Diabetes research and clinical practice最新文献_第7页

Impact of metformin on the risk of osteoarthritis in patients with type 2 diabetes: a real-world study. 二甲双胍对2型糖尿病患者骨关节炎风险的影响：一项真实世界的研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-24 DOI: 10.1016/j.diabres.2026.113191

Shengwei Liu, Junyu Chen, Jiawei Du, JiaJun Song, Yi Kang, Di Zhang, Shiqing Feng

Aims: To investigate the association between metformin use and osteoarthritis (OA) risk or total knee replacement (TKR) need in type 2 diabetes (T2DM) patients, addressing limited real-world evidence on metformin's potential joint-protective effects.

Methods: This retrospective cohort study analyzed electronic health records (January 2015-December 2021) from a large healthcare database. We identified 244,562 metformin users and 117,529 non-users with T2DM. Multivariable-adjusted Cox proportional hazards models evaluated OA development and TKR risk, with propensity score matching and competing risk models minimizing confounding.

Results: Among 362,091 patients, 28,724 incident OA cases and 1,593 TKR procedures occurred. Metformin users showed significantly reduced OA risk versus non-users (adjusted HR 0.95, 95% CI 0.92-0.96, p < 0.001). No significant TKR risk difference was observed (adjusted HR 1.05, 95% CI 0.94-1.18, p = 0.352). Results remained robust through sensitivity analyses including propensity score matching and competing risk regression.

Conclusion: In this large real-world T2DM cohort, metformin use associated with modestly reduced OA incidence but unchanged TKR risk. These findings support preclinical and clinical evidence for metformin's potential protective role against OA development.

目的：研究二甲双胍使用与2型糖尿病（T2DM）患者骨关节炎（OA）风险或全膝关节置换术（TKR）需求之间的关系，解决二甲双胍潜在关节保护作用的有限现实证据。方法：本回顾性队列研究分析了大型医疗数据库中2015年1月至2021年12月的电子健康记录。我们确定了244,562名二甲双胍使用者和117,529名未使用二甲双胍的T2DM患者。多变量调整Cox比例风险模型评估OA发展和TKR风险，倾向评分匹配和竞争风险模型最大限度地减少混淆。结果：在362,091例患者中，发生了28,724例OA病例和1,593例TKR手术。二甲双胍服用者与非服用者相比，OA风险显著降低（调整后HR 0.95, 95% CI 0.92-0.96, p ）。结论：在这个庞大的现实世界T2DM队列中，使用二甲双胍可适度降低OA发病率，但TKR风险不变。这些发现支持二甲双胍对OA发展的潜在保护作用的临床前和临床证据。

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引用次数: 0

Effectiveness of lifestyle modification in prediabetes remission among women with isolated impaired fasting glucose: A community-based, randomised controlled trial in India 生活方式改变对孤立性空腹血糖受损女性糖尿病前期缓解的有效性：印度一项基于社区的随机对照试验

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.diabres.2026.113106

Elezebeth Mathews , Thakarakkattil Narayanan Nair Anand , Anjaly Joseph , Bhagiaswari Kodapally , Rajendra Pilankatta , K M Venkat Narayan , Brian Oldenburg , Kavumpurathu Raman Thankappan

Aims

We evaluated the effectiveness of a lifestyle modification (LSM) intervention in prediabetes remission among women with isolated impaired fasting glucose (i-IFG).

Methods

We conducted a community-based, parallel-group, open-label, randomised controlled trial in Kerala, India. Women aged 30–60 years with i-IFG were randomly assigned (1:1) to receive either a 12-month LSM program or standard care (diabetes information booklet). Randomization was computer-generated with allocation concealed until assignment. The primary outcome was prediabetes remission based on oral glucose tolerance testing at 12 months. Secondary outcomes included progression to type 2 diabetes and changes in glycaemic markers, anthropometric measures, body composition, and blood pressure. Analyses followed the intention-to-treat approach.

Results

Of 1092 participants randomised, 1080 (98.9 %) completed the 12-month follow-up. Prediabetes remission was significantly higher in the LSM group than in controls (45.9 % vs 6.3 %; RR 7.04, 95 % CI 5.12–10.06). LSM also produced greater improvements in fasting plasma glucose (–5.2 mg/dL), HbA1c (–0.09 %), HOMA2-IR (log) (–0.38), weight (–3.7 kg), waist circumference (–1.4 cm), fat mass (–2.9 kg), and fat-free mass (+0.86 kg). The number needed to treat for prediabetes remission was 2.8 (1.8–4.0).

