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Li X, Zhang Y, Yu C, Guo X, Fu X, Chen S, Gao Y, Zhang Y, Xiang Q, Lu W, Zhang Y, Wang Q, Chen L, Zheng T. Angoroside C: A potent AMPK activator in the aqueous extract of Scrophularia ningpoensis, alleviates metabolic syndrome in db/db mice. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2025; 143:156873. [PMID: 40440908 DOI: 10.1016/j.phymed.2025.156873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2025] [Revised: 04/14/2025] [Accepted: 05/17/2025] [Indexed: 06/16/2025]
Abstract
BACKGROUND Scrophularia ningpoensis Hemsl. (SN) is a traditional herbal medicine used for treating diabetes mellitus (DM). Previous studies indicated that the aqueous extract of SN (AESN) improves type 2 DM (T2DM) by activating AMP-activated protein kinase (AMPK), but the active components were unclear. PURPOSE This study aimed to identify the compound in AESN responsible for AMPK activation and to verify its therapeutic effects on T2DM. METHODS Rats were administered AESN intragastrically. The absorbed compounds in serum samples were analyzed using LC-MS/MS and subjected to molecular docking with AMPK. The compound with the highest docking score was further verified using SPR, CETSA, and TR-FRET to confirm its effects on AMPK activation. Primary mouse hepatocytes were used to examine the effects of angoroside C (ANC) on AMPK activity, Akt/GSK3β signaling, NLRP3 inflammasome activation, and lipid accumulation. An AMPK inhibitor was used to determine whether the effects were AMPK-dependent. In type 2 diabetic db/db mice, various dosages of ANC were administered intragastrically to observe its therapeutic effects. RESULTS Among the 17 absorbed prototype compounds, ANC exhibited the strongest binding ability to AMPK. SPR, CETSA, and TR-FRET assays confirmed that ANC binds to and activates AMPK. In hepatocytes, ANC activated the Akt/GSK3β signaling, suppressed NLRP3 inflammasome activation, and inhibited lipid accumulation in an AMPK-dependent manner. In db/db mice, ANC intervention improved glucose and lipid metabolic disorders, insulin resistance, and histopathological abnormalities in a dose-dependent manner, while activating AMPK and alleviating lipid metabolic disorders and metabolic inflammatory responses. CONCLUSION ANC can treat T2DM by directly binding to and activating AMPK.
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Affiliation(s)
- Xiaohan Li
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yue Zhang
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Chunxiao Yu
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xu Guo
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xiangxiang Fu
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Shiqi Chen
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yanguo Gao
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yu Zhang
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Qin Xiang
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China
| | - Wei Lu
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yonghong Zhang
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Qibin Wang
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li Chen
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Tao Zheng
- Institute of Wudang Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, Hubei, China; Department of Pharmacy, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
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Wen T, Chen W, Wang F, Zhang R, Chen C, Zhang M, Ma T. The roles and functions of ergothioneine in metabolic diseases. J Nutr Biochem 2025; 141:109895. [PMID: 40058711 DOI: 10.1016/j.jnutbio.2025.109895] [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: 10/18/2024] [Revised: 01/25/2025] [Accepted: 03/04/2025] [Indexed: 04/04/2025]
Abstract
The global prevalence of metabolic diseases is on the increase, and it has become a significant threat to the health and lives of individuals. Ergothioneine (EGT) is a natural betaine amino acid found in various foods, particularly mushrooms. EGT cannot be synthesized by mammals; it is absorbed into small intestinal epithelial cells by a cationic protein, the novel organic cation transporter 1 (OCTN1), and transported to certain organs including liver, spleen, kidney, lung, heart, eyes and brain. EGT has been reported to exhibit antioxidant, anti-inflammatory, anti-apoptotic, anti-aging, and metal-chelating effects. The unique chemical properties and biological functions of EGT position it as a promising candidate for the research and treatment of metabolic diseases. This review summarizes EGT's capacities, potential therapeutic effects on multiple metabolic diseases, and their specific mechanisms. Finally, we outline challenges for future research on EGT and aspire to establish it as a prospective therapeutic agent for metabolic diseases.
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Affiliation(s)
- Tingting Wen
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China
| | - Wanjing Chen
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China
| | - Fengjing Wang
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China
| | - Rui Zhang
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China
| | - Cheng Chen
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China.
| | - Mingliang Zhang
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
| | - Teng Ma
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
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Zhang H, Jia Q, Song P, Li Y, Jiang L, Fu X, Li S. Incidence, prevalence, and burden of type 2 diabetes in China: Trend and projection from 1990 to 2050. Chin Med J (Engl) 2025; 138:1447-1455. [PMID: 40375461 DOI: 10.1097/cm9.0000000000003536] [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: 08/11/2024] [Indexed: 05/18/2025] Open
Abstract
BACKGROUND The epidemiological pattern and disease burden of type 2 diabetes have been shifting in China over the past decades. This analysis described the epidemiological transition of type 2 diabetes in the past three decades and projected the trend in the future three decades in China. METHODS Age-, sex-, and year-specific incidence, prevalence, death, and disability-adjusted life years (DALYs) for people with 15 years or older and diabetes or high fasting glucose in China and related countries from 1990 to 2021 were obtained from the Global Burden of Disease. We obtained the trends of age-, sex-, and year-specific rates and absolute numbers of incidence, prevalence, deaths, and DALYs attributable to type 2 diabetes in China from 1990 to 2021. Using the Lee-Carter model, we projected the incidence, prevalence, death, and DALYs attributable to type 2 diabetes to 2050 stratified by age and sex. RESULTS The age-standardized incidence of type 2 diabetes was 341.5 per 100,000 persons (1.6 times in 1990) and the age-standardized prevalence was 9.96% (9960.0 per 100,000 persons, 2.5 times in 1990) in China 2021. In 2021, there were 0.9 million deaths and 26.8 million DALYs due to type 2 diabetes or hyperglycemia, as 2.9 and 2.7 times the data in 1990, respectively. The age-standardized rates of type 2 diabetes and hyperglycemia were projected to raise to 449.5 per 100,000 persons for incidence, 18.17% for prevalence, 244.6 per 100,000 persons for death, and 4720.2 per 100,000 persons for DALYs by 2050. The incidence of type 2 diabetes kept growing among individuals under the age of 20 years in the past three decades (128.7 per 100,000 persons in 1990 and 439.9 per 100,000 persons in 2021) and estimating 1870.8 per 100,000 in 2050. CONCLUSIONS The incidence, prevalence, and disease burden of type 2 diabetes grew rapidly in China in the past three decades. The prevention of type 2 diabetes in young people and the care for elder adults will be the greatest challenge for the country.
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Affiliation(s)
- Haojie Zhang
- Department of Endocrinology and Metabolism, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qingyi Jia
- Institute of Metabolic Diseases and Pharmacotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yongze Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Lihua Jiang
- Teaching & Research Section of General Practice, The General Practice Medical Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xianghui Fu
- Division of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, MAGIC China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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Yao L, Hu Y, Yang JH, Wu R, Chen FL, Zhou X. Wastewater surveillance for chronic disease drugs in wastewater treatment plants: Mass load, removal, and sewage epidemiology. JOURNAL OF HAZARDOUS MATERIALS 2025; 489:137661. [PMID: 39986104 DOI: 10.1016/j.jhazmat.2025.137661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 02/08/2025] [Accepted: 02/17/2025] [Indexed: 02/24/2025]
Abstract
As the number of chronic disease patients continues to climb, vast quantities of chronic disease drugs are continuously discharged into the wastewater treatment plants (WWTPs) and then are released to the receiving environment. However, the situations of pollution, removal, and consumption of chronic disease drugs in China were not studied. Here we investigated the mass load and removal efficiency of 14 chronic disease drugs in seven wastewater treatment plants (WWTPs) of Guangdong Province, China, and estimated the proportional usage of chronic disease drugs and the prevalence of chronic diseases by wastewater-based epidemiology (WBE) method. The results showed that all target chronic disease drugs were detected in the WWTPs, among which gliclazide, valsartan, and bezafibrate were the mainly detected antidiabetic drug, antihypertensive drug, and antihyperlipidemic drug, respectively. The aqueous removal rates of chronic disease drugs ranged from -163 %-100 % in studied WWTPs, and most chronic disease drugs were mainly removed at anaerobic stage in WWTPs that using Anaerobic-Anoxic-Oxic treatment technologies. Mean mass loads of chronic disease drugs in the influent of seven WWTPs ranged at 72-318099 mg·d-1 (valsartan), and mean emission of chronic disease drugs in seven WWTPs ranged at 0-56.3 mg·d-1·1000 inhabitant-1 (valsartan). Based on the WBE method, the prevalence of diabetes, hypertension, and dyslipidemia estimated by gliclazide, glipizide, valsartan, and bezafibrate in this study was consistent with those obtained via cross-sectional survey. The results formulated the contamination characteristics of chronic disease drugs in China and assessed the accuracy of chronic disease drugs used for disease prevalence estimation.
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Affiliation(s)
- Li Yao
- Guangdong Provincial Engineering Research Center for Hazard Identification and Risk Assessment of Solid Waste, Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology, Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center, Guangzhou), Guangzhou 510070, China.
| | - Yang Hu
- Soil and Landscape Science, School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia
| | - Jia-Hui Yang
- Guangdong Provincial Engineering Research Center for Hazard Identification and Risk Assessment of Solid Waste, Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology, Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center, Guangzhou), Guangzhou 510070, China
| | - Rui Wu
- Guangdong Provincial Engineering Research Center for Hazard Identification and Risk Assessment of Solid Waste, Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology, Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center, Guangzhou), Guangzhou 510070, China
| | - Fei-Long Chen
- Guangdong Provincial Engineering Research Center for Hazard Identification and Risk Assessment of Solid Waste, Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology, Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center, Guangzhou), Guangzhou 510070, China
| | - Xi Zhou
- Guangdong Provincial Engineering Research Center for Hazard Identification and Risk Assessment of Solid Waste, Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology, Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center, Guangzhou), Guangzhou 510070, China.
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Gao H, Han Y, Deng D, Liu L. The intervention effect of comprehensive precision nursing in elderly patients with type 2 diabetes. Australas J Ageing 2025; 44:e70047. [PMID: 40369867 PMCID: PMC12079006 DOI: 10.1111/ajag.70047] [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: 03/17/2025] [Revised: 04/15/2025] [Accepted: 04/27/2025] [Indexed: 05/16/2025]
Abstract
OBJECTIVE This study evaluated the impact of precision nursing on blood sugar levels, psychological health and quality of life in ageing type 2 diabetes patients. METHODS A prospective cohort study involving 100 older patients was carried out at a tertiary hospital located in Sichuan Province, China. The patients were categorised into two groups: a control group that received standard nursing care and an observation group that received tailored nursing interventions. RESULTS The outcomes for the observation group were considerably more favourable, featuring decreased levels of fasting blood glucose (FPG), 2-h postprandial blood glucose (2hPG) and glycosylated haemoglobin (HbA1c). Additionally, this group reported lower levels of anxiety and depression, along with a better quality of life relative to the control group. Furthermore, the occurrence of hypoglycaemia was notably less in the observation group. CONCLUSIONS Precision nursing significantly improves glucose management, mental health and overall quality of life, while also lowering the risk of hypoglycaemia in older patients with type 2 diabetes. This research highlighted the efficacy of precision nursing in the care of ageing adults, promoting its integration as a common approach for managing chronic illnesses.
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Affiliation(s)
- Hongmei Gao
- Pengzhou People's HospitalChengduSichuanChina
| | - Yan Han
- Affiliated Hospital of Chengdu UniversityChengduSichuanChina
| | - Dan Deng
- Pengzhou People's HospitalChengduSichuanChina
| | - Liqiong Liu
- Pengzhou People's HospitalChengduSichuanChina
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An K, Zhang J, Wang X, Qiao R, An Z. The burden of type 2 diabetes in China from 1990 to 2021: A comparative analysis with G20 countries using the global burden of disease study 2021. Diabetes Res Clin Pract 2025; 224:112188. [PMID: 40250808 DOI: 10.1016/j.diabres.2025.112188] [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: 01/28/2025] [Revised: 04/09/2025] [Accepted: 04/16/2025] [Indexed: 04/20/2025]
Abstract
OBJECTIVES The study aims to evaluate the burden of Type 2 Diabetes (T2D) in China from 1990 to 2021, and compare to it across G20 countries. METHODS We utilized data from the Global Burden of Disease Study 2021 to examine the burden of T2D in China from 1990 to 2021. Prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) were calculated. Comparative analyses were conducted with other G20 countries. RESULTS T2D prevalence in China increased between 1990 and 2021, with rates rising from 3519.8 (3138.3-3910.1) to 6055.5 (5510.1-6614.3) per 100,000. The death rates slightly decreased from 9.3 (8.2-10.5) per 100,000 to 8.7 (7.3-10.3). The DALYs rate increased from 438.7 (358.5-531.5) to 569.8 (435.4-734.2), with increases observed in YLDs and YLLs. Males had a heavier disease burden in China. Compared to G20 countries, China ranked high in prevalence but had relatively better mortality outcomes in older age groups. CONCLUSION This study reveals the enormous burden and remarkable control efforts of T2D in China. Comparative analysis emphasizes the importance of tailored public health interventions to address this growing health crisis.
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Affiliation(s)
- Kang An
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinyi Zhang
- Chengdu Second People's Hospital, Chengdu, Sichuan, China; School of Computing, Ulster University, Belfast, UK
| | - Xingyou Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Runjuan Qiao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmei An
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Xu X, Li L, Chen F, Guo Z. Association between long-term changes in obesity-related anthropometric indicators and the risk of type 2 diabetes mellitus in the older population. J Int Med Res 2025; 53:3000605251348229. [PMID: 40501355 PMCID: PMC12163288 DOI: 10.1177/03000605251348229] [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: 02/04/2025] [Accepted: 05/21/2025] [Indexed: 06/16/2025] Open
Abstract
ObjectiveTo investigate the association of long-term changes in body mass index, waist circumference, and waist-to-height ratio with the risk of type 2 diabetes mellitus in the older population.MethodsWe conducted a prospective cohort study in Jiangsu Province, China. Data from 593 participants who were aged ≥60 years were analyzed. The hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model.ResultsOver a median follow-up period of 5.08 years, 70 participants (11.80%) developed type 2 diabetes mellitus. Compared with participants with persistently normal body mass index, waist circumference, and waist-to-height ratio, those in whom these parameters changed from normal to abnormal and those in whom these parameters were persistently abnormal had a significantly higher risk of type 2 diabetes mellitus, with adjusted hazard ratios of 2.11 (95% confidence interval: 1.05-4.26) and 2.37 (95% confidence interval: 1.21-4.63) for body mass index, 2.75 (95% confidence interval: 1.16-6.51) and 2.32 (95% confidence interval: 1.29-4.16) for waist circumference, and 2.24 (95% confidence interval: 1.14-5.91) and 4.11 (95% confidence interval: 2.21-7.68) for waist-to-height ratio, respectively.ConclusionLong-term changes in obesity-related anthropometric indicators are strongly associated with the risk of type 2 diabetes mellitus in the older population.
