Environmental (Lifestyle) Risk Factors for LADA

Author(s): Sofia Carlsson*.

Journal Name: Current Diabetes Reviews

Volume 15 , Issue 3 , 2019

Submit Manuscript
Submit Proposal

Abstract:

Background: In order to prevent diabetes it is important to identify common, modifiable risk factors in the population. Such knowledge is extensive for type 2 diabetes but limited for autoimmune forms of diabetes.

Objective: This review aims at summarizing the limited literature on potential environmental (lifestyle) risk factors for LADA.

Methods: A PubMed search identified 15 papers estimating the risk of LADA in relation to lifestyle. These were based on data from two population-based studies; one Swedish case-control study and one Norwegian cohort study.

Results: Studies published to date indicate that the risk of LADA is associated with factors promoting insulin resistance and type 2 diabetes such as overweight, physical inactivity, smoking, low birth weight, sweetened beverage intake and moderate alcohol consumption (protective). Findings also indicate potential effects on autoimmunity exerted by intake of coffee (harmful) and fatty fish (protective). This supports the concept of LADA as being a hybrid form of diabetes with an etiology including factors associated with both insulin resistance and autoimmunity.

Conclusion: LADA may in part be preventable through the same lifestyle modifications as type 2 diabetes including weight loss, physical activity and smoking cessation. However, current knowledge is hampered by the small number of studies and the fact that they exclusively are based on Scandinavian populations. There is a great need for additional studies exploring the role of lifestyle factors in the development of LADA.

Keywords: LADA, lifestyle, cohort, case-control, latent autoimmune diabetes in adults, risk factors, etiology.

