Identification of Metabolic Patterns in Korean Patients With Type 2 Diabetes and Their Association With Diabetes-Related Complications

초록

Resolving metabolic heterogeneity in type 2 diabetes (T2D) gives patients access to precision medicine. Despite ethnic diversity in pathophysiologic processes in individuals with T2D, studies on subtypes of diabetes related to clinical characteristics in Asians are insufficient. This study aimed to identify metabolic patterns in middle-aged patients with T2D in the Republic of Korea (Korea) and determine the incidence of diabetes-related complications according to patterns. We analyzed 6,603 patients with T2D aged 30-64 years who visited one of three general hospital centers in Korea. Three metabolic patterns were derived: obesity and hypertension (OH-P), liver function-related hyperglycemia (LFHG-P), and decreased kidney function (DKF-P). The highest tertile of the OH-P score was associated with an increased risk of peripheral vascular disease compared with the lowest tertile (hazard ratio [HR] 1.26; 95% CI 1.02-1.57). The highest tertile of the LFHG-P score was associated with an increased risk of myocardial infarction (HR 1.79; 95% CI 1.13-2.82) and atrial fibrillation (HR 1.54; 95% CI 1.07-2.23). No association with complications was found in the DKF-P. This study suggests the need for proper management and treatment according to metabolic patterns in patients with T2D.Article Highlights Identifying patterns of metabolic heterogeneity in type 2 diabetes (T2D) can help in the development of optimal treatment strategies. We aimed to identify metabolic patterns in patients with T2D in the Republic of Korea and analyze the risk of developing diabetes-related complications according to patterns. We identified three distinct metabolic patterns and observed that each pattern was associated with a heightened risk of developing various cardiovascular diseases. These findings highlight the necessity of devising treatment strategies based on these patterns to prevent diabetes-related complications.

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