ArticleJournal of the Endocrine Society2026
All-cause mortality in people with type 2 diabetes and lipodystrophy-like metabolic phenotype.
Article in Journal of the Endocrine Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: We wanted to investigate whether the lipodystrophy (LD)-like phenotype increases mortality in type 2 diabetes. To this end we first developed and confirmed the triglyceride/BMI ratio (TBR index) as an inexpensive and widely available marker of the LD-like metabolic phenotype. The TBR index was then tested for association with all-cause mortality in patients with type 2 diabetes. Research design and methods: Associations between TBR and mortality were assessed by Cox in 3 type 2 diabetes cohorts (n = 2137, n = 960, and n = 5060). A 20-SNP genotype risk score (GRS), associated with LD-like phenotype was investigated to identify the molecular basis of TBR variability. Main finding: In all cohorts, the highest TBR decile showed features of LD-like phenotype, including atherogenic dyslipidemia, lower BMI, worse glycemic control, insulin resistance, elevated gamma-glutamyl transferase, and hypoadiponectinemia. In the meta-analysis, decile 10 had higher mortality risk (HR = 1.46, Conclusion: The TBR is a novel, inexpensive and easily available marker that identifies a subgroup of type 2 diabetes patients with a LD-like phenotype, partly explained by genetic factors. Our findings help disentangle the heterogeneity of death risk in diabetes, refine diagnostic and follow-up algorithms and enable specific treatments for improving long-term outcomes in LD-like individuals.
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