Muazu Salisu Babura, Okpe Innocent, Anumah Felicia
Department of Medicine, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Department of Medicine, College of Medicine, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
Ann Afr Med. 2016 Oct-Dec;15(4):163-170. doi: 10.4103/1596-3519.194277.
Latent autoimmune diabetes in adult (LADA) is a form of Type 1 diabetes mellitus (T1DM) that occurs in adult or with advancing age. It commonly occurs in people aged ≥30 years and is characterized by initial response to oral hypoglycemic agents, lean body mass, and presence of glutamic acid decarboxylase autoantibody (GAD-Ab). It exhibits rapid deterioration of the pancreatic β-cells secretory function due to the destructive action of the autoantibodies. The prevalence of LADA among T2DM patients varies among population due to different diagnostic criteria, patients' characteristics, the assay used, and genetic predisposition. In this study, we intend to document prevalence and clinical characteristics of LADA subset patients in Northern Nigeria.
Two-hundred noninsulin-requiring T2DM patients were recruited from the diabetes clinic based on the selection criteria. Their clinical characteristics were documented, and we measured their serum GAD-Ab, glycated hemoglobin (HbA1c), fasting C-peptide, fasting plasma glucose, and fasting serum lipids. The mean (standard deviation) of these clinical and biochemical parameters was compared between GAD-Ab+ and GAD-Ab- groups. The data were analyzed using SPSS version 20 with P< 0.05 as statistically significant.
The prevalence of LADA among the T2DM patients studied was found to be 10.5% (21/200); there were more males than females (15 [71%]:6 [29%], χ2 = 4.2, P< 0.05). The mean age of the GAD-Ab+ was 52.0 (11.0), and there was no statistical difference with GAD-Ab- group. GAD-Ab+ was found more common in the age group of 40-49 years 10/21 (48%). The body mass index, waist circumference, and serum C-peptide were found to be significantly lower in GAD-Ab+ than in GAD-Ab- group (22.1 [51], 80.1 [12.4], 0.84 [0.05] vs. 27.3 [4.9], 93.2 [10.9], 1.72 [0.43]), P< 0.05. The HbA1c was found to be significantly higher in GAD-Ab+ than in GAD-Ab- (8.3 [1.4] vs. 7.0 [2.1]). Other clinical and metabolic parameters were found not to be significantly different between the two groups.
We conclude that the prevalence of LADA among T2DM patients in Northern Nigeria is 10.5%. It is more common among males aged 40-49 years and lean subjects. The male sex and decreasing central adiposity are predictors of GAD-Ab+ among T2DM subjects.
成人隐匿性自身免疫性糖尿病（LADA）是1型糖尿病（T1DM）的一种形式，发生于成人或随着年龄增长而发病。它通常发生在年龄≥30岁的人群中，其特征为对口服降糖药的初始反应、瘦体重以及存在谷氨酸脱羧酶自身抗体（GAD-Ab）。由于自身抗体的破坏作用，它表现为胰腺β细胞分泌功能的快速恶化。由于诊断标准、患者特征、所使用的检测方法以及遗传易感性不同，T2DM患者中LADA的患病率在不同人群中有所差异。在本研究中，我们旨在记录尼日利亚北部LADA亚组患者的患病率和临床特征。
根据选择标准，从糖尿病诊所招募了200例非胰岛素依赖型T2DM患者。记录他们的临床特征，并检测他们的血清GAD-Ab、糖化血红蛋白（HbA1c）、空腹C肽、空腹血糖和空腹血脂。比较GAD-Ab阳性组和GAD-Ab阴性组这些临床和生化参数的均值（标准差）。使用SPSS 20版进行数据分析，P<0.05为具有统计学意义。
在所研究的T2DM患者中，LADA的患病率为10.5%（21/200）；男性多于女性（15例[71%]：6例[29%]，χ2 = 4.2，P<0.05）。GAD-Ab阳性组的平均年龄为52.0（11.0）岁，与GAD-Ab阴性组无统计学差异。发现GAD-Ab阳性在40-49岁年龄组中更为常见，为10/21（48%）。发现GAD-Ab阳性组的体重指数、腰围和血清C肽显著低于GAD-Ab阴性组（分别为22.1[5.1]、80.1[12.4]、0.84[0.05]与27.3[4.9]、93.2[10.9]、1.72[0.43]），P<0.05。发现GAD-Ab阳性组的HbA1c显著高于GAD-Ab阴性组（8.3[1.4]与
