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Individualized statin associated type 2 diabetes risk estimation with a deep causal model

delete2026-08-03
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OA
AI
周豪 (Hao Zhou) *
J
Jorge Passamani Zubelli
H
Haralampos Hatzikirou
A
Andreas Henschel
L
Laurent Alain Najman
D
Daniel E. Platt
A
Antonello Maruotti
S
Siobhán O’Sullivan
L
Lithe Basbous
C
Cynthia Al Hageh
M
Mariam Al Harbi
A
Antoine Abchee
P
Pierre Zalloua *
DOI:10.1186/s10020-026-01589-zdelete
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Abstract

Abstract

En 中文
Statin therapy reduces cardiovascular risk, but recorded statin exposure is associated with subsequent type 2 diabetes (T2D) in some populations. Individualized risk estimation and separation of low-density lipoprotein cholesterol (LDL-C)-mediated from non-LDL components remain challenging in observational data. We analyzed adults free of diagnosed diabetes and without substantial baseline hyperglycemia in UK Biobank, the All of Us Research Program, and the Abu Dhabi Public Health Center cohort. We used weighted survival and regression analyses, UK Biobank exposure-definition and propensity-score sensitivity analyses, two-stage residual inclusion Mendelian randomization mediation, and CausalT2DNet, a balanced deep counterfactual prediction model. Recorded statin exposure was associated with higher incident T2D risk over cohort-specific horizons. UK Biobank matched-method 10-year sensitivity analyses yielded adjusted risk ratios of 2.18–2.25, and a broader baseline-only IPTW sensitivity model yielded a weighted risk ratio of 1.95. In a separate CausalT2DNet 12-year absolute-risk scenario, predicted T2D risk increased from 2.24% under no statin exposure to 4.05% under statin exposure. Mediation and counterfactual analyses suggested that much of the excess risk was not explained by LDL-C lowering, under their respective assumptions. Recorded statin exposure was consistently associated with higher incident T2D risk across three longitudinal cohorts. The framework supports assumption-explicit research risk estimation and hypothesis generation and requires external recalibration and prospective validation before clinical use.
Keywords:
Statin
LDL
Cardiovascular
Diabetes
Machine learning
Causal inference

Journal

Molecular Medicine cover
Molecular Medicine
IF:
6.4
Papers:
3.2K
Citations:
8.3K

Organization

K
khalifa university
Scholars:
434
Papers: 209
Citations: 0
A
abu dhabi public health center
Scholars:
2
Papers: 2
Citations: 0
C
College of Medicine and Health Sciences
Scholars:
967
Papers: 315
Citations: 1
D
department of computer science
Scholars:
541
Papers: 283
Citations: 0
C
College of Computing and Mathematical Sciences
Scholars:
7
Papers: 4
Citations: 0
C
Center for Biotechnology
Scholars:
26
Papers: 7
Citations: 0
F
faculty of medicine
Scholars:
6.1K
Papers: 2.1K
Citations: 0
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