Conclusion

A structured LSM intervention effectively promotes prediabetes remission in women with i-IFG and improves cardio metabolic health.

目的：我们评估生活方式改变（LSM）干预对孤立性空腹血糖受损（i-IFG）女性糖尿病前期缓解的有效性。方法：我们在印度喀拉拉邦进行了一项基于社区、平行组、开放标签、随机对照试验。年龄在30-60岁 的i-IFG女性被随机分配（1:1）接受12个月的LSM计划或标准治疗（糖尿病信息手册）。随机化是由计算机生成的，分配是隐藏的，直到分配。主要结局是基于12 个月的口服葡萄糖耐量试验的糖尿病前期缓解。次要结局包括进展为2型糖尿病以及血糖标志物、人体测量、身体成分和血压的变化。分析采用意向治疗方法。结果：在1092名随机参与者中，1080名（98.9 %）完成了12个月的随访。LSM组糖尿病前期缓解明显高于对照组（45.9 % vs 6.3 %;RR 7.04, 95 % CI 5.12-10.06）。LSM对空腹血糖（-5.2 mg/dL）、糖化血红蛋白（-0.09 %）、homa - ir (log)（-0.38）、体重（-3.7 kg）、腰围（-1.4 cm）、脂肪量（-2.9 kg）和无脂量（+0.86 kg）也有更大的改善。需要治疗糖尿病前期缓解的人数为2.8（1.8-4.0）。结论：结构化LSM干预可有效促进i-IFG女性糖尿病前期缓解，改善心脏代谢健康。

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引用次数: 0

Therapeutic potential of prebiotics in modulating postprandial GLP-1, GLP-2, and glucose homeostasis in type 2 diabetes mellitus: Targeting gut dysbiosis and insulin resistance 益生元调节2型糖尿病餐后GLP-1、GLP-2和葡萄糖稳态的治疗潜力：针对肠道生态失调和胰岛素抵抗

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-12 DOI: 10.1016/j.diabres.2026.113102

Zainab Irfan , Jitu Halder , Sumon Giri , Ekbal Ali Molla , Sofia Khanam

Type 2 diabetes mellitus is associated with gut dysbiosis, decreased microbial diversity, short-chain fatty acid synthesis, and altered GLP secretion, which are crucial for intestinal integrity, insulin sensitivity, and postprandial glucose control. Evidence from peer-reviewed mechanistic studies, observational research, clinical trials, and meta-analyses was summarised in this review. Prebiotics, an emerging potential treatment, increase the formation of SCFA during fermentation, thereby enhancing the release of GLP through FFAR2/3 signalling. This chain of events enhances glucose-dependent insulin production, inhibits glucagon secretion, delays stomach emptying, strengthens the intestinal barrier, and reduces inflammation throughout the body. Human trials demonstrate statistically significant but clinically modest improvements in HbA1c, postprandial glucose fluctuations, and an increased response to incretin-based treatments, with meta-analytic evidence reporting decreased fasting glucose and HbA1c levels. Prebiotics effect on incretin hormones in humans appears to be diverse, depending on the type, dose, duration, and baseline microbiota composition. Resistant starch and inulin-type fructans have the most consistent effects for lowering postprandial glucose. Prebiotics are viable supplementary therapy for improving glycaemic management by regulating the gut microbiota-SCFA-incretin axis. While the molecular evidence is substantial, clinical effects are moderate and diverse. Long-term microbiome-specific trials are required to understand therapeutic potential and optimise tailored therapies fully.

