Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the TEDDY Study.

Lönnrot, Maria; Lynch, Kristian F; Rewers, Marian; Lernmark, Åke; Vehik, Kendra; Akolkar, Beena; Hagopian, William; Krischer, Jeffrey; McIndoe, Rickhard A; Toppari, Jorma; Ziegler, Anette-G; Petrosino, Joseph F; Lloyd, Richard; Hyöty, Heikki

doi:10.2337/dc23-0518

2023

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Titel:: Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the TEDDY Study.
Dokumenttyp:: Article; Journal Article; Research Support, N.I.H., Extramural
Autor(en):: Lönnrot, Maria; Lynch, Kristian F; Rewers, Marian; Lernmark, Åke; Vehik, Kendra; Akolkar, Beena; Hagopian, William; Krischer, Jeffrey; McIndoe, Rickhard A; Toppari, Jorma; Ziegler, Anette-G; Petrosino, Joseph F; Lloyd, Richard; Hyöty, Heikki
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 <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.
Zeitschriftentitel:: Diabetes Care
Jahr:: 2023
Band / Volume:: 46
Heft / Issue:: 11
Seitenangaben Beitrag:: 1908-1915
Volltext / DOI:: doi:10.2337/dc23-0518
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/37607456
Print-ISSN:: 0149-5992
TUM Einrichtung:: Klinik und Poliklinik für Kinder- und Jugendmedizin (Prof. Hauer)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Kinder- und Jugendmedizin (Prof. Hauer)2023