Type 2 diabetes classification: a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort

Research output: Contribution to journalJournal articlepeer-review

Standard

Type 2 diabetes classification : a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. / Christensen, Diana Hedevang; Nicolaisen, Sia K.; Ahlqvist, Emma; Stidsen, Jacob V.; Nielsen, Jens Steen; Hojlund, Kurt; Olsen, Michael H.; García-Calzón, Sonia; Ling, Charlotte; Rungby, Jørgen; Brandslund, Ivan; Vestergaard, Peter; Jessen, Niels; Hansen, Torben; Brøns, Charlotte; Beck-Nielsen, Henning; Sørensen, Henrik T; Thomsen, Reimar W.; Vaag, Allan.

In: B M J Open Diabetes Research & Care, Vol. 10, No. 2, e002731, 2022.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Christensen, DH, Nicolaisen, SK, Ahlqvist, E, Stidsen, JV, Nielsen, JS, Hojlund, K, Olsen, MH, García-Calzón, S, Ling, C, Rungby, J, Brandslund, I, Vestergaard, P, Jessen, N, Hansen, T, Brøns, C, Beck-Nielsen, H, Sørensen, HT, Thomsen, RW & Vaag, A 2022, 'Type 2 diabetes classification: a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort', B M J Open Diabetes Research & Care, vol. 10, no. 2, e002731. https://doi.org/10.1136/bmjdrc-2021-002731

APA

Christensen, D. H., Nicolaisen, S. K., Ahlqvist, E., Stidsen, J. V., Nielsen, J. S., Hojlund, K., Olsen, M. H., García-Calzón, S., Ling, C., Rungby, J., Brandslund, I., Vestergaard, P., Jessen, N., Hansen, T., Brøns, C., Beck-Nielsen, H., Sørensen, H. T., Thomsen, R. W., & Vaag, A. (2022). Type 2 diabetes classification: a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. B M J Open Diabetes Research & Care, 10(2), [e002731]. https://doi.org/10.1136/bmjdrc-2021-002731

Vancouver

Christensen DH, Nicolaisen SK, Ahlqvist E, Stidsen JV, Nielsen JS, Hojlund K et al. Type 2 diabetes classification: a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. B M J Open Diabetes Research & Care. 2022;10(2). e002731. https://doi.org/10.1136/bmjdrc-2021-002731

Author

Christensen, Diana Hedevang ; Nicolaisen, Sia K. ; Ahlqvist, Emma ; Stidsen, Jacob V. ; Nielsen, Jens Steen ; Hojlund, Kurt ; Olsen, Michael H. ; García-Calzón, Sonia ; Ling, Charlotte ; Rungby, Jørgen ; Brandslund, Ivan ; Vestergaard, Peter ; Jessen, Niels ; Hansen, Torben ; Brøns, Charlotte ; Beck-Nielsen, Henning ; Sørensen, Henrik T ; Thomsen, Reimar W. ; Vaag, Allan. / Type 2 diabetes classification : a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. In: B M J Open Diabetes Research & Care. 2022 ; Vol. 10, No. 2.

Bibtex

@article{316e6944ff9e434c88a24e7e9b1d851b,
title = "Type 2 diabetes classification: a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort",
abstract = "Introduction A Swedish data-driven cluster study identified four distinct type 2 diabetes (T2D) clusters, based on age at diagnosis, body mass index (BMI), hemoglobin A1c (HbA1c) level, and homeostatic model assessment 2 (HOMA2) estimates of insulin resistance and beta-cell function. A Danish study proposed three T2D phenotypes (insulinopenic, hyperinsulinemic, and classical) based on HOMA2 measures only. We examined these two new T2D classifications using the Danish Centre for Strategic Research in Type 2 Diabetes cohort. Research design and methods In 3529 individuals, we first performed a k-means cluster analysis with a forced k-value of four to replicate the Swedish clusters: severe insulin deficient (SIDD), severe insulin resistant (SIRD), mild age-related (MARD), and mild obesity-related (MOD) diabetes. Next, we did an analysis open to alternative k-values (ie, data determined the optimal number of clusters). Finally, we compared the data-driven clusters with the three Danish phenotypes. Results Compared with the Swedish findings, the replicated Danish SIDD cluster included patients with lower mean HbA1c (86 mmol/mol vs 101 mmol/mol), and the Danish MOD cluster patients were less obese (mean BMI 32 kg/m 2 vs 36 kg/m 2). Our data-driven alternative k-value analysis suggested the optimal number of T2D clusters in our data to be three, rather than four. When comparing the four replicated Swedish clusters with the three proposed Danish phenotypes, 81%, 79%, and 69% of the SIDD, MOD, and MARD patients, respectively, fitted the classical T2D phenotype, whereas 70% of SIRD patients fitted the hyperinsulinemic phenotype. Among the three alternative data-driven clusters, 60% of patients in the most insulin-resistant cluster constituted 76% of patients with a hyperinsulinemic phenotype. Conclusion Different HOMA2-based approaches did not classify patients with T2D in a consistent manner. The T2D classes characterized by high insulin resistance/hyperinsulinemia appeared most distinct. ",
keywords = "classification, clusters, cohort, type 2 diabetes",
author = "Christensen, {Diana Hedevang} and Nicolaisen, {Sia K.} and Emma Ahlqvist and Stidsen, {Jacob V.} and Nielsen, {Jens Steen} and Kurt Hojlund and Olsen, {Michael H.} and Sonia Garc{\'i}a-Calz{\'o}n and Charlotte Ling and J{\o}rgen Rungby and Ivan Brandslund and Peter Vestergaard and Niels Jessen and Torben Hansen and Charlotte Br{\o}ns and Henning Beck-Nielsen and S{\o}rensen, {Henrik T} and Thomsen, {Reimar W.} and Allan Vaag",
note = "Publisher Copyright: {\textcopyright} ",
year = "2022",
doi = "10.1136/bmjdrc-2021-002731",
language = "English",
volume = "10",
journal = "B M J Open Diabetes Research & Care",
issn = "2052-4897",
publisher = "B M J Group",
number = "2",

}

RIS

TY - JOUR

T1 - Type 2 diabetes classification

T2 - a data-driven cluster study of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort

AU - Christensen, Diana Hedevang

AU - Nicolaisen, Sia K.

