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Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity.

Abstract

AIMS/HYPOTHESIS

We investigated the association of early serum fatty acid composition with the risk of type 1 diabetes-associated autoimmunity. Our hypothesis was that fatty acid status during infancy is related to type 1 diabetes-associated autoimmunity and that long-chain n-3 fatty acids, in particular, are associated with decreased risk.

METHODS

We performed a nested case-control analysis within the Finnish Type 1 Diabetes Prediction and Prevention Study birth cohort, carrying HLA-conferred susceptibility to type 1 diabetes (n = 7782). Serum total fatty acid composition was analysed by gas chromatography in 240 infants with islet autoimmunity and 480 control infants at the age of 3 and 6 months. Islet autoimmunity was defined as repeated positivity for islet cell autoantibodies in combination with at least one of three selected autoantibodies. In addition, a subset of 43 infants with primary insulin autoimmunity (i.e. those with insulin autoantibodies as the first autoantibody with no concomitant other autoantibodies) and a control group (n = 86) were analysed. A third endpoint was primary GAD autoimmunity defined as GAD autoantibody appearing as the first antibody without other concomitant autoantibodies (22 infants with GAD autoimmunity; 42 infants in control group). Conditional logistic regression was applied, considering multiple comparisons by false discovery rate <0.05.

RESULTS

Serum fatty acid composition differed between breastfed and non-breastfed infants, reflecting differences in the fatty acid composition of the milk. Fatty acids were associated with islet autoimmunity (higher serum pentadecanoic, palmitic, palmitoleic and docosahexaenoic acids decreased risk; higher arachidonic:docosahexaenoic and n-6:n-3 acid ratios increased risk). Furthermore, fatty acids were associated with primary insulin autoimmunity, these associations being stronger (higher palmitoleic acid, cis-vaccenic, arachidonic, docosapentaenoic and docosahexaenoic acids decreased risk; higher α-linoleic acid and arachidonic:docosahexaenoic and n-6:n-3 acid ratios increased risk). Moreover, the quantity of breast milk consumed per day was inversely associated with primary insulin autoimmunity, while the quantity of cow's milk consumed per day was directly associated.

CONCLUSIONS/INTERPRETATION

Fatty acid status may play a role in the development of type 1 diabetes-associated autoimmunity. Fish-derived fatty acids may be protective, particularly during infancy. Furthermore, fatty acids consumed during breastfeeding may provide protection against type 1 diabetes-associated autoimmunity. Further studies are warranted to clarify the independent role of fatty acids in the development of type 1 diabetes.

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  • Authors+Show Affiliations

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    Department of Public Health Solutions, National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland. sari.niinisto@thl.fi.

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    Department of Public Health Solutions, National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland. The Faculty of Social Sciences, University of Tampere, Tampere, Finland.

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    Department of Public Health Solutions, National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland.

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    Department of Public Health Solutions, National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland. The Faculty of Social Sciences, University of Tampere, Tampere, Finland. Science Center, Tampere University Hospital, Tampere, Finland.

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    Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland. Department of Pediatrics, Turku University Hospital, Turku, Finland.

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    Immunogenetics Laboratory, University of Turku, Turku, Finland.

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    Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.

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    Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. Folkhälsan Research Center, Helsinki, Finland. Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.

    ,

    Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.

    Department of Public Health Solutions, National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland. The Faculty of Social Sciences, University of Tampere, Tampere, Finland. Science Center, Tampere University Hospital, Tampere, Finland. Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.

    Source

    Diabetologia 60:7 2017 07 pg 1223-1233

    MeSH

    Animals
    Autoantibodies
    Autoimmunity
    Case-Control Studies
    Child, Preschool
    Chromatography, Gas
    Cohort Studies
    Diabetes Mellitus, Type 1
    Fatty Acids
    Fatty Acids, Omega-3
    Female
    Finland
    Genetic Predisposition to Disease
    Genotype
    HLA-DQ beta-Chains
    Humans
    Infant
    Infant, Newborn
    Islets of Langerhans
    Male
    Milk
    Milk, Human
    Risk
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    28474159

