Nutr Metab Cardiovasc Dis. 2026 Mar 4:104675. doi: 10.1016/j.numecd.2026.104675. Online ahead of print.
ABSTRACT
BACKGROUND AND AIM: Despite differing clinical phenotypes, the cardiovascular-metabolic risks and complications of latent autoimmune diabetes in adults (LADA) versus type 2 diabetes mellitus (T2DM) are not fully defined. This study aimed to compare subclinical carotid atherosclerosis between LADA and T2DM.
METHODS AND RESULTS: This cross-sectional analysis included 202 LADA and 206 T2DM patients matched for age, sex, body mass index, hemoglobin A1c, and statin use. Following assessment of carotid ultrasonography [carotid intima-media thickness (IMT), plaque], ankle-brachial index, toe-brachial index, brachial-ankle pulse wave velocity, lipid profile, urine albumin-to-creatinine ratio (uACR), and microvascular complications, group differences were analyzed. Univariable and multivariable logistic regression were then employed to identify independent predictors of carotid IMT ≥1.0 mm. Patients with LADA demonstrated a more favorable cardiometabolic profile than those with T2DM, including lower blood pressure, improved lipids, reduced uACR, and less severe carotid disease (all p < 0.05). T2DM was linked to higher rates of diabetic kidney disease and autonomic neuropathy. In multivariable analysis, LADA status was independently associated with a lower likelihood of increased IMT (OR = 0.405, 95% CI: 0.196-0.840, p = 0.003), whereas age, hypertension, smoking, and dyslipidemia were positively associated with increased IMT.
CONCLUSION: Even when key metabolic risk factors are comparable, LADA exhibit a lower burden of subclinical carotid atherosclerosis than T2DM. This finding suggests that vascular injury in diabetes is driven more substantially by cumulative metabolic exposure and traditional cardiovascular risk factors, rather than by glycemic control or the diabetes subtype alone.
PMID:41935855 | DOI:10.1016/j.numecd.2026.104675