The following is a summary of “Metabolic Profiles of Type 2 Diabetes and Their Association With Renal Complications,” published in the April 2024 issue of Endocrinology by Li, et al.
For a study, researchers sought to identify prevalent metabolic profiles in patients diagnosed with type 2 diabetes (T2D) and determine which profiles served as risk markers for renal progression.
The study involved 3,556 participants with T2D from a hospital (derivation cohort) and 931 participants with T2D from a community survey (external validation cohort). The primary outcome assessed was the onset of diabetic kidney disease (DKD), while secondary outcomes included estimated glomerular filtration rate (eGFR) decline, macroalbuminuria, and end-stage renal disease (ESRD). Clusters of metabolic profiles were identified in the derivation cohort using the 5 components of metabolic syndrome (MetS), and their relationships with the outcomes were analyzed. The findings were then validated in the external validation cohort.
Six distinct metabolic profiles were identified in the derivation cohort. Compared to cluster 1, cluster 3 (severe hyperglycemia) showed increased risks of DKD (hazard ratio [HR]: 1.72 [95% CI: 1.39-2.12]), macroalbuminuria (HR: 2.74 [95% CI: 1.84-4.08]), ESRD (HR: 4.31 [95% CI: 1.16-15.99]), and eGFR decline (P < .001). Similarly, cluster 4 (moderate dyslipidemia) exhibited elevated risks of DKD (HR: 1.97 [95% CI: 1.53-2.54]) and macroalbuminuria (HR: 2.62 [95% CI: 1.61-4.25]). These associations were significant in both the derivation and validation cohorts.
The study unveiled common metabolic profiles among patients with T2D, with severe hyperglycemia and moderate dyslipidemia emerging as significant risk factors for DKD. The findings underscored the importance of metabolic management in preventing renal complications in individuals with T2D.
Reference: academic.oup.com/jcem/article-abstract/109/4/1051/7337055