Evidence mapPaperPMID 39920748Full record

ArticleCardiovascular diabetology2025

A sex-disaggregated analysis of the prognostic value of lean type 2 diabetes mellitus in the adult population with acute myocardial infarction.

Gwyneth Kong, Jaycie Koh, Jobelle Chia, Bryan Neo, Yiming Chen, Grace Cao, Bryan Chong, Mark Muthiah, Hui Wen Sim, Gavin Ng and 5 more

Abstract readComparative Study
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Gwyneth Kong *Department of Medicine, National University Hospital, Singapore, Singapore.
Jaycie Koh *Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Jobelle Chia *Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Bryan NeoYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Yiming ChenYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Grace CaoYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Bryan ChongYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Mark MuthiahDivision of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
Hui Wen SimDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Gavin NgDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Chieh Yang KooDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Chin Meng KhooDivision of Endocrinology, Department of Medicine, National University Hospital, Singapore, Singapore.
Mark Yan-Yee ChanDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Poay-Huan LohDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.
Nicholas W S ChewDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore. nicholas.w.chew@gmail.com.ORCID 0000-0002-0640-0430

Funding

National Medical Research Council Research Training Fellowship MH 095:003/008-303NUHS Clinician Scientist Program NCSP2.0/2024/NUHS/NCWSNUHS Seed Fund NUHSRO/2022/058/RO5+6/Seed-Mar/03
6 · The paper itself

Abstract

backgroundEmerging evidence has demonstrated the unfavourable cardiovascular risk of individuals with lean type 2 diabetes mellitus (T2DM). Our study aims to investigate the prognostic value of lean T2DM in patients with acute myocardial infarction (AMI), stratified by sex.

methodsThe study cohort examines the clinical characteristics and long-term outcomes of individuals with AMI, stratified by four phenotypes based on T2DM and lean body category-lean T2DM, non-lean T2DM, lean non-T2DM and non-lean non-T2DM. The primary outcome was long-term all-cause mortality. Cox regression model was constructed to investigate the associations of lean and non-lean T2DM phenotypes with mortality, adjusted for age, ethnicity, previous AMI, AMI type, chronic kidney disease, angiotensin converting enzyme inhibitor or angiotensin receptor blockers, beta-blockers, and smoking status.

resultsA cohort of 9545 AMI patients was examined, with a mean follow-up duration of 3.4 ± 2.4 years. Majority had the non-lean T2DM phenotype (40.4%), followed by non-lean non-T2DM (29.8%), lean non-T2DM (15.9%), and lean T2DM (13.9%). In the T2DM group, one-quarter was lean (N = 1324), while the vast majority (74.5%) was non-lean. Individuals with lean T2DM tended to be female and older. Patients with lean T2DM had the highest rates of heart failure (23.3%, p < 0.001), cardiogenic shock (9.1%, p = 0.036), and long-term all-cause mortality (32.6%, p < 0.001). Cox regression demonstrated that lean T2DM was an independent predictor of mortality (adjusted hazard ratio [aHR] 1.171, 95% CI 1.040-1.319, p = 0.009) after adjustment. The presence of higher mortality risk following AMI was present in males (aHR 1.201, 95% CI 1.037-1.391, p = 0.015), but not in females (aHR 1.066, 95% CI 0.869-1.308, p = 0.538).

conclusionsThe lean T2DM phenotype was present in one-quarter of the AMI cohort with T2DM. The lean T2DM phenotype was an independent predictor of long-term mortality following AMI, although this association was stronger in males than in females.

Indexed as

Diabetes Mellitus, Type 2Myocardial InfarctionThinnessAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesSex FactorsSingaporeAcute myocardial infarctionCardiovascular outcomesLeanSex differencesType 2 diabetes mellitus

Identifiers

PMID39920748
PMCPMC11806904

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.