Xiaohong Niu1,2,3, Shuoming Luo1,2, Xia Li1,2, Zhiguo Xie1,2, Yufei Xiang1,2, Gan Huang1,2, Jian Lin1,2, Lin Yang1,2, Zhenqi Liu4, Xiangbing Wang5, R David Leslie6, Zhiguang Zhou1,2. 1. Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, National Clinical Research Center for Metabolic Disease, Changsha, China. 3. Department of Endocrinology, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia, USA. 5. Division of Endocrinology, Metabolism, and Nutrition, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 6. Department of Diabetes and Metabolic Medicine, Blizard Institute, London, UK.
Abstract
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.
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-LADApatients 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.
Authors: Helen C S Meier; Dale P Sandler; Eleanor M Simonsick; Nan-Ping Weng; Christine G Parks Journal: Exp Gerontol Date: 2020-03-05 Impact factor: 4.032
Authors: Olov Rolandsson; Christiane S Hampe; Stephen J Sharp; Eva Ardanaz; Heiner Boeing; Guy Fagherazzi; Francesca Romana Mancini; Peter M Nilsson; Kim Overvad; Maria-Dolores Chirlaque; Miren Dorronsoro; Marc J Gunter; Rudolf Kaaks; Timothy J Key; Kay-Tee Khaw; Vittorio Krogh; Tilman Kühn; Domenico Palli; Salvatore Panico; Carlotta Sacerdote; Maria-José Sánchez; Gianluca Severi; Annemieke M W Spijkerman; Rosario Tumino; Yvonne T van der Schouw; Elio Riboli; Nita G Forouhi; Claudia Langenberg; Nicholas J Wareham Journal: Diabetologia Date: 2019-11-11 Impact factor: 10.122