Diabetes & metabolism最新文献_第2页

Factors impacting the recent doubling of French hyperglycaemia prevalence in pregnancy 影响近期法国妊娠期高血糖患病率翻倍的因素。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2026-01-08 DOI: 10.1016/j.diabet.2026.101724

Élodie Lebreton , Luveon Tang , Sandrine Fosse-Edorh , Anne Vambergue , Emmanuel Cosson , Nolwenn Regnault

Aim

To assessed hyperglycaemia in pregnancy (HIP) prevalence trends over the past decade, accounting for risk factors and screening practices (France introduced early risk-based HIP screening in 2010).

Methods

We analysed national delivery data from the French National Health Data System (SNDS) (2012-2022), excluding women with pre-existing diabetes (n=8,172,911). Poisson regressions with generalized estimating equations estimated prevalence ratios (PR) for HIP risk factors. Counterfactual scenarios quantified contributions of maternal age, early screening, and pre-pregnancy overweight to HIP increase.

Results

HIP prevalence increased from 7.5% in 2012 to 15.7% in 2022, with early HIP tripling. Prevalence rose in 2020–2021 during the Covid-19 pandemic. After adjustment for maternal age, parity, socioeconomic status, season of pregnancy onset, place of delivery, regional prevalence of pre-pregnancy overweight, and early screening, the aPR were 1.30 [1.11–1.51] in 2021 and 1.15 [0.97–1.36] in 2022 vs. 2012 (unadjusted: 2.24 [2.22–2.26] and 2.08 [2.06–2.10]), suggesting that these factors account for a large proportion of the observed increase. While the observed increase in HIP prevalence was 8.2 percentage points from 2012 to 2022, counterfactual scenarios estimated increases of 6.5 [5.9–7.3] for constant maternal age, 6.2 [5.1–7.7] for constant early screening (13.7%), and 4.3 [2.4–5.9] for constant regional pre-pregnancy overweight (11.8%) at 2012 levels.

Conclusion

Rising maternal age, increased early HIP screening, and higher regional pre-pregnancy overweight prevalence mostly contributed to HIP prevalence increase. Public health strategies should prioritize modifiable risk factors—particularly pre-pregnancy overweight—and evaluate the effectiveness of early screening practices.

目的:。-评估过去十年妊娠期高血糖（HIP）的流行趋势，考虑危险因素和筛查做法（法国在2010年引入了早期基于风险的HIP筛查）。方法:。-我们分析了法国国家健康数据系统（SNDS）（2012-2022）的全国分娩数据，排除了既往患有糖尿病的妇女（n=8,172,911）。用广义估计方程的泊松回归估计HIP危险因素的患病率（PR）。反事实情景量化了产妇年龄、早期筛查和孕前超重对HIP增加的贡献。结果:。- HIP患病率从2012年的7.5%上升到2022年的15.7%，早期HIP增加了两倍。在2019冠状病毒病大流行期间，2020-2021年患病率上升。在调整了产妇年龄、胎次、社会经济地位、妊娠季节、分娩地点、地区孕前超重患病率和早期筛查等因素后，与2012年相比，2021年和2022年的aPR分别为1.30[1.11-1.51]和1.15[0.97-1.36]（未经调整的aPR分别为2.24[2.22-2.26]和2.08[2.06-2.10]），表明这些因素在观察到的aPR增加中占很大比例。虽然观察到的HIP患病率从2012年到2022年增加了8.2个百分点，但反事实情景估计，在2012年的水平上，不变的产妇年龄增加了6.5[5.9-7.3]，不变的早期筛查增加了6.2[5.1-7.7](13.7%)，不变的地区孕前超重增加了4.3[2.4-5.9]（11.8%）。结论:。-产妇年龄上升、早期HIP筛查增加以及地区孕前超重患病率升高是HIP患病率上升的主要原因。公共卫生战略应优先考虑可改变的风险因素——特别是孕前超重——并评估早期筛查做法的有效性。

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引用次数: 0

Fracture risk and treatment thresholds in patients with diabetes 糖尿病患者骨折风险和治疗阈值

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2026-01-07 DOI: 10.1016/j.diabet.2026.101722

Jakob Starup-Linde , Katrine Hygum , Henrik Støvring , Jens-Erik Beck Jensen , Pia Eiken , Pernille Hermann , Bente Langdahl , Torben Harsløf

Aims

Traditional risk factors underestimate fracture risk in individuals with diabetes. In this population-based case-control study we aimed to determine T-score thresholds for type 1 and 2 diabetes (T1D and T2D) with equivalent risk of fractures as that of individuals without diabetes and a T-score of -2.5.

