Carlsson Sofia
Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Curr Diabetes Rev. 2019;15(3):178-187. doi: 10.2174/1573399814666180716150253.
In order to prevent diabetes it is important to identify common, modifiable risk factors in the population. Such knowledge is extensive for type 2 diabetes but limited for autoimmune forms of diabetes.
This review aims at summarizing the limited literature on potential environmental (lifestyle) risk factors for LADA.
A PubMed search identified 15 papers estimating the risk of LADA in relation to lifestyle. These were based on data from two population-based studies; one Swedish case-control study and one Norwegian cohort study.
Studies published to date indicate that the risk of LADA is associated with factors promoting insulin resistance and type 2 diabetes such as overweight, physical inactivity, smoking, low birth weight, sweetened beverage intake and moderate alcohol consumption (protective). Findings also indicate potential effects on autoimmunity exerted by intake of coffee (harmful) and fatty fish (protective). This supports the concept of LADA as being a hybrid form of diabetes with an etiology including factors associated with both insulin resistance and autoimmunity.
LADA may in part be preventable through the same lifestyle modifications as type 2 diabetes including weight loss, physical activity and smoking cessation. However, current knowledge is hampered by the small number of studies and the fact that they exclusively are based on Scandinavian populations. There is a great need for additional studies exploring the role of lifestyle factors in the development of LADA.
为预防糖尿病，识别普通且可改变的人群风险因素很重要。此类知识在2型糖尿病方面很广泛，但在自身免疫性糖尿病方面有限。
本综述旨在总结关于成人隐匿性自身免疫性糖尿病（LADA）潜在环境（生活方式）风险因素的有限文献。
通过PubMed检索确定了15篇评估LADA与生活方式相关风险的论文。这些论文基于两项基于人群的研究数据；一项瑞典病例对照研究和一项挪威队列研究。
迄今发表的研究表明，LADA的风险与促进胰岛素抵抗和2型糖尿病的因素相关，如超重、缺乏身体活动、吸烟、低出生体重、饮用含糖饮料以及适度饮酒（具有保护作用）。研究结果还表明，摄入咖啡（有害）和富含脂肪的鱼类（具有保护作用）对自身免疫有潜在影响。这支持了LADA是一种混合性糖尿病的概念，其病因包括与胰岛素抵抗和自身免疫相关的因素。
LADA部分可通过与2型糖尿病相同的生活方式改变来预防，包括减肥、体育锻炼和戒烟。然而，目前的知识受到研究数量少以及这些研究仅基于斯堪的纳维亚人群这一事实的限制。非常需要更多研究来探索生活方式因素在LADA发病中的作用。