    Citation

    Niinistö, Sari, et al. "Fatty Acid Status in Infancy Is Associated With the Risk of Type 1 Diabetes-associated Autoimmunity." Diabetologia, vol. 60, no. 7, 2017, pp. 1223-1233.
    Niinistö S, Takkinen HM, Erlund I, et al. Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity. Diabetologia. 2017;60(7):1223-1233.
    Niinistö, S., Takkinen, H. M., Erlund, I., Ahonen, S., Toppari, J., Ilonen, J., ... Virtanen, S. M. (2017). Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity. Diabetologia, 60(7), pp. 1223-1233. doi:10.1007/s00125-017-4280-9.
    Niinistö S, et al. Fatty Acid Status in Infancy Is Associated With the Risk of Type 1 Diabetes-associated Autoimmunity. Diabetologia. 2017;60(7):1223-1233. PubMed PMID: 28474159.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity. AU - Niinistö,Sari, AU - Takkinen,Hanna-Mari, AU - Erlund,Iris, AU - Ahonen,Suvi, AU - Toppari,Jorma, AU - Ilonen,Jorma, AU - Veijola,Riitta, AU - Knip,Mikael, AU - Vaarala,Outi, AU - Virtanen,Suvi M, Y1 - 2017/05/04/ PY - 2016/11/03/received PY - 2017/03/23/accepted PY - 2017/5/6/pubmed PY - 2018/5/10/medline PY - 2017/5/6/entrez KW - Autoimmunity KW - Breast milk KW - Fatty acid status KW - Infant KW - Type 1 diabetes KW - n-3 fatty acids SP - 1223 EP - 1233 JF - Diabetologia JO - Diabetologia VL - 60 IS - 7 N2 - AIMS/HYPOTHESIS: We investigated the association of early serum fatty acid composition with the risk of type 1 diabetes-associated autoimmunity. Our hypothesis was that fatty acid status during infancy is related to type 1 diabetes-associated autoimmunity and that long-chain n-3 fatty acids, in particular, are associated with decreased risk. METHODS: We performed a nested case-control analysis within the Finnish Type 1 Diabetes Prediction and Prevention Study birth cohort, carrying HLA-conferred susceptibility to type 1 diabetes (n = 7782). Serum total fatty acid composition was analysed by gas chromatography in 240 infants with islet autoimmunity and 480 control infants at the age of 3 and 6 months. Islet autoimmunity was defined as repeated positivity for islet cell autoantibodies in combination with at least one of three selected autoantibodies. In addition, a subset of 43 infants with primary insulin autoimmunity (i.e. those with insulin autoantibodies as the first autoantibody with no concomitant other autoantibodies) and a control group (n = 86) were analysed. A third endpoint was primary GAD autoimmunity defined as GAD autoantibody appearing as the first antibody without other concomitant autoantibodies (22 infants with GAD autoimmunity; 42 infants in control group). Conditional logistic regression was applied, considering multiple comparisons by false discovery rate <0.05. RESULTS: Serum fatty acid composition differed between breastfed and non-breastfed infants, reflecting differences in the fatty acid composition of the milk. Fatty acids were associated with islet autoimmunity (higher serum pentadecanoic, palmitic, palmitoleic and docosahexaenoic acids decreased risk; higher arachidonic:docosahexaenoic and n-6:n-3 acid ratios increased risk). Furthermore, fatty acids were associated with primary insulin autoimmunity, these associations being stronger (higher palmitoleic acid, cis-vaccenic, arachidonic, docosapentaenoic and docosahexaenoic acids decreased risk; higher α-linoleic acid and arachidonic:docosahexaenoic and n-6:n-3 acid ratios increased risk). Moreover, the quantity of breast milk consumed per day was inversely associated with primary insulin autoimmunity, while the quantity of cow's milk consumed per day was directly associated. CONCLUSIONS/INTERPRETATION: Fatty acid status may play a role in the development of type 1 diabetes-associated autoimmunity. Fish-derived fatty acids may be protective, particularly during infancy. Furthermore, fatty acids consumed during breastfeeding may provide protection against type 1 diabetes-associated autoimmunity. Further studies are warranted to clarify the independent role of fatty acids in the development of type 1 diabetes. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/28474159/Fatty_acid_status_in_infancy_is_associated_with_the_risk_of_type_1_diabetes_associated_autoimmunity_ L2 - https://dx.doi.org/10.1007/s00125-017-4280-9 DB - PRIME DP - Unbound Medicine ER -