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Comparative Study
. 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

Carin Andrén Aronsson  1 , Hye-Seung Lee  2 , Edwin Liu  3 , Ulla Uusitalo  2 , Sandra Hummel  4 , Jimin Yang  2 , Michael Hummel  4 , Marian Rewers  5 , Jin-Xiong She  6 , Olli Simell  7 , Jorma Toppari  8 , Anette-G Ziegler  4 , Jeffrey Krischer  2 , Suvi M Virtanen  9 , Jill M Norris  10 , Daniel Agardh  11 ; TEDDY STUDY GROUP
Collaborators, Affiliations
Comparative Study

Age at gluten introduction and risk of celiac disease

Carin Andrén Aronsson et al. Pediatrics. 2015 Feb.

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.

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Figures

FIGURE 1
FIGURE 1
Flowchart describing the TEDDY study population
See this image and copyright information in PMC

References

    1. Ludvigsson JF, Leffler DA, Bai JC, et al. . The Oslo definitions for coeliac disease and related terms. Gut. 2013;62(1):43–52 - PMC - PubMed
    1. Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progression of celiac disease? Gastroenterology. 2005;128(4 suppl 1):S47–S51 - PubMed
    1. Hoffenberg EJ, MacKenzie T, Barriga KJ, et al. . A prospective study of the incidence of childhood celiac disease. J Pediatr. 2003;143(3):308–314 - PubMed
    1. Steens RF, Csizmadia CG, George EK, Ninaber MK, Hira Sing RA, Mearin ML. A national prospective study on childhood celiac disease in the Netherlands 1993-2000: an increasing recognition and a changing clinical picture. J Pediatr. 2005;147(2):239–243 - PubMed
    1. Ivarsson A. The Swedish epidemic of coeliac disease explored using an epidemiological approach—some lessons to be learnt. Best Pract Res Clin Gastroenterol. 2005;19(3):425–440 - PubMed

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