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Affiliation(s)
- Xiaomin Xu
- Department of Clinical Medicine, Suzhou Vocational Health College, China
| | - Lirong Li
- Department of Clinical Medicine, Suzhou Vocational Health College, China
| | - Fengmei Chen
- Department of Public Health, Suzhou Vocational Health College, China
| | - Zhirong Guo
- Department of Epidemiology, School of Public Health, Soochow University, China
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Xin Y, Sun H, Peng S, Yin X, Ge A, Liu X, Wang T, Sun J, Wu Y, Law K, Trieu K, Wu JHY, Qiao H, Tian M. Barriers and Facilitators to Implementing Food is Medicine for the Management of Type 2 Diabetes in China. J Gen Intern Med 2025; 40:1701-1710. [PMID: 39663338 PMCID: PMC12119429 DOI: 10.1007/s11606-024-09251-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 11/26/2024] [Indexed: 12/13/2024]
Abstract
BACKGROUND 'Food is Medicine', a rapidly growing innovative intervention, has been shown to improve the management of type 2 diabetes mellitus (T2DM). However, due to the unique characteristics of Chinese dietary culture, it remains unclear whether such intervention measures can be implemented in China. OBJECTIVE To identify the potential barriers and facilitators to implementing 'Food is Medicine' intervention for the management of people living with T2DM in three Chinese provinces. DESIGN Face-to-face semi-structured individual in-depth interview and focus group discussions in Heilongjiang, Hubei and Ningxia provinces in China. PARTICIPANT People living with T2DM. APPROACH Both inductive and deductive methods were used to analyse the interview data, guided by the COM-B framework. KEY RESULTS A total of 97 individuals participated in the study. Participants were concerned about the prices of buying prescribed meals, if not fully subsidised by healthcare system. Other barriers included the potential challenge to adhering to prescribed meals for long periods if the variety was limited, the difficulties in delivering fresh food or meals to remote areas and the lack of knowledge of healthy diets among the people living with T2DM and their relatives. In contrast, clinicians' confidence in the effectiveness of food and meal prescription, the opportunities to collaborate with community canteens on producing prescribed foods, and the convenience of preparing food for people with T2DM were identified as the main enablers. CONCLUSIONS There are presently several potential barriers to future implementing 'Food is Medicine' to manage people living with T2DM. But there are also clear opportunities to develop a context-tailored 'Food is Medicine' intervention in China.
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Affiliation(s)
- Yuze Xin
- School of Public Health, Harbin Medical University, Harbin, China
| | - Hongru Sun
- School of Public Health, Harbin Medical University, Harbin, China
| | - Shuangjie Peng
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xuejun Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Anqi Ge
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xinyan Liu
- School of Public Health, Harbin Medical University, Harbin, China
| | - Tengyi Wang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Jingxue Sun
- Department of Endocrinology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yanmeizhi Wu
- Department of Endocrinology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kristy Law
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Kathy Trieu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- School of Population Health, The University of New South Wales, Sydney, Australia
| | - Hong Qiao
- Department of Endocrinology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Maoyi Tian
- School of Public Health, Harbin Medical University, Harbin, China.
- Division of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Zhang W, Sun C, Huang Y, Zhang M, Xu A, Wang C, Lv F, Pan T. Inflammation levels in type 2 diabetes mellitus patients with mild cognitive impairment: Assessment followed by amelioration via dapagliflozin therapy. J Diabetes Complications 2025; 39:109017. [PMID: 40228375 DOI: 10.1016/j.jdiacomp.2025.109017] [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: 03/03/2025] [Revised: 03/21/2025] [Accepted: 03/22/2025] [Indexed: 04/16/2025]
Abstract
AIMS To investigate systemic inflammation and the effect of dapagliflozin treatment in (type 2 diabetes mellitus) T2DM patients with mild cognitive impairment (MCI). METHODS Between January and December 2023, 200 participants were recruited from the Department of Endocrinology of Hefei First People's Hospital. Baseline data collected included medical history, fasting blood glucose, HbA1c, liver and kidney function, lipid profiles, IL-1β, TNF-α, sVCAM-1 level, and the urinary albumin-creatinine ratio (uACR). Based on their Montreal Cognitive Assessment Scale (MoCA) scores, these participants were categorized into two groups: 127 in the MCI group and 73 in the non-MCI group. MCI group received dapagliflozin (10 mg daily) alongside standard treatment. RESULTS The MCI group showed higher age, height, weight, BMI, HbA1c, FBG, disease duration, carotid plaques, stenosis rates, and elevated IL-1β, TNF-α, and sVCAM-1. MoCA scores were significantly lower in the MCI group. Correlation analysis showed a negative correlation of MoCA scores with IL-1β, TNF-α, sVCAM-1, plaques, stenosis, FBG, and HbA1c, and a positive correlation with height. Binary logistic regression identified age, BMI, IL-1β, sVCAM-1, and FBG as predictors of cognitive impairment in T2DM. Dapagliflozin treatment reduced BMI, HbA1c, inflammatory markers, and FBG, improving MoCA scores. CONCLUSION Dapagliflozin treatment may improve cognitive function by reducing inflammation.
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Affiliation(s)
- Wei Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China; Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Chunping Sun
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Yating Huang
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Meng Zhang
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Ao Xu
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Chen Wang
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China
| | - Fang Lv
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (Hefei First People's Hospital), Hefei 230061, China.
| | - Tianrong Pan
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
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Zhang R, Yao D, Cai X, Zhang Y, Yang Y, Li S, Jing J, Wang S, Wang Y, Pan Y, Wang Y. Prevalence and risk factors of covert brain infarction: A community-based cross-sectional study. Int J Stroke 2025; 20:611-622. [PMID: 39743676 DOI: 10.1177/17474930241313435] [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: 01/04/2025]
Abstract
BACKGROUND Covert brain infarction (CBI) is common and poses a potential and non-negligible burden of disease worldwide. The prevalence and risk factors for CBI have been reported inconsistently in previous studies. AIMS This study aims to ascertain the prevalence and risk factors of CBI and its imaging phenotypes in community-dwelling adults. METHODS The study population was derived from the baseline survey of a population-based cohort from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events study, involving adults aged 50-75 years from Lishui City, Southeast China. The 3.0T magnetic resonance imaging (MRI) was performed to access CBI and detect intracranial and extracranial vascular lesions. The prevalence rates of CBI and three imaging phenotypes were stratified separately by age, sex, atherosclerotic burden, and artery stenosis. The intracranial and extracranial atherosclerotic burden was graded by summing atherosclerosis scores. Multivariable logistic regression with a stepwise selection method was used to identify independent CBI risk factors. RESULTS A total of 2947 participants (mean age of 61.1 ± 6.6 years, 53.8% women) were included. CBI prevalence among study subjects was 9.6%, and the most common subtype was other chronic infarction (5.6%), followed by cavitatory lesions (4.6%) and acute cerebral infarction (0.5%). In multivariable analysis, older age (odds ratio (OR): 1.59, 95% confidence interval (CI): 1.40-1.83), hypertension (OR: 1.45, 95% CI: 1.08-1.94), higher levels of low-density lipoprotein cholesterol (LDL-C) (OR: 1.17, 95% CI: 1.04-1.32), homocysteine (OR: 1.12, 95% CI: 1.01-1.23) and diastolic blood pressure (DBP) (OR: 1.22, 95% CI: 1.06-1.41), intracranial artery plaque (OR: 1.56, 95% CI: 1.16-2.10), and severe extracranial atherosclerotic burden (OR: 6.57, 95% CI: 1.67-25.79) were associated with a higher CBI odds. There is a linear relationship between age, DBP, LDL-C, and CBI odds, while homocysteine shows a nonlinear relevancy. Age, DBP, homocysteine, and LDL-C elevation increase CBI risk. CONCLUSION CBI prevalence in this Chinese community-based population was not low. Age, hypertension, intracranial artery plaque, extracranial atherosclerotic burden, homocysteine, LDL-C, and DBP were found to be the risk factors of CBI.
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Affiliation(s)
- Ruinan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Dongxiao Yao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Institute of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Xueli Cai
- Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Yanli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yingying Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shan Li
- Cerebrovascular Research Lab, Lishui Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Jing Jing
- 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, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, 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
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
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Sun Z, Sun M, Wei W, Peng W, Wang Y. China launches National Obesity Campaign. Lancet Diabetes Endocrinol 2025; 13:465-466. [PMID: 40404276 DOI: 10.1016/s2213-8587(25)00131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Accepted: 04/28/2025] [Indexed: 05/24/2025]
Affiliation(s)
- Zhaozhang Sun
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK; Centre for National Training and Research Excellence in Understanding Behaviour, University of Birmingham, Birmingham, UK
| | - Mengzi Sun
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Wei Wei
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Institute of Health Sciences, China Medical University, Shenyang, China; Department of Pediatric Surgery, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Youfa Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Public Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Liu H, Chen Y, Huang B, Lam SHM, Romiti GF, Liu Y, Olshansky B, Huisman M, Hong K, Chao TF, Lip GYH. Long-term clinical outcomes of oral anticoagulation in the older patients with atrial fibrillation aged ≥80 years: a report from the GLORIA-AF registry phase III. Age Ageing 2025; 54:afaf139. [PMID: 40462483 PMCID: PMC12133677 DOI: 10.1093/ageing/afaf139] [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] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Older age increases the risk of thromboembolism (TE) and major bleeding in atrial fibrillation (AF) patients, but limited evidence exists regarding the older population (age ≥ 80) especially from different global regions. Data on benefits of oral anticoagulants in these very old individuals are also limited. METHODS From the prospective, multicenter Global Registry on Long-Term Antithrombotic Treatment in Patients with Atrial Fibrillation registry, we analysed by age all-cause death, cardiovascular death, major adverse cardiovascular events (MACE), TE, major bleeding, stroke, and myocardial infarction (MI) over 3-years follow-up. RESULTS Of 7652 patients aged ≥75 years (age 80.1 ± 3.9 years, 47.1% male), 4006 were ≥ 80 years (age 83.4 ± 3.9 years, 43.5% male). After multivariable adjustment, older patients had a higher risk of all-cause death (HR:1.94, 95% CI: 1.67-2.27), cardiovascular death (HR: 2.17, 95% CI: 1.71-2.74), MACE (HR: 1.57, 95% CI: 1.32-1.86), TE (HR: 1.45, 95% CI: 1.14-1.83), major bleeding (HR: 1.30, 95% CI: 1.04-1.63), stroke (HR: 1.38, 95% CI: 1.06-1.80) and MI (HR: 1.59, 95% CI:1.14-2.22). Compared with VKA, NOAC use in patients ≥80 years was associated with lower risks of all-cause death (HR: 0.79, 95% CI: 0.65-0.97), cardiovascular death (HR: 0.70, 95% CI: 0.51-0.96), MACE (HR: 0.72, 95% CI: 0.56-0.92), and major bleeding (HR: 0.66, 95% CI: 0.48-0.92). NOACs were more beneficial than warfarin for mortality, MACE and major bleeding in frail patients. The risk of clinical events associated with older patients was primarily seen in Europe and Asia (p-interaction > 0.05), but the effectiveness and safety of NOACs vs. warfarin was consistent across regions. CONCLUSIONS Older age was independently associated with higher risk of death, major bleeding, TE and MACE. Compared with VKA, NOACs show improved effectiveness and safety in the older and patients with frailty, with similar efficacy across regions and ethnic groups.
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Affiliation(s)
- Hongyu Liu
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
- Department of Genetic Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, NO.1, MINDE ROAD, Nanchang, Jiangxi 330006, China
| | - Yang Chen
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
| | - Bi Huang
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Steven Ho Man Lam
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Lazio, Italy
| | - Yang Liu
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Molecular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University. Nanchang, Jiangxi, China
| | - Brian Olshansky
- Division of Cardiology, The University of Iowa, Iowa City, IO, USA
| | - Menno Huisman
- Department of Medicine – Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Kui Hong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Molecular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University. Nanchang, Jiangxi, China
- Department of Medical Genetics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Tze-Fan Chao
- Cardiology Department, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan Province, Taiwan
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK
- Department of Clinical Medicine, Aalborg University—Danish Center for Health Services Research, Aalborg, Denmark
- Medical University of Bialystok, Bialystok, Poland
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Li H, Moungkum S, Jullamate P. Factors influencing health-related quality of life among people with uncontrolled type II diabetes mellitus in Wenzhou, China: A cross-sectional study. BELITUNG NURSING JOURNAL 2025; 11:321-329. [PMID: 40438656 PMCID: PMC12107268 DOI: 10.33546/bnj.3785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/19/2025] [Accepted: 04/18/2025] [Indexed: 06/01/2025] Open
Abstract
Background China has a high prevalence of Type 2 Diabetes Mellitus (T2DM), and more than half of the population has uncontrolled blood sugar levels. As a result, this leads to a reduction in health-related quality of life (HRQOL). Therefore, identifying the factors that influence HRQOL in individuals with uncontrolled T2DM is a clinical priority. Objectives This study aimed to describe the level of HRQOL among people with uncontrolled T2DM in Wenzhou, China, and to examine the predictive factors, including social support, diabetes distress, self-efficacy, and health literacy, in relation to HRQOL among these individuals. Methods This predictive correlational study used a simple random sampling technique to recruit 107 adults with uncontrolled T2DM from the Endocrinology outpatient department at the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, China, between August and September 2024. Data were collected through questionnaires and standardized tools to assess the correlation between HRQOL, social support, health literacy, self-efficacy, and diabetes distress. Data were analyzed using descriptive statistics and multiple regression analysis. Results The HRQOL in this study was moderate (Mean = 3.34, SD = 0.31). Significant factors associated with HRQOL were health literacy (r = 0.819, p <0.01), self-efficacy (r = 0.825, p <0.01), and social support (r = 0.477, p <0.01). All predictor variables in the regression model collectively explained 79.8% of the variance in HRQOL among individuals with uncontrolled T2DM. Furthermore, health literacy (β = 0.426, p <0.001), self-efficacy (β = 0.463, p <0.001), and social support (β = 0.130, p = 0.009) were significant predictors of HRQOL. Conclusion Enhancing health literacy, self-efficacy, and social support is crucial for improving HRQOL. Healthcare professionals and nurses should develop and implement intervention programs that help individuals and families enhance their critical thinking abilities and adopt lifestyles that support disease management and improve HRQOL.
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Affiliation(s)
- Huiwei Li
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Zhang Y, Yang S, Wang S, Zou X, Tang L, Chen L, Ma J, Li Y, Yao T, Zhang X, Tang R, Tang L, Zhang F, Zhou H, Xu L, Tang Q, Ma S, Yi Y, Liu R, Bai G, Zeng Y, Zhou Y, Zhao Y, Wang Y, Yang Q, Wang D, Shen M, Zhang L. Prevalence and 10-Year Risk of Intracerebral Hemorrhage in Central China Using Estimates From the 1 Million Cross-Sectional Study. Neurology 2025; 104:e213545. [PMID: 40258204 DOI: 10.1212/wnl.0000000000213545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 02/11/2025] [Indexed: 04/23/2025] Open
Abstract
BACKGROUND AND OBJECTIVES Intracerebral hemorrhage (ICH) is a common and fatal type of stroke, especially in central China. However, recent epidemiologic data are scarce. The study aimed to investigate the latest prevalence of ICH in central China and assess the risk of ICH in the next 10 years based on the Resident Health Records (RHR) data. METHODS First, this cross-sectional study was based on a large-scale face-to-face investigation of ICH, which was launched on residents aged 20 years or older from January 1, 2021, to December 31, 2021, and estimated the prevalence of ICH in Hunan, a representative province in central China. Then, based on the RHR database, we assessed the ICH risk, population attributable fraction (PAF), and effects of ICH prevention under different risk factor control scenarios over the next decade by the China Kadoorie Biobank (CKB)-cardiovascular disease (CVD) model. RESULTS In 2021, 1.78 million participants enrolled in the investigation (mean age = 50.1 years; 51% male). The age-standardized prevalence rate of ICH was 159.2 (95% CI 153.7-164.9) per 100,000. The prevalence rate of ICH in men was 193.6 (95% CI 185.2-202.5) per 100,000, while in women was 124.0 (95% CI 117.1-131.3) per 100,000, and it increased with age. Spatial aggregation was observed, with the peak prevalence rate of ICH at 327.3 (95% CI 293.1-365.5) per 100,000 in Zhuzhou, followed by Changsha was 215.8 (95% CI 190.6-243.9) per 100,000, while Shaoyang had the lowest rate was 62.8 (95% CI 51.2-77.1) per 100,000. For the assessment of 10-year ICH risk, we included a total of 8.36 million participants aged 30-79 with the RHR database into the CKB-CVD model. We found that there will be 354,146 cases (ICH risk: 4.2%) of ICH among the participants in the next decade. Controlling hypertension showed the highest potential for ICH prevention, with a PAF of 8.6%. By controlling hypertension, smoking, waist circumference, and diabetes, 56,673 ICH cases (PAF 19.1%) can be avoided in the next decade. DISCUSSION The ICH prevalence in central China remained high. Strict blood pressure control could significantly reduce the risk of ICH in the next 10 years. It is important to continually improve ICH prevention strategies in the general population.
