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. Author manuscript; available in PMC: 2024 Oct 1.
Published in final edited form as: Nat Med. 2024 Mar 5;30(4):1065–1074. doi: 10.1038/s41591-024-02865-3

Table 1.

Overview of multi-ancestry T2D genetic clusters. Refer to Supplementary Table 3 for trait abbreviations legend.

Cluster (# Variants) Expected physiological impact Key top-weighted traits Key top-weighted loci Suspected mechanism Note
Beta Cell 1 (82) Insulin deficiency CIR (−), disposition index (−) CDKAL1, C2CD4A, HHEX, ST6GAL1, LDHB, TET2 Beta cell function, glucose homeostasis Recaptures part of Beta Cell cluster from Udler et al 2018 [3] and Beta Cell 1 from Kim et al 2022 [4]
Beta Cell 2 (40) Insulin deficiency HbA1c female (+), FGadjBMI (+), glucose male (+), proinsulin (+) GCK, TCF7L2, SLC30A8, SLC2A2, ADCY5, DGKB Beta cell function, insulin processing Recaptures part of Beta Cell cluster from Udler et al 2018 [3] and Beta Cell 2 from Kim et al 2022 [4]
Proinsulin (16) Insulin deficiency PI (−), VAT (−) ARAP1/STARD1, LINC01512 Insulin synthesis Recaptures Proinsulin cluster from Udler et al 2018 [3] and Kim et al 2022 [4]
Obesity (76) Insulin resistance BMI male (+), SAT (+), waist C female (+), Trunk fat % female (+) FTO, MC4R, TMEM18, BDNF Obesity-mediated insulin resistance Recaptures Obesity cluster from Udler et al 2018 [3] and Kim et al 2022 [4]
Hyper Insulin (41) Insulin resistance DI (+), CIR (+) PDE3A, RBM6, TRAF3, CNTN2 Insulin secretion, inflammation Recaptures Hyper Insulin cluster from Kim et al 2022 [4]
Cholesterol (5) Insulin resistance CRP male (+), Cholesterol (−), Apolipoprotein A (+) APOE, NECTIN2, TM6SF2, POLK/HMGCR HMGCR expression New cluster in this study
Lipodystrophy 1 (47) Insulin resistance GFATAdjBMI (−), VAT/GFAT (+), adiponectin (−) VEGFA, CCFC92, LINC01625/CITED2, GRB14/COBLL1, FAM13A Fat distribution-mediated insulin resistance Recaptures Lipodystrophy cluster from Udler et al 2018 [3] and Kim et al 2022 [4]
Lipodystrophy 2 (29) Insulin resistance ALT (+), ISIadjAgeSexBMI (−), AST (+), GGT (+) PNPLA3, PPARG, LOC646736/IRS1, PEPD, ANKRD55, ERLIN1 Hepatic steatosis New cluster in this study; split from previous Lipodystrophy cluster
Liver-Lipid (7) Insulin resistance TG female (−), SHBG male (+), IGF female (+), Albumin male (−) GCKR, FADS1, PPIP5K1 Liver/lipid metabolism Recaptures Liver-Lipid cluster from Udler et al 2018 [3] and Kim et al 2022 [4]
Bilirubin (2) Unclear Bilirubin (+) UGT1A3 Bilirubin metabolism New cluster in this study
SHBG-LpA (3) Unclear SHBG male (−), Lp(a) female (+), oestradiol female (−) SHBG, SLC22A3, STAG1 SHBG and Lp(a) metabolism Merged from LpA and SHBG clusters from Kim et al 2022 [4]
ALP Negative (6) Insulin resistance ALP (−), RBC count (−), Hgb concentration (−) ABO, FADS1 ALP activity levels Recaptures ALP Neg cluster from Kim et al 2022 [4]