Dokument: Phenotype-based clusters, inflammation and cardiometabolic complications in older people before the diagnosis of type 2 diabetes: KORA F4/FF4 cohort study

Titel:	Phenotype-based clusters, inflammation and cardiometabolic complications in older people before the diagnosis of type 2 diabetes: KORA F4/FF4 cohort study
URL für Lesezeichen:	https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=69349
URN (NBN):	urn:nbn:de:hbz:061-20250414-104029-8
Kollektion:	Publikationen
Sprache:	Englisch
Dokumententyp:	Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:	Text
Autoren:	Huemer, Marie-Theres [Autor] Spagnuolo, Maria C. [Autor] Maalmi, Haifa [Autor] Wagner, Robert [Autor] Bönhof, Gidon J. [Autor] Heier, Margit [Autor] Koenig, Wolfgang [Autor] Rathmann, Wolfgang [Autor] Prystupa, Katsiaryna [Autor] Nano, Jana [Autor]
Dateien:	[Dateien anzeigen] Adobe PDF [Details] 2,99 MB in einer Datei [ZIP-Datei erzeugen] Dateien vom 14.04.2025 / geändert 14.04.2025
Stichwörter:	Mortality, Polyneuropathy, Prediabetes, Heterogeneity, Chronic kidney disease, Inflammation, Cardiovascular disease, Cohort, Diabetes, Subtypes
Beschreibung:	Background Using a data-driven approach, six clusters with different risk profiles and burden of complications were recently identified in middle-aged people before the diagnosis of type 2 diabetes (T2D). We aimed to investigate whether these clusters could be generalised to older people and if subclinical inflammation was related to their cardiometabolic risk profiles. Methods We assigned 843 participants of the KORA F4 study aged 61–82 years without T2D to the six previously defined phenotype-based clusters. Based on 73 biomarkers of subclinical inflammation, we derived an inflammation-related score (“inflammatory load”) using principal component analysis to assess subclinical inflammation. Risk factors, inflammatory load as well as prevalence and incidence of (pre)diabetes-related complications were compared between the clusters using pairwise comparisons and regression analyses. Results Clusters 1 and 2 had the lowest cardiometabolic risk, whereas clusters 5 and 6 the highest. T2D risk was highest in clusters 3, 4, 5, and 6 compared with the low-risk cluster 2 (age- and sex-adjusted ORs between 3.6 and 34.0). In cross-sectional analyses, there were significant between-cluster differences in chronic kidney disease (CKD), distal sensorimotor polyneuropathy (DSPN) and cardiovascular disease (all p < 0.045). In prospective analyses (mean follow-up time 6.5–8.3 years), clusters differed significantly in CKD and DSPN incidence, but not in incident CVD or all-cause mortality. The inflammatory load was highest in the high-risk cluster 5 and lowest in cluster 2. Adjustment for the inflammatory load had only a minor impact on the aforementioned differences in outcomes between clusters. Conclusions Our findings extend the knowledge about the previously identified six phenotype-based clusters in older people without T2D. Differences between clusters were more pronounced for T2D risk than for prevalent or incident (pre)diabetes-related complications and absent for mortality. The high cardiometabolic risk corresponded to the high inflammatory load in cluster 5 but not to the lower inflammatory load of high-risk clusters 3 and 6.
Rechtliche Vermerke:	Originalveröffentlichung: Huemer, M.-T., Spagnuolo, M. C., Maalmi, H., Wagner, R., Bönhof, G., Heier, M., Koenig, W., Rathmann, W., Prystupa, K., Nano, J., Ziegler, D., Peters, A., Roden, M., Thorand, B., & Herder, C. (2025). Phenotype-based clusters, inflammation and cardiometabolic complications in older people before the diagnosis of type 2 diabetes: KORA F4/FF4 cohort study. Cardiovascular Diabetology, 24, Article 83. https://doi.org/10.1186/s12933-025-02617-8
Lizenz:	Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:	Medizinische Fakultät
Dokument erstellt am:	14.04.2025
Dateien geändert am:	14.04.2025