Al-Zubairi Thekra, Al-Habori Molham, Saif-Ali Riyadh
Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen.
Diabetes Metab Syndr Obes. 2021 Oct 13;14:4223-4232. doi: 10.2147/DMSO.S332416. eCollection 2021.
Although there is ample data about the prevalence of diabetes in the Middle East, little is known about the prevalence and features of autoimmune diabetes in this region. The aim of this study was to investigate the prevalence and metabolic characteristics of latent autoimmune diabetes in adults (LADA) amongst Yemeni Type 2 DM patients.
In this cross-section study, 270 Type 2 DM patients aged 30-70 years were recruited from the National Diabetes Center, Al-Thowra Hospital, Sana'a city, during the period November 2015 to August 2016. All Type 2 DM patients were diagnosed within 5 years and who did not require insulin for a minimum of 6 months following diagnosis. Levels of glutamic acid decarboxylase autoantibodies (GADA) were measured in all patients, and LADA was diagnosed in patients testing positive for anti-GAD antibodies. Further, biochemical analysis was carried out including fasting blood glucose (FBG), glycated haemoglobin (HbA1c), insulin, and lipid profile. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were calculated.
The prevalence of LADA, as defined by GADA-positive, amongst patient with Type 2 DM was 4.4%; with no significant difference in the prevalence between male (5.8%) and female (3.4%). LADA patients were younger than GADA-negative Type 2 DM. Body mass index, waist circumference, insulin and HOMA-β were significantly lower in LADA patients, whereas triglyceride, cholesterol, HDL-c and HOMA-IR were non-significantly lower with respect to Type 2 DM. In contrast, FBG and HbA1c were significantly higher in LADA patients. Moreover, the prevalence of metabolic syndrome was significantly lower in LADA as compared with Type 2 DM. Only 2 out of the 12 GADA-positive (16.7%) were on insulin treatment at the time of the study.
The prevalence of LADA in Yemeni Type 2 DM is lower than many of those reported in the literature, with no gender preference. Metabolic syndrome was significantly lower in LADA patients. Patients with LADA share insulin resistance with Type 2 DM but display a more severe defect in β-cell function, thus highlighting the importance of an early diagnosis of LADA, to correctly treat LADA patients, allowing safe and effective therapies.
尽管有大量关于中东地区糖尿病患病率的数据，但对于该地区自身免疫性糖尿病的患病率和特征却知之甚少。本研究的目的是调查也门2型糖尿病患者中成人隐匿性自身免疫性糖尿病（LADA）的患病率和代谢特征。
在这项横断面研究中，2015年11月至2016年8月期间，从萨那市的Al-Thowra医院国家糖尿病中心招募了270名年龄在30至70岁之间的2型糖尿病患者。所有2型糖尿病患者均在5年内确诊，且确诊后至少6个月内不需要胰岛素治疗。对所有患者检测谷氨酸脱羧酶自身抗体（GADA）水平，抗GAD抗体检测呈阳性的患者被诊断为LADA。此外，进行了生化分析，包括空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胰岛素和血脂谱。计算胰岛素抵抗（HOMA-IR）和β细胞功能（HOMA-β）。
在2型糖尿病患者中，GADA阳性定义的LADA患病率为4.4%；男性（5.8%）和女性（3.4%）的患病率无显著差异。LADA患者比GADA阴性的2型糖尿病患者年轻。LADA患者的体重指数、腰围、胰岛素和HOMA-β显著较低，而甘油三酯、胆固醇、高密度脂蛋白胆固醇和HOMA-IR相对于2型糖尿病患者无显著降低。相比之下，LADA患者的FBG和HbA1c显著较高。此外，与2型糖尿病相比，LADA患者代谢综合征的患病率显著较低。在研究时，12名GADA阳性患者中只有2名（16.7%）接受胰岛素治疗。
也门2型糖尿病患者中LADA的患病率低于文献报道的许多地区，且无性别差异。LADA患者的代谢综合征显著较低。LADA患者与2型糖尿病患者一样存在胰岛素抵抗，但β细胞功能缺陷更为严重，因此强调了早期诊断LADA的重要性，以便正确治疗LADA患者，实现安全有效的治疗。