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Affiliation(s)
- Yupeng Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Songchun Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Sai Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Xuelun Zou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Lei Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Junyi Ma
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Ye Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Tianxing Yao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Xiangbin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Rongmei Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Lei Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Feng Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Huifang Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Lianxu Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Qiaoling Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Siyuan Ma
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Yexiang Yi
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Ran Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
| | - Genghuai Bai
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanhong Zhou
- Cancer Research Institute, Basic School of Medicine, Central South University, Changsha, Hunan, China
| | - Ying Zhao
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yang Wang
- Institute of Integrative Chinese Medicine, Department of Integrated Chinese Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qidong Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Brain Health Center of Hunan Province, Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, Hunan, China
- Human Brain Disease Biological Resources Platform of Hunan Province, Changsha, China; and
- FuRong Laboratory, Changsha, Hunan, China
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15
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Kuo L, Tan Y, Wu Y, Qin X, Gong H, Zhao Y, Wu T, Chen D, Wang M, Wang J, Hu Y. Diet-Gene Interaction Between Fruit Intake and CMIP rs2925979 Polymorphism in Relation to Type 2 Diabetes: A Family-Based Study in Northern China. Nutrients 2025; 17:1789. [PMID: 40507058 PMCID: PMC12156986 DOI: 10.3390/nu17111789] [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: 04/25/2025] [Revised: 05/21/2025] [Accepted: 05/22/2025] [Indexed: 06/16/2025] Open
Abstract
Background/Objectives: This study aimed to investigate the association between dietary intake and the risk of type 2 diabetes mellitus (T2DM) in a rural northern Chinese population, and to explore potential gene-diet interactions that may influence T2DM susceptibility. Methods: A total of 1747 participants (1138 with T2DM and 609 without) were included, using baseline data from a family-based cohort study in rural northern China. Demographic characteristics, lifestyle factors, and medical history were collected via standardized questionnaires. Dietary intake was assessed using a semi-quantitative food frequency questionnaire, and anthropometric measurements were conducted according to standardized protocols. Based on findings from previous genome-wide association studies, several T2DM-related single-nucleotide polymorphisms were selected for genotyping. Generalized linear models accounting for familial clustering were employed to examine the associations between dietary intake and T2DM risk, and to assess gene-diet interaction. Results: A significant inverse association was observed between fruit intake and T2DM risk. Furthermore, a significant interaction was found between fruit consumption and the CMIP rs2925979 polymorphism: the protective effect of higher fruit intake was evident among individuals carrying the T allele but not among those with the CC genotype. Conclusions: These findings suggest that genetic variation may modify metabolic responses to dietary factors, particularly fruit intake. The results underscore the importance of considering gene-diet interactions in the prevention of T2DM.
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Affiliation(s)
- Liangchun Kuo
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (L.K.); (Y.T.)
| | - Yinxi Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (L.K.); (Y.T.)
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (Y.W.); (X.Q.); (T.W.); (D.C.); (Y.H.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (Y.W.); (X.Q.); (T.W.); (D.C.); (Y.H.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Haiying Gong
- Beijing Fangshan District Centre for Disease Control and Prevention, Beijing 102446, China; (H.G.); (Y.Z.)
| | - Yao Zhao
- Beijing Fangshan District Centre for Disease Control and Prevention, Beijing 102446, China; (H.G.); (Y.Z.)
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (Y.W.); (X.Q.); (T.W.); (D.C.); (Y.H.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (Y.W.); (X.Q.); (T.W.); (D.C.); (Y.H.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Mengying Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (L.K.); (Y.T.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Junbo Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (L.K.); (Y.T.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (Y.W.); (X.Q.); (T.W.); (D.C.); (Y.H.)
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
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Liu Y, Cai Y, Wei X, Gao K, Jin G, Zhou X, Zhao Z. Molecular Mechanisms of Potentilla Discolor Bunge in Regulating Ferroptosis to Alleviate DKD via the Nrf2 Signaling Pathway. JOURNAL OF ETHNOPHARMACOLOGY 2025:120035. [PMID: 40414576 DOI: 10.1016/j.jep.2025.120035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 05/15/2025] [Accepted: 05/23/2025] [Indexed: 05/27/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Potentilla Discolor Bunge (PDB), a plant belonging to the Rosaceae family, is often used in traditional folk medicine to treat diabetes and prevent related complications. Additionally, fresh and tender PDB stems could be consumed as a vegetable or used to make tea. AIM OF THE STUDY To explore the potential targets and mechanisms of PDB in treating Diabetic Kidney Disease (DKD) through network pharmacology, and to investigate its role in modulating the Nrf2 signaling pathway to inhibit ferroptosis using in vivo and in vitro experiments, thereby presenting a potential therapeutic avenue for DKD. MATERIALS AND METHODS Targets of PDB compounds were screened using the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, while PDB action targets were screened using the DrugBank, OMIM, GeneCards, DisGeNET, and TTD databases. The intersecting targets were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Meanwhile, the binding modes of PDB core monomers to key targets were analysed using Molecular Docking (MD) and Surface Plasmon Resonance (SPR) experiments. Experimental validation was conducted using a High-Fat/Sucrose Diet (HFD) combined with Streptozotocin (STZ)-induced DKD rat model and an Advanced Glycation End Products (AGEs)-damaged human renal proximal tubular cell (HK-2) model. RESULTS As predicted through network pharmacology, PDB exerted therapeutic effects against DKD through multiple pathways, including AGE/RAGE, Nrf2 signaling, Oxidative Stress, and apoptosis. Furthermore, PDB's primary active constituents were Quercetin, Kaempferol, and β-sitosterol, with MD analyses suggesting strong binding affinities to the Nrf2 and Ho-1 proteins. In vivo experiments further revealed that PDB treatment reduced the 24 h urinary protein, Serum Creatinine (SCr), and urea levels. It also downregulated Malondialdehyde (MDA), Fe2+, and Reactive Oxygen Species (ROS) accumulation in renal tissues. Additionally, PDB alleviated the histopathological damage in DKD-afflicted rats and significantly upregulated Nrf2, Ho-1, Gpx4, and Slc7a11 in renal tissues. Moreover, Quercetin, Kaempferol, and β-sitosterol significantly upregulated Nrf2, Ho-1, and Gpx4, increased intracellular Glutathione (GSH) levels, reduced ROS and MDA content, and mitigated mitochondrial damage in the AGEs-exposed HK-2 cell injury model. CONCLUSION We predicted the mechanism of action of natural botanical PDB against DKD through network pharmacology, revealing that it significantly upregulated the Nrf2 signaling pathway and inhibited ferroptosis initiation, thus decelerating DKD progression. These findings were further validated through in vivo and in vitro experiments.
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Affiliation(s)
- Yunhua Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yanmo Cai
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoyu Wei
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Kun Gao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ge Jin
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Zhou
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zongjiang Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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He R, Shen Z, Chen Q, Hu H, Ding X, Zheng Z, Feng Q, Li B. Pancreatic cancer mortality in China from 2004 to 2021: an in-depth analysis of age, gender, and regional disparities. BMC Cancer 2025; 25:891. [PMID: 40389880 PMCID: PMC12087137 DOI: 10.1186/s12885-025-13863-0] [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: 10/01/2024] [Accepted: 03/04/2025] [Indexed: 05/21/2025] Open
Abstract
OBJECTIVE This study aimed to analyze the trends and epidemiological characteristics of pancreatic cancer (PC) mortality in China from 2004 to 2021, focusing on gender, age, and regional disparities. The goal was to provide a comprehensive understanding of PC mortality and identify key risk factors to support future prevention and control strategies. METHODS Using data from the national Disease Surveillance Point (DSP) system, which covers a large and representative sample of the Chinese population, the study examined pancreatic cancer mortality trends across different age groups, sexes, and regions. Statistical analyses, including the independent-sample t-test and age-period-cohort (APC) model, were employed to assess mortality differences and annual percentage changes from 2004 to 2021. RESULTS The study recorded a significant increase in pancreatic cancer mortality, particularly among males and older adults. Mortality was consistently higher in urban areas, but the growth rate in rural areas surpassed that of urban areas. Regional disparities were also observed, with the eastern region showing the highest mortality rates but slower increases compared to the central and western regions. Key risk factors, including aging, diabetes, smoking, and chronic pancreatitis, were identified, with gender-specific differences linked to lifestyle factors such as smoking and alcohol consumption. CONCLUSION Pancreatic cancer mortality in China has shown significant increases over the past 18 years, especially among males, older adults, and rural populations. The findings highlight the urgent need for targeted public health interventions to address gender- and age-specific risks, as well as healthcare access inequalities in less developed regions. Future research should focus on gathering more granular, individual-level data to better understand the complex interplay of risk factors and inform more effective prevention and treatment strategies.
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Affiliation(s)
- Rui He
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhengnan Shen
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qiuping Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Haiyang Hu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xin Ding
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhenglong Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Quansheng Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Baixue Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
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Li C, Liu L. Correlation Between ENPP1 Gene rs1044498 Polymorphism with the Risk of Type 2 Diabetes Mellitus: A Meta-analysis. TOHOKU J EXP MED 2025; 266:19-28. [PMID: 38960641 DOI: 10.1620/tjem.2024.j057] [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: 07/05/2024]
Abstract
As a common metabolic disease, type 2 diabetes mellitus (T2DM) is regulated by the ectoenzyme nucleotide pyrophosphatase phosphodiesterase 1 (ENPP1). A functional polymorphism of ENPP1 (rs1044498, K121Q) has been found to contribute to T2DM susceptibility. This study aims to analyze the combined association of ENPP1 rs1044498 polymorphism with T2DM risk. We searched for publications in Embase, Medline, EBSCO, PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang databases from January 2010 to December 2023. Pooled association strength was analyzed using either a random-effects or fixed-effects model, and expressed as combined odds ratios (ORs) with 95% confidence intervals (CIs). Data analysis was performed by STAT 12.0. Due to high heterogeneity, a random-effects model was used for the calculation. In the total population, ENPP1 rs1044498 was evidently related to an increased susceptibility to T2DM under the following models: Q vs. K (OR = 1.405, 95% CI = 1.059-1.863), KQ + QQ vs. KK (OR = 1.475, 95% CI = 1.075-2.023), QQ vs. KK + KQ (OR = 2.355, 95% CI = 1.302-4.262), QQ vs. KK (OR = 3.096, 95% CI = 1.393-6.882) and KQ vs. KK (OR = 1.399, 95% CI = 1.038-1.885). In ethnic subgroups, rs1044498 was associated with T2DM risk in Asians under the following models: Q vs. K (OR = 1.480, 95% CI = 1.017-2.154), KQ + QQ vs. KK (OR = 1.578, 95% CI = 1.047-2.379), QQ vs. KK+ KQ (OR = 3.709, 95% CI = 1.727-7.967), QQ vs. KK (OR = 5.049, 95% CI = 1.784-16.397) and KQ vs. KK (OR = 1.478, 95% CI = 1.008-2.167). The distinct association between rs1044498 and T2DM risk was discovered in the diagnostic criteria not shown subgroup and plasma subgroup. This study demonstrated high sensitivity with minimal publication bias. The ENPP1 121Q allele is a risk factor for T2DM, particularly in the Asian population.
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Affiliation(s)
- Chunlin Li
- Public Health and International Development, Geography Department, University of Sheffield
| | - Li Liu
- Department of General Practice, Affiliated Hospital of Panzhihua University
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Zhou X, Zhang Y, Li Z. Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study. Front Endocrinol (Lausanne) 2025; 16:1552484. [PMID: 40444230 PMCID: PMC12119272 DOI: 10.3389/fendo.2025.1552484] [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: 12/28/2024] [Accepted: 04/22/2025] [Indexed: 06/02/2025] Open
Abstract
Objective Thyroid hormones (THs) play a pivotal role in regulating metabolism, and their sensitivity may influence the risk of metabolic syndrome (MetS). This study aimed to investigate the association of impaired sensitivity to THs with MetS and MetS severity score (MetSSS) in Chinese euthyroid adults. Methods A cross-sectional analysis was conducted involving 17,272 health check-up participants. THs sensitivity indices, including Thyroid Feedback Quantile-Based Index (TFQI), Parametric Thyroid Feedback Quantile-Based Index (PTFQI), TSH Index (TSHI), Thyrotropin Thyroxine Resistance Index (TT4RI), and free triiodothyronine/free thyroxine (FT3/FT4) ratio were assessed. Multivariable regression and restricted spline cubic analyses were conducted to explore the association between THs sensitivity indices and MetS and MetSSS. Subgroup analysis was also performed to examine this association stratified by sex and age. Results Multivariable logistic regression analysis indicated that MetS risk was positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.20, 95%CI: 1.15-1.25); PTFQI: OR=1.28, 95%CI: 1.23-1.33; TSHI: OR=1.35, 95%CI: 1.29-1.42; TT4RI: OR=1.57, 95%CI: 1.47-1.67; FT3/FT4: OR=1.17, 95%CI: 1.12-1.23)(all P-value<0.001). After adjusting for confounders, compared with the lowest group of MetSSS, individuals in the highest group of MetSSS were positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.16, 95%CI: 1.07-1.21 PTFQI: OR=1.12, 95%CI: 1.06-1.17; TSHI: OR=1.13, 95%CI: 1.06-1.19; TT4RI: OR=1.25, 95%CI: 1.15-1.35; FT3/FT4: OR=1.82, 95%CI: 1.72-1.93). Nonlinear associations were found between THs sensitivity indicators and MetS (P for non-linear<0.001). Subgroup analysis indicated that all thyroid hormones sensitivity indices were positively associated with MetS by gender (male/female) and age (<60 years/≥60 years). Conclusion Impaired sensitivity to THs is associated with an increased risk of MetS and MetSSS in Chinese euthyroid adults. Future research should consider thyroid hormones sensitivity indices in the assessment of MetS risk.
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Affiliation(s)
| | - Ye Zhang
- Department of Minimally Invasive Laparoscopy, The Affiliated Wuxi People’s
Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Zengyao Li
- Department of Minimally Invasive Laparoscopy, The Affiliated Wuxi People’s
Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
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Zhang Z, Xie Y, Bu Z, Xiang Y, Sheng W, Cao Y, Lian L, Zhang L, Qian W, Ji G. Genetically proxied glucokinase activation and risk of diabetic complications: Insights from phenome-wide and multi-omics mendelian randomization. Diabetes Res Clin Pract 2025; 225:112246. [PMID: 40374125 DOI: 10.1016/j.diabres.2025.112246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 03/31/2025] [Accepted: 05/12/2025] [Indexed: 05/17/2025]
Abstract
AIMS This study aims to assess the benefits and adverse effects of long-term glucokinase (GK) activation from a genetic perspective. METHODS We identified genetic variants in the GCK gene associated with glycated hemoglobin (HbA1c) levels from a genome-wide association study (GWAS) involving 146,806 individuals, which served as proxies for glucokinase activation. To assess the effects and potential pathways of GK activation on a range of diabetic complications and safety outcomes, we integrated drug-target Mendelian randomization (MR), lipidome-wide and proteome-wide MR, phenome-wide MR, and colocalization analyses. RESULTS Genetically proxied GK activation was associated with reduced risks of several predefined diabetic complications, including cardiovascular diseases, stroke and diabetic retinopathy. No kidney-related benefits were observed. Safety analysis revealed a relationship between GK activation and elevated AST levels, while impaired interaction between GK and glucokinase regulatory protein (GKRP) was associated with dyslipidemia, increased liver fat content, AST, systolic blood pressure, and uric acid. Phenome-wide MR suggested that GK activation may have potential benefits for lung function and fluid intelligence score. CONCLUSIONS Our genetic evidence supports GK as a promising target for reducing the risk of specific diabetic complications. These findings require further validation through cohort studies and randomized controlled trials in patients with diabetes.
