Background: Viruses, which trigger and promote islet cell destruction, cause type 1 diabetes mellitus (T1DM). However, the existence of a cause-and-effect relationship is under debate. The aim of this study was to investigate sero-epidemiological and molecular evidence of enteroviruses and respiratory viruses in patients with newly diagnosed T1DM during cold season.
Methods: This study included 40 children with newly diagnosed T1DM and 30 healthy children during a year. Children were studied for coxsackievirus B4 (CVB4) RNA and screened in serum for IgM antibodies to a number of viruses including enteroviruses and respiratory viruses. The seasons of diagnosis were classified into autumn-winter and spring-summer. The months of diagnosis were separated in terms of cold, moderate, or warm temperature.
Results: The following percentages of IgM antibodies against the most common viruses were detected in the patients: Influenza B (IVB) (70%), echovirus 7 (ECHO7) (45%), parainfluenza virus 4 (PIV4) (40%), coxsackievirus A7 (CAV7) (27.5%), H3N2 (22.5%). Compared with the control group, these viruses had a significant association with T1DM (P=0.000, P=0.000, P=0.035, P=0.003, P=0.023, respectively). coxsackievirus B4 RNA was not detected in any serum. A total of 75% and 95% patients were diagnosed with T1DM in autumn-winter and cold or moderate months, respectively.
Conclusion: Our study demonstrates significant association of T1DM with seropositivity for IgM antibodies against IVB, ECHO7, PIV4, CAV7, and H3N2, and the majority of newly diagnosed T1DM appeared in autumn-winter, suggesting that enteroviruses and respiratory viruses, in addition to seasonal variation could play a role in the etiopathogenesis and clinical onset of T1DM.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology