First Genome-Wide Association Study of Latent Autoimmune Diabetes in Adults Reveals Novel Insights Linking Immune and Metabolic Diabetes

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Latent autoimmune diabetes in adults (LADA) shares clinical features with both type 1 and type 2 diabetes; however, there is ongoing debate regarding the precise definition of LADA. Understanding its genetic basis is one potential strategy to gain insight into appropriate classification of this diabetes subtype.

RESEARCH DESIGN AND METHODS: We performed the first genome-wide association study of LADA in case subjects of European ancestry versus population control subjects (n = 2,634 vs. 5,947) and compared against both case subjects with type 1 diabetes (n = 2,454 vs. 968) and type 2 diabetes (n = 2,779 vs. 10,396).

RESULTS: The leading genetic signals were principally shared with type 1 diabetes, although we observed positive genetic correlations genome-wide with both type 1 and type 2 diabetes. Additionally, we observed a novel independent signal at the known type 1 diabetes locus harboring PFKFB3, encoding a regulator of glycolysis and insulin signaling in type 2 diabetes and inflammation and autophagy in autoimmune disease, as well as an attenuation of key type 1-associated HLA haplotype frequencies in LADA, suggesting that these are factors that distinguish childhood-onset type 1 diabetes from adult autoimmune diabetes.

CONCLUSIONS: Our results support the need for further investigations of the genetic factors that distinguish forms of autoimmune diabetes as well as more precise classification strategies.

Details

Authors
Organisations
External organisations
  • Queen Mary University
  • Skåne University Hospital
  • Institute for Molecular Medicine Finland (FIMM)
  • Helsinki University Central Hospital
  • University of Helsinki
  • University of Pennsylvania
  • The Children's Hospital of Philadelphia
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes
  • Rheumatology and Autoimmunity

Keywords

  • Adult, Aged, Case-Control Studies, Diabetes Mellitus, Type 1/genetics, Diabetes Mellitus, Type 2/genetics, Female, Genome-Wide Association Study, Glucose Intolerance/genetics, Haplotypes, Humans, Immune System Phenomena/genetics, Insulin/metabolism, Latent Autoimmune Diabetes in Adults/genetics, Male, Middle Aged, Young Adult
Original languageEnglish
Pages (from-to)2396-2403
JournalDiabetes Care
Volume41
Issue number11
Publication statusPublished - 2018 Nov
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

© 2018 by the American Diabetes Association.