Department of Endocrinology and Metabolism, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey,
Department of Endocrinology and Metabolism, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
Arch Endocrinol Metab. 2021 May 18;64(5):584-590. doi: 10.20945/2359-3997000000268.
In this study, we aimed to determine the frequency of and the clinical and metabolic features of patients with latent autoimmune diabetes in adults (LADA) at a single center in Turkey.
Patients over 30 years of age diagnosed with type 2 diabetes who did not require insulin for a minimum of 6 months following diagnosis were included. Data from 324 patients (163 women; 161 men), with a mean age of 54.97 ± 7.53 years, were analyzed in the study. Levels of antibodies to glutamate decarboxylase (anti-GAD) were measured in all patients, and LADA was diagnosed in patients testing positive for anti-GAD antibodies.
Anti-GAD positivity was identified in 5 patients (1.5%). Family history of diabetes, body mass index (BMI), age, sex distribution, insulin resistance, serum triglycerides, high-density lipoprotein, and low-density lipoprotein were similar in the LADA and type 2 diabetes patients. Median HbA1c was significantly higher (10.8% vs. 7.38%, p = 0.002) and fasting C-peptide was lower (0.75 ng/mL 2.82 ng/mL, p = 0.009) in patients with LADA compared to in those with type 2 diabetes. Among the 5 patients with LADA, 4 were positive for antithyroid peroxidase antibodies. The median disease duration was relatively shorter among patients with LADA (4 years vs. 7 years, p = 0.105).
We observed a LADA frequency of 1.5% among Turkish patients followed for type 2 diabetes. The presence of obesity and metabolic syndrome did not exclude LADA, and patients with LADA had worse glycemic control than patients with type 2 diabetes did.
本研究旨在土耳其的一家中心确定成人隐匿性自身免疫性糖尿病(LADA)患者的频率以及临床和代谢特征。
纳入年龄大于 30 岁且确诊为 2 型糖尿病至少 6 个月后无需胰岛素治疗的患者。共分析了 324 例患者(女性 163 例,男性 161 例)的数据,平均年龄为 54.97±7.53 岁。所有患者均检测谷氨酸脱羧酶(GAD)抗体,阳性患者诊断为 LADA。
5 例(1.5%)患者 GAD 阳性。LADA 组和 2 型糖尿病组的家族糖尿病史、体质指数(BMI)、年龄、性别分布、胰岛素抵抗、血清甘油三酯、高密度脂蛋白和低密度脂蛋白相似。LADA 组患者的中位糖化血红蛋白(HbA1c)明显更高(10.8% vs. 7.38%,p=0.002),空腹 C 肽更低(0.75ng/ml vs. 2.82ng/ml,p=0.009)。5 例 LADA 患者中有 4 例抗甲状腺过氧化物酶抗体阳性。LADA 组患者的中位病程相对较短(4 年 vs. 7 年,p=0.105)。
我们观察到土耳其 2 型糖尿病患者中 LADA 的发病率为 1.5%。肥胖和代谢综合征并不能排除 LADA 的存在,且 LADA 患者的血糖控制比 2 型糖尿病患者差。