Nature子刊：揭示前驱糖尿病的6种亚型 | 热心肠日报
Pathophysiology-based subphenotyping of individuals at elevated risk for type 2 diabetes
基于病理生理学的2型糖尿病高风险个体的亚表型
10.1038/s41591-020-1116-9
01-04, Article
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The state of intermediate hyperglycemia is indicative of elevated risk of developing type 2 diabetes1. However, the current definition of prediabetes neither reflects subphenotypes of pathophysiology of type 2 diabetes nor is predictive of future metabolic trajectories. We used partitioning on variables derived from oral glucose tolerance tests, MRI-measured body fat distribution, liver fat content and genetic risk in a cohort of extensively phenotyped individuals who are at increased risk for type 2 diabetes2,3 to identify six distinct clusters of subphenotypes. Three of the identified subphenotypes have increased glycemia (clusters 3, 5 and 6), but only individuals in clusters 5 and 3 have imminent diabetes risks. By contrast, those in cluster 6 have moderate risk of type 2 diabetes, but an increased risk of kidney disease and all-cause mortality. Findings were replicated in an independent cohort using simple anthropomorphic and glycemic constructs4. This proof-of-concept study demonstrates that pathophysiological heterogeneity exists before diagnosis of type 2 diabetes and highlights a group of individuals who have an increased risk of complications without rapid progression to overt type 2 diabetes.
First Authors:
Robert Wagner
Correspondence Authors:
Robert Wagner
All Authors:
Robert Wagner,Martin Heni,Adam G Tabák,Jürgen Machann,Fritz Schick,Elko Randrianarisoa,Martin Hrabě de Angelis,Andreas L Birkenfeld,Norbert Stefan,Andreas Peter,Hans-Ulrich Häring,Andreas Fritsche