Intake of B vitamins and the risk of developing islet autoimmunity and type 1 diabetes in the TEDDY study
Authors: Hakola Leena , Mramba Lazarus K. , Uusitalo Ulla , Andrén Aronsson Carin , Hummel Sandra , Niinistö Sari , Erlund Iris , Yang Jimin , Rewers Marian J. , Akolkar Beena , McIndoe Richard A. , Rich Stephen S. , Hagopian William A. , Ziegler Anette , Lernmark Åke , Toppari Jorma , Krischer Jeffrey P. , Norris Jill M. , Virtanen Suvi M. ,   The TEDDY Study Group, Rewers Marian , Bautista Kimberly , Baxter Judith , Felipe-Morales Daniel , Frohnert Brigitte I , Stahl Marisa , Garcia Isabel Flores , Gesualdo Patricia , Hays Sierra , Hoffman Michelle , Johnson Randi , Karban Rachel , Liu Edwin , Loaiza Leila , Norris Jill , O’Donnell Holly , Thorndahl Loana , Steck Andrea , Waugh Kathleen , Simell Olli G , Adamsson Annika , Ahonen Suvi , Åkerlund Mari , Anttila Sirpa , Hekkala Anne , Honkanen Tiia , Hurskainen Teija , Hyöty Heikki , Ilonen Jorma , Itoshima Saori , Jokipolvi Minna , Jokipuu Sanna , Karjalainen Taru , Karlsson Leena , Kero Jukka , Korpela Marika , Koskenniemi Jaakko J , Kähönen Miia , Knip Mikael , Koivikko Minna-Liisa , Kokkonen Katja , Koskinen Merja , Koreasalo Mirva , Kurppa Kalle , Kuusela Salla , Kytölä Jarita , Laakso Mia , Laiho Jutta , Latva-aho Tiina , Leisku Siiri , Leppänen Laura , Lindfors Katri , Lönnrot Maria , Mäntymäki Elina , Mattila Markus , Miettinen Maija , Niininen Tiina , Nurminen Noora , Oikarinen Sami , Oinas Hanna-Leena , Ollikainen Paula , Othmani Zhian , Pohjola Sirpa , Raja-Hanhela Solja , Rautanen Jenna , Riikonen Anne , Romo Minna , Rönkä Juulia , Rönkä Nelli , Simell Satu , Tihinen Aino , Tossavainen Päivi , Vähä-Mäkilä Mari , Varjonen Eeva , Veijola Riitta , Viinikangas Irene , Vilmi Silja , Virtanen Suvi M , McIndoe Richard , Schatz Desmond , Hopkins Diane , Haller Michael , Gardiner Melissa , Sharma Ashok , Jacobsen Laura , Gordon Percy , Hosford Jennifer , Maina Sharon , Salmon Chelsea , Ziegler Anette G , Bonifacio Ezio , Gezginci Cigdem , Grätz Willi , Heublein Anja , Knopff Annette , Koletzko Sibylle , Ramminger Claudia , Roth Roswith , Schmidt Jennifer , Scholz Marlon , Stock Joanna , Warncke Katharina , Wendel Lorena , Winkler Christiane , Agardh Daniel , Bennet Rasmus , Cilio Corrado , Dahlberg Susanne , Tsubarah Malin Goldman , Ericson-Hallström Emelie , Fransson Lina , Halilovic Emina , Hyberg Susanne , Jonsdottir Berglind , Karimi Naghmeh , Larsson Helena Elding , Lindström Marielle , Lundgren Markus , Maziarz Marlena , Melin Jessica , Rahmati Kobra , Ramelius Anita , Salami Falastin , Sjöberg Anette , Amboh Evelyn Tekum , Törn Carina , Hagopian William A , Killian Michael , Crouch Claire Cowen , Skidmore Jennifer , Bender Trevor , Llewellyn Megan , McCall Cody , Meyer Arlene , Meyer Jocelyn , Mulenga Denise , Powell Nole , Radtke Jared , Roy Shreya , Tucker Preston , Becker Dorothy , Franciscus Margaret , Smith MaryEllen Dalmagro-Elias , Daftary Ashi , Klein Mary Beth , Yates Chrystal , Krischer Jeffrey P , Adusumali Rajesh , Austin-Gonzalez Sarah , Avendano Maryouri , Baethke Sandra , Burkhardt Brant , Butterworth Martha , Cadigan Nicholas , Clasen Joanna , Counts Kevin , Gandolfo Laura , Garmeson Jennifer , Gowda Veena , Karges Christina , Liu Shu , Liu Xiang , Lynch Kristian , Malloy Jamie , Mramba Lazarus , McCarthy Cristina , Moreno Jose , Parikh Hemang M , Remedios Cassandra , Shaffer Chris , Smith Susan , Sulman Noah , Tamura Roy , Tewey Dena , Thuma Henri , Toth Michael , Vehik Kendra , Vijayakandipan Ponni , Wroble Melissa , Young Kenneth , Yu Liping , Miao Dongmei , Gillespie Kathleen , Chandler Kyla , Pearce Olivia , Stollery Sarah , Balch Elinor , Batholomew Hanah , Hashmi Zahra , Hagopian William , Radtke Jared , Tucker Preston , Briese Thomas , Brusko Todd , Buckner Teresa , Johnson Suzanne Bennett , McKinney Eoin , Pastinen Tomi , Thorsen Steffen Ullitz , Triplett Eric 
Published: February 2024

Abstract
Purpose
The aim was to study the association between dietary intake of B vitamins in childhood and the risk of islet autoimmunity (IA) and progression to type 1 diabetes (T1D) by the age of 10 years.

Methods
We followed 8500 T1D-susceptible children born in the U.S., Finland, Sweden, and Germany in 2004 -2010 from the Environmental Determinants of Diabetes in the Young (TEDDY) study, which is a prospective observational birth cohort. Dietary intake of seven B vitamins was calculated from foods and dietary supplements based on 24-h recall at 3 months and 3-day food records collected regularly from 6 months to 10 years of age. Cox proportional hazard models were adjusted for energy, HLA-genotype, first-degree relative with T1D, sex, and country.

Results
A total of 778 (9.2) children developed at least one autoantibody (any IA), and 335 (3.9%) developed multiple autoantibodies. 280 (3.3%) children had IAA and 319 (3.8%) GADA as the first autoantibody. 344 (44%) children with IA progressed to T1D. We observed that higher intake of niacin was associated with a decreased risk of developing multiple autoantibodies (HR 0.95; 95% CI 0.92, 0.98) per 1 mg/1000 kcal in niacin intake. Higher intake of pyridoxine (HR 0.66; 95% CI 0.46, 0.96) and vitamin B12 (HR 0.87; 95% CI 0.77, 0.97) was associated with a decreased risk of IAA-first autoimmunity. Higher intake of riboflavin (HR 1.38; 95% CI 1.05, 1.80) was associated with an increased risk of GADA-first autoimmunity. There were no associations between any of the B vitamins and the outcomes “any IA” and progression from IA to T1D.

Conclusion
In this multinational, prospective birth cohort of children with genetic susceptibility to T1D, we observed some direct and inverse associations between different B vitamins and risk of IA.