2型糖尿病与肠道生态失调、微生物多样性减少、短链脂肪酸合成和GLP分泌改变有关，这对肠道完整性、胰岛素敏感性和餐后血糖控制至关重要。本综述总结了同行评议的机制研究、观察性研究、临床试验和荟萃分析的证据。益生元是一种新兴的潜在治疗方法，在发酵过程中增加SCFA的形成，从而通过FFAR2/3信号传导促进GLP的释放。这一系列事件增强了葡萄糖依赖性胰岛素的产生，抑制了胰高血糖素的分泌，延缓了胃排空，加强了肠道屏障，减少了全身的炎症。人体试验显示，在HbA1c、餐后血糖波动和对肠促胰岛素治疗的反应增加方面，HbA1c水平在统计学上有显著改善，但在临床上表现温和，荟萃分析证据显示空腹血糖和HbA1c水平降低。益生元对人类肠促胰岛素激素的影响似乎是多种多样的，这取决于类型、剂量、持续时间和基线微生物群组成。抗性淀粉和菊糖型果聚糖对降低餐后葡萄糖的效果最为一致。益生元是通过调节肠道微生物群- scfa -肠促胰岛素轴改善血糖管理的可行补充疗法。虽然分子证据是充分的，但临床效果是中等和多样化的。需要长期的微生物组特异性试验来了解治疗潜力并充分优化量身定制的治疗方法。

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引用次数: 0

Cerebral microbleeds are associated with deficits in cognitive processing speed and executive functions in middle-aged adults with type 1 diabetes 1型糖尿病中年患者脑微出血与认知处理速度和执行功能缺陷有关。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.diabres.2025.113080

Iiris Kyläheiko , Aleksi Tarkkonen , Linda Kuusela , Juha Martola , Teemu I. Paajanen , Jussi Virkkala , Per-Henrik Groop , Lena M. Thorn , Turgut Tatlisumak , Jukka Putaala , Daniel Gordin , Hanna Jokinen , on behalf of the FinnDiane Study Group

Aims

Adults with type 1 diabetes (T1D) have an increased risk of cerebral small vessel disease (cSVD)-related brain changes already in midlife, yet their significance for cognitive functions remains poorly understood. We investigated associations between cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and cognition in individuals with T1D and without any neurological symptoms.

Methods

Participants (n=167; age 46.4±7.7 years) underwent cross-sectional clinical and biochemical evaluations, brain magnetic resonance imaging, and neuropsychological assessment. CMB number and topography (lobar, deep/infratentorial, or mixed location) and WMHs, quantified volumetrically, were evaluated.

Results

Compared to absence of CMBs, higher burden of CMBs (≥3) was associated independently of age with poorer processing speed (standardized β from 0.18 to 0.23, p<0.05) and executive functions (standardized β from 0.18 to –0.25, p<0.05), but not with episodic memory. Mild WMHs had no independent relationships with cognition. Compared to other topographies, mixed CMB location was more often negatively related to cognition (standardized β from 0.20 to 0.32, p<0.05).

Conclusions

CMBs were related to a subtle, yet systematic impairment in cognition, whereas mild WMHs were not. The results provide insight into the development of early cSVD-related cognitive changes already in midlife and suggest an increased risk of cognitive decline in T1D.

目的：1型糖尿病（T1D）成人在中年时发生脑血管疾病（cSVD）相关脑变化的风险增加，但其对认知功能的意义仍知之甚少。我们研究了没有任何神经系统症状的T1D患者脑微出血（CMBs）、白质高信号（WMHs）和认知之间的关系。方法：167名参与者（年龄46.4±7.7岁）接受了横断面临床和生化评估、脑磁共振成像和神经心理学评估。定量评估CMB数量和地形（大叶、深/幕下或混合位置）和wmh。结果：与没有CMBs相比，CMBs负担高（≥3）与较差的处理速度（标准化β从0.18到0.23）独立相关。结论：CMBs与细微的系统性认知障碍有关，而轻度wmh与此无关。该结果为中年早期csvd相关认知变化的发展提供了见解，并表明T1D患者认知能力下降的风险增加。

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引用次数: 0

Lived experience of fully closed-loop insulin delivery in adolescents with type 1 diabetes and HbA1c above target HbA1c高于目标的青少年1型糖尿病患者全闭环胰岛素输送的生活经验

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2025-12-30 DOI: 10.1016/j.diabres.2025.113078

Nithya Kadiyala , Janet Allen , Rama Lakshman , Charlotte K. Boughton , Malgorzata E. Wilinska , Ajay Thankamony , Sara Hartnell , Hood Thabit , Ruben H. Willemsen , Pratik Shah , Julia Ware , Roman Hovorka

Aims

The aim of this qualitative study was to explore the impact of using the CamAPS HX fully closed-loop system, which does not require carbohydrate counting, meal announcements or pre-meal bolusing, on the daily lives of adolescents with type 1 diabetes and HbA1c above the recommended target (≥ 7.5 % [58 mmol/mol]).

