Associations Between Clinical Characteristics and Chronic Complications in Latent Autoimmune Diabetes in Adults and Type 2 Diabetes

Diabetes Metab Res Rev. 2015 May;31(4):411-20. doi: 10.1002/dmrr.2626. Epub 2015 Jan 23.

Abstract

Background: This study aimed to assess the associations between clinical characteristics and chronic complications in latent autoimmune diabetes in adults (LADA) and type 2 diabetes.

Methods: This is a retrospective study. Our diabetes registry included 6975 patients aged 30-75 years old with phenotypic type 2 diabetes who underwent islet autoantibody screening between 2003 and 2012; 384 patients were identified to have LADA. Rates of chronic complications for LADA and type 2 diabetes were compared using a 1 : 2 matched design. Logistic models were fitted to identify the presence of chronic diabetic complications using clinical characteristics including gender, age, duration of diabetes, glycemic control and metabolic syndrome.

Results: When duration of diabetes is <5 years, the prevalence of diabetic nephropathy (nephropathy; 12.2% versus 21.8%, p = 0.018) and diabetic retinopathy (retinopathy; 8.1% versus 15.9%, p = 0.011) were significantly lower in patients with LADA than in patients with type 2 diabetes; the prevalence of nephropathy and retinopathy were comparable between both groups when duration is ≥5 years. There was no significant difference in the prevalence of macrovascular complications between groups. The areas under the receiver operating characteristic curves based on the nephropathy and retinopathy models were larger for LADA than for type 2 diabetes (0.72 versus 0.61, p = 0.013; 0.76 versus 0.68, p = 0.056).

Conclusions: Patients with LADA had a lower prevalence of microvascular complications than patients with type 2 diabetes when the duration of diabetes was <5 years. Regression equation fitted by clinical characteristics can better predict the risk of microvascular complications in LADA than in type 2 diabetes.

Keywords: cardiovascular disease; diabetic nephropathy; diabetic retinopathy; latent autoimmune diabetes in adults; type 2 diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / analysis
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / physiopathology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / immunology
  • Cardiovascular Diseases / physiopathology
  • China / epidemiology
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / immunology
  • Diabetes Mellitus / physiopathology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / immunology
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / immunology
  • Diabetic Cardiomyopathies / physiopathology
  • Diabetic Neuropathies / epidemiology
  • Diabetic Neuropathies / immunology
  • Diabetic Neuropathies / physiopathology*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Microvessels / physiopathology
  • Middle Aged
  • Prevalence
  • ROC Curve
  • Registries
  • Retrospective Studies
  • Risk Factors

Substances

  • Autoantibodies