Immunological and clinical characteristics of latent autoimmune diabetes in the elderly

Autores
Yohena, Silvina; Penas Steinhardt, Alberto; Muller, Clara; Faccinetti, Natalia Ines; Cerrone, Gloria Edith; Lovecchio, Silvia; Ridner, Alberrto Edgardo; Valdez, Silvina Noemi; Frechtel, Gustavo Daniel
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Latent autoimmune diabetes in adults (LADA) is determined by both a noninsulin-dependent clinical presentation and an autoimmune pathogenic process. Glutamic acid decarboxylase antibody (GADA) constitutes the most important marker, although IA-2A and ZnT8A also define LADA presentation. Type 2 diabetes mellitus (T2DM) is the most prevalent type particularly over 65 years old. Studies about autoimmunity in this age group are scarce. Objective: The aim of this work was to determine whether three autoantibodies for diabetes autoimmunity were present in elderly T2DM patients, and to assess the distinctive clinical features of autoantibody-positive patients. Research Design and Methods: We recruited 153 patients with diabetes with onset of diabetes after 65 years of age and a BMI under 30 kg/m2. Results: The prevalence of at least one of the autoantibodies was 15.68% (24/153). The most prevalent autoantibody was GADA with 8.49% (13/153), followed by ZnT8A with 6.50% (10/153) and IA2A with 1.96% (3/153). The autoimmunity-positive group presented higher HbA1c (7.01 ± 1.98 vs 6.35 ± 1.01; P = 0.007) and more prevalent insulin therapy (25% vs 10.85%; P = 0.047). GADA-positive patients with diabetes presented higher FPG (7.79 ± 3.79 mmol/L vs 6.43 ± 1.6 mmol/L; P = 0.014) and insulin therapy more frequently (46% vs 10.71%; p = 0.015). GADA titre levels in the individuals with BMI under 27 kg/m2 were higher (35.00 ± 4.20) than those in the group with BMI over 27 kg/m2 (8.83 ± 3.041; P = 0.0005). Conclusion:: Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly.
Fil: Yohena, Silvina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Penas Steinhardt, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina. Universidad Nacional de Luján; Argentina
Fil: Muller, Clara. Hospital Sirio Libanés; Argentina
Fil: Faccinetti, Natalia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Cerrone, Gloria Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Lovecchio, Silvia. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Ridner, Alberrto Edgardo. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Valdez, Silvina Noemi. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Frechtel, Gustavo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Materia
AUTOIMMUNITY
DIABETES
ELDERLY
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/118223
Acceder
id CONICETDig_c7dc52c32507bbc86fcdef0a855021d0
oai_identifier_str oai:ri.conicet.gov.ar:11336/118223
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Immunological and clinical characteristics of latent autoimmune diabetes in the elderlyYohena, SilvinaPenas Steinhardt, AlbertoMuller, ClaraFaccinetti, Natalia InesCerrone, Gloria EdithLovecchio, SilviaRidner, Alberrto EdgardoValdez, Silvina NoemiFrechtel, Gustavo DanielAUTOIMMUNITYDIABETESELDERLYhttps://purl.org/becyt/ford/3.1https://purl.org/becyt/ford/3Background: Latent autoimmune diabetes in adults (LADA) is determined by both a noninsulin-dependent clinical presentation and an autoimmune pathogenic process. Glutamic acid decarboxylase antibody (GADA) constitutes the most important marker, although IA-2A and ZnT8A also define LADA presentation. Type 2 diabetes mellitus (T2DM) is the most prevalent type particularly over 65 years old. Studies about autoimmunity in this age group are scarce. Objective: The aim of this work was to determine whether three autoantibodies for diabetes autoimmunity were present in elderly T2DM patients, and to assess the distinctive clinical features of autoantibody-positive patients. Research Design and Methods: We recruited 153 patients with diabetes with onset of diabetes after 65 years of age and a BMI under 30 kg/m2. Results: The prevalence of at least one of the autoantibodies was 15.68% (24/153). The most prevalent autoantibody was GADA with 8.49% (13/153), followed by ZnT8A with 6.50% (10/153) and IA2A with 1.96% (3/153). The autoimmunity-positive group presented higher HbA1c (7.01 ± 1.98 vs 6.35 ± 1.01; P = 0.007) and more prevalent insulin therapy (25% vs 10.85%; P = 0.047). GADA-positive patients with diabetes presented higher FPG (7.79 ± 3.79 mmol/L vs 6.43 ± 1.6 mmol/L; P = 0.014) and insulin therapy more frequently (46% vs 10.71%; p = 0.015). GADA titre levels in the individuals with BMI under 27 kg/m2 were higher (35.00 ± 4.20) than those in the group with BMI over 27 kg/m2 (8.83 ± 3.041; P = 0.0005). Conclusion:: Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly.Fil: Yohena, Silvina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; ArgentinaFil: Penas Steinhardt, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina. Universidad Nacional de Luján; ArgentinaFil: Muller, Clara. Hospital Sirio Libanés; ArgentinaFil: Faccinetti, Natalia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Cerrone, Gloria Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Lovecchio, Silvia. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; ArgentinaFil: Ridner, Alberrto Edgardo. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; ArgentinaFil: Valdez, Silvina Noemi. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Frechtel, Gustavo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; ArgentinaJohn Wiley & Sons Ltd2019-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/118223Yohena, Silvina; Penas Steinhardt, Alberto; Muller, Clara; Faccinetti, Natalia Ines; Cerrone, Gloria Edith; et al.; Immunological and clinical characteristics of latent autoimmune diabetes in the elderly; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 5; 7-2019; 1-25; e31371520-7552CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.3137info:eu-repo/semantics/altIdentifier/doi/10.1002/dmrr.3137info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-11-26T08:59:52Zoai:ri.conicet.gov.ar:11336/118223instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-11-26 08:59:52.724CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
title Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
spellingShingle Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
Yohena, Silvina
AUTOIMMUNITY
DIABETES
ELDERLY
title_short Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
title_full Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
title_fullStr Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
title_full_unstemmed Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
title_sort Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
dc.creator.none.fl_str_mv Yohena, Silvina
Penas Steinhardt, Alberto
Muller, Clara
Faccinetti, Natalia Ines
Cerrone, Gloria Edith
Lovecchio, Silvia
Ridner, Alberrto Edgardo
Valdez, Silvina Noemi
Frechtel, Gustavo Daniel
author Yohena, Silvina
author_facet Yohena, Silvina
Penas Steinhardt, Alberto
Muller, Clara
Faccinetti, Natalia Ines
Cerrone, Gloria Edith
Lovecchio, Silvia
Ridner, Alberrto Edgardo
Valdez, Silvina Noemi
Frechtel, Gustavo Daniel
author_role author
author2 Penas Steinhardt, Alberto
Muller, Clara
Faccinetti, Natalia Ines
Cerrone, Gloria Edith
Lovecchio, Silvia
Ridner, Alberrto Edgardo
Valdez, Silvina Noemi
Frechtel, Gustavo Daniel
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv AUTOIMMUNITY
DIABETES
ELDERLY
topic AUTOIMMUNITY
DIABETES
ELDERLY
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.1
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Latent autoimmune diabetes in adults (LADA) is determined by both a noninsulin-dependent clinical presentation and an autoimmune pathogenic process. Glutamic acid decarboxylase antibody (GADA) constitutes the most important marker, although IA-2A and ZnT8A also define LADA presentation. Type 2 diabetes mellitus (T2DM) is the most prevalent type particularly over 65 years old. Studies about autoimmunity in this age group are scarce. Objective: The aim of this work was to determine whether three autoantibodies for diabetes autoimmunity were present in elderly T2DM patients, and to assess the distinctive clinical features of autoantibody-positive patients. Research Design and Methods: We recruited 153 patients with diabetes with onset of diabetes after 65 years of age and a BMI under 30 kg/m2. Results: The prevalence of at least one of the autoantibodies was 15.68% (24/153). The most prevalent autoantibody was GADA with 8.49% (13/153), followed by ZnT8A with 6.50% (10/153) and IA2A with 1.96% (3/153). The autoimmunity-positive group presented higher HbA1c (7.01 ± 1.98 vs 6.35 ± 1.01; P = 0.007) and more prevalent insulin therapy (25% vs 10.85%; P = 0.047). GADA-positive patients with diabetes presented higher FPG (7.79 ± 3.79 mmol/L vs 6.43 ± 1.6 mmol/L; P = 0.014) and insulin therapy more frequently (46% vs 10.71%; p = 0.015). GADA titre levels in the individuals with BMI under 27 kg/m2 were higher (35.00 ± 4.20) than those in the group with BMI over 27 kg/m2 (8.83 ± 3.041; P = 0.0005). Conclusion:: Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly.
