2461-PUB: Increased Apolipoprotein A1 Can Suggest the Presence of Latent Autoimmune Diabetes and a Lower Cardiovascular Risk Compared with Type 2 Diabetes

Latent autoimmune diabetes (LADA) could be misdiagnosed as type 2 diabetes (DM2). Lipids, apolipoproteins, adiponectin (APN), interleukin-6 (IL-6), homocysteine (HCY), other markers of DM, including antibodies, were tested in 276 patients with DM1, DM2 and LADA. Quartiles of lipid accumulation product (LAP) (Q1:≤21.23, Q2:(21.23, 40.69], Q3:(40.69, 92.02], Q4:>92.02) were calculated as: [waist (cm) - 65 for men/58 for women] x triglycerides (mmol/L)]. In all statistical tests: ANOVA and Tukey post hoc test, and stepwise multivariate regression, α=0.05 was considered statistically significant. ANOVA revealed significant differences in HCY, APN, IL-6 and apolipoprotein A1 (Apo A1) among DM types. Patients with DM1 (1.73±0.33) and LADA (1.66±0.38) had significantly higher values of HDL compared to DM2 (1.33±0.31). IL-6 was statistically increased in DM2 compared to DM1; Apo A1 was statistically increased in LADA (1.7±0.36) compared to DM2 (1.4±0.22), whereas HCY was decreased (LADA: 10.9±2.74 vs. DM2 18.2±9.44). APN was decreased in DM2 compared to the control group. Logistic regression for DM2 pointed to APN (OR=0.826; p=0.02), HCY (OR=1.202; p=0.08) and HDL (OR=0.142; p=0.08) as statistically significant predictors, whereas uric acid (OR=0.991; p=0.08) was a predictor of LADA. After stepwise procedure the best model for APN included HDL (R²=0.46), for HCY glomerular filtration (parR²=0.26) and Apo A1 (parR²=0.08), and for Apo A1 HDL (parR²=0.79) and fasting glucose (parR²=0.03). 60% of DM2 patients, but 10.5% of LADA were in the 4^th LAP quartile. Patients in the 4^th quartile had significantly lower values of APN and Apo A1 compared to 1^th and 2^nd quartiles; HCY was increased in 4^th compared to the 1th quartile. Significantly increased HDL and Apo A1 and decreased HCY in LADA compared to DM2 uncover LADA prior to determination of antibodies. Only 10.5% of LADA patients in the 4^th quartile pointed to a lower cardiovascular risk than in DM2.