Diabetes research and clinical practice最新文献_第3页

Distinct microRNA signatures in Platelet-Rich Plasma-Derived extracellular vesicles predict healing outcomes in chronic diabetic foot ulcers 富血小板血浆来源的细胞外囊泡中不同的microRNA特征预测慢性糖尿病足溃疡的愈合结果。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.diabres.2026.113142

Yu-Chi Tsai , Shu-Yu Wu , Chien-Ju Wu , Hao-Yu Chiao , Hsu-Ping Tseng , Yu-Min He , Tim-Mo Chen , Min-Yu Tu , Yuan-sheng Tzeng

Background

Diabetic foot ulcers (DFUs) present a major challenge due to impaired angiogenesis and chronic inflammation. Autologous platelet-rich plasma (PRP) is a widely used therapy, but clinical outcomes remain inconsistent. We hypothesized that the microRNA (miRNA) cargo of platelet-derived extracellular vesicles (PRP-EVs) drives this therapeutic variability.

Methods

Ten patients with refractory DFUs were enrolled. Autologous PRP-EVs were isolated, and wound healing-associated miRNAs were quantified via qRT-PCR. Clinical wound closure was monitored weekly, with the primary efficacy endpoint assessed at 6 weeks. The biological effects of patient-specific PRP-EVs on keratinocyte migration were evaluated in vitro.

Results

PRP treatment resulted in significant wound area reduction, achieving an average closure rate of approximately 90% by week 6. However, miRNA expression exhibited substantial heterogeneity. High levels of miR-20a-5p and miR-21-5p in PRP-EVs were significantly associated with delayed clinical healing and impaired keratinocyte migration. Conversely, elevated miR-223-3p correlated with accelerated wound closure.

Conclusion

The intrinsic miRNA composition of PRP-EVs is a critical determinant of PRP therapeutic efficacy. miR-20a-5p and miR-21-5p serve as negative predictive biomarkers, whereas miR-223-3p indicates a favorable prognosis. Profiling these miRNAs offers a novel approach for PRP quality control and personalized regenerative strategies.

背景：糖尿病足溃疡（DFUs）由于血管生成受损和慢性炎症而面临重大挑战。自体富血小板血浆（PRP）是一种广泛使用的治疗方法，但临床结果仍不一致。我们假设血小板来源的细胞外囊泡（prp - ev）的microRNA （miRNA）货物驱动了这种治疗变动性。方法：纳入10例难治性dfu患者。分离自体prp - ev，通过qRT-PCR定量检测创面愈合相关mirna。每周监测临床伤口愈合情况，在6 周时评估主要疗效终点。体外评估患者特异性prp - ev对角质形成细胞迁移的生物学效应。结果：PRP治疗显著减少创面面积，到第6周平均愈合率约为90%。然而，miRNA表达表现出实质性的异质性。prp - ev中高水平的miR-20a-5p和miR-21-5p与临床愈合延迟和角质细胞迁移受损显著相关。相反，miR-223-3p升高与伤口愈合加速相关。结论：PRP- ev的内在miRNA组成是PRP治疗效果的关键决定因素。miR-20a-5p和miR-21-5p作为阴性预测生物标志物，而miR-223-3p预示着良好的预后。分析这些mirna为PRP质量控制和个性化再生策略提供了新的方法。

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引用次数: 0

Corrigendum to “Dietary glycocalyx mimetic reduces vascular risk in Type 2 diabetes: evidence from urinary peptidomic classifiers in a South–Asian Surinamese Cohort”. [DIAB 229 (2025) 112931] “饮食糖萼模拟物降低2型糖尿病血管风险：来自南亚苏里南队列尿肽组学分类的证据”的勘误表。[diab 229 (2025) 112931]

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2025-10-25 DOI: 10.1016/j.diabres.2025.112953

Sajjad Biglari , Lushun Yuan , Harald Mischak , Justyna Siwy , Agnieszka Latosinska , Miroslaw Banasik , Bernard M. van den Berg

引用次数: 0

Risk of type 2 diabetes mellitus after respiratory syncytial viral infection: A retrospective cohort study using US database 呼吸道合胞病毒感染后2型糖尿病的风险：一项使用美国数据库的回顾性队列研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.diabres.2026.113123

Sunny Ssu-Yu Chen , Tina Ting-An Lin , Yi-Lin Chiang , Chien-Yun Chen , Hui-Yuan Chen , Yao-Min Hung , Renin Chang

Objective

Whether respiratory syncytial virus (RSV) infection contributes to the development of type 2 diabetes (T2DM) or serves as an early warning indicator of T2DM risk remains unclear.

Methods

The study utilized TriNetX US Collaborative Database between January 1, 2022, and March 31, 2024. Patients with a history of T2DM diagnosis, antidiabetic medication use, or HbA1c ≥ 6.5 were excluded. RSV infection was designated as the index event with propensity score matching. The risk of T2DM was assessed using Cox proportional hazards regression models. Sensitivity analyses were conducted for two periods: 2010–2015 and 2016–2019, and across different databases.

Results

A total of 3,052,016 patients, including 15,205 with RSV (mean age, 51.1 years; 59.9% female) and 3,036,811 without RSV (mean age, 46.9 years; 53.4% female). T2DM incidence was 5.69% in the RSV group vs 2.48% in controls, HR 2.684 [95% CI: 2.378–3.030], E-value 4.81. Risk was significantly increased from infection to 3 and 6 months (HR 3 months: 2.697 [95% CI: 2.332–3.119]; HR 6 months: 2.271 [95% CI: 1.911–2.699]). All sensitivity analyses consistently showed a positive trend.

Conclusions

Our findings suggest an association between RSV infection and subsequent T2DM. Prospective studies and mechanistic investigations are warranted to validate these observations and elucidate the underlying pathways.

目的：呼吸道合胞病毒（RSV）感染是否有助于2型糖尿病（T2DM）的发展或作为T2DM风险的早期预警指标尚不清楚。方法：研究使用TriNetX美国协同数据库，时间为2022年1月1日至2024年3月31日。排除有T2DM诊断史、抗糖尿病药物使用史或HbA1c ≥ 6.5的患者。将RSV感染指定为倾向评分匹配的指标事件。采用Cox比例风险回归模型评估T2DM风险。敏感性分析在2010-2015年和2016-2019年两个不同的数据库中进行。结果：共3052016例患者，其中RSV患者15205例（平均年龄51.1 岁，女性59.9%），无RSV患者3036811例（平均年龄46.9 岁，女性53.4%）。RSV组T2DM发病率为5.69%，对照组为2.48%，HR为2.684 [95% CI: 2.378-3.030]， e值为4.81。感染至3和6 个月的风险显著增加（HR 3 个月：2.697 [95% CI: 2.332-3.119]； HR 6 个月：2.271 [95% CI: 1.911-2.699]）。所有敏感性分析均一致显示阳性趋势。结论：我们的研究结果表明RSV感染与随后的T2DM之间存在关联。有必要进行前瞻性研究和机制调查，以验证这些观察结果并阐明潜在的途径。

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引用次数: 0

Effects of liraglutide treatment for 35-days on total and regional fat free, lean, and bone mass, and on the Myostatin–Activin–Follistatin–IGF-1 axes: a secondary analysis of a randomized placebo-controlled crossover study 利拉鲁肽治疗35天对总和局部脂肪、瘦肉和骨量的影响，以及对肌生成抑制素-激活素-卵泡素- igf -1轴的影响：一项随机安慰剂对照交叉研究的二次分析。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.diabres.2026.113113

Valeria Gutierrez de Piñeres , Arantxa Ramirez-Cisneros , Claudia S. Tamayo-Torres , Angeliki M. Angelidi , Marianthi Kavelidou , Konstantinos Stefanakis , Christos S. Mantzoros

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used to treat obesity and metabolic diseases, yet their early impact on body composition and circulating regulators of muscle and bone remain unclear. This study aimed to assess early effects of liraglutide on total and regional body composition and associated changes in circulating markers of muscle and bone metabolism.

Methods: Twenty adults with obesity received liraglutide 3.0 mg/day or placebo for 35 days in this crossover randomized controlled trial. In this secondary analysis, body composition was assessed by dual-energy X-ray absorptiometry at the end of each phase, while hormones were measured by ELISA at baseline and at each of 6 weekly visits over 5 weeks.

Results: Liraglutide reduced body weight, BMI, and total and regional mass (trunk, hip, and extremities). Absolute fat-free mass was slightly but significantly lower. Absolute lean mass in the trunk and extremities decreased, whereas relative lean mass and fat-free mass percentages remained stable at treatment completion.

Conclusions: Short-term liraglutide treatment reduces total and regional mass without altering relative body composition. Further research is warranted to confirm and clarify the clinical significance of these changes, to further study hormonal changes and identify strategies to preserve muscle mass during weight loss.