Research Design and Methods

We collected dual energy x-ray absorptiometry (DXA) data (2000–2019), information on diagnoses (1977–2019) and redeemed medications (1997–2019) from the National Danish Registries which are linked by a unique identifier. Cases were individuals with the first incident major osteoporotic fracture (MOF) within two years before or one year after a DXA and controls were fracture free and matched on age, gender, and time period of the DXA. Logistic regression modelling was used in the case-control analysis.

Results

We identified 17,703 cases and 17,703 controls. T1D and T2D were associated with an increased risk of MOF (odds ratio: 1.8, 95 % CI:1.4;2.3 and 1.2, 95 % CI:1.1;1.3, respectively) adjusted for hip BMD. T1D and T2D patients had a similar risk of MOF at T-scores (total hip) = -1.4 and -2.1, respectively, as patients without diabetes with a T-score of -2.5. For hip fracture, the equivalent risk was correspondingly reached with T-scores of -1.9 and -1.6. Similar findings apply for femoral neck and lumbar spine BMD.

Conclusions

Compared to individuals without diabetes, fracture risk was increased in patients with T1D and T2D independent of BMD. Our study suggests that the T-score thresholds for treatment initiation in T1D and T2D should be increased.

传统的风险因素低估了糖尿病患者的骨折风险。在这项以人群为基础的病例对照研究中，我们旨在确定t评分阈值为1型和2型糖尿病（T1D和T2D），其骨折风险与无糖尿病且t评分为-2.5的个体相当。研究设计和方法我们从丹麦国家登记处收集双能x射线吸收仪（DXA）数据（2000-2019年）、诊断信息（1977-2019年）和赎回药物（1997-2019年），这些数据通过唯一标识符链接。病例是在DXA术前2年或术后1年内首次发生严重骨质疏松性骨折（MOF）的个体，对照组是无骨折且DXA的年龄、性别和时间段相匹配的个体。病例-对照分析采用Logistic回归模型。结果共发现病例17703例，对照组17703例。经髋关节骨密度调整后，T1D和T2D与MOF风险增加相关（比值比：1.8,95% CI:1.4；2.3和1.2,95% CI:1.1;1.3）。T1D和T2D患者在t评分（全髋关节）分别为-1.4和-2.1时发生MOF的风险与t评分为-2.5的非糖尿病患者相似。对于髋部骨折，相应达到等效风险，t评分为-1.9和-1.6。类似的结果也适用于股骨颈和腰椎的骨密度。结论与非糖尿病患者相比，独立于BMD的T1D和T2D患者骨折风险增加。我们的研究表明，T1D和T2D患者开始治疗的t评分阈值应该提高。

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引用次数: 0

Is Omnipod 5 cost effective for the management of type 1 diabetes among adults in France? Omnipod 5在法国治疗成人1型糖尿病是否具有成本效益？

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2026-01-01 DOI: 10.1016/j.diabet.2025.101721

Jean-Pierre Riveline , Colin Hopley , Anamaria-Vera Olivieri , Gabriel Guigand , Melanie Littlewood , Alfred Penfornis

Aim

-To compare long-term cost-effectiveness between the Omnipod® 5 Automated Insulin Delivery System and continuous subcutaneous insulin infusion + continuous glucose monitoring for type 1 diabetes among adults in France.

Methods

- The analysis used the IQVIA Core Diabetes Model (v9.5) and considered both the French healthcare system and societal perspective. The study population and treatment effects were from the OP5–003 randomized controlled trial. Life-years, quality-adjusted life-years, incremental cost-effectiveness ratios and incremental cost-utility ratios, modeled over a 50-year horizon (base case), were analyzed. Sensitivity analyses were conducted to test treatment effects with different time horizons and discounting. Utility values were based on Omnipod 5 EuroQoL 3-Dimensions data and literature sources.

