Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the The Environmental Determinants of Diabetes in the Young (TEDDY) Study
Authors' conclusion
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.
Study context
- Population
- Children in The Environmental Determinants of Diabetes in the Young (TEDDY) cohort
- Participants
- 7,867 children
- Comparison
- Gastrointestinal infection episodes vs none, by age at report
- Outcome
- IAA or GADA as the first-appearing islet autoantibody
- Follow-up
- 10-year follow-up
Methodological details10-year follow-up, nested case-control stool virome analysis
- 10-year follow-up
- Nested case-control stool virome analysis
Main finding
As reported in the abstract
IAA or GADA as first-appearing autoantibody
- GIE reports at <1 year of age and IAA risk at 2-4 years of age, OR
- 2.17 (1.39-3.39) (95% CI)
- Norwalk viruses in stool at <1 year of age and IAA risk at 2-4 years of age, OR
- 5.69 (1.36-23.7) (95% CI)
- Gastrointestinal infection episodes (GIEs) at age 1 to <2 years and lower IAA risk up to 10 years of age, OR
- 0.48 (0.35-0.68) (95% CI)
- GIE observed 12-23 months prior and IAA risk, OR
- 2.04 (1.41-2.96) (95% CI)
- GIEs <6 months prior to autoantibody development and GADA risk, children <4 years, OR
- 2.16 (1.54-3.02) (95% CI)
Observational data: associations, not effects.
Original publication
Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the TEDDY Study. Diabetes Care. Published 22 August 2023. doi:10.
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