Study Links Enterovirus in Kids to T1D

Published: Oct 20, 2014
By Kristina Fiore, Staff Writer, MedPage Today



Enterovirus infection may be tied to the development of type 1 diabetes, Taiwanese researchers found.

In a retrospective analysis of national insurance data, children younger than age 18 who had been infected with enterovirus were 48% more likely to develop type 1 diabetes, Tsai- Chung Li, MD, of China Medical University in Taiwan, and colleagues reported online in Diabetologia.

The results "suggest that a preventive strategy, such as an effective vaccine against enterovirus infection, may lessen the incidence of type 1 diabetes in Taiwan," the researchers wrote.

It's well known that type 1 diabetes is caused by a complex interaction between genetic susceptibility, the immune system, and environmental factors. Genetic predisposition to type 1 diabetes has been elucidated, Chung-Li and colleagues said, but environmental triggers are less understood.

It's become important to investigate that aspect because type 1 diabetes incidence has grown, and genetic factors alone don't explain the rise, they said.

Some work has suggested that infection with enterovirus -- which includes Coxsackievirus A, Coxsackievirus B, and echovirus -- may play a role.

They looked at data from Taiwan's national health insurance system from 2000-2007.

During that time, a total of 570,133 children had an enterovirus infection, and the researchers matched them with 570,133 controls who didn't have an infection over that time period.

They found that the overall incidence of type 1 diabetes was higher in kids who'd been infected by enterovirus (5.73 versus 3.89 per 100,000), for an incidence rate ratio 1.48 of among infected children (95% CI 1.19 to 1.83).

Adjusted analyses showed that enterovirus infection and older age were associated with a higher risk of type 1 diabetes.

Specifically, kids who were older than age 10 had an increased risk of type 1 diabetes (HR 2.18, 95% CI 1.18 to 4.04).

There was no relationship, however, between type 1 diabetes and either allergic rhinitis or bronchial asthma.

Chung-Li and colleagues noted that The Environmental Determinants of Diabetes in the Young (TEDDY) study is ongoing and aims to determine how environmental factors influence the onset of type 1 diabetes in susceptible patients. It has already shown, for instance, that Coxsackievirus B1 is associated with an increased risk of type 1 diabetes in Finland.

Although the researchers acknowledged that type 1 diabetes clearly involved a "major genetic component," they said their observational findings are "solid enough to guide further research on this association."

The study was supported by the Bureau of National Health Insurance and the Taiwain Ministry of Health Welfare Clinical Trial and Research Center of Excellence.

The authors disclosed no relevant relationships with industry.

http://www.medpagetoday.com/Endocrin...Diabetes/48153