V, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany. 10. Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 11. National Institute of Diabetes & Digestive & Kidney Diseases, National Institute of Health, Bethesda, Maryland. 12. Public Health Promotion, Department of Public Health Solutions, National Institute for Health and Welfare, Helinski, Finland. 13. Faculty of Social Sciences, University of Tampere, Tampere, Finland. 14. Research Center for Child Health, Tampere University and University Hospital and the Science Center of Pirkanmaa Hospital District, Tampere, Finland. 15. Department of Epidemiology, University of Colorado Denver, Colorado School of Public Health, Aurora, Colorado.
Abstract
OBJECTIVE: We investigated the association between maternal use of vitamin D and omega-3 fatty acids (n-3 FAs) supplements during pregnancy and risk of islet autoimmunity (IA) in the offspring. METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) Study is prospectively following 8676 children with increased genetic risk for type 1 diabetes in Finland, Germany, Sweden, and the United States. Blood samples were collected every 3 months between 3 and 48 months of age then every 6 months thereafter to determine persistent IA. Duration, frequency, and supplement dose during pregnancy were recalled by mothers at 3 to 4 months postpartum. Cumulative intakes of supplemental vitamin D and n-3 FAs were analyzed as continuous or binary variables. We applied time-to-event analysis to study the association between maternal supplement use and IA, adjusting for country, human leukocyte antigen-DR-DQ genotype, family history of type 1 diabetes and sex. Secondary outcomes included insulin autoantibodies (IAA) or glutamic acid decarboxylase (GADA) as the first appearing autoantibody. RESULTS: As of February 2018, there were 747 (9.0%) children with IA. Vitamin D supplement intake during pregnancy (any vs none) was not associated with risk for IA (hazard ratio [HR] 1.11; 95% confidence interval [CI] 0.94, 1.31); neither was cumulative vitamin D supplement intake. Supplemental n-3 FA intake was similarly not associated with IA risk (HR: 1.19, 95% CI 0.98, 1.45). Similar lack of association was observed for either IAA or GADA as the first appearing autoantibody. CONCLUSIONS: The TEDDY cohort showed no evidence of benefit regarding IA risk for vitamin D or n-3 FA supplementation during pregnancy.
OBJECTIVE: We investigated the association between maternal use of vitamin D and omega-3 fatty acids (n-3 FAs) supplements during pregnancy and risk of islet autoimmunity (IA) in the offspring. METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) Study is prospectively following 8676 children with increased genetic risk for type 1 diabetes in Finland, Germany, Sweden, and the United States. Blood samples were collected every 3 months between 3 and 48 months of age then every 6 months thereafter to determine persistent IA. Duration, frequency, and supplement dose during pregnancy were recalled by mothers at 3 to 4 months postpartum. Cumulative intakes of supplemental vitamin D and n-3 FAs were analyzed as continuous or binary variables. We applied time-to-event analysis to study the association between maternal supplement use and IA, adjusting for country, human leukocyte antigen-DR-DQ genotype, family history of type 1 diabetes and sex. Secondary outcomes included insulin autoantibodies (IAA) or glutamic acid decarboxylase (GADA) as the first appearing autoantibody. RESULTS: As of February 2018, there were 747 (9.0%) children with IA. Vitamin D supplement intake during pregnancy (any vs none) was not associated with risk for IA (hazard ratio [HR] 1.11; 95% confidence interval [CI] 0.94, 1.31); neither was cumulative vitamin D supplement intake. Supplemental n-3 FA intake was similarly not associated with IA risk (HR: 1.19, 95% CI 0.98, 1.45). Similar lack of association was observed for either IAA or GADA as the first appearing autoantibody. CONCLUSIONS: The TEDDY cohort showed no evidence of benefit regarding IA risk for vitamin D or n-3 FA supplementation during pregnancy.
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