First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study

Sandra Hummel, Andreas Beyerlein, Roy Tamura, Ulla Uusitalo, Carin Andŕen Aronsson, Jimin Yang, Anne Riikonen, Ake Lernmark, Marian J. Rewers, William A. Hagopian, Jin-Xiong She, Olli G. Simell, Jorma Toppari, Anette G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Suvi M. Virtanen, Jill M. Norris

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE Studies on the introduction of infant formulas and its effect on the risk of islet autoimmunity and type 1 diabetes (T1D) have yielded inconsistent results. We investigated whether the introduction of formula based on hydrolyzed cow'smilk as the first formula is associated with reduced islet autoimmunity risk in a large prospective cohort. RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively monitors 8,676 children at increased genetic risk for T1D. Autoantibodies to insulin, GAD65, and IA2 were measured regularly to define islet autoimmunity. Information on formula feeding was collected by questionnaires at 3 months of age. RESULTS In survival analyses, after adjustment for family history with T1D, HLA genotype, sex, country, delivery mode, breast-feeding 3 months, and seasonality of birth, we observed no significant association with islet autoimmunity in infants who received extensively hydrolyzed compared with nonhydrolyzed cow'smilk-based formula as the first formula during the first 3 months (adjusted hazard ratio 1.38 [95% CI 0.95; 2.01]), and a significantly increased risk for extensively hydrolyzed formula introduced during the first 7 days (adjusted hazard ratio 1.57 [1.04; 2.38]). Using a partially hydrolyzed or other formula as the first formula, or no formula, was not associated with islet autoimmunity risk. CONCLUSIONS These results add to the existing evidence that islet autoimmunity risk is not reduced, and may be increased, by using hydrolyzed compared with nonhydrolyzed cow's milk-based infant formula as the first formula in infants at increased genetic risk for T1D .

Original languageEnglish (US)
Pages (from-to)398-404
Number of pages7
JournalDiabetes Care
Volume40
Issue number3
DOIs
StatePublished - Mar 1 2017

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Infant Formula
Autoimmunity
Type 1 Diabetes Mellitus
Survival Analysis
Breast Feeding
Autoantibodies
Milk
Genotype
Parturition
Insulin

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Hummel, S., Beyerlein, A., Tamura, R., Uusitalo, U., Andŕen Aronsson, C., Yang, J., ... Norris, J. M. (2017). First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study. Diabetes Care, 40(3), 398-404. https://doi.org/10.2337/dc16-1624

First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study. / Hummel, Sandra; Beyerlein, Andreas; Tamura, Roy; Uusitalo, Ulla; Andŕen Aronsson, Carin; Yang, Jimin; Riikonen, Anne; Lernmark, Ake; Rewers, Marian J.; Hagopian, William A.; She, Jin-Xiong; Simell, Olli G.; Toppari, Jorma; Ziegler, Anette G.; Akolkar, Beena; Krischer, Jeffrey P.; Virtanen, Suvi M.; Norris, Jill M.

In: Diabetes Care, Vol. 40, No. 3, 01.03.2017, p. 398-404.

