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

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

Affiliations
Meta-Analysis

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

Aaron J Deutsch et al. Diabetes Care. .

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.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Flowchart for selection of study participants. Participants were selected from the Mass General Brigham Biobank according to specified inclusion and exclusion criteria.
Figure 2
Figure 2
Factors that modulate the risk of glucocorticoid-induced hyperglycemia. A: We used a logistic regression model to test the association between a T2D global extended polygenic score and GIH, while simultaneously controlling for the listed covariates. The 95% CI is displayed for each data point. B: We constructed receiver operating curves to distinguish between individuals with and without GIH. The initial regression model (black) included only those covariates that were significantly associated with GIH (eGFR, glucocorticoid dose). The revised regression model (red) additionally included the T2D global extended polygenic score. The area under the curve (AUC) is displayed for each model. P value was obtained using the DeLong test.

Comment in

  • Steroidgabe als früher Diabetes-Sensor?
    Müssig K. Müssig K. MMW Fortschr Med. 2024 Apr;166(7):26. doi: 10.1007/s15006-024-3873-8. MMW Fortschr Med. 2024. PMID: 38637377 Review. German. No abstract available.

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