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Affiliation(s)
- Ziqi Zhang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanxiao Xie
- Department of Respiratory Medicine, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China; The Ninth Clinical Medical College, Guangzhou University of Chinese Medicine, Dongguan, Guangdong, China
| | - Zhenlin Bu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China; The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Yingying Xiang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Sheng
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Cao
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - LeShen Lian
- Department of Respiratory Medicine, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China; The Ninth Clinical Medical College, Guangzhou University of Chinese Medicine, Dongguan, Guangdong, China
| | - Li Zhang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; State Key Laboratory of Integration and Innovation of Classical Formula and Modern Chinese Medicine, Shanghai, China
| | - Wei Qian
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Guang Ji
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; State Key Laboratory of Integration and Innovation of Classical Formula and Modern Chinese Medicine, Shanghai, China.
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Liu M, Li J, Yan K, Zhang K, Zhu P, Tang X, Yuan D, Yang Y, Gao R, Yuan J, Zhao X. The relationship between ABO blood types and clopidogrel-related low on-treatment platelet reactivity in patients with coronary artery diseases and type 2 diabetes mellitus: a secondary analysis of a prospective cohort study. Diabetol Metab Syndr 2025; 17:151. [PMID: 40355973 PMCID: PMC12070505 DOI: 10.1186/s13098-025-01716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 04/25/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND The risk of bleeding associated with antiplatelet therapy in patients with coronary artery disease (CAD) has received a lot of attention. The aim of this study was to investigate the relationship between ABO blood system and low on-treatment platelet reactivity (LTPR) in patients with CAD and type 2 diabetes mellitus (T2DM). METHODS This study examined 10,724 consecutive patients who received percutaneous coronary intervention in China between January and December in 2013 and applied logistic regression to assess the association between ABO blood types and LTPR. These patients who were diagnosed with T2DM, had thromboelastogram (TEG) results and were administered clopidogrel were ultimately enrolled. LTPR is defined by a platelet maximum amplitude of < 31 mm on TEG, induced by adenosine diphosphate. RESULTS Among 3,039 patients (mean age, 59.35 ± 9.89; male, 74.60%), 1,089 (35.83%) presented with LTPR. Multivariate logistic regression revealed that blood type O was independently related to higher odds of LTPR (OR O vs. Non-O: 1.298, 95% CI 1.099-1.534) and that blood type A was independently related to lower odds of LTPR (OR A vs. Non-A: 0.804, 95% CI 0.674-0.958). For further analysis, multivariate logistic regression revealed that, compared to blood type A, type O was independently related to higher odds of LTPR (OR O vs. A: 1.409, 95% CI 1.147-1.729). CONCLUSIONS This study reported that in patients with CAD and T2DM, blood type O was independently associated with higher odds of LTPR, indicating a greater likelihood of bleeding, while blood type A was independently related to lower odds of LTPR, suggesting a reduced likelihood of bleeding.
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Affiliation(s)
- Menglu Liu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Jiawen Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Kailun Yan
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Kexin Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Pei Zhu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Xiaofang Tang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Deshan Yuan
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Yuejin Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Runlin Gao
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Jinqing Yuan
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
| | - Xueyan Zhao
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
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Luo Y, Li JE, Xu S, Zeng H, Zhang Y, Yang S, He X, Liu J. METTL3 promotes human amniotic epithelial stem cells differentiation into insulin-producing cells by regulation of MaFA expression. Biochim Biophys Acta Mol Basis Dis 2025; 1871:167904. [PMID: 40374016 DOI: 10.1016/j.bbadis.2025.167904] [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: 10/31/2024] [Revised: 04/23/2025] [Accepted: 05/12/2025] [Indexed: 05/17/2025]
Abstract
OBJECTIVE Generating mature β-cells from stem cells remains a significant challenge in diabetes cell therapy. Human amniotic epithelial stem cells (hAESCs) have made their mark in regenerative medicine, and provide several advantages compared to other stem cells. Methyltransferase-like 3 (METTL3), an essential RNA methyltransferase participating in N6-methyladenosine (m6A) mRNA methylation, plays a critical role in the normal development of β-cells, yet its deletion in β-cells leads to β-cell dysfunction and hyperglycemia. METHODS In this study, we isolated and characterized hAESCs from human amniotic membranes, differentiated these hAESCs into insulin-producing cells (IPCs), and explored the role of METTL3 in such differentiation. We examined the expression of METTL3 and insulin like growth factor 2 mRNA binding protein 2 (IGF2BP2, a decodes m6A methylation "reader") in the generated IPCs. Subsequently, we suppressed METTL3 using an inhibitor (STM2457) and overexpressed METTL3 via plasmid transfection (METTL3-OE). The differentiated STM2457 and METTL3-OE IPCs were compared to normal induction (WT) IPCs regarding the expression of β-cell markers by RT-qPCR and western blotting, immunofluorescence, C-peptide release, and glucose-stimulated insulin secretion (GSIS). Methylated RNA immunoprecipitation (MeRIP)-qPCR was used to examine the molecular mechanism underlying METTL3/m6A signaling axis in MaFA (endocrine pancreatic β-cells marker) expression. We examined the potential therapeutic uses and efficacy of IPCs through streptozotocin (STZ)-induced C57BL/6 DM. RESULTS Isolated hAESCs displayed all characteristics of ESCs and could generate IPCs. METTL3 and IGF2BP2 were elevated during differentiation. Overexpressing METTL3 improved the expression of β-cell markers in the final differentiated IPCs, improved C-peptide release, and demonstrated increased insulin secretion upon challenging with high glucose conditions, whereas inhibiting METTL3 attenuated these effects. Moreover, METTL3 modulated the MaFA expression in an m6A-dependent manner. CONCLUSIONS These findings suggest METTL3 as a promoting factor of IPCs generation, with its up-regulation potentially generating more mature IPCs for hAESCs therapy of diabetes mellitus.
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Affiliation(s)
- Yunfei Luo
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China; School of basic medicine, Nanchang Medical College, Nanchang City, Jiangxi Province, China
| | - Jin-E Li
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Shan Xu
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Haixia Zeng
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Yuying Zhang
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Shiqi Yang
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Xiaoju He
- Department of Obstetrics and Gynecology of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Jianping Liu
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China; Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang City, Jiangxi Province, China; Jiangxi Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China.
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Zhang N, Wang Y, Zhang H, Fang H, Li X, Li Z, Huan Z, Zhang Z, Wang Y, Li W, Gong Z. Application of interpretable machine learning algorithms to predict macroangiopathy risk in Chinese patients with type 2 diabetes mellitus. Sci Rep 2025; 15:16393. [PMID: 40355529 PMCID: PMC12069545 DOI: 10.1038/s41598-025-01161-5] [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: 09/24/2024] [Accepted: 05/05/2025] [Indexed: 05/14/2025] Open
Abstract
Macrovascular complications are leading causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), yet early diagnosis of cardiovascular disease (CVD) in this population remains clinically challenging. This study aims to develop a machine learning model that can accurately predict diabetic macroangiopathy in Chinese patients. A retrospective cross-sectional analytical study was conducted on 1566 hospitalized patients with T2DM. Feature selection was performed using recursive feature elimination (RFE) within the mlr3 framework. Model performance was benchmarked using 29 machine learning (ML) models, with the ranger model selected for its superior performance. Hyperparameters were optimized through grid search and 5-fold cross-validation. Model interpretability was enhanced using SHAP values and PDPs. An external validation set of 106 patients was used to test the model. Key predictive variables identified included the duration of T2DM, age, fibrinogen, and serum urea nitrogen. The predictive model for macroangiopathy was established and showed good discrimination performance with an accuracy of 0.716 and an AUC of 0.777 in the training set. Validation on the external dataset confirmed its robustness with an AUC of 0.745. This study establish an approach based on machine learning algorithm in features selection and the development of prediction tools for diabetic macroangiopathy.
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Affiliation(s)
- Ningjie Zhang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yan Wang
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, NO. 1, Jianshe East Road, Zhengzhou, 450052, Henan, China
| | - Hui Zhang
- 'The 14th Five-Year Plan' Application Characteristic Discipline of Hunan Province (Clinical Medicine), Changsha, China
- Hunan Provincial Key Laboratory of the Traditional Chinese Medicine Agricultural Biogenomics, Changsha, China
- Department of Basic Medical Sciences, Changsha Medical University, Changsha, China
| | - Huilong Fang
- School of Basic Medical Sciences, Xiangnan University, Chenzhou, 423000, China
| | - Xinyi Li
- School of Basic Medical Sciences, Xiangnan University, Chenzhou, 423000, China
| | - Zhifen Li
- School of Basic Medical Sciences, Xiangnan University, Chenzhou, 423000, China
| | - Zhenghang Huan
- School of Basic Medical Sciences, Xiangnan University, Chenzhou, 423000, China
| | - Zugui Zhang
- Institute for Research on Equity and Community Health, Christiana Care Health System, Newark, USA
| | - Yongjun Wang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, NO. 1, Jianshe East Road, Zhengzhou, 450052, Henan, China.
| | - Zheng Gong
- Sino-Cellbiomed Institutes of Medical Cell & Pharmaceutical Proteins Qingdao University, Qingdao, Shandong, China.
- Department of Basic Medicine, Xiangnan University, 889 Chenzhou Avenue, Chenzhou, Hunan, China.
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Shi C, Shen X, Liu J, Huang L, Ni H, Tang P, Feng Y, Wu M, Zhang J. Influence of Type 2 Diabetes Mellitus on the Clinical Outcomes in Hospitalized Patients with Active Pulmonary Tuberculosis: A Retrospective, Single-Center, Real-World Study in China. Infect Drug Resist 2025; 18:2415-2425. [PMID: 40357418 PMCID: PMC12068386 DOI: 10.2147/idr.s490491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 04/23/2025] [Indexed: 05/15/2025] Open
Abstract
Purpose To explore the influence of type 2 diabetes mellitus (T2DM) on the clinical outcomes of pulmonary tuberculosis (TB) and the factors that may affect outcomes. In addition, the treatment regimens of active pulmonary TB patients with or without T2DM were described. Methods This is a retrospective, single-center, real-world study conducted in the Fifth People's Hospital of Suzhou (China), an urban hospital. This study divided 340 inpatients with active TB who received standard anti-tuberculosis treatment into the T2DM and control groups, with 61 patients in the T2DM group and 279 patients in the control group. The outcomes were the time to negative Mycobacterium tuberculosis sputum conversion and the rate of negative sputum conversion for tuberculosis bacteria at 2 months. Results The percentage of patients who received the isoniazid, rifampin, pyrazinamide, and ethambutol (HRZE) regimen was numerically lower in the T2DM vs control group (73.8% vs 79.6%), while the use of the isoniazid, rifapentine, ethambutol, and levofloxacin (HRftELfx) regimen was numerically higher (14.8% vs 9.7%). The median time to negative sputum conversion was longer in the T2DM group (median, 60.00 vs 52.00 days, P<0.001). The rates of negative sputum conversion at 2 months were 85.2% vs 92.8% in the T2DM and control groups (P=0.055). The multivariable Cox regression analysis showed that the male sex (adjusted HR=0.759, 95% CI: 0.585-0.984, P=0.037) and T2DM (adjusted HR=0.721, 95% CI: 0.528-0.986, P=0.040) were independently associated with the time to negative sputum Mycobacterium tuberculosis conversion. Conclusion Patients with TB and T2DM had a longer time to negative sputum Mycobacterium tuberculosis conversion. In addition, being male significantly increased the risk of prolonged time to negative sputum Mycobacterium tuberculosis conversion.
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Affiliation(s)
- Cuilin Shi
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Xinghua Shen
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Jing Liu
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Lijun Huang
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Huanglei Ni
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Peijun Tang
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Yanjun Feng
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Meiying Wu
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
| | - Jianping Zhang
- The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China
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Wang L, Sun Y, Sang Q, Wang Z, Yu C, Li Z, Shang M, Zhang N, Du D. Establishing a Prediction Model for Weight Loss Outcomes After LSG in Chinese Obese Patients with BMI ≥ 32.5 Kg/m 2 Using Body Composition Data. Diabetes Metab Syndr Obes 2025; 18:1467-1487. [PMID: 40356711 PMCID: PMC12067650 DOI: 10.2147/dmso.s508067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 03/24/2025] [Indexed: 05/15/2025] Open
Abstract
Background Laparoscopic sleeve gastrectomy (LSG) is associated with sustained and substantial weight loss. However, suboptimal results are observed in certain patients. Objective Drawing from body composition data at our center, clinically accessible predictive factors for weight loss outcomes were identified, leading to the development and validation of a preoperative predictive model for weight loss following LSG. Methods and Materials A retrospective analysis was conducted on the general clinical baseline and body composition data of obese patients (body mass index [BMI] ≥ 32.5 kg/m2) who underwent LSG between December 2016 and December 2022. Independent predictors for weight loss outcomes were selected through univariate logistic regression, random forest analysis, and multivariate logistic regression. Subsequently, a nomogram was developed to predict weight loss outcomes and was evaluated for discrimination, accuracy, and clinical utility, with validation performed in a separate cohort. Results A total of 473 patients with mean BMI were included. The preoperative resting energy expenditure to body weight ratio (REE/BW), fat-free mass index (FFMI), and waist circumference (WC) emerged as independent predictive factors for weight loss outcomes at one year post-LSG. These body composition parameters were incorporated into the construction of an Inbody predictive nomogram, which yielded area under the curve (AUC) values of 0.868 (95% CI: 0.826-0.902) for the modeling cohort and 0.829 (95% CI: 0.756-0.887) for the validation cohort. Calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC) from both groups demonstrated the model's robust discrimination, accuracy, and clinical utility. Conclusion In obese Chinese patients with a BMI ≥ 32.5 kg/m2, the Inbody-based nomogram integrating REE/BW, FFMI, and WC offers an effective preoperative tool for predicting weight loss outcomes one year after LSG, facilitating surgical planning and postoperative management.
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Affiliation(s)
- Liang Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Yilan Sun
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Qing Sang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Chengyuan Yu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Zhehong Li
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Mingyue Shang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People’s Republic of China
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Chen X, Zhang X, Sun Z, Mao Y, Wu W, Yuan G, Deng X. Clinical significance of obesity measurement indicators and carotid artery plaques in type 2 diabetes. BMC Cardiovasc Disord 2025; 25:347. [PMID: 40325388 PMCID: PMC12051268 DOI: 10.1186/s12872-025-04722-8] [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: 02/17/2025] [Accepted: 04/01/2025] [Indexed: 05/07/2025] Open
Abstract
INTRODUCTION To investigate the clinical significance of obesity measurement indicators in patients with type 2 diabetes mellitus(T2DM) complicated with carotid plaque. METHODS A total of 1009 subjects with T2DM were recruited in the cross-sectional study, and body measurements were collected. According to the results of carotid artery ultrasound, the study subjects were divided into T2DM without carotid plaque group (NCP: n = 617) and with carotid plaque group (WCP: n = 392). RESULTS Compared with the NCP group, the waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), Chinese visceral fat index (CVAI), body roundness index (BRI), body fat index (BAI), body shape index (ABSI), and abdominal volume index (AVI) were significantly increased in the WCP group (P < 0.05). The results of multivariate stepwise logistic regression analysis showed that BAI, CVAI and ABSI had the greatest effect on carotid plaque (P < 0.05). After adjusting for multiple confounding factors, CVAI and ABSI remained independently associated with carotid plaques, and the combination of the three indicators exhibited superior predictive value for carotid plaques. CONCLUSION CVAI and ABSI are closely related to the occurrence and development of carotid plaque in subjects with T2DM, and the combined application has a good effect on predicting carotid plaque.
