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Network efficiency of functional brain connectomes altered in type 2 diabetes patients with and without mild cognitive impairment. 伴有和不伴有轻度认知障碍的 2 型糖尿病患者大脑功能连接组的网络效率发生了改变。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-15 DOI: 10.1186/s13098-024-01484-9
Juan Li, Qiang Zhang, Juan Wang, Ying Xiong, Wenzhen Zhu

Aim: To explore the topological organization alterations of functional connectomes in type 2 diabetes (T2DM) patients with and without mild cognitive impairment (MCI), and compare these with structural connectomes changes.

Methods: Twenty-six T2DM patients with MCI (DM-MCI), 26 without cognitive impairment (DM-NC), and 28 healthy controls were included. Diffusion tensor imaging (DTI) and resting-state functional MRI images were acquired. Networks were constructed and graph-theory based network measurements were calculated. The global network parameters and nodal efficiencies were compared across the three groups using one-way ANOVA and a false-discovery rate correction was applied for multiple comparisons. Partial correlation analyses were performed to investigate relationships between network parameters, cognitive performance and clinical variables.

Results: In the structural connectome, the DM-MCI group exhibited significantly decreased global efficiency (Eglob) and local efficiency (Eloc) compared to the DM-NC and control groups. In the functional connectome, the DM-MCI group exhibited increased Eloc and clustering coefficient (Cp) compared to the controls. No significant differences were found in Eglob, Eloc, or Cp between the DM-NC and the control group, both in structural and functional connectomes. Nodal efficiencies decreased in some brain regions of structural and functional networks in the DM-MCI and DM-NC groups, but increased in five regions in functional network, some of which were involved in the default-mode network.

Conclusion: Unlike the consistently decreased global properties and nodal efficiencies in the structural connectome of T2DM patients, increases in Eloc, Cp, and nodal efficiencies in the functional connectome may be viewed as a compensatory mechanism due to functional plasticity and reorganization. Altered nodal efficiency can hint at cognitive decrements at an early stage in T2DM patients.

目的:探讨伴有和不伴有轻度认知障碍(MCI)的2型糖尿病(T2DM)患者功能连接组的拓扑组织变化,并将这些变化与结构连接组的变化进行比较:方法:纳入26名患有轻度认知障碍(MCI)的T2DM患者(DM-MCI)、26名未患有轻度认知障碍(DM-NC)的患者和28名健康对照者。研究人员采集了弥散张量成像(DTI)和静息态功能磁共振成像图像。构建网络并计算基于图论的网络测量值。使用单因素方差分析比较了三组的全局网络参数和节点效率,并对多重比较进行了误发现率校正。对网络参数、认知表现和临床变量之间的关系进行了偏相关分析:在结构连接组中,与DM-NC组和对照组相比,DM-MCI组的全局效率(Eglob)和局部效率(Eloc)明显下降。在功能连接组中,与对照组相比,DM-MCI 组的 Eloc 和聚类系数(Cp)有所增加。DM-NC 组和对照组在 Eglob、Eloc 或 Cp 方面没有发现明显差异,无论是在结构连接组还是在功能连接组。在DM-MCI组和DM-NC组中,结构网络和功能网络的一些脑区的节点效率有所下降,但功能网络的五个区域的节点效率有所上升,其中一些区域涉及默认模式网络:结论:与T2DM患者结构连接组的全局属性和节点效率持续下降不同,功能连接组中Eloc、Cp和节点效率的增加可被视为功能可塑性和重组导致的一种补偿机制。结节效率的改变可在 T2DM 患者的早期阶段暗示其认知能力下降。
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引用次数: 0
Insulinemic potential of diet and the risk of type 2 diabetes: a meta-analysis and systematic review. 饮食的胰岛素潜能与 2 型糖尿病风险:荟萃分析和系统综述。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-10 DOI: 10.1186/s13098-024-01474-x
Hossein Farhadnejad, Mehrnaz Abbasi, Hamid Ahmadirad, Morteza Omrani, Mitra Kazemi Jahromi, Mostafa Norouzzadeh, Niloufar Saber, Farshad Teymoori, Parvin Mirmiran

Background: The possible role of the insulinemic potential of diet in the etiology of type 2 diabetes (T2D) has recently received significant attention in observational studies. This meta-analysis aimed to synthesize available evidence and quantify the potential association between the empirical dietary index for hyperinsulinemia (EDIH) score and T2D risk.

