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Overweight, obesity and the risk of LADA: results from a Swedish case-control study and the Norwegian HUNT Study
Karolinska Inst, Inst Environm Med, Unit Epidemiol, Box 210, S-17177 Stockholm, Sweden.
Lund Univ, Dept Clin Sci Malmo, Clin Res Ctr, Malmo, Sweden.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Transplantation och regenerativ medicin.
Norwegian Univ Sci & Technol, Dept Clin & Mol Med, NTNU, Trondheim, Norway;Trondheim Reg & Univ Hosp, St Olavs Hosp, Dept Endocrinol, Trondheim, Norway.
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2018 (Engelska)Ingår i: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 61, nr 6, s. 1333-1343Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims/hypothesis Excessive weight is a risk factor for type 2 diabetes, but its role in the promotion of autoimmune diabetes is not clear. We investigated the risk of latent autoimmune diabetes in adults (LADA) in relation to overweight/obesity in two large population-based studies. Methods Analyses were based on incident cases of LADA (n = 425) and type 2 diabetes (n = 1420), and 1704 randomly selected control participants from a Swedish case-control study and prospective data from the Norwegian HUNT Study including 147 people with LADA and 1,012,957 person-years of follow-up (1984-2008). We present adjusted ORs and HRs with 95% CI. Results In the Swedish data, obesity was associated with an increased risk of LADA (OR 2.93, 95% CI 2.17, 3.97), which was even stronger for type 2 diabetes (OR 18.88, 95% CI 14.29, 24.94). The association was stronger in LADA with low GAD antibody (GADA; <median) (OR 4.25; 95% CI 2.76, 6.52) but present also in LADA with high GADA (OR 2.14; 95% CI 1.42, 3.24). In the Swedish data, obese vs normal weight LADA patients had lower GADA levels, better beta cell function, and were more likely to have low-risk HLA-genotypes. The combination of overweight and family history of diabetes (FHD) conferred an OR of 4.57 (95% CI 3.27, 6.39) for LADA and 24.51 (95% CI 17.82, 33.71) for type 2 diabetes. Prospective data from HUNT indicated even stronger associations; HR for LADA was 6.07 (95% CI 3.76, 9.78) for obesity and 7.45 (95% CI 4.02, 13.82) for overweight and FHD. Conclusions/interpretation Overweight/obesity is associated with increased risk of LADA, particularly when in combination with FHD. These findings support the hypothesis that, even in the presence of autoimmunity, factors linked to insulin resistance, such as excessive weight, could promote onset of diabetes.

Ort, förlag, år, upplaga, sidor
SPRINGER , 2018. Vol. 61, nr 6, s. 1333-1343
Nyckelord [en]
ANDIS, ANDiU, Body mass index, Case-control study, ESTRID, HUNT Study, LADA, Latent autoimmune diabetes in adults, Prospective study, Type 2 diabetes
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
URN: urn:nbn:se:uu:diva-356380DOI: 10.1007/s00125-018-4596-0ISI: 000431650800011PubMedID: 29589073OAI: oai:DiVA.org:uu-356380DiVA, id: diva2:1239162
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärdEU, Europeiska forskningsrådet, GA 269045VetenskapsrådetTillgänglig från: 2018-08-15 Skapad: 2018-08-15 Senast uppdaterad: 2018-08-15Bibliografiskt granskad

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