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Affiliation(s)
- Xia Chen
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China
| | - Xiuhui Zhang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China
| | - Ziyan Sun
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China
| | - Ying Mao
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China
| | - Wentao Wu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China
| | - Guoyue Yuan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China.
| | - Xia Deng
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China.
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Jiang J, Feng Q, Yan L, Guo Y, Yang Q. Perceptions and Experiences of Self-Management in Patients with Prediabetes: A Qualitative Study in China. Patient Prefer Adherence 2025; 19:1283-1293. [PMID: 40337289 PMCID: PMC12057631 DOI: 10.2147/ppa.s513389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 04/07/2025] [Indexed: 05/09/2025] Open
Abstract
Purpose This study aimed to investigate self-management experiences among individuals with prediabetes and analyze their potential self-management needs, thereby informing strategies to enhance self-management efficacy and facilitate the development of evidence-based, personalized interventions. Patients and Methods Twelve prediabetes patients from a physical examination center in Nanchong, China, were recruited using purposive sampling. An interpretive phenomenological research method was employed. Semi-structured, in-depth interviews were conducted to explore patients' self-management experiences. The interviews were audio-recorded, transcribed, and analyzed thematically to develop the results. In addition, web-based information support and peer support facilitated patient self-management. Results Four overarching themes emerged: (1) cognitive limitations, (2) intrinsic motivation, (3) hurdles to overcome, (4) perceived social support. Revealed the debilitating effect of non-medical terminology expression on the potential harm of the disease, neglect of diagnosis and health education by healthcare providers exacerbated the lack of awareness of prediabetes among patients. The complex social environment (unhealthy food environment, heavy work pressure, etc.) confronts prediabetes with self-management dilemmas. It was also revealed that patients' behavioral change motivation was "threat-benefit" dual-driven and was strongly influenced by family ethics, with family culture significantly influencing health decision-making. In addition, web-based information support and peer support facilitate patient self-management. Conclusion This study investigated the perceptions and self-management experiences of individuals with prediabetes, proposing targeted intervention strategies. Key recommendations include: (1) Healthcare providers' perceptions and attitudes toward prediabetes significantly influence patient engagement, necessitating standardized diagnostic and treatment protocols that emphasize disease progression risks during initial diagnosis to enhance clinical awareness; (2) Implementation of motivational interviewing (MI) techniques could effectively strengthen patients' intrinsic motivation for behavioral modification; (3) Multidimensional support systems should be established through AI-powered medical question-answering systems, standardized nutritional labeling regulations, family-involved health education programs, and peer-led "health coach" initiatives. These strategies provide a framework for developing comprehensive prediabetes management interventions aimed at improving self-management ability.
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Affiliation(s)
- Jinfeng Jiang
- Endocrinology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Qiongyao Feng
- Faculty of Nursing, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Lihua Yan
- Faculty of Nursing, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Yingchao Guo
- Faculty of Nursing, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Qiu Yang
- Endocrinology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
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Zhang Q, Fan Y, Liu X, Zhang M, Zhang J, Du Q, Kang L, Chen L. Population profile and glycemic control following initiation or switch of injectable therapies in Tianjin, China: A real-world retrospective cohort study of adults with type 2 diabetes. J Diabetes Investig 2025; 16:842-851. [PMID: 39899440 PMCID: PMC12057371 DOI: 10.1111/jdi.14415] [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: 08/21/2024] [Revised: 01/06/2025] [Accepted: 01/16/2025] [Indexed: 02/05/2025] Open
Abstract
AIMS To evaluate characteristics and glycemic outcomes in individuals with type 2 diabetes using injectable therapies in real-world clinical practice in Tianjin, China. MATERIALS AND METHODS Data from inpatients and outpatients receiving injectable therapies between January 2015 and December 2019 were collected from the Tianjin regional electronic medical records and retrospectively analyzed. Seven cohorts were identified, including individuals initiating injectable therapies (premixed insulin [n = 4,687], basal insulin [4,177], or glucagon-like peptide-1 receptor agonists [541]) or switching injectable therapies (premixed insulin to basal insulin [1,298], basal insulin to premixed insulin [1,457], basal insulin to basal + bolus insulin [1,772], or glucagon-like peptide-1 receptor agonists to basal insulin ± glucagon-like peptide-1 receptor agonists [82]). RESULTS In participants initiating therapy, glycated hemoglobin and fasting plasma glucose were highest in the basal insulin cohort, while among participants switching therapy, the highest values were in the basal insulin ± glucagon-like peptide-1 receptor agonists cohort. Initiating therapy with premixed or basal insulin and switching from basal insulin to basal + bolus insulin improved glycemic control over 12 months. A mean delay in initiating therapy of up to 13 months after oral glucose-lowering drug failure was observed, with 60% having a delay of >6 months. This delay was associated with a lower proportion achieving glycemic control 3 months after initiation. CONCLUSIONS Effectiveness was not observed at all time points in all cohorts, suggesting some treatments were not used in the appropriate population. Delays in initiating injectable therapies were observed and were associated with poor glycemic control.
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Affiliation(s)
- Qiumei Zhang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien‐I Memorial Hospital and Tianjin Institute of EndocrinologyTianjin Medical UniversityTianjinChina
| | - Yaqing Fan
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien‐I Memorial Hospital and Tianjin Institute of EndocrinologyTianjin Medical UniversityTianjinChina
| | - Xixi Liu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien‐I Memorial Hospital and Tianjin Institute of EndocrinologyTianjin Medical UniversityTianjinChina
| | | | | | - Qin Du
- Sanofi Investment Co., Ltd.ShanghaiChina
| | - Lei Kang
- Sanofi Investment Co., Ltd.ShanghaiChina
| | - Liming Chen
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien‐I Memorial Hospital and Tianjin Institute of EndocrinologyTianjin Medical UniversityTianjinChina
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Liu Y, Cai C, Tian J, Shen L, Tang PY, Coufal MM, Chen H, Evans MS, Qian Y, Yu W, Wu X, Wu X, Fisher EB, Jia W. Community-Based Peer Support for Diabetes Management: 24-Month Changes Relative to Comparison Communities. Diabetes Care 2025; 48:807-815. [PMID: 40163517 PMCID: PMC12034902 DOI: 10.2337/dc24-2748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 02/25/2025] [Indexed: 04/02/2025]
Abstract
OBJECTIVE To evaluate the effectiveness of community-based peer support for diabetes self-management with HbA1c and other clinical and psychosocial outcomes over 24 months. RESEARCH DESIGN AND METHODS This study used an intervention comparison design with 12 intervention communities and 4 comparison communities matched according to location in urban or suburban areas. A community organization approach was used to integrate standardization of key messages and patient education protocols, along with adaptation and innovation among multiple community partners. The primary outcome was HbA1c; secondary outcomes included BMI, fasting plasma glucose (FPG), systolic and diastolic blood pressure, LDL cholesterol (LDL-C), depressive symptoms (PHQ-8), diabetes distress, and general quality of life (EQ-5D). RESULTS The analyses included 967 participants completing both the baseline and follow-up assessment. Intervention communities versus comparison communities were older (mean age 66.43 vs. 63.45 years), included more women (57.1% vs. 45.5%), and had longer diabetes duration (mean 7.95 vs. 6.40 years). Significant improvements were found for HbA1c (7.42% [58 mmol/mol] vs. 7.95% [63 mmol/mol]), BMI (25.31 vs. 25.94 kg/m2), FPG (7.91 vs. 8.59 mmol/L), and depressive symptoms (PHQ-8 score 1.39 vs. 1.41), favoring intervention communities, after adjusting for baseline values of outcome measures and confounders (P ≤ 0.028). No interactions were found with age (<65 vs. ≥65 years). Men showed modestly greater diastolic blood pressure reduction, and women showed a minor increase of LDL-C in intervention communities. These analyses by age or sex and sensitivity analyses with missing data imputation supported the robustness of findings. CONCLUSIONS Culturally adapted and appropriate community-based peer support for diabetes management may improve clinical and psychosocial outcomes at 24 months among people with diabetes.
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Affiliation(s)
- Yuexing Liu
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Research Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Chun Cai
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Research Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jiahe Tian
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Research Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Patrick Y. Tang
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Hongli Chen
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Research Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Megan S. Evans
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Yiqing Qian
- Center for Equity in Aging, Johns Hopkins University School of Nursing, Baltimore, MD
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyu Wu
- Department of Health Promotion, Shanghai Municipal Health Commission, Shanghai, China
| | - Xiaobing Wu
- Department of Cardio-Cerebrovascular and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Edwin B. Fisher
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Research Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Institute for Proactive Healthcare of Shanghai Jiao Tong University, Shanghai, China
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Lu Y, Liu D, Liang Z, Liu R, Chen P, Liu Y, Li J, Feng Z, Li LM, Sheng B, Jia W, Chen L, Li H, Wang Y. A pretrained transformer model for decoding individual glucose dynamics from continuous glucose monitoring data. Natl Sci Rev 2025; 12:nwaf039. [PMID: 40191259 PMCID: PMC11970253 DOI: 10.1093/nsr/nwaf039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Revised: 01/22/2025] [Accepted: 02/05/2025] [Indexed: 04/09/2025] Open
Abstract
Continuous glucose monitoring (CGM) technology has grown rapidly to track real-time blood glucose levels and trends with improved sensor accuracy. The ease of use and wide availability of CGM will facilitate safe and effective decision making for diabetes management. Here, we developed an attention-based deep learning model, CGMformer, pretrained on a well-controlled and diverse corpus of CGM data to represent individual's intrinsic metabolic state and enable clinical applications. During pretraining, CGMformer encodes glucose dynamics including glucose level, fluctuation, hyperglycemia, and hypoglycemia into latent space with self-supervised learning. It shows generalizability in imputing glucose value across five external datasets with different populations and metabolic states (MAE = 3.7 mg/dL). We then fine-tuned CGMformer towards a diverse panel of downstream tasks in the screening of diabetes and its complications using task-specific data, which demonstrated a consistently boosted predictive accuracy over direct fine-tuning on a single task (AUROC = 0.914 for type 2 diabetes (T2D) screening and 0.741 for complication screening). By learning an intrinsic representation of an individual's glucose dynamics, CGMformer classifies non-diabetic individuals into six clusters with elevated T2D risks, and identifies a specific cluster with lean body-shape but high risk of glucose metabolism disorders, which is overlooked by traditional glucose measurements. Furthermore, CGMformer achieves high accuracy in predicting an individual's postprandial glucose response with dietary modelling (Pearson correlation coefficient = 0.763) and helps personalized dietary recommendations. Overall, CGMformer pretrains a transformer neural network architecture to learn an intrinsic representation by borrowing information from a large amount of daily glucose profiles, and demonstrates predictive capabilities fine-tuned towards a broad range of downstream applications, holding promise for the early warning of T2D and recommendations for lifestyle modification in diabetes management.
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Affiliation(s)
- Yurun Lu
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Dan Liu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Zhongming Liang
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- BGI-Research, Hangzhou 310030, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Pei Chen
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Yitong Liu
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Jiachen Li
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Zhanying Feng
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- Department of Statistics, Department of Biomedical Data Science, Bio-X Program, Stanford University, Stanford CA 94305, USA
| | - Lei M Li
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Luonan Chen
- State Key Laboratory of Cell Biology, Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai 200031, China
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- Guangdong Institute of Intelligence Science and Technology, Zhuhai 519031, China
- Pazhou Laboratory (Huangpu), Guangzhou 510555, China
| | - Huating Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yong Wang
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
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He Y, Zheng Q, Zhifang Z, Xiaofeng N, Shenggen W, Xue M, Zheng C, Liu Z. When COVID-19 meets diabetes: A bibliometric analysis. Diabetes Res Clin Pract 2025; 223:112118. [PMID: 40132732 DOI: 10.1016/j.diabres.2025.112118] [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: 11/01/2024] [Revised: 03/13/2025] [Accepted: 03/19/2025] [Indexed: 03/27/2025]
Abstract
Coronavirus disease 2019 (COVID-19) survivors are concerned about the likelihood of developing further diseases. This study examines the global trends in scientific research on diabetes associated with COVID-19 from several perspectives. Bibliometric analyses are used to undertake a scientific review of the literature. The Web of Science Core Collection (WoSCC) database was used to acquire bibliographic information on diabetes related to COVID-19 from Jan 2020 to Dec. 2023. The visual map was built via advanced CiteSpace 6.2.R6. 7,348 papers were found. Khunti Kamlesh and Rizzo-Manfredi are the most well-known high-yield authors in this area, and the top ten authors collaborate extensively. Most of these papers came from universities. Harvard Medical School has the most publications, followed by Wuhan University and Huazhong University of Science and Technology. China and the United States are the countries with the most publications. Angiotensin-converting enzymes, chronic disease, intensive care unit, viral infection, and gestational diabetes mellitus were scored 0-11, 2, 3, and 4, respectively. Zhou et al.'s work on this topic, which appeared in the prominent medical journal The Lancet, was cited 1,366 times, highlighting its importance. "clinical characteristics," "diabetes mellitus," "metabolic syndrome," and "angiotensin-converting enzyme" were used as keywords for reference co-citation and clustering data identify. Over the last four years, related investigations have focused primarily on observing clinical aspects. This report is important for developing treatment strategies, directing future research, and guiding clinical practice.
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Affiliation(s)
- Yingli He
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Qingcong Zheng
- Department of Spinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhang Zhifang
- Fujian Center for Disease Control and Prevention, Fuzhou 350012, China
| | | | - Wu Shenggen
- Fujian Center for Disease Control and Prevention, Fuzhou 350012, China
| | - Mengzhou Xue
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Chunfu Zheng
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.
| | - Zhijun Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, China.
