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Clinical and geneti...
Clinical and genetic determinants of progression of type 2 diabetes : a DIRECT study
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- Zhou, Kaixin (författare)
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K.
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- Donnelly, Louise A. (författare)
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K.
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- Morris, Andrew D. (författare)
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K.
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- Franks, Paul W. (författare)
- Lund University,Lunds universitet,Umeå universitet,Medicin,Department of Clinical Science, Genetic & Molecular Epidemiology Unit, Lund University, Malmö, Sweden ; Department of Nutrition, Harvard University, School of Public Health, Boston, MA,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups
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- Jennison, Chris (författare)
- Department of Mathematical Sciences, University of Bath, Bath, U.K.
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- Palmer, Colin N. A. (författare)
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K.
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- Pearson, Ewan R. (författare)
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K.
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Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK. Medicin (creator_code:org_t)
- 2014-02-11
- 2014
- Engelska.
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 37:3, s. 718-724
- Relaterad länk:
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https://umu.diva-por... (primary) (Raw object)
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https://care.diabete...
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https://portal.resea... (primary) (free)
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.2...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To identify the clinical and genetic factors that explain why the rate of diabetes progression is highly variable between idividuals following diagnosis of type 2 diabetes.RESEARCH DESIGN AND METHODS: We studied 5,250 patients with type 2 diabetes using comprehensive electronic medical records in Tayside, Scotland, from 1992 onward. We investigated the association of clinical, biochemical, and genetic factors with the risk of progression of type 2 diabetes from diagnosis to the requirement of insulin treatment (defined as insulin treatment or HbA(1c) 8.5% [69 mmol/mol] treated with two or more noninsulin therapies).RESULTSRisk of progression was associated with both low and high BMI. In an analysis stratified by BMI and HbA(1c) at diagnosis, faster progression was independently associated with younger age at diagnosis, higher log triacylglyceride (TG) concentrations (hazard ratio [HR] 1.28 per mmol/L [95% CI 1.15-1.42]) and lower HDL concentrations (HR 0.70 per mmol/L [95% CI 0.55-0.87]). A high Genetic Risk Score derived from 61 diabetes risk variants was associated with a younger age at diagnosis and a younger age when starting insulin but was not associated with the progression rate from diabetes to the requirement of insulin treatment.CONCLUSIONS: Increased TG and low HDL levels are independently associated with increased rate of progression of diabetes. The genetic factors that predispose to diabetes are different from those that cause rapid progression of diabetes, suggesting a difference in biological process that needs further investigation.
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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