| Objective: To explore the distribution of IAA positive LADA patients in phenotypic type 2 diabetic population, and to find diagnostic clues for autoimmune diabetes.Subjects and Methods: Sera of 1003 phenotypic type 2 diabetic patients, 110 type 1 diabetes, 131 latent autoimmune diabetes in adults(GADA/IA-2A positive) before insulin therapy, and 317 health controls, were determinated for IAA with the micro-titer plate radioimmune assay and also screened for GADA and IA-2A with radioligand assay respectively. Observed the distribution of IAA, and explored the value of combined or isolated determination of IAA, GADA, IA-2A in phenotypic type 2 diabetic patients.Results: In T2DM group, the frequencies of IAA were 3.39%, higher than 0.95% of health controls (x~2=53, P<0.05) , but lower than 21.82% of T1DM (x~2=68.2, P<0.001). IAA frequencies were lower than that of GADA (3.39% vs 6.58%, x~2=10.8, P=0.001), but no significant difference was found compared with that of IA-2A (3.39% vs 2.79% P> 0.05) . No significant difference was found in the frequencies of IAA and IA-2A between any age gap, but the frequencies of GADA (14.29%) in 25-34 age group were higher than any other age group. In phenotypic type 2 diabetic patients, the frequency of single IAA positive was 2.39% (24/1003) , 1% (10/1003) of which combined with GADA positive, 0.3% (3/1003) of which combined with both GADA and IA-2A positive. IAA overlapped with GADA or IA-2A were 12.35%. The frequencies of IAA in LADA(GADA/IA-2A positive) patients were 7.63%, all of them combined with GADA, 2.29%(3/131) of them still combined with IA-2A. The combined determination of three antibodies in phenotypic type 2 diabetic patients was 10.47%, of which was higher than IAA,GADA,IA-2A single antibody assay (P<0.05～0.001) , and higher than combined testing of IA-2A和IAA (P<0.05) .Conclusions: A certain proportion of IAA positive LADA patients can be found in phenotypic type 2 diabetes. It is less influenced by age, and less combined with other autoantibodies. The determination of IAA at the basis of GADA, IA-2A, can increase diagnostic sensitivity of LADA. Objective: To investigate the clinical features LADA patients with IAA positive.Subjects and Methods: 1003 phenotypic T2DM and 131 LADA patients (GADA/IA-2A positive) before insulin therapy have been determinated for IAA, GADA, IA-2A. We observed the distribution of IAA. The subjects were divided into subgroups according to IAA. Then we compared clinical features among different subgroups.Results: Family history of IAA positive in LADA group was higher than IAA-negative matched group(P< 0.001). There was no significant difference of clinical features (BMI, HbA1c and C peptide) between IAA-positive LADA group and IAA-negative matched T2DM group (P> 0.05). TG level of single IAA-positive group was higher than single GADA-negative group (P=0.017) , while compared with antibody-negative group, there was no significant difference of clinical features. WHR, TG, and TC of single GADA-positive group were lower than antibody-negative group(P was 0.004, 0.000 and 0.002, respectively). The duration of IAA-positive LADA group was shorter than IAA-negative matched group(P< 0.001), levels of FINS, HOMA-IR and HOMA-IS were lower than IAA-negative matched group(respective P was 0.012, 0.024 and 0.012), and the levels of FINS and FCP were lower than LADA group(P was 0.011, and 0.05, respectively). Conclusions: 1.IAA positive LADA patients had significant family history, but no different clinical features compared with type 2 diabetic patients. 2. IAA-positive LADA patients had worse beta-cell function than IAA-negative LADA patients. Objective: To investigate the Changes of clinical features and autoantibody titers in 4 LADA Patients with IAA positive in four-year follow up.Subjects and Methods: Sera of 4 IAA positive diabetic patients and 20 IAA negative matched T2DM patients in four-year follow up. IAA, GADA and IA-2A were tested each year. We observed three antoantibodies titers and clinical features every year in different groups. All of them accepted no insulin therapy in four years.Results: The positivity of IAA decreased year by year in IAA positive follow-up group. 4 cases of IAA positive turned negative at the fourth year, during the follow up, two cases appeared GADA positive. HbA1c was higher in IAA positive follow-up group at the second year, and FBS was higher at the third year, compared with IAA-negative follow-up group at same period. However, there were no significant difference of BMI, WHR, FINS, HOMA-IR, HOMA-IS, SBP, DBP between IAA positive group and its matched group at the same year. Average descending rate of beta cell function in IAA positive group was 15.37%, compared with 6.86% of its matched group. When IAA positive followed subgroup compared with IAA negative followed subgroup, the descending tendency of FINS, HOMA-IS, HOMA-IR and HbA1c level had no significant difference(P>0.05) in the four years. HOMA-IR,HOMA-IS,FINS and TG at the first year in IAA positive follow-up group were lower than its baseline, HOMA-IS and FINS were also lower than its baseline at the fourth year. HbA1c, HOMA-IR, and FINS at the first year were lower than its baseline in IAA negative matched group, HbA1c at the second year was lower at the third year, HbA1c, SBP, TG, TC and LDL-C were lower, HOMA-IR, FINS, SBP and DBP were lower at the fourth year.Conclusions: 1. GADA combined with IAA or appeared after IAA in IAA positive-patients in follow-up study. 2. Average descending rate of beta cell function in IAA positive group had a fast tendency, but no significant difference was found compared with IAA negative matched group.
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