[1]
Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L. The many faces of diabetes: A disease with increasing heterogeneity. Lancet 2014; 383(9922): 1084-94.
[2]
Leslie RD, Palmer J, Schloot NC, Lernmark A. Diabetes at the crossroads: Relevance of disease classification to pathophysiology and treatment. Diabetologia 2016; 59(1): 13-20.
[3]
Vandenbroucke JP, Pearce N. Case-control studies: Basic concepts. Int J Epidemiol 2012; 41(5): 1480-9.
[4]
Krokstad S, Langhammer A, Hveem K, et al. Cohort Profile: The HUNT Study, Norway. Int J Epidemiol 2013; 42(4): 968-77.
[5]
Olsson L, Ahlbom A, Grill V, Midthjell K, Carlsson S. High levels of education are associated with an increased risk of latent autoimmune diabetes in adults: Results from the Nord-Trøndelag health study. Diabetes Care 2011; 34(1): 102-7.
[6]
Hjort R, Alfredsson L, Andersson T, et al. Family history of type 1 and type 2 diabetes and risk of latent autoimmune diabetes in adults (LADA). Diabetes Metab 2017; 43(6): 536-42.
[7]
Samuel VT1, Shulman GI. Mechanisms for insulin resistance: common threads and missing links. Cell 2012; 148(5): 852-71.
[8]
Abdullah A, Peeters A, de Courten M, Stoelwinder J. The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract 2010; 89(3): 309-19.
[9]
Verbeeten KC, Elks CE, Daneman D, Ong KK. Association between childhood obesity and subsequent Type 1 diabetes: A systematic review and meta-analysis. Diabet Med 2011; 28(1): 10-8.
[10]
Carlsson S, Midthjell K, Tesfamarian MY, Grill V. Age, overweight and physical inactivity increase the risk of latent autoimmune diabetes in adults: Results from the Nord-Trøndelag health study. Diabetologia 2007; 50(1): 55-8.
[11]
Hjort R, Ahlqvist E, Carlsson PO, et al. Overweight, obesity and the risk of LADA, results from a Swedish case-control study and the Norwegian HUNT Study. Diabetologia 2018; 61(6): 1333-43.
[12]
Tuomi T, Carlsson A, Li H, et al. Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies. Diabetes 1999; 48(1): 150-7.
[13]
Hawa MI, Kolb H, Schloot N, et al. Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7. Diabetes Care 2013; 36(4): 908-13.
[14]
Zhou Z, Xiang Y, Ji L, et al. Frequency, immunogenetics, and clinical characteristics of latent autoimmune diabetes in China (LADA China study): A nationwide, multicenter, clinic-based cross-sectional study. Diabetes 2013; 62(2): 543-50.
[15]
Wilkin TJ. The accelerator hypothesis: a review of the evidence for insulin resistance as the basis for type I as well as type II diabetes. Int J Obes(Lond) 2009; 33(7): 716-26.
[16]
Carlsson A, Kockum I, Lindblad B, et al. Swedish Better Diabetes Diagnosis Study Group.Low risk HLA-DQ and increased body mass index in newly diagnosed type 1 diabetes children in the Better Diabetes Diagnosis study in Sweden. Int J Obes(Lond) 2012; 36(5): 718-24.
[17]
Yang J, Lernmark Å, Uusitalo UM, et al. Prevalence of obesity was related to HLA-DQ in 2-4-year-old children at genetic risk for type 1 diabetes. Int J Obes (Lond) 2014; 38(12): 1491-6.
[18]
Whincup PH, Kaye SJ, Owen CG, et al. Birth weight and risk of type 2 diabetes: A systematic review. JAMA 2008; 300(24): 2886-97.
[19]
Tyrrell JS, Yaghootkar H, Freathy RM, Hattersley AT, Frayling TM. Parental diabetes and birthweight in 236 030 individuals in the UK biobank study. Int J Epidemiol 2013; 42(6): 1714-23.
[20]
Cardwell CR, Stene LC, Joner G, et al. Birthweight and the risk of childhood-onset type 1 diabetes: A meta-analysis of observational studies using individual patient data. Diabetologia 2010; 53(4): 641-51.
[21]
Hjort R, Alfredsson L, Carlsson PO, et al. Low birthweight is associated with an increased risk of LADA and type 2 diabetes: Results from a Swedish case-control study. Diabetologia 2015; 58(11): 2525-32.
[22]
Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2(1): e000143.
[23]
Smith AD, Crippa A, Woodcock J, Brage S. Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies. Diabetologia 2016; 59(12): 2527-45.
[24]
Rasouli B, Grill V, Midthjell K, Ahlbom A, Andersson T, Carlsson S. Smoking is associated with reduced risk of autoimmune diabetes in adults contrasting with increased risk in overweight men with type 2 diabetes: a 22-year follow-up of the HUNT study. Diabetes Care 2013; 36(3): 604-10.
[25]
Rasouli B, Andersson T, Carlsson PO, et al. Smoking and the Risk of LADA: Results fFrom a Swedish Population-Based Case-Control Study. Diabetes Care 2016; 39(5): 794-800.
[26]
Bajaj M. Nicotine and insulin resistance: when the smoke clears. Diabetes 2012; 61(12): 3078-80.
[27]
Pan A, Wang Y, Talaei M, Hu FB, Wu T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: A systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015; 3(12): 958-67.
[28]
Mabley JG, Pacher P, Southan GJ, Salzman AL, Szabó C. Nicotine reduces the incidence of type I diabetes in mice. J Pharmacol Exp Ther 2002; 300: 876-81.
[29]
Sopori M. Effects of cigarette smoke on the immune system. Nat Rev Immunol 2002; 2(5): 372-7.
[30]
Rasouli B, Andersson T, Carlsson PO, et al. Use of Swedish smokeless tobacco (snus) and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). Diabet Med 2017; 34(4): 514-21.
[31]
Haynes A, Cooper MN, Bower C, Jones TW, Davis EA. Maternal smoking during pregnancy and the risk of childhood type 1 diabetes in Western Australia. Diabetologia 2014; 57(3): 469-72.
[32]
Toschke AM, Ehlin A, Koletzko B, Montgomery SM. Paternal smoking is associated with a decreased prevalence of type 1 diabetes mellitus among offspring in two national British birth cohort studies (NCDS and BCS70). J Perinat Med 2007; 35(1): 43-7.
[33]
Dahlquist G, Källén B. Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1992; 35(7): 671-5.
[34]
Mattsson Jönsson I, Malmqvist E, Larsson HE, Rylander L. Maternal smoking during pregnancy and offspring type 1 diabetes mellitus risk: accounting for HLA haplotype. Eur J Epidemiol 2015; 30(3): 231-8.
