Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.I...Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.In this mini-review,through browsing important peer-reviewed publications,(original articles and reviews),we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity.A unique combination of immunological,clinical and metabolic characteristics has been identified in this group of patients,namely persistent islet cell antibodies,high frequency of thyroid and gastric autoimmunity,DR3 and DR4 human leukocyte antigen haplotypes,progressive loss of beta cells,adult disease onset,normal weight,defective glycaemic control,and without tendency to ketoacidosis.Although anthropomorphic measurements are useful as a first line screening,the detection of C-peptide levels and the presence of glutamic acid decarboxylase(GAD)autoantibodies is undoubtedly the sine qua non condi-tion for a confirmatory LADA diagnosis.In point of fact,GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied.Nevertheless,the lack of diagnostic criteria and guidelines still puzzle the physicians,who struggle between early diagnosis and correct timing for insulin treatment.展开更多
目的探讨初诊为2型糖尿病(T2DM)患者中成人隐匿性自身免疫性糖尿病(LADA)的比例及C肽(CP)在LADA和T2DM鉴别诊断中的价值。方法331例初诊T2DM患者为研究对象,检测胰岛自身抗体,根据胰岛自身抗体结果将患者分为LADA组和T2DM组,比较2组临...目的探讨初诊为2型糖尿病(T2DM)患者中成人隐匿性自身免疫性糖尿病(LADA)的比例及C肽(CP)在LADA和T2DM鉴别诊断中的价值。方法331例初诊T2DM患者为研究对象,检测胰岛自身抗体,根据胰岛自身抗体结果将患者分为LADA组和T2DM组,比较2组临床资料和生化检测结果,绘制受试者工作特征(ROC)曲线,评价相关指标在鉴别LADA与T2DM的诊断效能。结果初诊为T2DM患者中LADA检出率为9.06%。LADA患者“三多一少”症状和自发性酮症比例、空腹血糖(FPG)、餐后2 h PG和糖化血红蛋白(HbA1c)水平均明显高于T2DM,LADA组病程明显短于T2DM组,起病年龄、BMI、腰围、腰臀比、糖尿病家族史比例和外周血中性粒细胞数(NC)、血清TG、空腹CP(FCP)与餐后2 h CP水平LADA组均明显低于T2DM组,上述差异均有统计学意义(P<0.05)。以0.855μg/L和2.013μg/L分别为FCP与2 h CP鉴别诊断LADA与T2DM的最佳临界值,鉴别诊断LADA与T2DM的准确度明显高于其他指标,差异有统计学意义(P<0.05),其AUC分别为0.866和0.854。结论在T2DM初诊患者中,胰岛自身抗体检测可用于LADA筛查,FCP与2 h CP可作为LADA与T2DM鉴别诊断指标。展开更多
文摘Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.In this mini-review,through browsing important peer-reviewed publications,(original articles and reviews),we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity.A unique combination of immunological,clinical and metabolic characteristics has been identified in this group of patients,namely persistent islet cell antibodies,high frequency of thyroid and gastric autoimmunity,DR3 and DR4 human leukocyte antigen haplotypes,progressive loss of beta cells,adult disease onset,normal weight,defective glycaemic control,and without tendency to ketoacidosis.Although anthropomorphic measurements are useful as a first line screening,the detection of C-peptide levels and the presence of glutamic acid decarboxylase(GAD)autoantibodies is undoubtedly the sine qua non condi-tion for a confirmatory LADA diagnosis.In point of fact,GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied.Nevertheless,the lack of diagnostic criteria and guidelines still puzzle the physicians,who struggle between early diagnosis and correct timing for insulin treatment.
文摘目的探讨初诊为2型糖尿病(T2DM)患者中成人隐匿性自身免疫性糖尿病(LADA)的比例及C肽(CP)在LADA和T2DM鉴别诊断中的价值。方法331例初诊T2DM患者为研究对象,检测胰岛自身抗体,根据胰岛自身抗体结果将患者分为LADA组和T2DM组,比较2组临床资料和生化检测结果,绘制受试者工作特征(ROC)曲线,评价相关指标在鉴别LADA与T2DM的诊断效能。结果初诊为T2DM患者中LADA检出率为9.06%。LADA患者“三多一少”症状和自发性酮症比例、空腹血糖(FPG)、餐后2 h PG和糖化血红蛋白(HbA1c)水平均明显高于T2DM,LADA组病程明显短于T2DM组,起病年龄、BMI、腰围、腰臀比、糖尿病家族史比例和外周血中性粒细胞数(NC)、血清TG、空腹CP(FCP)与餐后2 h CP水平LADA组均明显低于T2DM组,上述差异均有统计学意义(P<0.05)。以0.855μg/L和2.013μg/L分别为FCP与2 h CP鉴别诊断LADA与T2DM的最佳临界值,鉴别诊断LADA与T2DM的准确度明显高于其他指标,差异有统计学意义(P<0.05),其AUC分别为0.866和0.854。结论在T2DM初诊患者中,胰岛自身抗体检测可用于LADA筛查,FCP与2 h CP可作为LADA与T2DM鉴别诊断指标。