Methods

Twelve adolescents took part in virtual semi-structured interviews. Data was analyzed thematically using an inductive-deductive approach. Study participants also completed quality of life questionnaires.

Results

All interviewees reported reduced effort in managing diabetes, as they no longer needed to count carbohydrates or bolus, and worried less about their glucose levels. This led to improved quality of life, with a greater sense of freedom and normalcy, particularly around meals. A few also noted benefits in physical activity, sleep, work and social life. Interviewees expressed dissatisfaction with the algorithm’s slow response to postprandial glucose spikes, and the need for a tethered pump. Questionnaires showed no significant differences in hypoglycaemia fear or diabetes distress between study periods but reflected a positive experience with the closed-loop system.

Conclusions

In adolescents with type 1 diabetes, fully closed-loop insulin delivery reduced the daily burden of self-management, leading to improved quality of life.

Clinical trial registration: NCT05653050.

目的：本质性研究的目的是探讨使用CamAPS HX全闭环系统对HbA1c高于推荐目标（≥7.5 %[58 mmol/mol]）的青少年1型糖尿病患者日常生活的影响，该系统不需要碳水化合物计数、进餐通知或餐前bolings。方法：对12名青少年进行虚拟半结构化访谈。使用归纳演绎方法对数据进行主题分析。研究参与者还完成了生活质量调查问卷。结果：所有受访者都表示，他们管理糖尿病的努力减少了，因为他们不再需要计算碳水化合物或丸剂，也不太担心自己的血糖水平。这导致了生活质量的提高，有了更大的自由和正常的感觉，特别是在吃饭的时候。一些人还指出，锻炼身体、睡眠、工作和社交生活都有好处。受访者对该算法对餐后血糖峰值的缓慢反应以及需要拴绳泵表示不满。问卷调查显示，在研究期间，低血糖恐惧或糖尿病困扰没有显著差异，但反映了闭环系统的积极体验。结论：在青少年1型糖尿病患者中，全闭环胰岛素输送减轻了日常自我管理的负担，从而提高了生活质量。临床试验注册：NCT05653050。

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引用次数: 0

The burden and mortality impact of cardiovascular disease–metabolic dysfunction–associated steatotic liver disease comorbidity 心血管疾病-代谢功能障碍相关脂肪变性肝病合并症的负担和死亡率影响

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.diabres.2026.113092

Siyuan Tan , Ting Huang , Zixi Zhang , Jiabao Zhou , Hao Chen , Tao Tu , Qiuzhen Lin , Yichao Xiao , Qiming Liu

Background

Cardiovascular disease (CVD) and metabolic dysfunction–associated steatotic liver disease (MASLD) are metabolically linked, yet their combined burden and mortality impact remain underexplored.

Methods

Using Global Burden of Disease (GBD) 2023 data, we assessed temporal and regional trends in CVD, MASLD, and metabolic risk factors. National Health and Nutrition Examination Survey (NHANES) data were subsequently analyzed to examine the association between CVD–MASLD comorbidity and mortality using multivariable and survival models.

Results

From 1990 to 2023, the global burden of CVD declined steadily, whereas MASLD rose continuously, showing divergent and regionally heterogeneous trends. In high-income countries, CVD indicators decreased despite increasing MASLD burden, whereas this inverse pattern was weaker in upper–middle-income regions. In NHANES, individuals with CVD–MASLD comorbidity exhibited the highest metabolic abnormalities and mortality risk. Compared with those without comorbidities, adjusted hazard ratios were 1.68 for all-cause and 2.68 for cardiovascular mortality. Mortality rose progressively with fibrosis severity. PAF analyses showed that CVD, MASLD, and their comorbidity accounted for 13.3%, 1.3%, and 7.8% of cardiovascular deaths, respectively, totaling 22.4%. These associations demonstrated marked age-related heterogeneity.

Conclusion

CVD–MASLD comorbidity is an emerging global concern associated with excess mortality, emphasizing the need to incorporate MASLD screening and fibrosis evaluation into cardiovascular prevention strategies.

