HLA genotype and probiotics modify the association between timing of solid food introduction and islet autoimmunity in the TEDDY Study

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posted on 2023-08-14, 21:09 authored by William Hagopian, Ulla Uusitalo, Lazarus K. Mramba, Carin Andrén Aronsson, Kendra Vehik, Jimin Yang, Sandra Hummel, Åke Lernmark, Marian Rewers, Richard McIndoe, Jorma Toppari, Anette G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Suvi M. Virtanen, Jill M. Norris

Objective

To study the interaction between HLA genotype, early probiotic exposure, and timing of complementary foods in relation to risk of islet autoimmunity (IA).

Research design and methods

The TEDDY study prospectively follows 8,676 children with increased genetic risk of type 1 diabetes. We used Cox regression model adjusting for potential confounders to study early feeding and the risk of IA in a sample of 7,770 children

Results

Any solid food introduced early (<6 months) was associated with increased risk of IA if the child had the HLA DR3/4 genotype and no probiotic exposure during the first year of life. Rice introduced at 4-5.9 months compared to later in the U.S. was associated with increased risk of IA.

Conclusions

Timing of solid food introduction, including rice, may be associated with IA in HLA DR3/4 children not exposed to probiotics. The microbiome composition under these exposure combinations requires further study.