Age at Gluten Introduction and Risk of Celiac Disease

被引：94

作者：

Aronsson, Carin Andren ^{[1
]}

Lee, Hye-Seung ^{[2
]}

Liu, Edwin ^{[3
]}

Uusitalo, Ulla ^{[2
]}

Hummel, Sandra ^{[4
,5
,6
]}

Yang, Jimin ^{[2
]}

Hummel, Michael ^{[4
,5
,6
]}

Rewers, Marian ^{[7
]}

She, Jin-Xiong ^{[8
]}

Simell, Olli ^{[9
]}

Toppari, Jorma ^{[10
]}

Ziegler, Anette-G. ^{[4
,5
,6
]}

Krischer, Jeffrey ^{[2
]}

Virtanen, Suvi M. ^{[11
,12
,13
,14
,15
]}

Norris, Jill M. ^{[16
]}

Agardh, Daniel ^{[1
]}

机构：

[1] Lund Univ, Dept Clin Sci, S-20502 Malmo, Sweden

[2] Univ S Florida, Dept Pediat, Pediat Epidemiol Ctr, Morsani Coll Med, Tampa, FL 33620 USA

[3] Univ Colorado, Digest Hlth Inst, Childrens Hosp Colorado, Denver, CO 80202 USA

[4] Tech Univ Munich, Helmholtz Zentrum Munchen, Diabet Res Inst, Neuherberg, Germany

[5] Tech Univ Munich, Klinikum Rechts Isar, Neuherberg, Germany

[6] Forsch Grp Diabet eV, Neuherberg, Germany

[7] Univ Colorado, Barbara Davis Ctr Childhood Diabet, Aurora, CO USA

[8] Georgia Regents Univ, Med Coll Georgia, Ctr Biotechnol & Genom Med, Augusta, GA USA

[9] Turku Univ Hosp, Dept Pediat, FIN-20520 Turku, Finland

[10] Univ Turku, Dept Physiol & Pediat, Turku, Finland

[11] Natl Inst Hlth & Welf, Nutr Unit, Helsinki, Finland

[12] Univ Tampere, Sch Hlth Sci, FIN-33101 Tampere, Finland

[13] Tampere Univ, Res Ctr Child Hlth, FIN-33101 Tampere, Finland

[14] Univ Hosp, Tampere, Finland

[15] Sci Ctr Pirkanmaa Hosp Dist, Tampere, Finland

[16] Univ Colorado, Colorado Sch Publ Hlth, Dept Epidemiol, Denver, CO 80202 USA

来源：

PEDIATRICS | 2015年 / 135卷 / 02期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1542/peds.2014-1787

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

OBJECTIVES: The goal of this study was to determine whether age at introduction to gluten was associated with risk for celiac disease (CD) in genetically predisposed children. METHODS: TEDDY (The Environmental Determinants of Diabetes in the Young) is a prospective birth cohort study. Newborn infants (N = 6436) screened for high-risk HLA-genotypes for CD were followed up in Finland, Germany, Sweden, and the United States. Information about infant feeding was collected at clinical visits every third month. The first outcome was persistent positive for tissue transglutaminase autoantibodies (tTGA), the marker for CD. The second outcome was CD, defined as either a diagnosis based on intestinal biopsy results or on persistently high levels of tTGA. RESULTS: Swedish children were introduced to gluten earlier (median: 21.7 weeks) compared with children from Finland (median: 26.1 weeks), Germany, and the United States (both median: 30.4 weeks) (P < .0001). During a median follow-up of 5.0 years (range: 1.7-8.8 years), 773 (12%) children developed tTGA and 307 (5%) developed CD. Swedish children were at increased risk for tTGA (hazard ratio: 1.74 [95% CI: 1.47-2.06]) and CD (hazard ratio: 1.76 [95% CI: 1.34-2.24]) compared with US children, respectively (P < .0001). Gluten introduction before 17 weeks or later than 26 weeks was not associated with increased risk for tTGA or CD, adjusted for country, HLA, gender, and family history of CD, neither in the overall analysis nor on a country-level comparison. CONCLUSIONS: In TEDDY, the time to first introduction to gluten introduction was not an independent risk factor for developing CD.

引用

页码：239 / 245

页数：7

共 25 条

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