背景：心血管疾病（CVD）和代谢功能障碍相关的脂肪变性肝病（MASLD）是代谢相关的，但它们的综合负担和死亡率影响仍未得到充分研究。方法：利用全球疾病负担（GBD） 2023数据，我们评估了CVD、MASLD和代谢危险因素的时间和区域趋势。随后分析NHANES数据，使用多变量和生存模型检查CVD-MASLD合并症与死亡率之间的关系。结果：从1990年到2023年，全球心血管疾病负担稳步下降，而MASLD持续上升，呈现出差异和区域异质性趋势。在高收入国家，尽管MASLD负担增加，但心血管疾病指标有所下降，而在中高收入地区，这种相反的模式较弱。在NHANES中，患有CVD-MASLD合并症的个体表现出最高的代谢异常和死亡风险。与无合并症的患者相比，调整后的全因死亡率风险比为1.68，心血管死亡率风险比为2.68。死亡率随着纤维化的严重程度逐渐上升。PAF分析显示，CVD、MASLD及其合并症分别占心血管死亡的13.3%、1.3%和7.8%，总计22.4%。这些关联显示出明显的年龄相关异质性。结论：CVD-MASLD合并症是一个新兴的全球关注的问题，与过高的死亡率有关，强调需要将MASLD筛查和纤维化评估纳入心血管预防策略。

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引用次数: 0

Immunometabolic reprogramming and β-cell dedifferentiation: Integrated mechanisms driving type 2 diabetes progression 免疫代谢重编程和β细胞去分化：驱动2型糖尿病进展的综合机制。

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-19 DOI: 10.1016/j.diabres.2026.113111

Ritu Dahiya, Ajay Pal Singh, Aruna Rawat

Type 2 diabetes is increasingly recognised as a condition driven by sustained metabolic overload and chronic low-grade inflammation rather than a simple decline in insulin secretion. Findings from single-cell transcriptomics, human islet studies, and metabolic profiling show that pancreatic β-cells undergo progressive alterations in identity when exposed to glucotoxic, lipotoxic, oxidative, and inflammatory stress. In parallel, cytokines, lipid intermediates, adipose-derived factors, hepatokines, myokines, and gut microbial metabolites generate an immunometabolic environment that accelerates β-cell dedifferentiation and promotes transitions toward progenitor-like or alternative endocrine states. Originally described through lineage-tracing studies in experimental models, β-cell dedifferentiation is now recognized as a dynamic and potentially reversible process shaped by immunometabolic stress in diabetes. This review synthesizes current evidence to illustrate how metabolic and immune pathways converge on key molecular regulators of β-cell fate. It further describes how interorgan communication reinforces these disturbances and contributes to the gradual shift of β-cells along a continuum of stress adaptation, functional decline, and identity loss. A conceptual framework, referred to as the beta-cell identity clock, is presented to capture the dynamic and potentially reversible nature of these transitions. Finally, emerging therapeutic strategies are discussed, including anti-inflammatory agents, metabolic modulators, epigenetic regulators, and regenerative approaches aimed at preserving or restoring β-cell identity in the context of modern metabolic stress.

2型糖尿病越来越被认为是一种由持续代谢超载和慢性低度炎症引起的疾病，而不是简单的胰岛素分泌下降。来自单细胞转录组学、人类胰岛研究和代谢谱的研究结果表明，当暴露于糖毒性、脂毒性、氧化和炎症应激时，胰腺β细胞的特性会发生进行性改变。与此同时，细胞因子、脂质中间体、脂肪衍生因子、肝因子、肌因子和肠道微生物代谢物产生免疫代谢环境，加速β细胞去分化，促进向祖细胞样或替代内分泌状态的转变。最初通过实验模型中的谱系追踪研究描述，β细胞去分化现在被认为是糖尿病中由免疫代谢应激形成的动态和潜在可逆过程。这篇综述综合了目前的证据来说明代谢和免疫途径如何汇聚在β细胞命运的关键分子调节因子上。它进一步描述了器官间的通信如何加强这些干扰，并有助于β细胞沿着压力适应，功能下降和身份丧失的连续体逐渐转移。一个概念框架，被称为β细胞身份时钟，提出捕捉这些转变的动态和潜在的可逆性质。最后，讨论了新兴的治疗策略，包括抗炎剂、代谢调节剂、表观遗传调节剂和旨在保存或恢复现代代谢应激背景下β细胞身份的再生方法。

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引用次数: 0

Associations between inflammatory indices derived from complete blood counts and mortality risk in diabetes and prediabetes patients: A cohort study from NHANES 1999--2018 糖尿病和糖尿病前期患者全血细胞计数得出的炎症指数与死亡风险之间的关系：NHANES 1999- 2018年的一项队列研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-21 DOI: 10.1016/j.diabres.2026.113112

