Enteroviruses and risk of islet autoimmunity or type 1 diabetes: systematic review and meta-analysis of controlled observational studies detecting viral nucleic acids and proteins
Authors' conclusion
These findings highlight the association between enteroviruses and islet autoimmunity or type 1 diabetes. Our data strengthen the rationale for vaccine development targeting diabetogenic enterovirus types, particularly those within Enterovirus B. Prospective studies of early life are needed to elucidate the role of enterovirus timing, type, and infection duration on the initiation of islet autoimmunity and the progression to type 1 diabetes.
Study context
- Population
- Cohort or case-control studies detecting enterovirus RNA or protein in individuals with islet autoimmunity or T1D; pregnancy and other types of diabetes excluded; PubMed and Embase to Jan 1, 2023
- Participants
- 12,077 participants60 studies
- Comparison
- Enterovirus detection vs no detection
- Casesn = 5,981
- Controlsn = 6,096reference
- Outcome
- Association between enteroviruses and islet autoimmunity or T1D
Methodological detailsrandom effects models, Mantel-Haenszel odds ratios, Study quality assessed with Newcastle-Ottawa Scale and NHMRC levels of evidence
- Random effects models
- Mantel-Haenszel odds ratios
- Study quality assessed with Newcastle-Ottawa Scale and NHMRC levels of evidence
Pooled result
As reported in the abstract
EnterovirusEstimate (95% CI)P value
n=18 studies; I2=63%
OR (islet autoimmunity) 2.1(1.3–3.3)
P = 0.002n=48 studies; I2=85%
OR (T1D) 8.0(4.9–13.0)
P < 0.0001n=28 studies; I2=69%
OR (within 1 month of T1D) 16.2(8.6–30.5)
P < 0.0001Further pooled results
Multiple or consecutive enteroviruses and islet autoimmunity
| OR (95% CI) | P value | ||
|---|---|---|---|
| Multiple or consecutive enterovirusesn=8 studies | 2.0 (1.0–4.0) | P = 0.050 | |
| 0.20.5125Odds ratio (log scale) |
Enterovirus B and T1D
| OR (95% CI) | P value | ||
|---|---|---|---|
| Enterovirus Bn=15 studies | 12.7 (4.1–39.1) | P < 0.0001 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Enteroviruses and risk of islet autoimmunity or type 1 diabetes: systematic review and meta-analysis of controlled observational studies detecting viral nucleic acids and proteins. Lancet Diabetes Endocrinol. Published 27 June 2023. doi:10.
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