Results

- In the base case, Omnipod 5 showed better clinical outcomes and lower diabetes-related complication rates than continuous subcutaneous insulin infusion + continuous glucose monitoring, gaining 0.373 life-years and 1.568 quality-adjusted life-years (incremental cost-utility ratio considering direct costs from a healthcare perspective = €791 per quality-adjusted life-year). With Omnipod 5, although direct healthcare costs were €1240 higher, there were savings from reduced complications, and total costs including societal productivity were €3071 lower. Sensitivity analyses confirmed lower total costs with Omnipod 5 across time horizons and discounting, and the direct cost-utility ratio was €2438 per quality-adjusted life-year when the treatment effect on glycosylated hemoglobin was halved.

Conclusion

- Considering the reported benefits on glycemic control and health-related quality of life, Omnipod 5 is a cost-effective alternative to continuous subcutaneous insulin infusion + continuous glucose monitoring for adults with type 1 diabetes in France.

目的：比较Omnipod®5自动胰岛素输送系统和持续皮下胰岛素输注 + 对法国成人1型糖尿病持续血糖监测的长期成本效益。方法：-分析使用IQVIA核心糖尿病模型（v9.5），并考虑了法国医疗保健系统和社会观点。研究人群和治疗效果来自OP5-003随机对照试验。对50年（基本情况）的寿命年、质量调整寿命年、增量成本效益比和增量成本效用比进行了分析。进行敏感性分析以检验不同时间范围和折现的治疗效果。效用值基于Omnipod 5 EuroQoL 3-Dimensions数据和文献来源。结果：-在基本情况下，Omnipod 5比持续皮下胰岛素输注 + 连续血糖监测显示出更好的临床结果和更低的糖尿病相关并发症发生率，增加0.373生命年和1.568质量调整生命年（从医疗保健角度考虑直接成本的增量成本效用比 = 每质量调整生命年€791）。使用Omnipod 5，虽然直接医疗费用增加了1,240欧元，但由于并发症减少而节省了费用，包括社会生产力在内的总成本降低了3,071欧元。敏感性分析证实，Omnipod 5在时间跨度和折扣方面的总成本较低，当糖化血红蛋白的治疗效果减半时，每个质量调整生命年的直接成本效用比为2438欧元。结论：考虑到已报道的血糖控制和健康相关生活质量方面的益处，Omnipod 5是一种具有成本效益的替代方案，可替代持续皮下胰岛素输注 + 对法国成人1型糖尿病患者进行持续血糖监测。

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引用次数: 0

"Usefulness of continuous interstitial glucose in diabetic patient undergoing hemodialysis 持续间质葡萄糖在糖尿病血液透析患者中的应用。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-12-04 DOI: 10.1016/j.diabet.2025.101720

Elise Berchoux , Ilan Szwarc , Jean-Baptiste Bonnet , Joanna Pissarra , Antoine Avignon , Sébastien Jugant , Moglie Le Quintrec , Ariane Sultan

Backgroung

In patients with type 2 diabetes (T2D) undergoing hemodialysis (HD), glycemic control is challenging, and glycated hemoglobin (HbA1c) is often unreliable due to altered red blood cell turnover, anemia, and treatments such as erythropoiesis-stimulating agents. Continuous glucose monitoring (CGM) provides additional metrics—such as time in range (TIR), time below range (TBR), and glycemic variability—that may better reflect glucose control in this population. This study aimed to assess the usefulness of 14-day CGM data compared to HbA1c in evaluating glycemic control in T2D patients on HD.

Methods

This is a prospective and multicenter study. Patients included were of > 18 years, DM2, and hemodialysis patients. We assessed glycemic control of diabetic hemodialysis patient over 14 days with the CGM freestyle 1 comparing to HbA1c.

Results

Forty-one patients were included. While 68 % had HbA1c < 8 %, only 21 % met the CGM targets (P < 0.005). Mean glucose levels were significantly lower on dialysis days (−13 mg/dl, P < 0.0001), without an increase in hypoglycemic episodes. Discrepancies between HbA1c and CGM metrics were associated with diabetes-related nephropathy and longer duration of HD.

Conclusion

HbA1c alone may substantially underestimate glycemic burden in patients on hemodialysis. CGM provides a more accurate assessment of glucose control and reveals undetected hypo- and hyperglucose levels. Incorporating CGM into routine care may improve diabetes management and therapeutic decision-making in this high-risk population.

