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. 2011 Jan;60(1):276-9.
doi: 10.2337/db10-0186. Epub 2010 Oct 13.

Enterovirus RNA in blood is linked to the development of type 1 diabetes

Sami Oikarinen  1 , Mika Martiskainen, Sisko Tauriainen, Heini Huhtala, Jorma Ilonen, Riitta Veijola, Olli Simell, Mikael Knip, Heikki Hyöty
Affiliations

Enterovirus RNA in blood is linked to the development of type 1 diabetes

Sami Oikarinen et al. Diabetes. 2011 Jan.

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.

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Figures

FIG. 1.
FIG. 1.
Enterovirus (EV) RNA positivity in serum samples during different stages of the diabetic disease process. 6 month period prior AAb, 6-month time window before autoantibody seroconversion; Aab-T1D, period from autoantibody seroconversion to diagnosis of type 1 diabetes; birth-before 6 month period prior Aab, time from birth to 6 months before the seroconversion to positivity for the first autoantibody; birth-T1D, time from birth to diagnosis of type 1 diabetes. A: the whole cohort. B: boys. C: girls. ■, case children; □, control children. The differences between case and control children were tested using conditional logistic regression analysis (P values shown).
FIG. 2.
FIG. 2.
Age of the first detection of enterovirus (EV) RNA (A) and autoantibodies (B) in serum. ■, case children; □, control children.
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