Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the TEDDY Study.
- Resource Type
- Academic Journal
- Authors
- Lönnrot M; Department of Virology, Faculty of Medicine and Health Technology, Tampere University, and Department of Dermatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.; Lynch KF; Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL.; Rewers M; Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO.; Lernmark Å; Department of Clinical Sciences, Lund University Clinical Research Center, Skåne University Hospital, Malmo, Sweden.; Vehik K; Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL.; Akolkar B; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.; Hagopian W; Pacific Northwest Research Institute, Seattle, WA.; Krischer J; Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL.; McIndoe RA; Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA.; Toppari J; Department of Pediatrics, Turku University Hospital, and Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland.; Ziegler AG; Institute of Diabetes Research, Helmholtz Zentrum München, Neuherberg, Germany.; Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany.; Forschergruppe Diabetes e.V., Neuherberg, Germany.; Petrosino JF; Baylor Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX.; Lloyd R; Baylor Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX.; Hyöty H; Department of Virology, Faculty of Medicine and Health Technology, Tampere University, and Fimlab Laboratories, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
- Source
- Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE
- Subject
- Language
- English
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 <1 year of age were associated with an increased IAA risk at 2-4 years of age. GIEs reported at age 1 to <2 years correlated with a lower risk of IAA up to 10 years of age (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 <6 months prior to autoantibody development in children <4 years of age (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.
(© 2023 by the American Diabetes Association.)