背景：在接受血液透析（HD）的2型糖尿病（T2D）患者中，血糖控制具有挑战性，糖化血红蛋白（HbA1c）通常不可靠，原因是红细胞周转改变、贫血和使用促红细胞生成药物等治疗。连续血糖监测（CGM）提供了额外的指标，如范围内时间（TIR）、范围下时间（TBR）和血糖变异性，可以更好地反映这一人群的血糖控制情况。本研究旨在评估14天CGM数据与HbA1c在评估糖尿病合并糖尿病患者血糖控制方面的有用性。方法：这是一项前瞻性多中心研究。纳入的患者包括18岁以下、DM2和血液透析患者。我们用CGM自由式1与HbA1c比较，评估糖尿病血液透析患者14天的血糖控制情况。结果：纳入41例患者。68%的患者HbA1c < 8%，只有21%的患者达到CGM目标（P < 0.005）。透析日的平均血糖水平显著降低（-13 mg/dl, P < 0.0001），低血糖发作没有增加。HbA1c和CGM指标之间的差异与糖尿病相关性肾病和更长的HD持续时间有关。结论：单独的HbA1c可能大大低估了血液透析患者的血糖负担。CGM提供更准确的血糖控制评估，揭示未检测到的低血糖和高血糖水平。将CGM纳入常规护理可改善这一高危人群的糖尿病管理和治疗决策。

{"title":"\"Usefulness of continuous interstitial glucose in diabetic patient undergoing hemodialysis","authors":"Elise Berchoux , Ilan Szwarc , Jean-Baptiste Bonnet , Joanna Pissarra , Antoine Avignon , Sébastien Jugant , Moglie Le Quintrec , Ariane Sultan","doi":"10.1016/j.diabet.2025.101720","DOIUrl":"10.1016/j.diabet.2025.101720","url":null,"abstract":"<div><h3>Backgroung</h3><div>In patients with type 2 diabetes (T2D) undergoing hemodialysis (HD), glycemic control is challenging, and glycated hemoglobin (HbA1c) is often unreliable due to altered red blood cell turnover, anemia, and treatments such as erythropoiesis-stimulating agents. Continuous glucose monitoring (CGM) provides additional metrics—such as time in range (TIR), time below range (TBR), and glycemic variability—that may better reflect glucose control in this population. This study aimed to assess the usefulness of 14-day CGM data compared to HbA1c in evaluating glycemic control in T2D patients on HD.</div></div><div><h3>Methods</h3><div>This is a prospective and multicenter study. Patients included were of > 18 years, DM2, and hemodialysis patients. We assessed glycemic control of diabetic hemodialysis patient over 14 days with the CGM freestyle 1 comparing to HbA1c.</div></div><div><h3>Results</h3><div>Forty-one patients were included. While 68 % had HbA1c < 8 %, only 21 % met the CGM targets (<em>P</em> < 0.005). Mean glucose levels were significantly lower on dialysis days (−13 mg/dl, <em>P</em> < 0.0001), without an increase in hypoglycemic episodes. Discrepancies between HbA1c and CGM metrics were associated with diabetes-related nephropathy and longer duration of HD.</div></div><div><h3>Conclusion</h3><div>HbA1c alone may substantially underestimate glycemic burden in patients on hemodialysis. CGM provides a more accurate assessment of glucose control and reveals undetected hypo- and hyperglucose levels. Incorporating CGM into routine care may improve diabetes management and therapeutic decision-making in this high-risk population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101720"},"PeriodicalIF":4.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epicardial adipose tissue measurement is an interesting biomarker for cardiovascular health in a case control study of patients with familial partial type 2 lipodystrophy 在家族性部分2型脂肪营养不良患者的病例对照研究中，心外膜脂肪组织测量是心血管健康的一个有趣的生物标志物。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-12-03 DOI: 10.1016/j.diabet.2025.101719

Mathilde Simonson , Patricia Ancel , Romain Mortier , Mohamed Lamine Mariko , Bénédicte Fontaine , Julie Koue-Chon-Lim , Jules Martel , Estelle Nobécourt , Bénédicte Gaborit

Aim

Clinical cardiovascular risk scoring and Coronary artery calcification evaluation are lacking in Type 2 Familial Partial Lipodystrophy patients who present higher cardiovascular events and risk factors. The epicardial adipose tissue volume - a visceral adipose tissue which is accumulated during lipodystrophy - is higher in type 2 diabetic patients with coronary artery disease. In this case control study, we assessed epicardial adipose tissue volume as a new marker of interest in these patients.

