Suvi M Virtanen1, Hanna-Mari Takkinen2, Bright I Nwaru3, Minna Kaila4, Suvi Ahonen5, Jaakko Nevalainen6, Sari Niinistö7, Heli Siljander8, Olli Simell9, Jorma Ilonen10, Heikki Hyöty11, Riitta Veijola12, Mikael Knip13. 1. The National Institute for Health and Welfare, Nutrition Unit, Helsinki, Finland2Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland3The Science Center of Pirkanmaa Hospital District, Tampere, Finland4. 2. The National Institute for Health and Welfare, Nutrition Unit, Helsinki, Finland4School of Health Sciences, University of Tampere, Tampere, Finland. 3. School of Health Sciences, University of Tampere, Tampere, Finland. 4. Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland5University of Helsinki, Hjelt Institute, Helsinki, Finland. 5. The National Institute for Health and Welfare, Nutrition Unit, Helsinki, Finland3The Science Center of Pirkanmaa Hospital District, Tampere, Finland4School of Health Sciences, University of Tampere, Tampere, Finland. 6. Department of Statistics, Faculty of Mathematics and Natural Sciences, University of Turku, Turku, Finland. 7. The National Institute for Health and Welfare, Nutrition Unit, Helsinki, Finland. 8. Children's Hospital, University of Helsinki, and University Central Hospital, Helsinki, Finland8University of Helsinki, Diabetes and Obesity Research Program, Helsinki, Finland. 9. Department of Pediatrics, Faculty of Medicine, University of Turku, Turku, Finland. 10. Immunogenetics Laboratory, University of Turku, Turku, Finland11Department of Clinical Microbiology, Faculty of Health Sciences, University of Eastern Finland, Kuopio. 11. School of Medicine, University of Tampere, Tampere, Finland. 12. Department of Pediatrics, University of Oulu, Oulu, Finland. 13. Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland7Children's Hospital, University of Helsinki, and University Central Hospital, Helsinki, Finland8University of Helsinki, Diabetes and Obesity Research.
Abstract
IMPORTANCE: The role of microbial exposure during early life in the development of type 1 diabetes mellitus is unclear. OBJECTIVE: To investigate whether animal contact and other microbial exposures during infancy are associated with the development of preclinical and clinical type 1 diabetes. DESIGN, SETTING, AND PARTICIPANTS: A birth cohort of children with HLA antigen-DQB1-conferred susceptibility to type 1 diabetes was examined. Participants included 3143 consecutively born children at 2 hospitals in Finland between 1996 and 2004. EXPOSURES: The following exposures during the first year of life were assessed: indoor and outdoor dogs and cats, farm animals, farming, visit to a stable, day care, and exposure to antibiotics during the first week of life. MAIN OUTCOMES AND MEASURES: Clinical and preclinical type 1 diabetes were used as outcomes. The latter was defined as repeated positivity for islet-cell antibodies plus for at least 1 of 3 other diabetes-associated autoantibodies analyzed and/or clinical type 1 diabetes. The autoantibodies were analyzed at 3- to 12-month intervals since the birth of the child. RESULTS: Children exposed to an indoor dog, compared with otherwise similar children without an indoor dog exposure, had a reduced odds of developing preclinical type 1 diabetes (adjusted odds ratio [OR], 0.47; 95% CI, 0.28-0.80; P = .005) and clinical type 1 diabetes (adjusted OR, 0.40; 95% CI, 0.14-1.14; P = .08). All of the other microbial exposures studied were not associated with preclinical or clinical diabetes: the odds ratios ranged from 0.74 to 1.58. CONCLUSIONS AND RELEVANCE: Among the 9 early microbial exposures studied, only the indoor dog exposure during the first year of life was inversely associated with the development of preclinical type 1 diabetes. This finding needs to be confirmed in other populations.
IMPORTANCE: The role of microbial exposure during early life in the development of type 1 diabetes mellitus is unclear. OBJECTIVE: To investigate whether animal contact and other microbial exposures during infancy are associated with the development of preclinical and clinical type 1 diabetes. DESIGN, SETTING, AND PARTICIPANTS: A birth cohort of children with HLA antigen-DQB1-conferred susceptibility to type 1 diabetes was examined. Participants included 3143 consecutively born children at 2 hospitals in Finland between 1996 and 2004. EXPOSURES: The following exposures during the first year of life were assessed: indoor and outdoor dogs and cats, farm animals, farming, visit to a stable, day care, and exposure to antibiotics during the first week of life. MAIN OUTCOMES AND MEASURES: Clinical and preclinical type 1 diabetes were used as outcomes. The latter was defined as repeated positivity for islet-cell antibodies plus for at least 1 of 3 other diabetes-associated autoantibodies analyzed and/or clinical type 1 diabetes. The autoantibodies were analyzed at 3- to 12-month intervals since the birth of the child. RESULTS:Children exposed to an indoor dog, compared with otherwise similar children without an indoor dog exposure, had a reduced odds of developing preclinical type 1 diabetes (adjusted odds ratio [OR], 0.47; 95% CI, 0.28-0.80; P = .005) and clinical type 1 diabetes (adjusted OR, 0.40; 95% CI, 0.14-1.14; P = .08). All of the other microbial exposures studied were not associated with preclinical or clinical diabetes: the odds ratios ranged from 0.74 to 1.58. CONCLUSIONS AND RELEVANCE: Among the 9 early microbial exposures studied, only the indoor dog exposure during the first year of life was inversely associated with the development of preclinical type 1 diabetes. This finding needs to be confirmed in other populations.
Authors: Jutta E Laiho; Olli H Laitinen; Johannes Malkamäki; Leena Puustinen; Aki Sinkkonen; Juha Pärkkä; Heikki Hyöty Journal: Environ Epidemiol Date: 2022-06-08
Authors: Kaisa M Kemppainen; Kendra Vehik; Kristian F Lynch; Helena Elding Larsson; Ronald J Canepa; Ville Simell; Sibylle Koletzko; Edwin Liu; Olli G Simell; Jorma Toppari; Anette G Ziegler; Marian J Rewers; Åke Lernmark; William A Hagopian; Jin-Xiong She; Beena Akolkar; Desmond A Schatz; Mark A Atkinson; Martin J Blaser; Jeffrey P Krischer; Heikki Hyöty; Daniel Agardh; Eric W Triplett Journal: JAMA Pediatr Date: 2017-12-01 Impact factor: 16.193
Authors: Noora Nurminen; Damiano Cerrone; Jussi Lehtonen; Anirudra Parajuli; Marja Roslund; Maria Lönnrot; Jorma Ilonen; Jorma Toppari; Riitta Veijola; Mikael Knip; Juho Rajaniemi; Olli H Laitinen; Aki Sinkkonen; Heikki Hyöty Journal: Diabetes Care Date: 2021-05-05 Impact factor: 19.112
Authors: Hasinika K A H Gamage; Sasha G Tetu; Raymond W W Chong; John Ashton; Nicolle H Packer; Ian T Paulsen Journal: Sci Rep Date: 2017-10-30 Impact factor: 4.379