Dietary iron intake in the first 4 months of infancy and the development of type 1 diabetes: a pilot study

Ambika P Ashraf,Sreelatha Meleth,Edmond K Kabagambe,Kenneth L McCormick,Josna Haritha,Nancy B Eason

doi:10.1186/1758-5996-2-58

Abstract

AimsTo investigate the impact of iron intake on the development of type 1 diabetes (T1DM).MethodsCase-control study with self-administered questionnaire among families of children with T1DM who were less than 10 years old at the time of the survey and developed diabetes between age 1 and 6 years. Data on the types of infant feeding in the first 4 months of life was collected from parents of children with T1DM (n = 128) and controls (n = 67) <10 years old. Because some cases had sibling controls, we used conditional logistic regression models to analyze the data in two ways. First we performed a case-control analysis of all 128 cases and 67 controls. Next, we performed a case-control analysis restricted to cases (n = 59) that had a sibling without diabetes (n = 59). Total iron intake was modeled as one standard deviation (SD) increase in iron intake. The SD for iron intake was 540 mg in the total sample and 539 mg in the restricted sample as defined above.ResultsThe median (min, max) total iron intake in the first 4 months of life was 1159 (50, 2399) mg in T1DM cases and 466 (50, 1224) mg among controls (P < 0.001). For each one standard deviation increase in iron intake, the odds ratio (95% confidence interval) for type 1 diabetes was 2.01 (1.183, 3.41) among all participants (128 cases and 67 controls) while it was 2.26 (1.27, 4.03) in a restricted sample of T1 D cases with a control sibling (59 cases and 59 controls) in models adjusted for birth weight, age at the time of the survey, and birth order.ConclusionIn this pilot study, high iron intake in the first 4 months of infancy is associated with T1DM. Whether iron intake is causal or a marker of another risk factor warrants further investigation.

Highlights

The incidence of type 1 diabetes (T1DM) is increasing worldwide and the age of onset is shifting downwards with a significant number of cases occurring between birth and 4 years of age [1,2,3,4]
The aim of this study is to explore whether the amount of iron consumed in the first 4 months of life is associated with T1DM before 6 years of age
There was no association between sibling rank and T1DM, nor was there an association between maternal history of gestational diabetes or T2 D and T1DM in children

Summary

Introduction

The incidence of type 1 diabetes (T1DM) is increasing worldwide and the age of onset is shifting downwards with a significant number of cases occurring between birth and 4 years of age [1,2,3,4]. The causes for increased incidence and early onset of T1DM are uncertain [1], a number of risk factors associated with induction of autoimmunity in the genetically susceptible individuals have been suggested. These include viral infections (especially enterovirus), stressful life events, vaccinations, early exposure to milk protein, such as bovine insulin, casein and other proteins, early introduction of cereal to infants, low. Iron absorption for term infants fed cow’s milk formulas varies from 4-12% depending on a variety of factors including age of the infant, reticulocyte count, body iron status, and composition of the baby formula (e.g., calcium concentration and added ascorbic acid). Lack of breast milk lactoferrin may predispose the formula fed infants for further added oxidative damage at critical time period

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