Dietary Intake and Body Mass Index Influence the Risk of Islet Autoimmunity in Genetically At-Risk Children: A Mediation Analysis Using the TEDDY Cohort.

Autor: Aronsson CA; Department of Clinical Sciences, Lund University, Malmo, Sweden., Tamura R; Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Vehik K; Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Uusitalo U; Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Yang J; Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Haller MJ; University of Florida Diabetes Institute, Gainesville, FL, USA., Toppari J; Department of Pediatrics, Turku University Hospital, Turku, Finland.; Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Centre for Population Health Research, University of Turku, Turku, Finland., Hagopian W; Pacific Northwest Research Institute, Seattle, WA, USA., McIndoe RA; Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA., Rewers MJ; Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA., Ziegler AG; Institute of Diabetes Research, Helmholtz Zentrum München and Klinikum rechts der Isar, Technische Universität München, Forschergruppe Diabetes e.V, Neuherberg, Germany., Akolkar B; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA., Krischer JP; Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Norris JM; Department of Epidemiology, University of Colorado Denver, Colorado School of Public Health, Aurora, CO, USA., Virtanen SM; Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland.; Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.; Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland and Research, Development, and Innovation Center, Tampere University Hospital, Tampere, Finland., Larsson HE; Department of Clinical Sciences, Lund University, Malmo, Sweden.; Department of Pediatrics, Skane University Hospital, Malmo, Lund, Sweden.
Jazyk: angličtina
Zdroj: Pediatric diabetes [Pediatr Diabetes] 2023; Vol. 2023. Date of Electronic Publication: 2023 Feb 17.
DOI: 10.1155/2023/3945064
Abstrakt: Background/objective: Growth and obesity have been associated with increased risk of islet autoimmunity (IA) and progression to type 1 diabetes. We aimed to estimate the effect of energy-yielding macronutrient intake on the development of IA through BMI.
Research Design and Methods: Genetically at-risk children ( n = 5,084) in Finland, Germany, Sweden, and the USA, who were autoantibody negative at 2 years of age, were followed to the age of 8 years, with anthropometric measurements and 3-day food records collected biannually. Of these, 495 (9.7%) children developed IA. Mediation analysis for time-varying covariates (BMI z -score) and exposure (energy intake) was conducted. Cox proportional hazard method was used in sensitivity analysis.
Results: We found an indirect effect of total energy intake (estimates: indirect effect 0.13 [0.05, 0.21]) and energy from protein (estimates: indirect effect 0.06 [0.02, 0.11]), fat (estimates: indirect effect 0.03 [0.01, 0.05]), and carbohydrates (estimates: indirect effect 0.02 [0.00, 0.04]) (kcal/day) on the development of IA. A direct effect was found for protein, expressed both as kcal/day (estimates: direct effect 1.09 [0.35, 1.56]) and energy percentage (estimates: direct effect 72.8 [3.0, 98.0]) and the development of GAD autoantibodies (GADA). In the sensitivity analysis, energy from protein (kcal/day) was associated with increased risk for GADA, hazard ratio 1.24 (95% CI: 1.09, 1.53), p = 0.042.
Conclusions: This study confirms that higher total energy intake is associated with higher BMI, which leads to higher risk of the development of IA. A diet with larger proportion of energy from protein has a direct effect on the development of GADA.
Competing Interests: Conflicts of Interest The authors declare that they have no conflicts of interest.
Databáze: MEDLINE
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