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Identification of a distinct phenotype of elderly latent autoimmune diabetes in adults: LADA China Study 8
Author(s) -
Niu Xiaohong,
Luo Shuoming,
Li Xia,
Xie Zhiguo,
Xiang Yufei,
Huang Gan,
Lin Jian,
Yang Lin,
Liu Zhenqi,
Wang Xiangbing,
Leslie R. David,
Zhou Zhiguang
Publication year - 2019
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3068
Subject(s) - medicine , insulin resistance , autoimmune diabetes , diabetes mellitus , autoantibody , type 2 diabetes , human leukocyte antigen , insulin , immunology , type 1 diabetes , endocrinology , antibody , antigen
Background Latent autoimmune diabetes in adults (LADA) exhibits significant clinical heterogeneity, but the underlying causes remain unclear. The aim of this study was to investigate whether age of onset of LADA contributes to the observed clinical heterogeneity by comparing the clinical, metabolic, and immunogenetic characteristics between elderly and young LADA patients. Methods The cross‐sectional study included a total of 579 patients with LADA which was further divided into elderly LADA (E‐LADA) group (n = 135, age of onset ≥60 years) and young LADA (Y‐LADA) group (n = 444, age of onset <60 years). Age‐matched subjects with type 2 diabetes were served as control (E‐T2D group, n = 622). Clinical characteristics, serum autoantibodies, and HLA‐DQ haplotypes were compared among these groups. Results Compared with patients with Y‐LADA, patients with E‐LADA have better residual beta‐cell function and higher level of insulin resistance (both P < .01), more metabolic syndrome characteristics, similar proportion of islet autoantibody positivity, and strikingly different HLA‐DQ genetic background. In comparison with E‐T2D patients, E‐LADA patients tend to have similar metabolic syndrome prevalence, comparable C‐peptide levels, and insulin resistance levels and share similar HLA‐DQ genetic characteristics. Conclusions Elderly LADA differs phenotypically and genetically from Y‐LADA but has a clinical and genetic profile more similar to that of E‐T2D. These distinct phenotypes could potentially help physicians better manage patients with E‐LADA.