Background.
Latent autoimmune diabetes in adults (LADA) is characterized by islet beta-cell loss and absolute
insulin deficiency, however, studies in recent years have shown some extent of
insulin resistance in LADA patients. In view of
insulin resistance being the central pathogenesis of
metabolic syndrome (MS), we hypothesized that MS could be found in LADA patients. Methods. A total of 60
glutamic acid decarboxylase antibody (GAD-Ab)-positive LADA patients and 120 patients with
type 2 diabetes (T2DM) were enrolled for the study. MS and its components were diagnosed according to the working definitions proposed by World Health Organization and National
Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults (Adult Treatment Panel III [
ATP III]).
Insulin resistance and high sensitive
C reactive protein (
hsCRP) levels were also evaluated in patients with or without MS. Serum
insulin and
hsCRP levels were determined with radioimmune and immunoturbidimetric assays, respectively. Results. MS was found in 50% of LADA patients by WHO criteria and in 40% by
ATP III criteria. The proportions of MS and its metabolic components were all comparable between LADA and T2DM patients except that a lower proportion of
hypertension was seen in LADA. LADA patients with MS had significantly higher HOMA-IR index (0.85 +/- 0.33 vs. 0.60 +/- 0.26, p = 0.001 for WHO criteria; 0.89 +/- 0.34 vs. 0.62 +/- 0.26, p = 0.000 for
ATP III criteria) and
hsCRP levels (0.86 vs. 0.41, p = 0.019 for WHO criteria; 0.96 vs. 0.66, p = 0.018 for
ATP III criteria) than LADA without MS patients. Conclusions. Our findings indicate that MS does exist in LADA patients, suggesting that the a diagnosis of MS could not exclude one of LADA and that
insulin sensitizers may be beneficial in therapeutic strategies for treating these conditions.