title: Autoimmune diabetes in adults and risk of myocardial infarction: the HUNT study in Norway.
abstract: The long-term consequences of autoimmune diabetes in adults (AIDA) are largely unexplored.
  
  
  
  To investigate the risk of myocardial infarction (MI) in AIDA compared to type 2 diabetes, taking into consideration the effects of socio-economic and lifestyle factors, the metabolic syndrome and glycaemic control.
  
  
  
  A total of 62 995 participants including 207 individuals with AIDA (onset ≥35 years and anti-GAD positive) and 2322 individuals with type 2 diabetes (onset ≥35 years and anti-GAD negative), from the population-based Norwegian HUNT study, were followed for a first MI during the period 1995-2008. We identified 2614 MIs by hospital records or the National Cause of Death Registry. Cox proportional hazard models were used to estimate the risk of MI by diabetes subgroups after adjustment for age and socio-economic and lifestyle factors.
  
  
  
  AIDA amongst women was associated with a nearly fourfold increased risk of MI [hazard ratio (HR) 3.63, 95% confidence interval (CI) 2.21-5.96) compared to nondiabetic participants, whereas no excess risk was found in men with AIDA (HR 1.30, 95% CI 0.70-2.52). By contrast, type 2 diabetes was associated with an increased MI risk in both men (HR 1.92, 95% CI 1.62-2.26) and women (HR 2.39, 95% CI 1.98-2.89). The metabolic profile was more favourable in patients with AIDA than in those with type 2 diabetes, but glycaemic control was worse. Multivariable models and sensitivity analyses suggest that these results were robust.
  
  
  
  Women with AIDA were more likely to develop MI, compared to men with AIDA and both men and women with type 2 diabetes. Further investigations are warranted to confirm this gender difference.
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. lars.e.laugsand@ntnu.no.|Department of Cardiology, St. Olavs Hospital, Trondheim, Norway. lars.e.laugsand@ntnu.no.
authors.forename: L E
authors.initials: LE
authors.lastname: Laugsand
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Janszky
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: L J
authors.initials: LJ
authors.lastname: Vatten
authors.affiliation: Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.|Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Dalen
authors.affiliation: HUNT Research Centre, Department of Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Midthjell
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: V
authors.initials: V
authors.lastname: Grill
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Carlsson
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications*; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose
keywords: autoimmune diabetes in adults; cardiovascular disease risk factors; epidemiology; latent autoimmune diabetes in adults; myocardial infarction; type 2 diabetes