IMMUNOMETABOLIC CORRELATIONS OF AUTOANTIBODIES IN LATENT AUTOIMMUNE DIABETES IN ADULTS PATIENTS (LADA): A CROSS-SECTIONAL STUDY

Background: As a form of diabetes mellitus, latent autoimmune diabetes in adults (LADA) shares the features of both type 1 diabetes mellitus and type 2 diabetes mellitus, which can result in misdiagnosis at the early stage of insulin-independence. However, we have limited knowledge about the relations between immunological, anthropometric and clinical parameters in LADA, mainly in Sudanese subjects. Objective: We aimed to assess the prevalence of LADAin patients withT2DMandtoinvestigateassociationsbetweenautoantibodies, C-peptide, anthropometry, and clinical characteristics. Methods: A cross-sectional comparative study was conducted from April 2020 to January 2024 in Osman Degna Hospital and Ahmed Hassan Diabetic Center. A total of 250 patients with type 2 diabetes were included in the study: 150 on insulin treatment several years after diagnosis (study group) and 100 patients not using insulin (control group). Structured interviews were used to obtain demographic, clinical and lifestyle information. C-peptide, GADA, and IA-2A autoantibodies in serum were detected by the MAGLUMI-800 chemiluminescence immunoassay. Results: The prevalence of LADA was 10.7%. The mean C-peptide level was significantly lower in patients with LADAas compared to non-LADA patients (0.50±0.18 vs. p0.7, p<0.001], whilst C-peptide levels negatively correlated with GADA concentrations [r=-0.65, p<0.001]. Inverted correlations were found for autoantibody titers and BMI, waist, weight (p<0.01), showing a link of autoimmune activity with leaner phenotypes and less preserved β cell function. Conclusion: LADA is under recognized with (10.7%), GADA as a significant early marker. Its close associations with C-peptide and anthropometric indices underline its autoimmune-metabolic profile.