Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7.
Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7.
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DOI：
10.2337/dc12-0931
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发表时间：
2013-04
期刊：
影响因子：
16.2
通讯作者：
Action LADA consortium
中科院分区：
文献类型：
--
作者：
Hawa MI;Kolb H;Schloot N;Beyan H;Paschou SA;Buzzetti R;Mauricio D;De Leiva A;Yderstraede K;Beck-Neilsen H;Tuomilehto J;Sarti C;Thivolet C;Hadden D;Hunter S;Schernthaner G;Scherbaum WA;Williams R;Brophy S;Pozzilli P;Leslie RD;Action LADA consortium
特异性自身抗体是儿童期1型糖尿病的特征，但也见于成人发病的糖尿病，即使最初不需要胰岛素，例如，潜伏性自身免疫性糖尿病（LADA）我们的目的是描述成人发病的自身免疫性糖尿病。我们连续研究了6，156名欧洲糖尿病患者，他们在诊断后5年内（年龄范围，30-70岁）就诊，进行了横断面临床检查和GAD抗体（GADA）以及胰岛素瘤相关抗原-2（IA-2A）和锌转运蛋白8（ZnT 8A）抗体检查。在6，156名患者中，541名（8.8%）患有GADA，仅57名（0.9%）患有IA-2A或ZnT 8A。与自身抗体阴性患者相比，自身抗体阳性患者更年轻，更瘦，接受胰岛素治疗（49.5% vs. 13.2%），女性（均P < 0.0001），尽管LADA患者（占总数的9.7%）并未显示出与自身抗体阴性2型糖尿病明显不同的临床特征。同样，与低滴度（n = 138）相比，高滴度（>200世界卫生组织IU）（n = 403）的GADA患者更多为女性、瘦型和胰岛素治疗（54.6% vs. 39.7%）（各P < 0.02）。自身抗体阳性患者通常有GADA（541/598; 90.5%），LADA比1型自身免疫性糖尿病更常见（比值比3.3）。成人型自身免疫性糖尿病是一种常见的自身免疫性糖尿病。我们的研究结果表明，成人发病的自身免疫性糖尿病在欧洲包括1型糖尿病和LADA在相同的广泛的临床和自身抗体阳性谱。在诊断时，成人发病的自身免疫性糖尿病患者通常不需要胰岛素，临床上与2型糖尿病患者难以区分，尽管他们往往更年轻，更瘦。只有筛查自身抗体，特别是GADA，才能确定它们。
Specific autoantibodies characterize type 1 diabetes in childhood but are also found in adult-onset diabetes, even when initially non–insulin requiring, e.g., with latent autoimmune diabetes (LADA). We aimed to characterize adult-onset autoimmune diabetes. We consecutively studied 6,156 European diabetic patients attending clinics within 5 years of diagnosis (age range, 30–70 years) examined cross-sectionally clinically and for GAD antibodies (GADA) and antibodies to insulinoma-associated antigen-2 (IA-2A) and zinc-transporter 8 (ZnT8A). Of 6,156 patients, 541 (8.8%) had GADA and only 57 (0.9%) IA-2A or ZnT8A alone. More autoantibody-positive than autoantibody-negative patients were younger, leaner, on insulin (49.5 vs. 13.2%), and female (P < 0.0001 for each), though LADA patients (9.7% of total) did not show categorically distinct clinical features from autoantibody-negative type 2 diabetes. Similarly, more GADA patients with high (>200 World Health Organization IU) (n = 403) compared with low (n = 138) titer were female, lean, and insulin treated (54.6 vs. 39.7%) (P < 0.02 for each). Autoantibody-positive patients usually had GADA (541 of 598; 90.5%) and had LADA more often than type 1 autoimmune diabetes (odds ratio 3.3). Adult-onset autoimmune diabetes emerges as a prevalent form of autoimmune diabetes. Our results indicate that adult-onset autoimmune diabetes in Europe encompasses type 1 diabetes and LADA in the same broad clinical and autoantibody-positive spectrum. At diagnosis, patients with adult-onset autoimmune diabetes are usually non–insulin requiring and clinically indistinguishable from patients with type 2 diabetes, though they tend to be younger and leaner. Only with screening for autoantibodies, especially GADA, can they be identified with certainty.
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影响因子：
16.2
作者：
Hawa, Mohammed I.;Thivolet, Charles;Mauricio, Didac;Alemanno, Irene;Cipponeri, Elisa;Collier, David;Hunter, Steven;Buzzetti, Raffaella;de Leiva, Alberto;Pozzilli, Paolo;Leslie, Richard David G.
通讯作者：
Leslie, Richard David G.
影响因子：
7.7
作者：
Bingley, PJ;Bonifacio, E;Mueller, PW
通讯作者：
Mueller, PW
DOI：
10.1073/pnas.0705894104
发表时间：
2007-10-23
影响因子：
11.1
作者：
Wenzlau, Janet M.;Juhl, Kirstine;Hutton, John C.
通讯作者：
Hutton, John C.
影响因子：
16.2
作者：
Brophy, Sinead;Yderstrede, Knud;Williams, Rhys
通讯作者：
Williams, Rhys
影响因子：
16.2
作者：
Petrone, Antonio;Suraci, Concetta;Buzzetti, Raffaella
通讯作者：
Buzzetti, Raffaella