Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

Hernández, Marta; López, Carolina Martínez; Real, Jordi; Valls, Joan; Ortega, Emilio; Vázquez, Federico; Rubinat, Esther; Granado-Casas, Minerva; Alonso, Núria; Molí, Teresa; Betriu, Àngels; Lecube, Albert; Fernàndez, Elvira; Leslie, Richard; Mauricio, Dı́dac

doi:10.1186/s12933-017-0576-9

Cited by 21 publications

(15 citation statements)

References 62 publications

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“…Another cross-sectional study showed that LADA patients had a higher prevalence of carotid atherosclerosis than age-matched T2D patients. 19 These results were in contrast with findings from the prospective population-based HUNT2 study, that showed all-cause mortality and CV mortality to be equal in LADA and T2D patients. 20 Unlike the UKPDS, however, the HUNT2 study did not evaluate nonfatal events, had a shorter mean follow-up period (9.1 years among patients with diabetes) and the diagnosis of LADA was based on measurement of only one AAb.…”

Section: Effect Of Assigned Glycaemic Strategy On CV Outcomes By Lamentioning

confidence: 57%

“…On the contrary, in a recent cohort study LADA seemed to be associated with lower short‐term risk of CV events and mortality, even though patients with insulin‐dependent diabetes were not considered as possibly affected by LADA. Another cross‐sectional study showed that LADA patients had a higher prevalence of carotid atherosclerosis than age‐matched T2D patients . These results were in contrast with findings from the prospective population‐based HUNT2 study, that showed all‐cause mortality and CV mortality to be equal in LADA and T2D patients .…”

Section: Discussionmentioning

confidence: 90%

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Long‐term risk of cardiovascular disease in individuals with latent autoimmune diabetes in adults (UKPDS 85)

Maddaloni

Coleman

Pozzilli

et al. 2019

Diabetes Obesity Metabolism

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Aims: Latent autoimmune diabetes in adults (LADA) is diagnosed in up to 12% of adults with clinically diagnosed type 2 diabetes (T2D). LADA tends to have healthier cardiovascular (CV) risk profiles than T2D, but it remains uncertain whether the risk of CV events differs between the two. We examined the risk of CV events in patients enrolled in the United Kingdom Prospective Diabetes Study (UKPDS) according to LADA status. Materials and methods: Diabetes autoantibodies (AAb) were measured in 5062 UKPDS participants. The incidence of major adverse CV events (MACE), defined as CV death, non-fatal myocardial infarction or non-fatal stroke, was compared in those with LADA (≥1 AAb test positive) and those without LADA (AAb negative). Results: There were 567 participants (11.2%) with LADA. Compared with participants with T2D, they were younger, with higher mean HbA1c and HDL-cholesterol values, and with lower body mass index and total cholesterol and systolic blood pressure values (all P < 0.01). After a median (25th, 75th percentile) 17.3 (12.6-20.7) years of follow-up, MACE occurred in 157 (17.4 per 1000 person-years) participants with LADA and in 1544 (23.5 per 1000 person-years) participants with T2D (HR, 0.73; 95% confidence interval [CI], 0.62-0.86; P < 0.001). However, after adjustment for confounders, this difference was no longer significant (HR adj , 0.90; 95% CI, 0.76-1.07; P = 0.22).Conclusions: In adults thought to have newly diagnosed T2D, the long-term risk of MACE was lower in those with LADA. However, this did not differ after adjustment for traditional CV risk factors, suggesting that measurement of AAb in addition to traditional CV risk factors will not aid in stratification of CV risk in clinically diagnosed T2D.

