Research Article Details
| Article ID: | A00279 |
| PMID: | 35154005 |
| Source: | Front Endocrinol (Lausanne) |
| Title: | Novel Subgroups and Chronic Complications of Diabetes in Middle-Aged and Elderly Chinese:A Prospective Cohort Study. |
| Abstract: | Background: Diabetes mellitus, especially type 2 diabetes mellitus (T2DM), is regarded as highly heterogeneous. Novel diabetes phenotypes by cluster analysis have been proposed in Europeans but may show different cluster features in Asians. The applicability of cluster analysis in middle-aged and elderly Chinese community T2DM patients needs further investigation. Methods: Participants were recruited from Jiading community in Shanghai, China. We adopted k-means cluster analysis in 1130 patients (aged ≥ 40 years) with newly-diagnosed T2DM at baseline. Cluster analysis was performed based on seven variables, including fasting plasma glucose, 2 hours postprandial blood glucose, age at diagnosis, body mass index, hemoglobin A1c, homoeostatic model assessment estimates of β-cell function and insulin resistance. All subjects were re-examined at 4.4 years later. Metabolic associated fatty liver disease was diagnosed using B-ultrasound, hepatic fibrosis by non-invasive scores, renal and cardiovascular status by subclinical biomarkers. Multivariable logistic regression models were used to compare the risks of complications between clusters. Results: Patients were classified into 4 clusters. 381 (33.7%), 456 (40.4%), 87 (7.7%), and 206 (18.2%) patients were separately assigned to mild age-related diabetes (MARD), mild obesity-related diabetes (MOD), severe insulin-deficient and insulin-resistant diabetes (SIDRD), or severe obesity-related and insulin-resistant diabetes (SOIRD), respectively. Participants in MARD, SOIRD, and SIDRD clusters were associated with significantly increased risks of different complications. SOIRD and SIDRD showed novel features in Chinese T2DM patients that were different from those in Europeans. Conclusions: The refined diabetes phenotypic approach was applicable to Chinese middle-aged and elderly T2DM patients. Patients in different clusters presented significantly different characteristics, progression of metabolic features, and risks of diabetic complications. |
| DOI: | 10.3389/fendo.2021.802114 |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | Details |
| S03 | Anti-fibrosis | fibrosis | Angiotensin Receptor Blocker (ARB); CCR2/CCR5 antagonist; Thyroid receptor β agonist; PEGylated human FGF21 analogue; Monoclonal antibody to lysyl oxidase-like 2 (LOXL2); Galectin-3 inhibitor; FGF19 variant | Losartan; Cenicriviroc; VK-2809; MGL-3196; Pegbelfermin; Simtuzumab; GR-MD-02; NGM282 | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |
| I07 | 1936 | Arteriosclerosis | Build-up of fatty material and calcium deposition in the arterial wall resulting in partial or complete occlusion of the arterial lumen.https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C35768 | disease of anatomical entity/cardiovascular system disease/ vascular disease/ artery disease | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D083 | CLA | Chemical drug | DB01211 | KCNH2; SLCO1B1; SLCO1B3 | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D094 | Cysteamine | Chemical drug | DB00847 | GSS stimulant | Renal drug | Under clinical trials | Details |
| D095 | Cysteamine bitartrate | Chemical drug | DB00847 | -- | -- | Under clinical trials | Details |