1.The Study Of Insulin Sensitivity And Islet β Cell Function Of Latent Autoimmune Diabetes In Adults 2.The Immune Mechanism Study Of Latent Autoimmune Diabetes In Adults

Objective Latent autoimmune diabetes in adults(LADA)presenting with a different phenotype at early stages,belongs to the slowly progressive subtype of autoimmune type 1 diabetes. LADA differs from classic juvenile-onset type 1 diabetes in which its autoimmune destructive process of islet beta-cells is much slower, so LADA may serve as a human model of autoimmune type 1 diabetes. Although no international standardized criteria for the diagnosis of LADA has been established, it should be noted that LADA has some specific feature in clinical characteristics, humoral immune markers, as well as islet pathology. Early selecting LADA from newly diagnosed diabetes and protecting their residual might slow down the progression of diabetes. The objective in our study: To compare the clinical parameters, C-peptide levels, the association with the risk factors of macrovascular complications, the prevalence of microvascular complications in subjects with latent autoimmune diabetes in adults, type 1 diabetes and type 2 diabetes. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to estimated insulin sensitivity, as well as HOMA-IS was used to estimate insulin function. To compare pattern of islet cell specific autoantibodies between LADA and type 1 diabetes .Methods We elvaluated the clinical parameters, C-peptide levels in 40 LADA, 40 type 1 diabetic with rapid progression, and 50 type 2 diabetic patients. We estimated insulin sensitivity and islet β cells function in 40 LADA, 40 type 1 diabetic with rapid progression, 50 type 2 diabetic patients and 30 controlpopulation by the homeostasis model assessment. Islet cell autoantibodies were also compared between LADA and type 1 diabetic patients.Results (l)Patients with LADA and type 1 diabetes had lower BMI, waist-to-hip ratio, total cholesterol, triglyceride levels, and lower prevalence of hypertension compared with patients type 2 diabetes(P<0.05). HDL cholesterol levels were higher in the LADA and type 1 diabetic subjects compared with type 2 diabetes (P <0.05). The diagnosed age of diabetes was higher in the LADA compare with type 1 diabetes. There were no difference between the LADA and the adult-onset type 1 diabetes groups in the parameters of the metabolic syndrome mentioned above. There were no differences in the prevalence of microvascular complications in three subjects. (2) The HOMA-IR of LADA patients was higher than control population and type 1 diabetes, while was lower than type 2 diabetes. The HOMA-IS of LADA patients was higher than type 1 diabetes, while lower than type 2 diabetes. (3) Double-autoantibody positivity was more often seen in type 1 diabetes than in LADA(P<0.01).Conclusions Subjects with LADA had clinical characteristics similar to those with adult-onset type 1 diabetes with rapid progression. The progression of LADA were linkage to the insulin resistance and islet cell function deficiency. Patients with LADA rather had single islet cell specific autoantibody positivity.