Pub Date : 2024-09-30DOI: 10.1186/s13098-024-01476-9
Tianyi Yuan, Senlin Lin, Yi Xu, Lina Lu, Minna Cheng, Yuheng Wang, Qinping Yang, Saiguang Ling, Dengji Zhou, Yan Shi, Haidong Zou, Yingyan Ma
Aim: To investigate the associations between insulin use and diabetic retinopathy (DR), and retinal vascular parameters in type 2 diabetes (T2DM).
Methods: A total of 6,374 T2DM patients, consisting of 2,231 patients receiving insulin alone and 4143 patients without any hypoglycemic medication, were included in cross-sectional analyses. Among those without DR at baseline, 791 patients were followed for three years in longitudinal analyses. Fundus photography was taken to diagnose DR and calculate central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), arteriolar-to-venular ratio (AVR), and vascular tortuosity. Inverse probability treatment-weighted analyses were performed.
Results: After adjusting for gender, age, body mass index, blood pressure, blood glucose, T2DM duration, smoking, and alcohol use, insulin users showed a higher risk of DR (odds ratio (OR) = 2.27, 95% confidence interval (95%CI) = 2.08-2.48, P < 0.001), larger CRVE (β = 3.92, 95%CI = 2.46-5.37, P < 0.001), smaller AVR (β=-0.0083, 95%CI=-0.0121- -0.0046, P < 0.001), and larger vascular curvature (β = 0.19, 95%CI = 0.05-0.33, P = 0.008). After 3 years, insulin users had a higher risk of developing DR (OR = 1.94; 95% CI = 1.37-2.73, P = 0.002), and greater change in CRVE (β = 3.92, 95%CI = 0.96-6.88, P = 0.009).
Conclusions: The impact of insulin on the retinal microvasculature provides support for linking insulin to the increased risk of DR, as well as cardiovascular events in T2DM.
{"title":"The influence of insulin on diabetic retinopathy and retinal vessel parameters in diabetes.","authors":"Tianyi Yuan, Senlin Lin, Yi Xu, Lina Lu, Minna Cheng, Yuheng Wang, Qinping Yang, Saiguang Ling, Dengji Zhou, Yan Shi, Haidong Zou, Yingyan Ma","doi":"10.1186/s13098-024-01476-9","DOIUrl":"10.1186/s13098-024-01476-9","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the associations between insulin use and diabetic retinopathy (DR), and retinal vascular parameters in type 2 diabetes (T2DM).</p><p><strong>Methods: </strong>A total of 6,374 T2DM patients, consisting of 2,231 patients receiving insulin alone and 4143 patients without any hypoglycemic medication, were included in cross-sectional analyses. Among those without DR at baseline, 791 patients were followed for three years in longitudinal analyses. Fundus photography was taken to diagnose DR and calculate central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), arteriolar-to-venular ratio (AVR), and vascular tortuosity. Inverse probability treatment-weighted analyses were performed.</p><p><strong>Results: </strong>After adjusting for gender, age, body mass index, blood pressure, blood glucose, T2DM duration, smoking, and alcohol use, insulin users showed a higher risk of DR (odds ratio (OR) = 2.27, 95% confidence interval (95%CI) = 2.08-2.48, P < 0.001), larger CRVE (β = 3.92, 95%CI = 2.46-5.37, P < 0.001), smaller AVR (β=-0.0083, 95%CI=-0.0121- -0.0046, P < 0.001), and larger vascular curvature (β = 0.19, 95%CI = 0.05-0.33, P = 0.008). After 3 years, insulin users had a higher risk of developing DR (OR = 1.94; 95% CI = 1.37-2.73, P = 0.002), and greater change in CRVE (β = 3.92, 95%CI = 0.96-6.88, P = 0.009).</p><p><strong>Conclusions: </strong>The impact of insulin on the retinal microvasculature provides support for linking insulin to the increased risk of DR, as well as cardiovascular events in T2DM.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"237"},"PeriodicalIF":3.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Relative fat mass (RFM) is a newly developed, sex-specific anthropometric formula designed to estimate total body fat percentage. However, research investigating the correlation between RFM and the risk of non-alcoholic fatty liver disease (NAFLD) remains limited. This study evaluates the association between RFM and the risk of NAFLD within the Japanese population.
Methods: This study including 14,250 Japanese adults who underwent physical examinations at Murakami Memorial Hospital between 2004 and 2015. We employed binary logistic regression to elucidate the direct relationship between RFM levels and the incidence of NAFLD. Additionally, a generalized additive model (GAM) coupled with smooth curve fitting techniques was utilized to map the non-linear association.
Results: The cohort had an average age of 43.53 ± 8.89 years, with a male majority of 52.00%. NAFLD was identified in 17.59% of the participants. After adjusting for confounding factors, a significant positive correlation between RFM and NAFLD risk was observed (OR: 1.15, 95%CI: 1.10-1.21, P < 0.0001 for females; OR: 1.15, 95%CI: 1.10-1.19, P < 0.0001 for males). Additionally, a non-linear relationship between RFM and the incidence of NAFLD was detected in both genders. The RFM threshold was identified as 34.95 for women and 23.40 for men. RFM was positively associated with the risk of NAFLD when RFM was below the respective threshold (OR: 1.29, 95%CI: 1.19-1.40, P < 0.0001 for females; OR: 1.23, 95%CI: 1.17-1.29, P < 0.0001 for males), whereas no significant association was found when RFM was above the threshold (OR: 1.05, 95%CI: 0.98-1.12, P = 0.1829 for females; OR: 1.01, 95%CI: 0.95-1.08, P = 0.7392 for males).
Conclusion: Our findings suggest a positive, nonlinear relationship between RFM and the risk of NAFLD, with a saturation effect. These results imply that maintaining RFM at a lower level may be advantageous in mitigating the risk of NAFLD.
{"title":"The nonlinear connection between relative fat mass and non-alcoholic fatty liver disease in the Japanese population: an analysis based on data from a cross-sectional study.","authors":"Changchun Cao, Meiling Huang, Yong Han, Xiaohua Zhang, Haofei Hu, Yulong Wang","doi":"10.1186/s13098-024-01472-z","DOIUrl":"https://doi.org/10.1186/s13098-024-01472-z","url":null,"abstract":"<p><strong>Background: </strong>Relative fat mass (RFM) is a newly developed, sex-specific anthropometric formula designed to estimate total body fat percentage. However, research investigating the correlation between RFM and the risk of non-alcoholic fatty liver disease (NAFLD) remains limited. This study evaluates the association between RFM and the risk of NAFLD within the Japanese population.</p><p><strong>Methods: </strong>This study including 14,250 Japanese adults who underwent physical examinations at Murakami Memorial Hospital between 2004 and 2015. We employed binary logistic regression to elucidate the direct relationship between RFM levels and the incidence of NAFLD. Additionally, a generalized additive model (GAM) coupled with smooth curve fitting techniques was utilized to map the non-linear association.</p><p><strong>Results: </strong>The cohort had an average age of 43.53 ± 8.89 years, with a male majority of 52.00%. NAFLD was identified in 17.59% of the participants. After adjusting for confounding factors, a significant positive correlation between RFM and NAFLD risk was observed (OR: 1.15, 95%CI: 1.10-1.21, P < 0.0001 for females; OR: 1.15, 95%CI: 1.10-1.19, P < 0.0001 for males). Additionally, a non-linear relationship between RFM and the incidence of NAFLD was detected in both genders. The RFM threshold was identified as 34.95 for women and 23.40 for men. RFM was positively associated with the risk of NAFLD when RFM was below the respective threshold (OR: 1.29, 95%CI: 1.19-1.40, P < 0.0001 for females; OR: 1.23, 95%CI: 1.17-1.29, P < 0.0001 for males), whereas no significant association was found when RFM was above the threshold (OR: 1.05, 95%CI: 0.98-1.12, P = 0.1829 for females; OR: 1.01, 95%CI: 0.95-1.08, P = 0.7392 for males).</p><p><strong>Conclusion: </strong>Our findings suggest a positive, nonlinear relationship between RFM and the risk of NAFLD, with a saturation effect. These results imply that maintaining RFM at a lower level may be advantageous in mitigating the risk of NAFLD.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"236"},"PeriodicalIF":3.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1186/s13098-024-01471-0
Mingyang Li, Xiaodong Cui, Yan Zhang, Jiachun Lang, Tianxu Hao, Yihang Su, Yuecheng Hu
Background: Cardiovascular disease continues to be the leading cause of global mortality and disability, particularly posing elevated risks in patients diagnosed with multivessel disease (MVD). Efficient risk stratification in MVD patients is crucial for improving prognosis, prompting investigation into novel biomarkers such as the triglyceride-glucose index (TyG index) and the stress hyperglycemia ratio (SHR).
Methods: This study enrolled a cohort comprising 679 patients diagnosed with MVD who underwent coronary angiography at Tianjin Chest Hospital. Patients were stratified into four groups based on their TyG index levels, categorized as TyG index-L and TyG index-H, and SHR levels, categorized as SHR-L and SHR-H. The primary endpoint was the occurrence of major adverse cardio-cerebral events (MACCEs). This Study conducted univariate and multivariable Cox regression analyses to assess the association between TyG index and SHR levels, both as continuous and categorical variables, in relation to MACCEs. Kaplan-Meier survival curves were employed to evaluate the correlation among patient groups.
Results: During a mean follow-up of 61 months, 153 cases of MACCEs were recorded. The TyG index and SHR served as independent predictors of long-term prognosis in patients with MVD, whether considered as continuous or categorical variables. Multivariable analysis revealed that patients with TyG index-H + SHR-H group exhibited the highest incidence of MACCEs (HR: 2.227; 95% CI 1.295-3.831; P = 0.004). The area under the curve (AUC) for predicting MACCEs was 0.655 for TyG index, 0.647 for SHR, and 0.674 when combined.
Conclusion: This study underscores the potential of the TyG index and SHR as independent and combined predictive markers for MACCEs in patients with MVD. Their integrated assessment enhances risk stratification, providing valuable insights for personalized treatment strategies aimed at optimizing patient prognosis.
{"title":"The relative and combined ability of triglyceride-glucose index and stress hyperglycemia ratio to predict major adverse cardio-cerebral events in patients with multivessel coronary artery disease.","authors":"Mingyang Li, Xiaodong Cui, Yan Zhang, Jiachun Lang, Tianxu Hao, Yihang Su, Yuecheng Hu","doi":"10.1186/s13098-024-01471-0","DOIUrl":"https://doi.org/10.1186/s13098-024-01471-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease continues to be the leading cause of global mortality and disability, particularly posing elevated risks in patients diagnosed with multivessel disease (MVD). Efficient risk stratification in MVD patients is crucial for improving prognosis, prompting investigation into novel biomarkers such as the triglyceride-glucose index (TyG index) and the stress hyperglycemia ratio (SHR).</p><p><strong>Methods: </strong>This study enrolled a cohort comprising 679 patients diagnosed with MVD who underwent coronary angiography at Tianjin Chest Hospital. Patients were stratified into four groups based on their TyG index levels, categorized as TyG index-L and TyG index-H, and SHR levels, categorized as SHR-L and SHR-H. The primary endpoint was the occurrence of major adverse cardio-cerebral events (MACCEs). This Study conducted univariate and multivariable Cox regression analyses to assess the association between TyG index and SHR levels, both as continuous and categorical variables, in relation to MACCEs. Kaplan-Meier survival curves were employed to evaluate the correlation among patient groups.</p><p><strong>Results: </strong>During a mean follow-up of 61 months, 153 cases of MACCEs were recorded. The TyG index and SHR served as independent predictors of long-term prognosis in patients with MVD, whether considered as continuous or categorical variables. Multivariable analysis revealed that patients with TyG index-H + SHR-H group exhibited the highest incidence of MACCEs (HR: 2.227; 95% CI 1.295-3.831; P = 0.004). The area under the curve (AUC) for predicting MACCEs was 0.655 for TyG index, 0.647 for SHR, and 0.674 when combined.</p><p><strong>Conclusion: </strong>This study underscores the potential of the TyG index and SHR as independent and combined predictive markers for MACCEs in patients with MVD. Their integrated assessment enhances risk stratification, providing valuable insights for personalized treatment strategies aimed at optimizing patient prognosis.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"234"},"PeriodicalIF":3.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1186/s13098-024-01469-8
Silas Alves-Costa, Bruno Feres de Souza, Francisco Aparecido Rodrigues, Alexandre Archanjo Ferraro, Gustavo G Nascimento, Fabio R M Leite, Lorena Lúcia Costa Ladeira, Rosângela Fernandes Lucena Batista, Erika Bárbara Abreu Fonseca Thomaz, Claudia Maria Coelho Alves, Cecilia Claudia Costa Ribeiro
Background: Noncommunicable diseases (NCDs) predominantly affect adults, but pathophysiological changes begin decades earlier, as a continuum, with initial events apparent in adolescence. Hence, early identification and intervention are crucial for the prevention and management of NCDs. We investigated the complex network of socioeconomic, behavioral, and metabolic factors associated with the presence of NCD in Brazilian adolescents.
Methods: We conducted a cross-sectional study nested within the São Luís segment of the Ribeirão Preto, Pelotas, and São Luís (RPS) cohort's consortium, focusing on 18-19-year-olds (n = 2515). Data were collected prospectively, from which we constructed a complex network with NCD-related factors/indicators as nodes and their co-occurrences as edges. General and sex-based models analyzed: socioeconomic status, behavioral (smoking, alcohol, and other drugs use, unhealthy diet, poor sleep, physical inactivity), and metabolic factors (overweight/obesity, elevated blood pressure, poor lipid profile). We also looked for NCDs in adolescence like asthma, abnormal spirometry, depression, suicide risk, and poor oral health. The network was characterized by degree, betweenness, eigenvector, local transitivity, Shannon entropy, and cluster coefficient.
Results: The adolescents had an average age of 18.3 years, 52.3% were female and 47.7% male. 99.8% of them have a diet rich in free sugars, 15% are overweight/obese and 72.3% had an elevated TyG index. High free sugar emerged as the central hub, followed by high TyG index (an early marker of insulin resistance) and low socioeconomic class. In males, low fiber intake and a high triglycerides/HDL ratio highlighted cardiometabolic concerns; in females, sedentary behavior and poor sleep marked metabolic and psychological challenges, along with caries in both sexes.
Conclusions: Our findings provide insights into central health challenges during adolescence, such as high free sugars, insulin resistance, and low socioeconomic indicators, suggesting that interventions targeted at these central hubs could have a significant impact on their NCD network.
{"title":"High free sugars, insulin resistance, and low socioeconomic indicators: the hubs in the complex network of non-communicable diseases in adolescents.","authors":"Silas Alves-Costa, Bruno Feres de Souza, Francisco Aparecido Rodrigues, Alexandre Archanjo Ferraro, Gustavo G Nascimento, Fabio R M Leite, Lorena Lúcia Costa Ladeira, Rosângela Fernandes Lucena Batista, Erika Bárbara Abreu Fonseca Thomaz, Claudia Maria Coelho Alves, Cecilia Claudia Costa Ribeiro","doi":"10.1186/s13098-024-01469-8","DOIUrl":"https://doi.org/10.1186/s13098-024-01469-8","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases (NCDs) predominantly affect adults, but pathophysiological changes begin decades earlier, as a continuum, with initial events apparent in adolescence. Hence, early identification and intervention are crucial for the prevention and management of NCDs. We investigated the complex network of socioeconomic, behavioral, and metabolic factors associated with the presence of NCD in Brazilian adolescents.</p><p><strong>Methods: </strong>We conducted a cross-sectional study nested within the São Luís segment of the Ribeirão Preto, Pelotas, and São Luís (RPS) cohort's consortium, focusing on 18-19-year-olds (n = 2515). Data were collected prospectively, from which we constructed a complex network with NCD-related factors/indicators as nodes and their co-occurrences as edges. General and sex-based models analyzed: socioeconomic status, behavioral (smoking, alcohol, and other drugs use, unhealthy diet, poor sleep, physical inactivity), and metabolic factors (overweight/obesity, elevated blood pressure, poor lipid profile). We also looked for NCDs in adolescence like asthma, abnormal spirometry, depression, suicide risk, and poor oral health. The network was characterized by degree, betweenness, eigenvector, local transitivity, Shannon entropy, and cluster coefficient.</p><p><strong>Results: </strong>The adolescents had an average age of 18.3 years, 52.3% were female and 47.7% male. 99.8% of them have a diet rich in free sugars, 15% are overweight/obese and 72.3% had an elevated TyG index. High free sugar emerged as the central hub, followed by high TyG index (an early marker of insulin resistance) and low socioeconomic class. In males, low fiber intake and a high triglycerides/HDL ratio highlighted cardiometabolic concerns; in females, sedentary behavior and poor sleep marked metabolic and psychological challenges, along with caries in both sexes.</p><p><strong>Conclusions: </strong>Our findings provide insights into central health challenges during adolescence, such as high free sugars, insulin resistance, and low socioeconomic indicators, suggesting that interventions targeted at these central hubs could have a significant impact on their NCD network.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"235"},"PeriodicalIF":3.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1186/s13098-024-01452-3
Ahmed Ragab, Ahmed Reda Sayed, Sameh Fayek GamalEl Din, Ashraf Zeidan, Faten Fathi Ewis, Mostafa Ahmed Hamed
Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus (T2DM). The current study aimed to assess the serum level of irisin in T2DM men with erectile dysfunction (ED) compared to T2DM patients with normal erectile function and healthy controls, as well as investigate the association between serum irisin level and the severity of ED in T2DM patients. A cross-sectional study was conducted on 90 males, divided into three groups: 32 T2DM patients with ED, 24 T2DM patients without ED, and 34 healthy controls. Socio-demographic characteristics and scores of the validated Arabic version of the international Index of Erectile Function-5 (ArIIEF-5), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were obtained. Furthermore, routine laboratory tests employed for diabetes monitoring and serum levels of total testosterone and irisin were assessed within these groups. T2DM men with ED had significantly lower serum levels of irisin and testosterone, as well as a lower ArIIEF-5 score, but their GAD-7 and PHQ-9 scores were significantly higher than those without ED or controls (p < 0.001). Among T2DM men, serum irisin levels positively associated with ArIIEF-5 scores and serum testosterone (r = 0.413, p = 0.002; r = 0.936, p < 0.001, respectively) but negatively associated with glycosylated hemoglobin levels (r = -0.377, p = 0.004). Multivariate regression analysis to predict ED in T2DM patients found that GAD-7 score was the only most significant predictor for ED (ꞵ = − 1.176, standard error = 0.062, p < 0.001). The current study had demonstrated that irisin positively correlated with the ArIIEF-5 and serum testosterone but negatively correlated with HbA1c in T2DM men. Nevertheless, further validation of these findings is necessary through cohort studies.
{"title":"Evaluation of serum irisin level and severity of erectile dysfunction in diabetic males: a cross sectional prospective study","authors":"Ahmed Ragab, Ahmed Reda Sayed, Sameh Fayek GamalEl Din, Ashraf Zeidan, Faten Fathi Ewis, Mostafa Ahmed Hamed","doi":"10.1186/s13098-024-01452-3","DOIUrl":"https://doi.org/10.1186/s13098-024-01452-3","url":null,"abstract":"Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus (T2DM). The current study aimed to assess the serum level of irisin in T2DM men with erectile dysfunction (ED) compared to T2DM patients with normal erectile function and healthy controls, as well as investigate the association between serum irisin level and the severity of ED in T2DM patients. A cross-sectional study was conducted on 90 males, divided into three groups: 32 T2DM patients with ED, 24 T2DM patients without ED, and 34 healthy controls. Socio-demographic characteristics and scores of the validated Arabic version of the international Index of Erectile Function-5 (ArIIEF-5), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were obtained. Furthermore, routine laboratory tests employed for diabetes monitoring and serum levels of total testosterone and irisin were assessed within these groups. T2DM men with ED had significantly lower serum levels of irisin and testosterone, as well as a lower ArIIEF-5 score, but their GAD-7 and PHQ-9 scores were significantly higher than those without ED or controls (p < 0.001). Among T2DM men, serum irisin levels positively associated with ArIIEF-5 scores and serum testosterone (r = 0.413, p = 0.002; r = 0.936, p < 0.001, respectively) but negatively associated with glycosylated hemoglobin levels (r = -0.377, p = 0.004). Multivariate regression analysis to predict ED in T2DM patients found that GAD-7 score was the only most significant predictor for ED (ꞵ = − 1.176, standard error = 0.062, p < 0.001). The current study had demonstrated that irisin positively correlated with the ArIIEF-5 and serum testosterone but negatively correlated with HbA1c in T2DM men. Nevertheless, further validation of these findings is necessary through cohort studies.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1186/s13098-024-01466-x
Jing Wang, Haojie Xue, Jinyu He, Li Deng, Julong Tian, Yang Jiang, Jian Feng
Diabetic cardiomyopathy (DCM) is a kind of myocardial disease that occurs in diabetes patients and cannot be explained by hypertensive heart disease, coronary atherosclerotic heart disease and other heart diseases. Its pathogenesis may be closely related to programmed cell death, oxidative stress, intestinal microbes and micro-RNAs. The excessive activation of mineralocorticoid receptors (MR) in DCM can cause damage to the heart and kidneys. The third-generation non-steroidal mineralocorticoid receptor antagonist (MRA), finerenone, can effectively block MR, thus playing a role in protecting the heart and kidneys. This review mainly introduces the classification of MRA, and the mechanism of action, applications and limitations of finerenone in DCM, in order to provide reference for the study of treatment plans for DCM patients.
{"title":"Therapeutic potential of finerenone for diabetic cardiomyopathy: focus on the mechanisms","authors":"Jing Wang, Haojie Xue, Jinyu He, Li Deng, Julong Tian, Yang Jiang, Jian Feng","doi":"10.1186/s13098-024-01466-x","DOIUrl":"https://doi.org/10.1186/s13098-024-01466-x","url":null,"abstract":"Diabetic cardiomyopathy (DCM) is a kind of myocardial disease that occurs in diabetes patients and cannot be explained by hypertensive heart disease, coronary atherosclerotic heart disease and other heart diseases. Its pathogenesis may be closely related to programmed cell death, oxidative stress, intestinal microbes and micro-RNAs. The excessive activation of mineralocorticoid receptors (MR) in DCM can cause damage to the heart and kidneys. The third-generation non-steroidal mineralocorticoid receptor antagonist (MRA), finerenone, can effectively block MR, thus playing a role in protecting the heart and kidneys. This review mainly introduces the classification of MRA, and the mechanism of action, applications and limitations of finerenone in DCM, in order to provide reference for the study of treatment plans for DCM patients.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"1 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-16DOI: 10.1186/s13098-024-01465-y
Jianping Liu, Sufang Wang, Yuan Shen, Haicun Shi, Lijian Han
To explore the influence of lipid metabolism on the risk of sarcopenia. Two-sample Mendelian randomization (MR) analysis was used to determine causality. A total of 179 lipid metabolism data points were used for exposure, and the data were obtained from a plasma lipid metabolite study of 7174 participants. The total muscle mass and total muscle strength, as well as the muscle strength and muscle mass of different sex groups, were selected as the relevant traits of sarcopenia. Data for outcomes were obtained from the UK Biobank, and sample sizes ranged from 135 468 to 450 243. Inverse-variance weighted (IVW), as the main method for evaluating the causal relationship between lipid metabolites and sarcopenia, uses the false discovery rate (FDR) for multiple comparisons and conducts heterogeneity, pleiotropy, and reverse causality tests. Twenty-seven lipid metabolites, mainly phosphatidylcholine, phosphatidylethanolamine, ceramide, triacylglycerol, sphingomyelin, and sterol ester, were found to be associated with the risk of sarcopenia. Ceramide (d40:1), ceramide (d40:2), and sterol ester are risk factors for decreased muscle mass and strength. There is a positive causal relationship between various phosphatidylcholine lipids and muscle mass and strength. Sphingomyelin (d42:2) is a protective factor for total muscle strength and female muscle strength. There are inconsistent effects between different lipid metabolites, triacylglycerol, and muscle strength and muscle mass. There was a causal relationship between 27 lipid metabolites and sarcopenia traits, and targeting specific lipid metabolites may benefit sarcopenia diagnosis, disease assessment, and treatment.
{"title":"Lipid metabolites and sarcopenia-related traits: a Mendelian randomization study","authors":"Jianping Liu, Sufang Wang, Yuan Shen, Haicun Shi, Lijian Han","doi":"10.1186/s13098-024-01465-y","DOIUrl":"https://doi.org/10.1186/s13098-024-01465-y","url":null,"abstract":"To explore the influence of lipid metabolism on the risk of sarcopenia. Two-sample Mendelian randomization (MR) analysis was used to determine causality. A total of 179 lipid metabolism data points were used for exposure, and the data were obtained from a plasma lipid metabolite study of 7174 participants. The total muscle mass and total muscle strength, as well as the muscle strength and muscle mass of different sex groups, were selected as the relevant traits of sarcopenia. Data for outcomes were obtained from the UK Biobank, and sample sizes ranged from 135 468 to 450 243. Inverse-variance weighted (IVW), as the main method for evaluating the causal relationship between lipid metabolites and sarcopenia, uses the false discovery rate (FDR) for multiple comparisons and conducts heterogeneity, pleiotropy, and reverse causality tests. Twenty-seven lipid metabolites, mainly phosphatidylcholine, phosphatidylethanolamine, ceramide, triacylglycerol, sphingomyelin, and sterol ester, were found to be associated with the risk of sarcopenia. Ceramide (d40:1), ceramide (d40:2), and sterol ester are risk factors for decreased muscle mass and strength. There is a positive causal relationship between various phosphatidylcholine lipids and muscle mass and strength. Sphingomyelin (d42:2) is a protective factor for total muscle strength and female muscle strength. There are inconsistent effects between different lipid metabolites, triacylglycerol, and muscle strength and muscle mass. There was a causal relationship between 27 lipid metabolites and sarcopenia traits, and targeting specific lipid metabolites may benefit sarcopenia diagnosis, disease assessment, and treatment.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-16DOI: 10.1186/s13098-024-01467-w
Mingrui Zou, Zhenxing Shao
Sarcopenia is a common complication of diabetes. Nevertheless, precise evaluation of sarcopenia risk among patients with diabetes is still a big challenge. The objective of this study was to develop a nomogram model which could serve as a practical tool to diagnose sarcopenia in patients with diabetes. A total of 783 participants with diabetes from China Health and Retirement Longitudinal Study (CHARLS) 2015 were included in this study. After oversampling process, 1,000 samples were randomly divided into the training set and internal validation set. To mitigate the overfitting effect caused by oversampling, data of CHARLS 2011 were utilized as the external validation set. Least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression analysis were employed to explore predictors. Subsequently, a nomogram was developed based on the 9 selected predictors. The model was assessed by area under receiver operating characteristic (ROC) curves (AUC) for discrimination, calibration curves for calibration, and decision curve analysis (DCA) for clinical efficacy. In addition, machine learning models were constructed to enhance the robustness of our findings and evaluate the importance of the predictors. 9 factors were selected as predictors of sarcopenia for patients with diabetes. The nomogram model exhibited good discrimination in training, internal validation and external validation sets, with AUC of 0.808, 0.811 and 0.794. machine learning models revealed that age and hemoglobin were the most significant predictors. Calibration curves and DCA illustrated excellent calibration and clinical applicability of this model. This comprehensive nomogram presented high clinical predictability, which was a promising tool to evaluate the risk of sarcopenia in patients with diabetes.
{"title":"Construction and evaluation of sarcopenia risk prediction model for patients with diabetes: a study based on the China health and retirement longitudinal study (CHARLS)","authors":"Mingrui Zou, Zhenxing Shao","doi":"10.1186/s13098-024-01467-w","DOIUrl":"https://doi.org/10.1186/s13098-024-01467-w","url":null,"abstract":"Sarcopenia is a common complication of diabetes. Nevertheless, precise evaluation of sarcopenia risk among patients with diabetes is still a big challenge. The objective of this study was to develop a nomogram model which could serve as a practical tool to diagnose sarcopenia in patients with diabetes. A total of 783 participants with diabetes from China Health and Retirement Longitudinal Study (CHARLS) 2015 were included in this study. After oversampling process, 1,000 samples were randomly divided into the training set and internal validation set. To mitigate the overfitting effect caused by oversampling, data of CHARLS 2011 were utilized as the external validation set. Least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression analysis were employed to explore predictors. Subsequently, a nomogram was developed based on the 9 selected predictors. The model was assessed by area under receiver operating characteristic (ROC) curves (AUC) for discrimination, calibration curves for calibration, and decision curve analysis (DCA) for clinical efficacy. In addition, machine learning models were constructed to enhance the robustness of our findings and evaluate the importance of the predictors. 9 factors were selected as predictors of sarcopenia for patients with diabetes. The nomogram model exhibited good discrimination in training, internal validation and external validation sets, with AUC of 0.808, 0.811 and 0.794. machine learning models revealed that age and hemoglobin were the most significant predictors. Calibration curves and DCA illustrated excellent calibration and clinical applicability of this model. This comprehensive nomogram presented high clinical predictability, which was a promising tool to evaluate the risk of sarcopenia in patients with diabetes.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"56 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1186/s13098-024-01464-z
Aldair Darlan Santos-de-Araújo, Daniela Bassi-Dibai, Izadora Moraes Dourado, Cássia da Luz Goulart, Renan Shida Marinho, Jaqueline de Almeida Mantovani, Gabriela Silva de Souza, Polliana Batista dos Santos, Meliza Goi Roscani, Shane A. Phillips, Audrey Borghi-Silva
Type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) present a decrease in functional capacity due to the intrinsic nature of both pathologies. It is not known about the potential impact of T2DM on functional capacity when assessed by 6-min step test (6MST) and its effect as a prognostic marker for fatal and non-fatal events in patients with CHF. to evaluate the coexistence of T2DM and CHF in functional capacity through 6MST when compared to CHF non-T2DM, as well as to investigate the different cardiovascular responses to 6MST and the risk of mortality, decompensation of CHF and acute myocardial infarction (AMI) over 36 months. This is a prospective cohort study with 36 months of follow-up in individuals with T2DM and CHF. All participants completed a clinical assessment, followed by pulmonary function testing, echocardiography, and 6MST. The 6MST was performed on a 20 cm high step and cardiovascular responses were collected: heart rate, systemic blood pressure, oxygen saturation, BORG dyspnea and fatigue. The risk of mortality, acute myocardial infarction and decompensation of CHF was evaluated. Eighty-six participants were included. The CHF-T2DM group had a significantly lower functional capacity than the CHF non-T2DM group (p < 0.05). Forced Expiratory Volume in one second (L), ejection fraction (%), gender and T2DM influence and are predictors of functional capacity (p < 0.05; adjusted R squared: 0.419). CHF-T2DM group presented a higher risk of mortality and acute myocardial infarction over the 36 months of follow-up (p < 0.05), but not to the risk of decompensation (p > 0.05). T2DM negatively affects the functional performance of 6MST in patients with CHF. Gender, ejection fraction (%), FEV1 (L) and T2DM itself negatively influence exercise performance.
