Lipid metabolism and its association with carotid atherosclerosis in patients with latent autoimmune diabetes mellitus in adults

Abstract

Objective To explore the characteristics of lipid metabolism and its correlation with carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA) within 2 years of onset. Methods A total of 38 patients with LADA (LADA group), 50 patients with typical type 1 diabetes mellitus(TT1DM group) within 2 years of onset and 50 individules without diabetes mellitus (NDM group) were enrolled. Blood lipid, carotid artery ultrasound, blood glucose, height, weight, waist circumference and hip circumference were measured. Differences of blood lipids were compared by ANOVA-analysis among three groups, and the correlation between each lipid index and carotid plaque formation were studied. Finally, the predictive value of body fat distribution index in the formation of carotid plaque was estimated by receiver operating characteristic(ROC) curve. Results Body mass index and high density lipoprotein-cholesterol (HDL-C) in LADA group were significantly lower than those in NDM group and higher than those in TT1DM group(F=9.322, 3.190, all P<0.05), while triglyceride (TG) was significantly higher in LADA group than that of the other two groups(F=3.213, P<0.05). After adjusted with HbA1c, fasting glucose and 2 h postprandial glucose, the carotid plaque were positively correlated with TG (r=0.387, P=0.036), TG/HDL-C (r=0.393, P=0.027) and lipid accumulation index (LAP) (r=0.397, P=0.021) , but negatively correlated with HDL-C(r=-0.384, P=0.037)in LADA group. LAP, TG, TG/HDL-C and waist hip ratio(WHR)were significant predictors of carotid plaque, and LAP had the largest area under the curve of ROC (0.707, 95% CI: 0.441-0.906, P=0.031) in patients with LADA. Conclusions Lipid metabolism in patients with LADA are mainly characterized by increase of TG and decrease of HDL-C. TG is a risk factor of atherosclerosis in patients with LADA, and HDL-C is a protective factor. LAP is able to predict the formation of carotid atherosclerosis in patients with LADA. Key words: Latent autoimmune diabetes in adults; Carotid plaque; Atherosclerosis; Lipid accumulation index