Abstract
Background The study aimed to estimate the prevalence of unrecognized cases with positive autoantibodies among type 2 diabetes (T2D) in a sample of the Bulgarian population and to compare some metabolic and inflammatory markers to those of patients having negative autoantibodies and subjects with latent autoimmune diabetes (LADA). Methods Patients with T2D, patients with LADA, and control participants were enrolled. Antiglutamic acid decarboxylase, anti-insulinoma-associated 2, and antizinc transporter 8 autoantibodies were assayed through ELISA. C-reactive protein and interleukin 6 (IL-6) and tumor necrosis factor alpha were assessed. Results Ten percent of patients with T2D had positive autoantibodies. They had lower body mass index (p = 0.014), worse glycemic control (HbA1c, p = 0.033), and better HDL cholesterol (p = 0.026) than those in negative autoantibodies cases. Compared to LADA, glycemia and anthropometric data did not differ significantly but metabolic syndrome was more prevalent among newly found cases with positive autoantibodies (p = 0.046). Their level of inflammatory markers was similar to that of patients having negative autoantibodies (p > 0.05), but IL-6 was higher when compared to LADA (p = 0.002). Conclusion Prevalence of patients having positive autoantibodies within T2D in the analyzed sample of the Bulgarian population was 10%. They shared common metabolic features with subjects with LADA, but inflammatory phenotype was closer to that of T2D.
Highlights
Whilst type 1 diabetes mellitus (T1D) is most commonly diagnosed in children and type 2 diabetes mellitus (T2D) predominantly affects adults, it is hard to establish any age boundaries between both forms of the disease
The aim of the study was to analyze the prevalence of unrecognized cases with positive diabetes-associated autoantibodies among patients initially diagnosed with T2D, to describe their metabolic features and characterize the alterations in high sensitivity C-reactive protein, interleukin 6 (IL-6), and tumor necrosis factor alpha (TNFα) in comparison with participants having negative autoantibodies and patients already known to meet the criteria for latent autoimmune diabetes (LADA)
For all patients with previously diagnosed autoimmune diabetes, the presence of autoantibodies was confirmed—all (100%) were positive for GAD65A and 6 (42.9%) were positive for insulinoma-associated-2 antibodies—tyrosine phosphatase associated (IA-2A)
Summary
Whilst type 1 diabetes mellitus (T1D) is most commonly diagnosed in children and type 2 diabetes mellitus (T2D) predominantly affects adults, it is hard to establish any age boundaries between both forms of the disease. The study aimed to estimate the prevalence of unrecognized cases with positive autoantibodies among type 2 diabetes (T2D) in a sample of the Bulgarian population and to compare some metabolic and inflammatory markers to those of patients having negative autoantibodies and subjects with latent autoimmune diabetes (LADA). Compared to LADA, glycemia and anthropometric data did not differ significantly but metabolic syndrome was more prevalent among newly found cases with positive autoantibodies (p = 0 046) Their level of inflammatory markers was similar to that of patients having negative autoantibodies (p > 0 05), but IL-6 was higher when compared to LADA (p = 0 002). Prevalence of patients having positive autoantibodies within T2D in the analyzed sample of the Bulgarian population was 10% They shared common metabolic features with subjects with LADA, but inflammatory phenotype was closer to that of T2D
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