Clonal Hematopoiesis of Indeterminate Potential and Risk of Microvascular Complications Among Individuals With Type 2 Diabetes: A Cohort Study.

Diabetes Pub Date : 2025-04-01 DOI:10.2337/db24-0841
Jiahe Wei, Yuefeng Yu, Hanzhang Wu, Yingjun Li, Ningjian Wang, Xiao Tan
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Abstract

Article highlights: Clonal hematopoiesis of indeterminate potential (CHIP) is an age-related disorder that is associated with macrovascular diseases, such as coronary artery disease and stroke. However, the effects of CHIP on microvascular complication have not been explored in individuals with type 2 diabetes. We wanted to determine whether CHIP is associated with diabetic microvascular complications (DMCs). CHIP was associated with a high risk of DMCs, specifically, diabetic retinopathy and diabetic kidney disease, but not diabetic neuropathy. Gene-specific analyses suggested that some driver genes were associated with risk of developing DMCs. These findings indicated that CHIP may represent a novel risk factor for DMCs among individuals with type 2 diabetes, distinct from traditional risk factors, which may have implications for prevention and management of DMCs.

克隆造血在2型糖尿病患者中潜在和微血管并发症风险不确定:一项队列研究
不确定潜能克隆性造血(CHIP)与冠心病和中风等大血管疾病有关。然而,CHIP 对微血管并发症的影响尚未在 2 型糖尿病(T2D)患者中进行评估。这项研究纳入了 20712 名 2 型糖尿病患者,他们在基线时没有流行性糖尿病微血管并发症(DMCs)和血液恶性肿瘤。通过对外周血样本进行全外显子组测序,确定了 CHIP 及相关表型。DMCs的发病率被定义为糖尿病肾病、糖尿病视网膜病变或糖尿病神经病变的综合结果。使用 Cox 回归评估了任何 CHIP 与 DMCs 和亚型的相关性。还进行了基因特异性分析,以确定突变驱动基因对 DMCs 的影响。在中位 13.0 年的随访期间,共有 5673 名参与者罹患 DMCs。任何 CHIP 均与 DMCs 的高风险相关(HR, 1.23; 95% CI, 1.10-1.38; P
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