Breast-feeding and childhood-onset type 1 diabetes : A pooled analysis of individual participant data from 43 observational studies

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dc.contributor.authorCardwell, Chris R.
dc.contributor.authorStene, Lars C.
dc.contributor.authorLudvigsson, Johnny
dc.contributor.authorRosenbauer, Joachim
dc.contributor.authorCinek, Ondrej
dc.contributor.authorSvensson, Jannet
dc.contributor.authorPerez-Bravo, Francisco
dc.contributor.authorMemon, Anjum
dc.contributor.authorGimeno, Suely G.
dc.contributor.authorWadsworth, Emma J.K.
dc.contributor.authorStrotmeyer, Elsa S.
dc.contributor.authorGoldacre, Michael J.
dc.contributor.authorRadon, Katja
dc.contributor.authorChuang, Lee Ming
dc.contributor.authorParslow, Roger C.
dc.contributor.authorChetwynd, Amanda
dc.contributor.authorKaravanaki, Kyriaki
dc.contributor.authorBrigis, Girts
dc.contributor.authorPozzilli, Paolo
dc.contributor.authorUrbonaite, Brone
dc.contributor.authorSchober, Edith
dc.contributor.authorDevoti, Gabriele
dc.contributor.authorSipetic, Sandra
dc.contributor.authorJoner, Geir
dc.contributor.authorIonescu-Tirgoviste, Constantin
dc.contributor.authorDe Beaufort, Carine E.
dc.contributor.authorHarrild, Kirsten
dc.contributor.authorBenson, Victoria
dc.contributor.authorSavilahti, Erkki
dc.contributor.authorPonsonby, Anne Louise
dc.contributor.authorSalem, Mona
dc.contributor.authorRabiei, Samira
dc.contributor.authorPatterson, Chris C.
dc.contributor.institutionDepartment of Public Health and Epidemiology
dc.date.accessioned2021-04-28T20:15:01Z
dc.date.available2021-04-28T20:15:01Z
dc.date.issued2012-11
dc.description.abstractOBJECTIVE - 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.en
dc.description.statusPeer reviewed
dc.format.extent11
dc.format.extent358017
dc.identifier.citationCardwell, 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 2012, 'Breast-feeding and childhood-onset type 1 diabetes : A pooled analysis of individual participant data from 43 observational studies', Diabetes Care, vol. 35, no. 11, pp. 2215-2225. https://doi.org/10.2337/dc12-0438
dc.identifier.doi10.2337/dc12-0438
dc.identifier.issn0149-5992
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/3980
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=84868121007&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofDiabetes Care
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subject3.2 Clinical medicine
dc.subject3.3 Health sciences
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectInternal Medicine
dc.subjectEndocrinology, Diabetes and Metabolism
dc.subjectAdvanced and Specialised Nursing
dc.subjectSDG 3 - Good Health and Well-being
dc.titleBreast-feeding and childhood-onset type 1 diabetes : A pooled analysis of individual participant data from 43 observational studiesen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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