Identification of Metabolic Patterns in Korean Patients with Type 2 Diabetes Mellitus and their Association with Diabetes-Related Complications

Resolving metabolic heterogeneity in patients with type 2 diabetes mellitus (T2DM) gives them access to precision medicine. Despite ethnic diversity in pathophysiological processes in individuals with T2DM, studies on subtypes of diabetes related to clinical characteristics in Asians are insufficient. This study aims to identify metabolic patterns in middle-aged patients with T2DM in Republic of Korea (Korea) and determine the incidence of diabetes-related complications according to patterns. We analyzed 6,603 patients with T2DM aged 30 to 64 who visited three centers of general hospital in Korea. Three metabolic patterns were derived: Obesity and Hypertension pattern (OH-P), Liver Function-related HyperGlycemia pattern (LFHG-P), and Decreased Kidney Function pattern (DKF-P). The highest tertile of the OH-P score was associated with an increased risk of peripheral vascular disease compared to the lowest tertile (HR = 1.26, 95% CI = 1.02-1.57). The highest tertile of the LFHG-P score was associated with an increased risk of myocardial infarction (HR = 1.79, 95% CI = 1.13-2.82) and atrial fibrillation (HR = 1.54, 95% CI = 1.07-2.23). No association with complications was found in the DKF-P. This study suggests the need for proper management and treatment according to metabolic patterns in patients with T2DM.