Methods

Patients with type 2 Familial Partial Lipodystrophy or control patients, in primary prevention for cardiovascular events, were followed up at the University Hospital of La Réunion. Type 2 Familial Partial Lipodystrophy patients undergoing both coronary artery calcification and clinical cardiovascular risk scoring were retrospectively included and paired with control patients for age, sex and body mass index (NCT07090629). The epicardial adipose tissue volume was measured for each of the 126 subjects, with a semi-automated technique using deep learning and AI. Results: Type 2 Familial Partial Lipodystrophy patients displayed significantly higher adipose tissue volume (77 ± 39 cm³) than control subjects at high cardiovascular risk (60 ± 30 cm³; P = 0.010).

Conclusions

we show for the first time patients with Type 2 Familial Partial Lipodystrophy present higher values of epicardial adipose tissue volume, an interesting biomarker to add to coronary artery calcification and clinical scoring.

目的：2型家族性部分脂肪营养不良患者存在较高的心血管事件和危险因素，缺乏临床心血管风险评分和冠状动脉钙化评估。心外膜脂肪组织体积-脂肪营养不良期间积累的内脏脂肪组织-在2型糖尿病合并冠状动脉疾病患者中较高。在这个病例对照研究中，我们评估了心外膜脂肪组织体积作为这些患者感兴趣的新标志物。方法：在拉西姆大学医院对2型家族性部分脂肪营养不良患者或对照患者进行心血管事件一级预防随访。回顾性纳入接受冠状动脉钙化和临床心血管风险评分的2型家族性部分脂肪营养不良患者，并根据年龄、性别和体重指数（NCT07090629）与对照患者配对。通过使用深度学习和人工智能的半自动技术，测量了126名受试者的心外膜脂肪组织体积。结果：2型家族性部分脂肪营养不良患者脂肪组织体积（77±39 cm3）明显高于心血管高危对照组（60±30 cm3, P = 0.010）。结论：我们首次发现2型家族性部分脂肪营养不良患者的心外膜脂肪组织体积值更高，这是一个有趣的生物标志物，可以增加冠状动脉钙化和临床评分。

{"title":"Epicardial adipose tissue measurement is an interesting biomarker for cardiovascular health in a case control study of patients with familial partial type 2 lipodystrophy","authors":"Mathilde Simonson , Patricia Ancel , Romain Mortier , Mohamed Lamine Mariko , Bénédicte Fontaine , Julie Koue-Chon-Lim , Jules Martel , Estelle Nobécourt , Bénédicte Gaborit","doi":"10.1016/j.diabet.2025.101719","DOIUrl":"10.1016/j.diabet.2025.101719","url":null,"abstract":"<div><h3>Aim</h3><div>Clinical cardiovascular risk scoring and Coronary artery calcification evaluation are lacking in Type 2 Familial Partial Lipodystrophy patients who present higher cardiovascular events and risk factors. The epicardial adipose tissue volume - a visceral adipose tissue which is accumulated during lipodystrophy - is higher in type 2 diabetic patients with coronary artery disease. In this case control study, we assessed epicardial adipose tissue volume as a new marker of interest in these patients.</div></div><div><h3>Methods</h3><div>Patients with type 2 Familial Partial Lipodystrophy or control patients, in primary prevention for cardiovascular events, were followed up at the University Hospital of La Réunion. Type 2 Familial Partial Lipodystrophy patients undergoing both coronary artery calcification and clinical cardiovascular risk scoring were retrospectively included and paired with control patients for age, sex and body mass index (NCT07090629). The epicardial adipose tissue volume was measured for each of the 126 subjects, with a semi-automated technique using deep learning and AI. Results: Type 2 Familial Partial Lipodystrophy patients displayed significantly higher adipose tissue volume (77 ± 39 cm<sup>3</sup>) than control subjects at high cardiovascular risk (60 ± 30 cm<sup>3</sup>; <em>P</em> = 0.010).</div></div><div><h3>Conclusions</h3><div>we show for the first time patients with Type 2 Familial Partial Lipodystrophy present higher values of epicardial adipose tissue volume, an interesting biomarker to add to coronary artery calcification and clinical scoring.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101719"},"PeriodicalIF":4.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pancreatic polypeptide in patients with type 1 diabetes and exocrine failure or chronic pancreatitis. The DIAPP study 胰腺多肽在1型糖尿病和外分泌衰竭或慢性胰腺炎患者中的作用。DIAPP的研究。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-09 DOI: 10.1016/j.diabet.2025.101712

