Short-term exclusive breastfeeding predisposes young children with increased genetic risk of Type I diabetes to progressive beta-cell autoimmunity

Kimpimäki, Teija; Erkkola, Maijaliisa; Korhonen, Sari; Kupila, Antti; Virtanen, Suvi Μ.; Ilonen, Jorma; Simell, Olli; Knip, Mikael

doi:10.1007/s001250051581

Cited by 113 publications

(110 citation statements)

References 23 publications

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“…Human pancreatic beta cells, in contrast to rodent beta cells, have been shown to be resistant to the toxic action of streptozotocin and alloxan in vitro [2,3,4]. RINm5F insulin-producing cells which do not constitutively express the GLUT2 glucose transporter are virtually resistant to the toxic action of streptozotocin and alloxan [5,6]. Expression of the rat GLUT2 glucose transporter isoform rendered these cells sensitive and the toxicity of both streptozotocin and alloxan increased in parallel with the increase of the level of GLUT2 glucose transporter expression in this rat insulin-producing tissue culture cell line [5,6].…”

Section: Mechanism Underlying Resistance Of Human Pancreatic Beta Celmentioning

confidence: 99%

“…Our data show that diabetes development in diabetes-prone (DP)-BB rats can be delayed and prevented by prolonging the nursing period of these rats. These results provide experimental evidence strengthening human epidemiological data that the duration of exclusive breastfeeding influences diabetes development later in life.Most human epidemiological data suggest that a short, as opposed to a long, duration of exclusive breastfeeding is related with an increased risk for IDDM development [1,2,3,4,5]. The introduction of cow's milk and wheat proteins at a young age has been suggested as potential diabetogenic risk factors for infants at risk of developing diabetes [1,2,3,4,5].…”

mentioning

confidence: 99%

“…The introduction of cow's milk and wheat proteins at a young age has been suggested as potential diabetogenic risk factors for infants at risk of developing diabetes [1,2,3,4,5]. The importance of food ingredients in IDDM is further illustrated by the fact that the development of diabetes is reduced in DP-BB rats receiving a special diet in which hydrolysed casein is the sole source of protein [6].…”

mentioning

confidence: 99%

“…The importance of food ingredients in IDDM is further illustrated by the fact that the development of diabetes is reduced in DP-BB rats receiving a special diet in which hydrolysed casein is the sole source of protein [6]. Since, in epidemiological studies the period of nursing is established using questionnaires, the exact duration of breastfeeding remains unclear and duration of breastfeeding varies considerably between the siblings [1,2,3,4,5]. DP-BB rats normally spontaneously develop diabetes between 60 and 160 days of age and are used as an animal model for the study of Type 1 diabetes.…”

mentioning

confidence: 99%

“…Such experiments will provide additional experimental evidence in contribution to epidemiological data [1,2,3,4,5] on this intriguing topic. (a) Diabetes prone BB rats received exclusively mother's milk and were weaned at 21 days (■ ■; n=25), 31 days (• •; n=12) or 40 days (▲ ▲; n=11).…”

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The diabetes prone BB rat model of IDDM shows duration of breastfeeding to influence Type 1 diabetes development later in life

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Besides genetic background, environmental factors such as food ingredients and viral infections have been indicated as important and possibly decisive elements for the induction of insulin-dependent diabetes mellitus (IDDM). Our data show that diabetes development in diabetes-prone (DP)-BB rats can be delayed and prevented by prolonging the nursing period of these rats. These results provide experimental evidence strengthening human epidemiological data that the duration of exclusive breastfeeding influences diabetes development later in life.Most human epidemiological data suggest that a short, as opposed to a long, duration of exclusive breastfeeding is related with an increased risk for IDDM development [1,2,3,4,5]. The introduction of cow's milk and wheat proteins at a young age has been suggested as potential diabetogenic risk factors for infants at risk of developing diabetes [1,2,3,4,5]. The importance of food ingredients in IDDM is further illustrated by the fact that the development of diabetes is reduced in DP-BB rats receiving a special diet in which hydrolysed casein is the sole source of protein [6]. Since, in epidemiological studies the period of nursing is established using questionnaires, the exact duration of breastfeeding remains unclear and duration of breastfeeding varies considerably between the siblings [1,2,3,4,5]. DP-BB rats normally spontaneously develop diabetes between 60 and 160 days of age and are used as an animal model for the study of Type 1 diabetes. In the DP-BB rat model for the study of diabetes, the period of suckling can be established precisely. To investigate whether a relation exists between the duration of exclusive breastfeeding and the onset of diabetes

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Section: Mechanism Underlying Resistance Of Human Pancreatic Beta Celmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The diabetes prone BB rat model of IDDM shows duration of breastfeeding to influence Type 1 diabetes development later in life