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Kong Y, Luo Q, Zhang Q, Wei Q. Association of the body roundness index with new-onset cardiovascular disease in middle-aged and older adults with and without diabetes: evidence from the China Health and Retirement Longitudinal Study. Diabetol Metab Syndr 2025; 17:142. [PMID: 40296132 PMCID: PMC12036263 DOI: 10.1186/s13098-025-01705-9] [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: 12/12/2024] [Accepted: 04/17/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Among noncommunicable diseases, cardiovascular disease (CVD) is the leading cause of mortality and morbidity. In China, diabetes is renowned for its high incidence rate, and the body roundness index (BRI) is an emerging indicator for assessing obesity, particularly abdominal obesity. High BRI may lead to new-onset CVD events. However, the relationships between the BRI and new-onset CVD in individuals with or without diabetes remain unclear. METHODS Data for this analysis were extracted from the China Health and Retirement Longitudinal Study (CHARLS). Our research utilized a cohort that was meticulously assessed over a period from 2011 to 2018, encompassing a comprehensive follow-up of 17,708 participants. Ultimately, this study focused on a subset of 6,737 individuals aged 45 years or older. Methodological approaches include Cox regression, Kaplan-Meier survival analysis, restricted cubic splines (RCS) analysis, receiver operating characteristic (ROC) curve analysis, subgroup analysis, and mediation analysis to explore the relationships of interest. RESULTS This study included 6,737 participants, all of whom were above the age of 45. Our findings revealed that within this demographic group, 1,481 (22.0%) patients experienced new-onset CVD. The Kaplan-Meier survival analysis further revealed that the group characterized by non-diabetes mellitus (Non-DM) had the lowest cumulative incidence of CVD compared with the diabetes mellitus (DM) group. Multivariate Cox regression revealed that in the fully adjusted model (Model 3) (HR = 1.122, 95% CI = 1.080 to 1.167), BRI was associated with the risk of CVD in the Non-DM group during the three-wave follow-up. RCS analysis revealed a positive, linear-like dose‒dependent relationship between BRI and new-onset CVD in Non-DM patients (P = 0.007, P for nonlinearity = 0.938). Smoking could affect the ability of the BRI to predict the incidence rate of CVD in the total population and in the population without diabetes (P interaction = 0.007). Moreover, the mediating effect of the BRI on new-onset CVD among diabetic patients was particularly pronounced in the long term, exceeding 4 years. CONCLUSIONS Our findings demonstrate a significant association between the BRI and CVD risk in non-diabetic individuals, with diabetes influencing the incidence and risk of new-onset CVD in middle-aged and elderly Chinese populations through the BRI playing a mediating role. As an obesity indicator, the BRI provides a valuable tool for early detection and intervention of CVD. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Youli Kong
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qian Luo
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qing Zhang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Yu Z, Zhang X, Fu X, Jia X, Ju M, Zhang Y, Li Y, Yin Y, Liu F. An analysis of trends in the burden of ischemic stroke caused by air pollution in China between 1990 and 2021. BMC Public Health 2025; 25:1567. [PMID: 40296073 PMCID: PMC12036216 DOI: 10.1186/s12889-025-22287-1] [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: 01/21/2025] [Accepted: 03/11/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND This study evaluates the burden of ischemic stroke attributable to air pollution in China from 1990 to 2021, examines gender and age-specific differences, and projects future disease burden trends from 2022 to 2036. By analyzing the impact of air pollution on ischemic stroke, this study aims to provide insights for public health policies and preventive measures. METHODS Utilizing data from the 2021 Global Burden of Disease (GBD) study, this research examined the ischemic stroke burden associated with air pollution in China. To assess historical trends and project disease burden from 2022 to 2036, Joinpoint regression modeling and decomposition analysis were employed. These methods allow for identifying significant trend changes and disentangling the contributions of various factors. RESULTS From 1990 to 2021, China observed a decline in both age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALY) rates for ischemic stroke attributed to air pollution. However, the decline was slower among men than women, with a higher burden observed in elderly males. Epidemiological transitions, including improved healthcare and lifestyle changes, were the main drivers behind the overall reduction in disease burden. Projections indicate that over the next 15 years, ASMR and age-standardized DALY rates (ASDR) for women will continue to decline, while ASMR for men is expected to rise and ASDR for men will gradually increase before stabilizing. CONCLUSION Elderly males are disproportionately affected by ischemic stroke related to air pollution, highlighting a critical public health issue. To mitigate this burden, it is essential for the government to implement targeted, gender- and age-specific policies aimed at improving air quality, enhancing healthcare access, and promoting preventive measures for vulnerable populations, particularly the elderly and men. These findings underscore the need for integrated strategies to reduce health disparities and address the ongoing challenges posed by air pollution.
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Affiliation(s)
- Zhengfeng Yu
- Acumox and Tuina Institute, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Xiuyun Zhang
- Department of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Xiaomei Fu
- Shandong First Medical University Affiliated Hospital for Cervical, Shoulder, Back and Leg Pain, Jinan, Shandong Province, China
| | - Xuemin Jia
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Mingyan Ju
- Acumox and Tuina Institute, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Yuxuan Zhang
- Acumox and Tuina Institute, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Yuying Li
- Acumox and Tuina Institute, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Ying Yin
- Department of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China.
| | - Fanjie Liu
- Bone Biomechanics Engineering Laboratory of Shandong Province, Shandong Medicinal Biotechnology Center (School of Biomedical Sciences), Neck-Shoulder and Lumbocrural Pain Hospital, Shandong First Medical University, and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
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Jiang R, Chang G, Liu T, Xu L, Zhang X, Zhou Y, Wang Y. National and province-level primary health care policies for the prevention and control of non-communicable diseases in China from 2009 to 2023: a scoping review. BMJ Open 2025; 15:e097826. [PMID: 40280618 PMCID: PMC12035461 DOI: 10.1136/bmjopen-2024-097826] [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: 12/12/2024] [Accepted: 04/10/2025] [Indexed: 04/29/2025] Open
Abstract
OBJECTIVES This study systematically characterises policies related to the prevention and control of non-communicable diseases (NCDs) at the provincial primary healthcare (PHC) level, identifying key characteristics and potential gaps compared with national policies. STUDY DESIGN Policy review and thematic content analysis. METHODS Policy documents from Guangdong and Heilongjiang provinces (2009-2023) were analysed using the WHO's six building blocks framework. A total of 135 eligible documents were included, with thematic analysis conducted to categorise policies as 'extension' or 'reduction' based on their alignment with national directives. RESULTS 12 major policy initiatives were identified, with most themes reflecting provincial adaptations ('extension') of national strategies. Leadership and governance, medicines and technologies and service delivery received robust policy support, while health information systems lagged. Provincial policies demonstrated significant multisectoral collaboration, though gaps in health financing and workforce capacity persisted. CONCLUSIONS To strengthen PHC-based NCD control, future reforms must prioritise multisectoral collaboration, interoperable digital health systems and tailored health education. Addressing regional disparities in policy implementation is critical for equitable outcomes.
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Affiliation(s)
- Rui Jiang
- General Practice of Department, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Guangming Chang
- Nursing Teaching and Research Department, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tingzhuo Liu
- School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lingling Xu
- General Practice of Department, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinyi Zhang
- School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuhan Zhou
- General Practice of Department, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yongchen Wang
- General Practice of Department, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Tang Y, Chen Y, Zhou Y, Wu B, Zhang S, Gong Y, Ni Q. Global burden of Type 2 Diabetes Mellitus attributable to dietary risks in elderly adults: insights from the Global Burden of Disease study 2021. Front Nutr 2025; 12:1557923. [PMID: 40342370 PMCID: PMC12058732 DOI: 10.3389/fnut.2025.1557923] [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: 01/09/2025] [Accepted: 04/07/2025] [Indexed: 05/11/2025] Open
Abstract
Background Type 2 Diabetes Mellitus (T2DM) poses a significant global health challenge, particularly among elderly adults. Dietary risk factors, such as high consumption of processed meats and sugar-sweetened beverages and low intake of whole grains and fruits, play a critical role in the burden of T2DM. This study aims to comprehensively quantify the global burden of T2DM attributable to dietary risks among elderly adults, identify significant dietary risk factors driving disease burden, and evaluate temporal, regional, and demographic variations to inform targeted public health strategies and interventions for reducing the impact of T2DM. Methods This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to assess T2DM burden attributable to dietary risks among adults aged 65 years and older across 204 countries and territories. Metrics included age-standardized mortality rates (ASMR) and disability-adjusted life-year rates (ASDR). Dietary risk factors analyzed included low intake of whole grains, fruits, vegetables, and fiber, as well as high intake of processed meat, red meat, and sugar-sweetened beverages. Joinpoint regression and decomposition analyses were performed to examine temporal trends and drivers of changes by region, SDI level, sex, and age. Results In 2021, dietary risks accounted for 23.61% of T2DM-related deaths and 24.85% of DALYs among elderly adults. ASMR showed a slight decline globally (AAPC: -0.08), while ASDR exhibited a significant upward trend (AAPC: +0.7) from 1990 to 2021. High SDI regions demonstrated decreasing ASMR but persistent DALYs due to prolonged survival with complications. Conversely, low and middle SDI regions exhibited rapid increases in ASMR and ASDR, driven by dietary transitions and limited healthcare resources. Males consistently bore a higher burden than females, with pronounced disparities in low and middle SDI regions. Aging and population growth were the primary drivers of the increasing burden globally. Conclusion This study underscores the substantial burden of T2DM attributable to dietary risks among elderly adults and highlights significant regional and demographic disparities. Targeted public health interventions, personalized nutritional strategies, and improved healthcare access are essential to mitigate this burden. Future research should explore the impact of emerging dietary trends and precision nutrition on T2DM prevention and management.
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Affiliation(s)
- Yiting Tang
- Beijing University of Chinese Medicine, Beijing, China
| | - Yupeng Chen
- Department of Endocrinology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Zhou
- Beijing University of Chinese Medicine, Beijing, China
| | - Bingrong Wu
- Department of Endocrinology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Shan Zhang
- Department of Endocrinology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanbing Gong
- Beijing University of Chinese Medicine, Beijing, China
| | - Qing Ni
- Department of Endocrinology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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Li S, Xia R, Gong X, Wang C, Liu H, Dong H, Su Z, Liang Y, Wang S, Yang T. Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis. BMC Endocr Disord 2025; 25:114. [PMID: 40275221 PMCID: PMC12020057 DOI: 10.1186/s12902-025-01892-6] [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: 11/12/2024] [Accepted: 02/27/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVE This study aimed to investigate the association of dietary patterns (DPs) with risk of T2DM, emphasizing the intermediary role of HOMA or TyG indices among a Chinese adult population. RESEARCH DESIGN AND METHODS Directed acyclic graphs combined with propensity score matching were used to minimize confounding, resulting in 1330 subjects for final analysis. Principal component analysis and reduced rank regression, applied to eleven food groups. Multivariable logistic regression and restricted cubic spline regression models were used to assess associations between there DPs with prevalent T2DM, as well as insulin resistance and β-cell function (HOMA-TyG). Mediation analyses were conducted to evaluate whether the HOMA-TyG index mediated the relationship between DPs and T2DM. RESULTS The DP1, characterized by high intakes of poultry, meat, and preserved foods, was associated with elevated body mass index, triglycerides, and hemoglobin A1c. Both PCA-DP1(ORQ4VsQ1 = 2.15, 95% CI: 1.53-3.03) and RRR-DP1 (ORQ4VsQ1 = 1.69, 95% CI: 1.82-3.58) were significantly positively correlated with T2DM. RRR-DP1 additionally demonstrated a dose-dependent relationship with HOMA-insulin resistance and TyG. Furthermore, the TyG index mediated approximately 19.51% of the relationship between RRR-DP1 and T2DM. CONCLUSIONS These findings indicate that glucose-lipid metabolism-related dietary pattern, notably high in animal fat, exacerbates insulin resistance and heightens T2DM risk. Tailoring dietary interventions to modify this pattern may be an effective strategy for preventing and managing T2DM.
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Affiliation(s)
- ShuShu Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
- Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, 213022, PR China
| | - Rong Xia
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, PR China
- Department of Respiratory & Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Xing Gong
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, PR China
| | - Chao Wang
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, PR China
| | - Hechun Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Huibin Dong
- Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, 213022, PR China
| | - Zhangyao Su
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Yucheng Liang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Shoulin Wang
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, PR China.
| | - Tao Yang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China.
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He S, Qian X, Wang J, Shen X, An Y, Zhang B, Chen B, Li H, Chen X, Chen Y, Wang Y, Jin C, Gong Q, Li G. Younger-onset type 2 diabetes associated with increased long-term cancer risk in Chinese adults: A 30-year follow-up of the Da Qing Diabetes Study. BJC REPORTS 2025; 3:24. [PMID: 40263628 PMCID: PMC12015435 DOI: 10.1038/s44276-025-00142-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 03/05/2025] [Accepted: 04/01/2025] [Indexed: 04/24/2025]
Abstract
BACKGROUND We investigated the association between younger-onset type 2 diabetes, duration of diabetes, and cancer risk based on data from the Da Qing Diabetes Prevention Outcome Study (DQDPOS). METHODS The analysis recruited 620 younger-onset (age≤50 years) and 649 older-onset (age>50 years) patients with type 2 diabetes, and 310 younger non-diabetes controls (age≤50 years). Multiple regression analysis was used to test the influence of younger-onset diabetes and duration of diabetes on the long-term risk of cancer. RESULTS The annual incidence of all cancer among the non-diabetes, younger-, and older-onset type 2 diabetes was significantly different (3.7, 5.5, and 4.0/1000 person-years, respectively). The standard Cox analysis revealed that the patients with younger-onset diabetes had a significantly higher risk of cancer than those with older-onset diabetes (hazard ratio [HR]:1.81; 95% confidence interval [CI]:1.20-2.73) and younger non-diabetic controls (HR:2.43; 95% CI:1.34-4.41) after adjustment for diabetes duration and other confounders. Stepwise general linear regression model analysis revealed that a longer diabetes-free time was associated with longer lifetime cancer-free years (partial R2 = 0.36, p < 0.001), in addition to the non-modifiable predictor duration of diabetes. CONCLUSIONS Younger-onset type 2 diabetes was significantly associated with an increased risk of cancer beyond the influence of diabetes duration.
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Affiliation(s)
- Siyao He
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Qian
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Xiaoxia Shen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Bo Chen
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Xiaoping Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Wang
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
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Gao M, Dai MT, Gong GH. Dysfunctional glucose metabolism triggers oxidative stress to induce kidney injury in diabetes. World J Diabetes 2025; 16:102554. [PMID: 40236851 PMCID: PMC11947919 DOI: 10.4239/wjd.v16.i4.102554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 01/14/2025] [Accepted: 02/05/2025] [Indexed: 02/28/2025] Open
Abstract
In this editorial, we discussed the article published in the recent issue of the World Journal of Diabetes. To understand the effect of mizagliflozin on kidney injury induced by diabetes, we focused on the mechanisms by which high glucose triggers oxidative stress and contributes to kidney injury in diabetes. The high level of unmetabolized glucose reaching the kidney triggers glucose reabsorption by renal tubules, which elevates the cellular glucose level of renal cells. High glucose induces lactate dehydrogenase overexpression and thus shifts glucose metabolism, which causes mitochondrial dysfunction. Mitochondria generate approximately 90% of the reactive oxygen species in cells, whose dysfunction further alters glucose metabolism and enhances reactive oxygen species generation. Oxidative stress stimulates proinflammatory factor production and kidney inflammatory injury. Mizagliflozin decreases glucose reabsorption and thus ameliorates diabetes-induced kidney injury.
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Affiliation(s)
- Meng Gao
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
- Institute for Regenerative Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Meng-Ting Dai
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Guo-Hua Gong
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
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Yang W, Lu J, Si SC, Wang WH, Li J, Ma YX, Zhao H, Liu J. Digital health technologies/interventions in smart ward development for elderly patients with diabetes: A perspective from China and beyond. World J Diabetes 2025; 16:103002. [PMID: 40236871 PMCID: PMC11947930 DOI: 10.4239/wjd.v16.i4.103002] [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: 11/05/2024] [Revised: 01/22/2025] [Accepted: 02/17/2025] [Indexed: 02/28/2025] Open
Abstract
Diabetes is highly prevalent among the elderly worldwide, with the highest number of diabetes cases in China. Yet, the management of diabetes remains unsatisfactory. Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients. There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management, including an increased vulnerability to hypoglycemia, the presence of multiple chronic diseases, and cognitive decline. In this review, studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies, such as real-time continuous glucose monitoring, sensor-augmented pump technology, and their integration with 5th generation networks, big data cloud storage, and hospital information systems, can address issues specifically related to elderly diabetes patients in hospital wards. Furthermore, the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed, and these challenges may also be applicable to other countries worldwide, not just in China. Taken together, the smart wards may enhance clinical outcomes, address specific issues, and eventually improve patient-centered hospital care for elderly patients with diabetes.
