Breast-Feeding and Childhood-Onset Type 1 Diabetes A pooled analysis of individual participant data from 43 observational studies

Breast-Feeding and Childhood-Onset Type 1 Diabetes A pooled analysis of individual participant data from 43 observational studies

Author Cardwell, Chris R. Google Scholar
Stene, Lars C. Google Scholar
Ludvigsson, Johnny Google Scholar
Rosenbauer, Joachim Google Scholar
Cinek, Ondrej Google Scholar
Svensson, Jannet Google Scholar
Perez-Bravo, Francisco Google Scholar
Memon, Anjum Google Scholar
Gimeno, Suely Godoy Agostinho Autor UNIFESP Google Scholar
Wadsworth, Emma J. K. Google Scholar
Strotmeyer, Elsa S. Google Scholar
Goldacre, Michael J. Google Scholar
Radon, Katja Google Scholar
Chuang, Lee-Ming Google Scholar
Parslow, Roger C. Google Scholar
Chetwynd, Amanda Google Scholar
Karavanaki, Kyriaki Google Scholar
Brigis, Girts Google Scholar
Pozzilli, Paolo Google Scholar
Urbonaite, Brone Google Scholar
Schober, Edith Google Scholar
Devoti, Gabriele Google Scholar
Sipetic, Sandra Google Scholar
Joner, Geir Google Scholar
Ionescu-Tirgoviste, Constantin Google Scholar
Beaufort, Carine E. de Google Scholar
Harrild, Kirsten Google Scholar
Benson, Victoria Google Scholar
Savilahti, Erkki Google Scholar
Ponsonby, Anne-Louise Google Scholar
Salem, Mona Google Scholar
Rabiei, Samira Google Scholar
Patterson, Chris C. Google Scholar
Institution Queens Univ Belfast
Norwegian Inst Publ Hlth
Oslo Univ Hosp
Linkoping Univ Hosp
Univ Dusseldorf
Charles Univ Prague
Univ Hosp Motol
Herlev Univ Hosp
Univ Chile
Brighton & Sussex Med Sch & NHS Brighton & Hove
Universidade Federal de São Paulo (UNIFESP)
Cardiff Univ
Univ Pittsburgh
Univ Oxford
Hosp Ludwig Maximilian Univ Munich
Natl Taiwan Univ Hosp
Univ Leeds
Univ Lancaster
Univ Athens
Riga Stradins Univ
Univ Campus Biomed
Lithuanian Univ Hlth Sci
Med Univ Vienna
Univ Salento
Univ Belgrade
Univ Oslo
N Paulescu Inst Diabet
Clin Pediat Luxembourg
Univ Aberdeen
Univ Helsinki
Royal Childrens Hosp
Ain Shams Univ
Shahid Beheshti Univ Med Sci & Hlth Serv
Abstract OBJECTIVE-To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders.RESEARCH DESIGN and METHODS-Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies.RESULTS-Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I-2 = 58, 76, 54, and 68%, respectively). in studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I-2 = 0%). Adjustments for potential confounders altered these estimates very little.CONCLUSIONS-The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. Diabetes Care 35: 2215-2225, 2012
Language English
Sponsor National Institutes of Health
Chinese Foundation of Health
Department of Health, Executive Yuan, Republic of China
Ministry for Science and Technology of the Republic of Serbia
German Research Foundation
Research Council of Norway
Grant number National Institutes of Health: R01-DK-46498
National Institutes of Health: R01-DK-42316
Department of Health, Executive Yuan, Republic of China: DOH91-TD1167
Ministry for Science and Technology of the Republic of Serbia: 175042
German Research Foundation: HE 234/1-1
Research Council of Norway: 148359/330
Date 2012-11-01
Published in Diabetes Care. Alexandria: Amer Diabetes Assoc, v. 35, n. 11, p. 2215-2225, 2012.
ISSN 0149-5992 (Sherpa/Romeo, impact factor)
Publisher Amer Diabetes Assoc
Extent 2215-2225
Origin http://dx.doi.org/10.2337/dc12-0438
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000311424100023
URI http://repositorio.unifesp.br/handle/11600/35441

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