Background: recently, a novel subgroups of adult-onset diabetic patients has been reported. Their work implied that type 2 diabetic patients can be classified into four groups. However, the utility of this classification method in Tibet populations and the clinical character of each cluster of Tibetan patients is unknown.
Methods: this is a cross-sectional study, patients newly diagnosed with type 2 diabetes was analyzed. Data was collected from hospital information system (HIS) , and homoeostasis model assessment 2 of β-cell function (HOMA2-B) and insulin resistance (HOMA2-IR) was calculated using fasting glucose and fasting C-peptide by HOMA calculator. The age at onset of diabetes, Hba1c, BMI, HOMA2-B and HOMA2-IR was used for clustering. K-means cluster method was used with k value of 4. The stability of each cluster was assessed by resampling the dataset and computing Jaccard similarities. All statistical analysis was performed on R and fpc package.
Result: A total of 581 patients was enrolled, the four clusters with similar clinical aspect is observed in Tibetan population and the average jaccard similarities is over 0.7. The same as Ji's result, the largest subgroup is mild age-related diabetes cluster (MARD) 255 out of 581 (44.3%) patients is classified into this cluster. And 147 (25.6%) patients is classified into mild obesity related diabetes (MOD) . The proportion of severe insulin- resistant related diabetes (SIRD) (1.4%) is lower and those of severe insulin-deficient related diabetes (SIDD) (28.7%) is higher compared to Ji's study. This result implies that there may be more severe insulin-deficient patients and less severe insulin-resistant patients in Tibet plateau.
Discussion: in this study, we found out that the cluster method developed by Emma Ahlqvist is suitable for Tibetan population, compared to the rest Chinese population, there're more severe insulin-deficient patient, and less severe insulin-resistance patients.
W.Suyuan: None. C.Zhang: None.