{"title":"Type 2 diabetes mellitus negatively affects the functional performance of 6-min step test in chronic heart failure: a 3-year follow-up study","authors":"Aldair Darlan Santos-de-Araújo, Daniela Bassi-Dibai, Izadora Moraes Dourado, Cássia da Luz Goulart, Renan Shida Marinho, Jaqueline de Almeida Mantovani, Gabriela Silva de Souza, Polliana Batista dos Santos, Meliza Goi Roscani, Shane A. Phillips, Audrey Borghi-Silva","doi":"10.1186/s13098-024-01464-z","DOIUrl":"https://doi.org/10.1186/s13098-024-01464-z","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) present a decrease in functional capacity due to the intrinsic nature of both pathologies. It is not known about the potential impact of T2DM on functional capacity when assessed by 6-min step test (6MST) and its effect as a prognostic marker for fatal and non-fatal events in patients with CHF. to evaluate the coexistence of T2DM and CHF in functional capacity through 6MST when compared to CHF non-T2DM, as well as to investigate the different cardiovascular responses to 6MST and the risk of mortality, decompensation of CHF and acute myocardial infarction (AMI) over 36 months. This is a prospective cohort study with 36 months of follow-up in individuals with T2DM and CHF. All participants completed a clinical assessment, followed by pulmonary function testing, echocardiography, and 6MST. The 6MST was performed on a 20 cm high step and cardiovascular responses were collected: heart rate, systemic blood pressure, oxygen saturation, BORG dyspnea and fatigue. The risk of mortality, acute myocardial infarction and decompensation of CHF was evaluated. Eighty-six participants were included. The CHF-T2DM group had a significantly lower functional capacity than the CHF non-T2DM group (p < 0.05). Forced Expiratory Volume in one second (L), ejection fraction (%), gender and T2DM influence and are predictors of functional capacity (p < 0.05; adjusted R squared: 0.419). CHF-T2DM group presented a higher risk of mortality and acute myocardial infarction over the 36 months of follow-up (p < 0.05), but not to the risk of decompensation (p > 0.05). T2DM negatively affects the functional performance of 6MST in patients with CHF. Gender, ejection fraction (%), FEV1 (L) and T2DM itself negatively influence exercise performance.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"187 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1186/s13098-024-01456-z
Laura Betat Pereira, Helena Trevisan Schroeder, Juciela Keller dos Santos, Paulo César Brizolla Capelari, Beatriz D. Schaan, Patrícia Martins Bock
Gestational diabetes mellitus (GDM) is characterized by hyperglycemia during pregnancy. There are many diabetes-specific tools for collecting information validated in Brazilian Portuguese. However, there are no specific instruments to assess knowledge about GDM in Brazilian Portuguese. The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus questionnaire (GDMKQ). This study was conducted in southern Brazil from January to December 2023. Women with GDM or diabetes identified during pregnancy were considered eligible based on specific criteria. Clinical and demographic data were obtained through a medical records search. The GDMKQ underwent a multistep adaptation process, including translation, back-translation, content validity assessment, and cognitive interviews. After administration to participants, internal consistency, item-total correlation, and intraclass correlation were assessed. Confirmatory factor analysis was also conducted to ensure validity. A total of 155 pregnant women were recruited for the study. Most participants were aged 18–30 years, and hypertension was the main comorbidity (25.2%). Regarding education, most participants (58.7%) attended high school. The Brazilian Portuguese version of the GDMKQ consisted of 32 items. The intraclass correlation was established by two independent interviews with 57 participants, yielding a correlation coefficient of 0.79 (p < 0.01). Internal consistency (Cronbach’s alpha) was 0.81 overall but was less than 0.7 for each domain. Item-total correlations were calculated, and confirmatory factor analysis indicated a good model fit. The final Brazilian Portuguese version of the questionnaire consisted of 32 items. The Brazilian Portuguese version of the GDMKQ yielded a reliable and valid tool for evaluating diabetes knowledge in pregnant women.
{"title":"Cross-cultural adaptation and validation to Brazilian Portuguese of the ‘knowledge of gestational diabetes (GDM)’ questionnaire for women with GDM","authors":"Laura Betat Pereira, Helena Trevisan Schroeder, Juciela Keller dos Santos, Paulo César Brizolla Capelari, Beatriz D. Schaan, Patrícia Martins Bock","doi":"10.1186/s13098-024-01456-z","DOIUrl":"https://doi.org/10.1186/s13098-024-01456-z","url":null,"abstract":"Gestational diabetes mellitus (GDM) is characterized by hyperglycemia during pregnancy. There are many diabetes-specific tools for collecting information validated in Brazilian Portuguese. However, there are no specific instruments to assess knowledge about GDM in Brazilian Portuguese. The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus questionnaire (GDMKQ). This study was conducted in southern Brazil from January to December 2023. Women with GDM or diabetes identified during pregnancy were considered eligible based on specific criteria. Clinical and demographic data were obtained through a medical records search. The GDMKQ underwent a multistep adaptation process, including translation, back-translation, content validity assessment, and cognitive interviews. After administration to participants, internal consistency, item-total correlation, and intraclass correlation were assessed. Confirmatory factor analysis was also conducted to ensure validity. A total of 155 pregnant women were recruited for the study. Most participants were aged 18–30 years, and hypertension was the main comorbidity (25.2%). Regarding education, most participants (58.7%) attended high school. The Brazilian Portuguese version of the GDMKQ consisted of 32 items. The intraclass correlation was established by two independent interviews with 57 participants, yielding a correlation coefficient of 0.79 (p < 0.01). Internal consistency (Cronbach’s alpha) was 0.81 overall but was less than 0.7 for each domain. Item-total correlations were calculated, and confirmatory factor analysis indicated a good model fit. The final Brazilian Portuguese version of the questionnaire consisted of 32 items. The Brazilian Portuguese version of the GDMKQ yielded a reliable and valid tool for evaluating diabetes knowledge in pregnant women.","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"18 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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