title: Zinc and Other Metals Deficiencies and Risk of Type 1 Diabetes: An Ecological Study in the High Risk Sardinia Island.
abstract: BACKGROUND
  Type 1 diabetes incidence presents a decreasing gradient in Europe from the Nordic countries to the Mediterranean ones. Exception to this gradient is represented by Sardinia, the second largest Mediterranean island whose population shows the highest incidence in Europe, after Finland. The genetic features of this population have created a fertile ground for the epidemic of the disease, however, as well as being strikingly high, the incidence rate has suddenly presented a continuous increase from the '50s, not explainable by accumulation of new genetic variants. Several environmental factors have been taken into account, possibly interacting with the genetic/epigenetic scenario, but there are no strong evidences to date.
  
  
  METHODS
  The present study investigated the hypothesis that geochemical elements could create permissive environmental conditions for autoimmune diabetes. An ecological analysis was performed to test possible correlations between the values of eight elements in stream sediments and type 1 diabetes incidence rate in Sardinia.
  
  
  RESULTS
  Analyses revealed negative associations between elements, such as Co, Cr, Cu, Mn, Ni, Zn, and type 1 diabetes incidence.
  
  
  CONCLUSIONS
  The results suggest a possible protective role of some elements against the onset of the disease.
authors.affiliation: Department of Civil-Environmental Engineering and Architecture, University of Cagliari, Cagliari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Valera
authors.affiliation: Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Zavattari
authors.affiliation: Department of Civil-Environmental Engineering and Architecture, University of Cagliari, Cagliari, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanna
authors.affiliation: Department of Civil-Environmental Engineering and Architecture, University of Cagliari, Cagliari, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pretti
authors.affiliation: Department of Civil-Environmental Engineering and Architecture, University of Cagliari, Cagliari, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Marcello
authors.affiliation: Centre for the Study of Diabetes Complications and Metabolic Diseases, St. Michele Hospital, Cagliari, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Mannu
authors.affiliation: Centre for the Study of Diabetes Complications and Metabolic Diseases, St. Michele Hospital, Cagliari, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Targhetta
authors.affiliation: Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Bruno
authors.affiliation: Centre for the Study of Diabetes Complications and Metabolic Diseases, St. Michele Hospital, Cagliari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Songini
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D005843:Geography; D019015:Geologic Sediments / Q000737:chemistry; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D062312:Islands; D007558:Italy / Q000453:epidemiology; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D019216:Metals, Heavy / Q000032:analysis* / Q000378:metabolism; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors; D045483:Rivers / Q000737:chemistry; D013054:Spectrophotometry, Atomic; D015032:Zinc / Q000032:analysis* / Q000172:deficiency
chemical_list: D019216:Metals, Heavy; D015032:Zinc