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Open Access 01-12-2017 | Original investigation

Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

Authors: Marta Hernández, Carolina López, Jordi Real, Joan Valls, Emilio Ortega-Martinez de Victoria, Federico Vázquez, Esther Rubinat, Minerva Granado-Casas, Nuria Alonso, Teresa Molí, Angels Betriu, Albert Lecube, Elvira Fernández, Richard David Leslie, Dídac Mauricio

Published in: Cardiovascular Diabetology | Issue 1/2017

Abstract

Background

LADA is probably the most prevalent form of autoimmune diabetes. Nevertheless, there are few data about cardiovascular disease in this group of patients. The aim of this study was to investigate the frequency of carotid atherosclerotic plaques in patients with LADA as compared with patients with classic type 1 diabetes and type 2 diabetes.

Methods

Patients with LADA were matched for age and gender in different proportions to patients with type 2 diabetes, and classic type 1 diabetes. None of the patients had clinical cardiovascular disease. All subjects underwent B-mode carotid ultrasound to detect atheroma plaques. Demographics were obtained from all subjects.

Results

We included 71 patients with LADA, 191 patients with type 2 diabetes and 116 patients with type 1 diabetes. Carotid atherosclerosis was more frequent in patients with LADA compared with type 2 diabetes (73.2% vs. 56.9%, P = 0.0018) and classic type 1 diabetes (57.1%, P = 0.026); these changes occurred despite healthier macrovascular risk profiles in the former. Age (P < 0.001), smoking (P = 0.003) and hypertension (P = 0.019) were independently associated with carotid atherosclerosis. Multiple plaques were also more frequent in patients with LADA as compared with classic type 1 diabetes and type 2 diabetes (45.1% and 33.6% vs. 27.2%, respectively, P = 0.022). The frequency of carotid plaques increased with increasing diabetes duration in LADA patients compared with type 2 diabetes (85.7% vs. 58.8%, inverse OR 5.72 [1.5–21.8]; P = 0.009).

Conclusions

LADA patients do not present with less carotid atherosclerosis than patients with type 1 and type 2 diabetes. Their macrovascular risk occurs despite a healthier macrovascular risk profile than those patients with type 2 diabetes.

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Title: Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes
Authors: Marta Hernández
Carolina López
Jordi Real
Joan Valls
Emilio Ortega-Martinez de Victoria
Federico Vázquez
Esther Rubinat
Minerva Granado-Casas
Nuria Alonso
Teresa Molí
Angels Betriu
Albert Lecube
Elvira Fernández
Richard David Leslie
Dídac Mauricio
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Cardiovascular Diabetology / Issue 1/2017
Electronic ISSN: 1475-2840
DOI: https://doi.org/10.1186/s12933-017-0576-9

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