Elezebeth Mathews , Anjaly Joseph , Thakarakattil Narayanan Nair Anand , Brian Oldenburg , Kavumpurathu R. Thankappan , K M Venkat Narayan
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引用次数: 0
Abstract
Aims
Data on pathophysiological phenotypes for prediabetes in Indian ethnic populations are scarce. We investigated data-driven, pathophysiological phenotypes of prediabetes associated with the incidence of diabetes mellitus.
Methods
We characterised pathophysiological prediabetes phenotypes in a survey sample (n = 1455), and its progression to diabetes at one year. Data-driven clusters were identified using k-means cluster algorithm along with measures of glycaemia, adiposity, dyslipidaemia, beta-cell function, insulin resistance and blood pressure. Logistic regression analysis was employed to assess the risk of diabetes incidence.
Results
Four distinct pathophysiological prediabetes phenotypes were identified: Phenotype 1 (Combined Insulin Resistant and Deficient Prediabetes – CIRDP) [n = 323, 22.2 %]; Phenotype 2 (Severe Insulin Resistant Obese Prediabetes – SIROP) [n = 290, 19.9 %]; Phenotype 3 (Severe Insulin Deficient Prediabetes – SIDP) [n = 544, 37.4 %] and Phenotype 4 (High Blood Pressure Moderate Insulin Deficient Prediabetes – HBPMIDP) [n = 298, 20.5 %]. At one year, the progression to diabetes was highest in Phenotype 1-CIRDP (OR: 6.07, 95 % CI: 3.59–10.65), followed by Phenotype 4-HBPMIDP (OR: 2.05, 95 % CI-1.10, 3.87) compared to Phenotype 3-SIDP after adjusting for age, BMI, educational and marital status.
Conclusions
CIRDP and HBPMIDP had higher progression rates to diabetes at one year compared to SIDP. Eighty percent of the pathophysiological prediabetes phenotypes displayed beta-cell dysfunction.
期刊介绍:
Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.