Could the aetiology of IDDM be multifactorial?

Haverkos, Harry W.

doi:10.1007/s001250050813

Cited by 24 publications

(10 citation statements)

References 51 publications

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“…These potential confounders warrant more detailed consideration in future research. There may also be interaction between some of these environmental exposures, for example, infection and nutritional factors (Haverkos 1997). However, it is not possible to determine such interactions in ecologic analyses, as there is a lack of data on joint environmental exposures at the individual level (Ponsonby et al 2002).…”

Section: Resultsmentioning

confidence: 99%

Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence.

Staples

Ponsonby

Lim

et al. 2003

Environ Health Perspect

157

104

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The apparent immune-suppressive effect of ultraviolet radiation (UVR) has suggested that this environmental exposure may influence the development of immune-related disorders. Self-reported prevalence rates of type 1 diabetes mellitus, rheumatoid arthritis (RA), eczema/dermatitis, and asthma, from the 1995 Australian National Health Survey, were therefore examined by latitude and ambient level of UVR. A positive association of type 1 diabetes mellitus prevalence was found with both increasing southern latitude of residence (r = 0.77; p = 0.026) and decreasing regional annual ambient UVR (r = -0.80; p = 0.018); a 3-fold increase in prevalence from the northernmost region to the southernmost region was evident. In contrast, asthma correlated negatively with latitude (r = -0.72; p = 0.046), although the change in asthma prevalence from the north to the south of Australia was only 0.7-fold. For both RA and eczema/dermatitis, there were no statistically significant associations between latitude/UVR and disease prevalence. These ecologic data provide some support for a previously proposed beneficial effect of UVR on T-helper 1-mediated autoimmune disorders such as type 1 diabetes. The inverse association of type 1 diabetes prevalence with UVR is consistent with that previously reported for another autoimmune disease, multiple sclerosis, in Australia, and also with type 1 diabetes latitudinal gradients in the Northern Hemisphere. The finding also accords with photoimmunologic evidence of UVR-induced immunosuppression and may suggest a beneficial effect of UVR in reducing the incidence of such autoimmune conditions. In light of this study, analytic epidemiologic studies investigating risk of immune disorders in relation to personal UVR exposure in humans are required.

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Section: Resultsmentioning

confidence: 99%

Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence.

Staples

Ponsonby

Lim

et al. 2003

Environ Health Perspect

157

104

View full text Add to dashboard Cite

show abstract

“…Case-control studies applying food frequency questionnaires show both negative [an Australian study (19)] and positive [a Swedish study (16)] effects of intake of foods with high nitrosamine content. In the Swedish study (16), intake of food rich in nitrosamines and intake of food rich in nitrate and nitrite were associated with increased incidence of type 1 diabetes, whereas a Finnish study showed an effect of intake of nitrite-but not of nitratein food, but no effect of intake of nitrate and nitrite via drinking water (18 (31,32). As an example, a 10-fold increase in risk was observed in the Swedish study (17) when combining a variable measuring infectious disease with the frequency of food consumption containing nitrosamines.…”

Section: Discussionmentioning

confidence: 96%

Does the Risk of Childhood Diabetes Mellitus Require Revision of the Guideline Values for Nitrate in Drinking Water?

Maanen¹,

Albering²,

Kok³

et al. 2000

Environmental Health Perspectives

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In recent years, several studies have addressed a possible relationship benteen nitrate exposure and childhood type 1 insulin-dependent diabetes meilitus. The present ecologic study describes a possible relation between the incidence of type 1 diabetes and nitrate levels in drinking water in The Netherlands, and evaluates whether the World Health Organization and the European Commission stndard for nitrate in drinking water (50 mg/L) is adequate to prevent risk of this disease. During 1993During -1995 Even though experimental data raise serious concern about the formation of Nnitroso compounds and carcinogenic risk, the epidemiologic evidence for an association between the intake of nitrate and cancer is regarded to be insufficient. Therefore, the World Health Organization (WHO) guideline value for nitrate in drinking water (50 mg/L nitrate units as nitrate ion) was established solely to prevent methemoglobinemia (6). In the European Union, the maximum admissible nitrate level in drinking water was also set at 50 mg/L (A). In a recent review on the role of drinking water nitrate as a cause of infantile methemoglobinemia (7), it was concluded that the standard of 50 mg/L might be unnecessarily strict and that gastrointestinal infection and inflammation and the ensuing overproduction of nitric oxide may be the cause of infantile methemoglobinemia attributed to drinking water nitrate (8). In our view, however, rather than raising the standard of nitrate to levels > 50 mg/L, other adverse health effects of nitrate exposure should be taken into consideration. We suggest that the present drinking water guideline value for nitrate of 50 mg/L needs to be reconsidered for multiple reasons. Even though the guideline value is aimed at the protection of infants as the highest risk group against methemoglobinemia, cases of methemoglobinemia as a result of exposure to nitrate in drinking water < 50 mg/L have been reported (59. In a previous study (1), we observed increased hprt variant frequencies in lymphocyte DNA of subjects who used private well water with nitrate levels below the guideline value of 50 mg/L as drinking water. Also, formation of the carcinogenic N-nitrosodimethylamine was observed during uptake of nitrate at the acceptable daily intake level-corresponding with the standard of nitrate in drinking water-in combination with nitrosatable

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“…The influence of early infant nutrition as well as that of the later childhood diet in the pathogenesis of Type I diabetes should be assessed in extensive prospective cohort studies starting from birth. Also, the possible role of other environmental factors, their interactions and their relations to genetic predisposition [30,31] remain to be defined.…”

Section: Discussionmentioning

confidence: 99%

Short-term exclusive breastfeeding predisposes young children with increased genetic risk of Type I diabetes to progressive beta-cell autoimmunity

et al. 2001

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Could the aetiology of IDDM be multifactorial?

Cited by 24 publications

References 51 publications

Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence.

Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence.

Does the Risk of Childhood Diabetes Mellitus Require Revision of the Guideline Values for Nitrate in Drinking Water?

Short-term exclusive breastfeeding predisposes young children with increased genetic risk of Type I diabetes to progressive beta-cell autoimmunity

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