Key result
Scottish tree-based prediabetes stratification links upper-right branch phenotypes to higher CVD and mortality risk.
Why the study?
Does stratifying prediabetic patients using the Scottish phenotypic tree model identify their risks of developing diabetes, cardiovascular disease, and mortality?
Cohort (n=14,255)
Yes
Does stratifying prediabetic patients using the Scottish phenotypic tree model identify their risks of developing diabetes, cardiovascular disease, and mortality?
Answers are grounded in this paper and cite their sources.
Stratifying prediabetic patients using a phenotypic tree model can identify distinct subgroups with varying risks for progression to diabetes, cardiovascular disease, and mortality.
Background and Objectives To investigate whether stratifying participants with prediabetes using the Scottish tree model could identify their risks of developing diabetes and related outcomes. Methods The current study enrolled subjects with prediabetes at baseline from the China Health and Retirement Longitudinal Study and the Chinese follow-up cohort, comprising 10,165 and 4,090 participants, respectively. We assigned individuals to the Scottish tree using the mapping function based on nine phenotypic variables, including HbA1c, BMI, blood lipids, liver enzyme, creatinine, and blood pressure. Cox proportional hazards regression models were utilized to assess the relationships between dimensions on the tree and future diabetes, renal and cardiovascular diseases, and death from all causes. Results Our findings showed that individuals in the upper-right branch of the tree exhibited the increased risk of progression to subclinical atherosclerosis, cardiovascular disease, microalbuminuria, and all-cause mortality, potentially linked to elevated blood pressure, dyslipidemia, and body fat percentage. Individuals in the right part of the tree were more likely to progress to the onset of type 2 diabetes and chronic kidney disease, which was possibly associated with insulin resistance, triglycerides, and blood pressure. Conclusions The phenotypic tree model could be incorporated into future risk stratification and treatment plans to better benefit individuals with prediabetes.
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Zhang et al. (2026) conducted a cohort in Prediabetes (n=14,255). Scottish phenotypic tree model stratification vs. Other branches of the tree model was evaluated on Future diabetes, renal and cardiovascular diseases, and death from all causes. Stratifying prediabetes patients using the Scottish tree model identified individuals in the upper-right branch as having an increased risk of cardiovascular disease and all-cause mortality.
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