背景：胰高血糖素样肽-1受体激动剂（GLP-1RAs）用于治疗肥胖和代谢疾病，但其对身体成分和肌肉和骨骼循环调节因子的早期影响尚不清楚。本研究旨在评估利拉鲁肽对整体和局部身体组成的早期影响，以及与肌肉和骨代谢循环标志物相关的变化。方法：在这项交叉随机对照试验中，20名肥胖成人接受利拉鲁肽3.0 mg/天或安慰剂治疗35 天。在这个二次分析中，在每个阶段结束时，通过双能x射线吸收仪评估身体成分，而在基线和5 周内6次就诊时，通过ELISA测量激素。结果：利拉鲁肽降低了体重、BMI、总质量和局部质量（躯干、髋关节和四肢）。绝对无脂质量略低但显著降低。躯干和四肢的绝对瘦质量下降，而相对瘦质量和无脂质量百分比在治疗结束时保持稳定。结论：短期利拉鲁肽治疗可减少总质量和局部质量，而不改变相对体成分。需要进一步的研究来证实和阐明这些变化的临床意义，进一步研究激素的变化，并确定在减肥过程中保持肌肉质量的策略。

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引用次数: 0

Diabetes technology use in the Middle East and Southeast Asia: penetrance, challenges, and unmet needs 中东和东南亚的糖尿病技术使用：外显率、挑战和未满足的需求。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-24 DOI: 10.1016/j.diabres.2026.113117

Asma Deeb , Hussain Al Saffar , Nadha Yaqoob , Andrea E. Scaramuzza

Aims

Little data exist on the extent of diabetes technology use in the treatment of diabetes in young people outside high-income, Western countries. Here we explored uptake of diabetes technology in the Middle East, Southeast Asia, and beyond.

Methods

A multinational, cross-sectional survey was distributed via major pediatric endocrine societies to healthcare professionals (HCPs) managing children and adolescents with diabetes. The survey assessed CGM and insulin pump penetrance, challenges to adoption, and perceived solutions.

Results

Based on 196 responses from 27 countries, a profound technology gap was confirmed. Nearly half of HCPs (49.2%) reported CGM use in fewer than 5% of their patients, while insulin pump use was even lower, with 74.1% reporting use in under 5% of their pediatric population. While lack of financial resources was the principal barrier (>95%), HCPs also highlighted critical non-financial needs, including simpler technology (53.3%), maintaining patient motivation (52.3%), and deficits in provider training (47.2%) and structured patient education (46.7%).

Conclusion

The adoption of modern diabetes technology is critically low in these regions, reinforcing the existence of an interregional “technology gap”. Improving outcomes for children and adolescents with type 1 diabetes not only relies on funding to promote equitable access but also support through culturally-adapted education for providers, patients, and their families.

目的：在西方高收入国家以外的年轻人中，关于糖尿病技术在糖尿病治疗中的应用程度的数据很少。方法：一项跨国横断面调查通过主要儿科内分泌学会分发给管理糖尿病儿童和青少年的医疗保健专业人员（HCPs）。该调查评估了CGM和胰岛素泵的外显率、采用的挑战和可感知的解决方案。结果：根据来自27个国家的196份答复，确认了深刻的技术差距。近一半的HCPs（49.2%）报告称，不到5%的患者使用了CGM，而胰岛素泵的使用率甚至更低，74.1%报告称，不到5%的儿科人群使用了胰岛素泵。虽然缺乏财政资源是主要障碍（95%），但HCPs也强调了关键的非经济需求，包括更简单的技术（53.3%），保持患者动机（52.3%），提供者培训不足（47.2%）和结构化患者教育（46.7%）。结论：这些地区现代糖尿病技术的采用率极低，加剧了地区间“技术差距”的存在。改善1型糖尿病儿童和青少年的预后不仅依赖于促进公平获取的资金，还需要通过对提供者、患者及其家庭进行适应文化的教育来提供支持。

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引用次数: 0

Gestational diabetes mellitus phenotypes defined by 75-g oral glucose tolerance test response patterns: associations with perinatal outcomes and persistent postpartum diabetes 75克口服葡萄糖耐量试验反应模式定义的妊娠糖尿病表型：与围产期结局和产后持续性糖尿病的关系

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-02-08 DOI: 10.1016/j.diabres.2026.113148

Hanne Bulat Cim , Canan Satır Özel , Melis Altuğ İnan , Nisan Helin Dönmez , Esmehan Ayşit , Ergül Demirçivi , Bilge Kapudere , Neslişah Ar , Abdulkadir Turgut

Aims

To assess whether 75-g oral glucose tolerance test (OGTT) response patterns define clinically meaningful phenotypes among women with gestational diabetes mellitus (GDM) and whether these phenotypes are associated with perinatal outcomes and persistent postpartum diabetes.

Methods

This single-center ambispective cohort included women diagnosed with GDM by a 75-g OGTT at 24–28 weeks’ gestation (IADPSG) between January 2020 and May 2025. Women were classified as isolated fasting hyperglycemia (Group 1), isolated post-load hyperglycemia (Group 2), or combined hyperglycemia (Group 3). From ≥ 12 weeks postpartum onward, participants were recontacted for assessment of glycemic status, and outcomes were verified using available clinical records, laboratory results when available, and medication data.

Results

Among 251 women (mean age 31.4 years; mean BMI 32.5 kg/m²), insulin therapy was most frequent in Group 3 (27.4%; p < 0.001), which also had higher HbA1c (p = 0.011) and earlier delivery (p = 0.008). Persistent postpartum diabetes occurred in 12%. In multivariable analyses, higher BMI and phenotypes incorporating fasting hyperglycemia (Groups 1/3) were independently associated with persistent postpartum diabetes.

Conclusion

OGTT pattern–based phenotyping differentiates GDM subgroups in routine care, with differences in metabolic severity, treatment need, selected perinatal indicators, and postpartum diabetes risk, supporting targeted antenatal management and postpartum follow-up.

目的：评估75 g口服葡萄糖耐量试验（OGTT）反应模式是否定义妊娠糖尿病（GDM）妇女的临床有意义的表型，以及这些表型是否与围产期结局和产后持续性糖尿病相关。方法：该单中心双视角队列纳入了2020年1月至2025年5月期间24-28 孕周（IADPSG）通过75 g OGTT诊断为GDM的女性。将女性分为空腹高血糖组（1组）、负荷后高血糖组（2组）和合并高血糖组（3组）。从产后 ≥ 12 周开始，再次联系参与者评估血糖状态，并使用可用的临床记录、实验室结果和药物数据验证结果。结果：251名女性（平均年龄31.4 岁，平均BMI 32.5 kg/m2）中，胰岛素治疗在第3组最常见（27.4%）；p 结论：基于OGTT模式的表型分型在常规护理中区分GDM亚组，在代谢严重程度、治疗需求、围产期指标选择和产后糖尿病风险方面存在差异，支持有针对性的产前管理和产后随访。

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引用次数: 0

Insights for personalized choice of a hybrid closed–loop system: an expert opinion 混合闭环系统个性化选择的见解：专家意见

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-27 DOI: 10.1016/j.diabres.2026.113120

S. Di Molfetta , F. Boscari , A. Rossi , A. Girelli , G. Lepore , L. Bozzetto , C. Irace , L. Laviola , D. Bruttomesso

Hybrid closed-loop (HCL) systems have transformed diabetes management by integrating continuous glucose monitoring (CGM) with insulin pumps and algorithm-driven insulin dosing. In type 1 diabetes, randomized controlled trials and meta-analyses consistently demonstrate increased time in range and reduced HbA1c with HCL compared to other insulin treatments, without an increased risk of hypoglycemia. Benefits have also been reported in individuals with type 2 diabetes, in pregnant women, and across other groups of persons with diabetes (PWDs). As multiple HCL systems become available, tailoring the choice to clinical profiles and patient preferences can help optimize system selection. This expert paper discusses pump, CGM device and whole system features, supporting evidence from the literature, and other factors to guide the personalized selection of HCL systems currently available in Italy. Practical examples of sound alignment between device features and patient needs/preferences are also provided. The result is a patient–centered framework that combines device features, clinical needs, lifestyle, and preferences to support shared decision–making and ultimately improve outcomes and quality of life for PWDs.

