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Liu T, Fan Z, Li Y, Xiao B, He C. Combination treatment of SGLT2i and GLP-1RA associated with improved cardiovascular outcomes in type 2 diabetes patients with acute coronary syndrome: A propensity score-matched cohort study. Int J Cardiol 2025; 431:133229. [PMID: 40187657 DOI: 10.1016/j.ijcard.2025.133229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Revised: 03/22/2025] [Accepted: 04/01/2025] [Indexed: 04/07/2025]
Abstract
BACKGROUND Few studies have investigated the effect of the combined use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) on the cardiovascular (CV) composite outcomes in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS). METHODS We retrospectively collected the data of 1325 T2D patients treated with SGLT2i for more than 3 months before ACS admission at Civil Aviation General Hospital. According to the initiative GLP-1RA use after admission, patients were divided into a combination group (SGLT2i and GLP-1RA) or a SGLT2i group. The primary CV composite outcomes were defined as the first occurrence of major adverse cardiovascular events (MACE) with 1-year, encompassing all cause death, CV death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission. Propensity score-matched (PSM) was used to control the confounding factors. RESULTS After matching, 208 pairs were finally included. Compared with the SGLT2i group, the combination group demonstrated a 31.0 % reduced risk of MACE (HR = 0.690, 95 %CI: 0.488-0.976), attributed primarily to a substantial 22.9 % (HR = 0.771, 95 %CI: 0.599-0.992) reduction in all-cause mortality and a 36.3 % reduction in non-fatal stroke (HR = 0.637, 95 %CI: 0.413-0.982). Subgroup analyses indicated consistent CV benefits across different subgroups (P interaction values >0.05). CONCLUSIONS The combined use of SGLT2i and GLP-1RA was associated with a significantly decreased risk of MACE primarily driven by the lowering risks of all-cause mortality and nonfatal stroke in T2D patients with ACS, compared with SGLT2i use alone.
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Affiliation(s)
- Tao Liu
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Zeyuan Fan
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China.
| | - Yuntao Li
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Bing Xiao
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Chang He
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
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Li L, Xu D, Xu M, Ji Y, Lou Z, Sun J. Insomnia and its risk factors in patients with type 2 diabetes: A cross-sectional study. Sleep Med 2025; 131:106484. [PMID: 40233517 DOI: 10.1016/j.sleep.2025.106484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 03/19/2025] [Accepted: 03/27/2025] [Indexed: 04/17/2025]
Abstract
AIMS Insomnia is notably prevalent among individuals with type 2 diabetes and adversely affects both glycemic control and overall quality-of-life. The objective of this study was to evaluate the possible risk factors for insomnia in patients diagnosed with type 2 diabetes and co-morbid insomnia. METHODS This is a baseline study analyzing cross-sectional data at baseline timepoint collected in a randomized controlled trial study. A total of 227 participants with type 2 diabetes and insomnia were recruited. The diagnosis of insomnia was based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the total score of Insomnia Severity Index. Multiple linear regression model was used to analyze the possible biomedical and mental health risk factors for insomnia severity, total sleep time, sleep efficiency and sleep onset latency. RESULTS Factors significantly associated with insomnia severity included fasting blood glucose and depression. Blood magnesium level was related to total sleep time. Sleep efficiency was associated with blood phosphorus. Factors related to sleep onset latency were depression and fatigue. CONCLUSION Factors related to high insomnia severity and poor sleep quality in type 2 diabetes patients with insomnia included fasting blood glucose, blood magnesium, blood phosphorus, depression and fatigue.
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Affiliation(s)
- Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Dawei Xu
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia; Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo Key Laboratory of Nervous System and Brain Function, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Ningbo Key Laboratory of Nervous System and Brain Function, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China; School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Jing Sun
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia; Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia; Data Science Institute, University of Technology Sydney, Sydney, New South Wales, Australia.
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Xu WS, Xing H, Wang QQ, Qi H, He JT, Jin T, Kan YP, Sun SY, Wang JY, Lin FQ. Identification and validation of serum amino acids as diagnostic biomarkers for diabetic peripheral neuropathy. World J Diabetes 2025; 16:105592. [DOI: 10.4239/wjd.v16.i6.105592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Revised: 03/27/2025] [Accepted: 05/14/2025] [Indexed: 06/13/2025] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) is the most prevalent complication of type 2 diabetes mellitus (T2DM). Due to a lack of specific biomarkers, the early diagnosis of this disorder is limited.
AIM To identify and validate serum amino acids that could discriminate T2DM patients with DPN from those without DPN.
METHODS T2DM patients with DPN, T2DM patients without DPN, and healthy controls were recruited for this study. The participants comprised two nonoverlapping cohorts: A training cohort (DPN = 84 participants, T2DM = 82 participants, normal = 50 participants) and a validation cohort (DPN = 112 participants, T2DM = 93 participants, normal = 58 participants). A prediction model of the ability of serum amino acids to distinguish DPN from T2DM was established using a logistic regression model, and area under the curve (AUC) analysis was used to evaluate the diagnostic ability of the model. In addition, the serum amino acid levels of 13 DPN patients were also detected before treatment and after 3 months of treatment.
RESULTS A clinical detection method for the diagnosis of DPN based on a biomarker panel of three serum amino acids and diabetes duration was developed. The diagnostic model demonstrated AUC values of 0.805 (95%CI: 0.739-0.871) and 0.810 (95%CI: 0.750-0.870) in the training and verification cohorts, respectively. In the identification of T2DM patients and normal controls, the AUC values were 0.891 (95%CI: 0.836-0.945) and 0.883 (95%CI: 0.832-0.934) in the training and validation cohorts, respectively. Arginine and tyrosine levels were increased after treatment, whereas aspartic acid levels were decreased after treatment.
CONCLUSION This study successfully identified and validated the metabolomic significance of arginine, tyrosine, and glutamic acid as potential biomarkers for diagnosing DPN. These findings are particularly valuable, as they establish a foundational step toward developing the first routine laboratory test for DPN. Moreover, the diagnostic model that was constructed in this study effectively distinguishes DPN patients from those with T2DM without neuropathy, thereby potentially facilitating early diagnosis and intervention.
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Affiliation(s)
- Wei-Sheng Xu
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Huan Xing
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Qing-Qing Wang
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Hui Qi
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jian-Tao He
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Tong Jin
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yan-Peng Kan
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Shi-Yu Sun
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ji-Ying Wang
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Fu-Qing Lin
- Department of Pain Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
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Llauradó G, Cedó L, Climent E, Badia J, Rojo-Martínez G, Flores-Le Roux J, Yanes O, Vinaixa M, Granado-Casas M, Mauricio D, Fernández-Veledo S, Vendrell J. Circulating short-chain fatty acids and Mediterranean food patterns. A potential role for the prediction of type 2 diabetes risk: The Di@bet.es Study. BMC Med 2025; 23:337. [PMID: 40481510 PMCID: PMC12143092 DOI: 10.1186/s12916-025-04186-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 06/02/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Identifying nutritional patterns associated with developing type 2 diabetes (T2D) can facilitate more effective and personalized dietary interventions. Short-chain fatty acids (SCFAs), key metabolites derived from gut microbiota, are produced through the anaerobic fermentation of dietary fibers. This study aimed to evaluate whether circulating concentrations of SCFAs are associated with specific food consumption patterns and to assess their association with T2D development in at-risk subjects within a prospective cohort (The Di@bet.es Study). METHODS The Di@bet.es study is a prospective, population-based study utilizing random cluster sampling from the Spanish population aged over 18 years (n = 5,072). Among these participants, 4,347 were free of T2D at baseline. Follow-up losses were approximately 45%, resulting in a final re-screened sample of 2,408 subjects. A qualitative food frequency questionnaire evaluated Mediterranean diet (MedDiet) adherence and high-fiber food consumption. The risk of developing T2D was assessed using the FINDRISK. Metabolomics-driven analyses of SCFAs were conducted using gas chromatography-mass spectrometry. RESULTS Subjects who developed T2D after a median follow-up of seven years had higher baseline circulating concentrations of butyrate and isobutyrate. Circulating concentrations of SCFAs were associated with high-fiber food consumption at baseline. In multivariate analysis, baseline circulating concentrations of butyrate and isobutyrate were independently associated with incident T2D after adjusting for traditional clinical factors. The C-statistics for predicting T2D were 0.847 (95%CI:0.816-0.877) for butyrate and 0.843 (95%CI:0.812-0.875) for isobutyrate in adjusted models, similar to the reference model based on traditional clinical factors (0.840 [95%CI: 0.807-0.873]). Both models improved risk prediction compared to FINDRISK. Dietary patterns did not add predictive value. Sensitivity analysis excluding subjects with prediabetes at baseline confirmed these results. In addition, an association between baseline consumption of high-fiber foods with incident T2D emerged, suggesting a different behaviour between healthy and prediabetic subjects. CONCLUSIONS Baseline circulating concentrations of SCFAs are associated with high-fiber food consumption and independently predict the development of T2D over seven years of follow-up. However, they offer limited improvement in risk prediction compared to traditional risk factors, though they enhance risk prediction as assessed by FINDRISK. Further studies are necessary to evaluate the impact of dietary interventions on SCFA.
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Affiliation(s)
- Gemma Llauradó
- Department of Endocrinology and Nutrition, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), C/ Pg. Marítim 23-25, 08003, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Lídia Cedó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Elisenda Climent
- Department of Endocrinology and Nutrition, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), C/ Pg. Marítim 23-25, 08003, Barcelona, Spain
| | - Joan Badia
- Statistics and Bioinformatics Platform, Institute of Health Reserach Pere Virgili (IISPV), Reus, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma Bionand), Málaga, Spain
| | - Juana Flores-Le Roux
- Department of Endocrinology and Nutrition, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), C/ Pg. Marítim 23-25, 08003, Barcelona, Spain
| | - Oscar Yanes
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Electronic Engineering, Metabolomics Interdisciplinary Laboratory, Universitat Rovira I Virgili (URV), Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Metabolomics Platform, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira I Virgili (URV), Reus, Spain
| | - Maria Vinaixa
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Electronic Engineering, Metabolomics Interdisciplinary Laboratory, Universitat Rovira I Virgili (URV), Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Metabolomics Platform, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira I Virgili (URV), Reus, Spain
| | - Minerva Granado-Casas
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | - Didac Mauricio
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, IR Sant Pau, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Sonia Fernández-Veledo
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
- Universitat Rovira I Virgili (URV), Reus, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain.
- Universitat Rovira I Virgili (URV), Reus, Spain.
- Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.
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Pobee RA, Danielson KK, Kong A, Eisenberg Y, Layden BT, Lin J. Examining the reach of a diabetes screening program in an urban emergency department. PUBLIC HEALTH IN PRACTICE 2025; 9:100577. [PMID: 39877316 PMCID: PMC11773073 DOI: 10.1016/j.puhip.2024.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 12/17/2024] [Accepted: 12/19/2024] [Indexed: 01/31/2025] Open
Abstract
Background Screening for diabetes in non-traditional settings like emergency departments (ED) can enhance early detection among patients at higher risk for diabetes. This study aims to assess the reach of an ED-based screening program by examining the characteristics of patients screen-detected for diabetes or prediabetes. Study design Retrospective cross-sectional study. Methods Sociodemographic characteristics (age, gender, race and ethnicity, insurance, zip code) of patients who were screened for diabetes using hemoglobin A1c test (A1c) were examined. The distribution of prediabetes and diabetes within each race/ethnicity, age, and gender groups were determined. ArcGIS Pro 2.9.0 was used to geocode patient zip codes, to generate heat maps of high occurrences of prediabetes and diabetes. Results Of the 5997 individuals screened in the ED, 49 % were non-Hispanic Black, 27 % Hispanic, 15 % non-Hispanic White, 5 % non-Hispanic Asian, and 4 % non-Hispanic Other/unknown. Almost half (47 %, n = 2808) had elevated A1c levels indicative of prediabetes (n = 2070; A1c: 5.7-6.4 %) or diabetes (n = 738; A1c: ≥6.5 %). Non-Hispanic Black females had a higher prevalence of both prediabetes (54 %) and diabetes (55 %) diagnoses as compared to other race/ethnic or gender categories; whereas non-Hispanic Asians had a lower prevalence of both prediabetes and diabetes except for those ≥65 years or older. Furthermore, most patients screened for prediabetes and diabetes reside in resource poor neighborhoods on the west and south sides of Chicago. Conclusion The burden of prediabetes and diabetes were greater among non-Hispanic Black females, with a high prevalence of prediabetes observed among younger individuals, particularly those residing in resource poor neighborhoods in the west and south sides of Chicago. More investment in resources for diabetes prevention and management for these groups may be warranted.
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Affiliation(s)
- Ruth A. Pobee
- UI Health/University of Illinois Chicago College of Medicine, Department of Emergency Medicine Chicago, Illinois, USA
| | - Kirstie K. Danielson
- UI Health/University of Illinois Chicago College of Medicine, Division of Endocrinology, Diabetes, and Metabolism Chicago, Illinois, USA
| | - Angela Kong
- UI Health/University of Illinois Chicago College of Medicine, College of Pharmacy, Department of Pharmacy Systems, Outcomes, and Policy Chicago, Illinois, USA
| | - Yuval Eisenberg
- UI Health/University of Illinois Chicago College of Medicine, Division of Endocrinology, Diabetes, and Metabolism Chicago, Illinois, USA
| | - Brian T. Layden
- UI Health/University of Illinois Chicago College of Medicine, Division of Endocrinology, Diabetes, and Metabolism Chicago, Illinois, USA
- Jesse Brown VA medical center, Chicago, IL, USA
| | - Janet Lin
- UI Health/University of Illinois Chicago College of Medicine, Department of Emergency Medicine Chicago, Illinois, USA
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Tang YF, Su YT, Liang LJ, Feng Y, Huang XJ, Xiang XL, Liang ZH. Association Between Metabolic Dysfunction and Gallstone Disease in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey. J Dig Dis 2025. [PMID: 40420773 DOI: 10.1111/1751-2980.13349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Revised: 05/07/2025] [Accepted: 05/13/2025] [Indexed: 05/28/2025]
Abstract
OBJECTIVES Gallstones affect a significant proportion of U.S. adults and can cause serious complications. We aimed to investigate the association between gallstone disease and common metabolic disorders in a nationally representative sample in the United States. METHODS We analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected from 2017 to 2020. We included 6164 participants meeting the eligibility criteria, which represented 171 407 370 participants. The associations between gallstone disease and six metabolic disorders were analyzed using multivariate logistic regression analyses, accounting for potential confounding factors. Subgroup analyses were conducted by age, gender, and race. RESULTS Altogether 10.9% of participants had gallstone disease, with prevalence increasing with age (mean age with vs. without gallstones: 56.435 years vs. 46.896 years, p < 0.001) and a female predominance (75.1% vs. 24.9%, p < 0.001). Non-alcoholic fatty liver disease (NAFLD), obesity, hypertension, and diabetes mellitus were significantly associated with an increased risk of gallstone formation, with adjusted odds ratios (OR) of 1.523 (95% confidence interval [CI] 1.180-1.965, p = 0.002), 1.733 (95% CI 1.265-2.374, p = 0.001), 1.466 (95% CI 1.203-1.785, p = 0.001), and 1.522 (95% CI 1.165-1.989, p = 0.003), respectively. These associations were more pronounced in individuals under 60 years of age and in females. No significant associations were observed with hyperlipidemia or hyperuricemia. CONCLUSIONS Gallstone disease is significantly associated with obesity, NAFLD, diabetes mellitus, and hypertension, with stronger associations found in younger individuals and females. Sensitivity analyses confirmed the robustness of these findings.