Research output: Contribution to journalArticle

Hummel, S, Beyerlein, A, Tamura, R, Uusitalo, U, Andŕen Aronsson, C, Yang, J, Riikonen, A, Lernmark, A, Rewers, MJ, Hagopian, WA, She, J-X, Simell, OG, Toppari, J, Ziegler, AG, Akolkar, B, Krischer, JP, Virtanen, SM & Norris, JM 2017, 'First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study', Diabetes Care, vol. 40, no. 3, pp. 398-404. https://doi.org/10.2337/dc16-1624
Hummel, Sandra ; Beyerlein, Andreas ; Tamura, Roy ; Uusitalo, Ulla ; Andŕen Aronsson, Carin ; Yang, Jimin ; Riikonen, Anne ; Lernmark, Ake ; Rewers, Marian J. ; Hagopian, William A. ; She, Jin-Xiong ; Simell, Olli G. ; Toppari, Jorma ; Ziegler, Anette G. ; Akolkar, Beena ; Krischer, Jeffrey P. ; Virtanen, Suvi M. ; Norris, Jill M. / First infant formula type and risk of islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study. In: Diabetes Care. 2017 ; Vol. 40, No. 3. pp. 398-404.
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abstract = "OBJECTIVE Studies on the introduction of infant formulas and its effect on the risk of islet autoimmunity and type 1 diabetes (T1D) have yielded inconsistent results. We investigated whether the introduction of formula based on hydrolyzed cow'smilk as the first formula is associated with reduced islet autoimmunity risk in a large prospective cohort. RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively monitors 8,676 children at increased genetic risk for T1D. Autoantibodies to insulin, GAD65, and IA2 were measured regularly to define islet autoimmunity. Information on formula feeding was collected by questionnaires at 3 months of age. RESULTS In survival analyses, after adjustment for family history with T1D, HLA genotype, sex, country, delivery mode, breast-feeding 3 months, and seasonality of birth, we observed no significant association with islet autoimmunity in infants who received extensively hydrolyzed compared with nonhydrolyzed cow'smilk-based formula as the first formula during the first 3 months (adjusted hazard ratio 1.38 [95{\%} CI 0.95; 2.01]), and a significantly increased risk for extensively hydrolyzed formula introduced during the first 7 days (adjusted hazard ratio 1.57 [1.04; 2.38]). Using a partially hydrolyzed or other formula as the first formula, or no formula, was not associated with islet autoimmunity risk. CONCLUSIONS These results add to the existing evidence that islet autoimmunity risk is not reduced, and may be increased, by using hydrolyzed compared with nonhydrolyzed cow's milk-based infant formula as the first formula in infants at increased genetic risk for T1D .",
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AU - Beyerlein, Andreas

AU - Tamura, Roy

AU - Uusitalo, Ulla

AU - Andŕen Aronsson, Carin

AU - Yang, Jimin

AU - Riikonen, Anne

AU - Lernmark, Ake

AU - Rewers, Marian J.

AU - Hagopian, William A.

AU - She, Jin-Xiong

AU - Simell, Olli G.

AU - Toppari, Jorma

AU - Ziegler, Anette G.

AU - Akolkar, Beena

AU - Krischer, Jeffrey P.

AU - Virtanen, Suvi M.

AU - Norris, Jill M.

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N2 - OBJECTIVE Studies on the introduction of infant formulas and its effect on the risk of islet autoimmunity and type 1 diabetes (T1D) have yielded inconsistent results. We investigated whether the introduction of formula based on hydrolyzed cow'smilk as the first formula is associated with reduced islet autoimmunity risk in a large prospective cohort. RESEARCH DESIGN AND METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively monitors 8,676 children at increased genetic risk for T1D. Autoantibodies to insulin, GAD65, and IA2 were measured regularly to define islet autoimmunity. Information on formula feeding was collected by questionnaires at 3 months of age. RESULTS In survival analyses, after adjustment for family history with T1D, HLA genotype, sex, country, delivery mode, breast-feeding 3 months, and seasonality of birth, we observed no significant association with islet autoimmunity in infants who received extensively hydrolyzed compared with nonhydrolyzed cow'smilk-based formula as the first formula during the first 3 months (adjusted hazard ratio 1.38 [95% CI 0.95; 2.01]), and a significantly increased risk for extensively hydrolyzed formula introduced during the first 7 days (adjusted hazard ratio 1.57 [1.04; 2.38]). Using a partially hydrolyzed or other formula as the first formula, or no formula, was not associated with islet autoimmunity risk. CONCLUSIONS These results add to the existing evidence that islet autoimmunity risk is not reduced, and may be increased, by using hydrolyzed compared with nonhydrolyzed cow's milk-based infant formula as the first formula in infants at increased genetic risk for T1D .

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