LADA prevalence estimation and insulin dependency during follow-up
- Authors
- Park, Yongsoo; Hong, Sangmo; Park, Leejin; Woo, Jungtaek; Baik, Sehyun; Nam, Munsuk; Lee, Kwanwoo; Kim, Youngseol
- Issue Date
- Nov-2011
- Publisher
- WILEY
- Keywords
- LADA; prevalence; incidence; insulin dependency; multiple autoantibody positivity
- Citation
- DIABETES-METABOLISM RESEARCH AND REVIEWS, v.27, no.8, pp.975 - 979
- Indexed
- SCIE
SCOPUS
- Journal Title
- DIABETES-METABOLISM RESEARCH AND REVIEWS
- Volume
- 27
- Number
- 8
- Start Page
- 975
- End Page
- 979
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/167292
- DOI
- 10.1002/dmrr.1278
- ISSN
- 1520-7552
- Abstract
- Background Latent autoimmune diabetes in adults (LADA) is a form of autoimmune-mediated diabetes in adults, usually defined by GAD autoantibody positivity. Few epidemiological surveys on LADA in Asians did not come to a conclusive answer regarding prevalence and incidence, because of different criteria used in patient ascertainment. Methods We estimated LADA prevalence in a recent type 2 diabetes cohort by the positivity of circulating autoantibodies to pancreatic islet cell antigens (GAD, IA-2 and zinc transporter 8 (ZnT8)) applying a comparable Caucasian criteria. We then observed the development of insulin dependency prospectively for 36 months. Results Applying the European NIRAD LADA group criteria, we found a high prevalence of LADA (4.4%) in Korean patients with phenotypic type 2 diabetes. This high prevalence of LADA in Korea is noteworthy since the previous population-based LADA prevalence survey reported low prevalence (1.7%). When we consider the low-titre GAD antibodies and the low prevalence of multiple autoantibodies, however, increased LADA prevalence does not necessarily mean increase in future insulin dependency. After 36 months of follow-up, only 3 of 39 patients who were initially classified as LADA have become insulin-dependent. Those three were all positive for multiple autoantibodies (GAD, IA-2 and zinc transporter 8 antibody). Other features of insulin secretion or insulin resistance did not determine future insulin necessity. Conclusions Although the LADA prevalence estimated by anti-GAD positivity appeared to increase, the true insulin dependency evidenced by multiple antibody positivity did not increase in Korea.
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