Ethnic Differences in the Incidence of Childhood IDDM in Israel (1965–1993): Marked increase since 1985, especially in Yemenite Jews

Shamis, Igor; Gordon, Olivia French; Albag, Y; Goldsand, G.; Laron, Zvi

doi:10.2337/diacare.20.4.504

Cited by 42 publications

(27 citation statements)

References 15 publications

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“…These studies have shown that there are wide variations in incidence between geographical areas or population groups. In recent years a marked increase in the incidence of childhood T1DM has been reported from many countries [Bingley and Gale, 1989;Joner and Sovik, 1989;Nystrom et al, 1990;Soltesz et al, 1990;Tuomilehto-Wolf and Akerblom, 1991;Schober et al, 1995;Shamis et al, 1997]. The highest incidences were found in Finland, Sardinia and the Yemenite Jews in Israel, and the lowest ones in the Far East.…”

Section: Initiation Of the Autoimmune Process Of Type 1 Diabetes Begimentioning

confidence: 97%

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

Laron

2002

Am. J. Med. Genet.

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The fast increase in the incidence of childhood type 1 diabetes mellitus (T1DM) that cannot be explained by changes in the genetic susceptibility, led us to look for environmental causes. To test the hypothesis that the initiation of the autoimmune process of childhood T1DM in genetically susceptible subjects begins in the perinatal period by a viral infection, we studied the seasonal variations in the month of birth of several cohorts of patients compared to the general population. Population groups with high or low T1DM incidence were analyzed separately by t-test and the Cosinor methods. In areas with populations with a high incidence (Israeli Jews, Sicily, Sardinia, Slovenia, Germany) we found that the children (in Sicily also young adults) who subsequently developed T1DM, have a higher incidence of births in the summer months than in other seasons of the year, a mirror image of the seasonality of the clinical onset of disease. This pattern differed significantly from the seasonality of the total live births in the same populations. In populations with a low T1DM incidence, (China, Japan and Cuba) no seasonality of month of birth was found. Similar findings have been reported, from five counties in the U.K. and the Netherlands. It is hypothesized that mothers who become pregnant during the period of yearly viral epidemics transmit to the fetus, either a virus or antiviral antibodies, which determine whether an autoimmune process against the pancreatic beta is initiated or whether the fetus is protected against that process.

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Section: Initiation Of the Autoimmune Process Of Type 1 Diabetes Begimentioning

confidence: 97%

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

Laron

2002

Am. J. Med. Genet.

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“…For example, the incidence in the Nordic countries (Finland, Sweden, and Norway) is 2-4 times higher than that in Estonia (3,4,13,14) and 2-3 times higher than that in Iceland (15). Large interethnic differences in the incidence rates between Jewish and Arab populations have been reported in Israel (16). Geographical variation in incidence appears to reflect the global distribution of major ethnic populations, which demonstrates a different degree of genetic susceptibility to diabetes among populations.…”

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confidence: 99%

Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group.

Karvonen¹,

Viik-Kajander²,

Moltchanova³

et al. 2000

Diabetes Care

870

437

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OBJECTIVE: To investigate and monitor the patterns in incidence of childhood type 1 diabetes worldwide. RESEARCH DESIGN AND METHODS: The incidence of type 1 diabetes (per 100,000 per year) from 1990 to 1994 was determined in children < or =14 years of age from 100 centers in 50 countries. A total of 19,164 cases were diagnosed in study populations totaling 75.1 million children. The annual incidence rates were calculated per 100,000 population. RESULTS: The overall age-adjusted incidence of type 1 diabetes varied from 0.1/100,000 per year in China and Venezuela to 36.8/100,000 per year in Sardinia and 36.5/100,000 per year in Finland. This represents a >350-fold variation in the incidence among the 100 populations worldwide. The global pattern of variation in incidence was evaluated by arbitrarily grouping the populations with a very low (<1/100,000 per year), a low (1-4.99/100,000 per year), an intermediate (5-9.99/100,000 per year), a high (10-19.99/100,000 per year), and a very high (> or =20/100,000 per year) incidence. Of the European populations, 18 of 39 had an intermediate incidence, and the remainder had a high or very high incidence. A very high incidence (> or =20/ 100,000 per year) was found in Sardinia, Finland, Sweden, Norway Portugal, the U.K., Canada, and New Zealand. The lowest incidence (<1/100,000 per year) was found in the populations from China and South America. In most populations, the incidence increased with age and was the highest among children 10-14 years of age. CONCLUSIONS: The range of global variation in the incidence of childhood type 1 diabetes is even larger than previously described. The earlier reported polar-equatorial gradient in the incidence does not seem to be as strong as previously assumed, but the variation seems to follow ethnic and racial distribution in the world population.

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“…There is, however, a notable variation among Israel's different ethnic groups, which has been attributed to differences in genetic or environmental factors (7). Among these groups, the Yemenites are unique, having the highest incidence of type 1 diabetes (18.5/100,000) compared with the overall Jewish population (5.7/100,000) (8).…”

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confidence: 99%

Type 1 Diabetes Environmental Factors and Correspondence Analysis of HLA Class II Genes in the Yemenite Jewish Community in Israel

et al. 2001

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OBJECTIVE -The Israeli Yemenite Jewish community has displayed an exceptionally rapid increase in the frequency of type 1 diabetes, having the highest rate of all Israeli ethnic groups. We studied the role of the environment, in relation to the nature and frequency of HLA class II genes, to evaluate its possible involvement in the development of diabetes.RESEARCH DESIGN AND METHODS -We interviewed 196 elderly Yemenite women, who had immigrated to Israel as adults, in programmed encounters about signs and symptoms of type 1 diabetes, infant feeding customs, and infectious diseases in Yemen. We also performed HLA oligotyping of DRB1, DQA1, and DQB1 genes in 120 unrelated Yemenite Jews, including 44 type 1 diabetic patients and 76 healthy control subjects, and used these data in correspondence analysis comparing Yemenites with different Israeli ethnic groups.RESULTS -Interviews indicated that early exposure to cow's milk was very common in Yemen. However, none of the women could recall classical presentations of diabetes. HLA oligotyping showed that gene frequencies of non-Asp-57 (of the HLA-DQB chain) in the patients (0.94) and control subjects (0.6) were similar to those of other populations with a known high incidence of type 1 diabetes. Correspondence analysis revealed that Yemenite Jews are genetically distinct from other ethnic groups in Israel.CONCLUSIONS -The genetic distinctiveness of Yemenite Jews may explain their unusually high incidence of type 1 diabetes in Israel. Despite the presence of highly susceptible diabetogenic HLA class II genes in this community, early exposure to cow's milk did not cause phenotypic expression of diabetes in Yemen. This finding suggests that in this population, either cow's milk does not play a crucial role in triggering diabetes, or environmentally conferred protection, such as frequent infectious disease in Yemen, was dominant. Diabetes Care 24:650 -653, 2001

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Ethnic Differences in the Incidence of Childhood IDDM in Israel (1965–1993): Marked increase since 1985, especially in Yemenite Jews

Cited by 42 publications

References 15 publications

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group.

Type 1 Diabetes Environmental Factors and Correspondence Analysis of HLA Class II Genes in the Yemenite Jewish Community in Israel

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