混合闭环（HCL）系统通过将连续血糖监测（CGM）与胰岛素泵和算法驱动的胰岛素给药相结合，改变了糖尿病管理。在1型糖尿病中，随机对照试验和荟萃分析一致表明，与其他胰岛素治疗相比，HCL治疗范围延长，HbA1c降低，低血糖风险未增加。在2型糖尿病患者、孕妇和其他糖尿病患者（pwd）群体中也有获益的报道。随着多种HCL系统的出现，根据临床概况和患者偏好定制选择可以帮助优化系统选择。这篇专家论文讨论了泵、CGM装置和整个系统的特点，从文献中获得的支持证据，以及其他因素，以指导意大利目前可用的HCL系统的个性化选择。还提供了设备功能与患者需求/偏好之间声音对齐的实际示例。结果是一个以患者为中心的框架，结合了设备的特点、临床需求、生活方式和偏好，以支持共同决策，最终改善残疾患者的预后和生活质量。

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引用次数: 0

Leisure-time physical activity and sedentary behavior trajectories during middle and late adulthood in relation to type 2 diabetes mellitus: An 11-year longitudinal study 成年中后期的休闲时间体力活动和久坐行为轨迹与2型糖尿病的关系：一项为期11年的纵向研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.diabres.2026.113135

Mengyao Guo , Shiyi Chen , Huanyu Wang , Jialin Fang , Mingjia Yang

Background

Leisure-time physical activity (LTPA) and sedentary behavior (SB) are considered important modifiable risk factors for Type 2 diabetes mellitus (T2DM). However, the associations of long-term trajectories of LTPA and LTSB with T2DM risk remains uncertain.

Methods

Leveraging prospective cohort data from the China Health and Nutrition Survey (CHNS), we identified the long-term trajectories of LTPA and LTSB among 7,188 participants from 2004 (31 to 77 years) to 2015 (42 to 88 years) by group-based trajectory modeling. Cox regression was used to assess the associations of LTPA and LTSB trajectories with T2DM.

Results

During a mean follow-up of 9.13 years, 715 new-onset T2DM were identified. Three distinct trajectories were identified for both LTPA and LTSB, respectively. Participants in the high decreasing trajectory, but still remains at a relatively high level of LTPA had a 45% lower risk of T2DM (HR: 0.55; 95% CI: 0.30–0.99), relative to those in the inactive stable trajectory. Conversely, compared with the low stable trajectory, the high increasing trajectory of LTSB had a 130% higher risk of T2DM (HR: 2.30; 95% CI: 1.03–5.10).

Conclusion

This prospective study suggests that maintaining higher levels of LTPA and lower levels of LTSB may reduce the risk of T2DM during middle and late adulthood.

背景：休闲时间体力活动（LTPA）和久坐行为（SB）被认为是2型糖尿病（T2DM）重要的可改变危险因素。方法：利用中国健康与营养调查（CHNS）的前瞻性队列数据，我们通过基于组的轨迹建模，确定了2004年（31至77 年）至2015年（42至88 年）7188名参与者的LTPA和LTSB的长期轨迹。采用Cox回归评估LTPA和LTSB轨迹与T2DM的关系。结果：在平均9.13 年的随访期间，确定了715例新发T2DM。分别为LTPA和LTSB确定了三个不同的轨迹。处于高下降轨迹的参与者，但仍然保持相对较高的LTPA水平，相对于不活跃的稳定轨迹的参与者，T2DM的风险降低了45% （HR: 0.55; 95% CI: 0.30-0.99）。相反，与低稳定轨迹相比，LTSB高增加轨迹发生T2DM的风险高130% （HR: 2.30; 95% CI: 1.03-5.10）。结论：这项前瞻性研究表明，维持较高水平的LTPA和较低水平的LTSB可能会降低成年中后期患T2DM的风险。

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引用次数: 0

Quantifying the impact of inequality on traditional and emerging diabetes complications: A registry study of cause-specific hospital admissions and deaths in Australia 量化不平等对传统和新出现的糖尿病并发症的影响：澳大利亚特定原因住院和死亡的登记研究。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-01-25 DOI: 10.1016/j.diabres.2026.113114

Jedidiah I. Morton , Emily D. Williams , Jonathan E. Shaw , Dianna J. Magliano

Background and aims

Our aim was to quantify the relationship of a large range of diabetes complications with socioeconomic disadvantage.

Methods

This study included 621,114 people with type 2 diabetes from the Australian National Diabetes Services Scheme, with follow-up from July 2010 to June 2022. These data were linked to hospital admission and death datasets. The association of socioeconomic disadvantage with cause-specific outcomes (first occurrence of either admission or death) was assessed using Poisson regression, adjusted for age, sex, and year.

Results

Most diabetes-related complications studied were positively associated with increasing socioeconomic disadvantage, with the highest incidence rate ratios per 1-SD increase in socioeconomic disadvantage for admission or death from chronic obstructive pulmonary disease (1.19 (95%CI: 1.18, 1.21)) myocardial infarction (1.12 (1.11, 1.13)), heart failure (1.11 (1.10, 1.12)), cellulitis (1.10 (1.09, 1.12)), and end-stage kidney disease (1.09 (1.07, 1.12)). Foot complications and respiratory diseases showed a positive association with disadvantage, as did cardiovascular and kidney diseases, while most cancers, depression, and dementia did not.

