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Subgroups of adult-...
Subgroups of adult-onset diabetes : a data-driven cluster analysis in a Ghanaian population
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- Danquah, Ina (författare)
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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- Mank, Isabel (författare)
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; German Institute for Development Evaluation (DEval), Bonn, Germany
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- Hampe, Christiane S. (författare)
- Department of Medicine, University of Washington, WA, Seattle, United States
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- Meeks, Karlijn A. C. (författare)
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, MD, Bethesda, United States; Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
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- Agyemang, Charles (författare)
- Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
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- Owusu-Dabo, Ellis (författare)
- Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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- Smeeth, Liam (författare)
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
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- Klipstein-Grobusch, Kerstin (författare)
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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- Bahendeka, Silver (författare)
- MKPGMS-Uganda Martyrs University, Kampala, Uganda
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- Spranger, Joachim (författare)
- Department of Endocrinology and Metabolism, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Berlin, Germany
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- Mockenhaupt, Frank P. (författare)
- Institute of Tropical Medicine and International Health, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
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- Schulze, Matthias B. (författare)
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
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- Rolandsson, Olov (författare)
- Umeå universitet,Allmänmedicin
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(creator_code:org_t)
- Nature Publishing Group, 2023
- 2023
- Engelska.
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 13:1
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Adult-onset diabetes mellitus (here: aDM) is not a uniform disease entity. In European populations, five diabetes subgroups have been identified by cluster analysis using simple clinical variables; these may elucidate diabetes aetiology and disease prognosis. We aimed at reproducing these subgroups among Ghanaians with aDM, and establishing their importance for diabetic complications in different health system contexts. We used data of 541 Ghanaians with aDM (age: 25–70 years; male sex: 44%) from the multi-center, cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) Study. Adult-onset DM was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L, documented use of glucose-lowering medication or self-reported diabetes, and age of onset ≥ 18 years. We derived subgroups by cluster analysis using (i) a previously published set of variables: age at diabetes onset, HbA1c, body mass index, HOMA-beta, HOMA-IR, positivity of glutamic acid decarboxylase autoantibodies (GAD65Ab), and (ii) Ghana-specific variables: age at onset, waist circumference, FPG, and fasting insulin. For each subgroup, we calculated the clinical, treatment-related and morphometric characteristics, and the proportions of objectively measured and self-reported diabetic complications. We reproduced the five subgroups: cluster 1 (obesity-related, 73%) and cluster 5 (insulin-resistant, 5%) with no dominant diabetic complication patterns; cluster 2 (age-related, 10%) characterized by the highest proportions of coronary artery disease (CAD, 18%) and stroke (13%); cluster 3 (autoimmune-related, 5%) showing the highest proportions of kidney dysfunction (40%) and peripheral artery disease (PAD, 14%); and cluster 4 (insulin-deficient, 7%) characterized by the highest proportion of retinopathy (14%). The second approach yielded four subgroups: obesity- and age-related (68%) characterized by the highest proportion of CAD (9%); body fat-related and insulin-resistant (18%) showing the highest proportions of PAD (6%) and stroke (5%); malnutrition-related (8%) exhibiting the lowest mean waist circumference and the highest proportion of retinopathy (20%); and ketosis-prone (6%) with the highest proportion of kidney dysfunction (30%) and urinary ketones (6%). With the same set of clinical variables, the previously published aDM subgroups can largely be reproduced by cluster analysis in this Ghanaian population. This method may generate in-depth understanding of the aetiology and prognosis of aDM, particularly when choosing variables that are clinically relevant for the target population.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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Danquah, Ina
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Mank, Isabel
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Hampe, Christian ...
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Meeks, Karlijn A ...
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Agyemang, Charle ...
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Owusu-Dabo, Elli ...
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Smeeth, Liam
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Klipstein-Grobus ...
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Bahendeka, Silve ...
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Spranger, Joachi ...
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Mockenhaupt, Fra ...
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Schulze, Matthia ...
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Rolandsson, Olov
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