Autoimmune Phenotype Confirmation Intervals and Clinical Indicators in Patients With Latent Autoimmune Diabetes in Adults (LADA) in Southwest China: A Multicenter Retrospective Cross-Sectional Study.

Authors

Qiang Zhang, Haojie Zhou, Guniqing Zhu, Ran Li, Weiwei Xu, Ruonan Lin, Yuan Zhao, Hui Li, Xiangfu Gu, Xiaoli Zhu

Published in

Journal of diabetes research. Volume 2026. Issue 1. Pages e7481709.

Abstract

Patients with latent autoimmune diabetes in adults (LADA) share overlapping clinical phenotypes with Type 2 diabetes mellitus. Extended autoimmune phenotype confirmation intervals and higher complication risks are observed alongside this phenotypic overlap. Real-world epidemiological data characterizing this interval and relevant clinical indicators remain scarce for Southwest China. This study is aimed at quantifying the duration of this interval and identifying clinical indicators of prolonged confirmation intervals among hospitalized patients in this understudied region.
This multicenter retrospective cross-sectional study recruited consecutive inpatients with confirmed LADA from tertiary hospitals across Southwest China between January 2019 and June 2025. Standardized extraction of baseline demographic, clinical, and laboratory data was performed from electronic medical records. The primary binary outcome was defined as the confirmation interval from initial diabetes diagnosis to autoimmune serological testing, which was dichotomized to distinguish patients with prolonged confirmation intervals. Multivariable binary logistic regression was used to identify clinical indicators showing synchronous coexistence with the intervals. The area under the curve (AUC) and Hosmer-Lemeshow goodness-of-fit test were adopted to evaluate the discrimination and calibration of the regression model.
A total of 578 eligible participants were included, among whom 363 (62.8%) presented prolonged confirmation intervals. The median interval was 2 (0, 7) years across the overall cohort and 5 (2, 10) years for the prolonged-interval group. The multivariate regression model showed satisfactory goodness-of-fit. Seven clinical indicators of prolonged confirmation intervals were divided into three categories: demographic and behavioral characteristics including educational level and duration of alcohol consumption; metabolic biomarkers measured at LADA confirmation including inpatient mean blood glucose and 2-hour C-peptide levels; advanced diabetic manifestations including diabetic retinopathy, diabetic ketosis, and polypharmacy.
A substantial proportion of hospitalized LADA patients in Southwest China present prolonged autoimmune confirmation intervals. Seven clinical indicators showing stable synchronous coexistence with the intervals were identified. The findings provide region-specific real-world evidence characterizing clinical features of patients with such intervals to guide inpatient clinical management. Multicenter prospective studies enrolling community populations are required to examine whether these synchronously coexisting indicators apply to broader patient groups.

PMID:
42708827
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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