Alterations in Serum Micronutrient Concentrations in North Indian Children with New-onset Type 1 Diabetes: A Case–Control Study

A BSTRACT Background: Micronutrient disturbances have long been postulated to play an etiological role in diabetes. However, data on alterations in serum micronutrient concentrations in children with type 1 diabetes (T1D) remain scarce. Materials and methods: Serum concentrations of micronutrients (trace elements and vitamins) in children with newly diagnosed T1D were measured using standard laboratory methods. Sixty-seven children with T1D aged 1–12 years and 60 near-age- and sex-matched controls were enrolled. Results: The mean age of cases and controls was similar (7.1 ± 3.1 vs. 6.7 ± 3.0, P = 0.43). The median duration of diabetes at enrollment was 8 days (interquartile range: 4.7–27.2). Compared to controls, cases had lower manganese (2.51 ± 0.64 vs. 1.96 ± 0.48 μg/dL, P < 0.001) and higher selenium (7.68 ± 2.5 vs. 12.80 ± 17.30 μg/dL, P < 0.001) concentrations. The mean concentrations of chromium, iron, cobalt, copper, and zinc were similar in cases and controls. All measured water-soluble vitamins (thiamine, riboflavin, pantothenic acid, biotin, and folate) except Vitamin B12 and fat-soluble vitamins (A, D, and E) were lower in cases. In conclusion, the serum concentrations of several micronutrients were altered at the onset of T1D in children. Conclusions: The micronutrient disturbances at the onset of pediatric T1D may reflect the hyperglycemic state or suggest a causative role of micronutrient deficiency or excess as one of the several environmental triggers of T1D. Larger studies, especially during the presymptomatic phase, are needed to further elucidate the role of micronutrients in the onset of T1D in children.