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Risk Evaluation of Progression of Proteinuria and Renal Decline Based on a Novel Subgroup Classification in Chinese Patients with Type 2 Diabetes

  • 0Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Han-Zhong Road, Nanjing, 210029, China.
Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders +

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November 18, 2024

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November 18, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

This study identified four distinct subgroups of type 2 diabetes in Chinese patients. Certain subgroups, like mild insulin resistance (MIRD), showed a higher risk of diabetic kidney disease (DKD) onset and progression.

Area Of Science

  • Endocrinology and Metabolism
  • Nephrology
  • Genetics and Genomics

Background

  • Type 2 diabetes mellitus (T2DM) is a complex, heterogeneous disease with variable complication risks.
  • Novel subgroup classifications aid in evaluating diabetic complication risks.
  • The predictive value of these subgroups for diabetic kidney disease (DKD) in Chinese populations requires investigation.

Purpose Of The Study

  • To evaluate the risk of diabetic kidney disease (DKD) onset and progression in Chinese patients with T2DM using a novel cluster-based subgroup classification.
  • To determine if this classification strategy can predict DKD risk in this specific demographic.

Main Methods

  • A retrospective study of 612 Chinese T2DM patients with a median 3.5-year follow-up.
  • Two-step cluster analysis categorized subgroups based on age at onset, BMI, HbA1c, HOMA2-IR, and HOMA2-β.
  • Multivariate logistic regression assessed risks for albuminuria progression and renal function decline.

Main Results

  • Four subgroups were identified: severe insulin-deficient diabetes (SIDD), mild insulin resistance (MIRD), moderate glycemic control diabetes (MGCD), and moderate weight insulin deficiency diabetes (MWIDD).
  • The MIRD subgroup had a significantly higher risk of progressing from non-albuminuria to albuminuria (aOR=2.92, 95% CI: 1.06–8.04) compared to MWIDD.
  • The SIDD subgroup showed a higher risk of progressing from micro- to macro-albuminuria (aOR=3.39, 95% CI: 1.01–11.41) compared to MGCD. No significant GFR decline was observed across groups.

Conclusions

  • This study provides initial evidence linking cluster-based T2DM subgroups to DKD risk in Chinese patients.
  • The MIRD subgroup is associated with a higher risk of DKD onset, while the SIDD subgroup faces increased albuminuria progression risk.
  • This classification system shows potential for predicting DKD risk and guiding personalized treatment strategies in Chinese T2DM patients.

Keywords:

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