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Affiliation(s)
- Yong Feng Tang
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yong Tian Su
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Li Juan Liang
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yong Feng
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiang Jiao Huang
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xue Lian Xiang
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zhi Hai Liang
- Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
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Rebelos E, Honka MJ, Latva-Rasku A, Rajander J, Salminen P, Anastasiou IA, Kounatidis D, Tentolouris N, Campi B, Dardano A, Daniele G, Saba A, Ferrannini E, Nuutila P. Circulating N-Acetylaspartate Levels Associate with Measures of Peripheral and Tissue-Specific Insulin Sensitivity. Int J Mol Sci 2025; 26:5107. [PMID: 40507917 PMCID: PMC12154542 DOI: 10.3390/ijms26115107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2025] [Revised: 05/20/2025] [Accepted: 05/23/2025] [Indexed: 06/16/2025] Open
Abstract
N-acetylaspartate (NAA) is the second most abundant metabolite in the human brain. Quantifiable amounts of NAA are also present in the blood, but its role in the peripheral tissues is largely unknown. First, we determined the acute effects of insulin administration on NAA concentrations; second, we assessed whether circulating NAA levels associate with markers of central and peripheral insulin sensitivity. A total of 24 persons living with obesity and 19 healthy, lean controls, without neurological disorders, underwent a euglycemic hyperinsulinemic clamp combined with fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) imaging of the brain, abdomen, and femoral area. Plasma concentrations of NAA were measured at baseline and ~2 h into the clamp using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS-MS). Glucose uptake (GU) rates were analysed using a fractional uptake rate. Serum acetate levels were also assessed using nuclear magnetic resonance (NMR) metabolomics. From baseline to steady-state, insulin levels increased from a mean level of 66 to 447 pmol/L (p < 0.0001). Over this period, circulating NAA concentrations decreased by 5% (p = 0.01), similarly in both groups. The change in NAA was inversely related with the change in plasma acetate (r = -0.36, p = 0.048). Circulating NAA was associated with waist-hip ratio (rho = -0.54, p = 0.0002), steady-state free fatty acids (rho = -0.44, p = 0.003), and directly with HDL cholesterol (rho = 0.54, p = 0.0002), adiponectin (rho = 0.48, p = 0.003), and whole-body insulin sensitivity (rho = 0.34, p = 0.03). Circulating NAA was directly related with skeletal muscle (rho = 0.42, p = 0.01) and visceral adipose tissue GU (rho = 0.41, p = 0.02). Insulin administration leads to a small decrease in circulating NAA levels, and NAA associates consistently with markers of insulin sensitivity. While plasma NAA may be relevant to aspects of whole-body homeostasis, mechanistic insights are needed.
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Affiliation(s)
- Eleni Rebelos
- Turku PET Centre, University of Turku, 20014 Turku, Finland; (M.-J.H.); (P.N.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (A.D.); (G.D.)
- Diabetes Center, First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece; (I.A.A.); (D.K.); (N.T.)
| | - Miikka-Juhani Honka
- Turku PET Centre, University of Turku, 20014 Turku, Finland; (M.-J.H.); (P.N.)
| | - Aino Latva-Rasku
- Turku PET Centre, University of Turku, 20014 Turku, Finland; (M.-J.H.); (P.N.)
| | - Johan Rajander
- Turku PET Centre, Accelerator Laboratory, Åbo Akademi University, 20520 Turku, Finland;
| | - Paulina Salminen
- Division of Digestive Surgery and Urology, Turku University Hospital, 20520 Turku, Finland;
- Department of Surgery, University of Turku, 20014 Turku, Finland
| | - Ioanna A. Anastasiou
- Diabetes Center, First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece; (I.A.A.); (D.K.); (N.T.)
| | - Dimitris Kounatidis
- Diabetes Center, First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece; (I.A.A.); (D.K.); (N.T.)
| | - Nikolaos Tentolouris
- Diabetes Center, First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece; (I.A.A.); (D.K.); (N.T.)
| | - Beatrice Campi
- Consiglio Nazionale delle Ricerche (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (B.C.); (E.F.)
| | - Angela Dardano
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (A.D.); (G.D.)
| | - Giuseppe Daniele
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (A.D.); (G.D.)
| | - Alessandro Saba
- Laboratory of Clinical Pathology, St. Chiara University Hospital, 56100 Pisa, Italy;
| | - Ele Ferrannini
- Consiglio Nazionale delle Ricerche (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (B.C.); (E.F.)
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, 20014 Turku, Finland; (M.-J.H.); (P.N.)
- InFLAMES Research Flagship, University of Turku, 20014 Turku, Finland
- Department of Endocrinology, Turku University Hospital, 20520 Turku, Finland
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8
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Qiu B, Liu Z, Zuo D, Cui C, Sang C, Li C, Chen W, Zhang C. Triglyceride-glucose index is associated with silent cerebral infarcts in patients with atrial fibrillation undergoing catheter ablation. BMC Cardiovasc Disord 2025; 25:398. [PMID: 40413397 DOI: 10.1186/s12872-025-04803-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Accepted: 04/25/2025] [Indexed: 05/27/2025] Open
Abstract
BACKGROUND Atrial fibrillation catheter ablation (AFCA) is associated with a high risk of silent cerebral infarcts (SCI). Triglyceride-glucose (TyG) index is associated with stroke. However, the relationship between TyG index and SCI is unclear. The aim of this study was to investigate the association of TyG index with SCI after AFCA. METHODS This was a single-center prospective study. We consecutively selected patients who underwent AFCA from October 2019 to March 2024. All patients completed cranial magnetic resonance imaging (MRI) within 24-48 h after AFCA. SCI was defined as new single or multiple brain injuries detectable on MRI without any clinical manifestations or neurolocalization signs. RESULTS A total of 379 patients were enrolled, including 60 patients (15.8%) with SCI. Compared with patients without SCI, patients with SCI had a higher TyG index (9.03 ± 0.87 vs. 8.65 ± 0.56, p < 0.01). Pearson correlation analysis showed that TyG index correlated with left atrium dimension (LAD) (r = 0.119, p = 0.020), neutrophils (r = 0.176, p < 0.001), lymphocytes (r = 0.107, p = 0.037), and skin sympathetic nerve activity (r = 0.304, p = 0.020). After adjusting for potential confounding factors, multivariate analysis showed that TyG index (OR = 2.426; 95%CI: 1.567 ~ 3.757, p < 0.001) was independent factors for SCI after AFCA. Integrating TyG index could significantly improve ability of the model to recognize SCI after AFCA (NRI 0.164, 95% CI 0.069-0.258, p < 0.001; IDI 0.063, 95% CI 0.026-0.100, p < 0.001). CONCLUSIONS TyG index is associated with SCI after AFCA, and elevated TyG index is an independent risk factor for SCI. Integrating TyG index could significantly improve the risk assessment model regarding SCI.
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Affiliation(s)
- Bowen Qiu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhongxiao Liu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Dandan Zuo
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chenchen Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chuanyi Sang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chengzong Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Wensu Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Chaoqun Zhang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
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9
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Koh JYJ, Tan CYH, Li M, Liu MH, Chew HSJ. The Effectiveness of Time-Restricted Eating as an Intermittent Fasting Approach on Shift Workers' Glucose Metabolism: A Systematic Review and Meta-Analysis. Nutrients 2025; 17:1689. [PMID: 40431429 PMCID: PMC12114545 DOI: 10.3390/nu17101689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2025] [Revised: 05/07/2025] [Accepted: 05/13/2025] [Indexed: 05/29/2025] Open
Abstract
Background/Objectives: Shift workers face higher risks of impaired glucose metabolism due to irregular eating habits and circadian misalignment. Time-restricted eating (TRE) could improve glucose metabolism by aligning food intake with the circadian clock, but its effectiveness remains unclear. Methods: Ten electronic databases (PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus, Web of Science, ProQuest Dissertations and Theses, Science.gov, and ClinicalTrials.gov) were searched from journal inception to September 2024. Only randomized controlled trials (RCTs) involving shift workers were included. Meta-analyses with sensitivity analyses were conducted using a random-effects model to pool glucose metabolism and sleep outcomes, with heterogeneity and quality assessments performed. Results: Six RCTs were included. TRE demonstrated positive but non-significant effects on glucose metabolism outcomes: fasting blood glucose (weighted mean difference [WMD]: -0.02 mmol/L, 95% confidence interval [CI]: -0.13 to 0.10, I2 = 0%), fasting blood insulin (WMD: -5.77 pmol/L, 95% CI: -85.62 to 74.08, I2 = 92%), HOMA-IR (WMD: -0.50, 95% CI: -2.76 to 1.76, I2 = 82%), 2 h postprandial glucose (WMD: -0.65 mmol/L, 95% CI: -3.18 to 1.89, I2 = 86%), total sleep time (g = 0.07, 95% CI: -0.23 to 0.37, I2 = 0%), and sleep efficiency (g = -0.05, 95% CI: -0.63 to 0.53, I2 = 62%). Sensitivity analyses yielded similar findings, and overall certainty of evidence was rated 'very low'. Conclusions: While TRE shows potential for improving the glucose metabolism in shift workers, current evidence remains inconclusive due to small sample sizes and study limitations. Future research should prioritize well-powered TRE RCTs in shift workers that adhere to a 6-10 h eating window. Incorporating early-TRE schedules with sleep hygiene may optimize metabolic outcomes, with circadian biomarkers analyzed to better elucidate the mechanistic pathway implicated.
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Affiliation(s)
- Jia Ying Jennell Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore; (J.Y.J.K.); (C.Y.H.T.)
| | - Celine Yu Han Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore; (J.Y.J.K.); (C.Y.H.T.)
| | - Meng Li
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China;
| | - Mei Hui Liu
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore 117543, Singapore;
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore; (J.Y.J.K.); (C.Y.H.T.)
- Cardiovascular Metabolic Disease Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore
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10
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Li D, Qiao F, Dai J, Xu M, Gong HY, Yang HM, Li JC, Huai D. Therapeutic effectiveness of intratympanic and retroauricular methylprednisolone sodium succinate for refractory sudden sensorineural hearing loss in diabetic patients. World J Diabetes 2025; 16:99576. [DOI: 10.4239/wjd.v16.i5.99576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 02/17/2025] [Accepted: 03/21/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND Managing refractory sudden sensorineural hearing loss (RSSHL) in patients with diabetes mellitus (DM) presents significant therapeutic challenges, highlighting the importance of identifying effective treatment strategies.
AIM To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM.
METHODS This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024, all receiving routine treatment. Participants were categorized into the control group (40 cases), receiving an intratympanic injection of methylprednisolone sodium succinate (MPSS), and the research group (44 cases), treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group. The efficacy, adverse reactions (tympanic membrane perforation, middle ear infections, burning sensation, vertigo, and tinnitus), blood glucose (BG) [fasting BG (FBG), 2-hour postprandial BG (2hPBG), and glycosylated hemoglobin (HbA1c)], hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz), serum biochemical indexes [interleukin (IL)-6, C-reactive protein (CRP), and procalcitonin (PCT)], and quality of life assessed by the short-form 36 item health survey (SF-36) were comparatively analyzed.
RESULTS The research group demonstrated a markedly higher total effectiveness rate (81.82% vs 60.00%, P = 0.027) and a comparable incidence of total adverse reactions than the control group. Further, the research group exhibited notably reduced FBG, 2hPBG, HbA1c, IL-6, CRP, and PCT post-treatment (P < 0.01), which were lower compared with the pre-treatment levels and the control group (P < 0.05), as well as reduced hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz, P < 0.05). Furthermore, the post-treatment SF-36 scores of the research group in terms of energy, social functioning, role functioning, physical functioning, mental health, and overall health were all significantly improved than the pre-treatment levels and the control group (P < 0.05).
CONCLUSION The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions, which has a health promotion value.
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Affiliation(s)
- Dong Li
- Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
| | - Fei Qiao
- Department of Otolaryngology Head and Neck Surgery, Jinhu County People's Hospital, Huai’an 211600, Jiangsu Province, China
| | - Jun Dai
- Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
| | - Min Xu
- Department of Radiology, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
| | - He-Yan Gong
- Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
| | - Hui-Ming Yang
- Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
| | - Jing-Cheng Li
- Department of Otorhinolaryngology, The Affiliated Huai'an Hospital of Yangzhou University (The Fifth People's Hospital of Huai'an), Huai’an 223300, Jiangsu Province, China
| | - De Huai
- Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
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11
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Balatoni I. Parental Attitude Toward the Engagement in Physical Activity of Their Children with Type 1 Diabetes Mellitus in Hungary. CHILDREN (BASEL, SWITZERLAND) 2025; 12:612. [PMID: 40426791 PMCID: PMC12110388 DOI: 10.3390/children12050612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2025] [Revised: 05/03/2025] [Accepted: 05/04/2025] [Indexed: 05/29/2025]
Abstract
BACKGROUND/OBJECTIVES Physical activity plays an essential role in a healthy lifestyle. For children, the development of an encouraging attitude toward exercise can define a positive life-long behaviour. Type 1 diabetes mellitus (T1DM) is a metabolic disorder that usually develops in early childhood and severely affects glucose metabolism. Associated hypo- and hyperglycaemic conditions can dramatically interfere with the patient's everyday life. Since exercise significantly alters the glucose consumption of the body, this might influence how T1DM patients view physical activity. As parental guidance is critical in their children's behaviour, we investigate how parents of T1DM children relate to the engagement in physical activity of their children as compared to parents of healthy children. METHODS A self-reported survey was conducted among those parents whose T1DM children were cared for at the Paediatric Clinic of the University of Debrecen, Hungary. All together, 318 children, 140 with T1DM and 178 healthy peers, participated in the study. RESULTS We found no significant difference in the body mass index of healthy and T1DM children and, furthermore, no significant difference was observed in HbA1c levels in exercising and non-exercising T1DM children. Nevertheless, while 67.6% of the healthy children regularly engage in physical activity, only 57.5% of T1DM children do so (p = 0.044). Importantly, parents whose T1DM child exercised regularly believed that daily PhysEd classes improved their children's health and had positive effects on their attitude toward exercise. In contrast, parents of children who did not regularly exercise were significantly less convinced. CONCLUSIONS These findings highlight the importance of targeted educational efforts to foster positive attitudes toward physical activity among families with T1DM children and contribute valuable insights into how parental perceptions may influence children's engagement in exercise.