Methods: Various electronic databases, including Scopus, PubMed, and Web of Science, were comprehensively searched up to January 2024 using related keywords to identify relevant studies. The hazard ratios (HR) or odds ratios were extracted from eligible cohort studies, and a random-effects model with an inverse variance weighting method was used to calculate the pooled effect size, which was expressed as HR.

Results: The analysis included six cohort studies (four publications), with sample sizes ranging from 3,732 to 90,786 individuals aged 20 to 79 years. During follow-up periods of 5 to over 20 years, 31,284 T2D incidents were identified. The pooled results showed that a higher EDIH score was associated with an increased risk of T2D incidence (HR: 1.47; 95%CI 1.21-1.77; I2 = 91.3%). Significant publication bias was observed in the present meta-analysis (P = 0.020). Geographical region and follow-up period can be as sources of heterogeneity (Pheterogeneity <0.001).

Conclusion: Our meta-analysis of observational studies suggested that a diet with a higher EDIH score may be associated with an increased risk of incidence of T2D.

背景:饮食的胰岛素血症潜能在 2 型糖尿病(T2D)病因学中可能发挥的作用最近在观察性研究中受到了极大关注。这项荟萃分析旨在综合现有证据,量化高胰岛素血症经验饮食指数(EDIH)评分与 T2D 风险之间的潜在关联:使用相关关键词全面检索了截至 2024 年 1 月的各种电子数据库,包括 Scopus、PubMed 和 Web of Science,以确定相关研究。从符合条件的队列研究中提取危险比(HR)或几率比,并采用随机效应模型和反方差加权法计算汇总效应大小,以HR表示:分析包括六项队列研究(四项出版物),样本量从 3,732 到 90,786 人不等,年龄在 20 到 79 岁之间。在 5 至 20 多年的随访期间,共发现了 31,284 例终末期糖尿病。汇总结果显示,EDIH得分越高,T2D发病风险越高(HR:1.47;95%CI 1.21-1.77;I2 = 91.3%)。在本荟萃分析中观察到了明显的发表偏倚(P = 0.020)。地理区域和随访期可能是异质性的来源(异质性结论):我们对观察性研究的荟萃分析表明,EDIH 评分越高的饮食可能与 T2D 发病风险的增加有关。
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引用次数: 0
Atherogenic index of plasma and obesity-related risk of stroke in middle-aged and older Chinese adults: a national prospective cohort study. 中国中老年人血浆致动脉粥样硬化指数与肥胖相关的中风风险:一项全国前瞻性队列研究。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1186/s13098-024-01481-y
Lu Zhai, Rong-Rui Huo, Yan-Li Zuo

Backgroud: The association between the atherogenic index of plasma (AIP) and stroke risk is uncertain. Overweight and obese individuals frequently develop atherosclerosis, suggesting AIP may mediate the relationship between body mass index (BMI) and stroke risk. This study investigates whether AIP mediates the BMI-stroke association and evaluates the interaction effects of AIP and BMI on stroke risk in middle-aged and older Chinese adults.

Method: This study analyzes data from the China Health and Retirement Longitudinal Study (CHARLS), an ongoing nationally representative prospective cohort study that began in 2011. It includes 8 598 middle-aged and older Chinese adults without stroke at baseline. A mediation analysis, employing a novel two-stage regression method, was conducted to evaluate the indirect effect of BMI on stroke through AIP.

Results: During a median follow-up of 7.1 years, 615 (7.2%) participants developed a stroke. After adjusting for confounders, AIP was significantly associated with stroke risk (hazard ratio [HR] per 1-SD increase, 1.24; 95% CI 1.14-1.35). Mediation analysis indicated that compared to normal weight, obesity similarly raised stroke risk by 78.0% (HR 1.78, 95% CI 1.40-2.27), with 29.67% (95% CI 14.27-45.08%) of the association mediated through AIP (HR 1.15, 95% CI 1.08-1.23). No significant multiplicative or additive interactions were observed between BMI and AIP on stroke.