Xiao She , Jie Yang , Bincheng Ren , Xin Yang , Xiaojing Cheng , Tian Tian , Shanshan Liu , Xinrui Zhao , Hui Zhao , Xiaoguang Cui

Background

The associations between blood count-derived inflammatory indices and mortality risk in individuals with diabetes and prediabetes have gained attention, but systematic studies are lacking.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed to investigate various inflammatory indices (such as the SII and NLR) in relation to all-cause mortality, cardiovascular disease (CVD) mortality, and diabetes-specific mortality via the Cox proportional hazards model.

Results

A total of 12,119 participants were included, with an average age of 60 years and approximately 52 % being male. During the follow-up, the overall mortality rate was 25.7 %. All nine inflammatory indices were significantly associated with all-cause mortality and CVD mortality (P < 0.01), and seven indices were correlated with diabetes-specific mortality. Eight indices exhibited significant nonlinear relationships with all-cause mortality, with the exception of the NPR, whereas the SIRI, PLR, NPR, and MPR showed significant nonlinear associations with CVD mortality.

Conclusion

Inflammatory indices such as the SII, SIRI, and NLR are significantly associated with all-cause and CVD mortality among U.S. adults with diabetes and prediabetes, demonstrating index-specific association patterns and threshold characteristics.

背景：糖尿病和前驱糖尿病患者血液计数衍生炎症指标与死亡风险之间的关系已引起关注，但缺乏系统的研究。方法分析全国健康与营养调查（NHANES）的数据，通过Cox比例风险模型研究各种炎症指数（如SII和NLR）与全因死亡率、心血管疾病（CVD）死亡率和糖尿病特异性死亡率的关系。结果共纳入12119名参与者，平均年龄60岁，约52%为男性。随访期间，总死亡率为25.7%。9项炎症指标均与全因死亡率和CVD死亡率显著相关（P < 0.01）， 7项炎症指标与糖尿病特异性死亡率相关。8个指标与全因死亡率呈显著的非线性关系，除NPR外，SIRI、PLR、NPR和MPR与CVD死亡率呈显著的非线性关系。结论炎性指数如SII、SIRI和NLR与美国成人糖尿病和前驱糖尿病患者的全因死亡率和CVD死亡率显著相关，显示出指数特异性的关联模式和阈值特征。

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引用次数: 0

Inverse association of insulin-like growth factor binding protein 1 with epicardial and intrathoracic adiposity in older adults: The Longenity study 胰岛素样生长因子结合蛋白1与老年人心外膜和胸内肥胖的负相关：长寿研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-11 DOI: 10.1016/j.diabres.2026.113099

Rohan Kankaria , J.Nicholas Charla , Kenny Ye , Leandro Slipczuk , Damini Dey , Jeffrey M. Levsky , Wanda Guzman , Daniel Amadeo , Aribah Zaidi , Jorge R. Kizer , Nir Barzilai , Sofiya Milman , Anna E. Bortnick

Aims

Higher serum insulin-like growth factor binding protein 1 (IGFBP-1) is associated with insulin sensitivity and reduced risk of obesity, diabetes, and atherosclerosis. Epicardial (EAT) and intrathoracic adipose tissue (IAT) are associated with increased atherosclerosis. Whether there is an inverse association of IGFBP-1 with EAT and IAT is unknown.

Methods

We measured EAT, IAT, and IGFBP-1 from n = 102 participants from the LonGenity parent study at the Albert Einstein Institute of Aging, Bronx NY, who were enrolled to investigate healthy aging in Ashkenazi Jewish offspring of parents with exceptional longevity (OPEL) vs usual survival (OPUS). Participants underwent non-contrast electrocardiogram-gated computed tomography (CT) for fat volume quantification. Multiple linear regression models for the cross-sectional association of IGFBP-1 with EAT and IAT were adjusted for demographic, clinical, and laboratory factors.

Results

Higher IGFBP-1 levels were statistically significantly associated with lower EAT and IAT, particularly in the OPEL. This inverse relationship remained significant after adjusting for age, body mass index, high-density lipoprotein cholesterol, and cardiometabolic factors. In contrast, among the OPUS, the point estimates for these associations were directionally similar but not statistically significant.