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Affiliation(s)
- Ildikó Balatoni
- Clinical Center, University of Debrecen, H-4032 Debrecen, Hungary
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12
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Pukkila J, Vääräsmäki M, Eteläinen S, Mustaniemi S, Nikkinen H, Gissler M, Männistö T, Laivuori H, Kajantie E, Keikkala E. The recurrence risk of gestational diabetes according to the number of abnormal values in the oral glucose tolerance test. Acta Obstet Gynecol Scand 2025. [PMID: 40318017 DOI: 10.1111/aogs.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 04/17/2025] [Accepted: 04/20/2025] [Indexed: 05/07/2025]
Abstract
INTRODUCTION Oral glucose tolerance test (OGTT) results may be used to estimate the risk of recurrent gestational diabetes mellitus (GDM) in a subsequent pregnancy in the different study settings. This study assesses the association between the number of abnormal glucose values in the OGTT in the first pregnancy and GDM recurrence in a subsequent pregnancy in a Nordic cohort. MATERIAL AND METHODS This register-based cohort study included 1677 women who had their first singleton delivery in 2009, underwent a 75 g 2-h OGTT during the pregnancy, and gave birth at least once more within 10 years according to the Finnish Medical Birth Register. The cut-off values were as follows: ≥5.3 mmol/L at fasting, ≥10.0 mmol/L at 1 h, and ≥8.6 mmol/L at 2 h. The odds ratio (OR) for GDM recurrence in the second pregnancy was analyzed via multivariable logistic regression adjusted for other potential factors associated with recurrence risk. RESULTS During the first pregnancy, GDM was diagnosed in 331 (24.5%) women based on one (n = 250) or two or three (n = 81) abnormal glucose values in the OGTT. The total recurrence rate for GDM in the subsequent pregnancy was 56.2%. The rate differed significantly between women with one (51.6%) and women with two or three (70.4%) abnormal values in first-pregnancy OGTT. Compared with those with normal OGTT results, the adjusted OR (aOR) for GDM in the subsequent pregnancy in women with one abnormal glucose value was 6.00 (95% CI, 4.34-8.30), while it was 13.37 (7.52-23.76) in women with two or three abnormal values. The odds for GDM recurrence among those with two or three abnormal glucose values was double compared to those with only one abnormal value (aOR 2.03, 1.12-3.68). CONCLUSIONS Primiparous women with one abnormal glucose value in the first OGTT have remarkable odds of GDM recurrence, with the odds doubling when there are two or three abnormal values during the first pregnancy. These findings can be used when planning effective counseling, prevention, and screening strategies for GDM in the subsequent pregnancy.
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Affiliation(s)
- Jenni Pukkila
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Marja Vääräsmäki
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Sanna Eteläinen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Sanna Mustaniemi
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Hilkka Nikkinen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Mika Gissler
- Datasets and Dataproducts Unit, Department of Data and Analytics, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Tuija Männistö
- Department of Clinical Chemistry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Joint County Authority for ISLAB Laboratories, Kuopio, Finland
- Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Hannele Laivuori
- Faculty of Medicine and Health Technology, Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Helsinki Institute of Life Science, Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elina Keikkala
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Welfare Epidemiology and Monitoring Unit, Department of Public Health, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
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Poprzeczny AJ, Mitchell M, Deussen AR, Habibi N, Cheung TO, Grieger JA. Pre-Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Aust N Z J Obstet Gynaecol 2025. [PMID: 40318041 DOI: 10.1111/ajo.70032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 01/15/2025] [Accepted: 03/19/2025] [Indexed: 05/07/2025]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with short- and long-term adverse health outcomes for women and their infants. Antenatal diet and/or physical activity interventions have not been effective at preventing GDM, and currently, it is not clear whether intervening similarly prior to pregnancy is beneficial. AIMS This review aims to evaluate the impact of pre-pregnancy diet and/or physical activity interventions on rates of GDM and other maternal and infant health outcomes. METHODS A systematic literature search of the online databases Embase, Pubmed, Cochrane Central Register of Controlled Trials, Ovid MEDLINE and CINAHL was conducted from inception to 7 February 2023. All randomised controlled trials comparing pre-pregnancy diet and/or physical activity interventions with standard care or control were included. Data were extracted by two reviewers independently, and meta-analysis was performed using random-effects models to calculate summary effect estimates and 95% confidence intervals. The primary outcome was GDM. Five randomised trials assessing pre-pregnancy diet and/or physical activity interventions (n = 1924 women) were included. RESULTS Pre-pregnancy diet and/or physical activity interventions were not associated with a significant difference in rates of GDM (2 studies; n = 214; RR 1.19, 95% CI 0.81, 1.75). There were no statistically significant differences for any of the secondary maternal or infant outcomes reported. There was significant heterogeneity between studies with regard to type, duration and intensity of the pre-pregnancy diet and/or physical activity interventions. CONCLUSIONS There was no evidence that pre-pregnancy diet and/or physical activity interventions reduced the risk for GDM or other adverse maternal and infant outcomes.
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Affiliation(s)
- Amanda J Poprzeczny
- The Robinson Research Institute and Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia
- Women's and Babies Division, Department of Obstetrics and Gynaecology, The Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Megan Mitchell
- The Robinson Research Institute and Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Andrea R Deussen
- The Robinson Research Institute and Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nahal Habibi
- The Robinson Research Institute and Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tin Oi Cheung
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jessica A Grieger
- The Robinson Research Institute and Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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14
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Angulo AR, Caballero-Alvarado J, Sarmiento-Falen J, Zavaleta-Corvera C. Comparative Assessment of Negative Pressure Wound Therapy Versus Standard Treatment in Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis. J Wound Ostomy Continence Nurs 2025; 52:227-238. [PMID: 40377467 DOI: 10.1097/won.0000000000001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2025]
Abstract
PURPOSE The purpose of this systematic and metanalysis was to compare wound healing-related outcomes of negative pressure wound therapy (NPWT) to conventional therapy outcomes (time to granulation tissue formulation, ulcer depth, adverse effects amputation, pain, infection, and bleeding, along with hospital length of stay) for treatment of diabetic foot ulcers (DFU) in adults. METHODS Systematic review and meta-analysis of pooled data. SEARCH STRATEGY The electronic databases PubMed, Scopus, Web of Science, and Embase were searched. An artificial intelligence powered (Rayyan), proprietary software was used to retrieve, remove duplicates, and cite studies identified in our search. Two researchers and a conflict referee screened the studies in 2 phases; a title/abstract review, followed by reading all articles in full before identifying 12 studies included in this systematic review and metanalysis. RESULTS Twelve studies were included in our metanalysis; 8 were clinical trials and 4 were observational studies. The pooled sample in the 8 clinical trials comprised 760 participants; 373 were managed with NPWT and 387 were managed with conventional therapy. No significant difference was observed for ulcer depth (P = .16). However, significant differences were found in mean difference in time to granulation tissue formation (P = .03), rate of amputation, pain (P = .01), infection rates (P = .005), and hospital length of stay (P < .001). The pooled sample evaluated in the 4 observational studies was 222; 100 were managed with NPWT and 122 with CT. Significant differences were found in time to granulation tissue formation (P < .001), amputation rates (P = .04), infection rate (P = .04), and hospital length of stay (P < .001). CONCLUSIONS NPWT improves time to granulation tissue formation, reduces hospital stay, and the risk of secondary amputations, infections, and pain. Based on these findings we recommend incorporating NPWT as a standard component of DFU management.
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Affiliation(s)
- Alexandra Rodríguez Angulo
- Alexandra Rodríguez Angulo, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- José Caballero-Alvarado, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Joaquín Sarmiento-Falen, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Carlos Zavaleta-Corvera, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
| | - José Caballero-Alvarado
- Alexandra Rodríguez Angulo, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- José Caballero-Alvarado, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Joaquín Sarmiento-Falen, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Carlos Zavaleta-Corvera, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
| | - Joaquín Sarmiento-Falen
- Alexandra Rodríguez Angulo, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- José Caballero-Alvarado, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Joaquín Sarmiento-Falen, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Carlos Zavaleta-Corvera, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
| | - Carlos Zavaleta-Corvera
- Alexandra Rodríguez Angulo, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- José Caballero-Alvarado, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Joaquín Sarmiento-Falen, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
- Carlos Zavaleta-Corvera, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru
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15
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Gu JX, Hong TT, Zhang AM, Xu L, Hu NJ, Li SS, Zhang N, Qin L, Wang CY, Yin Y, Wang K, Jia M, Su M. Correlation of glycosylated apolipoprotein A1 and glycosylated low-density lipoprotein cholesterol levels with glucose homeostasis and the risk of developing type 2 diabetes mellitus. Diabetes Res Clin Pract 2025; 223:112155. [PMID: 40185244 DOI: 10.1016/j.diabres.2025.112155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 03/26/2025] [Accepted: 03/27/2025] [Indexed: 04/07/2025]
Abstract
INTRODUCTION This study explored the relationship between Glycosylated apolipoprotein A-1 (G-apoA1) and glycosylated low-density lipoprotein cholesterol (G-LDL-C) levels and the risk of developing type 2 diabetes mellitus (T2DM). METHODS This study included 3,098 patients with prediabetes and T2DM from two centers. Over a 3-year follow-up period, the study analyzed and assessed the risk of developing T2DM based on G-apoA1 and G-LDL-C levels. RESULTS In patients with T2DM, the levels of G-apoA1 and G-LDL-C were significantly higher than in patients with prediabetes. G-apoA1 and G-LDL-C levels were positively correlated with insulin resistance (HOMA-IR) and negatively correlated with insulin sensitivity (HOMA-IS). During the 3-year follow-up period, 197 patients with prediabetes progressed to T2DM. G-apoA1 and G-LDL-C levels were positively correlated with the risk of developing T2DM. Patients with the highest levels of G-apoA1 [hazard ratio (HR) = 3.452, 95 % confidence interval (95 % CI): 2.120-5.768, p < 0.001] and G-LDL-C (HR: 2.190, 95 % CI: 1.338-3.578, p = 0.002) had a significantly higher risk of developing T2DM compared to those in the lowest quartile. CONCLUSION G-apoA1 and G-LDL-C levels are inversely related to pancreatic β-cell function, positively related to insulin resistance, and linked with an increased risk of developing T2DM.
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Affiliation(s)
- Jun-Xu Gu
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Ting-Ting Hong
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, PR China
| | - Ai-Min Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Lei Xu
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, PR China
| | - Nai-Jing Hu
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Shan-Shan Li
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Na Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Li Qin
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Chun-Yan Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Yue Yin
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China
| | - Kun Wang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, PR China.
| | - Mei Jia
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China.
| | - Ming Su
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, PR China.
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16
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Sampson L, Scoglio AAJ, Nishimi K, Choi KW, Kim AH, Zhu Y, Sun Q, Kang JH, Rimm EB, Koenen KC, Kubzansky LD. Psychological resilience to trauma and longitudinal sleep outcomes among current and former nurses. J Psychosom Res 2025; 192:112090. [PMID: 40073790 PMCID: PMC12021551 DOI: 10.1016/j.jpsychores.2025.112090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 03/03/2025] [Accepted: 03/05/2025] [Indexed: 03/14/2025]
Abstract
OBJECTIVE A life-disrupting stressor (e.g. pandemic) may cause or exacerbate poor sleep health; resilience may offset impacts. We assessed relationships between pre-pandemic psychological resilience to trauma and sleep-related outcomes during the first year of the pandemic among current and former nurses. METHODS Using data from 18,670 women in the Nurses' Health Study II, we characterized pre-pandemic resilience by cross-classifying experiences of higher versus lower lifetime trauma burden with unfavorable, adequate, and favorable psychological health (through January 2020). Sleep was measured before (2017) and during the pandemic, including: changes, quality, and duration. We modeled trajectories of sleep duration assessed at five time points (pre-pandemic in 2017, and then in four COVID-19-related surveys, 2020-2021) using latent class growth analysis. RESULTS We observed four trajectories of sleep duration, all showing stable patterns, with averages ranging from 5.5 to 6 to 8.5-9 h of sleep per 24 h. Women with higher trauma/unfavorable psychological health had the highest risk for all poor sleep outcomes (e.g., RR for being in the shortest sleep trajectory versus healthy sleep duration: 2.53; 95 % CI: 2.21, 2.91). Relative to women categorized as most resilient, only women with lower trauma/favorable psychological health showed lower risk of getting less sleep after the pandemic started compared to no change (RR: 0.76; 95 % CI: 0.70, 0.83). This same pattern was observed for poor sleep quality. CONCLUSION Higher pre-pandemic resilience may have protected women against poor sleep outcomes during the pandemic. Findings could have long-term health implications, particularly if they generalize to other stressors.
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Affiliation(s)
- Laura Sampson
- Program in Public Health, Stony Brook University, Stony Brook, NY, USA; Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Arielle A J Scoglio
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Natural and Applied Sciences, Bentley University, Waltham, MA, USA.
| | - Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA; Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Karmel W Choi
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Psychiatric & Neurodevelopment Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ariel H Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yiwen Zhu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qi Sun
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jae Hee Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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17
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Cai W, Yao Y, Zheng S, Chen W, Bao L, Su J, Luo L, Xie L. Relationship Between the Drop Rate of Standing Blood Pressure and Major Adverse Cardiovascular Events. J Clin Hypertens (Greenwich) 2025; 27:e70061. [PMID: 40346868 PMCID: PMC12064936 DOI: 10.1111/jch.70061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Revised: 04/07/2025] [Accepted: 04/12/2025] [Indexed: 05/12/2025]
Abstract
Orthostatic hypotension (OH) is defined as a decrease of ≥20 mm Hg systolic blood pressure (SBP) or ≥10 mm Hg diastolic blood pressure (DBP) within 3 min after standing. OH was associated with an increased risk of major adverse cardiovascular events (MACEs) and mortality. As an indicator reflecting the characteristics of orthostatic blood pressure (BP) changes, there is currently no research available on the relationship between the orthostatic BP drop rate and MACEs or mortality. A total of 448 hospitalized patients (mean age 62.07 ± 12.15 years, 35.49% female) completed the follow-up. The median follow-up duration was 5.09 years (0.29-6.13 years). Ninety-two patients (20.54%) developed OH, 12 patients died (2.68%), and 21 patients developed MACEs (4.69%), including 8 cases of non-fatal acute myocardial infarction (MI), 3 cases of non-fatal stroke, and 10 cases died of cardiovascular disease and stroke. Patients were categorized into the BPdrop_rate_high group (defined as SBP drop rate ≥ $ \ge $ 15% and/or DBP drop rate ≥ $ \ge $ 5% within 3 min after standing) and the BPdrop_rate_normal group (defined as SBP drop rate< $\ < $ 15% and DBP drop rate < $ < $ 5% within 3 min after standing). The Chi-square test and Kaplan-Meier survival analysis indicated that the BPdrop_rate_high group had a higher risk of MACEs and mortality than the BPdrop_rate_normal group (all p < $ < $ 0.05). The Receiver Operating Characteristic (ROC) analysis demonstrated SBP drop rate ≥ $ \ge $ 15% and/or DBP drop rate ≥ $ \ge $ 5% within 3 min after standing has high diagnostic accuracy for OH, with an area under the curve (AUC) of 0.918.Cox regression analysis revealed that the cumulative survival rate of the BPdrop_rate_normal group was significantly higher than that of the BPdrop_rate_high group (98.45% vs. 93.69%, HR 0.304, 95% CI 0.095-0.969, p = 0.044). This study proposes a novel diagnostic threshold (SBP drop ≥15% and/or DBP drop ≥5% within 3 min after standing) for OH as a strong predictor of MACEs and mortality in hospitalized patients. Trial Registration: MRCTA, ECFAH of FMU[2024]490.
