Objective tongue phenotyping identifies phenotypic heterogeneity in diabetic kidney disease: a dual-center clustering analysis

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The study enrolled 331 patients with diabetic kidney disease (DKD) from two hospitals in Beijing to identify tongue-phenotype subtypes.
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K-means clustering identified two distinct clusters of tongue phenotypes, with Cluster 1 comprising 32.6% and Cluster 2 comprising 67.4% of participants.
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Cluster 2 exhibited higher brightness and lower saturation, while Cluster 1 showed darker color and higher saturation among tongue features.
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Significant differences in coating thickness and tooth marks were observed between the two clusters, but fissures did not differ significantly.
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Objective tongue phenotyping revealed two reproducible DKD subtypes that did not overlap with conventional laboratory profiles.

Frontiers In Endocrinology

by Zhaoxi Dong, Jiayou Liu, Jiyuan Hu, Jiaming Su, Zheyu Xu, Xinhui Yu, Jie Mei, Fengyi Cai, Fawei Li, Xinyue Zang, Runze Wang, Yuanhao Chen, Dongze Li, Weihong Chen, Qingqing Liu, Chengdong Peng, Yang Shi, Hongfang Liu
July 17, 2026

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