Metabolic Syndrome and Autoimmune Diabetes: Action LADA 3

Abstract

OBJECTIVE -The purpose of this study was to estimate whether prevalence of metabolic syndrome in adult European diabetic patients is associated with type of diabetes.RESEARCH DESIGN AND METHODS -A consecutive series of patients attending hospital-based diabetes clinics were assessed for the frequency of metabolic syndrome and compared with population-based control subjects as part of the Action LADA study. In total, 2,011 subjects (aged 30 -70 years) were studied, including 1,247 patients with recent-onset type 2 diabetes without glutamic acid decarboxylase autoantibodies (GADAs), 117 non-insulinrequiring patients with GADAs who had not received insulin therapy for at least 6 months after diagnosis (designated latent autoimmune diabetes of adults [LADA]), 288 type 1 diabetic patients, and 359 normal subjects.RESULTS -Frequency of metabolic syndrome was significantly different in patients with type 1 diabetes (31.9%) and LADA (41.9%) (P ϭ 0.015) and in both conditions was less frequent than in type 2 diabetic patients (88.8%) (P Ͻ 0.0001 for each). Eliminating glucose as a variable, the prevalence of metabolic syndrome was similar in patients with autoimmune diabetes (type 1 diabetes and/or LADA) (17.3%) and control subjects (23.7%) but remained more common in type 2 diabetic patients (47.8%) (P ϭ 0.001 for all groups). In both type 1 diabetic patients and those with LADA, individual components of metabolic syndrome were similar but less common than in type 2 diabetic patients (P Ͻ 0.0001 for each).CONCLUSIONS -The prevalence of metabolic syndrome is significantly higher in type 2 diabetic patients than in patients with LADA or adults with type 1 diabetes. Excluding glucose as a variable, metabolic syndrome is not more prevalent in patients with autoimmune diabetes than in control subjects. Metabolic syndrome is not a characteristic of autoimmune diabetes.

Prevalence and comorbidities of double diabetes

“…The autoimmune characteristics did not show significant differences between double diabetes and T1DM without MS (Table 1, 2) but people with double diabetes develop diabetes at a higher age, so probably genetic differences also contribute to the risk of double diabetes [26]. So since the genetic burden of the metabolic syndrome is quite high, it might also be possible, that people with DD inherit the T2DM genes from their parents on top of the T1DM, here genetic analysation should be carried out in people with DD.…”

Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults

“…Inconsistent data has also been reported about the prevalence and impact of metabolic syndrome (MetS) in the clinical course of LADA (15). Besides this, some genetic markers, e.g.…”

LADA and CARDS: A Prospective Study of Clinical Outcome in Established Adult-Onset Autoimmune Diabetes

“…Previous studies of LADA have indicated that this form of adult-onset autoimmune diabetes at the time of diagnosis is characterized by the predominant presence of autoantibodies to GAD (GADA), reduced frequency of metabolic syndrome, and an increased likelihood of progression to insulin treatment (5). Outcome studies, to date, have been underpowered because of short duration of review and limited numbers of cases under review (6)(7)(8)(9).…”