ArticleCardiovascular diabetology2023
Clusters of prediabetes and type 2 diabetes stratify all-cause mortality in a cohort of participants undergoing invasive coronary diagnostics.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Prediabetes and cardiovascular risk factors: the effectiveness of a guided self-determination counselling approach in primary health care, a randomized controlled trial.BMC public health · 2024Trial
- Insulin resistance in the 21st century: new takes on an old problem-2025 Diabetes, Diabetes Care, and Diabetologia Expert Forum.Diabetologia · 2026Review
- Cohort profile: The DIabetes and ST-segment Elevation Myocardial Infarction (DISTEMI) Study.Cardiovascular diabetology · 2026Observational
- Beyond Glucose-Rethinking Prediabetes for Precision Prevention.Diabetes care · 2026Review
- Data-driven phenotypic profiling of prediabetes reveals heterogeneous cardiometabolic risks in Chinese adults.Cardiovascular diabetology · 2025Article
- Identifying Cardio-Metabolic Subtypes of Prediabetes Using Latent Class Analysis.Medical sciences (Basel, Switzerland) · 2025Article
- Prediabetes.Nature reviews. Disease primers · 2025Review
- Phenotype-based clusters, inflammation and cardiometabolic complications in older people before the diagnosis of type 2 diabetes: KORA F4/FF4 cohort study.Cardiovascular diabetology · 2025Article
- Clustering-based risk stratification of prediabetes populations: Insights from the Taiwan and UK Biobanks.Journal of diabetes investigation · 2025Article
- Blood coagulation in Prediabetes clusters-impact on all-cause mortality in individuals undergoing coronary angiography.Cardiovascular diabetology · 2024Article
- Prediabetes Increases the Risk of Frailty in Prefrail Older Adults With Hypertension: Beneficial Effects of Metformin.Hypertension (Dallas, Tex. : 1979) · 2024Article
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Authors and funding
9 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundHeterogeneous metabolic clusters have been identified in diabetic and prediabetic states. It is not known whether such pathophysiologic clusters impact survival in at-risk persons being evaluated for coronary heart disease.
methodsThe LURIC Study recruited patients referred for coronary angiography at a median age of 63 (IQR 56-70) with a follow-up of 16.1 (IQR 9.6, 17.7) years. Clustering of 1269 subjects without diabetes was performed with oGTT-derived glucose and insulin; fasting triglyceride, high-density lipoprotein, BMI, waist and hip circumference. Patients with T2D (n = 794) were clustered using age, BMI, glycemia, homeostasis model assessment, and islet autoantibodies. Associations of clusters with mortality were analysed using Cox regression.
resultsIndividuals without diabetes were classified into six subphenotypes, with 884 assigned to subjects at low-risk (cluster 1,2,4) and 385 at high-risk (cluster 3,5,6) for diabetes. We found significantly increased mortality in clusters 3 (hazard ratio (HR)1.42), 5 (HR 1.43), and 6 (HR 1.46) after adjusting for age, BMI, HbA1c and sex. In the T2D group, 508 were assigned to mild age-related diabetes (MARD), 183 to severe insulin-resistant diabetes (SIRD), 84 to mild obesity-related diabetes (MOD), 19 to severe insulin-deficient diabetes (SIDD). Compared to the low-risk non-diabetes group, crude mortality was not different in MOD. Increased mortality was found for MARD (HR 2.2), SIRD (HR 2.2), and SIDD (HR 2.5).
conclusionsMetabolic clustering successfully stratifies survival even among persons undergoing invasive coronary diagnostics. Novel clustering approaches based on glucose metabolism can identify persons who require special attention as they are at risk of increased mortality.
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