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

Diabetes. 2011 Jan;60(1):276-9. doi: 10.2337/db10-0186. Epub 2010 Oct 13.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / virology*
  • Enterovirus / genetics*
  • Female
  • Finland
  • Genetic Predisposition to Disease
  • HLA Antigens / blood
  • HLA Antigens / genetics
  • HLA-DQ Antigens / genetics
  • Humans
  • Infant
  • Infant, Newborn
  • Insulin Antibodies / blood
  • Insulin-Secreting Cells / pathology
  • Insulin-Secreting Cells / virology
  • Male
  • Predictive Value of Tests
  • RNA, Viral / blood*


  • HLA Antigens
  • HLA-DQ Antigens
  • Insulin Antibodies
  • RNA, Viral