成人发病糖尿病的子组:在加纳人口中进行数据驱动的集群分析
Ina Danquah1, Isabel Mank2,3, Christiane S Hampe4
1Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany. ina.danquah@uni-heidelberg.de.
Scientific reports
|July 4, 2023
概括
成人发病的糖尿病不是统一的. 集群分析确定了加纳人的五个子组,揭示了不同的糖尿病并发症模式,并有助于了解糖尿病病因和预后.
科学领域:
- 内分泌学和新陈代谢学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 成人发病糖尿病 (adult-onset diabetes mellitus,简称ADM) 是一种异质的疾病.
- 之前在欧洲人口中进行的集群分析确定了五个不同的aDM子组.
- 这些子组可以提供有关糖尿病病因和预后的见解.
研究的目的:
- 在加纳人中复制之前识别的五个aDM子组.
- 评估这些子组在加纳糖尿病并发症中的重要性.
- 探索加纳特定变量的实用性,以确定子组.
主要方法:
- 对541名加纳成年患有aDM (非洲移民中肥胖和糖尿病研究研究) 的数据进行了集群分析.
- 使用了两组变量: (i) 以前公布的变量 (发病时的年龄,HbA1c,BMI,HOMA-β,HOMA-IR,GAD65Ab阳性) 和 (ii) 迦纳特有的变量 (发病时的年龄,腰围,FPG,禁食胰岛素).
- 对每个子组计算了临床,与治疗相关的形态特征和糖尿病并发症比例.
主要成果:
- 第一次分析复制了五个子组:与肥胖相关的 (73%),与年龄相关的 (10%) 与高CAD/中风率相关的,与自身免疫相关的 (5%) 与高功能障碍/PAD率相关的,胰岛素缺乏 (7%) 与高视网膜病变率相关的,以及抗胰岛素 (5%).
- 使用加纳特有的变量进行的第二次分析确定了四个子组:与肥胖和年龄相关的 (68%),与身体脂肪和胰岛素抗性 (18%),与营养不良相关的 (8%) 具有高视网膜病变,以及易发生 (6%) 具有高功能障碍.
- 之前识别的aDM子组在加纳人群中使用类似的临床变量在很大程度上是可复制的.
结论:
- 集群分析可以有效地复制像加纳这样多样化的人口中已建立的成人发病糖尿病小组.
- 确定的子组与糖尿病并发症的特定模式有关,突出显示了它们的预后重要性.
- 这种方法,特别是对目标人群使用临床相关的变量,可以提高对ADM病因和预后的理解.
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