Endocrine Abstracts

Introduction

Latent autoimmune diabetes in adults (LADA) is a specific type of diabetes mellitus (DM), the prevalence of which varies from 4% to 14%. Although LADA combines the pathogenetic and clinical features of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM), the latest recommendations of the American Diabetes Association refer it to T1DM (ADA, 2021). Given that this variant of diabetes is also similar to T2DM, the risk of metabolic syndrome (MS) in this category of patients is particularly relevant. At the same time, the existing results of research in this area are quite contradictory. The aim of this study was to determine the prevalence of metabolic syndrome and its components in LADA depending on the phenotype of the underlying disease.

Materials and methods

54 patients with LADA were examined, the comparison group consisted of patients with T1DM (30 patients) and T2DM (45 patients). The average age was 54.7 years. Patients with LADA according to the main phenotypes were divided into 2 groups: LADA 1 (28 individuals) with high antibody titres (≥180 U/ml) to glutamic acid decarboxylase (antiGAD) and LADA 2 (26 individuals) with low antibody titres (18 -180 U/ml). The phenotypic features of the prevalence of MS and its components in LADA were studied in accordance with the criteria of the International Diabetes Federation (IDF, 2009). In establishing LADA, we were guided by the recommendations of the Immunology of Diabetes Society (IDS, 2005).

Results

The prevalence of MS in LADA was 55.6% and exceeded that in T1DM (19%), but was lower compared with T2DM (71.4%). In addition to hyperglycemia, abdominal obesity (62.2% of patients), hypertension (77.8%), and dyslipidemia (55.6%) were the most common components of MS in LADA. The highest prevalence of MS was found in patients with LADA 2 phenotype (69.2%), which was close to that in T2DM. At the same time, it was lower (40.9%) in LADA 1, but twice as high as in T1DM. Negative correlations were found between body mass index, waist circumference and antiGAD titers in patients with LADA (P < 0.05).

Conclusion

Metabolic syndrome was found in 55.6% of patients with LADA. The prevalence of metabolic syndrome depends on the phenotype of the disease and was highest in LADA 2 (69.2%), which indicates that patients with this phenotype belong to the group of high cardiovascular risk.