title: The Swedish childhood diabetes study. Vaccinations and infections as risk determinants for diabetes in childhood.
abstract: In a nationwide incident case referent study we have evaluated vaccinations, early and recent infections and the use of medicines as possible risk determinants for Type 1 (insulin-dependent) diabetes mellitus in childhood. A total of 339 recently onset diabetic and 528 referent children, age 0-14 years, were included. Information about infections was collected from a mailed questionnaire and about vaccinations from childhood health care centres and schools. When vaccinations were considered as possible risk factors for diabetes, a significant decrease in relative risk estimated as odds ratio (OR) was noted for measles vaccination (OR = 0.69; 95% confidence limits 0.48-0.98). For vaccination against tuberculosis, smallpox, tetanus, whooping cough, rubella and mumps no significant effect on OR for diabetes was found. The odds ratios for Type 1 diabetes for children exposed to 0.1-2 or over 2 infections during the last year before diagnosis of diabetes revealed a linear increase (OR = 1.0, 1.96 and 2.55 for 0, 1-2 and over 2 infections, respectively). The trend was still significant when standardized for possible confounders such as age and sex of the children, maternal age and education and intake of antibiotics and analgetics. In conclusion, a protective effect of measles vaccination for Type 1 diabetes in childhood is indicated as well as a possible causal relationship between the onset of the disease and the total load of recent infections.
authors.affiliation: Department of Paediatrics, Karolinska Institute, Sachs' Children's Hospital, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Blom
authors.forename: L
authors.initials: L
authors.lastname: Nyström
authors.forename: G
authors.initials: G
authors.lastname: Dahlquist
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000150:complications*; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007114:Immunization; D007223:Infant; D011336:Probability; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden