Enterovirus RNA in Blood Is Linked to the Development of Type 1 Diabetes

  1. Heikki Hyöty1,9
  1. 1Department of Virology, Medical School, University of Tampere, Tampere, Finland;
  2. 2School of Public Health, University of Tampere, Tampere, Finland;
  3. 3Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland;
  4. 4Immunogenetics Laboratory, University of Turku, Turku, Finland;
  5. 5Department of Pediatrics, University of Oulu, Oulu, Finland;
  6. 6Department of Pediatrics, University of Turku, Turku, Finland;
  7. 7Department of Pediatrics, Tampere University Hospital, Tampere, Finland;
  8. 8Hospital for Children and Adolescents and Folkhälsan Research Center, University of Helsinki, Helsinki, Finland;
  9. 9Department of Clinical Microbiology, Centre of Laboratory Medicine, Tampere University Hospital, Tampere, Finland.
  1. Corresponding author: Sami Oikarinen, sami.oikarinen{at}


OBJECTIVE To assess whether the detection of enterovirus RNA in blood predicts the development of clinical type 1 diabetes in a prospective birth cohort study. Further, to study the role of enteroviruses in both the initiation of the process and the progression to type 1 diabetes.

RESEARCH DESIGN AND METHODS This was a nested case-control study where all case children (N = 38) have progressed to clinical type 1 diabetes. Nondiabetic control children (N = 140) were pairwise matched for sex, date of birth, hospital district, and HLA-DQ–conferred genetic susceptibility to type 1 diabetes. Serum samples, drawn at 3- to 12-month intervals, were screened for enterovirus RNA using RT-PCR.

RESULTS Enterovirus RNA–positive samples were more frequent among the case subjects than among the control subjects. A total of 5.1% of the samples (17 of 333) in the case group were enterovirus RNA–positive compared with 1.9% of the samples (19 of 993) in the control group (P < 0.01). The strongest risk for type 1 diabetes was related to enterovirus RNA positivity during the 6-month period preceding the first autoantibody-positive sample (odds ratio 7.7 [95% CI 1.9–31.5]). This risk effect was stronger in boys than in girls.

CONCLUSIONS The present study supports the hypothesis that enteroviruses play a role in the pathogenesis of type 1 diabetes, especially in the initiation of the β-cell damaging process. The enterovirus-associated risk for type 1 diabetes may be stronger in boys than in girls.


  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

  • Received March 2, 2010.
  • Accepted September 25, 2010.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.

Articles citing this article

| Table of Contents

This Article

  1. Diabetes vol. 60 no. 1 276-279
  1. All Versions of this Article:
    1. db10-0186v1
    2. 60/1/276 most recent