Conclusion

Circulating IGFBP-1 may be a novel biomarker for visceral adiposity and cardiometabolic risk stratification. Future studies should explore its role in cardiovascular aging.

目的：较高的血清胰岛素样生长因子结合蛋白1 （IGFBP-1）与胰岛素敏感性和肥胖、糖尿病和动脉粥样硬化风险降低有关。心外膜（EAT）和胸内脂肪组织（IAT）与动脉粥样硬化增加有关。IGFBP-1是否与EAT和IAT呈负相关尚不清楚。方法：我们测量了EAT， IAT和IGFBP-1（ = ）来自纽约布朗克斯阿尔伯特爱因斯坦老龄化研究所LonGenity父母研究的102名参与者，他们被招募来研究德系犹太人后代的健康衰老，他们的父母异常长寿（OPEL）与正常生存（OPUS）。参与者接受了非对比心电图门控计算机断层扫描（CT）来量化脂肪体积。根据人口统计学、临床和实验室因素对IGFBP-1与EAT和IAT横断面关联的多元线性回归模型进行调整。结果：较高的IGFBP-1水平与较低的EAT和IAT相关，尤其是在欧宝。在调整了年龄、体重指数、高密度脂蛋白胆固醇和心脏代谢因素后，这种负相关关系仍然显著。相比之下，在OPUS中，这些关联的点估计方向相似，但没有统计学意义。结论：循环IGFBP-1可能是内脏脂肪和心脏代谢危险分层的新生物标志物。未来的研究应探讨其在心血管衰老中的作用。

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引用次数: 0

The effects of e-Health and artificial intelligence literacy levels on disease self-management in patients with diabetes 电子健康和人工智能素养水平对糖尿病患者疾病自我管理的影响

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2026-02-01 Epub Date: 2026-01-03 DOI: 10.1016/j.diabres.2026.113082

Nilhan Töyer Şahin , Seda Pehlivan

Background

This study was conducted to examine the effects of eHealth and artificial intelligence literacy on disease self-management in patients with diabetes.

Methods

The cross-sectional study was conducted with 212 patients with diabetes who were followed up in Endocrinology clinics and outpatient clinics of a hospital between October 2024 and June 2025. Data were collected through face-to-face interviews using a Personal Information Form, the eHealth Literacy Scale, the Artificial Intelligence (AI) Literacy Scale, and the Diabetes Self-Management Questionnaire. Data were analysed using the SPSS-27 software, and p = 0.05 was considered statistically significant.

Results

The mean age of the 212 patients was 52.09 ± 17.02, and their mean disease duration was 9.66 ± 8.47 years. The patients had mean Diabetes Self-Management Questionnaire, eHealth Literacy Scale, and AI Literacy Scale scores of 6.47 ± 1.50, 27.87 ± 8.83, and 48.12 ± 11.26, respectively. Diabetes self-management was significantly and positively correlated with eHealth literacy (r = 0.505; p = 0.000) and AI literacy (r = 0.499; p = 0.000). Additionally, a positive significant relationship was found between general eHealth literacy and AI literacy (r = 0.865; p = 0.000).

Conclusions

The results of this study suggest that general eHealth and AI literacy play a significant role in supporting diabetes self-management.

背景：本研究旨在探讨电子健康和人工智能素养对糖尿病患者疾病自我管理的影响。方法：对2024年10月~ 2025年6月在某医院内分泌科门诊和门诊随访的212例糖尿病患者进行横断面研究。通过面对面访谈收集数据，使用个人信息表、电子健康素养量表、人工智能（AI）素养量表和糖尿病自我管理问卷。采用SPSS-27软件对数据进行分析，p = 0.05认为有统计学意义。结果：212例患者平均年龄为52.09 ± 17.02岁，平均病程为9.66 ± 8.47 年。患者糖尿病自我管理问卷、电子健康素养量表和人工智能素养量表的平均得分分别为6.47 ± 1.50、27.87 ± 8.83和48.12 ± 11.26。糖尿病自我管理与eHealth素养（r = 0.505;p = 0.000）和AI素养（r = 0.499;p = 0.000）呈显著正相关。此外，一般电子健康素养与人工智能素养之间存在显著的正相关关系（r = 0.865;p = 0.000）。结论：本研究的结果表明，一般的电子健康和人工智能素养在支持糖尿病自我管理方面发挥着重要作用。

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