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Affiliation(s)
- Wei Yang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Juan Lu
- Department of General Practice, The Longzeyuan Community Health Service Center, Beijing 102208, China
| | - Si-Cong Si
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Wei-Hua Wang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yi-Xin Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Huan Zhao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jia Liu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Xie T, Pan Y, Lu K, Wei Y, Chen F, Tian Z, Wu P, Li Q, Wu B, Liu Y, Xue J, Bai J, Dong W, Liu Y, Shao J, Chen Y, Zhou X, Du Y, Liu Z, Gao S, Cheng Y, Huang R, Zhang Z, Yue Y, Zhong S, Deng Z, Zhou K, Jin J, Li C, Xu T, Zhou K. Cohort Profile: Kunshan Aging Research with E-health (KARE). Int J Epidemiol 2025; 54:dyaf041. [PMID: 40286341 DOI: 10.1093/ije/dyaf041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 03/21/2025] [Indexed: 04/29/2025] Open
Affiliation(s)
- Tian Xie
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Ying Pan
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
- Kunshan Biomedical Big Data Innovation Application Laboratory, Jiangsu, China
| | - Ke Lu
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
- Kunshan Biomedical Big Data Innovation Application Laboratory, Jiangsu, China
| | - Yinlin Wei
- Centre for Health Statistics and Information, Health Commission of Kunshan, Suzhou, Jiangsu Province, China
| | - Fei Chen
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Zijian Tian
- National Laboratory of Biomacromolecules, Institute of Biophysics Chinese Academy of Sciences, Beijing, China
| | - Peng Wu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China
| | - Qian Li
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Benrui Wu
- National Laboratory of Biomacromolecules, Institute of Biophysics Chinese Academy of Sciences, Beijing, China
| | - Yiying Liu
- National Laboratory of Biomacromolecules, Institute of Biophysics Chinese Academy of Sciences, Beijing, China
| | - Jingnan Xue
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Jie Bai
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China
| | - Wanqing Dong
- Luoyang Key Laboratory of Clinical Multiomics and Translational Medicine, Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism Center, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yang Liu
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Jian Shao
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Ying Chen
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Xiaozhou Zhou
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Yuxuan Du
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Ziqing Liu
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Shiteng Gao
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- College of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yao Cheng
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Rong Huang
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Zhiqin Zhang
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
| | - Yushan Yue
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
- Kunshan Biomedical Big Data Innovation Application Laboratory, Jiangsu, China
| | - Shao Zhong
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
| | - Zhiyong Deng
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
| | - Kaiyun Zhou
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
| | - Jian Jin
- Centre for Health Statistics and Information, Health Commission of Kunshan, Suzhou, Jiangsu Province, China
| | - Chong Li
- Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu Province, China
- Kunshan Biomedical Big Data Innovation Application Laboratory, Jiangsu, China
| | - Tao Xu
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- National Laboratory of Biomacromolecules, Institute of Biophysics Chinese Academy of Sciences, Beijing, China
| | - Kaixin Zhou
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- College of Public Health, Guangzhou Medical University, Guangzhou, China
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Sun Z, Zheng Y. Metabolic diseases in the East Asian populations. Nat Rev Gastroenterol Hepatol 2025:10.1038/s41575-025-01058-8. [PMID: 40200111 DOI: 10.1038/s41575-025-01058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2025] [Indexed: 04/10/2025]
Abstract
East Asian populations, which account for approximately 20% of the global population, have become central to the worldwide rise of metabolic diseases over the past few decades. The prevalence of metabolic disorders, including type 2 diabetes mellitus, hypertension and metabolic dysfunction-associated steatotic liver disease, has escalated sharply, contributing to a substantial burden of complications such as cardiovascular disease, chronic kidney disease, cancer and increased mortality. This concerning trend is primarily driven by a combination of genetic predisposition, unique fat distribution patterns and rapidly changing lifestyle factors, including urbanization and the adoption of Westernized dietary habits. Current advances in genomics, proteomics, metabolomics and microbiome research have provided new insights into the biological mechanisms that might contribute to the heightened susceptibility of East Asian populations to metabolic diseases. This Review synthesizes epidemiological data, risk factors and biomarkers to provide an overview of how metabolic diseases are reshaping public health in East Asia and offers insights into biological and societal drivers to guide effective, region-specific strategies.
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Affiliation(s)
- Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
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Liu J, Yin H, Wang N, Wang Y, Guan L, Feng Y, Wu L, Liu W, Zhang H, Liu Z, Liu X, Zhou Y, Liu Y, Yin X, Wu Q, Jiao M, Liu C, Liang L. Factors associated with exposure to tuberculosis education among internal migrants with diabetes in China: a multilevel regression analysis of cross-sectional data from the 2017 China Migrants Dynamic Survey. BMJ Open 2025; 15:e086915. [PMID: 40204299 PMCID: PMC11979509 DOI: 10.1136/bmjopen-2024-086915] [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: 03/26/2024] [Accepted: 03/26/2025] [Indexed: 04/11/2025] Open
Abstract
OBJECTIVE Individuals with diabetes are at high risk for tuberculosis (TB) infection. This study aimed to identify the barriers to access to TB education among internal migrants with diabetes in China. DESIGN Cross-sectional study. SETTING The 2017 China Migrants Dynamic Survey. PARTICIPANTS 1978 migrants with diabetes were included. Consumer-side and provider-side factors both at the individual and the provincial level were considered. OUTCOME MEASURES Two-level and multivariate logistic regression models were established to identify the factors associated with exposure to TB education among migrants with diabetes over the past year at their migration destination. RESULTS Slightly more than one-third (33.52%) of the study participants received TB education. Individuals residing in provinces with higher TB death rates (adjusted OR (AOR)=1.48, 95% CI 1.02 to 2.15) and higher government spending as a proportion of total health expenditure (AOR=2.06, 95% CI 1.41 to 3.02) were more likely to be exposed to TB education. Higher individual awareness of essential public health services (AOR=3.52, 95% CI 2.69 to 4.59), establishment of personal health records at the migration destination (AOR=1.46, 95% CI 1.12 to 1.90), participation in community monitoring of hypertension/diabetes (AOR=1.95, 95% CI 1.52 to 2.51) and other factors were significant predictors of exposure to TB education (p<0.05). Participants older than 60 years were 27% less likely to receive TB education (AOR=0.73, 95% CI 0.54 to 0.99) compared with others. CONCLUSION The coverage of TB education among internal migrants with diabetes in China was lower than in some local communities, particularly among those who were older and had migrated long distances. Improving awareness of and access to basic public health services and social inclusion are critical to improving TB education.
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Affiliation(s)
- Junping Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Hui Yin
- Department of Health Education, School of Health Management, Harbin Medical University, Harbin, China
| | - Nan Wang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Yanfu Wang
- Heilongjiang Center for Disease Control, Harbin, China
| | - Li Guan
- Heilongjiang Provincial Hospital, Harbin, China
| | - Yajie Feng
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Lin Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Wei Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Huanyu Zhang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Zhaoyue Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Xinru Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Yue Zhou
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Yaping Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Xinle Yin
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Mingli Jiao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Libo Liang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- Institute for Medical Demography, Harbin Medical University, Harbin, China
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Li Y, Kar S, Li C, Liu M, Luan Z, Yuan G, Zhong X, Mu Y. Once-Weekly Insulin Icodec Versus Once-Daily Insulin Degludec in Insulin-Naive Chinese Participants with Type 2 Diabetes: A Post Hoc Analysis of ONWARDS 3. Diabetes Ther 2025; 16:685-699. [PMID: 40016570 PMCID: PMC11926311 DOI: 10.1007/s13300-025-01701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 01/27/2025] [Indexed: 03/01/2025] Open
Abstract
INTRODUCTION This post hoc analysis evaluated subgroup data from China (Chinese mainland, n = 100; Taiwan, n = 45) in ONWARDS 3, a 26-week, randomized, double-blind, double-dummy, treat-to-target, phase 3a trial comparing the efficacy and safety of once-weekly insulin icodec (icodec) versus once-daily insulin degludec (degludec) in insulin-naive participants with type 2 diabetes (T2D). METHODS Adults were randomized 1:1 to icodec and once-daily placebo (icodec; n = 72) or degludec and once-weekly placebo (degludec; n = 73). The primary endpoint was change in glycated hemoglobin (HbA1c) (baseline to week 26). Secondary assessments included change in fasting plasma glucose (FPG; baseline to week 26); total weekly insulin dose (weeks 24-26); body weight change (baseline to week 26); and clinically significant or severe hypoglycemia rates (baseline to week 31 [5-week follow-up included]). RESULTS At week 26, from baseline values of 8.22% (icodec) and 8.39% (degludec), estimated mean changes in HbA1c were - 1.38% points and - 1.10% points, respectively (estimated treatment difference [95% confidence interval], - 0.28%-points [- 0.50%-points, - 0.05%-points]; p = 0.0152). For icodec and degludec, estimated mean FPG change (- 2.3 mmol/L vs. - 2.3 mmol/L), estimated mean insulin doses (158 U/week vs. 142 U/week), and estimated body weight change (2.5 kg vs. 2.4 kg) were similar. Combined clinically significant or severe hypoglycemia rates were low (0.10 [icodec] vs. 0.07 [degludec] events per patient-year of exposure), with no statistically significant difference between groups. CONCLUSION In insulin-naive Chinese individuals with T2D, once-weekly icodec treatment showed significantly greater HbA1c reductions after 26 weeks than once-daily degludec, with low combined clinically significant or severe hypoglycemia rates across groups. CLINICALTRIALS GOV IDENTIFIER NCT04795531.
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Affiliation(s)
- Yijun Li
- Department of Endocrinology, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Soumitra Kar
- Novo Nordisk Service Centre India Private Ltd, Bangalore, India
| | - Congcong Li
- Department of General Practice, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang District, Jinan, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Zijian Luan
- Novo Nordisk Pharmaceutical Co. Ltd, Beijing, China
| | - Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Jiangsu, China
| | - Xing Zhong
- Novo Nordisk Pharmaceutical Co. Ltd, Beijing, China
| | - Yiming Mu
- Department of Endocrinology, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
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Zhang J, Li A, Quan J, Wu J, Cai H, Ding Y, Tang J, Ma X, Zhang J. Perspectives on Stringent Glycemic Control and Weight Loss Among Patients with Type 2 Diabetes in China: A Survey Study. Diabetes Ther 2025; 16:591-612. [PMID: 39946025 PMCID: PMC11925834 DOI: 10.1007/s13300-024-01690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 12/17/2024] [Indexed: 03/21/2025] Open
Abstract
INTRODUCTION Although current guidelines for type 2 diabetes (T2D) underscored the importance of attaining glycemic control and weight management goals, the patient perspectives on achieving these goals remained unclear in China. This study aimed to understand Chinese patients' perspectives on stringent glycemic control (hemoglobin A1c [HbA1c] ≤ 6.5%) and weight loss (≥ 10%) and their treatment preferences. METHODS Adult Chinese patients diagnosed with T2D who were aware of their latest HbA1c were enrolled in this survey study. An electronic questionnaire was designed to collect patients' characteristics, perspectives on safely achieving stringent glycemic control and weight loss, and preferences for different T2D treatment profiles. RESULTS The study included 495 patients. Patients predominantly indicated that safely achieving stringent glycemic control was extremely (82.83%) or moderately (12.12%) important. Nearly half of the patients (n = 231) perceived ≥ 10% weight loss as beneficial, among whom 117 (50.65%) and 84 (36.36%) indicated it was extremely and moderately important, respectively. Both having HbA1c > 6.5% within the past 6 months and body mass index ≥ 24 kg/m2 were associated with increased odds of choosing the T2D treatment with a higher chance of achieving stringent glycemic control and weight loss, given a similar safety profile. Conversely, age ≥ 60 years was associated with decreased odds of having the outcomes listed above. CONCLUSION This study demonstrated that most surveyed patients with T2D in China recognized the importance of safely achieving stringent glycemic control and weight loss. The identified factors associated with patients' perspectives and preferences could benefit clinical decision-making.
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Affiliation(s)
- Jian Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Ang Li
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Jinxing Quan
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Jun Wu
- Department of Endocrinology, The Third Hospital of Wuhan, Wuhan, China
| | - Hanqing Cai
- Department of Endocrinology, The Second Hospital of Jilin University, Jilin, China
| | | | | | - Xiao Ma
- Eli Lilly and Company, Shanghai, China
| | - Junqing Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, China.
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Qin YF, Zhang WH, Zhang HN, Li YW, Huang WQ, Xie JL, Yang S, Li LN, Cui C, Pei Q, Huang J, Yang GP. A phase 1, randomized, double-blind, placebo-controlled trial investigating the safety, tolerability, pharmacokinetics, and pharmacodynamics of KN056 (a recombinant human GLP-1 variant Fc fusion protein) in healthy Chinese participants. Expert Opin Investig Drugs 2025; 34:329-337. [PMID: 40328758 DOI: 10.1080/13543784.2025.2500303] [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: 02/13/2025] [Accepted: 04/15/2025] [Indexed: 05/08/2025]
Abstract
BACKGROUND This randomized clinical pharmacology trial investigated the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of KN056 following single-dose subcutaneous administration in healthy Chinese participants. METHODS Thirty healthy male subjects were randomized to receive a single dose of KN056 (0.5, 1.0, 3.0, 6.0, or 12.0 mg) or placebo. PK and PD parameters, as well as safety and tolerability, were assessed. RESULTS KN056 exposure increased proportionally with dose, with a half-life ranging from 141 to 188 hours. KN056 was well-tolerated, with gastrointestinal adverse events being the most common, particularly at the highest dose (12.0 mg). In the oral glucose tolerance test, KN056 dose-dependently decreased the AUC on the glucose versus time (gAUC) from baseline within 144 hours post-dosing. Specifically, the maximum reduction was 29.9% (occurring at the 72-hour mark). Body weight decreased within seven days of administration, correlating with dose levels, with a mean reduction of -1.68 kg in the 12.0 mg group; however, no significant change in body weight was observed by the end of the study. CONCLUSIONS KN056 demonstrated favorable PK, PD, and safety profiles in healthy Chinese participants, supporting its potential for once-weekly dosing.
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Affiliation(s)
- Yuan-Fang Qin
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Hua Zhang
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao-Nan Zhang
- Suzhou Alphamab Co, Ltd, Suzhou, Jiangsu Province, China
| | - Yu-Wei Li
- Suzhou Alphamab Co, Ltd, Suzhou, Jiangsu Province, China
| | - Wen-Qiao Huang
- Suzhou Alphamab Co, Ltd, Suzhou, Jiangsu Province, China
| | - Jin-Lian Xie
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shuang Yang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lan-Ni Li
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chang Cui
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qi Pei
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jie Huang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guo-Ping Yang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
- XiangYa school of Pharmaceutical Sciences, Central South University, Changsha, China
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Hai Q, Wang Y, Li H, Pei H, Wang N, Zhang X, Fan M, Liao J, Wen W, Zhao J, Yang L, Cui H. Plantamajoside Promotes NGF/TrkA Pathway to Inhibit Neuronal Apoptosis and Improve Diabetic Peripheral Neuropathy. J Cell Mol Med 2025; 29:e70571. [PMID: 40289624 PMCID: PMC12034938 DOI: 10.1111/jcmm.70571] [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: 12/10/2024] [Revised: 04/15/2025] [Accepted: 04/17/2025] [Indexed: 04/30/2025] Open
Abstract
The symptoms caused by diabetic peripheral neuropathy (DPN) have severely impacted patients' quality of life. While plantamajoside (PMS) exhibits neuroprotective properties, its efficacy and molecular mechanisms against DPN are unexplored. This study first established a high glucose (HG)-induced in vitro model of DPN and investigated the neuroprotective effects of PMS on RSC96 cells. We next demonstrated the anti-apoptotic effects of PMS and NGF/TrkA pathway mediated neurotrophic effects. Finally, we established a DPN mouse model and confirmed the therapeutic effects of PMS on DPN mice through behavioural tests and pathological staining, while also assessing the impact of PMS on the NGF/TrkA pathway and apoptosis. Our results showed that, in HG-induced DPN models, PMS enhanced cell viability while reducing LDH activity. Transcriptomics results indicated that the Apoptosis and Neurotrophins signalling pathways were key pathways for PMS on DPN. PMS treatment reduced HG-induced RSC96 cell apoptosis while enhancing NGF levels and upregulating NGF/TrkA-related protein expression. However, this protection was abolished by TrkA inhibitor or NGF neutralising antibodies. In vivo experimental results showed that PMS improved the mechanical pain threshold, thermal pain reaction time, and nerve conduction velocity of DPN mice. PMS improved pathological damage to the sciatic nerve, enhanced the number of Nissl bodies, reduced TUNEL-positive expression, and upregulated NGF levels. Furthermore, PMS reduced apoptosis and elevated NGF/TrkA-related protein expression in the sciatic nerve of DPN mice. In conclusion, PMS alleviates DPN through activating the NGF/TrkA pathway and inhibiting apoptosis.