Lea Dehghani , Fideline Bonnet-Serrano , Hendy Abdul , Laure Alexandre-Heymann , Jean Guibourdenche , Etienne Larger

Introduction

. - Exocrine dysfunction can occur in type 1 diabetes (T1D). When exocrine function is impaired, it is unclear whether alterations also involve other endocrine cell types beyond beta cells. Pancreatic polypeptide (PP) is, besides insulin, the sole hormone that is specific to islets of Langerhans. The aim of the DIAPP study was to evaluate if PP secretion is also altered when T1D is complicated by exocrine failure.

Materials and Methods

. - Seven patients with T1D and normal pancreatic function (T1DN), 9 patients with T1D and exocrine failure (T1DEF) were compared to 13 patients with type 3c diabetes; i. e. with chronic pancreatitis (CP). All of them had a mixed meal test (MMT), C-peptide and PP being determined before and at 60, 90 and 120 minutes.

Results

. – The area under the curve of C-peptide during MMT (AUC_Cpep) was significantly greater in the CP group than in both T1D groups (P < 0.0001 vs. the T1DEF group and P < 0.001 vs. the T1D group) while the area under the curve of PP (AUC_PP) was significantly smaller in the CP group than in both T1D groups (P < 0.01 vs. both groups). The AUC_PP / AUC_Cpep ratio was higher in the CP group than in both T1D groups (P < 0.0001 vs. both groups).

Conclusion

. - PP secretion was altered specifically in patients with CP, not in T1D, even when associated with pancreatic exocrine failure.

作品简介:。外分泌功能障碍可发生在1型糖尿病（T1D）。当外分泌功能受损时，尚不清楚这种改变是否也涉及β细胞以外的其他内分泌细胞类型。胰多肽（PP）是除胰岛素外唯一的朗格汉斯胰岛特有的激素。DIAPP研究的目的是评估当T1D合并外分泌衰竭时，PP分泌是否也会改变。材料与方法：。-将7例T1D伴胰腺功能正常（T1DN）患者，9例T1D伴外分泌功能衰竭（T1DEF）患者与13例3c型糖尿病患者进行比较；即慢性胰腺炎（CP）。试验前、60分钟、90分钟、120分钟分别进行混餐试验（MMT）、c肽和PP测定。结果:。- MMT过程中，CP组c肽曲线下面积（AUCCpep）显著大于T1D组（P < 0.0001 vs. T1DEF组，P < 0.001 vs. T1D组），而CP组PP曲线下面积（AUCPP）显著小于T1D组（P < 0.01 vs.两组）。CP组AUCPP / AUCCpep比值高于T1D组（P < 0.0001）。结论:。- PP分泌在CP患者中发生特异性改变，而在T1D患者中没有，即使与胰腺外分泌衰竭相关。

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引用次数: 0

Handgrip strength cut-off points for identifying French adults at risk of type 2 diabetes 确定法国成人2型糖尿病风险的握力分界点

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-09 DOI: 10.1016/j.diabet.2025.101713

Thi Chi Phuong Nguyen , Jean-Michel Oppert , Laurent Bourhis , Alice Bellicha , Bernard Srour , Emmanuelle Kesse-Guyot , Serge Hercberg , Pilar Galan , Mathilde Touvier , Léopold K Fezeu , Jérémy Vanhelst

Aim

To identify cut-off points for handgrip strength (HGS) detecting T2D risk among adults in France, and to examine the relationships between absolute and relative HGS and the incidence of T2D.

Methods

Data from 18,519 adults (5096 men) in the NutriNet-Santé cohort, were analyzed. HGS was measured using dynamometry on both hands. Nine indicators were derived, including absolute values and those relative to body weight and BMI. Receiver Operating Characteristic curves and cubic splines were used to assess predictive performance, as well as cut-off points for HGS that maximize this performance. Cox proportional hazards models were used to evaluate associations between reduced HGS and T2D.

