Prevalence of anti-GAD antibodies as biomarkers of latent autoimmune diabetes in adults (LADA), in patients diagnosed with type 2 diabetes

Authors

DOI:

https://doi.org/10.5377/universitas.v16i1.19057

Keywords:

anti-GAD, glycosylated hemoglobin, LADA, C-peptide.

Abstract

Diabetes mellitus (DM) is a chronic-degenerative disease. Type 1 diabetes, characterized by autoimmune destruction of insulin-producing β cells, and type 2 diabetes caused by resistance to the actions of insulin are routinely described. However, LADA diabetes shares immunological and clinical characteristics with both types of diabetes and it is estimated that 2-12% of adults diagnosed with T2DM could be suffering from LADA, leading to early complications due to a wrong diagnosis.In this study, the prevalence of anti-GAD antibodies as biomarkers of LADA and its relationship with the biochemical-clinical profile of 80 patients diagnosed with T2DM were estimated with the aim of characterizing them immunologically and biochemically. Biochemical-clinical parameters such as body mass index (BMI), glycosylated hemoglobin (HbA1c) and C-peptide were determined and compared according to the presence of antibodies. The female sex (65%) and the 50-59 year old group (38.8%) predominated; with an average HbA1c and C−peptide of 9.88% and 1.69 ng/mL respectively were found. The prevalence of anti-GAD was 5%, predominating in men (75%) and in the 30-39 year old group (75%). Patients positive for anti-GAD debuted early with DM (36.5 vs 47.9 years) (p=0.021), had lower BMI (23.8 vs 29.2) (p=0.006) and C-peptide (0.26 vs 1.38) (p=0.002) and higher HbA1c (13.65 vs 9.15) (p=0.002). The prevalence of anti-GAD antibodies was 5%. The biochemical-clinical profile of positive patients was characterized by an increase in HbA1c, lower C-peptide and BMI.

Downloads

Download data is not yet available.

Author Biographies

Eileen José Rivera Rivera, National Autonomous University of Nicaragua, León.

Lic. Clinical Bioanalysis. Researcher. Master's student in Clinical Biochemistry Knowledge Area Medical Sciences.
National Autonomous University of Nicaragua.

Aura Funes Ríos, National Autonomous University of Nicaragua, León.

PhD, full professor. Department of the basic area of ​​Medical Sciences. National University Autonomous of Nicaragua. Leon, Nicaragua.

References

Acción LADA Recuperado 16 de febrero de 2024, de https:

//actionlada.org/method/method.html

Al-Zubairi, T., AL-Habori, M., & Saif-Ali, R. (2021). Latent

Autoimmune Diabetes in Adults (LADA) and its Metabolic Characte

ristics among Yemeni Type 2 Diabetes Mellitus Patients. Diabetes,

Metabolic Syndrome and Obesity: Targets and Therapy, 14, 4223-

https://doi.org/10.2147/DMSO.S332416

American Diabetes Association. (2011). Diagnosis and Classification

of Diabetes Mellitus. Diabetes Care, 35(Supplement_1), S64-S71.

https://doi.org/10.2337/dc12-s064

Arranz Martín, A., Lecumberri Pascual, E., Brito Sanfiel, M. Á.,

Andía Melero, V., Nattero Chavez, L., Sánchez López, I., Cánovas

Molina, G., Arrieta Blanco, F., & González Pérez del Villar, N. (2017).

Perfil clínico y metabólico de pacientes con diabetes tipo LADA

atendidos en atención especializada en la comunidad de Madrid.

Endocrinología, Diabetes y Nutrición, 64(1), 34-39. https://doi.

org/10.1016/j.endinu.2016.09.001

Groop, L. C., Bottazzo, G. F., & Doniach, D. (1986). Islet cell

antibodies identify latent type I diabetes in patients aged 35-75

years at diagnosis. Diabetes, 35(2), 237-241. https://doi.org/10.2337/

diab.35.2.237

Hebert Teobaldo Ramos Choque. (2012). Detección de

Diabetes Autoinmune Latente del Adulto (LADA) en Pacientes con

Diagnóstico de Diabetes Mellitus Tipo 2 en el «Centro de Salud Pedro

P. Díaz» en el año 2012 [Universidad Católica de Santa María]. https://

repositorio.ucsm.edu.pe/server/api/core/bitstreams/0fe854d7-

ae47-4033-b943-6318979d404e/content

Huici Moreno, M. J., Herrera del Rey, M. T., Álvarez Ríos, A. I.,

Domínguez Pascual, I., Infante Fontán, R., León-Justel, A., & Guerrero

Montávez, J. M. (2011). Estudio de autoanticuerpos en el

inicio de la diabetes autoinmune en nuestro medio mediante ELISA.