Conclusions: This study found that the AIP appeared to be associated with stroke risk and mediates the association between obesity and stroke among middle-aged and older Chinese adults.

背景:血浆致动脉粥样硬化指数(AIP)与中风风险之间的关系尚不确定。超重和肥胖者经常发生动脉粥样硬化,这表明 AIP 可能介导体重指数(BMI)与中风风险之间的关系。本研究调查了 AIP 是否介导体重指数与脑卒中的关系,并评估了 AIP 和体重指数对中国中老年人脑卒中风险的交互影响:本研究分析了中国健康与退休纵向研究(CHARLS)的数据,该研究始于 2011 年,是一项具有全国代表性的前瞻性队列研究。该研究包括 8 598 名基线时未患中风的中国中老年人。研究采用新颖的两阶段回归方法进行了中介分析,以评估 BMI 通过 AIP 对中风的间接影响:结果:在中位数为 7.1 年的随访期间,有 615 人(7.2%)发生了脑卒中。在对混杂因素进行调整后,AIP 与中风风险显著相关(每增加 1-SD 的危险比 [HR] 为 1.24;95% CI 为 1.14-1.35)。中介分析表明,与正常体重相比,肥胖同样会使中风风险增加 78.0%(HR 1.78,95% CI 1.40-2.27),其中 29.67%(95% CI 14.27-45.08%)的关联通过 AIP 中介(HR 1.15,95% CI 1.08-1.23)。没有观察到 BMI 和 AIP 对中风有明显的乘法或加法相互作用:本研究发现,AIP 似乎与中风风险有关,并且在中国中老年人肥胖与中风之间起中介作用。
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引用次数: 0
New insights on genetic background of major diabetic vascular complications. 主要糖尿病血管并发症遗传背景的新见解。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-07 DOI: 10.1186/s13098-024-01473-y
Zuira Tariq, Salah Abusnana, Bashair M Mussa, Hala Zakaria

Background: By 2045, it is expected that 693 million individuals worldwide will have diabetes and with greater risk of morbidity, mortality, loss of vision, renal failure, and a decreased quality of life due to the devastating effects of macro- and microvascular complications. As such, clinical variables and glycemic control alone cannot predict the onset of vascular problems. An increasing body of research points to the importance of genetic predisposition in the onset of both diabetes and diabetic vascular complications.

Objectives: Purpose of this article is to review these approaches and narrow down genetic findings for Diabetic Mellitus and its consequences, highlighting the gaps in the literature necessary to further genomic discovery.

Material and methods: In the past, studies looking for genetic risk factors for diabetes complications relied on methods such as candidate gene studies, which were rife with false positives, and underpowered genome-wide association studies, which were constrained by small sample sizes.

Results: The number of genetic findings for diabetes and diabetic complications has over doubled due to the discovery of novel genomics data, including bioinformatics and the aggregation of global cohort studies. Using genetic analysis to determine whether diabetes individuals are at the most risk for developing diabetic vascular complications (DVC) might lead to the development of more accurate early diagnostic biomarkers and the customization of care plans.

Conclusions: A newer method that uses extensive evaluation of single nucleotide polymorphisms (SNP) in big datasets is Genome-Wide Association Studies (GWAS).

背景:到 2045 年,预计全球将有 6.93 亿人患有糖尿病,由于大血管和微血管并发症的破坏性影响,他们将面临更大的发病、死亡、视力丧失、肾功能衰竭和生活质量下降的风险。因此,仅凭临床变量和血糖控制并不能预测血管问题的发生。越来越多的研究表明,遗传易感性在糖尿病和糖尿病血管并发症的发病中具有重要作用:本文旨在回顾这些方法,缩小糖尿病及其后果的遗传发现范围,强调进一步发现基因组所需的文献空白:过去,寻找糖尿病并发症遗传风险因素的研究依赖于候选基因研究和全基因组关联研究等方法,前者充斥着假阳性,后者受制于样本量小:结果:由于新型基因组学数据的发现,包括生物信息学和全球队列研究的汇总,糖尿病和糖尿病并发症的基因研究结果数量增加了一倍多。利用基因分析来确定糖尿病患者是否最有可能患糖尿病血管并发症(DVC),可能有助于开发更准确的早期诊断生物标志物和定制护理计划:全基因组关联研究(GWAS)是一种在大型数据集中广泛评估单核苷酸多态性(SNP)的新方法。
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引用次数: 0
Prognosis and outcome of latent autoimmune diabetes in adults: T1DM or T2DM? 成人潜伏性自身免疫性糖尿病的预后和结局:T1DM还是T2DM?
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-07 DOI: 10.1186/s13098-024-01479-6
Zhipeng Zhou, Mingyue Xu, Pingjie Xiong, Jing Yuan, Deqing Zheng, Shenghua Piao

