Serologic Evidence of an Association between Enteroviruses and the Onset of Type 1 Diabetes Mellitus

Serum was collected from 128 patients ⩽18 years of age admitted to the Children's Hospital of Pittsburgh with new-onset insulin-dependent diabetes mellitus (IDDM) and from 120 control-patients who were frequency-matched to case-patients for age, sex, and date of bleed. Serum was tested for IgM against 14 enterovirus serotypes: coxsackieviruses B1–B6 and A9, echoviruses 4, 6, 9, 11, 30, and 34, and enterovirus 71. Case-children 13–18 years of age were more likely than control-patients to be IgM-positive for 9 of 14 serotypes (P ⩽ .05 for each). In contrast, case-children 10–12 years of age and 1–9 years of age were each more likely than age-matched control-children to be IgM positive for 1 serotype (P ⩽ .05 for each). In addition, the association between IgM positivity and IDDM occurred earlier in girls than in boys. These data support an association between IDDM and enterovirus IgM positivity in older children.