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Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity

Norris¹

2003

JAMA

457

356

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Context Dietary exposures in infancy have been implicated, albeit inconsistently, in the etiology of type 1 diabetes mellitus (DM). Objective To examine the association between cereal exposures in the infant diet and appearance of islet autoimmunity (IA). Design Birth cohort study conducted from 1994 to 2002 with a mean follow-up of 4 years. Setting Newborn screening for HLA was done at St Joseph's Hospital in Denver, Colo. First-degree relatives of type 1 DM individuals were recruited from the Denver metropolitan area. Participants We enrolled 1183 children at increased type 1 DM risk, defined as either HLA genotype or having a first-degree relative with type 1 DM, at birth and followed them prospectively. We obtained exposure and outcome measures for 76% of enrolled children. Participants had variable lengths of follow-up (9 months to 9 years). Main Outcome Measures Blood draws for the detection of insulin autoantibody, glutamic acid decarboxylase autoantibody, or IA-2 autoantibody were performed at 9, 15, and 24 months and annually thereafter. Children with IA (n=34) were defined as those testing positive for at least 1 of the autoantibodies on 2 or more consecutive visits and who tested positive or had diabetes on their most recent visit. Results Children initially exposed to cereals between ages 0 and 3 months (hazard ratio [HR], 4.32; 95% confidence interval [CI], 2.0-9.35) and those who were exposed at 7 months or older (HR, 5.36; 95% CI, 2.08-13.8) had increased hazard of IA compared with those who were exposed during the fourth through sixth month, after adjustment for HLA genotype, family history of type 1 DM, ethnicity, and maternal age. In children who were positive for the HLA-DRB1*03/04,DQB8 genotype, adjusted HRs were 5.55 (95% CI, 1.92-16.03) and 12.53 (95% CI, 3.19-49.23) for initial cereal exposure between ages 0 to 3 months and at 7 months or older, respectively. Conclusion There may be a window of exposure to cereals in infancy outside which initial exposure increases IA risk in susceptible children.

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Early Infant Feeding and Risk of Developing Type 1 Diabetes–Associated Autoantibodies

Ziegler

Schmid²,

Hüber³

et al. 2003

JAMA

472

365

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Context Dietary factors modifying type 1 diabetes mellitus (DM) risk have been proposed, but little is known if they trigger the islet autoimmunity that precedes clinical disease.Objective To determine whether breastfeeding duration, food supplementation, or age at introduction of gluten-containing foods influences the risk of developing islet autoantibodies. Design and SettingProspective natural history cohort study conducted from 1989 to 2003 in inpatient/outpatient clinics in Germany.Participants The BABYDIAB study follows newborn children of parents with type 1 DM. Eligibility requirements were met in 1610 children. Blood samples were obtained at birth, age 9 months, 2, 5, and 8 years. Dropout rate was 14.4% by age 5 years. Breastfeeding data were obtained by prospective questionnaires (91% complete), and food supplementation data were obtained by family interview (72% for food supplementation and 80% for age of gluten introduction).Main Outcome Measure Development of islet autoantibodies (insulin, glutamic acid decarboxylase, or IA-2 antibodies) in 2 consecutive blood samples.Results Life-table islet autoantibody frequency was 5.8% (SE, 0.6%) by age 5 years. Reduced total or exclusive breastfeeding duration did not significantly increase the risk of developing islet autoantibodies. Food supplementation with glutencontaining foods before age 3 months, however, was associated with significantly increased islet autoantibody risk (adjusted hazard ratio, 4.0; 95% confidence interval, 1.4-11.5; P=.01 vs children who received only breast milk until age 3 months). Four of 17 children who received gluten foods before age 3 months developed islet autoantibodies (life-table 5-year risk, 24%; SE, 10%). All 4 children had the high-risk DRB1 * 03/04,DQB1 * 0302 genotype. Early exposure to gluten did not significantly increase the risk of developing celiac disease-associated autoantibodies. Children who first received gluten foods after age 6 months did not have increased risks for islet or celiac disease autoantibodies. Conclusion Ensuring compliance to infant feeding guidelines is a possible way to reduce the risk of development of type 1 DM autoantibodies.

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Short-term exclusive breastfeeding predisposes young children with increased genetic risk of Type I diabetes to progressive beta-cell autoimmunity

Cited by 113 publications

References 23 publications

The diabetes prone BB rat model of IDDM shows duration of breastfeeding to influence Type 1 diabetes development later in life

The diabetes prone BB rat model of IDDM shows duration of breastfeeding to influence Type 1 diabetes development later in life

Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity

Early Infant Feeding and Risk of Developing Type 1 Diabetes–Associated Autoantibodies

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