Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Autoimmune diseases and the risk and prognosis of latent autoimmune diabetes in adults

Santoso, Cornelia ; Wei, Yuxia ; Ahlqvist, Emma LU ; Tuomi, Tiinamaija LU orcid and Carlsson, Sofia LU (2025) In Diabetologia 68(2). p.331-341
Abstract

Aims/hypothesis: The aim of this study was to clarify the impact of autoimmune disease (AD) comorbidity on the risk and prognosis of latent autoimmune diabetes in adults (LADA). Methods: We used data from a Swedish study comprising newly diagnosed cases of LADA (n=586, stratified into LADAlow and LADAhigh by autoantibody levels), type 2 diabetes (n=2003) and matched control participants (n=2355). Information on 33 ADs and diabetic retinopathy was obtained by linkage to regional and national registers. We estimated the ORs for LADA and type 2 diabetes in relation to ADs before diabetes diagnosis, and the HRs for diabetic retinopathy after diabetes diagnosis. We performed functional pathway analyses to explore... (More)

Aims/hypothesis: The aim of this study was to clarify the impact of autoimmune disease (AD) comorbidity on the risk and prognosis of latent autoimmune diabetes in adults (LADA). Methods: We used data from a Swedish study comprising newly diagnosed cases of LADA (n=586, stratified into LADAlow and LADAhigh by autoantibody levels), type 2 diabetes (n=2003) and matched control participants (n=2355). Information on 33 ADs and diabetic retinopathy was obtained by linkage to regional and national registers. We estimated the ORs for LADA and type 2 diabetes in relation to ADs before diabetes diagnosis, and the HRs for diabetic retinopathy after diabetes diagnosis. We performed functional pathway analyses to explore biological mechanisms driving the associations. Results: Individuals with ADs exhibit an increased susceptibility to LADA (OR 1.70; 95% CI 1.36, 2.13), particularly those with thyroid dysfunction (OR 1.88; 95% CI 1.38, 2.56), inflammatory bowel disease (OR 1.78; 95% CI 1.00, 3.16) or vitiligo (OR 3.91; 95% CI 1.93, 7.94), with stronger associations being observed for the LADAhigh phenotype. Only psoriasis was linked to type 2 diabetes (OR 1.47; 95% CI 1.08, 1.99). The biological pathways shared by LADA and ADs revolved around immune responses, including innate and adaptive immune pathways. The HRs for diabetic retinopathy in LADA patients with and without AD vs those with type 2 diabetes were 2.11 (95% CI 1.34, 3.32) and 1.68 (95% CI 1.15, 2.45), respectively. Conclusions/interpretation: We confirm that several common ADs confer an excess risk of LADA, especially LADA with higher GADA levels, but having such a comorbidity does not appear to affect the risk of diabetic retinopathy. Graphical Abstract: (Figure presented.)

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autoimmune disease, Diabetic retinopathy, Epidemiology, Latent autoimmune diabetes in adults, Prognosis, Risk factor
in
Diabetologia
volume
68
issue
2
pages
331 - 341
publisher
Springer
external identifiers
  • scopus:85207350385
  • pmid:39467873
ISSN
0012-186X
DOI
10.1007/s00125-024-06303-4
language
English
LU publication?
yes
id
b0046d97-9973-4bc6-a2af-0faf94509639
date added to LUP
2025-01-13 14:20:27
date last changed
2025-01-21 11:52:19
@article{b0046d97-9973-4bc6-a2af-0faf94509639,
  abstract     = {{<p>Aims/hypothesis: The aim of this study was to clarify the impact of autoimmune disease (AD) comorbidity on the risk and prognosis of latent autoimmune diabetes in adults (LADA). Methods: We used data from a Swedish study comprising newly diagnosed cases of LADA (n=586, stratified into LADA<sup>low</sup> and LADA<sup>high</sup> by autoantibody levels), type 2 diabetes (n=2003) and matched control participants (n=2355). Information on 33 ADs and diabetic retinopathy was obtained by linkage to regional and national registers. We estimated the ORs for LADA and type 2 diabetes in relation to ADs before diabetes diagnosis, and the HRs for diabetic retinopathy after diabetes diagnosis. We performed functional pathway analyses to explore biological mechanisms driving the associations. Results: Individuals with ADs exhibit an increased susceptibility to LADA (OR 1.70; 95% CI 1.36, 2.13), particularly those with thyroid dysfunction (OR 1.88; 95% CI 1.38, 2.56), inflammatory bowel disease (OR 1.78; 95% CI 1.00, 3.16) or vitiligo (OR 3.91; 95% CI 1.93, 7.94), with stronger associations being observed for the LADA<sup>high</sup> phenotype. Only psoriasis was linked to type 2 diabetes (OR 1.47; 95% CI 1.08, 1.99). The biological pathways shared by LADA and ADs revolved around immune responses, including innate and adaptive immune pathways. The HRs for diabetic retinopathy in LADA patients with and without AD vs those with type 2 diabetes were 2.11 (95% CI 1.34, 3.32) and 1.68 (95% CI 1.15, 2.45), respectively. Conclusions/interpretation: We confirm that several common ADs confer an excess risk of LADA, especially LADA with higher GADA levels, but having such a comorbidity does not appear to affect the risk of diabetic retinopathy. Graphical Abstract: (Figure presented.)</p>}},
  author       = {{Santoso, Cornelia and Wei, Yuxia and Ahlqvist, Emma and Tuomi, Tiinamaija and Carlsson, Sofia}},
  issn         = {{0012-186X}},
  keywords     = {{Autoimmune disease; Diabetic retinopathy; Epidemiology; Latent autoimmune diabetes in adults; Prognosis; Risk factor}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{331--341}},
  publisher    = {{Springer}},
  series       = {{Diabetologia}},
  title        = {{Autoimmune diseases and the risk and prognosis of latent autoimmune diabetes in adults}},
  url          = {{http://dx.doi.org/10.1007/s00125-024-06303-4}},
  doi          = {{10.1007/s00125-024-06303-4}},
  volume       = {{68}},
  year         = {{2025}},
}