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Cited by 251Diabetes and associated disordersDiabetes Management and ResearchAdrenal Hormones and Disorders

Frequency, Immunogenetics, and Clinical Characteristics of Latent Autoimmune Diabetes in China (LADA China Study)

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Zhou, Zhiguang, Xiang, Yufei, Ji, Linong, Jia, Weiping, Ning, Guang, Huang, Gan, Yang, Lin, Lin, Jian +4 more·2013·Diabetes
DOI 10.2337/db12-0207PMC PMC3554388
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Abstract

Adult non–insulin requiring diabetes includes latent autoimmune diabetes of adults (LADA), distinguished from type 2 diabetes by the presence of islet autoantibodies. LADA China determined the characteristics of Chinese LADA. This nationwide, multicenter, clinic-based cross-sectional study was conducted in 46 university-affiliated hospitals in 25 Chinese cities. All 4,880 ketosis-free diabetic patients (<1 year postdiagnosis, without insulin therapy for >6 months, aged ≥30 years) had GAD antibody (GADA) and HLA-DQ genotype measured centrally with clinical data collected locally. GADA-positive subjects were classified as LADA. Of the patients, 5.9% were GADA positive with LADA. LADA showed a north-south gradient. Compared with GADA-negative type 2 diabetes, LADA patients were leaner, with lower fasting C-peptide and less metabolic syndrome. Patients with high GADA titers are phenotypically different from those with low GADA titers, while only a higher HDL distinguished the latter from those with type 2 diabetes. HLA diabetes–susceptible haplotypes were more frequent in LADA, even in those with low-titer GADA. HLA diabetes-protective haplotypes were less frequent in LADA. Our study implicates universal immunogenetic effects, with some ethnic differences, in adult-onset autoimmune diabetes. Autoantibody positivity and titer could be important for LADA risk stratification and accurate therapeutic choice in clinical practice.

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  • The prevalence of several autoantibodies associated with type 1 diabetes mellitus tends to decrease with increasing age at diagnosis, but glutamic acid decarboxylase antibody remains the dominant autoantibody in adult-onset type 1 diabetes mellitus regardless of ethnicity.

    “Although the prevalence of several autoantibodies associated with T1DM tends to decrease with increasing age at diagnosis61, GADA remains the dominant autoantibody in adult-onset T1DM regardless of ethnicity62–64.”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [64]

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Authors
Zhou, Z., Xiang, Y., Ji, L., Jia, W., Ning, G., Huang, G., Yang, L., Lin, J., Liu, Z., Hagopian, W. A., Leslie, R. D., & on behalf of the LADA China Study Group
Affiliations
  • Central South University (CN)
  • Peking University People's Hospital (CN)
  • Shanghai Jiao Tong University (CN)
  • University of Virginia Health System (US)
  • Pacific Northwest Research Institute (US)
  • Blizard Institute (GB)
Corresponding author
Zhou, Zhiguang
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2013-01-17
Volume
62
Issue
2
Pages
543-550
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/db12-0207
PMC
PMC3554388
OpenAlex
W1991909333
Cited by
251
References
1
Citations by year
2026: 12 · 2025: 13 · 2024: 14 · 2023: 12 · 2022: 31 · 2021: 22 · 2020: 22 · 2019: 24 · 2018: 24 · 2017: 19 · 2016: 18 · 2015: 13 · 2014: 15 · 2013: 11 · 2012: 1
FWCI
7.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
latent autoimmune diabetes in adults, glutamic acid decarboxylase antibodies, HLA-DQ, islet autoantibodies, type 2 diabetes, HLA haplotypes, autoantibody titers, risk stratification, regional variation, Chinese population, metabolic syndrome, fasting C-peptide, HDL cholesterol
MeSH terms
Adult, Autoantibodies, C-Peptide, China, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glutamate Decarboxylase, Haplotypes, HLA-DQ Antigens, Humans, Lipoproteins, HDL, Male, Middle Aged, Prediabetic State, Risk, Genetic Predisposition to Disease, Metabolic Syndrome

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