A1 Refereed original research article in a scientific journal
Metabolic determinants of torque teno virus load across the diabetes spectrum: insights from a cross-sectional analysis; 
Authors: Spezia, Pietro Giorgio; Cappelli, Simone; Minosse, Claudia; Focosi, Daniele; Parenti, Martina; Brunetti, Michela; Gliozzo, Giulia; Ciccarelli, Gea; Carciero, Lorenzo; Di Giuseppe, Gianfranco; Sancho-Bornez, Veronica; Novazzi, Federica; Rebelos, Eleni; Nuutila, Pirjo; Honka, Miikka-Juhani; Tura, Andrea; Dardano, Angela; Mezza, Teresa; Maggi, Fabrizio; Daniele, Giuseppe
Publisher: Springer Science and Business Media LLC
Publication year: 2026
Journal: Scientific Reports
Article number: 16119
Volume: 16
eISSN: 2045-2322
DOI: https://doi.org/10.1038/s41598-026-47810-1
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://doi.org/10.1038/s41598-026-47810-1
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/522980372
Self-archived copy's licence: CC BY NC ND
Self-archived copy's version: Publisher`s PDF
Torquetenovirus (TTV) is a ubiquitous non-pathogenic DNA virus whose replication mirrors immune competence. We profiled TTV viremia (TTVv) across type 1 diabetes (T1D), type 2 diabetes (T2D), and non-diabetes (ND) controls and assessed clinical associations. Cross-sectional, multicentre analysis of 485 individuals (T2D n. 277; T1D n. 61; ND n. 147). Plasma TTV-DNA was quantified by real-time PCR. Clinical/metabolic variables were harmonized across cohorts. Associations with TTVv were tested with uni- and multivariable models adjusting for age, sex, body mass index (BMI), glycated haemoglobin (HbA1c), and antidiabetic therapies. TTVv was detectable in 74.4%, with higher prevalence in T2D (79.0%) and T1D (73.8%) versus ND (69.0%). Age was an independent predictor. In T2D, unlike T1D, TTVv correlated negatively with BMI and HbA1c; those with poor control (HbA1c ≥ 8%) had significantly lower TTVv. Dipeptidyl peptidase-4 inhibitors (DPP-IVi) were independently associated with both TTVv presence and higher titers. Among T2D, individuals with TTVv < 4.0 log copies/ml were more often obese, female, and less frequently treated with DPP-IVi. TTVv is more prevalent and higher in diabetes, yet lower with poor glycaemic control and obesity, suggesting a directionality paradox. TTVv may index immunometabolic balance in diabetes; longitudinal and mechanistic studies are warranted.
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Funding information in the publication:
This study was supported by funds allocated to the National Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS, 00149, Rome (Italy), from the Italian Ministry of Health (Programme CCM 2020 Ricerca Corrente—Linea 1 on emerging and re-emerging infections).
