| Objective: To investigate the prevalence rates and epidemic characters of latent autoimmune diabetes in adults (LADA) in Tianjin, the proportion of LADA in type 2 diabetes mellitus (T2DM) and explore the risk factors for LADA.Methods: A cross-sectional study was conducted in Tianjin from June to July in 2005. The multi-phasic stratified cluster sampling method was adapted. 8109 sujects older than 15 years old and having lived in Tianjin over 5 years were selected as survey sample. Information on risk factors was collected through face-to-face questionnaire interview and laboratory examination. The patients with type 2 diabetes mellitus were diagnosed according to the diagnostic criteria of American Diabetes Association in 1997. The serum glutamic acid decarboxylase antibodies (GADA) of patients with type 2 diabetes mellitus were measured with radioligand assay. LADA patients were defined as the patients of type 2 diabetes mellitus with positive of GADA. Univariate logistic regression and multivariate logistic regression were used to analyse odds ratio and its 95 percent of confidence interval for exploring the risk factors of LADA. The 1:2 matched case-control study was conducted to investigate the association between antibodies for coxsackievirus and LADA. The serum IgM and IgG antibodies for coxsackievirus were determined by enzyme-linked immunosorbent assay (ELISA). The positive rates of these antibodies in LADA patients, T2DM patients and non-diabetes mellitus controls were compared. Conditional logistic regression was used to analyze the association between antibodies for coxsackievirus and LADA.Results: There were 498 patients with T2DM and 46 patients with LADA in 8109 subjects. The prevalence rates of T2DM and LADA were 6.14% and 0.57% respectively, the proportion of LADA in T2DM was 9.24%. The results of univariate logistic regression analysis showed that the risk factors for LADA are age (OR= 1.034, 95%CI: 1.012-1.057), wsist-to-hip ratio (OR=1.475, 95%CI: 1.111-1.958), family history of diabetes (OR=18.509, 95%CI: 9.734-35.193), history of hypertension (OR=2.106, 95%CI: 1.125-3.941), irregular dinner (0R=2.430, 95%CI: 1.164-5.073), irregular breakfast (OR=2.552, 95%CI: 1.131-5.756) and history of spirit injury (OR=4.980, 95%CI: 2.190-11.326); And fish intake (OR=0.416, 95%CI: 0.246-0.704) is the protective factor for LADA. The results of multivariate logistic regression analysis showed that age (OR=1.556, 95%CI: 1.152-2.102), waist to hip ratio (OR=1.463, 95%CI: 1.101-1.944), family history of diabetes (OR=17.410, 95%CI: 8.862-34.203), irregular dinner (OR=2.518, 95%CI: 1.125-5.637) and history of spirit injury (OR=3.550, 95%CI: 1.443-8.729) increased the risk of LADA; and fish intake (OR=0.417, 95%CI: 0.239-0.728) decreased the the risk of LADA. The positive rates of IgM antibodies and IgG antibodies for coxsackievirus were 6.3%, 2.1%, 5.2% and 14.6%, 9.4% and 12.5% in LADA patients, T2DM patients and non-diabetes mellitus controls respectively. There were no differences in the positive rate of IgM and IgG antibodies for coxsackievirus among three groups. The results of logistic regression analysis also showed that no association between serum IgM and IgG antibodies for coxsackievirus and LADA was found.Conclusions: The prevalence rates of T2DM and LADA were 6.14% and 0.57% and the proportion of LADA in T2DM was 9.24% in the study population. Age, history of spirit injury, family history of diabetes, irregular dinner and waist to hip ratio may increase the risk of LADA while fish intake may decrease the risk of LADA. No association between serum IgM and IgG antibodies for coxsackievirus and LADA was found. |
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