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2 型糖尿病多基因风险评分可预测无糖尿病患者发生糖皮质激素诱导性高血糖的风险。

Type 2 Diabetes Polygenic Score Predicts the Risk of Glucocorticoid-Induced Hyperglycemia in Patients Without Diabetes.

机构信息

Diabetes Unit, Massachusetts General Hospital, Boston, MA.

Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA.

出版信息

Diabetes Care. 2023 Aug 1;46(8):1541-1545. doi: 10.2337/dc23-0353.

Abstract

OBJECTIVE

To assess whether increased genetic risk of type 2 diabetes (T2D) is associated with the development of hyperglycemia after glucocorticoid treatment.

RESEARCH DESIGN AND METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

研究设计和方法

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。

结果

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)。

结论

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。

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