Dokument: Recognising, quantifying and accounting for classification uncertainty in type 2 diabetes subtypes
| Titel: | Recognising, quantifying and accounting for classification uncertainty in type 2 diabetes subtypes | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=71171 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20251031-103530-2 | |||||||
| Kollektion: | Publikationen | |||||||
| Sprache: | Englisch | |||||||
| Dokumententyp: | Wissenschaftliche Texte » Artikel, Aufsatz | |||||||
| Medientyp: | Text | |||||||
| Autoren: | Mori, Tim [Autor] Zaharia, Oana P. [Autor] Straßburger, Klaus [Autor] Dennis, John M. [Autor] Mai, Knut [Autor] Kabisch, Stefan [Autor] Bornstein, Stefan [Autor] Szendroedi, Julia [Autor] Blüher, Matthias [Autor] Meyhöfer, Svenja [Autor] | |||||||
| Dateien: |
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| Stichwörter: | German Diabetes Study , Relative entropy , Precision medicine , Clusters , Type 2 diabetes mellitus , Classification uncertainty , Subtypes | |||||||
| Beschreibung: | Aims/hypothesis
Despite continued interest in precision diagnostics and type 2 diabetes subtypes, the challenge of uncertainty in the classification of individuals into subtypes remains. This study introduces a novel method for quantifying and accounting for classification uncertainty in type 2 diabetes subtypes. Methods Building on recommendations from the ADA/EASD Precision Medicine in Diabetes Initiative, we quantified classification uncertainty using the normalised relative entropy (NRE), computed from distances to cluster centroids. A lower NRE value indicates greater uncertainty in an individual’s cluster assignment. We examined the NRE in a cohort of 859 individuals with recent-onset type 2 diabetes from the prospective, observational German Diabetes Study (GDS) and compared it across previously identified diabetes subtypes, defined by age, BMI, HbA1c, HOMA-IR and HOMA-B. Predicted 10 year CVD risk (SCORE2-Diabetes) of the subtypes was evaluated with and without accounting for classification uncertainty. Results Individuals with mild age-related diabetes (n=395) and mild obesity-related diabetes (n=316) had a median NRE of 0.155 (95% CI 0.142, 0.177) and 0.119 (95% CI 0.107, 0.131), respectively. By contrast, individuals with severe insulin-resistant diabetes (n=130) and severe insulin-deficient diabetes (n=18) had a lower median NRE of 0.086 (95% CI 0.075, 0.108) and 0.082 (95% CI 0.071, 0.109), respectively. After weighting individuals by classification certainty, the proportion of variation in SCORE2-Diabetes explained by the subtypes (R2) increased from 17.4% (95% CI 12.8, 23.0) to 31.5% (95% CI 26.4, 37.1). The predicted 10 year CVD risk of the mild age-related diabetes subtype increased from 10.3% (95% CI 9.8, 10.7) to 11.6% (95% CI 11.2, 12.0). Conclusions/interpretation The NRE provides a means to quantify and compare individual classification uncertainty in type 2 diabetes subtypes. Classification uncertainty varied between subtypes and individuals with type 2 diabetes, and accounting for it improved the ability of the subtypes to predict 10 year CVD risk. | |||||||
| Rechtliche Vermerke: | Originalveröffentlichung:
Mori, T., Zaharia, O. P., Strassburger, K., Dennis, J. M., Mai, K., Kabisch, S., Bornstein, S., Szendrödi, J., Blüher, M., Meyhöfer, S., Seissler, J., Birkenfeld, A., Stefan, N., Roden, M., Wagner, R., & Kuß, O. (2025). Recognising, quantifying and accounting for classification uncertainty in type 2 diabetes subtypes. Diabetologia, 68(10), 2139–2150. https://doi.org/10.1007/s00125-025-06486-4 | |||||||
| Lizenz: |  Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz | |||||||
| Fachbereich / Einrichtung: | Medizinische Fakultät | |||||||
| Dokument erstellt am: | 31.10.2025 | |||||||
| Dateien geändert am: | 31.10.2025 |
