title: Relationship between the incidence of type 1 diabetes and maternal enterovirus antibodies: time trends and geographical variation.
abstract: OBJECTIVE
  We have previously observed an inverse correlation between the incidence of type 1 diabetes and enterovirus infections in the background population. The aim of this study was to analyse whether maternal enterovirus antibody status, which reflects both the frequency of enterovirus infections and the protection conferred by the mother on the offspring, also correlates with the incidence of type 1 diabetes.
  
  
  METHODS
  Maternal enterovirus antibodies were analysed from serum samples taken from pregnant women between 1983 and 2001 in Finland and Sweden using enzyme immunoassay and neutralisation assays. Comparable samples were also taken between 1999 and 2001 in countries with a lower incidence of diabetes (Estonia, Germany, Hungary, Israel, Lithuania, Russia).
  
  
  RESULTS
  A clear decrease was observed in maternal enterovirus antibody levels over the past 20 years (p<0.0001). The frequency of enterovirus antibodies was higher in countries with a low or intermediate incidence of type 1 diabetes compared with high-incidence countries (p<0.0001).
  
  
  CONCLUSIONS
  These findings are in line with our previous observations supporting the hypothesis that a low frequency of enterovirus infection in the background population increases the susceptibility of young children to the diabetogenic effect of enteroviruses.
authors.affiliation: JDRF Center for Prevention of Type 1 Diabetes in Finland, Finland. hanna.viskari@uta.fi
authors.forename: H
authors.initials: H
authors.lastname: Viskari
authors.forename: J
authors.initials: J
authors.lastname: Ludvigsson
authors.forename: R
authors.initials: R
authors.lastname: Uibo
authors.forename: L
authors.initials: L
authors.lastname: Salur
authors.forename: D
authors.initials: D
authors.lastname: Marciulionyte
authors.forename: R
authors.initials: R
authors.lastname: Hermann
authors.forename: G
authors.initials: G
authors.lastname: Soltesz
authors.forename: M
authors.initials: M
authors.lastname: Füchtenbusch
authors.forename: A-G
authors.initials: AG
authors.lastname: Ziegler
authors.forename: A
authors.initials: A
authors.lastname: Kondrashova
authors.forename: A
authors.initials: A
authors.lastname: Romanov
authors.forename: B
authors.initials: B
authors.lastname: Kaplan
authors.forename: Z
authors.initials: Z
authors.lastname: Laron
authors.forename: P
authors.initials: P
authors.lastname: Koskela
authors.forename: T
authors.initials: T
authors.lastname: Vesikari
authors.forename: H
authors.initials: H
authors.lastname: Huhtala
authors.forename: M
authors.initials: M
authors.lastname: Knip
authors.forename: H
authors.initials: H
authors.lastname: Hyöty
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D004770:Enterovirus / Q000276:immunology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005843:Geography; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D009500:Neutralization Tests; D011247:Pregnancy; D013548:Sweden / Q000453:epidemiology; D010948:Viral Plaque Assay
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G