TY - JOUR
T1 - The role of gluten consumption at an early age in celiac disease development
T2 - A further analysis of the prospective PreventCD cohort study
AU - Crespo-Escobar, Paula
AU - Mearin, Maria Luisa
AU - Hervás, David
AU - Auricchio, Renata
AU - Castillejo, Gemma
AU - Gyimesi, Judit
AU - Martinez-Ojinaga, Eva
AU - Werkstetter, Katharina
AU - Vriezinga, Sabine Lisa
AU - Korponay-Szabo, Ilma Rita
AU - Polanco, Isabel
AU - Troncone, Riccardo
AU - Stoopman, Els
AU - Kolaček, Sanja
AU - Shamir, Raanan
AU - Szajewska, Hania
AU - Koletzko, Sibylle
AU - Ribes-Koninckx, Carmen
N1 - Publisher Copyright:
© 2017 American Society for Nutrition.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background: We previously found that the introduction of small quantities of gluten at 4-6 mo of age did not reduce the risk of celiac disease (CD) in a group of high-risk children. However, the consumption of high amounts of gluten early in life has been suggested to increase CD risk. Objective: The aim of this study was to evaluate this hypothesis by using data from the previous study of the PreventCD trial (www. preventcd.com). Design: Gluten intake was prospectively quantified by using specific food records between 11 and 36 mo of age in 715 children positive for the human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8 from 5 European countries. According to the PreventCD protocol, infants received 100 mg immunologically active gluten/d or placebo from 4 to 6 mo of age, with a stepwise and fixed gluten increase until age 10 mo and unrestricted intake thereafter. The primary outcome of the present study was the impact of the amount of gluten consumed from age 10 mo onward on CD development. Results: Mean daily gluten intakes from 10 mo onward were significantly different between countries for children at all ages (P < 0.001) but not between children who developed CD and those who did not within the same country (P > 0.05). The variables country, sex, intervention group, and gluten consumption pattern did not show significant associations with CD development risk (HRs not significant). In addition, the interaction between HLA risk group and gluten consumption pattern showed no significant risk on CD development, except for the DQ2.2/DQ7 haplotype (HR: 5.81; 95% CI: 1.18, 28.74; P = 0.031). Conclusions: Gluten consumption patterns as well as the amount of gluten consumed at 11-36 mo of age do not influence CD development for most related HLA genotypes in children with a genetic risk. This study reports the gluten consumption pattern in children at risk of CD from different European countries. This trial was registered at www.controlled-trials.com as ISRCTN74582487. Am J Clin Nutr 2017;105:890-6.
AB - Background: We previously found that the introduction of small quantities of gluten at 4-6 mo of age did not reduce the risk of celiac disease (CD) in a group of high-risk children. However, the consumption of high amounts of gluten early in life has been suggested to increase CD risk. Objective: The aim of this study was to evaluate this hypothesis by using data from the previous study of the PreventCD trial (www. preventcd.com). Design: Gluten intake was prospectively quantified by using specific food records between 11 and 36 mo of age in 715 children positive for the human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8 from 5 European countries. According to the PreventCD protocol, infants received 100 mg immunologically active gluten/d or placebo from 4 to 6 mo of age, with a stepwise and fixed gluten increase until age 10 mo and unrestricted intake thereafter. The primary outcome of the present study was the impact of the amount of gluten consumed from age 10 mo onward on CD development. Results: Mean daily gluten intakes from 10 mo onward were significantly different between countries for children at all ages (P < 0.001) but not between children who developed CD and those who did not within the same country (P > 0.05). The variables country, sex, intervention group, and gluten consumption pattern did not show significant associations with CD development risk (HRs not significant). In addition, the interaction between HLA risk group and gluten consumption pattern showed no significant risk on CD development, except for the DQ2.2/DQ7 haplotype (HR: 5.81; 95% CI: 1.18, 28.74; P = 0.031). Conclusions: Gluten consumption patterns as well as the amount of gluten consumed at 11-36 mo of age do not influence CD development for most related HLA genotypes in children with a genetic risk. This study reports the gluten consumption pattern in children at risk of CD from different European countries. This trial was registered at www.controlled-trials.com as ISRCTN74582487. Am J Clin Nutr 2017;105:890-6.
KW - Celiac disease
KW - Children
KW - European cohort
KW - Gluten
KW - HLA
UR - http://www.scopus.com/inward/record.url?scp=85020543115&partnerID=8YFLogxK
U2 - 10.3945/ajcn.116.144352
DO - 10.3945/ajcn.116.144352
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C2 - 28228423
AN - SCOPUS:85020543115
SN - 0002-9165
VL - 105
SP - 890
EP - 896
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 4
ER -