Department of Internal Medicine, Division of Endocrinology and Metabolism, Soonchunhyang University School of Medicine, # 108 Jung-Dong, Wonmi-Ku, Kyunggi-Do, Bucheon, 110-746, Republic of Korea.
Acta Diabetol. 2013 Apr;50(2):129-34. doi: 10.1007/s00592-010-0228-y. Epub 2010 Oct 16.
Few studies were performed to evaluate the prevalence of latent autoimmune diabetes in adults (LADA) and the difference of chronic complications between LADA, T1DM, and T2DM in Korean. The aim of this study is to establish the prevalence of LADA in a diabetic clinic of Soonchunhyang University hospital and to compare the phenotypic characteristics according to DM classification based on positivity of glutamic acid decarboxylase antibodies (GADA). Also, another important point concerns the occurrence of diabetes chronic microvascular complications in LADA. 323 patients who were checked GADA among diabetic patients admitted at Soonchunhyang University hospital were recruited. Twenty-eight patients (8.7%) were identified as positive for GADA. 11.5% (n = 37) were diagnosed with T1DM and 5.3% (n = 17) were diagnosed with LADA. GADA titer showed significant negative correlation with age of onset, total cholesterol (TC), triglyceride (TG), fasting C-peptide, stimulated C-peptide, BMI, and positive correlation with HbA1C and HDL-C. Compared with those that tested negative for GADA, patients with GADA positive had lower values of onset age, BMI, TC, TG, LDL-C, fasting, and stimulated C-peptide levels and higher values of HbA1C. A significant gradual increase of values was observed for the onset age, BMI, SBP, DBP, fasting, and stimulated C-peptide across the T1DM, LADA, and T2DM subgroups. Concerning the chronic complications there was no difference in prevalence of retinopathy, neuropathy and nephropathy between three groups. Of LADA patients, 12 patients were receiving insulin treatment and mean time to insulin initiation was about 37 months. In conclusion, because our study suggests LADA subgroups in Korea appear to have a faster decline in C-peptide levels, it is worth detecting the patients with LADA early and effort to preserve beta cell function. Furthermore, our results showed that the prevalence of microvascular complication was comparable between the subgroups.
这项研究的目的是确定在顺天乡大学医院的糖尿病诊所中 LADA 的患病率，并根据谷氨酸脱羧酶抗体 (GADA) 的阳性率比较基于 DM 分类的表型特征。另一个重要的问题是 LADA 患者糖尿病慢性微血管并发症的发生情况。在顺天乡大学医院就诊的糖尿病患者中，有 323 名患者接受了 GADA 检查，其中 28 名（8.7%）GADA 阳性。11.5%（n=37）被诊断为 1 型糖尿病，5.3%（n=17）被诊断为 LADA。GADA 滴度与发病年龄、总胆固醇（TC）、甘油三酯（TG）、空腹 C 肽、刺激 C 肽、BMI 呈显著负相关，与 HbA1C 和 HDL-C 呈显著正相关。与 GADA 阴性患者相比，GADA 阳性患者的发病年龄、BMI、TC、TG、LDL-C、空腹和刺激 C 肽水平较低，HbA1C 水平较高。随着 T1DM、LADA 和 T2DM 亚组的进展，发病年龄、BMI、SBP、DBP、空腹和刺激 C 肽的数值呈显著逐渐增加趋势。关于慢性并发症，三组之间视网膜病变、神经病变和肾病的患病率无差异。在 LADA 患者中，12 名患者正在接受胰岛素治疗，开始胰岛素治疗的平均时间约为 37 个月。总之，由于我们的研究表明韩国的 LADA 亚组似乎 C 肽水平下降更快，因此值得早期检测 LADA 患者，并努力保护β细胞功能。此外，我们的结果表明，各亚组之间微血管并发症的患病率相当。
