Department of Epidemiology, Public Health School, Tianjin Medical University, Tianjin, China.
Diabetes Care. 2011 Jan;34(1):66-70. doi: 10.2337/dc10-0488. Epub 2010 Sep 27.
Data on latent autoimmune diabetes in adults (LADA) from population-based studies are sparse. We sought to investigate the prevalence and correlates of LADA.
A total of 8,109 participants, who were aged ≥15 years and living in Tianjin, China, were assessed to identify individuals with type 2 diabetes (American Diabetes Association Criteria, 1997) and further to detect patients with LADA. LADA was ascertained by 1) the presence of type 2 diabetes and age ≥35 years, 2) the lack of a requirement for insulin at least 6 months after the diagnosis of type 2 diabetes, and 3) serum GAD antibody positivity. Data were analyzed using multinomial logistic regression with adjustment for potential confounders.
Of all participants, 498 (6.1%) were patients with type 2 diabetes. Of them, 46 (9.2%) were found to have LADA. The prevalence of LADA was 0.6% (46 of 8,109), and tended to increase with age up to 50-59 years in all participants. The odds ratios (95% CI) of LADA related to hypertension, family history of diabetes, waist-to-hip ratio ≥0.85, and major stressful events were 1.93 (1.02-3.65), 17.59 (9.08-34.06), 5.37 (2.31-12.49), and 4.09 (1.75-9.52), respectively.
The prevalence of LADA is ∼9% in patients with type 2 diabetes. Hypertension, family history of diabetes, central obesity, and major stressful events may be associated with the occurrence of LADA.
基于人群的研究中有关成人隐匿性自身免疫性糖尿病（LADA）的数据很少。我们旨在调查 LADA 的患病率和相关因素。
共有 8109 名年龄≥15 岁、居住在中国天津的参与者接受了评估，以确定患有 2 型糖尿病（1997 年美国糖尿病协会标准）的个体，并进一步发现 LADA 患者。通过以下 3 种方法确定 LADA：1）存在 2 型糖尿病且年龄≥35 岁；2）确诊 2 型糖尿病至少 6 个月后无需使用胰岛素；3）血清谷氨酸脱羧酶抗体阳性。使用多变量逻辑回归分析调整潜在混杂因素后进行数据分析。
所有参与者中，有 498 人（6.1%）患有 2 型糖尿病。其中，有 46 人（9.2%）被诊断为 LADA。LADA 的患病率为 0.6%（46 例/8109 例），在所有参与者中，患病率随年龄增加至 50-59 岁而增加。与高血压、糖尿病家族史、腰臀比≥0.85 和重大压力事件相关的 LADA 的比值比（95%可信区间）分别为 1.93（1.02-3.65）、17.59（9.08-34.06）、5.37（2.31-12.49）和 4.09（1.75-9.52）。
2 型糖尿病患者中 LADA 的患病率约为 9%。高血压、糖尿病家族史、中心性肥胖和重大压力事件可能与 LADA 的发生有关。
