Table 2.
Association between gluten exposures and development of islet autoimmunity and progression from IA to type 1 diabetes
| TotalN (%) | IAn (%) | UnadjustedHR (95% CI) | AdjustedHR (95% CI) | |
|---|---|---|---|---|
| Development of IA | ||||
| Exposure | ||||
| Gluten (per 4 g/day) over time* | 1,820 (100) | 173 (100) | 1.00 (0.99–1.02) | 1.01 (0.99–1.02) |
| Gluten (per 4 g/day) at age 1–2 years† | 1,235 (100) | 128 (100) | 1.02 (0.90–1.15) | 1.00 (0.85–1.18) |
| Tertiles 1–2 years | ||||
| Low (0.0–9.0 g/day) | 415 (33.6) | 38 (29.7) | 1 | 1 |
| Middle (9.0–13.1 g/day) | 404 (32.7) | 44 (34.4) | 1.18 (0.76–1.84) | 1.07 (0.68–1.67) |
| High (13.1–34.9 g/day) | 416 (33.7) | 46 (35.9) | 1.20 (0.77–1.86) | 1.05 (0.62–1.77) |
| Age at gluten introduction (months)‡ | ||||
| <4 | 79 (6.4) | 7 (5.47) | 0.89 (0.39–2.01) | 0.97 (0.45–2.09) |
| 4.0–5.9 | 415 (33.6) | 41 (32.0) | 1 | 1 |
| ≥6 | 741 (60.0) | 80 (62.5) | 1.08 (0.74–1.59) | 1.06 (0.73–1.56) |
| TotalN (%) | T1Dn (%) | UnadjustedHR (95% CI) | AdjustedHR (95% CI) | |
| Progression from IA to T1D | ||||
| Exposure | ||||
| Gluten (per 4 g/day) over time* | 164 (100) | 49 (100) | 1.02 (0.99–1.04) | 1.02 (0.99–1.04) |
| Gluten (per 4 g/day) at age 1–2 years† | 128 (100) | 42 (100) | 1.00 (0.81–1.24) | 0.86 (0.57–1.29) |
| Tertiles 1–2 years | ||||
| Low (1.9–8.7 g/day) | 38 (29.7) | 13 (31.0) | 1 | 1 |
| Middle (9.1–13.1 g/day) | 44 (34.4) | 15 (35.7) | 1.24 (0.59–2.61) | 0.81 (0.28–2.33) |
| High (13.2–26.2 g/day) | 46 (35.9) | 14 (33.3) | 1.03 (0.48–2.20) | 0.63 (0.18–2.18) |
| Age at gluten introduction (months)‡ | ||||
| <4 | 7 (5.5) | 6 (14.3) | 5.09 (1.64–15.8) | 8.69 (1.69–44.8) |
| 4.0–5.9 | 41 (32.0) | 14 (33.3) | 1 | 1 |
| ≥6 | 80 (62.5) | 22 (52.4) | 0.76 (0.37–1.55) | 0.77 (0.31–1.88) |
IA, islet autoimmunity; T1D, type 1 diabetes.
*Adjusted for the child’s total energy intake, age at introduction of gluten, family history of CD, appearance of CDA, HLA genotype, family history of T1D, type of FFQ, parent-reported race-ethnicity, sex, and maternal age at delivery.
†Adjusted for the child’s total energy intake, age at introduction of gluten, family history of CD, HLA genotype, family history of T1D, parent-reported race-ethnicity, sex, and maternal age at the time of delivery.
‡Adjusted for the child’s total energy intake, gluten intake at age 1–2 years, family history of CD, HLA genotype, family history of T1D, parent-reported race-ethnicity, sex, and maternal age at the time of delivery.