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Breast-Feeding and Childhood-Onset Type 1 Diabetes: A pooled analysis of individual participant data from 43 observational studies

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Breast-Feeding and Childhood-Onset Type 1 Diabetes: A pooled analysis of individual participant data from 43 observational studies. / Cardwell, Chris R; Stene, Lars C; Ludvigsson, Johnny et al.
In: Diabetes Care, Vol. 35, No. 11, 11.2012, p. 2215-2225.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Cardwell, CR, Stene, LC, Ludvigsson, J, Rosenbauer, J, Cinek, O, Svensson, J, Perez-Bravo, F, Memon, A, Gimeno, SG, Wadsworth, EJK, Strotmeyer, ES, Goldacre, MJ, Radon, K, Chuang, L-M, Parslow, RC, Chetwynd, A, Karavanaki, K, Brigis, G, Pozzilli, P, Urbonaite, B, Schober, E, Devoti, G, Sipetic, S, Joner, G, Ionescu-Tirgoviste, C, de Beaufort, CE, Harrild, K, Benson, V, Savilahti, E, Ponsonby, A-L, Salem, M, Rabiei, S & Patterson, CC 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

APA

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., ... 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, 35(11), 2215-2225. https://doi.org/10.2337/dc12-0438

Vancouver

Cardwell CR, Stene LC, Ludvigsson J, Rosenbauer J, Cinek O, Svensson J et al. Breast-Feeding and Childhood-Onset Type 1 Diabetes: A pooled analysis of individual participant data from 43 observational studies. Diabetes Care. 2012 Nov;35(11):2215-2225. doi: 10.2337/dc12-0438

Author

Cardwell, Chris R ; Stene, Lars C ; Ludvigsson, Johnny et al. / Breast-Feeding and Childhood-Onset Type 1 Diabetes : A pooled analysis of individual participant data from 43 observational studies. In: Diabetes Care. 2012 ; Vol. 35, No. 11. pp. 2215-2225.

Bibtex

@article{292729d9a1f140a0b650c9ca61f0d4bb,
title = "Breast-Feeding and Childhood-Onset Type 1 Diabetes: A pooled analysis of individual participant data from 43 observational studies",
abstract = "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 METHODSRelevant 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.RESULTSData 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.CONCLUSIONThe 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.",
author = "Cardwell, {Chris R} and Stene, {Lars C} and Johnny Ludvigsson and Joachim Rosenbauer and Ondrej Cinek and Jannet Svensson and Francisco Perez-Bravo and Anjum Memon and Gimeno, {Suely G} and Wadsworth, {Emma J K} and Strotmeyer, {Elsa S} and Goldacre, {Michael J} and Katja Radon and Lee-Ming Chuang and Parslow, {Roger C} and Amanda Chetwynd and Kyriaki Karavanaki and Girts Brigis and Paolo Pozzilli and Brone Urbonaite and Edith Schober and Gabriele Devoti and Sandra Sipetic and Geir Joner and Constantin Ionescu-Tirgoviste and {de Beaufort}, {Carine E} and Kirsten Harrild and Victoria Benson and Erkki Savilahti and Anne-Louise Ponsonby and Mona Salem and Samira Rabiei and Patterson, {Chris C}",
note = "{\textcopyright} 2012 by the American Diabetes Association.",
year = "2012",
month = nov,
doi = "10.2337/dc12-0438",
language = "English",
volume = "35",
pages = "2215--2225",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

RIS

TY - JOUR

T1 - Breast-Feeding and Childhood-Onset Type 1 Diabetes

T2 - A pooled analysis of individual participant data from 43 observational studies

AU - Cardwell, Chris R

AU - Stene, Lars C

AU - Ludvigsson, Johnny

AU - Rosenbauer, Joachim

AU - Cinek, Ondrej

AU - Svensson, Jannet

AU - Perez-Bravo, Francisco

AU - Memon, Anjum

AU - Gimeno, Suely G

AU - Wadsworth, Emma J K

AU - Strotmeyer, Elsa S

AU - Goldacre, Michael J

AU - Radon, Katja

AU - Chuang, Lee-Ming

AU - Parslow, Roger C

AU - Chetwynd, Amanda

AU - Karavanaki, Kyriaki

AU - Brigis, Girts

AU - Pozzilli, Paolo

AU - Urbonaite, Brone

AU - Schober, Edith

AU - Devoti, Gabriele

AU - Sipetic, Sandra

AU - Joner, Geir

AU - Ionescu-Tirgoviste, Constantin

AU - de Beaufort, Carine E

AU - Harrild, Kirsten

AU - Benson, Victoria

AU - Savilahti, Erkki

AU - Ponsonby, Anne-Louise

AU - Salem, Mona

AU - Rabiei, Samira

AU - Patterson, Chris C

N1 - © 2012 by the American Diabetes Association.

PY - 2012/11

Y1 - 2012/11

N2 - 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 METHODSRelevant 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.RESULTSData 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.CONCLUSIONThe 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.

AB - 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 METHODSRelevant 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.RESULTSData 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.CONCLUSIONThe 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.

U2 - 10.2337/dc12-0438

DO - 10.2337/dc12-0438

M3 - Journal article

C2 - 22837371

VL - 35

SP - 2215

EP - 2225

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -