Obesity, clinical, and genetic predictors for glycemic progression in Chinese patients with type 2 diabetes: A cohort study using the Hong Kong Diabetes Register and Hong Kong Diabetes Biobank

Abstract

Background Type 2 diabetes (T2D) is a progressive disease whereby there is often deterioration in glucose control despite escalation in treatment. There is significant heterogeneity to this progression of glycemia after onset of diabetes, yet the factors that influence glycemic progression are not well understood. Given the tremendous burden of diabetes in the Chinese population, and limited knowledge on factors that influence glycemia, we aim to identify the clinical and genetic predictors for glycemic progression in Chinese patients with T2D.

Risk of Typical Diabetes-Associated Complications in Different Clusters of Diabetic Patients: Analysis of Nine Risk Factors

“…In a sex-specific analysis, a close relationship between smoking and diagnosis of angina pectoris and amputation of the legs in women could be observed. Smoking has been associated with an increased risk of glycemic progression in diabetics [ 30 ] as well as with an increased risk of macrovascular complications, especially peripheral artery disease, coronary artery disease [ 31 ], and diabetic foot ulcerations findings [ 32 ], which are superimposable with the risk characteristics of subgroup “cluster 10”. The underrepresentation of affections of the retina in nicotine-dependent diabetic patients is in accordance with a study by Cai et al, who noted a decreased risk of diabetic retinopathy and proliferative diabetic retinopathy [ 33 ].…”

Development of genome-wide polygenic risk scores for lipid traits and clinical applications for dyslipidemia, subclinical atherosclerosis, and diabetes cardiovascular complications among East Asians

“…The validation dataset consists of 4271 individuals at different stages of the life-course from four cohorts of Chinese ancestry: (1) 909 children enrolled in the follow-up visit of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study at the Hong Kong center [ 11 ]; (2) 1973 adolescents recruited from a community-based school survey for risk factor assessment [ 12 ]; (3) 441 healthy adults enlisted from hospital staff, a territory-wide health awareness, and promotion program selected by stratified random sampling with computer-generated codes in accordance to the distribution of occupational groups, and the community-based pharmacogenetics studies in hypertension and dyslipidemia [ 13 , 14 ]; and (4) 948 adult women attended the HAPO follow-up study [ 11 ]. The best PRSs for lipid traits were further evaluated in four independent testing datasets, comprising 426 adults recruited from hospital staff, and a territory-wide health awareness and promotion program, as well as a total of 7723 individuals drawn from three prospective cohorts of Chinese patients with T2D: (1) 4917 patients from the Hong Kong Diabetes Register (HKDR), which was established as a quality improvement program at the Prince of Wales Hospital at the Chinese University of Hong Kong since 1995 [ 15 ]; (2) 1941 patients; and (3) 865 patients enrolled in the Hong Kong Diabetes Biobank (HKDB) phase 1 and phase 2 studies, respectively [ 16 ], which aims to establish a territory-wide registry and biobank of individuals with diabetes for large-scale genetic replication studies, biomarker discovery, and epidemiology research.…”

<p>Characterization and Treatment of Inflammation and Insulin Resistance in Obese Adipose Tissue</p>

“…[7][8][9][10][11][12] In particular, non-insulindependent diabetes (type 2 diabetes) is closely related to obesity. 13,14 Obesity is defined as "abnormal or excessive fat accumulation that may impair health" by the World Health Organization. 5 Adipose tissue (AT) remodeling occurs during obesity, resulting in hypertrophy, hypoxic necrosis, immune cell infiltration, release of adipokines, and changes in inflammatory signaling.…”