揭示成人隐匿性自身免疫性糖尿病：苏丹苏丹港2型糖尿病患者中的患病率及特征

UNVEILING LADA: PREVALENCE AND CHARACTERISTICS AMONG TYPE 2 DIABETIC PATIENTS IN PORT SUDAN, SUDAN.

作者信息

Elebaid A, Khalid M, Saeed A, Osman H, Mostafa A, Abdelmola A, Ali E, Algarni A, Ismail M, Mahagoub M, Abdalhabib E, Abdelhadi M, Khudoykulova F, Alfeel A, Ismail M

机构信息

1Faculty of Medical Laboratory Sciences, Clinical Chemistry Department, Shendi University, Sudan.

2Faculty of Medical and Health Sciences, Liwa University, Abu Dhabi, UAE.

出版信息

Georgian Med News. 2025 May(362):122-128.

PMID:40737658

Abstract

BACKGROUND

The intermediate type of diabetes, known as latent autoimmune diabetes in adults (LADA), has traits in common with both type 1 and type 2 diabetic mellitus (T2DM). Initial insulin independence leads to misdiagnosis of type 2 diabetes.

AIM

This study sought to ascertain the prevalence and features of LADA in patients with type 2 diabetes in Port Sudan, Sudan.

METHODS

A comparative cross-sectional study was conducted from April 2020 to January 2024 at the Osman Degna Hospital and Ahmed Hassan Diabetic Center, Port Sudan. A total of 250 T2DM patients were recruited: 150 insulin-requiring patients after years of diagnosis (study group) and 100 non-insulin-requiring patients (control group). Structured interviews were used to gather demographic and clinical information, and a fully automated chemiluminescence immunoassay (CLIA) was used to quantify the blood levels of C-peptide, GAD-65A (glutamic acid decarboxylase 65 autoantibody), and IA-2A (Insulinoma-Associated Protein 2 Autoantibody) autoantibodies. SPSS version 26 was used for statistical analysis, and p<0.05 was chosen as the significance level.

RESULTS

10.7% of patients with type 2 diabetes had LADA. Compared to the non-LADA group (1.47±0.04 ng/ml, p<0.0001), the C-peptide levels in the LADA group were significantly lower (0.50±0.18 ng/ml). Compared to non-LADA patients, GAD-65A and IA-2A autoantibody titers were higher in LADA patients (p<0.0001). Patients with LADA had lower waist circumferences (79.62±15.42 cm vs. 92.55±17.24 cm, p<0.0001) and BMIs (Body Mass Index) (21.02±4.21 kg/m2 vs. 24.02±3.48 kg/m2, p<0.0001). Furthermore, 68.75% of patients with LADA had a first-degree family history of diabetes, compared to 50% of non-LADA patients.

CONCLUSION

LADA is underdiagnosed, with a prevalence of 10.7% among T2DM Sudanese patients. GAD-65A autoantibodies are the most sensitive biomarker. For prompt diagnosis and treatment, early screening is recommended.

摘要

背景

糖尿病的中间类型，即成人隐匿性自身免疫性糖尿病（LADA），具有1型和2型糖尿病（T2DM）的共同特征。初始阶段胰岛素非依赖会导致2型糖尿病的误诊。

目的

本研究旨在确定苏丹苏丹港2型糖尿病患者中LADA的患病率和特征。

方法

2020年4月至2024年1月在苏丹港的奥斯曼·德格纳医院和艾哈迈德·哈桑糖尿病中心进行了一项比较性横断面研究。共招募了250例T2DM患者：150例诊断多年后需要胰岛素治疗的患者（研究组）和100例不需要胰岛素治疗的患者（对照组）。采用结构化访谈收集人口统计学和临床信息，并使用全自动化学发光免疫分析（CLIA）定量检测C肽、GAD-65A（谷氨酸脱羧酶65自身抗体）和IA-2A（胰岛瘤相关蛋白2自身抗体）自身抗体的血液水平。使用SPSS 26版进行统计分析，选择p<0.05作为显著性水平。

结果

2型糖尿病患者中10.7%患有LADA。与非LADA组相比（1.47±0.04 ng/ml，p<0.0001），LADA组的C肽水平显著降低（0.50±0.18 ng/ml）。与非LADA患者相比，LADA患者的GAD-65A和IA-2A自身抗体滴度更高（p<0.0001）。LADA患者的腰围（79.62±15.42 cm对92.55±17.24 cm，p<0.0001）和体重指数（BMI）（21.02±4.21 kg/m²对24.02±3.48 kg/m²，p<0.0001）更低。此外，68.75%的LADA患者有糖尿病一级家族史，而非LADA患者为50%。