| Objective:To investigate the proportion of LADA among newly diagnosed adult DM patients,to analyze the clinical characteristics of LADA and T2DM patients and to verify the current clinical diagnosis model,so as to carry out screening and intervention as soon as possible.Methods:With informed consent,clinical data(general data,medical history,family and personal history)were collected from diabetic patients(diabetic duration≤1 year)aged 18-75 years,male or female,who visited outpatient and inpatient in the second Hospital of Jilin University from March 2015 to February 2019.Measure and record Their body height,weight and waist circumference were mesured and recorded,the body mass index(BMI)were calculeted.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting C peptide(FCP),and Peptide C 2 hours after meal(2h C-P),fasting plasma glucose(FPG)and glycosylated hemoglobin(Hb A1c),were deteced all in the hosipital,while all patients’serum GAD65 antibody(GADA)were detected at Xiangya second Hospital of Central South University(Central).All data were analyzed by SPSS24.0 software.The data from the normal distribution are represented by mean±standard deviation,Data that do not follow the normal distribution are expressed as median(quartile),The counting data is expressed in frequency,Comparison of quantitative data between groups using an independent sample t test,Comparison of rates and composition ratios between groups usingχ~2tests,(receiver operatingcharacteristic,)Working characteristics of subjects ROC)The curve is used to evaluate the diagnostic effectiveness of the model,p<0.05 was statistically significant.Results:1、This study included 397 patients with diabetes,including LADA group 44(11.08%)and T2DM group 353.2、The body weight,BMI,FPG,FC-P and 2 h C-P in LADA group were lower than those in T2DM group[(65.05±15.13)vs(70.77±14.11)kg,(22.70±3.70)vs(25.21±3.86)kg/m~2,(8.65±3.77)vs(9.72±3.68)mmol/L,(0.73±0.59)vs(1.42±1.02)ng/ml,(1.57±1.49)vs(3.31±2.42)ng/ml,p<0.05].The Hb A1c level in LADA group was higher than that in T2DM group[(11.34±2.55 vs 10.10±2.68)%,p<0.05].The proportion of patients with typical symptoms including polydipsia,polyuria,polyphagia and weight loss,DKA,history of thyroid disease in LADA group was higher than that in T2DM group(79.5%vs 63.5%,22.7%vs 8.2%,34.1%vs7.4%,p<0.05).3、The LDL-C level and 2 h C-P level in LADA-High group were lower than those in LADA-Low group;FPG level higher than LADA-Low group,[(2.09±0.54)vs(2.59±0.94)mmol/L;and(1.00±0.74)vs(2.19±1.70)ng/ml,(10.68±3.57)vs(8.69±2.39)mmol/L,p<0.05].4、When the model CODE-C0>10.80 as the tangent point,the diagnostic LADA specificity and sensitivity were 98.3%and 11.4%,respectively,and when the model CODE-C120CODE-C0>10.91 as the tangent point,the diagnostic specificity and sensitivity were 96.9%and 20.5%,respectively.The area(AUC)under the ROC curves of applied CODE-C0 and CODE-C120 were 0.756(95%CI 0.684～0.827)and 0.764(95%CI 0.688～0.840).Conclusion:1、The proportion of LADA among newly diagnosed DM adult patients in our hospital is11.08%.2、Compared to T2DM patients,The incidence of thyroid disease history,diabetic ketoacidosis(DKA),typical symptoms including polydipsia,polyuria,polyphagia and weight loss in LADA group was higher.LADA patients had lower FPG,FC-P and 2 h C-P at diagnosis,Higher Hb A1c,LADA group had lower body weight and BMI,TC.Compared with T2DM patients,LADA patients are thinner;Blood sugar control is more unstable,The islet function is worse.3、The LDL-C,2h C-P level of LADA-High group with high titer was lower than that of LADA-Low group with low GADA titer,and the FPG level was higher than that of LADA-Low group.These results suggest that blood glucose control and islet function are worse in LADA patients with high GADA titer.4、Specificity and sensitivity of LADA patients were still significantly different by using the T1DM clinical diagnostic model.Judging from the product below the model ROC curve,the CODE-C0 and CODE-C120 of clinical diagnosis model have certain diagnostic value. |
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