Fil: Yohena, Silvina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Penas Steinhardt, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina. Universidad Nacional de Luján; Argentina
Fil: Muller, Clara. Hospital Sirio Libanés; Argentina
Fil: Faccinetti, Natalia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Cerrone, Gloria Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Lovecchio, Silvia. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Ridner, Alberrto Edgardo. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
Fil: Valdez, Silvina Noemi. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina
Fil: Frechtel, Gustavo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Hospital Sirio Libanés; Argentina. Fundación Barceló. Instituto Universitario de Ciencias de la Salud; Argentina
description Background: Latent autoimmune diabetes in adults (LADA) is determined by both a noninsulin-dependent clinical presentation and an autoimmune pathogenic process. Glutamic acid decarboxylase antibody (GADA) constitutes the most important marker, although IA-2A and ZnT8A also define LADA presentation. Type 2 diabetes mellitus (T2DM) is the most prevalent type particularly over 65 years old. Studies about autoimmunity in this age group are scarce. Objective: The aim of this work was to determine whether three autoantibodies for diabetes autoimmunity were present in elderly T2DM patients, and to assess the distinctive clinical features of autoantibody-positive patients. Research Design and Methods: We recruited 153 patients with diabetes with onset of diabetes after 65 years of age and a BMI under 30 kg/m2. Results: The prevalence of at least one of the autoantibodies was 15.68% (24/153). The most prevalent autoantibody was GADA with 8.49% (13/153), followed by ZnT8A with 6.50% (10/153) and IA2A with 1.96% (3/153). The autoimmunity-positive group presented higher HbA1c (7.01 ± 1.98 vs 6.35 ± 1.01; P = 0.007) and more prevalent insulin therapy (25% vs 10.85%; P = 0.047). GADA-positive patients with diabetes presented higher FPG (7.79 ± 3.79 mmol/L vs 6.43 ± 1.6 mmol/L; P = 0.014) and insulin therapy more frequently (46% vs 10.71%; p = 0.015). GADA titre levels in the individuals with BMI under 27 kg/m2 were higher (35.00 ± 4.20) than those in the group with BMI over 27 kg/m2 (8.83 ± 3.041; P = 0.0005). Conclusion:: Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly.
publishDate 2019
dc.date.none.fl_str_mv 2019-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/118223
Yohena, Silvina; Penas Steinhardt, Alberto; Muller, Clara; Faccinetti, Natalia Ines; Cerrone, Gloria Edith; et al.; Immunological and clinical characteristics of latent autoimmune diabetes in the elderly; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 5; 7-2019; 1-25; e3137
1520-7552
CONICET Digital
CONICET
url http://hdl.handle.net/11336/118223
identifier_str_mv Yohena, Silvina; Penas Steinhardt, Alberto; Muller, Clara; Faccinetti, Natalia Ines; Cerrone, Gloria Edith; et al.; Immunological and clinical characteristics of latent autoimmune diabetes in the elderly; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 5; 7-2019; 1-25; e3137
1520-7552
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.3137
info:eu-repo/semantics/altIdentifier/doi/10.1002/dmrr.3137
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv John Wiley & Sons Ltd
publisher.none.fl_str_mv John Wiley & Sons Ltd
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.011256

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