Maternal dietary supplement use and development of islet autoimmunity in the offspring: TEDDY study

Pediatr Diabetes. 2019 Feb;20(1):86-92. doi: 10.1111/pedi.12794. Epub 2018 Dec 9.

Abstract

Objective: We investigated the association between maternal use of vitamin D and omega-3 fatty acids (n-3 FAs) supplements during pregnancy and risk of islet autoimmunity (IA) in the offspring.

Methods: The Environmental Determinants of Diabetes in the Young (TEDDY) Study is prospectively following 8676 children with increased genetic risk for type 1 diabetes in Finland, Germany, Sweden, and the United States. Blood samples were collected every 3 months between 3 and 48 months of age then every 6 months thereafter to determine persistent IA. Duration, frequency, and supplement dose during pregnancy were recalled by mothers at 3 to 4 months postpartum. Cumulative intakes of supplemental vitamin D and n-3 FAs were analyzed as continuous or binary variables. We applied time-to-event analysis to study the association between maternal supplement use and IA, adjusting for country, human leukocyte antigen-DR-DQ genotype, family history of type 1 diabetes and sex. Secondary outcomes included insulin autoantibodies (IAA) or glutamic acid decarboxylase (GADA) as the first appearing autoantibody.

Results: As of February 2018, there were 747 (9.0%) children with IA. Vitamin D supplement intake during pregnancy (any vs none) was not associated with risk for IA (hazard ratio [HR] 1.11; 95% confidence interval [CI] 0.94, 1.31); neither was cumulative vitamin D supplement intake. Supplemental n-3 FA intake was similarly not associated with IA risk (HR: 1.19, 95% CI 0.98, 1.45). Similar lack of association was observed for either IAA or GADA as the first appearing autoantibody.

Conclusions: The TEDDY cohort showed no evidence of benefit regarding IA risk for vitamin D or n-3 FA supplementation during pregnancy.

Keywords: dietary supplements; islet autoimmunity; omega-3 fatty acids; pregnancy; vitamin D.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Autoantibodies / blood
  • Autoimmunity* / drug effects
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / immunology
  • Dietary Supplements* / statistics & numerical data
  • Fatty Acids, Omega-3 / administration & dosage*
  • Female
  • Finland / epidemiology
  • Germany / epidemiology
  • Glutamate Decarboxylase / immunology
  • Humans
  • Infant
  • Islets of Langerhans / immunology*
  • Male
  • Maternal Nutritional Physiological Phenomena
  • Pregnancy
  • Prenatal Exposure Delayed Effects / blood
  • Prenatal Exposure Delayed Effects / immunology*
  • Sweden / epidemiology
  • United States / epidemiology
  • Vitamin D / administration & dosage*

Substances

  • Autoantibodies
  • Fatty Acids, Omega-3
  • Vitamin D
  • Glutamate Decarboxylase