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Affiliation(s)
- Wenqin Cai
- Department of GeriatricsThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Fujian Hypertension Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Clinical Research Center for Geriatric Hypertension Disease of Fujian provinceThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Branch of National Clinical Research Center for Aging and MedicineThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Department of GeriatricsNational Regional Medical CenterBinhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouFujianChina
| | - Yuexian Yao
- Department of GeriatricsFujian Provincial Geriatric HospitalFuzhouFujianChina
| | - Suli Zheng
- Department of GeriatricsThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Fujian Hypertension Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
| | - Wanting Chen
- College of Computer and Information SciencesFujian Agriculture and Forestry UniversityFuzhouFujianChina
| | - Lingxin Bao
- College of Computer and Information SciencesFujian Agriculture and Forestry UniversityFuzhouFujianChina
| | - Jinzi Su
- Fujian Hypertension Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
| | - Li Luo
- Department of GeriatricsThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Fujian Hypertension Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Clinical Research Center for Geriatric Hypertension Disease of Fujian provinceThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Branch of National Clinical Research Center for Aging and MedicineThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Department of GeriatricsNational Regional Medical CenterBinhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouFujianChina
| | - Liangdi Xie
- Department of GeriatricsThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Fujian Hypertension Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Clinical Research Center for Geriatric Hypertension Disease of Fujian provinceThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Branch of National Clinical Research Center for Aging and MedicineThe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Department of GeriatricsNational Regional Medical CenterBinhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouFujianChina
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18
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Altobaishat O, Gadelmawla AF, Almohtasib S, Suilik HA, Manasrah A, Abouzid M, Turkmani M, Abuelazm M. Once-Weekly Insulin Versus Once-Daily Insulin for Type 1 Diabetes Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Endocrinol Diabetes Metab 2025; 8:e70048. [PMID: 40186384 PMCID: PMC11971483 DOI: 10.1002/edm2.70048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Revised: 02/11/2025] [Accepted: 03/22/2025] [Indexed: 04/07/2025] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) represents a considerable global health burden, affecting approximately 5%-10% of individuals with diabetes. Once-weekly basal insulin could substantially reduce the number of injections for T1DM patients from 365 daily to 52 weekly doses annually. Therefore, this meta-analysis compares the safety and efficacy of once-weekly insulin formulations. METHODS The systematic review and meta-analysis included the relevant randomised controlled trials (RCTs) retrieved from PubMed, EMBASE, Web of Science, Cochrane, and SCOPUS databases until September 2024. The meta-analysis was performed using (RevMan 5.4.1). The study protocol was registered on PROSPERO (CRD42024603022). RESULTS Three RCTs comprising 1724 participants were included. Once-daily insulin significantly decreased glycated haemoglobin (HbA1c) compared to once-weekly insulin (estimated treatment difference: 0.09%, 95% CI [0.07, 0.11], p < 0.00001). Fasting blood glucose levels were comparable between the once-weekly and once-daily insulin groups (estimated treatment difference: 0.44 mg/dL, 95% CI [-0.64, 1.52], p = 0.42). Once-weekly insulin was associated with a significant increase in the incidence of injection site reactions (RR: 3.48 with 95% CI [1.30, 9.31], p = 0.01), serious adverse events (RR: 1.55 with 95% CI [1.09, 2.19], p = 0.01), and treatment-emergent adverse events (RR: 1.12 with 95% CI [1.02, 1.23], p = 0.02), while no significant difference was observed in hypersensitivity reactions (RR: 1.04 with 95% CI [0.78, 1.38], p = 0.79). CONCLUSION Once-daily insulin has demonstrated slightly superior HbA1c reduction, while once-weekly insulin offers potential advantages in patient adherence. However, these benefits must be weighed against an increased risk of injection site reactions and nocturnal hypoglycemia. Although once-weekly insulin is more convenient, treatment decisions should consider individual patient factors such as hypoglycemia risk and tolerance to injection reactions.
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Affiliation(s)
- Obieda Altobaishat
- Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | | | | | | | - AlMothana Manasrah
- Internal Medicine DepartmentUnited Health Services–Wilson Medical CenterJohnson CityNew YorkUSA
| | - Mohamed Abouzid
- Department of Physical Pharmacy and Pharmacokinetics, Faculty of PharmacyPoznan University of Medical SciencesPoznanPoland
- Doctoral SchoolPoznan University of Medical SciencesPoznanPoland
| | - Mustafa Turkmani
- Faculty of MedicineMichigan State UniversityEast LansingMichiganUSA
- Department of Internal MedicineMcLaren Health CareOaklandMichiganUSA
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19
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Baluku JB, Karungi D, Namanda B, Namiiro S, Katusabe S, Madalen AM, Nabwana M, Olum R, Bongomin F, Nuwagira E, Kansiime G, Kraef C, Shaughnessy M, Rhein J, Meya D. Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda. J Clin Tuberc Other Mycobact Dis 2025; 39:100523. [PMID: 40242079 PMCID: PMC12002871 DOI: 10.1016/j.jctube.2025.100523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2025] Open
Abstract
Background Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles. Methods We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed. Results A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p < 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m2, p < 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p < 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p < 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p < 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10-2.92) and DM (aPR 2.34, 95 % CI 1.11-4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20-0.88). Conclusion TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.
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Affiliation(s)
- Joseph Baruch Baluku
- Makerere University Lung Institute, Kampala, Uganda
- Kiruddu National Referral Hospital, Kampala, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | | | | | - Martin Nabwana
- Makerere University - John Hopkins University Research Collaboration, Kampala, Uganda
| | - Ronald Olum
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Grace Kansiime
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Christian Kraef
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Megan Shaughnessy
- Division of Infectious Disease, Department of Medicine, Hennepin County Medical Center, Minneapolis, USA
| | - Joshua Rhein
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, USA
| | - David Meya
- Makerere University College of Health Sciences, Kampala, Uganda
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20
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Zhou Q, Zhu W, Cai X, Jing J, Wang M, Wang S, Jin A, Meng X, Wei T, Wang Y, Pan Y. Obesity and brain volumes: mediation by cardiometabolic and inflammatory measures. Stroke Vasc Neurol 2025; 10:e003045. [PMID: 39160093 DOI: 10.1136/svn-2023-003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/25/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between overall obesity, central obesity and brain volumes, as well as to determine the extent to which cardiometabolic and inflammatory measures act as mediators in the association between body mass index (BMI), waist-hip ratio (WHR) and brain volumes. METHODS In the context of counterfactual framework, mediation analysis was used to explore the potential mediation in which cardiometabolic and inflammatory measures may mediate the relationship between BMI, WHR, and brain volumes. RESULTS Among 2413 community-dwelling participants, those with high BMI or WHR levels experienced an approximately brain ageing of 4 years. Especially, individuals with high WHR or BMI under the age of 65 exhibited white matter hyperintensity volume (WMHV) differences equivalent to around 5 years of ageing. Conversely, in the high-level WHR population over the age of 65, premature brain ageing in gray matter volume (GMV) exceeded 4.5 years. For GMV, more than 45% of the observed effect of WHR was mediated by glycaemic metabolism indicators. This proportion increases to 78.70% when blood pressure, triglyceride, leucocyte count, and neutrophil count are jointly considered with glycaemic metabolism indicators. Regarding WHR and BMI's association with WMHV, cardiometabolic and inflammatory indicators, along with high-density lipoprotein cholesterol, mediated 35.50% and 20.20% of the respective effects. CONCLUSIONS Overall obesity and central obesity were associated with lower GMV and higher WMHV, a process that is partially mediated by the presence of cardiometabolic and inflammatory measures.
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Affiliation(s)
- Qi Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wanlin Zhu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xueli Cai
- Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
- Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Mengxing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Suying Wang
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tiemin Wei
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, 2019RU018, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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21
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Włodarski A, Szymczak-Pajor I, Kasznicki J, Antanaviciute EM, Szymańska B, Śliwińska A. Dysregulated miR-21/SOD3, but Not miR-30b/CAT, Profile in Elderly Patients with Carbohydrate Metabolism Disorders: A Link to Oxidative Stress and Metabolic Dysfunction. Int J Mol Sci 2025; 26:4127. [PMID: 40362367 PMCID: PMC12071572 DOI: 10.3390/ijms26094127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Revised: 04/17/2025] [Accepted: 04/24/2025] [Indexed: 05/15/2025] Open
Abstract
Carbohydrate metabolism disorders (CMDs), including prediabetes and type 2 diabetes mellitus (T2DM), are increasingly prevalent in the aging population. Oxidative stress (OxS) plays a pivotal role in CMD pathogenesis, with extracellular superoxide dismutase (SOD3) and catalase (CAT) serving as critical antioxidant defenses. Additionally, microRNAs (miR-21 and miR-30b) regulate the oxidative and inflammatory pathways, yet their roles in elderly CMD patients remain unclear. This study evaluated miR-21 and miR-30b expression alongside SOD3 and CAT plasma levels in individuals aged ≥ 65 years (n = 126) categorized into control (n = 38), prediabetes (n = 37), and T2DM (n = 51) groups. Quantitative PCR assessed miRNA expression, while ELISA measured the enzyme levels. SOD3 levels were significantly reduced in CMDs, particularly in T2DM, whereas miR-21 was upregulated. A negative correlation between SOD3 and miR-21 was strongest in T2DM, suggesting a regulatory interplay. Neither CAT levels nor miR-30b expression differed among groups. Logistic regression indicated SOD3 as a protective biomarker, with each 1 ng/mL increase reducing the CMD risk by ~5-6%. The ROC analysis supported SOD3's diagnostic potential, while miR-21 showed a modest association. These findings highlight SOD3 downregulation and miR-21 upregulation as potential contributors to CMD progression in elderly patients, warranting further research into their mechanistic roles and therapeutic potential.
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Affiliation(s)
- Adam Włodarski
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 92-213 Lodz, Poland; (A.W.); (I.S.-P.)
| | - Izabela Szymczak-Pajor
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 92-213 Lodz, Poland; (A.W.); (I.S.-P.)
| | - Jacek Kasznicki
- Department of Internal Diseases, Diabetology and Clinical Pharmacology, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Egle Morta Antanaviciute
- Centre for Cellular Microenvironments, Mazumdar-Shaw Advanced Research Centre, University of Glasgow, Glasgow G12 8QQ, UK
| | - Bożena Szymańska
- CoreLab, Central Scientific Laboratory of the Medical University of Lodz, Mazowiecka 6/8 St., 92-215 Lodz, Poland;
| | - Agnieszka Śliwińska
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 92-213 Lodz, Poland; (A.W.); (I.S.-P.)
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22
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Petitclerc I, Perron J, Dugas C, Mayer T, Raymond F, Di Marzo V, Veilleux A, Robitaille J. Association between gestational diabetes mellitus, maternal health and diet, and gut microbiota in mother-infant dyads. BMC Pregnancy Childbirth 2025; 25:486. [PMID: 40275186 PMCID: PMC12023395 DOI: 10.1186/s12884-025-07584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 04/08/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) increasingly affects women and predisposes both mothers and their infants to short- and long-term health consequences. Emerging research links GDM to maternal gut microbiota dysbiosis. However, the impact of GDM on the infant gut microbiota remains unclear. This cross-sectional study aims to explore potential associations between GDM and the gut microbiota in mothers and their infants, as well as correlations between maternal diet, cardiometabolic profile, and gut microbiota composition. METHODS Gut microbiota taxonomic composition was characterized by 16S rRNA gene sequencing on fecal samples collected at 2 months postpartum from 28 mothers, including 17 with (GDM+) and 11 without (GDM-) GDM, as well as 30 infants, 17 GDM + and 13 GDM-. Variations in overall composition and specific taxa between GDM + and GDM- were assessed. Correlations between maternal cardiometabolic profile, dietary intakes, and taxa were performed. RESULTS GDM was associated with the overall composition of gut microbiota between GDM + and GDM- in the maternal group, but not in infants. No statistically significant difference in alpha diversity between groups was found in either mothers or infants. However, 14 taxa showed significantly different abundance between GDM + and GDM- mothers, and 4 taxa differed in infants. Specific taxa at the family rank were correlated with maternal dietary and cardiometabolic variables in both mothers and infants. CONCLUSIONS GDM exposition was associated with gut microbiota composition in both mothers and infants at two months postpartum. This study enhances our understanding of how maternal health could be linked with the gut microbiota of mothers and their infants. TRIAL REGISTRATION NCT02872402 (2016-08-04, https://clinicaltrials.gov/study/NCT02872402?term=NCT02872402&rank=1 ) and NCT04263675 (2020-02-07, https://clinicaltrials.gov/study/NCT04263675?term=NCT04263675&rank=1 ).
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Affiliation(s)
- Isabelle Petitclerc
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Julie Perron
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Camille Dugas
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Thomas Mayer
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
- Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Frédéric Raymond
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Vincenzo Di Marzo
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Quebec City, QC, G1V 0A6, Canada
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), Université Laval, Quebec City, QC, G1V 4G5, Canada
| | - Alain Veilleux
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Julie Robitaille
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC, G1V 0A6, Canada.
- School of Nutrition, Université Laval, Quebec City, QC, G1V 0A6, Canada.
