Behavioral-metabolic phenotypes and differential risks of diabetic kidney disease and peripheral neuropathy in type 2 diabetes: a latent class analysis
- 1Beijing University of Chinese Medicine
- 2Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine
- 3Integrated Chinese and Western Medicine Metabolic Disease Research Center, Fangshan District Traditional Chinese Medicine Hospital
Abstract
Background: Behavioral and metabolic risk factors frequently coexist in type 2 diabetes mellitus (T2DM), but their combined patterns and associations with microvascular complications remain insufficiently characterized.
Methods: This cohort study included 706 individuals with T2DM. Outcome-specific risk sets were established by excluding participants with prevalent diabetic kidney disease (DKD) or diabetic peripheral neuropathy (DPN) at baseline. Behavioral and metabolic factors were classified using latent class analysis. Multinomial logistic regression and Cox models, alongside socioeconomic status (SES)-stratified analyses, assessed associations among phenotypes, SES, and incident complications.
Results: Three behavioral-metabolic phenotypes were identified: the Behavioral-Visceral Adiposity (BVA) phenotype (14.3%), characterized by unhealthy lifestyle behaviors, lower BMI, and higher visceral adiposity; the Obesity-Related Metabolic Risk (OMR) phenotype (39.8%), characterized by obesity, physical inactivity, insulin resistance, and suboptimal blood pressure control; and the Low-Risk (LR) phenotype (45.9%). Compared with the LR phenotype, the OMR phenotype showed increased risks of incident DKD (HR = 2.01; 95% CI = 1.32–3.04) and DPN (HR = 2.06; 95% CI = 1.18–3.58). The BVA phenotype was associated with increased risk of DPN (HR = 2.47; 95% CI = 1.19–5.12). SES was independently associated with phenotype membership. Associations between the OMR phenotype and DKD or DPN were mainly observed among individuals with low SES, whereas the association between the BVA phenotype and DPN was mainly observed among individuals with high SES.
Conclusions: Three distinct behavioral-metabolic phenotypes were identified among individuals with T2DM and showed differential associations with DKD and DPN risks. Integrating behavioral patterns, metabolic profiles, and socioeconomic context into risk stratification strategies may enhance early identification and individualized prevention of microvascular complications.
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BibTeX
@article{wang2026behavioralmetabolic,
title = {{Behavioral-metabolic phenotypes and differential risks of diabetic kidney disease and peripheral neuropathy in type 2 diabetes: a latent class analysis}},
author = {Yue Wang and Zijian Liu and Zhengshan Zhang and An Hu and Lin Liu and Shuanghui Zeng and Ping Liu and Yahui Wang and Luying Sun},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1962966},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1962966/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Behavioral-metabolic phenotypes and differential risks of diabetic kidney disease and peripheral neuropathy in type 2 diabetes: a latent class analysis
AU - Yue Wang
AU - Zijian Liu
AU - Zhengshan Zhang
AU - An Hu
AU - Lin Liu
AU - Shuanghui Zeng
AU - Ping Liu
AU - Yahui Wang
AU - Luying Sun
PY - 2026
DA - 2026/10/15
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1962966
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1962966/full
AB - Background: Behavioral and metabolic risk factors frequently coexist in type 2 diabetes mellitus (T2DM), but their combined patterns and associations with microvascular complications remain insufficiently characterized. Methods: This cohort study included 706 individuals with T2DM. Outcome-specific risk sets were established by excluding participants with prevalent diabetic kidney disease (DKD) or diabetic peripheral neuropathy (DPN) at baseline. Behavioral and metabolic factors were classified using latent class analysis. Multinomial logistic regression and Cox models, alongside socioeconomic status (SES)-stratified analyses, assessed associations among phenotypes, SES, and incident complications. Results: Three behavioral-metabolic phenotypes were identified: the Behavioral-Visceral Adiposity (BVA) phenotype (14.3%), characterized by unhealthy lifestyle behaviors, lower BMI, and higher visceral adiposity; the Obesity-Related Metabolic Risk (OMR) phenotype (39.8%), characterized by obesity, physical inactivity, insulin resistance, and suboptimal blood pressure control; and the Low-Risk (LR) phenotype (45.9%). Compared with the LR phenotype, the OMR phenotype showed increased risks of incident DKD (HR = 2.01; 95% CI = 1.32–3.04) and DPN (HR = 2.06; 95% CI = 1.18–3.58). The BVA phenotype was associated with increased risk of DPN (HR = 2.47; 95% CI = 1.19–5.12). SES was independently associated with phenotype membership. Associations between the OMR phenotype and DKD or DPN were mainly observed among individuals with low SES, whereas the association between the BVA phenotype and DPN was mainly observed among individuals with high SES. Conclusions: Three distinct behavioral-metabolic phenotypes were identified among individuals with T2DM and showed differential associations with DKD and DPN risks. Integrating behavioral patterns, metabolic profiles, and socioeconomic context into risk stratification strategies may enhance early identification and individualized prevention of microvascular complications.
SN - 1664-2392
ER -