Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes.
BACKGROUND
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.


METHODS
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.


METHODS
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).


CONCLUSIONS
Dietary intake of omega-3 fatty acids is associated with reduced risk of IA in children at increased genetic risk for type 1 diabetes.
Norris
Jill M
JM
Department of Preventive Medicine and Biostatistics, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA. jill.norris@uchsc.edu
Yin
Xiang
X
Lamb
Molly M
MM
Barriga
Katherine
K
Seifert
Jennifer
J
Hoffman
Michelle
M
Orton
Heather D
HD
Barón
Anna E
AE
Clare-Salzler
Michael
M
Chase
H Peter
HP
Szabo
Nancy J
NJ
Erlich
Henry
H
Eisenbarth
George S
GS
Rewers
Marian
M
D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000235:genetics; D004032:Diet; D004910:Erythrocyte Membrane / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
D001323:Autoantibodies; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6