Publication Date
11-1-2023
Journal
Diabetes Care
DOI
10.2337/dc23-0518
PMID
37607456
PMCID
PMC10620548
PubMedCentral® Posted Date
8-22-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Child, Humans, Infant, Child, Preschool, Autoantibodies, Diabetes Mellitus, Type 1, Case-Control Studies, Insulin, Insulin Antibodies, Glutamate Decarboxylase, Islets of Langerhans
Abstract
OBJECTIVE: To investigate gastrointestinal infection episodes (GIEs) in relation to the appearance of islet autoantibodies in The Environmental Determinants of Diabetes in the Young (TEDDY) cohort.
RESEARCH DESIGN AND METHODS: GIEs on risk of autoantibodies against either insulin (IAA) or GAD (GADA) as the first-appearing autoantibody were assessed in a 10-year follow-up of 7,867 children. Stool virome was characterized in a nested case-control study.
RESULTS: GIE reports (odds ratio [OR] 2.17 [95% CI 1.39-3.39]) as well as Norwalk viruses found in stool (OR 5.69 [1.36-23.7]) at(OR 0.48 [0.35-0.68]). GIE reports at any other age were associated with an increase in IAA risk (OR 2.04 for IAA when GIE was observed 12-23 months prior [1.41-2.96]). Impacts on GADA risk were limited to GIEs(OR 2.16 [1.54-3.02]).
CONCLUSIONS: Bidirectional associations were observed. GIEs were associated with increased IAA risk when reported before 1 year of age or 12-23 months prior to IAA. Norwalk virus was identified as one possible candidate factor. GIEs reported during the 2nd year of life were associated with a decreased IAA risk.
Included in
Digestive System Diseases Commons, Endocrine System Diseases Commons, Endocrinology, Diabetes, and Metabolism Commons, Gastroenterology Commons, Medical Microbiology Commons, Virology Commons