Objectives: However, it is not known whether a data-driven cluster analysis can also subphenotype patients participating in a behavioral weight loss program and whether identified subclusters associate with differential therapeutic outcomes.
Methods: We performed k-means clustering using the variables age, body mass index (BMI), and c-peptide-based Homeostasis Model Assessment of beta cell function (HOMA2-%B) and insulin resistance (HOMA2-IR) at baseline in patients with obesity undergoing a four-year behavioral weight loss program at the University Hospital Leipzig, Germany. A total of 239 (170 female; 74 with type-2-diabetes) patients were included in the analysis.
Results: At baseline, the median (interquartile range) BMI was 43.2 (8.9) kg/m². After four years, mean weight loss was 3.1 (10.1) kg (p<0.001), and glucose and lipid parameters significantly improved. Based on descriptive cluster characteristics, the clusters “Insulin-deficient Elderly Obesity” (IDEO, N=114), “Insulin-resistant Severe Obesity” (IRSO, N=46) and “Young Glucose-tolerant Obesity” (YGTO, N=79) were formed. At baseline, the three identified clusters significantly differed in all parameters used for clustering (p<0.001), as well as in fasting c-peptide and glucose, hemoglobin A1c, high-density lipoprotein cholesterol and estimated glomerular filtration rate (all p<0.001). Patients from the IRSO cluster showed the highest BMI reductions over the four" /> Introduction: In patients with obesity and type 2 diabetes undergoing bariatric surgery, a data-driven clustering approach revealed that people with insulin resistance in particular benefit from obesity surgery (Raverdy et al. 2022).
Objectives: However, it is not known whether a data-driven cluster analysis can also subphenotype patients participating in a behavioral weight loss program and whether identified subclusters associate with differential therapeutic outcomes.
Methods: We performed k-means clustering using the variables age, body mass index (BMI), and c-peptide-based Homeostasis Model Assessment of beta cell function (HOMA2-%B) and insulin resistance (HOMA2-IR) at baseline in patients with obesity undergoing a four-year behavioral weight loss program at the University Hospital Leipzig, Germany. A total of 239 (170 female; 74 with type-2-diabetes) patients were included in the analysis.
Results: At baseline, the median (interquartile range) BMI was 43.2 (8.9) kg/m². After four years, mean weight loss was 3.1 (10.1) kg (p<0.001), and glucose and lipid parameters significantly improved. Based on descriptive cluster characteristics, the clusters “Insulin-deficient Elderly Obesity” (IDEO, N=114), “Insulin-resistant Severe Obesity” (IRSO, N=46) and “Young Glucose-tolerant Obesity” (YGTO, N=79) were formed. At baseline, the three identified clusters significantly differed in all parameters used for clustering (p<0.001), as well as in fasting c-peptide and glucose, hemoglobin A1c, high-density lipoprotein cholesterol and estimated glomerular filtration rate (all p<0.001). Patients from the IRSO cluster showed the highest BMI reductions over the four" />
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