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Gluten intake and risk of thyroid peroxidase autoantibodies in the Diabetes Autoimmunity Study In the Young (DAISY)

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Abstract

Purpose

Autoimmune diseases co-occur, perhaps due to common risk factors. The age at gluten introduction and gluten intake in early childhood has been associated with the autoimmunity preceding celiac disease (CD) and type-1 diabetes (T1D). We explored their associations with the development of thyroid autoimmunity.

Methods

DAISY has prospectively followed children at increased risk for T1D and CD since 1993. During follow-up, 107 children developed thyroid autoimmunity, defined as positivity for autoantibodies against thyroid peroxidase on at least two study visits. Age at gluten introduction was ascertained from food history interviews every 3 months until 15 months of age. Gluten intake (g/day) at age 1–2 years was estimated using a food frequency questionnaire.

Results

From multivariable Cox regression, there was no association between the age of gluten introduction nor the amount of gluten intake and development of thyroid autoimmunity. However, females (hazard ratio = 2.19, 95% CI: 1.46, 3.27) and cases of islet autoimmunity (HR = 2.20, 95% CI: 1.39, 3.50) were significantly more likely to develop thyroid autoimmunity, while exposure to environmental tobacco smoke decreased the risk (HR = 0.46, 95% CI: 0.30, 0.71).

Conclusions

Neither the age of gluten introduction nor the amount of gluten consumed in early childhood is associated with risk of thyroid autoimmunity.

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Data availability

Study data can be made available upon reasonable request to the corresponding author.

Code availability

Study code can be made available upon reasonable request to the corresponding author.

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Author contributions

J.A.G. and R.K.J. contributed equally to this work as first authors; they designed the study, performed statistical analyses, interpreted results, drafted, and approved the final manuscript. F.D. performed statistical analyses and critically reviewed and approved the final manuscript. M.H., A.K.S., and B.I.F. acquired study data, and critically reviewed and approved the final manuscript. M.R. and J.M.N. designed the DAISY study, interpreted results, and critically reviewed and approved the final manuscript.

Funding

This work was funded by NIH R01-DK104351 to J.M.N. and R01-DK32493 to M.R.

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Author notes

  1. These authors contributed equally: Jacqueline A. Gardner, Randi K. Johnson

Authors and Affiliations

  1. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA

    Jacqueline A. Gardner & Jill M. Norris

  2. Division of Bioinformatics and Personalized Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Randi K. Johnson

  3. Barbara Davis Center for Diabetes, Aurora, CO, USA

    Fran Dong, Michelle Hoffman, Andrea K. Steck, Brigitte I. Frohnert & Marian Rewers

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  1. Jacqueline A. Gardner
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Corresponding author

Correspondence to Jill M. Norris.

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The authors declare that they have no conflict of interest.

Ethics approval

The Colorado Multiple Institutional Review Board approved all DAISY study protocols (COMIRB 92-080). Informed consent was obtained from the parents/legal guardians of all children. Assent was obtained from children age 7 years and older. All research was performed in accordance with relevant guidelines/regulations.

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Gardner, J.A., Johnson, R.K., Dong, F. et al. Gluten intake and risk of thyroid peroxidase autoantibodies in the Diabetes Autoimmunity Study In the Young (DAISY). Endocrine 70, 331–337 (2020). https://doi.org/10.1007/s12020-020-02412-3

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