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Войти в исследования The Journal of clinical endocrinology and metabolism · 2026
Unequal distribution of plasma glucagon levels among clustering-based diabetes subtypes: a Japanese cohort.
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Tanabe Hayato, Shimajiri Yoshinori, Shiroma Kaori, Higa Moritake, Masuzaki Hiroaki, Shimabukuro Michio
Аннотация
CONTEXT: Hyperglucagonemia contributes to disturbances in glucose metabolism. Data-driven diabetes clustering reflects risk of diabetic complications better than classical classification, type 1 diabetes (T1D) vs type 2 diabetes (T2D); however, the pathophysiological features have not been clarified.
OBJECTIVE: To assess the distribution of plasma glucagon levels among clustering-based diabetes subtypes.
METHODS: A total of 546 Japanese participants with T1D or T2D were categorized into 5 diabetes subtypes. Plasma glucagon levels were compared across subtypes, and factors associated with hyperglucagonemia were evaluated using logistic regression analyses.
RESULTS: Plasma glucagon levels differed significantly among diabetes subtypes. Among the 5 subtypes, plasma glucagon levels and the frequency of hyperglucagonemia were highest in the severe insulin-resistant diabetes (SIRD) subtype (45.6%). The SIRD subtype was an independent risk factor for hyperglucagonemia (adjusted odds ratio 2.17, 95% CI 1.03-4.54, P = .041), even after adjusting for other risk factors, such as body mass index, glycated hemoglobin (HbA1c), and metabolic dysfunction-associated steatotic liver disease.
CONCLUSION: The distribution of plasma glucagon levels differed among the clustering-based diabetes subtypes. SIRD is a subtype of diabetes with a hyperglucagonemic phenotype. Elucidating the reason for hyperglucagonemia in SIRD may help to clarify the mechanisms underlying the unfavorable clinical phenotype.
OBJECTIVE: To assess the distribution of plasma glucagon levels among clustering-based diabetes subtypes.
METHODS: A total of 546 Japanese participants with T1D or T2D were categorized into 5 diabetes subtypes. Plasma glucagon levels were compared across subtypes, and factors associated with hyperglucagonemia were evaluated using logistic regression analyses.
RESULTS: Plasma glucagon levels differed significantly among diabetes subtypes. Among the 5 subtypes, plasma glucagon levels and the frequency of hyperglucagonemia were highest in the severe insulin-resistant diabetes (SIRD) subtype (45.6%). The SIRD subtype was an independent risk factor for hyperglucagonemia (adjusted odds ratio 2.17, 95% CI 1.03-4.54, P = .041), even after adjusting for other risk factors, such as body mass index, glycated hemoglobin (HbA1c), and metabolic dysfunction-associated steatotic liver disease.
CONCLUSION: The distribution of plasma glucagon levels differed among the clustering-based diabetes subtypes. SIRD is a subtype of diabetes with a hyperglucagonemic phenotype. Elucidating the reason for hyperglucagonemia in SIRD may help to clarify the mechanisms underlying the unfavorable clinical phenotype.