Latent Autoimmune Diabetes in Adults (LADA) is a type of diabetes mellitus often overlooked in clinical practice for its dual resemblance to Type 1 Diabetes Mellitus (T1DM) in pathogenesis and to Type 2 Diabetes Mellitus (T2DM) in clinical presentation. To better understand LADA's distinctiveness from T1DM and T2DM, we conducted a comprehensive review encompassing etiology, pathology, clinical features, treatment modalities, and prognostic outcomes. With this comparative lens, we propose that LADA defies simple classification as either T1DM or T2DM. The specific treatments for the disease are limited and should be based on the therapies of T1DM or T2DM that address specific clinical issues at different stages of the disease. It is crucial to identify LADA cases potentially misdiagnosed as T2DM, warranting prompt screening for poor blood sugar control, short-term blood sugar deterioration, and other conditions. If the prognosis for LADA is similar to T2DM, it can be managed as T2DM. However, if the prognosis fundamentally differs, early LADA screening is crucial to optimize patient outcomes and enhance research on tailored treatments. The pathogenesis of LADA is clear, so the prognosis may be the key to determining whether it can be classified as T2DM, which is also the direction of future research. On the one hand, this paper aims to provide suggestions for the clinical screening and treatment of LADA based on the latest progress and provide worthy directions for future research on LADA.

成人潜伏自身免疫性糖尿病(LADA)是一种在临床实践中经常被忽视的糖尿病类型,因为它在发病机制上与 1 型糖尿病(T1DM)和临床表现上与 2 型糖尿病(T2DM)具有双重相似性。为了更好地了解 LADA 与 T1DM 和 T2DM 的不同之处,我们对其病因、病理、临床特征、治疗方法和预后结果进行了全面的综述。通过这种比较视角,我们认为 LADA 既不能简单地归类为 T1DM,也不能简单地归类为 T2DM。该病的具体治疗方法是有限的,应该以 T1DM 或 T2DM 的治疗方法为基础,解决疾病不同阶段的具体临床问题。识别可能被误诊为 T2DM 的 LADA 病例至关重要,应及时筛查血糖控制不佳、短期血糖恶化等情况。如果 LADA 的预后与 T2DM 相似,可以按照 T2DM 进行管理。但是,如果预后与 T2DM 有本质区别,则早期 LADA 筛查对于优化患者预后和促进定制治疗研究至关重要。LADA 的发病机制已经明确,因此预后可能是决定其能否归类为 T2DM 的关键,这也是未来研究的方向。一方面,本文旨在根据最新进展为 LADA 的临床筛查和治疗提供建议,为 LADA 的未来研究提供值得借鉴的方向;另一方面,本文也希望为 LADA 的临床筛查和治疗提供参考,为 LADA 的未来研究提供值得借鉴的方向。
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引用次数: 0
A machine learning approach to predict foot care self-management in older adults with diabetes. 预测老年糖尿病患者足部护理自我管理情况的机器学习方法。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-07 DOI: 10.1186/s13098-024-01480-z
Su Özgür, Serpilay Mum, Hilal Benzer, Meryem Koçaslan Toran, İsmail Toygar

Background: Foot care self-management is underutilized in older adults and diabetic foot ulcers are more common in older adults. It is important to identify predictors of foot care self-management in older adults with diabetes in order to identify and support vulnerable groups. This study aimed to identify predictors of foot care self-management in older adults with diabetes using a machine learning approach.

