Endocrine Abstracts

Background: Among the heterogeneous types of diabetes mellitus (DM), latent autoimmune diabetes in adults (LADA) is the most common and attracts the attention of scientists, the pathogenesis of which combines the main mechanisms of classical type 1 (T1DM) and type 2 diabetes mellitus (T2DM). The role of hyperamylinemia in the development and progression of LADA remains out of the researchers’ attention.

The objective: of the study was to determine the features of the level of amylinemia in patients with LADA compared to classical types of DM.

Methods: 89 patients with diabetes and chronic kidney disease (CKD) were examined, as well as 15 representatives of the control group. The patients were divided into three groups by the types of DM (25 patients with classical T1DM, 36 patients with LADA, 28 patients with T2DM). The LADA group included patients with LADA1 phenotype (antiGAD ≥180 U/ml) and LADA2 phenotype. Serum amylin levels were measured using the ELISA method.

Results: In patients with classical T1DM, the level of amylinemia did not change, whereas in T2DM group it was 10.8 times significantly higher compared to the control and 8.3 times higher than in the group of patients with classical T1DM. In the group of patients with LADA, the amylin content was 9.0 times higher than in control and 6.8 times higher compared to classical T1DM. In the distribution of patients with LADA into phenotypes, in patients with LADA1, the serum level of amylin was 5.9 times higher relative to the control (P<0.01), 4.1 times higher relative to classical T1DM (P<0.01), but almost half as low as in T2DM (P<0.01). In LADA2 group, the above indicator exceeded that in the control group by 13.5 times (P<0.01), in the group of classical T1DM – by 9.3 times (P<0.01) and in patients with LADA1 – by 2.3 times (P<0.05). In patients with LADA, an interdependence was found between the content of amylin and insulin (r=0.64;P=0.000), C-peptide (r=0.74;P=0.000), the HOMA-IR index (r=0.54;P=0.001).

Conclusions: Serum amylin level significantly increase in patients with latent autoimmune diabetes in adults, especially in LADA2 phenotype compared to classical types of diabetes, which indicates the role of hyperamylinemia in the development and progression of this subtype of diabetes.