Respiratory infections in early childhood may be a potential risk factor for developing type 1 diabetes mellitus, according to a study.
The incidence of type 1 diabetes is increasing worldwide, although its etiology is not well understood, according to background information in the study, which was published July 1 on the website of JAMA Pediatrics. Infections have been discussed as an important environmental determinant.
Andreas Beyerlein, PhD, from the Institute of Diabetes Research in Munich, and colleagues sought to determine whether early, short-term or cumulative exposures to episodes of infection and fever during the first three years of life were associated with the initiation of persistent islet autoimmunity in children at increased risk for type 1 diabetes mellitus.
Our study identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for the development of T1D, the authors wrote. We also found some evidence for short-term effects of infectious events on development of autoimmunity, while cumulative exposure alone seemed not to be causative.
The study included 148 children at high risk for type 1 diabetes mellitus, with 1,245 documented infectious events during 90,750 person-days during their first three years of life.
According to the results, an increased risk of islet autoantibody seroconversion was associated with respiratory infections during the first six months of life and ages 6 to almost 12 months. During the second year of life, no meaningful associations were detected for any infectious category.
A higher number of respiratory infections in the six months prior to islet autoantibody seroconversion also was associated with an increased risk.
Potential prevention strategies against T1D derived from studies like this might address early vaccination against specific infectious agents, the authors concluded. Unfortunately, we were not able to identify a single infectious agent that might be instrumental in the development of T1D. Our results point to a potential role of infections in the upper respiratory tract and specifically of acute rhinopharyngitis.