Method: This cross-sectional study was conducted between November 2023 and February 2024. The data were collected in the endocrinology and metabolic diseases departments of three hospitals in Turkey. Patient identification form and the Foot Care Scale for Older Diabetics (FCS-OD) were used for data collection. Gradient boosting algorithms were used to predict the variable importance. Three machine learning algorithms were used in the study: XGBoost, LightGBM and Random Forest. The algorithms were used to predict patients with a score below or above the mean FCS-OD score.

Results: XGBoost had the best performance (AUC: 0.7469). The common predictors of the models were age (0.0534), gender (0.0038), perceived health status (0.0218), and treatment regimen (0.0027). The XGBoost model, which had the highest AUC value, also identified income level (0.0055) and A1c (0.0020) as predictors of the FCS-OD score.

Conclusion: The study identified age, gender, perceived health status, treatment regimen, income level and A1c as predictors of foot care self-management in older adults with diabetes. Attention should be given to improving foot care self-management among this vulnerable group.

背景:老年人对足部护理自我管理的利用率较低,而糖尿病足溃疡在老年人中更为常见。确定糖尿病老年人足部护理自我管理的预测因素对识别和支持弱势群体非常重要。本研究旨在利用机器学习方法确定老年糖尿病患者足部护理自我管理的预测因素:这项横断面研究于 2023 年 11 月至 2024 年 2 月间进行。数据在土耳其三家医院的内分泌和代谢疾病科收集。收集数据时使用了患者身份识别表和老年糖尿病患者足部护理量表(FCS-OD)。梯度提升算法用于预测变量的重要性。研究中使用了三种机器学习算法:XGBoost、LightGBM 和随机森林。这些算法用于预测得分低于或高于 FCS-OD 平均得分的患者:XGBoost的性能最佳(AUC:0.7469)。这些模型的共同预测因子是年龄(0.0534)、性别(0.0038)、健康状况感知(0.0218)和治疗方案(0.0027)。AUC值最高的XGBoost模型还发现收入水平(0.0055)和A1c(0.0020)是FCS-OD得分的预测因素:研究发现,年龄、性别、健康状况感知、治疗方案、收入水平和 A1c 是老年糖尿病患者足部护理自我管理的预测因素。应重视改善这一弱势群体的足部护理自我管理。
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引用次数: 0
Association of lipid-lowering drugs with the risk of type 2 diabetes and its complications: a mendelian randomized study. 降脂药与 2 型糖尿病及其并发症风险的关系:一项门德尔随机研究。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-04 DOI: 10.1186/s13098-024-01477-8
Yue-Yang Zhang, Bing-Xue Chen, Qin Wan

Background: The pathogenesis of type 2 diabetes mellitus is somewhat associated with lipid metabolism. We aim to assess the impact of lipid-lowering drugs (HMGCR inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors) on type 2 diabetes mellitus and its complications through a two-sample Mendelian randomization (MR) study.

Method: We identified suitable genetic instruments from the GWAS database that represent the expression levels of three genes, interpreting reduced genetically proxied gene expression as indicative of lipid-lowering drug use. We evaluated the causal relationships among these variables employing a two-sample Mendelian randomization approach, with the Inverse Variance Weighted (IVW) analysis serving as the primary method. Coronary artery disease was utilized as a positive control to validate the reliability of the selected genetic instruments.

Result: Increased genetically proxied HMGCR expression is significantly associated with a reduced risk of type 2 diabetes mellitus (OR = 0.64, 95%CI = 0.55-0.74), which was replicated in the FinnGen study with consistent results (OR = 0.65, 95%CI = 0.53-0.80). Increased genetically proxied HMGCR expression is associated with a reduced risk of diabetic retinopathy (OR = 0.23, 95%CI = 0.12-0.44) and diabetic nephropathy (OR = 0.35, 95%CI = 0.17-0.71). In contrast, increased genetically proxied PCSK9 expression is associated with a decreased risk of diabetic coma (OR = 0.70, 95%CI = 0.50-0.98), diabetic neuropathy (OR = 0.24, 95%CI = 0.14-0.42), diabetic retinopathy (OR = 0.67, 95%CI = 0.48-0.96), diabetic cardiovascular diseases (OR = 0.62, 95%CI = 0.38-0.99), and diabetic nephropathy (OR = 0.62, 95%CI = 0.41-0.95).

