Diabetes research and clinical practice最新文献

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Weight loss from glucagon-like peptide-1 receptor agonists by genetic factors in adults with type 2 diabetes 2型糖尿病成人患者胰高血糖素样肽-1受体激动剂所致体重减轻的遗传因素

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-12-03 DOI: 10.1016/j.diabres.2025.113041

Yulu Zheng , Zheng Guo , Eugene Jeong , Shuai Xu , Jason M. Samuels , Ghadeer K Dawwas , Ran Tao , Gitanjali Srivastava , You Chen , Danxia Yu

Aims

To identify whether genetic predisposition to obesity influences the weight loss effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) among adults with type 2 diabetes (T2D).

Methods

This study evaluated 52-week weight loss trajectories. Genetic exposures comprised: 1) a BMI polygenic risk score (PRS) incorporating 935,416 single-nucleotide polymorphisms (SNPs) and stratified into low (bottom 20 %), intermediate (middle 60 %), and high (top 20 %) categories; and 2) five major genetic variants for BMI PRS. Linear mixed models were applied to assess the associations between genetic factors and weight loss percentage, and the interaction effect between genetic factors and follow-up time was further considered.

Results

Among the 1,055 included adults (mean age 59 ± 11 years, 55 % female), intermediate and high BMI PRS groups were modestly associated with less weight loss over 52 weeks (0.7 % and 1.5 %, P = 0.0017 and 0.0023, respectively) than the low BMI PRS group. Individual SNPs showed no significant association with weight loss. BMI PRS modified response over time—intermediate PRS showed less early weight loss, whereas high PRS showed less late weight loss; several genotypes also showed significant time-varying effects.

Conclusions

BMI PRS could potentially be used to personalize obesity management with GLP-1RAs. Large-scale, multi-ancestry studies are needed to validate the application.

目的探讨肥胖遗传易感性是否会影响2型糖尿病（T2D）患者使用胰高血糖素样肽-1受体激动剂（GLP-1RAs）的减肥效果。方法本研究评估了52周的减肥轨迹。遗传暴露包括：1)BMI多基因风险评分（PRS），包含935,416个单核苷酸多态性（snp），并分为低（最低20%）、中（中间60%）和高（最高20%）三类；2) BMI PRS的5个主要基因变异。采用线性混合模型评估遗传因素与减重率之间的关系，并进一步考虑遗传因素与随访时间之间的交互作用。结果在1055名纳入的成年人（平均年龄59±11岁，55%为女性）中，与低BMI PRS组相比，中等和高BMI PRS组在52周内的体重减轻较少（分别为0.7%和1.5%，P分别= 0.0017和0.0023）。单个snp与体重减轻没有显著关联。随着时间的推移，BMI - PRS改善了反应-中间PRS显示较低的早期体重减轻，而高PRS显示较低的晚期体重减轻；几个基因型也表现出显著的时变效应。结论bmi PRS可用于GLP-1RAs的个体化肥胖管理。需要大规模、多祖先的研究来验证这一应用。

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引用次数: 0

When the summer camp ends: Short-term, post-camp deterioration of glycemic control in youth with type 1 diabetes 夏令营结束时：1型糖尿病青少年短期后血糖控制恶化。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-12-03 DOI: 10.1016/j.diabres.2025.113039

Georgia Sotiriou, Meropi Dimitriadou, Aggeliki Nemtsa, Evgenia Kavoura, Konstantina Pappa, Athanasios Christoforidis

Aims

To investigate short-term post-camp glycemic deterioration in youth with T1D using sensor-augmented or automated insulin delivery systems and to identify contributing factors.

Methods

This retrospective analysis included 93 children and adolescents with T1D using MiniMed™ CSII systems, attending a seven-day summer diabetes camp in Greece (2019–2025). Glycemic metrics, insulin dosing, carbohydrate intake, infusion set changes were assessed for the pre-camp week, the camp week, and the post-camp week.

Results

Glycemic control during camp was satisfactory and superior to pre-camp values. Post-camp, time in range (70–180 mg/dL) declined (64.53 %) compared with camp (71.27 %) and pre-camp (69.95 %), while time above range (>180 mg/dL and >250 mg/dL) increased. This short-term deterioration was consistent across all six years. Glucose variability peaked during camp (CV 35.21 %). MiniMed™780G users maintained better post-camp control than MiniMed™640G users (TIR 70.02 % vs. 55.43 %, p < 0.001). Post-camp, participants consumed more meals and carbohydrates and required higher total daily insulin (41.13 units/day, 0.84 U/kg). The TDD/Carbs ratio remained stable, and infusion set changes were less frequent during camp.

Conclusions

Children and adolescents with T1D maintain adequate glycemic control during camp, but experience a transient post-camp deterioration, underscoring the need for monitoring and individualized support during the week following camp.

目的：利用传感器增强或自动胰岛素输送系统研究青年T1D患者营后短期血糖恶化，并确定影响因素。方法：本回顾性分析包括93名使用MiniMed™CSII系统的T1D儿童和青少年，他们参加了希腊为期7天的糖尿病夏令营（2019-2025）。血糖指标、胰岛素剂量、碳水化合物摄入量、输液器变化在训练营前一周、训练营周和训练营后一周进行评估。结果：训练营期间血糖控制良好，优于训练营前。与营地（71.27 %）和营地前（69.95 %）相比，营地后在70 ~ 180 mg/dL范围内停留的时间（64.53 %）减少，而在180 ~ 180 mg/dL和250 mg/dL范围内停留的时间（> ~ 250 mg/dL）增加。这种短期恶化在所有六年中都是一致的。葡萄糖变异在营地期间达到峰值（CV 35.21 %）。与MiniMed™640G使用者相比，MiniMed™780G使用者在营地后保持了更好的控制（TIR为70.02 % vs. 55.43 %,p ）。结论：T1D儿童和青少年在营地期间维持了适当的血糖控制，但经历了短暂的营地后恶化，强调了在营地后一周进行监测和个性化支持的必要性。

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