Diabetes Unit, Massachusetts General Hospital, Boston, MA.
Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA.
Diabetes Care. 2023 Aug 1;46(8):1541-1545. doi: 10.2337/dc23-0353.
To assess whether increased genetic risk of type 2 diabetes (T2D) is associated with the development of hyperglycemia after glucocorticoid treatment.
We performed a retrospective analysis of individuals with no diagnosis of diabetes who received a glucocorticoid dose of ≥10 mg prednisone. We analyzed the association between hyperglycemia and a T2D global extended polygenic score, which was constructed through a meta-analysis of two published genome-wide association studies.
Of 546 individuals who received glucocorticoids, 210 developed hyperglycemia and 336 did not. T2D polygenic score was significantly associated with glucocorticoid-induced hyperglycemia (odds ratio 1.4 per SD of polygenic score; P = 0.038).
Individuals with increased genetic risk of T2D have a higher risk of glucocorticoid-induced hyperglycemia. This finding offers a mechanism for risk stratification as part of a precision approach to medical treatment.
评估 2 型糖尿病（T2D）遗传风险增加是否与糖皮质激素治疗后高血糖的发生有关。
我们对未被诊断为糖尿病且接受泼尼松≥10mg 剂量糖皮质激素治疗的个体进行了回顾性分析。我们分析了 T2D 全球扩展多基因评分与高血糖之间的关联，该评分通过对两项已发表的全基因组关联研究的荟萃分析构建而成。
在接受糖皮质激素治疗的 546 名个体中，210 名发生了高血糖，336 名未发生。T2D 多基因评分与糖皮质激素诱导的高血糖显著相关（多基因评分每标准差的优势比为 1.4；P=0.038）。
遗传上易患 T2D 的个体发生糖皮质激素诱导的高血糖的风险更高。这一发现为风险分层提供了一种机制，作为精准医疗治疗方法的一部分。
