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23-09-2022 | Diabetes | News | Article

EASD 2022

Degree of autoimmunity impacts CVD risk in LADA

Author: Claire Barnard

medwireNews: Research reported at the 58th EASD Annual Meeting in Stockholm, Sweden, suggests that people with latent autoimmune diabetes in adults (LADA) and high levels of glutamic acid decarboxylase antibodies (GADA) have a higher risk for cardiovascular disease (CVD) than those with lower autoantibody levels.

The population-based study included 521 people from Sweden with newly diagnosed LADA, 1639 with newly diagnosed type 2 diabetes, and 2165 population controls, among whom there were 322 first CVD events (ischemic heart disease, stroke, or heart failure) during a median follow-up of 6 years.

When people in the LADA group were categorized according to GADA levels, those with high levels of autoimmunity (GADA ≥250 IU/mL) had a significantly elevated risk for CVD relative to population controls (hazard ratio [HR]=1.67), which was similar in magnitude to the increased risk seen in people with type 2 diabetes (HR=1.53 vs controls).

On the other hand, people with LADA and low levels of autoimmunity (GADA <250 IU/mL) had a comparable CVD risk to the population controls.

Yuxia Wei, from the Karolinska Institutet in Stockholm, said that the proportion of individuals meeting target glycated hemoglobin levels of below 53 mmol/mol (7%) “increased sharply after diabetes diagnosis but then started to decline [over time] irrespective of diabetes type.”

She noted, however, that people with LADA, particularly those with a high degree of autoimmunity, had worse glycemic control during the study period than people with type 2 diabetes.

The researchers also compared baseline characteristics in the different diabetes groups, finding that people with LADA and high autoimmunity were less likely to have a history of CVD than those with low autoimmunity and those with type 2 diabetes (6.7 vs 14.9 and 18.1%, respectively), as well as a lower degree of insulin resistance.

Although the people with LADA and high autoimmunity had “healthier metabolic profiles” at the time of diagnosis, this was outweighed by their worse glycemic control during follow-up, remarked Wei.

She said that this, together with recent study results indicating that autoimmunity per se is linked to elevated CVD risk, could explain the increased CVD risk over time in people with LADA and high autoimmunity.

Wei concluded that people with LADA could be stratified into two disease trajectory groups based on GADA levels, in order to “help with more efficient and individualized LADA management.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

EASD Annual Meeting; Stockholm, Sweden: Sept 19–23, 2022