IMMUNOMETABOLIC CORRELATIONS OF AUTOANTIBODIES IN LATENT AUTOIMMUNE DIABETES IN ADULTS PATIENTS (LADA): A CROSS-SECTIONAL STUDY

Abstract

Background: As a form of diabetes mellitus, latent autoimmune diabetes in adults (LADA) shares the features of both type 1 diabetes mellitus and type 2 diabetes mellitus, which can result in misdiagnosis at the early stage of insulin independence. However, we have limited knowledge about the relations between immunological, anthropometric and clinical parameters in LADA, mainly in Sudanese subjects. Objective: We aimed to assess the prevalence of LADA in patients with T2DM and to investigate associations between autoantibodies, C-peptide, anthropometry, and clinical characteristics. Methods: A cross-sectional comparative study was conducted from April 2020 to January 2024 in Osman Degna Hospital and Ahmed Hassan Diabetic Center. A total of 250 patients with type 2 diabetes were included in the study: 150 on insulin treatment several years after diagnosis (study group) and 100 patients not using insulin (control group). Structured interviews were used to obtain demographic, clinical and lifestyle information. C-peptide, GADA, and IA-2A autoantibodies in serum were detected by the MAGLUMI-800 chemiluminescence immunoassay. Results: The prevalence of LADA was 10.7%. The mean C-peptide level was significantly lower in patients with LADA as compared to non-LADA patients (0.50±0.18 vs. p0.7, p<0.001], whilst C-peptide levels negatively correlated with GADA concentrations [r=-0.65, p<0.001]. Inverted correlations were found for autoantibody titers and BMI, waist, weight (p<0.01), showing a link of autoimmune activity with leaner phenotypes and less preserved β cell function. Conclusion: LADA is under recognized with (10.7%), GADA as a significant early marker. Its close associations with C-peptide and anthropometric indices underline its autoimmune-metabolic profile.