Abstract：
To characterize children and adolescents with latent autoimmune diabetes of the young (LADY), and to assess the utility of classifying individuals as LADYs regarding their cardiovascular (CV) risk factors.
Data from 25,520 individuals (age at diagnosis <18 years) of the Prospective Diabetes Follow-up Registry Diabetes-Patienten Verlaufsdokumentation (DPV) were analyzed. LADY was defined as positivity of ≥one islet autoantibody (iAb+) and an insulin-free interval of ≥6 months upon diabetes diagnosis. LADYs were compared to iAb+ individuals immediately requiring insulin (\"immunologically confirmed\" type 1 diabetes, T1DM), iAb-/Ins- individuals (\"classical\" T2DM) and to those clinically defined as T2DM (iAbs not measured).
Clinical characteristics of LADYs (n = 299) fell in between those with T1DM (n = 24,932) and T2DM (iAb-/Ins-, n = 152) or suspected T2DM (iAB not measured, n = 137). Stratifying LADYs according to their clinical diagnosis however revealed two distinct populations, highly resembling either T1DM or T2DM. Particularly, CV risk profile, precisely prevalence rates of arterial hypertension and dyslipidemia, was significantly higher in LADYs clinically classified as T2DM compared to LADYs classified as T1DM, and did not differ from those with \"classical\" T2DM.
In terms of CV risk, classifying children and adolescents with diabetes as LADYs provides no additional benefit. Instead, clinical diagnosis seems to better assign individuals to appropriate risk groups for increased CV risk profiles.
Data from 25,520 individuals (age at diagnosis <18 years) of the Prospective Diabetes Follow-up Registry Diabetes-Patienten Verlaufsdokumentation (DPV) were analyzed. LADY was defined as positivity of ≥one islet autoantibody (iAb+) and an insulin-free interval of ≥6 months upon diabetes diagnosis. LADYs were compared to iAb+ individuals immediately requiring insulin (\"immunologically confirmed\" type 1 diabetes, T1DM), iAb-/Ins- individuals (\"classical\" T2DM) and to those clinically defined as T2DM (iAbs not measured).
Clinical characteristics of LADYs (n = 299) fell in between those with T1DM (n = 24,932) and T2DM (iAb-/Ins-, n = 152) or suspected T2DM (iAB not measured, n = 137). Stratifying LADYs according to their clinical diagnosis however revealed two distinct populations, highly resembling either T1DM or T2DM. Particularly, CV risk profile, precisely prevalence rates of arterial hypertension and dyslipidemia, was significantly higher in LADYs clinically classified as T2DM compared to LADYs classified as T1DM, and did not differ from those with \"classical\" T2DM.
In terms of CV risk, classifying children and adolescents with diabetes as LADYs provides no additional benefit. Instead, clinical diagnosis seems to better assign individuals to appropriate risk groups for increased CV risk profiles.
摘要：
目的：描述儿童和青少年患有青少年隐匿性自身免疫性糖尿病（LADY），并评估将个体分类为LADY的心血管（CV）危险因素的效用。
方法：分析了来自25,520名前瞻性糖尿病随访登记处糖尿病患者Verlaufsdokumentation（DPV）的个体（诊断年龄<18岁）的数据。LADY定义为糖尿病诊断后≥1种胰岛自身抗体(iAb+)阳性且无胰岛素间期≥6个月。将LADYs与立即需要胰岛素的iAb+个体进行比较（“免疫证实”1型糖尿病，T1DM),iAbs-/Ins-个体（“经典”T2DM）和临床定义为T2DM的个体（iAbs未测量）。
结果：LADYs（n=299）的临床特征介于T1DM（n=24,932）和T2DM（iAb-/Ins-，n=152)或疑似T2DM(iAB未测量，n=137）。然而，根据他们的临床诊断对LADYs进行分层显示出两个不同的群体，与T1DM或T2DM非常相似。特别是,CV风险概况，精确的动脉高血压和血脂异常的患病率，与分类为T1DM的LADYs相比，临床分类为T2DM的LADYs明显更高，与“经典”T2DM没有区别。
结论：就CV风险而言，将患有糖尿病的儿童和青少年分类为LADYs没有额外的益处.相反，临床诊断似乎可以更好地将个体分配到适当的风险组,以增加CV风险.
方法：分析了来自25,520名前瞻性糖尿病随访登记处糖尿病患者Verlaufsdokumentation（DPV）的个体（诊断年龄<18岁）的数据。LADY定义为糖尿病诊断后≥1种胰岛自身抗体(iAb+)阳性且无胰岛素间期≥6个月。将LADYs与立即需要胰岛素的iAb+个体进行比较（“免疫证实”1型糖尿病，T1DM),iAbs-/Ins-个体（“经典”T2DM）和临床定义为T2DM的个体（iAbs未测量）。
结果：LADYs（n=299）的临床特征介于T1DM（n=24,932）和T2DM（iAb-/Ins-，n=152)或疑似T2DM(iAB未测量，n=137）。然而，根据他们的临床诊断对LADYs进行分层显示出两个不同的群体，与T1DM或T2DM非常相似。特别是,CV风险概况，精确的动脉高血压和血脂异常的患病率，与分类为T1DM的LADYs相比，临床分类为T2DM的LADYs明显更高，与“经典”T2DM没有区别。
结论：就CV风险而言，将患有糖尿病的儿童和青少年分类为LADYs没有额外的益处.相反，临床诊断似乎可以更好地将个体分配到适当的风险组,以增加CV风险.
