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Omega-3 Polyunsaturated Fatty Acid Intake and Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes
Jill M. Norris, MPH, PhD;
Xiang Yin, MD, MS;
Molly M. Lamb, BA;
Katherine Barriga, MSPH;
Jennifer Seifert, BS;
Michelle Hoffman, RN;
Heather D. Orton, MS;
Anna E. Barón, PhD;
Michael Clare-Salzler, MD;
H. Peter Chase, MD;
Nancy J. Szabo, PhD;
Henry Erlich, MD, PhD;
George S. Eisenbarth, MD, PhD;
Marian Rewers, MD, PhD
JAMA. 2007;298:1420-1428.
Context Cod liver oil supplements in infancy have been associated with a decreased risk of type 1 diabetes mellitus in a retrospective study.
Objective To examine whether intakes of omega-3 and omega-6 fatty acids are associated with the development of islet autoimmunity (IA) in children.
Design, Setting, and Participants A longitudinal, observational study, the Diabetes Autoimmunity Study in the Young (DAISY), conducted in Denver, Colorado, between January 1994 and November 2006, of 1770 children at increased risk for type 1 diabetes, defined as either possession of a high diabetes risk HLA genotype or having a sibling or parent with type 1 diabetes. The mean age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. A case-cohort study (N = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (as a percentage of total lipids) was examined.
Main Outcome Measure Risk of IA, defined as being positive for insulin, glutamic acid decarboxylase, or insulinoma-associated antigen-2 autoantibodies on 2 consecutive visits and still autoantibody positive or having diabetes at last follow-up visit.
Results Fifty-eight children developed IA. Adjusting for HLA genotype, family history of type 1 diabetes, caloric intake, and omega-6 fatty acid intake, omega-3 fatty acid intake was inversely associated with risk of IA (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.21-0.96; P = .04). The association was strengthened when the definition of the outcome was limited to those positive for 2 or more autoantibodies (HR, 0.23; 95% CI, 0.09-0.58; P = .002). In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was also inversely associated with IA risk (HR, 0.63; 95% CI, 0.41-0.96; P = .03).
Conclusion Dietary intake of omega-3 fatty acids is associated with reduced risk of IA in children at increased genetic risk for type 1 diabetes.
Author Affiliations: Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver (Drs Norris, Yin, and Barón, and Mss Lamb, Seifert, and Orton); The Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Aurora (Drs Chase, Eisenbarth, and Rewers, and Mss Barriga and Hoffman); Department of Pathology, Immunology, and Laboratory Medicine (Dr Clare-Salzler) and Analytical Toxicology Core Laboratory (Dr Szabo), University of Florida, Gainesville; and Department of Human Genetics, Roche Molecular Systems, Alameda, California (Dr Erlich).
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