Metabolic marker linked to higher death risk in type 2 diabetes
A pooled analysis of three type 2 diabetes cohorts linked the marker’s highest tenth to higher mortality, with a hazard ratio of 1.46.

5,060 participants, cohort study
Limit: The high-risk TBR cutoff was chosen after examining mortality patterns
Stake: Chiesi Italia funded the study. Omron Healthcare funded the study. Authors also declare ties to 6 more companies.
Edited by Boris Djordjevic · AgingResearch.News
An observational study analyzed three cohorts of 2,137, 960 and 5,060 people with type 2 diabetes. Researchers developed a marker by dividing blood triglyceride levels, a measure of blood fat, by body mass index, a measure of weight relative to height. They tested whether this ratio was associated with death from any cause.
In each cohort, people in the highest tenth of the ratio showed a metabolic pattern resembling lipodystrophy, a condition involving abnormal loss of body fat. They had lower body mass index, worse blood sugar control and other metabolic abnormalities. The pooled analysis linked this group to higher mortality, with a hazard ratio of 1.46—a relative measure of death risk during follow-up. In a subset of one cohort, a genetic risk score for the lipodystrophy-like pattern was also associated with the ratio.
Why it matters
The authors suggest that recognizing this metabolic pattern could refine diagnosis and follow-up for people with type 2 diabetes, helping address differences in long-term death risk.
Caveats
These observational associations do not show that the metabolic pattern caused higher mortality. The findings concern people with type 2 diabetes; the abstract does not specify follow-up length or the hazard ratio’s comparison group.
From the paper
- Participants
A total of 10 251 participants with type 2 diabetes who were at high cardiovascular risk were randomized in a 1:1 ratio to receive intensive or standard glycemic therapy at clinical sites in the United States and Canada.
- Result
The risk of death in decile 10 patients as compared to deciles 1-9 was replicated in the PMS (n = 960 individuals with type 2 diabetes, whose clinical features are shown in, middle, TBR median IQR = 1.52, 1.23-1.89, with adjusted HR for all-cause mortality being 1.79 (95% CI: 1.21-2.64; P =.0036) …
Quoted word for word from the full text on PubMed Central.
- Type 2 diabetes
- Triglyceride
- Lipodystrophy-like metabolic phenotype
- Atherogenic dyslipidemia
- Hypoadiponectinemia
- Humans
The paper
All-cause mortality in people with type 2 diabetes and lipodystrophy-like metabolic phenotype
Casa Sollievo della Sofferenza
Journal of the Endocrine Society, Oct 19, 2026, Open access, CC BY-NC-ND
