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Uusitalo, U.* ; Mramba, L.K.* ; Aronsson, C.A.* ; Vehik, K.* ; Yang, J.* ; Hummel, S. ; Lernmark, * ; Rewers, M.* ; Hagopian, W.* ; McIndoe, R.* ; Toppari, J.* ; Ziegler, A.G.* ; Akolkar, B.* ; Krischer, J.P.* ; Virtanen, S.M.* ; Norris, J.M.* ; Germany clinical center (Ziegler, A.-G. ; Gezginci, C. ; Heublein, A. ; Knopff, A. ; Köger, M. ; Koletzko, S. ; Roth, R. ; Scholz, M. ; Stock, J. ; Warncke, K. ; Wendel, L. ; Winkler, C.) ; Schmidt, J.

HLA genotype and probiotics modify the association between timing of solid food introduction and islet autoimmunity in the TEDDY Study.

Diabetes Care 46, 1839-1847 (2023)

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OBJECTIVE: To study the interaction among HLA genotype, early probiotic exposure, and timing of complementary foods in relation to risk of islet autoimmunity (IA). RESEARCH DESIGN AND METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively follows 8,676 children with increased genetic risk of type 1 diabetes. We used a Cox proportional hazards regression model adjusting for potential confounders to study early feeding and the risk of IA in a sample of 7,770 children. RESULTS: Any solid food introduced early (<6 months) was associated with increased risk of IA if the child had the HLA DR3/4 genotype and no probiotic exposure during the 1st year of life. Rice introduced at 4-5.9 months compared with later in the U.S. was associated with an increased risk of IA. CONCLUSIONS: Timing of solid food introduction, including rice, may be associated with IA in children with the HLA DR3/4 genotype not exposed to probiotics. The microbiome composition under these exposure combinations requires further study.

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