Results

Over 9.8 years, 329 incident T2D cases were validated. Absolute HGS showed not associated with T2D risk, whereas higher relative HGS was associated with lower risk (e.g. HR for HGS relative to body weight: 1.30, 95 % CI: 1.07–1.58). Relative HGS showed better discrimination (AUC 0.623–0.675) than absolute HGS (≤ 0.44). Optimal cut-offs were 0.446 kg/kg and 1.086 kg/kg/m² (dominant hand), and 0.397 kg/kg and 1.033 kg/kg/m² (non-dominant). Low relative HGS was associated with increased risk (HRs 1.42–1.68), consistent across sensitivity, sex, and age analyses.

Conclusions

Relative, but not absolute, handgrip strength is independently associated with T2D incidence and shows modest discriminative ability. Given its simplicity and cost-effectiveness, grip strength may be a useful screening tool in clinical and public health settings.

目的：确定法国成年人的握力（HGS）检测T2D风险的分界点，并研究绝对和相对HGS与T2D发病率之间的关系。方法：对来自nutrinet - sant队列的18,519名成年人（5,096名男性）的数据进行分析。HGS采用双手测力法测量。得出了9个指标，包括绝对值和相对于体重和BMI的值。接受者工作特征曲线和三次样条用于评估预测性能，以及HGS的截止点，使该性能最大化。Cox比例风险模型用于评估HGS降低与T2D之间的关系。结果：在9.8年的时间里，确诊了329例T2D病例。绝对HGS与T2D风险无关，而较高的相对HGS与较低的风险相关（例如，HGS相对于体重的HR: 1.30, 95% CI: 1.07-1.58）。相对HGS （AUC 0.623 ~ 0.675）优于绝对HGS （AUC≤0.44）。最优截断值为优势手0.446 kg/kg和1.086 kg/kg/m²，非优势手0.397 kg/kg和1.033 kg/kg/m²。低相对HGS与风险增加相关（HRs 1.42-1.68），在敏感性、性别和年龄分析中一致。结论：相对而非绝对握力与T2D发病率独立相关，并表现出适度的判别能力。鉴于其简单性和成本效益，握力可能是临床和公共卫生环境中有用的筛查工具。

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引用次数: 0

Increased epicardial adipose tissue is part of the phenotype of LMNA-associated partial lipodystrophy and could contribute to increased cardiovascular risk 心外膜脂肪组织增加是lmna相关部分脂肪营养不良表型的一部分，可能导致心血管风险增加

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101710

Sophie Lamothe , Patricia Ancel , Inès Belalem , Leïla Lecaque , Joris Fournel , Alexis Jacquier , Zouhair Houhou , Jean-Baptiste Julla , Jean-François Gautier , Corinne Vigouroux , Bénédicte Gaborit , Camille Vatier

LMNA-associated familial partial lipodystrophy (FPLD2) is characterized by limb lipoatrophy, cervicofacial and visceral abdominal lipohypertrophy, insulin resistance-related complications and early coronary artery disease (CAD), but epicardial adipose tissue (EAT) is poorly described. We aimed to characterize EAT as a potential new marker of cardiovascular risk in patients with FPLD2. Using a validated deep-learning algorithm, we measured EAT volume from cardiac CT-scans routinely performed for coronary artery calcium (CAC) scoring in patients with FPLD2 (n = 26, 24 women, 65 % with diabetes, median age 49 [32;57] years) compared to patients with type-2 diabetes (T2D) (n = 44, 40 women, age 49 [41;59], p = 0.18). Although lower BMI (23.3 [21;26.6] vs. 27.2 [24.7;29.6], P = 0.03) and HbA1c (6.5 [5.8;7.7] vs. 7.8 [7;8.5] %, P = 0.003) in patients with FPLD2 vs. T2D, EAT volume (110 [72;150] vs. 60 [42;78] ml, P < 0.001) and prevalence of CAD (19 vs. 2 %, P = 0.003) were higher. EAT was positively related to CAC score in the FPLD2 group. Our findings support that EAT is increased in patients with FPLD2 and represents a specific ectopic adipose tissue which could contribute to the increased cardiovascular risk.