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Zapater JL, Nicholoff ST, Sweis NS, Saraf SL, Layden BT. Hemoglobin S Promotes Glycemic Dysregulation in a Mouse Model of Human Sickle Cell Disease. Endocrinology 2025; 166:bqaf082. [PMID: 40294908 PMCID: PMC12075777 DOI: 10.1210/endocr/bqaf082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Revised: 04/08/2025] [Accepted: 04/26/2025] [Indexed: 04/30/2025]
Abstract
Hemoglobin S (HbS) presents a challenge to identifying glycemic dysregulation, as changes in red blood cell turnover produce inaccurate hemoglobin A1c (HbA1c) and incongruencies between HbA1c and other glycemic control measures. Concerningly, the prevalence of diabetes in those with HbS is rising, and studies demonstrate that HbS increases the risk of diabetes-related complications. Though a link between the sickle cell variant and HbA1c is reported, the precise mechanisms by which HbS affects glycemic control are unknown. Here, we utilized the Townes mouse model of sickle cell disease (SCD) to analyze the effect of sickle cell trait (SCT) and SCD on glucose homeostasis. We found that chow-fed SCD mice had greater ad libitum and fasting blood glucose than SCT or littermate controls from 8 to 20 weeks of age, along with declining fasting serum insulin with aging, regardless of sex. This was not a result of overt alterations in peripheral glucose or insulin tolerance, gross morphological changes in pancreatic structure, or deposition of iron in pancreatic islets. Furthermore, compared with age- and sex-matched SCT and littermate control mice, we found decreased pancreatic insulin content in 20-week-old SCD male mice and significantly reduced pancreatic islet area and β cell mass in SCD males and females. These findings suggest that having 2 copies of the HbS gene promotes early hyperglycemia and the development of pancreatic β cell dysfunction, which may enhance the risk for diabetes in this cohort.
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Affiliation(s)
- Joseph Louis Zapater
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Medicine, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Seth Thomas Nicholoff
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Nadia Saib Sweis
- Department of Medicine, Internal Medicine Residency, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Santosh Lumdas Saraf
- Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Brian Thomas Layden
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Medicine, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
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24
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Pedicino D, Liuzzo G. Weekly Journal Scan: long-term effects of tirzepatide for diabetes prevention in persons with obesity and prediabetes. Eur Heart J 2025:ehaf236. [PMID: 40249363 DOI: 10.1093/eurheartj/ehaf236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2025] Open
Affiliation(s)
- Daniela Pedicino
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Giovanna Liuzzo
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Catholic University, School of Medicine, Largo F. Vito 1, 00168 Rome, Italy
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25
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Mohammed JA, Basil B, Mba IN, Abubakar ND, Lawal AO, Momoh JA, Yahaya IA. Elevated high-sensitivity C-reactive protein and dyslipidaemia in type 2 diabetes mellitus: implications for cardiovascular risk prediction in Nigerian patients. BMC Endocr Disord 2025; 25:100. [PMID: 40247255 PMCID: PMC12004578 DOI: 10.1186/s12902-025-01930-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Accepted: 04/09/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM). Inflammation, marked by elevated high-sensitivity C-reactive protein (hs-CRP) levels, and dyslipidaemia, are critical contributors to atherosclerosis and cardiovascular risk. In Nigeria, where T2DM prevalence is rising, there is a need for more comprehensive risk prediction tools, incorporating both traditional and newer biomarkers such as hs-CRP. This study aimed to investigate the association between elevated hs-CRP levels and dyslipidaemia in Nigerian patients with T2DM and to explore the potential implications for cardiovascular risk prediction. METHODS A hospital-based cross-sectional study was conducted among 150 T2DM patients and 150 age-matched controls. Data on socio-demographics, medical history, clinical characteristics, and laboratory parameters, including lipid profiles and hs-CRP levels, were collected. The relationship between hs-CRP levels and lipid parameters was assessed using Pearson's correlation coefficient and independent t-tests. RESULTS T2DM patients exhibited significantly higher hs-CRP levels (2.2 ± 1.8 mg/L vs. 1.2 ± 1.0 mg/L, p < 0.001), dyslipidaemia (p < 0.001), and blood pressure (SPB- 127.6 ± 12.4 mmHg, DBP- 77.6 ± 6.6 mmHg vs. SBP- 119.6 ± 10.8 mmHg, DBP- 72.1 ± 8.0 mmHg; p = 0.001) compared to controls. However, no significant correlation was found between hs-CRP levels and lipid parameters. CONCLUSION Although no direct association was found between elevated hs-CRP levels and dyslipidaemia, hs-CRP remains an important marker of cardiovascular risk possibly through non-lipid pathways, such as inflammation-driven endothelial dysfunction. Further research is needed to evaluate its potential role in refining cardiovascular risk assessment in the Nigerian T2DM population. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
| | - Bruno Basil
- International Institute of Pathology and Forensic Science Research, David Umahi Federal University of Health Sciences, Uburu, Nigeria
| | | | | | | | | | - Isah Adagiri Yahaya
- Department of Chemical Pathology and Immunology, Bayero University, Kano, Nigeria
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26
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Norhammar A, Ritsinger V. The recent renewed interest among cardiologists in detecting and preventing diabetes is welcomed. Eur Heart J 2025; 46:1332-1334. [PMID: 39913237 PMCID: PMC11973563 DOI: 10.1093/eurheartj/ehae833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2025] Open
Affiliation(s)
- Anna Norhammar
- Cardiology Unit, Department of Medicine K2, Karolinska Institutet, 17176 Stockholm, Sweden
- Capio S:t Görans Hospital, Stockholm, Sweden
| | - Viveca Ritsinger
- Cardiology Unit, Department of Medicine K2, Karolinska Institutet, 17176 Stockholm, Sweden
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
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Zhan J, Wei Q, Guo W, Liu Z, Chen S, Huang Q, Liang S, Cai D. Evaluating the triglyceride glucose index as a predictive biomarker for osteoporosis in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2025; 16:1534232. [PMID: 40260282 PMCID: PMC12010436 DOI: 10.3389/fendo.2025.1534232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 03/10/2025] [Indexed: 04/23/2025] Open
Abstract
Objective Osteoporosis is a common condition among individuals with type 2 diabetes; however, the relationship between insulin resistance, as measured by the Triglyceride Glucose Index (TyG), and osteoporosis has not been sufficiently explored. This study seeks to address this research gap by investigating the diagnostic value of TyG in identifying osteoporosis in patients with type 2 diabetes. Methods A retrospective analysis was performed on clinical data from 207 diabetic subjects (83 in the osteoporosis group, 124 in the non-osteoporosis group), using SPSS version 27.0 and MedCalc 23 for statistical analysis. Results Significant statistical differences were noted between the two groups in terms of gender, age, hemoglobin levels, red blood cell count, total cholesterol levels, and the TyG. Binary logistic regression analysis revealed that gender, age, and TyG are independent predictors of osteoporosis in patients with type 2 diabetes. Receiver operating characteristic (ROC) analysis showed that the area under the curve for TyG, gender, age, and their combination in predicting osteoporosis among patients with T2DM was 0.653, 0.698, 0.760, and 0.857, respectively. Additionally, the diagnostic performance of the TyG value was effectively evaluated, determining 8.78 as the optimal cutoff value, with a corresponding sensitivity of 89.1% and specificity of 52.4%. Meanwhile, the predictive model constructed using gender, age, and the TyG index achieved an area under the curve (AUC) of 0.857 (95% confidence interval: 0.801~0.901), with a maximum Youden index of 0.629. The corresponding diagnostic sensitivity was 83.1% and the specificity was 79.8%. Conclusion The TyG holds potential to serve as a prominent biomarker for the diagnosis of osteoporosis among type 2 diabetic patients in various clinical settings.
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Affiliation(s)
- Jinxiang Zhan
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qipeng Wei
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Weijun Guo
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zihao Liu
- Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shiji Chen
- Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qingyan Huang
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shuang Liang
- Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Dongling Cai
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Hua X, Li J, Hu R, Zhang X. Joint association between tobacco smoke exposure and periodontitis and glycemic status. Front Endocrinol (Lausanne) 2025; 16:1539955. [PMID: 40260278 PMCID: PMC12010096 DOI: 10.3389/fendo.2025.1539955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Accepted: 03/13/2025] [Indexed: 04/23/2025] Open
Abstract
Objective Both tobacco smoke exposure (TSE) and periodontitis were independently associated with glycemic status. However, studies focusing on the co-exposure and relative contributions of TSE and periodontitis to glycemic status are rare. This study intended to examine the joint and mutual associations between TSE and periodontitis and glycemic status among American adults. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES, 2009-2014). Weighted logistic regression models were used to calculate their odds ratio (OR) and corresponding confidence interval (95% CI) with adjustments for confounding factors in the multivariate analysis that assessed the joint and mutual association between TSE and periodontitis and prediabetes and diabetes mellitus (DM). Results TSE and periodontitis were shown to be independently associated with prediabetes, and a positive association between periodontitis and DM was observed. Significant associations between both DM and prediabetes and the joint effect of periodontitis and TSE were detected. Moreover, a positive association between periodontitis and the risk of prediabetes and DM was observed in both active and passive smokers. Among the participants with TSE, a significantly higher risk of prediabetes or DM was found in those with moderate or severe periodontitis. Conclusions TSE and periodontitis synergistically increased the risk of incident DM or prediabetes, and the deleterious effect of periodontitis on glycemic control could be reduced by smoking abstinence. The findings highlight the importance of avoiding constant exposure to tobacco smoke or quitting smoking for the management of the glycemic status of patients with moderate or severe periodontitis.
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Affiliation(s)
- Xiaoguo Hua
- Office of Medical Insurance Management, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jiong Li
- College and Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China
| | - Rui Hu
- Department of Clinical Teaching Management, The First Affiliated Hospital, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
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Smit AL, Eikelboom RH, Bucks RS, Atlas MD, Hunter M, Stegeman I. Dizziness and imbalance and their association with general and mental health in a community-based cross-sectional study of middle-aged individuals: the Busselton healthy ageing study. BMC Public Health 2025; 25:1287. [PMID: 40188068 PMCID: PMC11971736 DOI: 10.1186/s12889-025-22502-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/26/2025] [Indexed: 04/07/2025] Open
Abstract
BACKGROUND Dizziness and imbalance are common symptoms among patients visiting healthcare providers. Current knowledge about their prevalence, impact on daily life, and associated factors is primarily based on selected samples from individuals seeking medical help, particularly older individuals. This study aimed to estimate the prevalence, symptoms, and impact of dizziness or imbalance symptoms, and to assess the association between these symptoms and their characteristics with demographic, general health, and mental health factors in middle-aged men and women from a representative, general population sample. METHODS Cross-sectional data were collected from participants aged 45 to 70 years in the Busselton Healthy Ageing Study (BHAS), recruited in the City of Busselton, Western Australia. The data included physical tests and health-related questionnaires covering demographics, medical history, general and mental health, including any dizziness and imbalance symptoms and their impact on daily life. Estimates were made of the prevalence, patterns, and impact of dizziness and imbalance symptoms. Logistic regression was employed to calculate the association between demographic, mental and general health (independent variables) and the presence of dizziness or imbalance symptoms (dependent variable). Adjustments were made for sex and age as confounding factors. RESULTS Of the 5086 participants, 1216 (23.9%) reported imbalance or dizziness, with light-headedness the most common type (64.3%; 782 of 1216). For nearly half (565; 46.5%) the imbalance or dizziness occasionally effected daily life, while for some, the impact was frequent (n = 50, 4.1%) or constant (n = 15, 1.2%). Being female (adjusted OR 2.05, 95%CI 1.79-2.34) and older in age (in years; adjusted OR 1.02, 95%CI 1.00-1.03), having a history of general health issues, and experiencing mental health problems or mental health symptoms were significantly associated with dizziness or imbalance symptoms. CONCLUSIONS Dizziness or imbalance are common symptoms among individuals aged 45 to 70 years and are associated with older age, being female, and poorer general and mental health. Given that approximately half of those affected reported occasional effects on daily life, with a few reporting frequent or constant effects, the outcomes of the study could help to raise awareness among healthcare providers about the prevalence, symptoms, and associated conditions.
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Affiliation(s)
- Adriana L Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Robert H Eikelboom
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, WA, Australia
- Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Romola S Bucks
- School of Psychological Science, The University of Western Australia, Perth, Australia
- The Raine Study, School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Marcus D Atlas
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
- Busselton Health Study Centre, Busselton Population Medical Research Institute, Busselton, Australia
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
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Li L, Li R, Liu YJ, Wang Z, Chen X, Xu LX, Chen ZH, Xu JC, Shan ZG. The relationship between blood glucose and clinical outcomes after extracorporeal circulation: a retrospective cohort study. Front Cardiovasc Med 2025; 12:1480163. [PMID: 40231030 PMCID: PMC11994716 DOI: 10.3389/fcvm.2025.1480163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 03/21/2025] [Indexed: 04/16/2025] Open
Abstract
Background Postoperative blood glucose levels significantly impact outcomes in cardiac surgery patients undergoing extracorporeal circulation (ECC) auxiliary to open heart surgery. While hypoglycemia and hyperglycemia are known risk factors for adverse outcomes, the optimal glycemic range for patients undergoing ECC remains unclear. This research examined the relationship between blood glucose levels and 90-day mortality in this high-risk group. Methods The data for this research were obtained from the Medical Information Mart for Intensive Care-IV database version 2.2(MIMIC-IV 2.2), including 4,033 patients who underwent ECC-assisted open-heart surgery. Patients were classified into quartiles based on blood glucose values measured within a 24 h period following admission to the ICU. The study's primary outcome was the 90-day mortality, and the duration of hospital and ICU stays were considered secondary outcomes. Kaplan-Meier survival analysis, Multivariate Cox regression models, smooth curve fitting, Restricted Cubic Spline (RCS) curve, and subgroup analyses were conducted to evaluate the relationship between blood glucose levels and patient outcomes. Results Higher blood glucose levels were significantly related to increased 90-day mortality. The analysis revealed the nonlinear relation between blood glucose and 90 days mortality, with an inflection point at 119 mg/dl (P < 0.05). Patients with blood glucose levels above this threshold had a markedly higher risk of mortality. Additionally, elevated blood glucose was associated with prolonged hospitalization and ICU stays. Conclusion Elevated postoperative blood glucose values were related to an increased 90-day mortality in patients who underwent ECC. When blood glucose levels exceeded 119 mg/dl, blood glucose levels were positively associated with 90-day postoperative mortality.
