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. 2021 Aug 11:8:720041.
doi: 10.3389/fnut.2021.720041. eCollection 2021.

25(OH)D Levels in Infancy Is Associated With Celiac Disease Autoimmunity in At-Risk Children: A Case-Control Study

Carin Andrén Aronsson  1 , Xiang Liu  2 , Jill M Norris  3 , Ulla Uusitalo  2 , Martha D Butterworth  2 , Sibylle Koletzko  4   5 , Suvi M Virtanen  6   7   8 , Iris Erlund  9 , Kalle Kurppa  10   11   12   13 , William A Hagopian  14 , Marian J Rewers  15 , Jin-Xiong She  16 , Jorma Toppari  17   18 , Anette-G Ziegler  19 , Beena Akolkar  20 , Jeffrey P Krischer  2 , Daniel Agardh  1
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25(OH)D Levels in Infancy Is Associated With Celiac Disease Autoimmunity in At-Risk Children: A Case-Control Study

Carin Andrén Aronsson et al. Front Nutr. .

Abstract

Objectives: An observed variation in the risk of celiac disease, according to the season of birth, suggests that vitamin D may affect the development of the disease. The aim of this study was to investigate if vitamin D concentration is associated with the risk of celiac disease autoimmunity (CDA) in genetically at-risk children. Study Design: Children prospectively followed in the multinational The Environmental Determinants of Diabetes in the Young study, conducted at six centers in Europe and the US, were selected for a 1-to-3 nested case-control study. In total, 281 case-control sets were identified. CDA was defined as positivity for tissue transglutaminase autoantibodies (tTGA) on two or more consecutive visits. Vitamin D was measured as 25-hydroxyvitamin D [25(OH)D] concentrations in all plasma samples prior to, and including, the first tTGA positive visit. Conditional logistic regression was used to examine the association between 25(OH)D and risk of CDA. Results: No significant association was seen between 25(OH)D concentrations (per 5 nmol/L increase) and risk for CDA development during early infancy (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.95-1.04) or childhood (OR 1.02, 95% CI 0.97-1.07). When categorizing 25(OH)D concentrations, there was an increased risk of CDA with 25(OH)D concentrations <30 nmol/L (OR 2.23, 95% CI 1.29, 3.84) and >75 nmol/L (OR 2.10, 95% CI 1.28-3.44) in early infancy, as compared with 50-75 nmol/L. Conclusion: This study indicates that 25(OH)D concentrations <30 nmol/L and >75 nmol/L during early infancy were associated with an increased risk of developing CDA in genetically at-risk children. The non-linear relationship raises the need for more studies on the possible role of 25(OH)D in the relation to celiac disease onset.

Keywords: TEDDY; celiac disease; celiac disease autoimmunity; children; infants; vitamin D.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The estimated effect [solid line, with pointwise standard error (dashed lines)] of 25(OH)D concentration in early infancy on the log hazard of CDA from conditional logistic regression analysis with smoothing splines (p = 0.014 for non-linearity).
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