Objective: To compare subclinical atherosclerosis (AS) between latent autoimmune diabetes in adults (LADA) and type 2 diabetes mellitus (T2D) and to evaluate the impact of early insulin intervention on AS progression in LADA.
Methods: Sixty-four LADA patients and forty T2D patients, matched for diabetes duration, were enrolled from the LADA China multicenter study. Baseline assessments included ultrasound examination of carotid arteries (common carotid artery [CCA], internal carotid artery [ICA], and femoral carotid artery [FCA]). Additionally, demographic and clinical parameters including body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (A1c), lipid panel, fasting C-peptide (FCP), and postprandial C-peptide (PCP) levels were measured. Medical history was recorded. LADA diagnosis was confirmed with positive glutamic acid decarboxylase antibodies (GADA). Subclinical AS was defined as an increase in intima-media thickness (IMT) greater than 1.0mm or the presence of plaque. Statistical analysis was performed using SPSS with significance set at p < 0.05.
Results: Regression analysis identified age, obesity, and lipid levels (total cholesterol and free fatty acids [FFA]) as risk factors for subclinical AS. After adjusting for age, LADA patients demonstrated similar IMT thickness compared to T2D patients, but a significantly lower AS diagnosis rate and smaller plaque area. Following a three-year follow-up with insulin or non-insulin interventions in LADA patients, the insulin intervention group exhibited a significantly lower AS progression rate.
Conclusion: Our study challenges previous findings by showing that LADA patients have less AS than T2D patients at baseline. Moreover, early insulin intervention may effectively reduce AS progression in LADA, emphasizing the importance of timely management in this population.
Y. Xiang: None. X. Li: None. Y. Xiao: None. G. Huang: None. Z. Zhou: None.