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Affiliation(s)
- Qingshan Hai
- Nanjing University of Chinese MedicineNanjinChina
- Basic Medical SchoolYunnan University of Chinese MedicineKunmingChina
| | - Yuming Wang
- Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Hanzhou Li
- Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Huan Pei
- Basic Medical SchoolYunnan University of Chinese MedicineKunmingChina
| | - Ning Wang
- First School of Clinical MedicineYunnan University of Chinese MedicineKunmingChina
| | - Xiaoxia Zhang
- Basic Medical SchoolYunnan University of Chinese MedicineKunmingChina
| | - Mingyao Fan
- Basic Medical SchoolYunnan University of Chinese MedicineKunmingChina
| | - Jiabao Liao
- First School of Clinical MedicineYunnan University of Chinese MedicineKunmingChina
| | - Weibo Wen
- Nanjing University of Chinese MedicineNanjinChina
- First School of Clinical MedicineYunnan University of Chinese MedicineKunmingChina
| | - Jie Zhao
- First School of Clinical MedicineYunnan University of Chinese MedicineKunmingChina
| | - Ling Yang
- School of NursingYunnan University of Chinese MedicineKunmingChina
| | - Huantian Cui
- First School of Clinical MedicineYunnan University of Chinese MedicineKunmingChina
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Hu S, Ji W, Zhang Y, Zhu W, Sun H, Sun Y. Risk factors for progression to type 2 diabetes in prediabetes: a systematic review and meta-analysis. BMC Public Health 2025; 25:1220. [PMID: 40165126 PMCID: PMC11956339 DOI: 10.1186/s12889-025-21404-4] [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: 07/05/2024] [Accepted: 01/10/2025] [Indexed: 04/02/2025] Open
Abstract
BACKGROUND Prediabetes is the earliest identifiable stage of glycemic dysregulation, and its progression can be delayed by effective control of risk factors. Currently, various risk factors for the progression from prediabetes to type 2 diabetes mellitus (T2DM) need to be further summarized. OBJECTIVE This systematic evaluation of the risk factors for the progression of prediabetes to type 2 diabetes mellitus provides a theoretical basis for early recognition and intervention. The meta-analysis identifies the Fatty Liver Index as a significant risk factor [OR = 6.14, 95% CI (5.22, 7.22)] for the progression from prediabetes to type 2 diabetes, highlighting its predictive value. METHODS PubMed, Web of Science, Embase, The Cochrane Library, CNKI, WANFANG, and VIP databases were searched to collect cohort studies on risk factors for progressing to type 2 diabetes in prediabetes from inception to February 15, 2024. STATA 17.0 was used for Meta-analysis. RESULTS A total of 59 studies were included, all of which were of medium to high quality. The factors were categorized into four major groups: sociodemographic factors, lifestyle factors, psychosocial factors, and comorbidities and clinical indicators. Meta-analysis results showed that sociodemographic factors [age [OR = 1.03, 95% CI (1.01, 1.04)], family history [OR = 1.48, 95% CI (1.36, 1.61)], male sex [OR = 1.13, 95% CI (1.08, 1.19)], high BMI [OR = 1.21, 95% CI (1.15, 1.27)], high waist circumference [OR = 1.49, 95% CI (1.23, 1.79)], and high waist-to-hip ratio [OR = 2.44, 95% CI (2.17, 2.74)]]. Lifestyle factors included a lack of physical exercise [OR = 1.86, 95% CI (1.19, 2.88)], smoking [OR = 1.31, 95% CI (1.22, 1.41)], and moderate physical activity [OR = 0.24, 95% CI (0.09, 0.67)]. Psychosocial factors included anxiety [OR = 2.61, 95% CI (1.36, 5.00)], depression [OR = 1.88, 95% CI (1.35, 2.61)], and social deprivation level 4 [OR = 1.15, 95% CI (1.13, 1.18)]. Comorbidities and clinical indicators included hypertension [OR = 1.41, 95% CI (1.33, 1.50)], high triglycerides [OR = 1.25, 95% CI (1.10, 1.43)], high cholesterol [OR = 1.09, 95% CI (1.06, 1.12)], fatty liver index [OR = 6.14, 95% CI (5.22, 7.22)], low HDL-C [OR = 1.13, 95% CI (1.09, 1.36)], and high blood glucose levels [OR = 1.01, 95% CI (1.01, 1.02)]. CONCLUSIONS This study found that age, male sex, positive family history of type 2 diabetes, high BMI, unhealthy lifestyle, anxiety, depression, high blood pressure, high triglycerides, and a high fatty liver index are risk factors for the progression from prediabetes to type 2 diabetes and should be given sufficient attention. Moderate physical activity and Low HDL-C are protective factors. Future studies should also increase follow-up, explore the best diagnostic criteria for prediabetes, and fully consider the definitions of various factors. The study was registered in PROSPERO (CRD42024513931).
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Affiliation(s)
- Shengying Hu
- School of Nursing, Peking University, Beijing, 100191, China
| | - Wenting Ji
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan, China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, 100191, China
| | - Wendi Zhu
- School of Nursing, Peking University, Beijing, 100191, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, 100191, China.
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, 100191, China.
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Zhang L, Du Y, Zhou J, Liu C, Li J, Qiao C. Timing of diagnostic workups in Chinese population with recurrent pregnancy loss: a cross-sectional study. BMC Pregnancy Childbirth 2025; 25:373. [PMID: 40158174 PMCID: PMC11954248 DOI: 10.1186/s12884-025-07330-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/14/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND There are no specific guidelines regarding the definition, diagnostic workup and treatment of recurrent pregnancy loss (RPL) in China at present. Whether the diagnostic workup should occur after two or three or more pregnancy losses in the Chinese population is not clear. METHODS This cross-sectional study collected data from January 2017 to December 2022 from the RPL Clinic at Shengjing Hospital, affiliated with China Medical University. The results of diagnostic tests for evidence-based and possible risk factors of RPL,which is defined as two or more failed clinical pregnancies, were collected. The data collected include parental chromosomal karyotypes, immune factors (anticardiolipin antibody, anti-β2-glycoprotein I antibody, lupus anticoagulants, and antinuclear antibodies), endocrine factors (polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, obesity, and glucose abnormalities), anatomical factors (uterine malformations, endometrial polyps, intrauterine adhesions, uterine fibroids or adenomyosis), coagulation factors (thrombelastogram, antithrombin III, and homocysteine levels) and other factors (vitamin D levels, MTHFR polymorphisms and ultrasound indices of endometrial receptivity). All these data were compared between patients with two or three or more pregnancy losses. RESULTS Among all 785 patients with RPL, the rates of abnormal anatomical factors (40.96% versus 32.94%, P = 0.021, OR 1.41, (95% Cl 1.05-1.89)), endometrial polyps (6.21% versus 3.06%, P = 0.034, OR 2.10, (95% Cl 1.04-4.23)) and obesity (13.76% versus 5.59%, P < 0.0001, OR 2.69, (95% Cl 1.62-4.49)) were significantly higher in people with three or more pregnancy losses than in people with two pregnancy losses. The rates of other diagnostic tests were not statistically significant between the two groups. CONCLUSION Based on the high rate of abnormal test results in the Chinese RPL population, our findings may provide evidence for patients in our area begin routine etiological screening after two pregnancy losses. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03561766, 18/5/2018.
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Affiliation(s)
- Liyang Zhang
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, Shenyang, China
| | - Yushu Du
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, Shenyang, China
| | - Jingshuang Zhou
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Chuanyang Liu
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
| | - Jiapo Li
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, Shenyang, China
| | - Chong Qiao
- Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China.
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China.
- Research Center of China Medical University Birth Cohort, Shenyang, China.
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Lian H, Ren Q, Liu W, Zhang R, Zou X, Zhang S, Luo Y, Deng W, Wang Q, Qi L, Li Y, Wang W, Zhong L, Zhang P, Guo C, Li L, Li Y, Ba T, Yang C, Huo L, Wang Y, Li C, Hao D, Zhang Y, Xu Y, Wang F, Wang X, Zhang F, Gong S, Yang W, Han X, Ji L. Cardiovascular abnormalities already occurred in newly-diagnosed patients with early-onset type 2 diabetes. Cardiovasc Diabetol 2025; 24:140. [PMID: 40140837 PMCID: PMC11948644 DOI: 10.1186/s12933-025-02665-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Accepted: 02/25/2025] [Indexed: 03/28/2025] Open
Abstract
BACKGROUND The prevalence of early-onset type 2 diabetes (EOD) is rapidly increasing. This study intends to screen for early cardiovascular abnormalities in patients newly diagnosed with EOD and evaluate the cardiovascular risk across cluster phenotypes. METHOD A total of 400 patients ≤ 40 years old with newly diagnosed type 2 diabetes were enrolled from the START cohort (the Study of The newly diAgnosed eaRly onset diabeTes). Cluster classification was performed using the K-means method based on age, BMI, HbA1c, HOMA2-β, HOMA2-IR, and GAD antibodies. Echocardiography and carotid ultrasound were performed within 3 months of diabetes diagnosis. Carotid ultrasound abnormalities included intimal thickening and plaque formation, while echocardiography assessed changes in cardiac structure and systolic/diastolic function. Cluster-specific partitioned polygenic scores (pPS) were used to validate our findings from a genetic perspective. RESULT Carotid artery abnormalities were detected in 26.3% of patients, and echocardiography abnormalities were observed in 20.0%. Patients with severe insulin resistant diabetes (SIRD) had the highest incidence of carotid artery abnormality (40.0%). After adjusting for relevant risk factors, fasting C-peptide levels were significantly associated with a 1.247-fold increase in the risk of carotid artery abnormalities. Left atrial enlargement was more prevalent in the SIRD (16.7%) and mild obesity-related diabetes (MOD) (18.5%) classifications. A high proportion of patients with SIRD had abnormal left ventricular geometry (36.1%). Increases in BMI, fasting C-peptide level and HOMA2IR were accompanied by a further increase in left atrial enlargement risk by 1.136-, 1.781- and 1.687-fold respectively. The pPS for lipodystrophy was higher in the EOD group with plaque formation, and showed a significant linear correlation with the ratio of the left atrial anteroposterior diameter to body surface area (LAAP/BSA) (R = 0.344, p < 0.001). CONCLUSION Heart and carotid artery abnormalities are common in patients with early-onset T2DM at the time of diagnosis. Patients with obesity and insulin resistance are at higher risk for cardiovascular abnormalities. Cluster classification based on clinical characteristics enables more accurate identification of patients at increased risk of cardiovascular complications at an early stage.
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Affiliation(s)
- Hong Lian
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Qian Ren
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Wei Liu
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Rui Zhang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Xiantong Zou
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Simin Zhang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Yingying Luo
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Wei Deng
- Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, 100035, People's Republic of China
| | - Qiuping Wang
- Department of Endocrinology, Bejing Fangshan District Liangxiang Hospital, Beijing, 102400, People's Republic of China
| | - Lin Qi
- Department of Endocrinology, Bejing Yanhua Hospital, Beijing, 102500, People's Republic of China
| | - Yufeng Li
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, 101299, People's Republic of China
| | - Wenbo Wang
- Department of Endocrinology, Beijing Univesity Shougang Hospital, Beijing, 100144, People's Republic of China
| | - Liyong Zhong
- Department of Endocrinology, Capital Medical University Beijing Tiantan Hospital, Beijing, 100050, People's Republic of China
| | - Pengkai Zhang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Chengcheng Guo
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Li Li
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Yating Li
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Tianhao Ba
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Chaochao Yang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Lili Huo
- Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, 100035, People's Republic of China
| | - Yan'ai Wang
- Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, 100035, People's Republic of China
| | - Chunxia Li
- Department of Endocrinology, Bejing Fangshan District Liangxiang Hospital, Beijing, 102400, People's Republic of China
| | - Dejun Hao
- Department of Endocrinology, Bejing Yanhua Hospital, Beijing, 102500, People's Republic of China
| | - Yajing Zhang
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, 101299, People's Republic of China
| | - Yan Xu
- Department of Endocrinology, Beijing Univesity Shougang Hospital, Beijing, 100144, People's Republic of China
| | - Fang Wang
- Department of Endocrinology, Capital Medical University Beijing Tiantan Hospital, Beijing, 100050, People's Republic of China
| | - Xiangqing Wang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Fang Zhang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Siqian Gong
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Wenjia Yang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Xueyao Han
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
| | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
- Peking University Diabetes Centre, Beijing, 100191, People's Republic of China.
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
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Chen X, Liang M, Zhang J, Xu C, Chen L, Hu R, Zhong J. The Non-High-Density Lipoprotein Cholesterol (Non-HDL-C) to HDL-C Ratio (NHHR) and Its Association with Chronic Kidney Disease in Chinese Adults with Type 2 Diabetes: A Preliminary Study. Nutrients 2025; 17:1125. [PMID: 40218883 PMCID: PMC11990853 DOI: 10.3390/nu17071125] [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: 03/03/2025] [Revised: 03/17/2025] [Accepted: 03/23/2025] [Indexed: 04/14/2025] Open
Abstract
Objectives: The objective of this study was to examine the association between non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) and chronic kidney disease (CKD) in Chinese adults with type 2 diabetes mellitus (T2DM). Methods: This study originated from a survey carried out in Zhejiang Province, located in eastern China, between March and November 2018. To explore the relationship between NHHR and CKD, a multivariable logistic regression model was employed. The dose-response relationship was assessed using restricted cubic spline (RCS) analysis, while generalized additive models (GAMs) were applied to examine the associations between NHHR and urinary albumin-to-creatinine ratio (UACR) as well as estimated glomerular filtration rate (eGFR). Subgroup analyses were performed across various demographic and clinical categories to assess the consistency of the NHHR-CKD association. The optimal NHHR cutoff for CKD diagnosis, its predictive accuracy, and its comparison with its components and HbA1c were determined through receiver operating characteristic (ROC) curve analysis. Results: The study enrolled 1756 participants, including 485 individuals with CKD and 1271 without CKD. Multivariable logistic regression revealed a significant positive association between NHHR and CKD, with each standard deviation (SD) increase in NHHR linked to a 23% higher odds of CKD (OR = 1.23, 95% CI: 1.09-1.37) after adjusting for potential confounders. When comparing quartiles, the fully adjusted ORs for Q2, Q3, and Q4 were 1.29 (0.92-1.79), 1.31 (0.94-1.83), and 1.87 (1.34-2.60), respectively, relative to Q1 (p for trend < 0.01). RCS analysis confirmed a linear dose-response relationship between NHHR and CKD in both sexes (p for nonlinearity > 0.05). GAMs indicated a significant positive correlation between NHHR and UACR (ρ = 0.109, p < 0.001) but no significant association with eGFR (ρ = -0.016, p = 0.502). Subgroup analyses demonstrated consistent associations across most subgroups, except for the 18-44 years age group, the well-controlled glycemic group, and the non-alcohol drinking group (p > 0.05). ROC curve analysis identified an optimal NHHR cutoff of 3.48 for CKD prediction, with an area under the curve (AUC) of 0.606 (95% CI: 0.577-0.635). Notably, NHHR outperformed its individual components and HbA1c in predictive performance. Conclusions: This study revealed a linear link between higher NHHR levels and increased CKD prevalence in Chinese T2DM patients. NHHR may also serve as a potential complementary biomarker for early CKD detection, though further prospective studies are needed to confirm its predictive value and clinical utility in high-risk T2DM populations.
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Affiliation(s)
| | | | | | | | | | | | - Jieming Zhong
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (X.C.); (M.L.); (J.Z.); (C.X.); (L.C.); (R.H.)
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