Association Between Enterovirus Infection and Type 1 Diabetes Risk: A Meta-Analysis of 38 Case-Control Studies

Front Endocrinol (Lausanne). 2021 Sep 7:12:706964. doi: 10.3389/fendo.2021.706964. eCollection 2021.

Abstract

Objective: The association between enterovirus infection and type 1 diabetes (T1D) is controversial, and this meta-analysis aimed to explore the correlation.

Methods: PubMed, Embase, Web of Science, and Cochrane Database were searched from inception to April 2020. Studies were included if they could provide sufficient information to calculate odds ratios and 95% confidence intervals. All analyses were performed using STATA 15.1.

Results: Thirty-eight studies, encompassing 5921 subjects (2841 T1D patients and 3080 controls), were included. The pooled analysis showed that enterovirus infection was associated with T1D (P < 0.001). Enterovirus infection was correlated with T1D in the European (P < 0.001), African (P = 0.002), Asian (P = 0.001), Australian (P = 0.011), and Latin American (P = 0.002) populations, but no conclusion could be reached for North America. The association between enterovirus infection and T1D was detected in blood and tissue samples (both P < 0.001); no association was found in stool samples.

Conclusion: Our findings suggest that enterovirus infection is associated with T1D.

Keywords: case-control studies; enterovirus infection; meta-analysis; odds ratio; type 1 diabetes.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Case-Control Studies
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / virology*
  • Enterovirus / physiology*
  • Enterovirus Infections / complications*
  • Enterovirus Infections / virology
  • Genetic Predisposition to Disease*
  • Humans
  • Prognosis