Nicolai A Lund-Blix1,2,3,4, Fran Dong2, Karl Mårild5,6, Jennifer Seifert4, Anna E Barón7, Kathleen C Waugh2, Geir Joner3, Ketil Størdal5,8, German Tapia5, Lars C Stene5, Randi K Johnson4, Marian J Rewers2, Jill M Norris4. 1. Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway nicolai.andre.lund-blix@fhi.no. 2. Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO. 3. Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. 4. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO. 5. Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway. 6. Department of Pediatrics, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden. 7. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO. 8. Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.
Abstract
OBJECTIVE: To study the association of gluten intake with development of islet autoimmunity and progression to type 1 diabetes. RESEARCH DESIGN AND METHODS: The Diabetes Autoimmunity Study in the Young (DAISY) follows children with an increased risk of type 1 diabetes. Blood samples were collected at 9, 15, and 24 months of age, and annually thereafter. Islet autoimmunity was defined by the appearance of at least one autoantibody against insulin, IA2, GAD, or ZnT8 (zinc transporter 8) in at least two consecutive blood samples. Using food frequency questionnaires, we estimated the gluten intake (in grams per day) annually from 1 year of age. Cox regression modeling early gluten intake, and joint modeling of the cumulative gluten intake during follow-up, were used to estimate hazard ratios adjusted for confounders (aHR). RESULTS: By August 2017, 1,916 subjects were included (median age at end of follow-up 13.5 years), islet autoimmunity had developed in 178 participants, and 56 of these progressed to type 1 diabetes. We found no association between islet autoimmunity and gluten intake at 1-2 years of age or during follow-up (aHR per 4 g/day increase in gluten intake 1.00, 95% CI 0.85-1.17 and 1.01, 0.99-1.02, respectively). We found similar null results for progression from islet autoimmunity to type 1 diabetes. Introduction of gluten at <4 months of age was associated with an increased risk of progressing from islet autoimmunity to type 1 diabetes compared with introduction at 4-5.9 months (aHR 8.69, 95% CI 1.69-44.8). CONCLUSIONS: Our findings indicate no strong rationale to reduce the amount of gluten in high-risk children to prevent development of type 1 diabetes.
OBJECTIVE: To study the association of gluten intake with development of islet autoimmunity and progression to type 1 diabetes. RESEARCH DESIGN AND METHODS: The Diabetes Autoimmunity Study in the Young (DAISY) follows children with an increased risk of type 1 diabetes. Blood samples were collected at 9, 15, and 24 months of age, and annually thereafter. Islet autoimmunity was defined by the appearance of at least one autoantibody against insulin, IA2, GAD, or ZnT8 (zinc transporter 8) in at least two consecutive blood samples. Using food frequency questionnaires, we estimated the gluten intake (in grams per day) annually from 1 year of age. Cox regression modeling early gluten intake, and joint modeling of the cumulative gluten intake during follow-up, were used to estimate hazard ratios adjusted for confounders (aHR). RESULTS: By August 2017, 1,916 subjects were included (median age at end of follow-up 13.5 years), islet autoimmunity had developed in 178 participants, and 56 of these progressed to type 1 diabetes. We found no association between islet autoimmunity and gluten intake at 1-2 years of age or during follow-up (aHR per 4 g/day increase in gluten intake 1.00, 95% CI 0.85-1.17 and 1.01, 0.99-1.02, respectively). We found similar null results for progression from islet autoimmunity to type 1 diabetes. Introduction of gluten at <4 months of age was associated with an increased risk of progressing from islet autoimmunity to type 1 diabetes compared with introduction at 4-5.9 months (aHR 8.69, 95% CI 1.69-44.8). CONCLUSIONS: Our findings indicate no strong rationale to reduce the amount of gluten in high-risk children to prevent development of type 1 diabetes.
Authors: Katya Mauff; Ewout W Steyerberg; Giel Nijpels; Amber A W A van der Heijden; Dimitris Rizopoulos Journal: Stat Med Date: 2017-07-17 Impact factor: 2.373
Authors: Lars C Stene; Katherine Barriga; Michelle Hoffman; Jaime Kean; Georgeanna Klingensmith; Jill M Norris; Henry A Erlich; George S Eisenbarth; Marian Rewers Journal: Pediatr Diabetes Date: 2006-10 Impact factor: 4.866
Authors: L Yu; M Rewers; R Gianani; E Kawasaki; Y Zhang; C Verge; P Chase; G Klingensmith; H Erlich; J Norris; G S Eisenbarth Journal: J Clin Endocrinol Metab Date: 1996-12 Impact factor: 5.958
Authors: Jill M Norris; Katherine Barriga; Georgeanna Klingensmith; Michelle Hoffman; George S Eisenbarth; Henry A Erlich; Marian Rewers Journal: JAMA Date: 2003-10-01 Impact factor: 56.272
Authors: M Rewers; T L Bugawan; J M Norris; A Blair; B Beaty; M Hoffman; R S McDuffie; R F Hamman; G Klingensmith; G S Eisenbarth; H A Erlich Journal: Diabetologia Date: 1996-07 Impact factor: 10.122
Authors: Benjamin Lebwohl; Yin Cao; Geng Zong; Frank B Hu; Peter H R Green; Alfred I Neugut; Eric B Rimm; Laura Sampson; Lauren W Dougherty; Edward Giovannucci; Walter C Willett; Qi Sun; Andrew T Chan Journal: BMJ Date: 2017-05-02
Authors: Randi K Johnson; Roy Tamura; Nicole Frank; Ulla Uusitalo; Jimin Yang; Sari Niinistö; Carin Andrén Aronsson; Anette-G Ziegler; William Hagopian; Marian Rewers; Jorma Toppari; Beena Akolkar; Jeffrey Krischer; Suvi M Virtanen; Jill M Norris Journal: Diabetologia Date: 2021-03-30 Impact factor: 10.460
Authors: Essi Syrjälä; Jaakko Nevalainen; Jaakko Peltonen; Hanna-Mari Takkinen; Leena Hakola; Mari Åkerlund; Riitta Veijola; Jorma Ilonen; Jorma Toppari; Mikael Knip; Suvi M Virtanen Journal: Sci Rep Date: 2019-05-23 Impact factor: 4.379
Authors: Nicolai A Lund-Blix; German Tapia; Karl Mårild; Anne Lise Brantsaeter; Pål R Njølstad; Geir Joner; Torild Skrivarhaug; Ketil Størdal; Lars C Stene Journal: PLoS Med Date: 2020-03-02 Impact factor: 11.069