Pattern of metabolic profile of latent autoimmune diabetes in adults (LADA) subgroup among type two diabetic patients attending tertiary health facility in Northern Nigeria

Abstract

Aims: Insulin secretory defect, but not resistance, is the common feature of latent autoimmune diabetes in adults (LADAs), and insulin resistance is considered central in the pathophysiology of metabolic syndrome (MS). The aim of the study is to describe the pattern of the clinical and cardiometabolic characteristics of LADA in Northern Nigeria. Methods: This cross-sectional survey was conducted involving age- and sex-matched 48 LADA patients, 50 type 2 diabetes mellitus (T2DM) patients, and 52 normal controls,. The clinical and physical characteristics including weight, height, waist circumference, hip circumference, and blood pressure measurements were performed. The body mass index (BMI) and waist–hip ratio were also determined. A fasting blood test was taken for glucose, lipids, HbA1c, c-peptide, and glutamic acid decarboxylase antibody (GADA) estimation. ELISA method (Kronus kit, USA) was used for GADA estimation, >5.0 units/ml was considered positive while c-peptide value of < 1.0 μ/ml is considered low. A clinical criterion for the diagnosis of LADA was used. The Modified International Diabetes Federation-ethnic criteria for classification of MS were used. The SPSS package version 20 was used to analyze the data with P < 0.05 as statistically significant level. Results: The mean ages for LADA and T2DM were 50.1 (11.3) and 51.2 (9.1) years, respectively, and the mean duration of disease was 6.1 (3.7) years in LADA and 7.0 (5.6) years in T2DM patients, P> 0.05. The BMI and WC were 22.1 (5.1) and 80.1 (12.4) cm for LADA and 27.3 (4.9) and 93.2 (10.9) cm for T2DM patients, respectively, P < 0.05. The LADA showed lower high-density lipoprotein-cholesterol (HDL-C), triglyceride (TGD), and blood pressure values, while the T2DM group had a better glucose control. The prevalence of MS was 5.7%, 19%, and 68% for the normal, LADA, and T2DM groups, respectively. Conclusions: It was found in this study that LADA subset of diabetes exhibited metabolic features consistent with both defective insulin secretion and insulin resistance. They were found to be lean with low TGD and HDL-C levels.