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Affiliation(s)
- Li Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Rui Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yi-Jiang Liu
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhan Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xin Chen
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Lin-Xi Xu
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Zhi-Huang Chen
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jia-Cheng Xu
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhong-Gui Shan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
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Wang H, Gu L, Ma Y, Xing X, Qu Y, Shi X, Liu X, Wan H, Zhu Q, Shen Y, Chen C, Su L, Wang Y, Liu K. High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes. Diabetol Metab Syndr 2025; 17:106. [PMID: 40148898 PMCID: PMC11951721 DOI: 10.1186/s13098-025-01656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 03/01/2025] [Indexed: 03/29/2025] Open
Abstract
AIMS To assess the association between serum uric acid (SUA) level and the prevalence of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes. METHODS A cross-sectional analysis was conducted involving diabetic patients from Shanghai General hospital during October 2018 and October 2021. Participants underwent measurements of SUA, renal function test and DR assessments via fundus photography. Multivariable ordinal logistic regression models assessed odd ratios (ORs) and 95% confidence intervals (95% CIs) for the progression of DR and CKD. Receiver operating characteristics (ROC) curves identified SUA thresholds, categorizing participants into low and high SUA groups. RESULTS Among the 1015 patients with diabetes, SUA levels were higher in individuals with advanced CKD stages (p < 0.001, compared with stage 1 CKD) and vision-threatening diabetic retinopathy (VTDR) (p = 0.019, compared with no diabetic retinopathy (NDR)). In multivariable models adjusted for potential confounders, higher SUA levels were associated with an increased risk of DR (OR: 1.002, 95% CI: 1.001-1.004) and CKD (OR: 1.008, 95% CI: 1.006-1.011). Notably, SUA levels exceeding 354.0 µmol/L (95% CI: 318.9-393.2) and 361.0 µmol/L (339.2-386.3) were associated with 1.571-fold (95% CI: 1.139-2.099, P = 0.006 for DR) and 1.395-fold (95% CI: 1.033-1.885, P = 0.030 for CKD) increased risks, respectively. Gender-specific analyses also demonstrated a positive correlation between higher SUA levels and the incidence of DR and CKD in both males and females. CONCLUSIONS Elevated SUA levels are independently coincided with increased risks of DR and CKD, suggesting that SUA may serve as a potential risk marker for diabetic complications.
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Affiliation(s)
- Hanying Wang
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Liping Gu
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Yuhang Ma
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Xindan Xing
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Yuan Qu
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Xin Shi
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Xinyi Liu
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Hancong Wan
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Qian Zhu
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Yingchen Shen
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Chong Chen
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Li Su
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China
| | - Yufan Wang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| | - Kun Liu
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China.
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Drugescu A, Gavril RS, Zota IM, Costache AD, Gavril OI, Roca M, Vasilcu TF, Mitu O, Leon MM, Dimitriu DC, Ghiciuc CM, Mitu F. Inflammatory and Fibrosis Parameters Predicting CPET Performance in Males with Recent Elective PCI for Chronic Coronary Syndrome. Life (Basel) 2025; 15:510. [PMID: 40283065 PMCID: PMC12028580 DOI: 10.3390/life15040510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 03/17/2025] [Accepted: 03/18/2025] [Indexed: 04/29/2025] Open
Abstract
Functional capacity (FC), ideally determined by a cardiopulmonary exercise test (CPET), is a valuable prognostic marker in chronic coronary syndrome (CCS). As CPET has limited availability, biomarkers of inflammation and/or fibrosis could help predict diminished FC. Our objective was to assess the value of galectin-3 (gal-3) and that of three inflammatory markers easily obtained from a complete blood count (NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) and MLR (monocyte-to-lymphocyte ratio) in predicting diminished FC in males with recent elective percutaneous coronary intervention (PCI) for CCS. Our prospective study enrolled 90 males who had undergone elective PCI in the previous 3 months (mean age 60.39 ± 10.39 years) referred to a cardiovascular rehabilitation (CR) clinic between February 2023 and December 2024. All subjects received clinical examination, a cardiopulmonary stress test, transthoracic echocardiography and bloodwork. Based on percentage of predicted oxygen uptake (%VO2max), patients were classified in two subgroups-impaired FC (≤70%, n = 50) and preserved FC (>70%, n = 40). NLR, PLR and gal-3 were elevated in patients with poor FC and were significant predictors of diminished FC in multivariate analysis. PLR, NLR and gal-3 could guide referrals for CR for high-risk males with recent elective PCI.
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Affiliation(s)
- Andrei Drugescu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Radu Sebastian Gavril
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Ioana Mădălina Zota
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Alexandru Dan Costache
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Oana Irina Gavril
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Mihai Roca
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Teodor Flaviu Vasilcu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Ovidiu Mitu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Maria Magdalena Leon
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
| | - Daniela Cristina Dimitriu
- Department of Morpho-Functional Sciences II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.C.D.); (C.M.G.)
| | - Cristina Mihaela Ghiciuc
- Department of Morpho-Functional Sciences II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.C.D.); (C.M.G.)
| | - Florin Mitu
- Department of Medical Specialties (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (A.D.C.); (O.I.G.); (M.R.); (T.F.V.); (O.M.); (M.M.L.); (F.M.)
- Romanian Acad Med Sci, 927180 Bucharest, Romania
- Romanian Acad Scientists, 050044 Bucharest, Romania
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Baluku JB, Karungi D, Namanda B, Namiiro S, Katusabe S, Madalen AM, Nabwana M, Olum R, Bongomin F, Nuwagira E, Kansiime G, Kraef C, Shaughnessy M, Rhein J, Meya D. Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2025:2025.03.19.25324234. [PMID: 40166552 PMCID: PMC11957088 DOI: 10.1101/2025.03.19.25324234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
Background Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles. Methods We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed. Results A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p<0.001) and a higher prevalence of DM (17.9% vs. 9.5%, p=0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m2, p<0.001) and waist circumference (81.0 vs. 84.0 cm, p=0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p<0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p<0.001) and lower prevalence of dyslipidemia (81.7% vs. 96.5%, p<0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95% CI 1.10-2.92) and DM (aPR 2.34, 95% CI 1.11-4.94), but decreased risk of obesity (aPR 0.42, 95% CI 0.20-0.88). Conclusion TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.
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Affiliation(s)
- Joseph Baruch Baluku
- Makerere University Lung Institute, Kampala, Uganda
- Kiruddu National Referral Hospital, Kampala, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | | | | | - Martin Nabwana
- Makerere University - John Hopkins University Research Collaboration, Kampala, Uganda
| | - Ronald Olum
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Grace Kansiime
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Christian Kraef
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Megan Shaughnessy
- Division of Infectious Disease, Department of Medicine, Hennepin County Medical Center, Minneapolis, USA
| | - Joshua Rhein
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, USA
| | - David Meya
- Makerere University College of Health Sciences, Kampala, Uganda
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Zhao X, Zhuang Y, Tang S, Ruan Y, Li Q, Liu Y, Lei J, Han Y, Chen Y, Zhao Y, Fan Z. Prognostic impact of prediabetes on long-term cardiovascular outcomes in patients under 35 with premature acute myocardial infarction. Diabetol Metab Syndr 2025; 17:90. [PMID: 40102916 PMCID: PMC11921701 DOI: 10.1186/s13098-025-01662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 03/07/2025] [Indexed: 03/20/2025] Open
Abstract
BACKGROUND Prediabetes (pre-DM) is recognized as an intermediate state of glucose metabolism with a high potential to progress to diabetes mellitus (DM). However, its prognostic value in patients with premature acute myocardial infarction (PAMI) under the age of 35 remains unclear. This study aimed to investigate the relationship between pre-DM and long-term cardiovascular outcomes in this unique population. METHODS This retrospective cohort study included 796 PAMI patients under 35 years of age who were categorized into three groups based to glycated hemoglobin levels or previous history: normal glucose regulation (NGR), pre-DM, and DM. The primary endpoint was the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) including all-cause death, non-fatal myocardial infarction, non-fatal stroke, or revascularization. Multivariable Cox regression, Kaplan-Meier and Subgroup analyses were performed. RESULTS Pre-DM was observed in 22.1% of the PAMI cohort. During the median follow-up of 81 months, the incidence of MACCE was 23.5%, with significantly higher rates in the pre-DM and DM group compared to the NGR group (18.4%, 27.3%, 34.2%; p < 0.001). After adjusting for confounding variables, pre-DM remained independently associated with an increased risk of MACCE (HR 1.51, 95%CI 1.05-2.18, p = 0.027). Subgroup analysis demonstrated that pre-DM status was a robust risk factor compared to NGR. Moreover, pre-DM had a similar impact on MACCE events as DM in patients with PAMI. CONCLUSIONS Pre-DM is associated with a poor prognosis in young AMI patients under 35 years old, suggesting that it may be an independent predictor of adverse events in this population.
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Affiliation(s)
- Xinlong Zhao
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yuansong Zhuang
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Siqi Tang
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
- Department of Internal Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yanping Ruan
- Department of Echocardiography, Beijing Anzhen Hospital, Maternal-Fetal Medicine Research Consultation Center, Capital Medical University, Beijing, 100029, China
| | - Quan Li
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yanbo Liu
- Department of Healthcare, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jinyan Lei
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yitao Han
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yuxiong Chen
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
- Department of Internal Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
- Department of Internal Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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Li X, Yu H, Yu K, Huang Z, Deng Z. Association between percent body fat and the risk of prediabetes among Chinese adults: a 5-years longitudinal cohort study. Sci Rep 2025; 15:8982. [PMID: 40089546 PMCID: PMC11910635 DOI: 10.1038/s41598-025-92367-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 02/27/2025] [Indexed: 03/17/2025] Open
Abstract
This study aimed to explore the influence of percent body fat (PBF) on the risk of developing prediabetes among Chinese individuals, given the limited evidence on this relationship. We conducted a retrospective cohort study involving 185,586 Chinese adults. We applied Cox proportional hazards regression models, cubic spline functions, and smooth curve fitting to analyze the relationship between initial PBF and the likelihood of prediabetes, focusing on its nonlinear connection. We conducted various sensitivity and subgroup analyses to strengthen our results. After adjusting for covariates, we found a positive correlation between PBF and the risk of prediabetes (HR = 1.13, 95% CI: 1.12-1.15, p < 0.0001). Moreover, a nonlinear correlation was identified between PBF and the likelihood of prediabetes, with a turning point at 29.5. On the left side of the turning point, the hazard ratio was 1.01 (95% CI: 0.99-1.03, p = 0.4128), while on the right side, it was 1.52 (95% CI: 1.45-1.59, p < 0.0001). Furthermore, sensitivity and subgroup analyses reaffirmed the robustness of these findings. Our research identified a nonlinear relationship between PBF and the development of prediabetes in the Chinese population, marked by a turning point at 29.5. Lowering PBF below 29.5 may reduce the risk of developing prediabetes.
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Affiliation(s)
- Xin Li
- Department of Emergency Medicine, Shenzhen Second People's Hospital & The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Haomiao Yu
- Department of Rheumatology Medicine, Shenzhen Second People's Hospital & The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Ke Yu
- Department of Pulmonary and Critical Care Medicine, Shenzhen Second People's Hospital & The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Zhenhua Huang
- Department of Emergency Medicine, Shenzhen Second People's Hospital & The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.
| | - Zhe Deng
- Department of Emergency Medicine, Shenzhen Second People's Hospital & The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.
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Song J, Wang C, Zhao T, Zhang Y, Xing J, Zhao X, Zhang Y, Zhang Z. Multi-omics approaches for biomarker discovery and precision diagnosis of prediabetes. Front Endocrinol (Lausanne) 2025; 16:1520436. [PMID: 40162315 PMCID: PMC11949806 DOI: 10.3389/fendo.2025.1520436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 02/24/2025] [Indexed: 04/02/2025] Open
Abstract
Recent advancements in multi-omics technologies have provided unprecedented opportunities to identify biomarkers associated with prediabetes, offering novel insights into its diagnosis and management. This review synthesizes the latest findings on prediabetes from multiple omics domains, including genomics, epigenomics, transcriptomics, proteomics, metabolomics, microbiomics, and radiomics. We explore how these technologies elucidate the molecular and cellular mechanisms underlying prediabetes and analyze potential biomarkers with predictive value in disease progression. Integrating multi-omics data helps address the limitations of traditional diagnostic methods, enabling early detection, personalized interventions, and improved patient outcomes. However, challenges such as data integration, standardization, and clinical validation and translation remain to be resolved. Future research leveraging artificial intelligence and machine learning is expected to further enhance the predictive power of multi-omics technologies, contributing to the precision diagnosis and tailored management of prediabetes.
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Affiliation(s)
- Jielin Song
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
| | - Chuanfu Wang
- Department of Encephalopathy, Liangping District Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Tong Zhao
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
| | - Yu Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
| | - Jixiang Xing
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
| | - Xuelian Zhao
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
| | - Yunsha Zhang
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhaohui Zhang
- TCM Institute of Sore and Ulcer, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Institute of Traditional Chinese Medicine Surgery, Tianjin, China
- Department of Traditional Chinese Medicine Surgery, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Jing J, Liu Y. A parallel-group controlled clinical study to evaluate the efficacy of self-family-environment empowerment diet management intervention in improving outcomes for pregnant women with gestational diabetes mellitus. Front Public Health 2025; 13:1558273. [PMID: 40182518 PMCID: PMC11966409 DOI: 10.3389/fpubh.2025.1558273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Accepted: 02/27/2025] [Indexed: 04/05/2025] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) is a serious health problem that poses threats to both mothers and babies, thus leading to the intensive need for management. The current study examined how the SFEE diet management intervention affected glycemic control, maternal outcomes, and dietary compliance in GDM. Methods Patients not enrolled were ascribed to either the SFEE intervention group or a control group in which standard dietary advice was provided. Although the assessors of the outcome were blind, the participants and providers were not. The principal outcomes included fasting blood glucose, HbA1c, macrosomia, cesarean rates, compliance, and GDM knowledge. Ethical approval was granted by the First Hospital of Shanxi Medical University Ethics Committee (ClinicalTrials.gov registration ID: NCTO6707064). Results All acute and long-term outcomes generally showed that the degree of improvement in fasting glucose and HbA1c was greater in the SFEE group compared with the rest (-0.45 mmol/L, p < 0.01; -0.35%, p < 0.05); 12% with macrosomia in the SFEE group versus 25% in the contrast group (p < 0.05); and cesarean section necessitations 18% in the SFEE group against 30% in the counterpart group (p < 0.05). Concerning other variables, dietary adherence and GDM knowledge also reported higher values (p < 0.05); the adherence proportion here is over 85%, with only a 6.25% dropout rate. Conclusion The SFEE found that the intervention improved glycemic control, maternal outcomes, and adherence, facilitated by increasing family and social support. This suggests a promising dietary intervention for managing GDM.
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Affiliation(s)
- Ji Jing
- Department of Delivery Room, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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Xie Y, Chen Q, Shan D, Pan X, Hu Y. Unraveling the role of the gut microbiome in pregnancy disorders: insights and implications. Front Cell Infect Microbiol 2025; 15:1521754. [PMID: 40125520 PMCID: PMC11925892 DOI: 10.3389/fcimb.2025.1521754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Accepted: 02/20/2025] [Indexed: 03/25/2025] Open
Abstract
The gut microbiota is the collective term for the microorganisms that reside in the human gut. In recent years, advances in sequencing technology and bioinformatics gradually revealed the role of gut microbiota in human health. Dramatic changes in the gut microbiota occur during pregnancy due to hormonal and dietary changes, and these changes have been associated with certain gestational diseases such as preeclampsia (PE) and gestational diabetes mellitus (GDM). Modulation of gut microbiota has also been proposed as a potential treatment for these gestational diseases. The present article aims to review current reports on the association between gut microbiota and gestational diseases, explore possible mechanisms, and discuss the potential of probiotics in gestational diseases. Uncovering the link between gut microbiota and gestational diseases could lead to a new therapeutic approach.