Revista del Laboratorio Clínico, 4(2), 77-83. https://doi.org/10.1016/j.

labcli.2011.01.005

Lerman, I., Granados, J., Aguilar-Salinas, C., Lobato, M.,

Villa, A. R., Velasco, M. L., & Gómez-Pérez, F. J. (2010). Baja prevalencia

de autoinmunidad (anticuerpos anti GAD +) en pacientes adultos con

diabetes tipo 2 de inicio temprano. Revista de Endocrinología y

Nutrición, 18(4), 170-175.

Maioli, M., Pes, G. M., Delitala, G., Puddu, L., Falorni, A., Tolu, F.,

Lampis, R., Orrù, V., Secchi, G., Cicalò, A. M., Floris, R., Madau, G. F.,

Pilosu, R. M., Whalen, M., & Cucca, F. (2010). Number of autoantibodies

and HLA genotype, more than high titers of glutamic acid

decarboxylase autoantibodies, predict insulin dependence in latent

autoimmune diabetes of adults. European Journal of Endocrinology,

(4), 541-549. https://doi.org/10.1530/EJE-10-0427

Manisha, A. M., Shangali, A. R., Mfinanga, S. G., & Mbugi, E. V.

(2022). Prevalence and factors associated with latent autoimmune

diabetes in adults (LADA): A cross-sectional study. BMC Endocrine

Disorders, 22(1), 175. https://doi.org/10.1186/s12902-022-01089-1

Ministerio de salud [MINSA] (2023). (2023). Mapa Nacional de La Salud

En Nicaragua. https://mapasalud.minsa.gob.ni/mapa-depadecimientos-

de-salud-de-nicaragua/

Muazu, S. B., Okpe, I., & Anumah, F. (2016). The prevalence

and characteristics of latent autoimmune diabetes in adults subset

among type two diabetes mellitus patients in Northern Nigeria.

Annals of African Medicine, 15(4), 163-170. https://doi.

org/10.4103/1596-3519.194277

Naik, R. G., Brooks-Worrell, B. M., & Palmer, J. P. (2009). Latent

Autoimmune Diabetes in Adults. The Journal of Clinical Endocrinology

& Metabolism, 94(12), 4635-4644. https://doi.org/10.1210/jc.2009-

Nolasco-Rosales, G. A., Ramírez-González, D., Rodríguez-Sánchez, E.,

Ávila-Fernandez, Á., Villar-Juarez, G. E., González-Castro, T. B.,

Tovilla-Zárate, C. A., Guzmán-Priego, C. G., Genis-Mendoza, A. D., Ble-

Castillo, J. L., Marín-Medina, A., & Juárez-Rojop, I. E. (2023).

Identification and phenotypic characterization of patients with LADA

in a population of southeast Mexico. Scientific Reports, 13, 7029.

https://doi.org/10.1038/s41598-023-34171-2

Organización Panamericana de la Salud/Organización Mundial de la

Salud [OPS/OMS]. Diabetes. (2022). Recuperado 29 de marzo de

, de https://www.paho.org/es/temas/diabetes

Organización Panamericana de la Salud/Organización Mundial de

la Salud [OPS/OMS]. Obesidad y sobrepeso. Recuperado 15 de mayo

de 2022, de https://www.who.int/es/news-room/fact-sheets/detail/

obesity-and-overweight

Park, Y., Hong, S., Park, L., Woo, J., Baik, S., Nam, M., Lee, K., Kim,

Y., & KNDP collaboratory Group. (2011). LADA prevalence estimation

and insulin dependency during follow-up. Diabetes/Metabolism

Research and Reviews, 27(8), 975-979. https://doi.org/10.1002/

dmrr.1278

Pieralice, S., & Pozzilli, P. (2018). Latent Autoimmune Diabetes in Adults:

A Review on Clinical Implications and Management. Diabetes & Me

tabolism Journal, 42(6), 451-464. https://doi.org/10.4093/

dmj.2018.0190

Rubio Cabezas, Ó., & Argente, J. (2012). Diabetes mellitus: Formas

de presentación clínica y diagnóstico diferencial de la hiperglucemia

en la infancia y adolescencia. Anales de Pediatría, 77(5), 344.e1-344.

e16. https://doi.org/10.1016/j.anpedi.2012.06.013

Tam, A. A., Ozdemir, D., Bestepe, N., Dellal, F. D., Bilginer, M. C.,

Faki, S., Bicer, C., Ersoy, R., & Cakir, B. (2020). Low rate of latent

autoimmune diabetes in adults (LADA) in patients followed for type

diabetes: A single center’s experience in Turkey. Archives of Endo

crinology and Metabolism, 64, 584-590. https://doi.

org/10.20945/2359-3997000000268

Taverna, D. M., Frechtel, G., Poskus, E., Perone, M., Matejic, A., Trifone,

L., Gonzalez, J., Amorin, M. A. A., & Domínguez, J. M. (2012). Diabe

tes autoinmune latente del adulto. LADA. 46.

Tuomi, T., Carlsson, A., Li, H., Isomaa, B., Miettinen, A., Nilsson, A.,

Nissén, M., Ehrnström, B. O., Forsén, B., Snickars, B., Lahti, K., Fors

blom, C., Saloranta, C., Taskinen, M. R., & Groop, L. C. (1999). Clini

cal and genetic characteristics of type 2 diabetes with and without

GAD antibodies. Diabetes, 48(1), 150-157. https://doi.org/10.2337/

diabetes.48.1.150

Turner, R., Stratton, I., Horton, V., Manley, S., Zimmet, P., Mackay,

I. R., Shattock, M., Bottazzo, G. F., & Holman, R. (1997). UKPDS 25:

Autoantibodies to islet-cell cytoplasm and glutamic acid de

carboxylase for prediction of insulin requirement in type 2 diabe

tes. The Lancet, 350(9087), 1288-1293. https://doi.org/10.1016/

S0140-6736(97)03062-6

Wu, Y., Ding, Y., Tanaka, Y., & Zhang, W. (2014). Risk factors

contributing to type 2 diabetes and recent advances in the treat

ment and prevention. International Journal of Medical Sciences,

(11), 1185-1200. https://doi.org/10.7150/ijms.10001

Xiang, Y., Huang, G., Zhu, Y., Zuo, X., Liu, X., Feng, Q., Li, X., Yang, T.,

Lu, J., Shan, Z., Liu, J., Tian, H., Ji, Q., Zhu, D., Ge, J., Lin, L., Chen, L.,

Guo, X., Zhao, Z., … On Behalf of the China National Diabetes and

Metabolic Disorders Study Group. (2019). Identification of autoim

mune type 1 diabetes and multiple organ‐specific autoantibodies in

adult‐onset non‐insulin‐requiring diabetes in China: A populationbased

multicentre nationwide survey. Diabetes, Obesity and Meta

bolism, 21(4), 893-902. https://doi.org/10.1111/dom.13595

Zinman, B., Kahn, S. E., Haffner, S. M., O’Neill, M. C., Heise, M. A.,

Freed, M. I., & ADOPT Study Group. (2004). Phenotypic Characte

ristics of GAD Antibody-Positive Recently Diagnosed Patients With

Type 2 Diabetes in North America and Europe. Diabetes, 53(12),

-3200. https://doi.org/10.2337/diabetes.53.12.3193

Published

2024-06-30

How to Cite

Rivera Rivera, E. J., & Funes Ríos, A. (2024). Prevalence of anti-GAD antibodies as biomarkers of latent autoimmune diabetes in adults (LADA), in patients diagnosed with type 2 diabetes. UNIVERSITAS (LEÓN): SCIENTIFIC JOURNAL OF THE UNAN-LEÓN, 16(1), 20–26. https://doi.org/10.5377/universitas.v16i1.19057

Issue

Section

Articles