Conclusions

Increasing socioeconomic disadvantage was associated with an increased risk of admission or death from most traditional diabetes-related complications and for respiratory disease. However, the associations with emerging complications of diabetes were weaker, null, or the risk decreased with increasing disadvantage.

背景和目的：我们的目的是量化大范围糖尿病并发症与社会经济劣势的关系。方法：本研究纳入了来自澳大利亚国家糖尿病服务计划的621,114例2型糖尿病患者，随访时间为2010年7月至2022年6月。这些数据与住院和死亡数据集相关联。使用泊松回归评估社会经济劣势与病因特异性结局（首次入院或死亡）的关联，并根据年龄、性别和年份进行调整。结果：所研究的大多数糖尿病相关并发症与社会经济劣势增加呈正相关，慢性阻塞性肺疾病入院或死亡时社会经济劣势每增加1-SD的发生率最高（1.19 (95%CI: 1.18, 1.21)）心肌梗死（1.12(1.11,1.13)）、心力衰竭（1.11(1.10,1.12)）、蜂窝组织炎（1.10(1.09,1.12)）和终末期肾病（1.09(1.07,1.12)）。足部并发症和呼吸系统疾病与不利因素呈正相关，心血管疾病和肾脏疾病也是如此，而大多数癌症、抑郁症和痴呆则没有。结论：社会经济劣势的增加与大多数传统糖尿病相关并发症和呼吸系统疾病的入院或死亡风险增加有关。然而，与新出现的糖尿病并发症的关联较弱，为零，或者风险随着不利因素的增加而降低。

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引用次数: 0

Insights to HDL dysfunctionality: hypothesis of exhausted HDL 对HDL功能障碍的认识：HDL耗竭假说。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI: 10.1016/j.diabres.2026.113145

Abdolkarim Mahrooz

In recent years, a growing understanding of high-density lipoprotein (HDL) properties has significantly reshaped our comprehension of this crucial lipoprotein. Emerging evidence indicates that HDL can lose its well-documented protective functions, becoming dysfunctional and, paradoxically, even proatherogenic. Dysfunctional HDL (dys-HDL) is recognized as a critical contributor to cardiovascular disease and diabetes mellitus, conditions where cardiovascular complications are the main cause of mortality. The concept of dys-HDL appears broad, necessitating a distinction between HDL with diminished protective functionality and HDL that actively promotes proatherogenic effects. In certain conditions, the transition from protective to proatherogenic HDL appears to be a gradual and progressive process. This transition may be conceptualized through the idea of ‘exhausted’ HDL (ex-HDL), which represents HDL that has experienced reduced functionality but has not yet fully acquired proatherogenic characteristics. It signifies an abnormality leading to a state of ‘partial functional impairment’ in HDL. Hypothetically, dys-HDL could be categorized into two groups: ex-HDL and proatherogenic HDL. Such a classifying offers a path towards more targeted therapies for cardiovascular risk reduction. This review aims to enhance our understanding of HDL dysfunctionality and propose ex-HDL, thereby offering insights into the transition from protective to proatherogenic HDL.

近年来，对高密度脂蛋白（HDL）特性的认识不断加深，极大地改变了我们对这种重要脂蛋白的认识。越来越多的证据表明，HDL可能失去其众所周知的保护功能，变得功能失调，甚至可能导致动脉粥样硬化。HDL功能失调（dysi -HDL）被认为是心血管疾病和糖尿病的关键因素，心血管并发症是导致死亡的主要原因。HDL异常的概念似乎很宽泛，因此需要区分保护功能减弱的HDL和积极促进动脉粥样硬化作用的HDL。在某些情况下，从保护性到致动脉粥样硬化性HDL的转变似乎是一个渐进的过程。这种转变可以通过“耗尽”HDL（前HDL）的概念来概念化，它代表HDL经历了功能降低，但尚未完全获得促动脉粥样硬化特征。这表明HDL出现了一种导致“部分功能损伤”的异常。假设，dysi -HDL可分为两组：前HDL和促粥样硬化HDL。这样的分类为降低心血管风险提供了更有针对性的治疗方法。这篇综述旨在提高我们对HDL功能障碍的理解，并提出前HDL，从而为从保护性到促粥样硬化性HDL的转变提供见解。

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引用次数: 0