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Affiliation(s)
- Yupei Xie
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
| | - Qian Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
| | - Dan Shan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
| | - Xiongfei Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China Second University Hospital, Sichuan University, Shuangliu Institute of Women’s and Children’s Health, Shuangliu Maternal and Child Health Hospital, Chengdu, China
| | - Yayi Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, Qingbaijiang Maternal and Child Health Hospital, Chengdu, China
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Jastreboff AM, le Roux CW, Stefanski A, Aronne LJ, Halpern B, Wharton S, Wilding JPH, Perreault L, Zhang S, Battula R, Bunck MC, Ahmad NN, Jouravskaya I. Tirzepatide for Obesity Treatment and Diabetes Prevention. N Engl J Med 2025; 392:958-971. [PMID: 39536238 DOI: 10.1056/nejmoa2410819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
BACKGROUND Obesity is a chronic disease and causal precursor to myriad other conditions, including type 2 diabetes. In an earlier analysis of the SURMOUNT-1 trial, tirzepatide was shown to provide substantial and sustained reductions in body weight in persons with obesity over a 72-week period. Here, we report the 3-year safety outcomes with tirzepatide and its efficacy in reducing weight and delaying progression to type 2 diabetes in persons with both obesity and prediabetes. METHODS We performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo. The current analysis involved the participants with both obesity and prediabetes, who received their assigned dose of tirzepatide or placebo for a total of 176 weeks, followed by a 17-week off-treatment period. The three key secondary end points, which were controlled for type I error, were the percent change in body weight from baseline to week 176 and onset of type 2 diabetes during the 176-week and 193-week periods. RESULTS At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who received placebo (P<0.001 for all comparisons with placebo). Fewer participants received a diagnosis of type 2 diabetes in the tirzepatide groups than in the placebo group (1.3% vs. 13.3%; hazard ratio, 0.07; 95% confidence interval [CI], 0.0 to 0.1; P<0.001). After 17 weeks off treatment or placebo, 2.4% of the participants who received tirzepatide and 13.7% of those who received placebo had type 2 diabetes (hazard ratio, 0.12; 95% CI, 0.1 to 0.2; P<0.001). Other than coronavirus disease 2019, the most common adverse events were gastrointestinal, most of which were mild to moderate in severity and occurred primarily during the dose-escalation period in the first 20 weeks of the trial. No new safety signals were identified. CONCLUSIONS Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1 ClinicalTrials.gov number, NCT04184622.).
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Affiliation(s)
- Ania M Jastreboff
- Y-Weight Yale Obesity Research Center, Section of Endocrinology and Metabolism, Department of Medicine, Yale School of Medicine, New Haven, CT
- Section of Pediatric Endocrinology, Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin
| | | | - Louis J Aronne
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, New York
| | | | - Sean Wharton
- University of Toronto, Toronto
- Wharton Weight Management Clinic, Toronto
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom
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Le Collen L, Desgrouas C, Lukas Croisier C, Creugnet B, Dechaume A, Toussaint B, Vaillant E, Amanzougarene S, Buse Falay E, Derhourhi M, Lourdelle A, Delemer B, Bonello-Palot N, Vaxillaire M, Badens C, Froguel P, Bonnefond A. Rare ZMPSTE24 variants increase risk of hypertriglyceridemia and metabolic syndrome. Eur J Endocrinol 2025; 192:240-247. [PMID: 39993161 DOI: 10.1093/ejendo/lvaf031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 01/07/2025] [Accepted: 02/20/2025] [Indexed: 02/26/2025]
Abstract
OBJECTIVE The global increase in the prevalence of metabolic syndrome represents a significant public health concern. Rare biallelic pathogenic variants in ZMPSTE24 have been identified as the cause of mandibuloacral dysplasia type B, ie, a lipodystrophy syndrome associated with metabolic complications. The role of monoallelic pathogenic variants in ZMPSTE24 concerning metabolic syndrome remains uncertain. DESIGN Case report and systematic review of literature. METHODS We investigated a Wallisian family with FPLD and metabolic syndrome via whole-exome sequencing. We performed functional analyses of an identified rare ZMPSTE24 variant. To broadly assess the effect of heterozygous pathogenic ZMPSTE24 variants on FPLD-associated phenotypes, and metabolic syndrome, we used the Human Gene Mutation Database (HGMD) and 200 K exome data from UK Biobank. RESULTS We investigated a Wallisian family where a 40-year-old female with metabolic syndrome was found to carry a rare heterozygous missense variant in ZMPSTE24. Functional assays showed a decreased prelamin to lamin A maturation and accelerated senescence. In silico analysis demonstrated that this variant might disrupt the lamin A binding site. We then analyzed the impact of monoallelic pathogenic ZMPSTE24 variants on metabolic traits using data from the HGMD and the UK Biobank. In HGMD, ZMPSTE24 variants carriers presented with dyslipidemia and hepatic steatosis. In the UK Biobank, monoallelic pathogenic variants were associated with an increased risk of hypertriglyceridemia, with a trend toward metabolic syndrome. CONCLUSIONS This study underscores the association of ZMPSTE24 rare variants with metabolic disorders and emphasizes the need for further research to clarify their clinical implications.
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Affiliation(s)
- Lauriane Le Collen
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, Nancy F-54000, France
| | - Camille Desgrouas
- Aix Marseille Univ, Centre de recherche en Cardiovasculaire et Nutrition, INSERM, 13005 Marseille, France
| | - Céline Lukas Croisier
- Department of Endocrinology Diabetology, University Hospital Center of Reims, 51092 Reims, France
| | | | - Aurélie Dechaume
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Bénédicte Toussaint
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Emmanuel Vaillant
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Souhila Amanzougarene
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Emmanuel Buse Falay
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Mehdi Derhourhi
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Alexandre Lourdelle
- Pediatric diabetology Department, American Memorial Hospital, University hospital, 51092 Reims, France
| | - Brigitte Delemer
- Department of Endocrinology Diabetology, University Hospital Center of Reims, 51092 Reims, France
- CRESTIC EA 3804, UFR Sciences Exactes et Naturelles, Moulin de La Housse, BP 1039, 51687 Reims, France
| | - Nathalie Bonello-Palot
- Aix Marseille Univ, Centre de recherche en Cardiovasculaire et Nutrition, INSERM, 13005 Marseille, France
| | - Martine Vaxillaire
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
| | - Catherine Badens
- Aix Marseille Univ, Centre de recherche en Cardiovasculaire et Nutrition, INSERM, 13005 Marseille, France
- Laboratoire de Génétique Moléculaire, APHM, 13005 Marseille, France
| | - Philippe Froguel
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
- Department of Metabolism, Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom
| | - Amélie Bonnefond
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, 59045 Lille, France
- University of Lille, Lille University Hospital, 59000 Lille, France
- Department of Metabolism, Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom
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Yamaji T, Yusoff FM, Kishimoto S, Kajikawa M, Harada T, Mizobuchi A, Maruhashi T, Nakashima A, Tomiyama H, Higashi Y. The relationship between continuation of exercise habit for three years and endothelial function in patients with hypertension. Hypertens Res 2025; 48:927-938. [PMID: 39639125 PMCID: PMC11879854 DOI: 10.1038/s41440-024-02029-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 11/08/2024] [Accepted: 11/09/2024] [Indexed: 12/07/2024]
Abstract
The aim of this study was to evaluate the relationship between continuation of exercise habit for a long period and endothelial function assessed by flow-mediated vasodilation (FMD) in patients with hypertension. This study was a multicenter retrospective observational study. A total of 639 patients with hypertension were enrolled in this study. The subjects were divided into two groups based on information on exercise habit: a regular exercise group and a non-regular exercise group (control group). The regular exercise group was defined as patients who had an exercise habit during a 3-year follow-up period. There was no significant difference in FMD at baseline between the regular exercise group and control group. The change in FMD examined by the Wilcoxon signed rank test was significantly larger in the regular exercise group than in the control group (0.4 (-1.4, 2.0) % vs. -0.1 (-2.2, 1.4) %, p = 0.008). After adjustment for confounding factors for FMD, the odds ratio for increase in FMD was significantly larger in the regular exercise group than in the control groups. (OR: 1.59, 95% CI: 1.14-2.21, p = 0.006) A cubic spline curve revealed that even subjects with regular exercise who had a mean exercise intensity of less than 20 Mets・hour/week a had higher odds ratio for increase in endothelial function compared to the control group. These findings suggest that patients with hypertension who engage in regular exercise exhibited better endothelial function compared to those who do not exercise. Clinical Trial Registry Information: http://www.umin.ac.jp (UMIN000012951).
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Affiliation(s)
- Takayuki Yamaji
- Center for Radiation Disaster Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Takahiro Harada
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Aya Mizobuchi
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Nephrology, Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | | | - Yukihito Higashi
- Center for Radiation Disaster Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
- Department of Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
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Gupta J, Khandelwal D, Gupta L, Dutta D, Mittal S, Khandelwal R, Chittawar S. Occurrence and Predictors of Diabetes Distress in Adult Patients with Type 2 Diabetes from North India. Indian J Endocrinol Metab 2025; 29:202-208. [PMID: 40416462 PMCID: PMC12101760 DOI: 10.4103/ijem.ijem_170_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 11/17/2024] [Accepted: 12/09/2024] [Indexed: 05/27/2025] Open
Abstract
Introduction There is limited data regarding the prevalence and predictors of diabetes distress in Indians with type 2 diabetes (T2D). The study aimed to determine the occurrence and predictors of diabetes distress in adult persons with T2D. Methods In a cross-sectional study, persons with T2D on pharmacotherapy for at least 1 year were evaluated. They were administered three questionnaires namely- Diabetes Distress Scale-17, Patient Health Questionnaire-9, and Morisky Medication Adherence Scale-8. Clinically meaningful data regarding diabetes complications, anthropometry, and biochemical parameters were recorded. Results Two hundred persons completed the study (mean age 57 ± 9.89 years, 59% males). Overall 140 (70%) of the patients had diabetes distress (mean DDS score ≥2). Clinically significant diabetes distress (CSDD) that requires a physician's attention (mean DDS score ≥3) was seen in 75 (37.50%) of the study participants. The mean HbA1c was significantly higher in participants with CSDD (10.24 ± 2.01 vs. 7.85 ± 1.14; P = <0.001). Both microvascular [retinopathy (28% vs. 5.60%; P ≤ 0.001), neuropathy (28% vs. 0%; P ≤ 0.001), nephropathy (32% vs. 6.40%; P ≤ 0.001)] and macrovascular (CAD 24% vs. 4.80%; P ≤ 0.001) and (CVA 6.67% vs. 1.60%; P = 0.059) complications were significantly correlated with CSDD. Medication adherence was significantly lower in patients with CSDD (p=<0.001). An increased number of insulin injections increased BMI and HbA1c, and the presence of nephropathy were independent predictors of CSDD. Conclusion Diabetes distress is a common co-morbid condition in persons with T2D. CSDD had a significant correlation with poor glycaemic control, higher BMI, presence of nephropathy, and higher number of insulin injections.
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Affiliation(s)
- Joshita Gupta
- Department of Medicine, Park Hospital, Gurugram, Haryana, India
| | - Deepak Khandelwal
- Department of Endocrinology and Diabetes, Khandelwal Diabetes, Thyroid and Endocrinology Clinic, Dwarka, India
| | - Lovely Gupta
- Department of Research, Sitaram Bhartia Institute of Science and Research, Qutab Institutional Area, Dwarka, India
| | - Deep Dutta
- Department of Endocrinology and Diabetes, Center for Endocrinology Diabetes Arthritis and Rheumatism (CEDAR) Superspeciality Clinics, Dwarka, India
| | - Suresh Mittal
- Department of Medicine, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi, India
| | - Ritesh Khandelwal
- Clinical Research Department, QREC Clinical Research LLP, Bhopal, Madhya Pradesh, India
| | - Sachin Chittawar
- Harmony- Dr Sachin’s 360 Degree Diabetes Care, Bhopal, Madhya Pradesh, India
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Adjei SK, Adjei P, Nkrumah PA. Poor Glycemic Control and Its Predictors Among Type 2 Diabetes Patients: Insights From a Single-Centre Retrospective Study in Ghana. Health Sci Rep 2025; 8:e70558. [PMID: 40078898 PMCID: PMC11896812 DOI: 10.1002/hsr2.70558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 02/12/2025] [Accepted: 02/22/2025] [Indexed: 03/14/2025] Open
Abstract
Background and Aims The primary objective of glycemic control in individuals with diabetes mellitus is to avert or postpone complications, which ultimately leads to an improved quality of life. Nonetheless, achieving the recommended targets for glycemic control in clinical settings often proves challenging. Consequently, it is crucial to ascertain factors that affect glycemic outcomes to enhance the management of diabetes mellitus. This study sought to evaluate the levels of glycemic control and the associated factors among patients with type 2 diabetes receiving care at the Methodist Hospital, Wenchi, Ghana. Methods A retrospective study was conducted using an existing database. Glycemic control was evaluated by HbA1c measurements with a target of < 7% indicating good control, as per the guidelines established by the American Diabetes Association for nonpregnant adults. HbA1c levels ≥ 7% were classified as poor control. Data analysis was conducted using SPSS version 25 and multivariate logistic regression analysis was employed to determine the factors affecting glycemic control. Results The median HbA1c level among the participants was 7.9% (IQR: 5.8-9.9). Majority (59.3%) demonstrated poor glycemic control with HbA1c ≥ 7%. Factors associated with poor glycemic control included advanced age (AOR: 4.32, 95% CI: 0.61-11.21, p = 0.012), duration of diabetes mellitus > 10 years (AOR: 3.60, 95% CI: 1.05-9.82, p = 0.019), insulin therapy (AOR: 3.13, 95% CI: 0.55-11.01, p = 0.009) and hypertension diagnosis (AOR: 2.88, 95% CI: 0.75-5.45, p = 0.030). Conclusions The study indicated that a considerable proportion of individuals with diabetes exhibited inadequate glycemic control. Older age, longer duration of diabetes mellitus, insulin therapy and comorbid hypertension were significantly associated with poor glycemic control among the study population. Multidisciplinary interventions as well as customized management strategies are required to ensure effective glycemic control to prevent long-term complications of diabetes mellitus.
