The Incidence Of LADA In Newly Diagnosed Diabetic Patients And Their Relationship With Autoimmune Thyroid Disease

Objective : the purpose of this study was to assess the incidence of LADA in newly diagnosed diabetic patients,explore the clinical characteristic of latent autoimmune diabetes in adults(LADA),and their relationship with autoimmune thyroid disease(AITD).in order to take more effective interventions in patients with LADA.Methods: Collected on June 6,2016-December 2017 in nanchang university the second affiliated hospital endocrine clinic and hospital,310 cases of patients with newly diagnosed diabetes,a total of 310 patients,According to the type standard of diabetes,it was divided into three groups,LADA group,T1 DM group and T2 DM group,respectively.among them,19 patients with LADA,defined as LADA group(male 13 cases,female 6 cases),11 patients with T1 DM,defined as T1 DM group(5 cases were male,female 6),280 patients with T2 DM,defined as T2 DM group(male 172,female 108).Collect all the selected patients basic information,including name,gender,age,cultural degree,diagnosis time,about a few symptoms,whether ketoacidosis,with or without family history of diabetes and hypertension,whether drinking and smoking history;Measure waist circumference,hip circumference,height,weight,calculate body mass index(BMI)and blood pressure;Fasting plasma glucose(FPG),blood sugar 2 hours after meal(2 HPG),glycosylated hemoglobin(HbA1c),fasting C peptide(FC-P),postprandial 2 hours C peptide(2 hc-P),blood lipid and thyroid autoantibodies(thyroid peroxidase antibody TPO-Ab,thyroglobulin antibody Tg-Ab),comparison between groups patients’ demographic characteristics,blood glucose,blood lipid,C peptide level and explore the relationship between different types of diabetes and AITD.Results:(1)The incidence of LADA in the study was 6.1%.(2)Compared with the demographic characteristics,the three groups showed no significant difference in the degree of culture,family history of diabetes,history of hypertension,drinking history,smoking and drinking history(P value of >0.05).The onset age of T1 DM group was lower than that of LADA group.The onset age of LADA group was lower than that of T2 DM group(P < 0.05).Compared with T2 DM group,LADA group in lower BMI,waist circumference,systolic blood pressure,and hip circumference and sanduo a little higher,the difference was statistically significant(P < 0.05),compared with T1 DM group,lower incidence of LADA group ketoacidosis,difference also was statistically significant(P < 0.05);T2DM group was higher in diastolic blood pressure,systolic blood pressure,BMI,waist circumference than T1 DM group,and ketoacidosis was low,and the difference was statistically significant(P<0.05).(3)Blood glucose and islet function: according to the features of C peptide level in patients with T2 DM group(C peptide on an empty stomach and postprandial 2 hour C peptide)were higher than in LADA group(P < 0.05),but blood sugar 2 hours after meal is below the LADA patients(P < 0.05),and fasting glucose,and glycosylated hemoglobin in no significant difference between the two groups(P > 0.05);Patients with T2 DM group on blood glucose determination(fasting plasma glucose,postprandial 2 hours blood glucose,glycosylated hemoglobin)and T1 DM group has no statistically significant difference(P > 0.05),but C peptide level(fasting c-peptide,postprandial 2 hours C peptide)were higher than in T1 DM group(P < 0.05).(4)There was no statistically significant difference between T1 DM,T2DM,and LADA group in T1 DM,T2DM,and LADA group(P values were all >0.05).The cholesterol of T2 DM group was lower than that in LADA group,and the cholesterol level was higher than that in T1 DM group,and the difference was statistically significant(P<0.05).(5)The total number of AITD 28 cases in the study was 12%,of which 3 cases were in LADA group,accounting for 27%,and 3 cases were positive for TPO-Ab antibody and Tg-Ab antibody.2 cases of T1 DM group,22%,one of which was a pure Tg-Ab antibody,and the other was a two-antibody positive.There were 23 cases in T2 DM group,accounting for 11%.Among them,there were 11 cases of TPO-Ab and Tg-Ab and 6 cases of pure TPO-Ab positive and 6 cases of pure Tg-Ab.There was no significant difference between the three groups of AITD patients in terms of gender,AITD composition,TPO-Ab positive rate and Tg-Ab positive rate(P value of >0.05).Conclusion:(1)The incidence of LADA in newly diagnosed DM patients was 6.1 %,which was basically consistent with the incidence of LADA in the national study.(2)the islet function of the patients with low age LADA was worse than that of the T2 DM patients with thin body,hypercholesterolemia and low age.Clinical features of both T1 DM and T2 DM.(3)the incidence of AITD in newly diagnosed diabetes is 12.It is suggested that routine screening for autoimmune thyroid diseases should be performed in newly diagnosed diabetes.