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The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young.

Abstract

BACKGROUND

Cow's milk intake has been inconsistently associated with islet autoimmunity (IA) and type 1 diabetes (T1D) development. Genetic and environmental factors may modify the effect of cow's milk on IA and T1D risk.

METHODS

The Diabetes Autoimmunity Study in the Young (DAISY) follows children at increased T1D risk of IA (presence of autoantibodies to insulin, GAD65, or IA-2 twice in succession) and T1D development. We examined 1835 DAISY children with data on cow's milk intake: 143 developed IA, 40 subsequently developed T1D. Cow's milk protein and lactose intake were calculated from prospectively collected parent- and self-reported food frequency questionnaires (FFQ). High risk HLA-DR genotype: HLA-DR3/4,DQB1*0302; low/moderate risk: all other genotypes. We examined interactions between cow's milk intake, age at cow's milk introduction, and HLA-DR genotype in IA and T1D development. Interaction models contained the base terms (e.g., cow's milk protein and HLA-DR genotype) and an interaction term (e.g., cow's milk protein*HLA-DR genotype).

RESULTS

In survival models adjusted for total calories, FFQ type, T1D family history, and ethnicity, greater cow's milk protein intake was associated with increased IA risk in children with low/moderate risk HLA-DR genotypes [hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.08-1.84], but not in children with high risk HLA-DR genotypes. Cow's milk protein intake was associated with progression to T1D (HR: 1.59, CI: 1.13-2.25) in children with IA.

CONCLUSIONS

Greater cow's milk intake may increase risk of IA and progression to T1D. Early in the T1D disease process, cow's milk intake may be more influential in children with low/moderate genetic T1D risk.

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  • Authors+Show Affiliations

    ,

    Colorado School of Public Health, University of Colorado, Aurora, CO, USA.

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    Source

    Pediatric diabetes 16:1 2015 Feb pg 31-8

    MeSH

    Animals
    Autoimmunity
    Cattle
    Child
    Child Nutritional Physiological Phenomena
    Child, Preschool
    Cohort Studies
    Diabetes Mellitus, Type 1
    Disease Susceptibility
    Eating
    Female
    Genotype
    HLA-DR Antigens
    Humans
    Infant
    Infant, Newborn
    Islets of Langerhans
    Male
    Milk
    Risk Factors
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24444005

    Citation

    Lamb, Molly M., et al. "The Effect of Childhood Cow's Milk Intake and HLA-DR Genotype On Risk of Islet Autoimmunity and Type 1 Diabetes: the Diabetes Autoimmunity Study in the Young." Pediatric Diabetes, vol. 16, no. 1, 2015, pp. 31-8.
    Lamb MM, Miller M, Seifert JA, et al. The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young. Pediatr Diabetes. 2015;16(1):31-8.
    Lamb, M. M., Miller, M., Seifert, J. A., Frederiksen, B., Kroehl, M., Rewers, M., & Norris, J. M. (2015). The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young. Pediatric Diabetes, 16(1), pp. 31-8. doi:10.1111/pedi.12115.
    Lamb MM, et al. The Effect of Childhood Cow's Milk Intake and HLA-DR Genotype On Risk of Islet Autoimmunity and Type 1 Diabetes: the Diabetes Autoimmunity Study in the Young. Pediatr Diabetes. 2015;16(1):31-8. PubMed PMID: 24444005.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young. AU - Lamb,Molly M, AU - Miller,Melissa, AU - Seifert,Jennifer A, AU - Frederiksen,Brittni, AU - Kroehl,Miranda, AU - Rewers,Marian, AU - Norris,Jill M, Y1 - 2014/01/20/ PY - 2013/09/08/received PY - 2013/12/07/revised PY - 2013/12/18/accepted PY - 2014/1/22/entrez PY - 2014/1/22/pubmed PY - 2015/10/2/medline KW - HLA-DR genotype KW - IA KW - childhood diet KW - cow's milk protein SP - 31 EP - 8 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 16 IS - 1 N2 - BACKGROUND: Cow's milk intake has been inconsistently associated with islet autoimmunity (IA) and type 1 diabetes (T1D) development. Genetic and environmental factors may modify the effect of cow's milk on IA and T1D risk. METHODS: The Diabetes Autoimmunity Study in the Young (DAISY) follows children at increased T1D risk of IA (presence of autoantibodies to insulin, GAD65, or IA-2 twice in succession) and T1D development. We examined 1835 DAISY children with data on cow's milk intake: 143 developed IA, 40 subsequently developed T1D. Cow's milk protein and lactose intake were calculated from prospectively collected parent- and self-reported food frequency questionnaires (FFQ). High risk HLA-DR genotype: HLA-DR3/4,DQB1*0302; low/moderate risk: all other genotypes. We examined interactions between cow's milk intake, age at cow's milk introduction, and HLA-DR genotype in IA and T1D development. Interaction models contained the base terms (e.g., cow's milk protein and HLA-DR genotype) and an interaction term (e.g., cow's milk protein*HLA-DR genotype). RESULTS: In survival models adjusted for total calories, FFQ type, T1D family history, and ethnicity, greater cow's milk protein intake was associated with increased IA risk in children with low/moderate risk HLA-DR genotypes [hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.08-1.84], but not in children with high risk HLA-DR genotypes. Cow's milk protein intake was associated with progression to T1D (HR: 1.59, CI: 1.13-2.25) in children with IA. CONCLUSIONS: Greater cow's milk intake may increase risk of IA and progression to T1D. Early in the T1D disease process, cow's milk intake may be more influential in children with low/moderate genetic T1D risk. SN - 1399-5448 UR - https://www.unboundmedicine.com/medline/citation/24444005/full_citation L2 - https://doi.org/10.1111/pedi.12115 DB - PRIME DP - Unbound Medicine ER -