Enterovirus RNA in Blood Is Linked to the Development of Type 1 Diabetes

Author:

Oikarinen Sami1,Martiskainen Mika1,Tauriainen Sisko1,Huhtala Heini2,Ilonen Jorma34,Veijola Riitta5,Simell Olli6,Knip Mikael78,Hyöty Heikki19

Affiliation:

1. Department of Virology, Medical School, University of Tampere, Tampere, Finland;

2. School of Public Health, University of Tampere, Tampere, Finland;

3. Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland;

4. Immunogenetics Laboratory, University of Turku, Turku, Finland;

5. Department of Pediatrics, University of Oulu, Oulu, Finland;

6. Department of Pediatrics, University of Turku, Turku, Finland;

7. Department of Pediatrics, Tampere University Hospital, Tampere, Finland;

8. Hospital for Children and Adolescents and Folkhälsan Research Center, University of Helsinki, Helsinki, Finland;

9. Department of Clinical Microbiology, Centre of Laboratory Medicine, Tampere University Hospital, Tampere, Finland.

Abstract

OBJECTIVE To assess whether the detection of enterovirus RNA in blood predicts the development of clinical type 1 diabetes in a prospective birth cohort study. Further, to study the role of enteroviruses in both the initiation of the process and the progression to type 1 diabetes. RESEARCH DESIGN AND METHODS This was a nested case-control study where all case children (N = 38) have progressed to clinical type 1 diabetes. Nondiabetic control children (N = 140) were pairwise matched for sex, date of birth, hospital district, and HLA-DQ–conferred genetic susceptibility to type 1 diabetes. Serum samples, drawn at 3- to 12-month intervals, were screened for enterovirus RNA using RT-PCR. RESULTS Enterovirus RNA–positive samples were more frequent among the case subjects than among the control subjects. A total of 5.1% of the samples (17 of 333) in the case group were enterovirus RNA–positive compared with 1.9% of the samples (19 of 993) in the control group (P < 0.01). The strongest risk for type 1 diabetes was related to enterovirus RNA positivity during the 6-month period preceding the first autoantibody-positive sample (odds ratio 7.7 [95% CI 1.9–31.5]). This risk effect was stronger in boys than in girls. CONCLUSIONS The present study supports the hypothesis that enteroviruses play a role in the pathogenesis of type 1 diabetes, especially in the initiation of the β-cell damaging process. The enterovirus-associated risk for type 1 diabetes may be stronger in boys than in girls.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference25 articles.

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