LADA prevalence estimation and insulin dependency during follow-up
- Title
- LADA prevalence estimation and insulin dependency during follow-up
- Author
- 박용수
- Keywords
- LADA; prevalence; incidence; insulin dependency; multiple autoantibody positivity
- Issue Date
- 2011-11
- Publisher
- Wiley-Blackwell
- Citation
- Diabetes/Metabolism Research and Reviews, NOV 2011, 27 8, P975-979
- 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. Copyright (C) 2011 John Wiley & Sons, Ltd.
- URI
- http://onlinelibrary.wiley.com/doi/10.1002/dmrr.1278/abstract
- ISSN
- 1520-7552; 1096-9837
- DOI
- 10.1002/dmrr.1278
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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