成人隐匿性自身免疫性糖尿病(LADA)是一种异质性疾病,共有一些表型,遗传,1型和2型糖尿病的免疫学特征。LADA患者的自身免疫过程相对较慢,发病时残留的胰岛β细胞功能较多,允许一个时间窗口来保护残留的胰岛β细胞并延迟或抑制疾病进展。发现影响胰岛β细胞功能的各种异质性因素对于精确的LADA治疗至关重要。在这次审查中,我们首先描述了LADA的自然历史。此后,我们总结了LADA中β细胞功能相关的异质性因子,包括发病年龄,身体质量指数,遗传背景,免疫,生活方式,和环境因素。并行,我们评估了目前降糖药和免疫干预疗法对胰岛β细胞保护的影响.最后,从胰岛β细胞功能保护的角度探讨LADA治疗的机遇与挑战。
Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease sharing some phenotypic, genetic, and immunological features with both type 1 and 2 diabetes. Patients with LADA have a relatively slow autoimmune process and more residual islet β-cell function at onset, allowing a time window to protect residual islet β cells and delay or inhibit disease progression. It is crucial to discover various heterogeneous factors affecting islet β-cell function for precise LADA therapy. In this review, we first describe the natural history of LADA. Thereafter, we summarize β-cell function-related heterogeneous factors in LADA, including the age of onset, body mass index, genetic background, and immune, lifestyle, and environmental factors. In parallel, we evaluate the impact of current hypoglycemic agents and immune intervention therapies for islet β-cell protection. Finally, we discuss the opportunities and challenges of LADA treatment from the perspective of islet β-cell function protection.