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Section: Effect Of Assigned Glycaemic Strategy On CV Outcomes By Lamentioning

confidence: 57%

Section: Discussionmentioning

confidence: 90%

Long‐term risk of cardiovascular disease in individuals with latent autoimmune diabetes in adults (UKPDS 85)

Maddaloni

Coleman

Pozzilli

et al. 2019

Diabetes Obesity Metabolism

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“…In both cases, well-known cardiovascular risk factors and, more importantly, advanced stages of DR were independently associated with subclinical atherosclerosis. Interestingly, in a recent study, we have reported that the frequency of preclinical carotid atherosclerosis in patients with latent autoimmune diabetes of the adults (LADA) is similar, or even greater in those with longer disease duration, to subjects of similar age with classic type 1 diabetes and type 2 diabetes [ 31 ]. In LADA, preclinical carotid atherosclerosis was also associated with classical risk factors like hypertension and tobacco exposure.…”

Section: Discussionmentioning

confidence: 99%

Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

Carbonell

Castelblanco

Valldeperas

et al. 2018

Cardiovasc Diabetol

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BackgroundCardiovascular (CV) disease due to atherosclerosis is a major cause of morbidity and mortality in adult patients with diabetes, either type 1 or type 2 diabetes. The aim of the study was to assess the association of the frequency and the burden of subclinical carotid atherosclerotic disease in patients with type 1 diabetes according to the presence and severity of diabetic retinopathy (DR).MethodsA cross-sectional study was conducted in 340 patients with type 1 diabetes (41.5% with DR), and in 304 non-diabetic individuals. All participants were free from previous CV disease and chronic kidney disease (CKD). B-mode carotid ultrasound imaging was performed in all the study subjects. Patients with type 1 diabetes underwent a full eye examination, and DR patients were divided into two groups: mild disease and advanced disease.ResultsIn the group of patients with type 1 diabetes, the percentage of patients with carotid plaques was higher in those with DR compared with those without DR (44.7% vs. 24.1%, p < 0.001). Patients with DR also presented a higher incidence of ≥ 2 carotid plaques (25.5% vs. 11.1%, p < 0.001). Apart from other traditional cardiovascular risk factors, the presence of advanced stages of DR was independently associated with the presence (p = 0.044) and the burden (≥ 2 carotid plaques; p = 0.009) of subclinical carotid atherosclerosis.ConclusionsIn patients with type 1 diabetes without previous CV disease or established CKD, the presence of advanced stages of DR is associated with a higher atherosclerotic burden in the carotid arteries. The presence of DR identifies patients at risk for carotid atherosclerotic disease.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0706-z) contains supplementary material, which is available to authorized users.

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“…1 Limited data suggest that cardiovascular comorbidity and mortality in such individuals are comparable to that of other people with type 2 diabetes. [2][3][4][5][6] However, the effect of different treatment regimens on clinical outcomes in the subgroup that are anti-GAD positive remains poorly studied.…”

Section: Introductionmentioning

confidence: 99%

The association of basal insulin treatment versus standard care with outcomes in anti‐GAD positive and negative subjects: A post‐hoc analysis of the ORIGIN trial

Birkeland

Grill

Wium

et al. 2018

Diabetes Obesity Metabolism

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We compared cardiovascular and other outcomes in patients with dysglycaemia with or without anti-glutamic acid dehydrogenase (GAD) antibodies participating in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial. Of the 12 537 participants, 8162 had anti-GAD measured at baseline and 267 were anti-GAD positive. The effects of insulin glargine versus standard care and of n-3 fatty acids supplements versus placebo were compared by testing the interaction of the treatment effects and anti-GAD status. The effect of glargine on development of new diabetes was assessed in participants without previous diabetes at baseline. The overall incidence of outcomes did not differ between anti-GAD positive and anti-GAD negative subjects. The incidence of the composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke did not differ between anti-GAD positive participants randomized to insulin glargine or to standard care, with a hazard ratio (HR) (95% confidence interval [CI]) of 0.80 (0.44-1.44) or in anti-GAD negative participants with a HR of 1.07 (0.96-1.20) (P for interaction = 0.20).

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Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

Cited by 21 publications

References 62 publications

Long‐term risk of cardiovascular disease in individuals with latent autoimmune diabetes in adults (UKPDS 85)

Long‐term risk of cardiovascular disease in individuals with latent autoimmune diabetes in adults (UKPDS 85)

Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

The association of basal insulin treatment versus standard care with outcomes in anti‐GAD positive and negative subjects: A post‐hoc analysis of the ORIGIN trial

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