Conclusions: This Mendelian randomization study suggests an association between HMGCR and the pathogenesis of type 2 diabetes mellitus, with increased genetically proxied HMGCR expression reducing the risk of type 2 diabetes mellitus, while PCSK9 and NPC1L1 show no significant association with type 2 diabetes mellitus. These findings may offer more reasonable lipid-lowering drug options for patients with dyslipidemia.

背景:2 型糖尿病的发病机制在一定程度上与脂质代谢有关。我们旨在通过一项双样本孟德尔随机化(MR)研究,评估降脂药物(HMGCR 抑制剂、PCSK9 抑制剂和 NPC1L1 抑制剂)对 2 型糖尿病及其并发症的影响:我们从 GWAS 数据库中找到了代表三个基因表达水平的合适基因工具,将基因替代基因表达的减少解释为降脂药物使用的指示。我们采用双样本孟德尔随机方法评估了这些变量之间的因果关系,并将反方差加权(IVW)分析作为主要方法。冠状动脉疾病被用作阳性对照,以验证所选遗传工具的可靠性:结果:基因替代 HMGCR 表达的增加与 2 型糖尿病风险的降低显著相关(OR = 0.64,95%CI = 0.55-0.74),这一结果在 FinnGen 研究中得到了验证(OR = 0.65,95%CI = 0.53-0.80)。HMGCR 基因表达的增加与糖尿病视网膜病变(OR = 0.23,95%CI = 0.12-0.44)和糖尿病肾病(OR = 0.35,95%CI = 0.17-0.71)风险的降低有关。相比之下,基因替代 PCSK9 表达的增加与糖尿病昏迷(OR = 0.70,95%CI = 0.50-0.98)、糖尿病神经病变(OR = 0.24,95%CI = 0.14-0.42)、糖尿病视网膜病变(OR = 0.67,95%CI = 0.48-0.96)、糖尿病心血管疾病(OR = 0.62,95%CI = 0.38-0.99)和糖尿病肾病(OR = 0.62,95%CI = 0.41-0.95):这项孟德尔随机化研究表明,HMGCR与2型糖尿病的发病机制有关,基因替代的HMGCR表达增加可降低2型糖尿病的发病风险,而PCSK9和NPC1L1与2型糖尿病无明显关系。这些发现可为血脂异常患者提供更合理的降脂药物选择。
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引用次数: 0
Association of hemoglobin glycation index with clinical outcomes in patients with coronary artery disease: a prospective cohort study. 血红蛋白糖化指数与冠心病患者临床预后的关系:一项前瞻性队列研究。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-04 DOI: 10.1186/s13098-024-01475-w
Zhi-Ying Wen, Fa-Peng Li, Ting-Ting Wu, Xian-Geng Hou, Ying Pan, Chang-Jiang Deng, Yan-Xiao Li, Xue-Chun He, Wei-Tong Gao, Hong-Xia Chen, Ying-Ying Zheng, Xiang Xie

Background: To analyze the association between the hemoglobin glycation index (HGI) and the long-term prognosis of patients with coronary artery disease (CAD).

Methods: HGI represented the difference between laboratory measured Hemoglobin A1c (HbA1c) and predicted HbA1c based on a liner regression between Hb1Ac and fasting plasma glucose (FPG). A total of 10 598 patients who treated with percutaneous coronary intervention (PCI) were stratified into three groups (low HGI group: HGI<-0.506, medium HGI group: -0.506 ≤ HGI < 0.179, and high HGI group: HGI ≥ 0.179). The primary endpoints includes all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs).

Results: A total of 321 ACMs, 243 CMs, 774 MACEs, and 854 MACCEs were recorded during a 60-month follow-up period. After adjusting for confounders using a multivariate Cox regression analysis, the patients in the low HGI group had a significantly increased risk of ACM (adjusted HR = 1.683, 95%CI:1.179-2.404, P = 0.004) and CM (HR = 1.604, 95%CI:1.064-2.417, P = 0.024) as compared with patients in the medium HGI group. Similarly, the patients in the high HGI group had an increased risk of MACEs (HR = 1.247, 95% CI: 1.023-1.521, P = 0.029) as compared with patients in the medium HGI group. For ACM, CM, and MACEs, a U-shaped relation were found among these three groups. However, we did not find significant differences in the incidence of MACCEs among these three groups.

