Ipadeola Arinola, Adeleye Jokotade O, Akinlade Kehinde S
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Prim Care Diabetes. 2015 Jun;9(3):231-6. doi: 10.1016/j.pcd.2014.09.003. Epub 2014 Oct 11.
The aim was to investigate the frequency and characteristics of persons with latent autoimmune diabetes in adults (LADA) amongst patients who had been clinically diagnosed as type 2 diabetes mellitus (CT2DM) in a tertiary care centre.
One hundred and sixty patients with CT2DM participated in this cross-sectional study following selection by systematic random sampling. Demographic data, relevant clinical history and anthropometric measurements (weight, height, waist circumference and hip circumference) were taken and blood samples were obtained for analysis of fasting blood glucose, glycated haemoglobin (HbA1c) and glutamic acid decarboxylase antibodies (GADA). The results were analysed using SPSS version 16.
Nineteen (11.9%) out of 160 persons with CT2DM were positive for GADA. 95(59.4%) of the total study population were females. The mean (SD) age, BMI, waist circumference, were 60.49 (10.37) years, 26.47 (4.80) kg/m2, 92.16 (11.50)cm respectively. Subjects with CT2DM who were GADA positive had trend towards lower mean BMI (25.64 kg/m2 vs. 26.59 kg/m2) and waist circumference (89.80 kg/m2 vs. 92.47 kg/m2) than GADA negative subjects. GADA positive subjects also had a trend showing higher mean fasting blood glucose (144 mg/dl vs. 125 mg/dl, t=2.20, p=0.14), higher mean HbA1c (7% vs. 6.1%, t=3.19, p=0.077) and a higher proportion on insulin (31.6% vs. 22%, χ2=0.07, p=0.25) when compared with GADA negative patients.
The prevalence of LADA amongst a subset of Nigerians with CT2DM was 11.9%. There were no distinguishing clinical features to help characterize persons with LADA. The above finding emphasizes the importance of GADA testing for appropriate classification of persons with CT2DM. Early diagnosis of LADA would help direct appropriate therapy to optimize glycaemic control.
本研究旨在调查在一家三级医疗中心临床诊断为2型糖尿病（CT2DM）的患者中成人隐匿性自身免疫性糖尿病（LADA）患者的频率及特征。
通过系统随机抽样选取160例CT2DM患者参与本横断面研究。记录人口统计学数据、相关临床病史及人体测量数据（体重、身高、腰围和臀围），采集血样以分析空腹血糖、糖化血红蛋白（HbA1c）和谷氨酸脱羧酶抗体（GADA）。结果采用SPSS 16.0软件进行分析。
160例CT2DM患者中19例（11.9%）GADA呈阳性。研究总人群中95例（59.4%）为女性。平均（标准差）年龄、体重指数、腰围分别为60.49（10.37）岁、26.47（4.80）kg/m²、92.16（11.50）cm。与GADA阴性的CT2DM患者相比，GADA阳性患者的平均体重指数（25.64 kg/m²对26.59 kg/m²）和腰围（89.80 kg/m²对92.47 kg/m²）有降低趋势。与GADA阴性患者相比，GADA阳性患者的平均空腹血糖也有升高趋势（144 mg/dl对125 mg/dl，t = 2.20，p = 0.14），平均HbA1c更高（7%对6.1%，t = 3.19，p = 0.077），使用胰岛素的比例更高（31.6%对22%，χ² = 0.07，p = 0.25）。
在一部分尼日利亚CT2DM患者中LADA的患病率为11.9%。没有可用于区分LADA患者的临床特征。上述发现强调了GADA检测对CT2DM患者进行恰当分类的重要性。LADA的早期诊断有助于指导恰当治疗以优化血糖控制。