AU - Ahlqvist, Emma

AU - Stidsen, Jacob V.

AU - Nielsen, Jens Steen

AU - Hojlund, Kurt

AU - Olsen, Michael H.

AU - García-Calzón, Sonia

AU - Ling, Charlotte

AU - Rungby, Jørgen

AU - Brandslund, Ivan

AU - Vestergaard, Peter

AU - Jessen, Niels

AU - Hansen, Torben

AU - Brøns, Charlotte

AU - Beck-Nielsen, Henning

AU - Sørensen, Henrik T

AU - Thomsen, Reimar W.

AU - Vaag, Allan

N1 - Publisher Copyright: ©

PY - 2022

Y1 - 2022

N2 - Introduction A Swedish data-driven cluster study identified four distinct type 2 diabetes (T2D) clusters, based on age at diagnosis, body mass index (BMI), hemoglobin A1c (HbA1c) level, and homeostatic model assessment 2 (HOMA2) estimates of insulin resistance and beta-cell function. A Danish study proposed three T2D phenotypes (insulinopenic, hyperinsulinemic, and classical) based on HOMA2 measures only. We examined these two new T2D classifications using the Danish Centre for Strategic Research in Type 2 Diabetes cohort. Research design and methods In 3529 individuals, we first performed a k-means cluster analysis with a forced k-value of four to replicate the Swedish clusters: severe insulin deficient (SIDD), severe insulin resistant (SIRD), mild age-related (MARD), and mild obesity-related (MOD) diabetes. Next, we did an analysis open to alternative k-values (ie, data determined the optimal number of clusters). Finally, we compared the data-driven clusters with the three Danish phenotypes. Results Compared with the Swedish findings, the replicated Danish SIDD cluster included patients with lower mean HbA1c (86 mmol/mol vs 101 mmol/mol), and the Danish MOD cluster patients were less obese (mean BMI 32 kg/m 2 vs 36 kg/m 2). Our data-driven alternative k-value analysis suggested the optimal number of T2D clusters in our data to be three, rather than four. When comparing the four replicated Swedish clusters with the three proposed Danish phenotypes, 81%, 79%, and 69% of the SIDD, MOD, and MARD patients, respectively, fitted the classical T2D phenotype, whereas 70% of SIRD patients fitted the hyperinsulinemic phenotype. Among the three alternative data-driven clusters, 60% of patients in the most insulin-resistant cluster constituted 76% of patients with a hyperinsulinemic phenotype. Conclusion Different HOMA2-based approaches did not classify patients with T2D in a consistent manner. The T2D classes characterized by high insulin resistance/hyperinsulinemia appeared most distinct.

AB - Introduction A Swedish data-driven cluster study identified four distinct type 2 diabetes (T2D) clusters, based on age at diagnosis, body mass index (BMI), hemoglobin A1c (HbA1c) level, and homeostatic model assessment 2 (HOMA2) estimates of insulin resistance and beta-cell function. A Danish study proposed three T2D phenotypes (insulinopenic, hyperinsulinemic, and classical) based on HOMA2 measures only. We examined these two new T2D classifications using the Danish Centre for Strategic Research in Type 2 Diabetes cohort. Research design and methods In 3529 individuals, we first performed a k-means cluster analysis with a forced k-value of four to replicate the Swedish clusters: severe insulin deficient (SIDD), severe insulin resistant (SIRD), mild age-related (MARD), and mild obesity-related (MOD) diabetes. Next, we did an analysis open to alternative k-values (ie, data determined the optimal number of clusters). Finally, we compared the data-driven clusters with the three Danish phenotypes. Results Compared with the Swedish findings, the replicated Danish SIDD cluster included patients with lower mean HbA1c (86 mmol/mol vs 101 mmol/mol), and the Danish MOD cluster patients were less obese (mean BMI 32 kg/m 2 vs 36 kg/m 2). Our data-driven alternative k-value analysis suggested the optimal number of T2D clusters in our data to be three, rather than four. When comparing the four replicated Swedish clusters with the three proposed Danish phenotypes, 81%, 79%, and 69% of the SIDD, MOD, and MARD patients, respectively, fitted the classical T2D phenotype, whereas 70% of SIRD patients fitted the hyperinsulinemic phenotype. Among the three alternative data-driven clusters, 60% of patients in the most insulin-resistant cluster constituted 76% of patients with a hyperinsulinemic phenotype. Conclusion Different HOMA2-based approaches did not classify patients with T2D in a consistent manner. The T2D classes characterized by high insulin resistance/hyperinsulinemia appeared most distinct.

KW - classification

KW - clusters

KW - cohort

KW - type 2 diabetes

U2 - 10.1136/bmjdrc-2021-002731

DO - 10.1136/bmjdrc-2021-002731

M3 - Journal article

C2 - 35428673

AN - SCOPUS:85128487309

VL - 10

JO - B M J Open Diabetes Research & Care

JF - B M J Open Diabetes Research & Care

SN - 2052-4897

IS - 2

M1 - e002731

ER -

ID: 305186174