Conclusion: The present study indicates that HGI could be an independent predictor for the risk of mortality and MACEs in patients with CAD.

背景:分析血红蛋白糖化指数(HGI)与冠心病患者长期预后的关系:方法:HGI代表实验室测量的血红蛋白A1c(HbA1c)与根据Hb1Ac和空腹血浆葡萄糖(FPG)之间的衬垫回归预测的HbA1c之间的差异。共有 10 598 名接受经皮冠状动脉介入治疗(PCI)的患者被分为三组(低 HGI 组、高 HGI 组和低 HGI 组):HGIResults:在 60 个月的随访期间,共记录了 321 例 ACM、243 例 CM、774 例 MACE 和 854 例 MACCE。使用多变量考克斯回归分析调整混杂因素后,与中等 HGI 组患者相比,低 HGI 组患者发生 ACM(调整后 HR = 1.683,95%CI:1.179-2.404,P = 0.004)和 CM(HR = 1.604,95%CI:1.064-2.417,P = 0.024)的风险显著增加。同样,与中等 HGI 组患者相比,高 HGI 组患者发生 MACE 的风险增加(HR = 1.247,95%CI:1.023-1.521,P = 0.029)。就 ACM、CM 和 MACEs 而言,这三类患者之间呈 U 型关系。结论:本研究表明,HGI 可以降低心肌梗死的发生率:本研究表明,HGI 可以独立预测 CAD 患者的死亡和 MACE 风险。
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引用次数: 0
Correlation between triglyceride-glucose index and diabetic kidney disease risk in adults with type 1 diabetes mellitus. 1 型糖尿病成人患者甘油三酯-葡萄糖指数与糖尿病肾病风险之间的相关性。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1186/s13098-024-01468-9
Mengyun Lei, Ping Ling, Yongwen Zhou, Jing Lv, Ying Ni, Hongrong Deng, Chaofan Wang, Daizhi Yang, Xubin Yang, Wen Xu, Jinhua Yan

Background: The triglyceride-glucose (TyG) index is identified as an alternative indicator of insulin resistance (IR) and is associated with macro- and micro-vascular diseases among patients with type 2 diabetes mellitus. The relationship between the TyG index and IR and its impact on diabetic kidney disease (DKD) remains unclear among adults with type 1 diabetes mellitus(T1DM).

Methods: This study comprised a cross-sectional analysis using data from the Guangdong T1DM Translational Medicine Study (GTT) and a longitudinal analysis using data from the type 1 diabetes (T1D) Exchange registry study. Correlation analysis was used to investigate the association between the TyG index and IR. Logistic regression and Cox proportional hazards regression were performed to explore the impact of the TyG index on DKD risk.

Results: The GTT Study included 836 adults (216 with DKD and 620 without DKD). A significant correlation existed between the TyG index and the estimated glucose disposal rate (r=-0.64, p < 0.01). The TyG index was a risk factor for DKD after confounder adjustment (OR = 1.34, 95% CI:1.03-1.74). The T1D Exchange registry study included 8,771 adults (2,050 with DKD and 6,721 without DKD). After adjusting confounding factors, the TyG index was identified as an independent risk factor for DKD at enrollment, with the highest risk of DKD incidence observed in the highest TyG tertile group (OR = 1.92, 95%CI:1.67-2.20). During a median follow-up of 44.58(21.84, 67.09) months, the risk of developing DKD was increased by 32% at every 1 SD increase of the TyG index over time among participants without DKD at enrollment.

Conclusions: The TyG index could be used to assess IR and was identified as an independent risk factor of DKD among adults with T1DM.

