PMID- 35154005
OWN - NLM
STAT- MEDLINE
DCOM- 20220302
LR  - 20221207
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 12
DP  - 2021
TI  - Novel Subgroups and Chronic Complications of Diabetes in Middle-Aged and Elderly 
      Chinese:A Prospective Cohort Study.
PG  - 802114
LID - 10.3389/fendo.2021.802114 [doi]
LID - 802114
AB  - 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 
      beta-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.
CI  - Copyright (c) 2022 Wang, Zheng, Li, Xu, Lu, Zhao, Li, Wang, Wang, Bi, Xu, Ning and 
      Cai.
FAU - Wang, Fei
AU  - Wang F
AD  - Department of Clinical Pharmacy and Pharmaceutical Management, School of 
      Pharmacy, Fudan University, Shanghai, China.
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Zheng, Ruizhi
AU  - Zheng R
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Li, Ling
AU  - Li L
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Xu, Min
AU  - Xu M
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Lu, Jieli
AU  - Lu J
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Zhao, Zhiyun
AU  - Zhao Z
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Li, Mian
AU  - Li M
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Wang, Tiange
AU  - Wang T
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Wang, Shuangyuan
AU  - Wang S
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Bi, Yufang
AU  - Bi Y
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Xu, Yu
AU  - Xu Y
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Ning, Guang
AU  - Ning G
AD  - Department of Clinical Pharmacy and Pharmaceutical Management, School of 
      Pharmacy, Fudan University, Shanghai, China.
AD  - Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine 
      and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
AD  - Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory 
      for Endocrine and Metabolic Diseases of the National Health Commission of the PR 
      China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of 
      Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Cai, Weimin
AU  - Cai W
AD  - Department of Clinical Pharmacy and Pharmaceutical Management, School of 
      Pharmacy, Fudan University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220126
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Blood Glucose/*metabolism
MH  - Body Mass Index
MH  - China
MH  - Cluster Analysis
MH  - Cohort Studies
MH  - Diabetes Complications
MH  - Diabetes Mellitus, Type 2/complications/*metabolism
MH  - Fasting/metabolism
MH  - Female
MH  - Glycated Hemoglobin/*metabolism
MH  - Humans
MH  - Insulin Resistance
MH  - Liver Cirrhosis/complications/metabolism
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Non-alcoholic Fatty Liver Disease/complications/*metabolism
MH  - Obesity/complications/*metabolism
MH  - Postprandial Period
MH  - Prospective Studies
MH  - Severity of Illness Index
PMC - PMC8825378
OTO - NOTNLM
OT  - cluster analysis
OT  - diabetic complications
OT  - metabolic associated fatty liver disease
OT  - subclinical atherosclerosis
OT  - type 2 diabetes
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/02/15 06:00
MHDA- 2022/03/03 06:00
PMCR- 2021/01/01
CRDT- 2022/02/14 05:30
PHST- 2021/10/26 00:00 [received]
PHST- 2021/12/28 00:00 [accepted]
PHST- 2022/02/14 05:30 [entrez]
PHST- 2022/02/15 06:00 [pubmed]
PHST- 2022/03/03 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2021.802114 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Jan 26;12:802114. doi: 
      10.3389/fendo.2021.802114. eCollection 2021.