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.

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Author Biographies

E.J. Rivera-Rivera, National Autonomous University of Nicaragua, León. Nicaragua

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

 

A.R. Funes-Ríos, National Autonomous University of Nicaragua, León. Nicaragua

Researcher. PhD, Full Professor. Department of Basic Medical Sciences.

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 Characteristics among Yemeni Type 2 Diabetes Mellitus Patients. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 4223-4232. 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., CánovasMolina, 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 35-75years 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 auto inmunidad (anticuerpos anti GAD +) en pacientes adultos con diabetes tipo 2 de inicio temprano. Revista de Endocrinología yNutrición, 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 aciddecarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults. European Journal of Endocrinology, 163(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 autoimmunediabetes 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/10.4103/15963519.194277

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.2009-1120

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 de2022, 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 mayode 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 estimationand 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 & Metabolism 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 hiperglucemiaen 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 latentautoimmune diabetes in adults (LADA) in patients followed for type 2 diabetes: A single center’s experience in Turkey. Archives of Endocrinology 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). Diabetes 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., Forsblom, C., Saloranta, C., Taskinen, M. R., & Groop, L. C. (1999). Clinical and genetic characteristics of type 2 diabetes with and withoutGAD 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 diabetes. 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 treatment and prevention. International Journal of Medical Sciences, 11(11), 1185-1200. https://doi.org/10.7150/ijms.10001

Xiang, Y., Huang, G., Zhu, Y., Zo, 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 autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A populationbasedmulticentre 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 Characteristics of GAD Antibody-Positive Recently Diagnosed Patients With Type 2 Diabetes in North America and Europe. Diabetes, 53(12),31933200.https://doi.org/10.2337/diabetes.53.12.3193

Published

2024-06-30

How to Cite

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

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