Four groups of type 2 diabetes contribute to the etiological and clinical heterogeneity in newly diagnosed individuals: An IMI DIRECT study
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The presentation and underlying pathophysiology of type 2 diabetes (T2D) is complex and heterogeneous. Recent studies attempted to stratify T2D into distinct subgroups using data-driven approaches, but their clinical utility may be limited if categorical representations of complex phenotypes are suboptimal. We apply a soft-clustering (archetype) method to characterize newly diagnosed T2D based on 32 clinical variables. We assign quantitative clustering scores for individuals and investigate the associations with glycemic deterioration, genetic risk scores, circulating omics biomarkers, and phenotypic stability over 36 months. Four archetype profiles represent dysfunction patterns across combinations of T2D etiological processes and correlate with multiple circulating biomarkers. One archetype associated with obesity, insulin resistance, dyslipidemia, and impaired β cell glucose sensitivity corresponds with the fastest disease progression and highest demand for anti-diabetic treatment. We demonstrate that clinical heterogeneity in T2D can be mapped to heterogeneity in individual etiological processes, providing a potential route to personalized treatments.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 100477 |
| Tidsskrift | Cell Reports Medicine |
| Vol/bind | 3 |
| Udgave nummer | 1 |
| Antal sider | 25 |
| ISSN | 2666-3791 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. M.I.C. has served on advisory panels for Pfizer, Novo Nordisk, and Zoe Global; has received honoraria from Merck, Pfizer, Novo Nordisk, and Eli Lilly; and has received research funding from Abbvie, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, Servier, and Takeda. As of June 2019, M.I.C. is an employee of Genentech and a holder of Roche stock. S.B. is holder of stock in Intomics, Hoba Therapeutics, Novo Nordisk, and Lundbeck and holds managing board memberships in Proscion and Intomics.
Funding Information:
The work leading to this publication has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement 115317 (DIRECT), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies? in-kind contribution. The Novo Nordisk Foundation is acknowledged (grants NNF17OC0027594 and NNF14CC0001). E.P. holds a Wellcome Trust New Investigator Award (102820/Z/13/Z). M.I.C. holds grants from NIDDK (U01-DK105535) and the Wellcome Trust (090532, 098381, 106130, 203141, and 212259). M.I.C. was a Wellcome investigator. K.B. and S. Brunak received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement 115881 (RHAPSODY). This research was funded, in whole or in part, by the Wellcome Trust (grants 102820/Z/13/Z, 090532, 098381, 106130, 203141, and 212259). Conceptualization: A.W.-A. C.A.B. M.I.C. E.P. and S.B.; formal analysis: A.W.-A. C.A.B. R.B. A. Mari, A.T. R.K. A. Mahajan, A.V. J.F.T. S.S. A.K. C.J. A.J. H.K.P. V.G. and C.E.T.; clinical investigation: A.J. A. Hattersley, A. Heggie, D.M. F.R. P.E. L.t'H. K.A. T.H.H. H.V. T.H. H. Thomsen, and M.R.; molecular data investigation: M.H. C.P. A.A. M.-G.H. P.B.M. G.K. J.B. L.T. G.F. T.M. and T.K.; project administration: F.D.M. K.T. I.F. R.K. G.N.G. I.P. H.R. O.P. M.W. E.P. S. Brage, and P.W.F.; resources: H. Teare; writing ? original draft: A.W.-A. C.A.B. M.I.C. E.P. and S.B.; writing ? reviewing & editing: R.B. A. Mari, A.T. M.H. K.B. M.I.C. E.P. and S.B.; funding acquisition: M.W. O.P. E.D. P.W.F. J.M.S. J.A. E.R.P. M.I.C. and S.B. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. M.I.C. has served on advisory panels for Pfizer, Novo Nordisk, and Zoe Global; has received honoraria from Merck, Pfizer, Novo Nordisk, and Eli Lilly; and has received research funding from Abbvie, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, Servier, and Takeda. As of June 2019, M.I.C. is an employee of Genentech and a holder of Roche stock. S.B. is holder of stock in Intomics, Hoba Therapeutics, Novo Nordisk, and Lundbeck and holds managing board memberships in Proscion and Intomics.
Funding Information:
The work leading to this publication has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement 115317 (DIRECT), resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme ( FP7/2007-2013 ) and EFPIA companies’ in-kind contribution. The Novo Nordisk Foundation is acknowledged (grants NNF17OC0027594 and NNF14CC0001 ). E.P. holds a Wellcome Trust New Investigator Award ( 102820/Z/13/Z ). M.I.C. holds grants from NIDDK ( U01-DK105535 ) and the Wellcome Trust ( 090532 , 098381 , 106130 , 203141 , and 212259 ). M.I.C. was a Wellcome investigator. K.B. and S. Brunak received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement 115881 (RHAPSODY). This research was funded, in whole or in part, by the Wellcome Trust (grants 102820/Z/13/Z , 090532 , 098381 , 106130 , 203141 , and 212259 ).
Publisher Copyright:
© 2021 The Authors
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