背景:甘油三酯-葡萄糖(TyG)指数被认为是胰岛素抵抗(IR)的替代指标,与2型糖尿病患者的大血管和微血管疾病有关。在1型糖尿病(T1DM)成人患者中,TyG指数与IR之间的关系及其对糖尿病肾病(DKD)的影响仍不清楚:本研究包括利用广东T1DM转化医学研究(GTT)数据进行的横断面分析和利用1型糖尿病(T1D)交流登记研究数据进行的纵向分析。相关分析用于研究TyG指数与IR之间的关系。为探讨TyG指数对DKD风险的影响,进行了逻辑回归和Cox比例危险度回归:GTT研究纳入了836名成年人(216名DKD患者和620名非DKD患者)。TyG指数与估计的葡萄糖处置率之间存在明显的相关性(r=-0.64,p 结论:TyG指数可用于预测DKD风险:TyG指数可用于评估IR,并被确定为T1DM成人中DKD的独立风险因素。
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引用次数: 0
Impact of an exercise program combined with dietary advice on avoiding insulin prescription in women with gestational diabetes: a randomized controlled trial. 运动计划与饮食建议相结合对避免妊娠糖尿病妇女使用胰岛素的影响:随机对照试验。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-30 DOI: 10.1186/s13098-024-01470-1
Michel Boulvain, Véronique Othenin-Girard, François R Jornayvaz, Bengt Kayser

Objective: To assess the effectiveness of an exercise intervention, in addition to standard care, in preventing or delaying insulin prescription in women with gestational diabetes mellitus (GDM).

Design: Randomised controlled trial.

Setting: University hospital.

Population: Pregnant women at 25-35 weeks of gestation diagnosed with GDM.

Methods: Women in the intervention group participated in weekly, supervised, 30-45 min exercise sessions and were encouraged to accumulate more than 5000 steps per day, tracked by a pedometer, in addition to receiving usual care. The control group received standard care only.

Main outcome measure: Insulin prescription.

Results: From February 2008 through April 2013, 109 women were randomized into the intervention group (n = 57) or the usual care group (n = 52). Two women in the intervention group were excluded from the analysis (one was randomised in error and one was lost to follow-up). Six women never attended the exercise sessions, and two attended fewer than two sessions. However, two-third of women were considered as compliant to the intervention (attended more than 50% of sessions and/or averaged more than 5000 steps/day). The incidence of insulin prescription did not differ between the groups: 31 women (56%) in the intervention group versus 24 women (46%) in the control group (RR 1.22, 95% CI 0.84 to 1.78). The median time from randomization to insulin prescription was also similar between groups (14 days in the intervention group and 13 days in the control group).

Conclusion: This study did not demonstrate that an exercise program reduces or delays insulin prescription in women with GDM. Low adherence to the intervention, a small sample size, and the short duration of the program may explain the lack of observed benefit.

Registered: At clinicaltrials.gov, NCT03174340, 02/06/2017.

目的评估除标准护理外,运动干预对预防或延迟妊娠糖尿病(GDM)妇女使用胰岛素的有效性:随机对照试验:人群: 怀孕 25-35 周的孕妇方法:干预组的妇女每周参加一次胰岛素治疗:干预组的孕妇每周参加 30-45 分钟有监督的运动课程,除了接受常规护理外,还鼓励她们通过计步器记录每天累积的步数超过 5000 步。对照组只接受标准护理。主要结果指标:胰岛素处方:从 2008 年 2 月到 2013 年 4 月,109 名妇女被随机分为干预组(57 人)或常规护理组(52 人)。干预组中有两名妇女被排除在分析之外(一名被错误随机,一名失去随访)。六名妇女从未参加过运动课程,两名妇女参加的课程少于两次。不过,有三分之二的妇女被认为遵守了干预措施(参加了50%以上的课程和/或平均每天走5000步以上)。胰岛素处方的发生率在两组之间没有差异:干预组 31 名妇女(56%),对照组 24 名妇女(46%)(RR 1.22,95% CI 0.84 至 1.78)。各组从随机分配到开具胰岛素处方的中位时间也相似(干预组为 14 天,对照组为 13 天):本研究并未证明运动项目可减少或延迟 GDM 女性患者的胰岛素处方。干预的依从性低、样本量小以及计划持续时间短可能是缺乏观察到的益处的原因:在 clinicaltrials.gov, NCT03174340, 02/06/2017.
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引用次数: 0
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Diabetology & Metabolic Syndrome
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