[35]
Li XH, Yu FF, Zhou YH, He J. Association between alcohol consumption and the risk of incident type 2 diabetes: A systematic review and dose-response meta-analysis. Am J Clin Nutr 2016; 103(3): 818-29.
[36]
Joosten MM, Beulens JW, Kersten S, Hendriks HF. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: A randomised, crossover trial. Diabetologia 2008; 51(8): 1375-81.
[37]
Pai JK, Hankinson SE, Thadhani R, Rifai N, Pischon T, Rimm EB. Moderate alcohol consumption and lower levels of inflammatory markers in US men and women. Atherosclerosis 2006; 186(1): 113-20.
[38]
Brand-Miller JC, Fatema K, Middlemiss C, et al. Effect of alcoholic beverages on postprandial glycemia and insulinemia in lean, young, healthy adults. Am J Clin Nutr 2007; 85(6): 1545-51.
[39]
Rasouli B, Ahlbom A, Andersson T, et al. Alcohol consumption is associated with reduced risk of Type 2 diabetes and autoimmune diabetes in adults: Results from the Nord-Trøndelag health study. Diabet Med 2013; 30(1): 56-64.
[40]
Rasouli B, Andersson T, Carlsson PO, et al. Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study. Eur J Endocrinol 2014; 171(5): 535-43.
[41]
Löfvenborg JE, Andersson T, Carlsson PO, et al. Coffee consumption and the risk of latent autoimmune diabetes in adults--results from a Swedish case-control study. Diabet Med 2014; 31(7): 799-805.
[42]
Virtanen SM, Rasanen L, Aro A, et al. Is children’s or parents’ coffee or tea consumption associated with the risk for type 1 diabetes mellitus in children? Childhood Diabetes in Finland Study Group. Eur J Clin Nutr 1994; 48(4): 279-85.
[43]
Lee YH, Bae SC, Song GG. Coffee or tea consumption and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol 2014; 33(11): 1575-83.
[44]
Sharif K, Watad A, Bragazzi NL, Adawi M, Amital H, Shoenfeld Y. Coffee and autoimmunity: More than a mere hot beverage. Autoimmun Rev 2017; 16(7): 712-21.
[45]
Ding M, Bhupathiraju SN, Chen M, van Dam RM, Hu FB. Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis. Diabetes Care 2014; 37(2): 569-86.
[46]
Löfvenborg JE, Andersson T, Carlsson PO, et al. Fatty fish consumption and risk of latent autoimmune diabetes in adults. Nutr Diabetes 2014; 4: e139.
[47]
Schwingshackl L, Hoffmann G, Lampousi AM, et al. Food groups and risk of type 2 diabetes mellitus: A systematic review and meta-analysis of prospective studies. Eur J Epidemiol 2017; 32(5): 363-75.
[48]
Norris JM, Yin X, Lamb MM, et al. Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes. JAMA 2007; 298(12): 1420-8.
[49]
Stene LC, Joner G. Norwegian Childhood Diabetes Study Group.Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: A large, population-based, case-control study. Am J Clin Nutr 2003; 78(6): 1128-34.
[50]
Niinistö S, Takkinen HM, Erlund I, et al. Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity. Diabetologia 2017; 60(7): 1223-33.
[51]
Calder PC. n-3 Fatty acids, inflammation and immunity: new mechanisms to explain old actions. Proc Nutr Soc 2013; 72(3): 326-36.
[52]
Greenwood DC, Threapleton DE, Evans CE, et al. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: Systematic review and dose-response meta-analysis of prospective studies. Br J Nutr 2014; 112(5): 725-34.
[53]
Lamb MM, Frederiksen B, Seifert JA, Kroehl M, Rewers M, Norris JM. Sugar intake is associated with progression from islet autoimmunity to type 1 diabetes: The Diabetes Autoimmunity Study in the Young. Diabetologia 2015; 58(9): 2027-34.
[54]
Löfvenborg JE, Andersson T, Carlsson PO, et al. Sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Eur J Endocrinol 2016; 175(6): 605-14.
[55]
Malik VS, Popkin BM, Bray GA, Després JP, and Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes, and cardiovascular disease risk. Circulation 2010; 121(11): 1356-64.
[56]
Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 2014; 514(7521): 181-6.
[57]
Mattes RD, and Popkin BM. Non-nutritive sweetener consumption in humans: Effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 2009; 89(1): 1-14.
[58]
Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet 2016; 387(10035): 2340-8.
[59]
Rasouli B, Andersson T, Carlsson PO, et al. Serious life events and the risk of latent autoimmune diabetes in adults (LADA) and Type 2 diabetes. Diabet Med 2017; 34(9): 1259-63.
[60]
Olsson L, Ahlbom A, Grill V, Midthjell K, Carlsson S. Sleep disturbances and low psychological well-being are associated with an increased risk of autoimmune diabetes in adults. Results from the Nord-Trøndelag Health Study. Diabetes Res Clin Pract 2012; 98(2): 302-11.
[61]
Kelly SJ, Ismail M. Stress and type 2 diabetes: a review of how stress contributes to the development of type 2 diabetes. Annu Rev Public Health 2015; 36: 441-62.
[62]
Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol 2011; 40(3): 804-18.
[63]
Holmqvist BM, Lofman O, Samuelsson U. A low incidence of Type 1 diabetes between 1977 and 2001 in south-eastern Sweden in areas with high population density and which are more deprived. Diabet Med 2008; 25(3): 255-60.
[64]
Haynes A, Bulsara MK, Bower C, Codde JP, Jones TW, Davis EA. Independent effects of socioeconomic status and place of residence on the incidence of childhood type 1 diabetes in Western Australia. Pediatr Diabetes 2006; 7(2): 94-100.
[65]
Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: An update. Clin Exp Immunol 2010; 160(1): 1-9.
[66]
Kolb H, Martin S. Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med 2017; 15(1): 131.
[67]
Lamb MM, Miller M, Seifert JA, et al. The effect of childhood cow’s milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: The Diabetes Autoimmunity Study in the Young. Pediatr Diabetes 2015; 16(1): 31-8.


Rights & PermissionsPrintExport Cite as


Article Details

VOLUME: 15
ISSUE: 3
Year: 2019
Page: [178 - 187]
Pages: 10
DOI: 10.2174/1573399814666180716150253

Article Metrics

PDF: 34
HTML: 4
EPUB: 1
PRC: 2