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Affiliation(s)
- Samuel Kyeremeh Adjei
- Department of Internal MedicineMethodist HospitalWenchiGhana
- School of Public Health and Allied SciencesCatholic University of GhanaFiapre‐SunyaniGhana
| | - Prosper Adjei
- Department of Internal MedicineMethodist HospitalWenchiGhana
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AlZeer I, AlBassam AM, AlFeraih A, AlMutairi A, AlAskar B, Aljasser D, AlRashed F, Alotaibi N, AlGhamdi S, AlRashed Z. Correlation Between Glycated Hemoglobin (HbA1c) Levels and Lipid Profile in Patients With Type 2 Diabetes Mellitus at a Tertiary Hospital in Saudi Arabia. Cureus 2025; 17:e80736. [PMID: 40242700 PMCID: PMC12003031 DOI: 10.7759/cureus.80736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2025] [Indexed: 04/18/2025] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is often associated with dyslipidemia, which increases the risk of cardiovascular disease. This study aimed to evaluate the relationship between glycated hemoglobin (HbA1c) levels and lipid profiles among newly diagnosed T2DM patients in Saudi Arabia. METHODS A cross-sectional retrospective study was conducted at King Fahad Medical City in Riyadh between January 2022 and December 2023. Data on demographic factors, body mass index (BMI), blood glucose levels, and lipid profiles were analyzed. RESULTS A total of 483 patients were included in the study, with the majority (42.2%) aged between 55 and 64 years. The study population consisted of 64.2% females with a mean BMI of 30.31±5.41. High HbA1c levels were observed in 68.3% of patients. Significant associations were found between HbA1c levels and triglycerides (TG) (p<0.001) as well as high-density lipoprotein cholesterol (HDL-c) (p<0.001), whereas low-density lipoprotein cholesterol (LDL-c) and total cholesterol (TC) showed no significant differences. Similarly, fasting blood glucose levels were associated with TG (p<0.001) and HDL-c (p=0.03) but not with TC or LDL-c. Regression analysis revealed that HDL-c was negatively correlated with HbA1c, whereas TG was positively correlated with HbA1c. No other parameter showed a significant correlation. CONCLUSION Poor glycemic control, as indicated by elevated HbA1c levels, is significantly associated with adverse lipid profile components, particularly higher TG levels and lower HDL-c.
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Toprak K, Kaplangoray M, Memioğlu T, İnanır M, Omar B, Ermiş MF, Toprak İH, Acar O, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. The HbA1c/C-Peptide Ratio is Associated With the No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction. Angiology 2025; 76:289-299. [PMID: 37920902 DOI: 10.1177/00033197231213166] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Currently, the gold standard treatment for ST-elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI), but even after successful pPCI, a perfusion disorder in the epicardial coronary arteries, termed no-reflow phenomenon (NR), can develop, resulting in short- and long-term adverse events. The present study assessed the relationship between NR and HbA1c/C-peptide ratio (HCR) in 1834 consecutive patients who underwent pPCI due to STEMI. Participants were divided into two groups according to NR status and the demographic, clinical and periprocedural characteristics of the groups were compared. NR developed in 352 (19.1%) of the patients in the study. While C-peptide levels were significantly lower in the NR group, HbA1c and HCR were significantly higher (P < .001, for all). In multivariable analysis, C-peptide, HbA1c, and HCR, were determined as independent predictors for NR (P < .05, for all). In Receiver Operating Characteristic (ROC) analysis, HCR predicted the NR with 80% specificity and 77% sensitivity. In STEMI patients, combining HbA1c and C-peptide in a single fraction has a predictive value for NR independent of diabetes. This ratio may contribute to risk stratification of STEMI patients.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medical, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Bahadır Omar
- Department of Cardiology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Fatih Ermiş
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - İbrahim Halil Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Osman Acar
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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Cheng H, Lin Z, Lin K, Chen H, Zhang X, Shen M, Xu S. ASSOCIATION BETWEEN OBESITY AND ALTERATIONS IN PHOTORECEPTOR-RETINAL PIGMENT EPITHELIUM-CHORIOCAPILLARIS COMPLEX IN HEALTHY EYES. Retina 2025; 45:555-564. [PMID: 39964828 DOI: 10.1097/iae.0000000000004338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2025]
Abstract
PURPOSE To investigate the effect of obesity on alterations in the photoreceptor-retinal pigment epithelium (RPE)-choriocapillaris complex. METHODS Two hundred and twenty participants with varying body mass index were enrolled and categorized into three groups: normal weight, overweight, and obese. Retinal and choroidal images were obtained using swept-source optical coherence tomography. Automatic segmentation was used for image analysis, evaluating retina thickness parameters such as retinal nerve fiber layer, ganglion cell layer and inner plexiform layer, inner nuclear layer, outer plexiform layer, outer nuclear layer, myoid and ellipsoid zone, outer segment of photoreceptors, RPE, and choroidal parameters including choroidal thickness, luminal area, stromal area, total choroidal area, choroidal vascular index, and choriocapillaris flow void percentage. Differences in photoreceptor-RPE-choriocapillaris complex among the groups and their correlation with body mass index were explored. RESULTS Compared with the control subjects, participants with obesity exhibited thinner myoid and ellipsoid zone and outer segment of photoreceptors, increased choriocapillaris flow void percentage, and thicker RPE. Correlation analysis revealed a negative correlation between body mass index and myoid and ellipsoid zone (r = -0.17, P = 0.01) and outer segment of photoreceptors (r = -0.16, P = 0.02), whereas a positive correlation was observed with RPE (r = 0.15, P = 0.00). CONCLUSION Individuals with obesity may present with a thinner myoid and ellipsoid zone and outer segment of photoreceptors, thicker RPE, and reduced choriocapillaris perfusion, suggesting potential damage to the photoreceptor-RPE-choriocapillaris complex. These alterations in the photoreceptor-RPE-choriocapillaris complex alterations could serve as potential biomarkers for monitoring early pathologic and physiologic changes associated with obesity.
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Affiliation(s)
- Hongling Cheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhiyang Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Kuangching Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hao Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xi Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Meixiao Shen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Suzhong Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China ; and
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Zhuo Y, Fu S, Qiu Y. Regulation of the immune microenvironment by SUMO in diabetes mellitus. Front Immunol 2025; 16:1506500. [PMID: 40078991 PMCID: PMC11896877 DOI: 10.3389/fimmu.2025.1506500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 02/12/2025] [Indexed: 03/14/2025] Open
Abstract
Post-translational modifications such as SUMOylation are crucial for the functionality and signal transduction of a diverse array of proteins. Analogous to ubiquitination, SUMOylation has garnered significant attention from researchers and has been implicated in the pathogenesis of various human diseases in recent years, such as cancer, neurological lesions, cardiovascular diseases, diabetes mellitus, and so on. The pathogenesis of diabetes, particularly type 1 and type 2 diabetes, has been closely associated with immune dysfunction, which constitutes the primary focus of this review. This review will elucidate the process of SUMOylation and its impact on diabetes mellitus development and associated complications, focusing on its regulatory effects on the immune microenvironment. This article summarizes various signaling pathways at both cellular and molecular levels that are implicated in these processes. Furthermore, it proposes potential new targets for drug development aimed at the prevention and treatment of diabetes mellitus based on insights gained from the SUMOylation process.
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Affiliation(s)
- Yuting Zhuo
- Department of Endocrinology and Metabolism, Jiujiang Hospital of Traditional Chinese Medicine, Jiujiang, Jiangxi, China
- The Second School of Clinical Medicine, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Shangui Fu
- The Second School of Clinical Medicine, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yue Qiu
- Department of Endocrinology and Metabolism, Jiujiang Hospital of Traditional Chinese Medicine, Jiujiang, Jiangxi, China
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Liang M, Fang L, Chen X, Huang W. Detecting severe coronary artery stenosis in T2DM patients with NAFLD using cardiac fat radiomics-based machine learning. Sci Rep 2025; 15:6788. [PMID: 40000860 PMCID: PMC11862222 DOI: 10.1038/s41598-025-91523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 02/20/2025] [Indexed: 02/27/2025] Open
Abstract
To analyze radiomics features of cardiac adipose tissue in individuals with type 2 diabetes (T2DM) and non-alcoholic fatty liver disease (NAFLD), integrating relevant clinical indicators, and employing machine learning techniques to construct a precise model for detecting severe coronary artery stenosis. A retrospective analysis of 710 T2DM patients with NAFLD was conducted at First People's Hospital of Wenling. The study population was randomly divided into a training set (n = 497) and a validation set (n = 213). Radiomics features from cardiac fat CT images, including epicardial adipose tissue (EAT) and paracardial adipose tissue (PAT), were extracted for all patients. The semi-automated segmentation and extraction of shape, first-order statistics, texture, and wavelet were performed using specialized software. Simultaneously, clinical characteristics were collected. Following feature selection, four machine learning algorithms were utilized to develop radiomics, clinical, and combined radiomics-clinical models. The detection performance of these models was subsequently evaluated in both the training and validation cohorts. Additionally, Shapley Additive exPlanations (SHAP) values were calculated to quantify the importance of features. A total of 10 radiomics features for EAT and PAT were extracted from CT images after feature selection. The clinical model obtained an area under the curve (AUC) of 0.747 with the support vector machine (SVM), while the radiomics model reached an AUC of 0.838 with the extreme gradient boosting (XGBoost) algorithm. In comparison, the radiomics-clinical model using XGBoost demonstrated superior detection capability, achieving an AUC of 0.883 in the training set and maintaining high performance in the validation set, with the highest F1 score, accuracy, and precision. SHAP analysis revealed the importance of radiomics features from EAT and PAT, as well as clinical factors such as diabetes duration, global longitudinal strain (GLS), and low-density lipoprotein cholesterol (LDL-C), in detecting severe coronary artery stenosis. This study confirms that the integrated application of cardiac fat radiomics features and clinical data using machine learning models, particularly the XGBoost algorithm, facilitates the detection of severe coronary artery stenosis in T2DM patients with NAFLD. SHAP analysis further elucidates the contribution of key variables in the model, providing crucial foundations for personalized treatment decision-making.
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Affiliation(s)
- Mengjie Liang
- Department of Ultrasound Imaging, the First People's Hospital of Wenling, Wenling City, Zhejiang Province, People's Republic of China
| | - Liting Fang
- Department of Radiology, Wenling Traditional Chinese Medicine Hospital, Wenling City, Zhejiang Province, People's Republic of China
| | - Xie Chen
- Department of Ultrasound Imaging, the First People's Hospital of Wenling, Wenling City, Zhejiang Province, People's Republic of China
| | - Wendi Huang
- Department of Ultrasound Imaging, the First People's Hospital of Wenling, Wenling City, Zhejiang Province, People's Republic of China.
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Balaj D, Burgstaller JM, Wallnöfer A, Weiss K, Senn O, Rosemann T, Grischott T, Markun S. Leveraging free-text diagnoses to identify patients with diabetes mellitus, obesity or dyslipidaemia - a cross-sectional study in a large Swiss primary care database. Swiss Med Wkly 2025; 155:3360. [PMID: 39977299 DOI: 10.57187/s.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2025] Open
Abstract
BACKGROUND Electronic medical records (EMRs) in general practice provide various methods for identifying patients with specific diagnoses. While several studies have focused on case identification via structured EMR components, diagnoses in general practice are frequently documented as unstructured free-text entries, making their use for research challenging. Furthermore, diagnoses may remain undocumented even when evidence of the underlying disease exists within structured EMR data. OBJECTIVE This study aimed to quantify the extent to which free-text diagnoses contribute to identifying additional cases of diabetes mellitus, obesity and dyslipidaemia (target diseases) and assess the cases missed when relying exclusively on free-text entries. METHODS This cross-sectional study utilised EMR data from all consultations up to 2019 for 6,000 patients across 10 general practices in Switzerland. Diagnoses documented in a free-text entry field for diagnoses were manually coded for target diseases. Cases were defined as patients with a corresponding coded free-text diagnosis or meeting predefined criteria in structured EMR components (medication data or clinical and laboratory parameters). For each target disease, prevalence was calculated along with the proportion of cases identified exclusively via free-text diagnoses and the proportion missed when using free-text diagnoses alone. RESULTS The prevalence estimates for diabetes mellitus, obesity and dyslipidaemia were 8.8%, 16.2% and 38.9%, respectively. Few cases relied exclusively on free-text diagnoses for identification, but a substantial proportion of cases were missed when relying solely on free-text diagnoses, particularly for obesity (19.5% exclusively identified; 50.7% missed) and dyslipidaemia (8.7% exclusively identified; 53.3% missed). CONCLUSION Free-text diagnoses were of limited utility for case identification of diabetes mellitus, obesity or dyslipidaemia, suggesting that manual coding of free-text diagnoses may not always be justified. Relying solely on free-text diagnoses for case identification is not recommended, as substantial proportions of cases may remain undetected, leading to biased prevalence estimates.
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Affiliation(s)
- Donika Balaj
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jakob M Burgstaller
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Audrey Wallnöfer
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Grischott
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Markun
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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50
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Li T, Chen L, Xu H, Zheng Y, Yang H, Zhao H, Chen C. The association between cardiovascular diseases and their subcategories with the severity of chronic obstructive pulmonary disease: a large cross-sectional study based on a Chinese hospital population cohort. Front Cardiovasc Med 2025; 12:1502205. [PMID: 40017517 PMCID: PMC11865066 DOI: 10.3389/fcvm.2025.1502205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 01/27/2025] [Indexed: 03/01/2025] Open
Abstract
Background Current evidence suggests that cardiovascular disease (CVD) plays a role in the progression of chronic obstructive pulmonary disease (COPD). However, the relationship between CVD and the severity of COPD remains inadequately understood. Therefore, this study aims to elucidate the association between CVD and the severity of COPD. Methods In this cross-sectional study involving 7,152 individuals with COPD., Logistic regression, subgroup and sensitivity analyses were employed to evaluate the association between CVD, its subcategories, and the severity of COPD. Results Multivariable logistic regression analysis showed that CVD and hypertension remained independently associated with COPD severity (P < 0.001). Patients with CVD had a 1.701 times higher risk of developing severe or very severe COPD compared to those without CVD, while patients with hypertension had a 1.686 times higher risk of developing severe or very severe COPD compared to those without hypertension (P < 0.05). Subgroup analyses showed that the association between CVD and COPD severity remained stable among men, patients ≤ 70 years of age, patients > 70 years of age, BMI < 24 or ≥24 kg/m2, and never smokers, whereas coronary artery disease was significantly associated with COPD severity only among patients ≤ 70 years of age and never smokers (P < 0.05). In addition, hypertension was also stably associated with COPD severity among men, patients ≤ 70 years of age, patients > 70 years of age, BMI < 24 or ≥24 kg/m2, and never smokers. Sensitivity analyses reconfirmed the robustness of the associations of CVD and hypertension with COPD severity among patients who excluded bronchiectasis, tuberculosis, lung cancer, pulmonary hypertension, pulmonary heart disease, and diabetes (P < 0.05). Conclusion The strong association between CVD and its subcategories (mainly hypertension) and the severity of COPD suggests that the potential risk of exacerbation of CVD should also be addressed in the clinical management of patients with COPD. However, limitations of the cross-sectional design may limit the extrapolation of the results, and more large prospective clinical cohort studies are needed in the future to further validate the association.
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Affiliation(s)
- Tianye Li
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lefu Chen
- Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, United States
| | - Hao Xu
- Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Yanhong Zheng
- Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Heying Yang
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongjun Zhao
- Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Chengshui Chen
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
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