Περίληψη:
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. © 2012 by the American Diabetes Association.
Συγγραφείς:
Cardwell, C.R.
Stene, L.C.
Ludvigsson, J.
Rosenbauer, J.
Cinek, O.
Svensson, J.
Perez-Bravo, F.
Memon, A.
Gimeno, S.G.
Wadsworth, E.J.K.
Strotmeyer, E.S.
Goldacre, M.J.
Radon, K.
Chuang, L.-M.
Parslow, R.C.
Chetwynd, A.
Karavanaki, K.
Brigis, G.
Pozzilli, P.
Urbonaite, B.
Schober, E.
Devoti, G.
Sipetic, S.
Joner, G.
Ionescu-Tirgoviste, C.
De Beaufort, C.E.
Harrild, K.
Benson, V.
Savilahti, E.
Ponsonby, A.-L.
Salem, M.
Rabiei, S.
Patterson, C.C.
Λέξεις-κλειδιά:
adolescent; adult; article; birth weight; breast feeding; child; child health care; clinical assessment; controlled study; data analysis; disease association; human; infant; insulin dependent diabetes mellitus; major clinical study; maternal age; maternal diabetes mellitus; observational study; onset age; preschool child; risk assessment; risk factor; risk reduction; school child, Adolescent; Breast Feeding; Child; Child, Preschool; Diabetes Mellitus, Type 1; Female; Humans; Male
