Latent autoimmune diabetes of adults and its clinical, immunological and genetics markers
Tatyana Tikhonova, Yurii Karachentsev, Svetlana Shtandel & Tamara Levchenko
The aim of the study was to determine the clinical, immunological and genetics markers of latent autoimmune diabetes of adults (LADA) in early terms of disease development.
Materials and methods: Seventy-eight LADA patients (47 women, 31 men, age of manifestation 45.52±1.83 years, average age 49.37±1.17 years, insulindependence age 49.33±0.34 years with anti islet, GADA antibodies and low C-peptide levels) were enrolled. The GADA, IA2A and ICA antibodies were measured with RIA. The presence of C1858T PTPN22 gene polymorphism was estimated using the DNA sequencing method.
Results: It has been shown, that the leading complaint during a manifestation of disease was progressing body weight reduction from 6 up to 20 kg (on the average 12.67±0.73 kg). At 11.54% patients before insulin application short-term acetonuria episodes were observed. The glycemia level at verification of the diagnosis was determined within the limits of from 8 up to 20.0 mmol/l (on the average 13.7±0.51 mmol/l). It has been shown, that definition only one kind of antibodies for LADA form final verification is not enough. Frequency a positive tytres of each of immunologic LADA markers changed from 6.4% (GAD ab, ICA ab) up to 16.67% (IA-2A ab). The least demonstrative were definition ICA ab+IA-2A ab, most GAD ab+IA-2A ab. Verification of LADA determination, are necessary at least two kinds of antibodies, in view of clinical features of disease manifestation. LADA patients had the high C1858T polymorphism of PTPN22 gene frequency: T/T genotype was 22.09% (; P=0.000) and powerful association LADA with C1858T polymorphism of PTPN22 gene: T/T genotype ORLADA=37.19 (8.30166.57).
Conclusions: It has been shown, that progressing body weight reduction, two kinds of antibodies and T/T genotype in 1858 position of PTPN22 gene are the important LADA markers.