Format

Send to

Choose Destination
Pediatrics. 2015 Feb;135(2):239-45. doi: 10.1542/peds.2014-1787. Epub 2015 Jan 19.

Age at gluten introduction and risk of celiac disease.

Collaborators (221)

Rewers M, Bautista K, Baxter J, Bedoy R, Gesualdo P, Hoffman M, Karban R, Liu E, Norris J, Waugh K, Samper A, Steck A, Davis B, She JX, Schatz D, Hopkins D, Steed L, Thomas J, Silvis K, Haller M, Shankar M, Sheehan E, Gardiner M, McIndoe R, Liu H, Nechtman J, Sharma A, Williams J, Foghis G, Anderson SW, Ziegler AG, Beyerlein A, Bonifacio E, Hummel M, Hummel S, Foterek K, Kersting M, Knopff A, Koletzko S, Peplow C, Roth R, Stock J, Strauss E, Warncke K, Winkler C, Simell OG, Toppari J, Hyöty H, Ilonen J, Kähönen M, Knip M, Koivu A, Koreasalo M, Kurppa K, Lönnrot M, Mäntymäki E, Multasuo K, Mykkänen J, Niininen T, Nyblom M, Rautanen J, Riikonen A, Romo M, Simell A, Simell B, Simell S, Simell T, Simell V, Sjöberg M, Stenius A, Varjonen E, Veijola R, Virtanen SM, Åkerlund M, Lernmark Å, Agardh D, Andrén Aronsson C, Ask M, Bremer J, Carlsson UM, Cilio C, Ekstrand C, Ericson-Hallström E, Fransson L, Gard T, Gerardsson J, Håkansson R, Hansen M, Hansson G, Hyberg S, Johansen F, Jonasdottir B, Jonsson L, Larsson H, Lernmark B, Månsson-Martinez M, Markan M, Massadakis T, Melin J, Mestan Z, Rahmati K, Ramelius A, Sedig Järvirova M, Sibthorpe S, Sjöberg B, Swartling U, Trulsson E, Törn C, Wallin A, Wimar Å, Åberg S, Hagopian WA, Yan X, Killian M, Crouch CC, Skidmore J, Ayres S, Dunson K, Heaney D, Hervey R, Kindschi R, Meyer A, Mulenga D, Scott E, Stabbert J, Williams N, Willis J, Becker D, Franciscus M, Smith ME, Daftary A, Klein MB, Krischer JP, Abbondondolo M, Austin-Gonzalez S, Brown R, Burkhardt B, Butterworth M, Cuthbertson D, Eberhard C, Fiske S, Garcia D, Gowda V, Hadley D, Lee HS, Liu S, Liu X, Lynch K, Malloy J, McCarthy C, McLeod W, Shaffer C, Smith L, Smith S, Tamura R, Uusitalo U, Vehik K, Washington E, Yang J, Akolkar B, Bourcier K, Briese T, Johnson SB, Oberste S, Triplett E, Yu L, Miao D, Bingley P, Williams A, Chandler K, Rokni S, Boldison J, Butterly J, Broadhurst J, Carreno G, Caygill C, Curnock R, Easton P, Geoghan I, Goode J, Long A, Payne M, Pearson J, Reed C, Ridewood S, Wyatt R, Eriksson EA, Karlsson EL, Erlund I, Salminen I, Sundvall J, Leiviskä J, Lehtonen M, Little RR, Tennill AL, Erlich H, Mack SJ, Fear AL, Fiehn O, Wikoff B, Kind T, Palazoglu M, Wong J, Petrosino JF, Marcovina SM, Gaur VP, Higgins H, Ke S, She JX, McIndoe R, Liu H, Nechtman J, Zhao Y, Jiang N, Rich SS, Chen WM, Onengut-Gumuscu S, Farber E, Pickin RR, Davis J, Gallo D.

Author information

1
Department of Clinical Sciences, Lund University, Malmö, Sweden; carin.andren_aronsson@med.lu.se.
2
Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida;
3
Digestive Health Institute, University of Colorado, Children's Hospital Colorado, Denver, Colorado;
4
Institute of Diabetes Research, Helmholtz Zentrum München, and Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V., Neuherberg, Germany;
5
Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, Colorado;
6
Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University, Augusta, Georgia;
7
Department of Pediatrics, Turku University Hospital, Turku, Finland;
8
Department of Physiology and Pediatrics, University of Turku, Turku, Finland;
9
National Institutes for Health and Welfare, Nutrition Unit, Helsinki, Finland; School of Health Sciences, University of Tampere, Tampere, Finland; Research Center for Child Health, Tampere University and University Hospital and the Science Center of Pirkanmaa Hospital District, Tampere, Finland; and.
10
Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Aurora, Colorado.
11
Department of Clinical Sciences, Lund University, Malmö, Sweden;

Abstract

OBJECTIVES:

The goal of this study was to determine whether age at introduction to gluten was associated with risk for celiac disease (CD) in genetically predisposed children.

METHODS:

TEDDY (The Environmental Determinants of Diabetes in the Young) is a prospective birth cohort study. Newborn infants (N = 6436) screened for high-risk HLA-genotypes for CD were followed up in Finland, Germany, Sweden, and the United States. Information about infant feeding was collected at clinical visits every third month. The first outcome was persistent positive for tissue transglutaminase autoantibodies (tTGA), the marker for CD. The second outcome was CD, defined as either a diagnosis based on intestinal biopsy results or on persistently high levels of tTGA.

RESULTS:

Swedish children were introduced to gluten earlier (median: 21.7 weeks) compared with children from Finland (median: 26.1 weeks), Germany, and the United States (both median: 30.4 weeks) (P < .0001). During a median follow-up of 5.0 years (range: 1.7-8.8 years), 773 (12%) children developed tTGA and 307 (5%) developed CD. Swedish children were at increased risk for tTGA (hazard ratio: 1.74 [95% CI: 1.47-2.06]) and CD (hazard ratio: 1.76 [95% CI: 1.34-2.24]) compared with US children, respectively (P < .0001).Gluten introduction before 17 weeks or later than 26 weeks was not associated with increased risk for tTGA or CD, adjusted for country, HLA, gender, and family history of CD, neither in the overall analysis nor on a country-level comparison.

CONCLUSIONS:

In TEDDY, the time to first introduction to gluten introduction was not an independent risk factor for developing CD.

KEYWORDS:

breastfeeding; celiac disease; gluten; infant feeding

PMID:
25601977
PMCID:
PMC4306795
DOI:
10.1542/peds.2014-1787
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Substance, Grant support

Publication types

MeSH terms

Substance

Grant support

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center