Evidence map›Paper›PMID 42522919›Full record

ArticleDiabetes/metabolism research and reviews2026

Coxsackievirus B Infections Are Associated With the Risk of Islet Autoimmunity in Children With Strong Genetic Susceptibility to Type 1 Diabetes-Results From the TRIGR Divia Study.

Maarit Oikarinen, Amirbabak Sioofy-Khojine, Leena Puustinen, David Cuthbertson, Jussi Lehtonen, Niila V V Jouppila, Johnny Ludvigsson, Leena Hakola, Sari Niinistö, Iris Erlund and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes/metabolism research and reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Maarit OikarinenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0003-1329-1508
Amirbabak Sioofy-KhojineFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0001-5538-5153
Leena PuustinenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0002-6677-8654
David CuthbertsonHealth Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.ORCID https://orcid.org/0000-0002-3785-9834
Jussi LehtonenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Niila V V JouppilaFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Johnny LudvigssonDepartment of Biomedical and Clinical Sciences, Division of Pediatrics, Crown Princess Victoria Children's Hospital, Linköping University, Linköping, Sweden.ORCID https://orcid.org/0000-0003-1695-5234
Leena HakolaFaculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0001-7115-6035
Sari NiinistöDepartment of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland.
Iris ErlundDepartment of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland.ORCID https://orcid.org/0000-0002-0083-1256
Mikael KnipResearch Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0003-0474-0033
Jeffrey P KrischerHealth Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Suvi M VirtanenFaculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0001-8928-0878
Heikki HyötyFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
TRIGR Investigators

Funding

Trial to Reduce IDDM in the Genetically at Risk StudyU01HD040364 · NICHD · UNIVERSITY OF HELSINKI · PI KNIP, MIKAEL · 2001 to 2015
$32.7M
Trial to Reduce IDDM in the Genetically at Risk: A Nutritional primary preventionU01HD042444 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BECKER, DOROTHY J · 2001 to 2015
$24.4M
Trial to Reduce IDDM in the Genetically at Risk (TRIGR) Data Management UnitU01HD051997 · NICHD · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2006 to 2015
$7.1M
Trial to Reduce IDDM in the Genetically at Risk (TRIGR) Data Management UnitR01HD051997 · NICHD · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2016 to 2018
$2.3M
Effect of early diet and virus infections on immune regulation and the development islet autoimmunity -Trial to Reduce IDDM in the Genetically at Risk (TRIGR)DP3DK106918 · NIDDK · NATIONAL INSTITUTE FOR HEALTH & WELFARE · PI VIRTANEN, SUVI MIRJAMI · 2015 to 2015
$1.1M
CIHRcommission of the european communities QLK1-2002-00372Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentEuropean Foundation for the Study of DiabetesHorizon 2020 Framework Programme 874864 HEDIMEDJDRFNICHD NIH HHS R01 HD051997NICHD NIH HHS U01 HD040364NICHD NIH HHS U01 HD042444NICHD NIH HHS U01 HD051997NIDDK NIH HHS DP3 DK106918NIH HHS 1DP3DK106918-01NIH HHS HD040364NIH HHS HD042444NIH HHS HD051997Päivikki ja Sakari Sohlbergin SäätiöYrjö Jahnssonin Säätiö
6 · The paper itself

Abstract

aimsEspecially, the coxsackievirus B group of enteroviruses has been linked to the development of islet autoimmunity and type 1 diabetes in genetically susceptible individuals. Our aim was to study the possible associations of 10 different microbial infections with islet autoimmunity in a large international prospective study. MATERIALS AND

methodsIn a nested case-control study within the TRIGR study, follow-up serum samples from 240 islet autoantibody-positive case children and 436 age- and country-matched control children were analysed for IgG class antibodies against 10 different respiratory and gastrointestinal microbes using an enzyme immunoassay, and for neutralising antibodies against all six coxsackievirus B types. The samples were obtained at several time points prior to and at the time of seroconversion for multiple islet autoantibodies. All children had a first-degree relative with type 1 diabetes, and they carried risk-associated HLA-DQ alleles.

resultsCoxsackievirus B5 was associated with an increased risk of islet autoimmunity (OR 2.22, 95% CI 1.29-3.80, p = 0.004, corrected p = 0.024), which remained after adjustment for HLA, sex, and maternal type 1 diabetes. This association was particularly seen for infections occurring more than 12 months (OR 2.02, 95% CI 1.06-3.84, p = 0.032) and 0-6 months (OR 2.66, 95% CI 1.11-6.35, p = 0.028) before the first detection of multiple islet autoantibodies. After correction for multiple comparisons, none of the other viruses showed an association with islet autoimmunity.

conclusionsThis study supports previous evidence of the risk association of coxsackievirus B infections. These results support the role of certain virus infections as possible modulating factors in the pathogenesis of type 1 diabetes.

Indexed as

AutoimmunityCoxsackievirus InfectionsDiabetes Mellitus, Type 1Enterovirus B, HumanGenetic Predisposition to DiseaseIslets of LangerhansAdolescentAutoantibodiesCase-Control StudiesChildChild, PreschoolFemaleFollow-Up StudiesHumansInfantMaleAutoantibodiescoxsackieviruscoxsackievirus BenterovirusIgG glass antibodyislet autoimmunitymicrobial infectionneutralising antibodyserologytype 1 diabetesviral infection

Identifiers

PMID42522919
PMCPMC13417744

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.