ArticleJournal of diabetes investigation2021
Identification of two novel subgroups in patients with diabetes mellitus and their association with clinical outcomes: A two-step cluster analysis.
Article in Journal of diabetes investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Clinical and laboratory characteristics of novel diabetes subgroups: A systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Ethnic differences between Asians and non-Asians in clustering-based phenotype classification of adult-onset diabetes mellitus: A systematic narrative review.Primary care diabetes · 2022Pooled it
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- Subtypes of Type 2 Diabetes and Prediabetes: Mortality and Excess Life Lost in South Asians.Diabetes care · 2026Article
- Subtypes of newly diagnosed type 2 diabetes and risk of complications: analysis of electronic health records in the USA.Diabetologia · 2026Article
- Phenotypic clustering of newly diagnosed type 2 diabetes in a Mediterranean cohort.Cardiovascular diabetology · 2026Article
- Diabetes mellitus as a multisystem disease: understanding subtypes, complications, and the link with steatotic liver diseases in humans.Hormones (Athens, Greece) · 2026Review
- Unveiling the heterogeneity of T2DM: a narrative review of clustering algorithms in stratifying comorbidity and complication risk.Cardiovascular diabetology. Endocrinology reports · 2026Review
- Association of dietary patterns and healthy diet scores with anxiety, depression, and their comorbidity among rural Chinese adults.BMC public health · 2026Article
- Precision phenotyping of type 2 diabetes in chinese populations using a variational autoencoder-informed tree model.Nature communications · 2026Article
- Development of a preoperative predictive classifier and tailored staging system for obstructive colorectal cancer.BMC surgery · 2025Article
- Sex Differences in Cardiovascular Risk and Diabetic Polyneuropathy: A Single-Center Retrospective Study in North-Eastern Hungary.Journal of clinical medicine · 2025Article
- The moderating effect of family socioeconomic status in the relationship between health-related behaviors and quality of life among the Hakka older adults in Fujian, China.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Cluster Analysis in Diabetes Research: A Systematic Review Enhanced by a Cross-Sectional Study.Journal of clinical medicine · 2025Review
- Recent updates to understand the heterogeneity of type 2 diabetes mellitus.Journal of diabetes investigation · 2025Article
- Article
- Coffee drinking timing and mortality in US adults.European heart journal · 2025Observational
- A novel scoring system for better management of small bowel obstruction.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
AIMS/
introductionThe aim of this study was to determine whether distinct subphenotypes of patients with type 2 diabetes in the European classification exist in Chinese populations, and to further establish novel subphenotypes more suitable for Chinese populations. MATERIAL AND
methodsThe research retrospectively analyzed 5414 patients with type 2 diabetes from the National Clinical Research Center for Metabolic Diseases Diabetes Center in China, and a two-step cluster analysis was carried out. First, we confirmed the European classification in Chinese populations by six parameters, including age at disease onset, body mass index, glycosylated hemoglobin, homeostatic model assessment 2 to estimate β-cell function and insulin resistance, and glutamate decarboxylase antibodies. Furthermore, triglycerides and uric acid were added to refine the cluster analysis, and Cox regression was used to evaluate the risk of diabetic complications.
resultsJust three clusters were replicated in our cohort according to Emma Ahlqvist's European classification. When other variables were added to the cluster analysis, seven subgroups were identified, including five clusters of the European classification and two novel subgroups, namely, uric acid-related diabetes and inheritance-related diabetes. Compared with patients with inheritance-related diabetes, patients with severe insulin-resistant diabetes showed a higher risk of diabetic peripheral neuropathy, hypertension and chronic kidney disease, and the uric acid-related diabetes subgroup showed a higher risk of coronary heart disease, cerebral vascular disease and end-stage renal disease. Patients with severe insulin-deficient diabetes showed a higher risk of diabetic retinopathy and diabetic foot than those with inheritance-related diabetes. Furthermore, there were sex-specific associations between subgroups and clinical outcomes. No significant difference was observed in the prevalence of cancer in each subgroup.
conclusionsSeven subgroups of type 2 diabetes were identified in Chinese populations, with distinct characteristics and disparate clinical outcomes. This etiology-based stratification might contribute to the diagnosis and management of type 2 diabetes.
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