{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:26:23Z","timestamp":1793157983969,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>The aim of this study was to determine whether distinct subphenotypes of patients with type\u00a02 diabetes in the European classification exist in Chinese populations, and to further establish novel subphenotypes more suitable for Chinese populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>The research retrospectively analyzed 5414 patients with type\u00a02 diabetes from the National Clinical Research Center for Metabolic Diseases Diabetes Center in China, and a two\u2010step cluster analysis was carried out. First, we confirmed the European classification in Chinese populations by six parameters, including age at disease onset, body mass index, glycosylated hemoglobin, homeostatic model assessment\u00a02 to estimate \u03b2\u2010cell function and insulin resistance, and glutamate decarboxylase antibodies. Furthermore, triglycerides and uric acid were added to refine the cluster analysis, and Cox regression was used to evaluate the risk of diabetic complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Just three clusters were replicated in our cohort according to Emma Ahlqvist's European classification. When other variables were added to the cluster analysis, seven subgroups were identified, including five clusters of the European classification and two novel subgroups, namely, uric acid\u2010related diabetes and inheritance\u2010related diabetes. Compared with patients with inheritance\u2010related diabetes, patients with severe insulin\u2010resistant diabetes showed a higher risk of diabetic peripheral neuropathy, hypertension and chronic kidney disease, and the uric acid\u2010related diabetes subgroup showed a higher risk of coronary heart disease, cerebral vascular disease and end\u2010stage renal disease. Patients with severe insulin\u2010deficient diabetes showed a higher risk of diabetic retinopathy and diabetic foot than those with inheritance\u2010related diabetes. Furthermore, there were sex\u2010specific associations between subgroups and clinical outcomes. No significant difference was observed in the prevalence of cancer in each subgroup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Seven subgroups of type\u00a02 diabetes were identified in Chinese populations, with distinct characteristics and disparate clinical outcomes. This etiology\u2010based stratification might contribute to the diagnosis and management of type\u00a02 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13494","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T21:35:17Z","timestamp":1610314517000},"page":"1346-1358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Identification of two novel subgroups in patients with diabetes mellitus and their association with clinical outcomes: A two\u2010step cluster analysis"],"prefix":"10.1111","volume":"12","author":[{"given":"Xiao\u2010fen","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4544-0822","authenticated-orcid":false,"given":"Lin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Xiangya Hospital Central South University Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30058-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.151"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310799"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62219-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03409.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31320-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.99"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/db16-0628"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31537-4"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30051-2"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-018-0011-9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7596"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2013.02.035"},{"key":"e_1_2_7_15_1","first-page":"590","article-title":"Prevalence and determinants of hyperuricemia in type 2 diabetes mellitus patients with central obesity in Guangdong Province in China","volume":"22","author":"Wang J","year":"2013","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0025-1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30316-4"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12098"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tig.2017.01.010"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-013-0023-5"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-007-0036-0"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2019.06.009"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00404074"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2016.07.002"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70065-0"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft132"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10370"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.07.021"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.08436"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0199-y"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-014-9075-0"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2014.01.010"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.10.048"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2905"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014070660"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12031-016-0848-y"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2005.01565.x"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000346603"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.08.017"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.171488"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.2337\/db13-1396"},{"key":"e_1_2_7_42_1","first-page":"243","article-title":"Effect of Uric Acid\u2010Lowering Agents on Endothelial Function: A Randomized, Double\u2010Blind","volume":"69","author":"Borgi L","year":"2017","journal-title":"Placebo\u2010Controlled Trial. Hypertension"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13494","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdi.13494","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T12:22:27Z","timestamp":1693311747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.13494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,14]]},"references-count":41,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/jdi.13494"],"URL":"https:\/\/doi.org\/10.1111\/jdi.13494","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"value":"2040-1116","type":"print"},{"value":"2040-1124","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,14]]},"assertion":[{"value":"2020-09-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}