lmna相关家族性部分脂肪营养不良（FPLD2）的特征是肢体脂肪萎缩、颈面和内脏腹部脂肪肥大、胰岛素抵抗相关并发症和早期冠状动脉疾病（CAD），但对心外膜脂肪组织（EAT）的描述很少。我们的目的是将EAT作为FPLD2患者心血管风险的潜在新标志物。使用经过验证的深度学习算法，我们测量了FPLD2患者（n = 26,24名女性，65%患有糖尿病，中位年龄49[32；57]岁）与2型糖尿病（T2D）患者（n = 44,40名女性，年龄49 [41；59],p = 0.18）常规心脏ct扫描的EAT体积。虽然FPLD2与T2D患者的BMI（23.3[21；26.6]比27.2 [24.7;29.6],P = 0.03）和HbA1c（6.5[5.8；7.7]比7.8 [7;8.5]%,P = 0.003）较低，但EAT体积（110[72；150]比60 [42；78]ml, P < 0.001）和CAD患病率（19比2%，P = 0.003）较高。在FPLD2组中，EAT与CAC评分呈正相关。我们的研究结果支持，FPLD2患者的EAT增加，代表了一种特殊的异位脂肪组织，可能导致心血管风险增加。

{"title":"Increased epicardial adipose tissue is part of the phenotype of LMNA-associated partial lipodystrophy and could contribute to increased cardiovascular risk","authors":"Sophie Lamothe , Patricia Ancel , Inès Belalem , Leïla Lecaque , Joris Fournel , Alexis Jacquier , Zouhair Houhou , Jean-Baptiste Julla , Jean-François Gautier , Corinne Vigouroux , Bénédicte Gaborit , Camille Vatier","doi":"10.1016/j.diabet.2025.101710","DOIUrl":"10.1016/j.diabet.2025.101710","url":null,"abstract":"<div><div><em>LMNA</em>-associated familial partial lipodystrophy (FPLD2) is characterized by limb lipoatrophy, cervicofacial and visceral abdominal lipohypertrophy, insulin resistance-related complications and early coronary artery disease (CAD), but epicardial adipose tissue (EAT) is poorly described. We aimed to characterize EAT as a potential new marker of cardiovascular risk in patients with FPLD2. Using a validated deep-learning algorithm, we measured EAT volume from cardiac CT-scans routinely performed for coronary artery calcium (CAC) scoring in patients with FPLD2 (<em>n</em> = 26, 24 women, 65 % with diabetes, median age 49 [32;57] years) compared to patients with type-2 diabetes (T2D) (<em>n</em> = 44, 40 women, age 49 [41;59], <em>p</em> = 0.18). Although lower BMI (23.3 [21;26.6] vs. 27.2 [24.7;29.6], <em>P</em> = 0.03) and HbA1c (6.5 [5.8;7.7] vs. 7.8 [7;8.5] %, <em>P</em> = 0.003) in patients with FPLD2 vs. T2D, EAT volume (110 [72;150] vs. 60 [42;78] ml, <em>P</em> < 0.001) and prevalence of CAD (19 vs. 2 %, <em>P</em> = 0.003) were higher. EAT was positively related to CAC score in the FPLD2 group. Our findings support that EAT is increased in patients with FPLD2 and represents a specific ectopic adipose tissue which could contribute to the increased cardiovascular risk.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101710"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The association of sweetened beverage intake with risk of type 2 diabetes in an Australian population: A longitudinal study 澳大利亚人群中含糖饮料摄入与2型糖尿病风险的关系：一项纵向研究。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101665

Robel Hussen Kabthymer , Tongzhi Wu , Sara Beigrezaei , Oscar H Franco , Allison M Hodge , Barbora de Courten

Aim

Globally, sugar intake from sugar-sweetened beverages (SSBs) exceeds the daily recommended limits for intake levels of free sugar. Artificially sweetened beverages (ASBs), widely used to replace SSBs, are increasingly linked to adverse health outcomes. Hence, we assessed the association of sweetened beverage intake (SSBs and ASBs) with the risk of type 2 diabetes (T2DM).

Methods

Data from the Melbourne Collaborative Cohort Study (MCCS) on 36,608 individuals aged 40 to 69 years were used. Self-reported data on diabetes were collected. The frequency of SSBs and ASBs consumption was categorized as: never or < 1 time/month; 1–3 per month; 1–6 times per week; ≥1 time / day. The association of sweetened beverage intake with the incidence of T2DM was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic, and other confounders.

Results

Intakes of SSBs and ASBs were associated with an increased risk of T2DM. A high intake (≥ 1 time/day) compared to a low intake (never or < 1 time / month) was associated with increased risk of T2DM for SSB intake (incidence risk ratio (IRR) = 1.23; 95 % CI: 1.05–1.45; P for trend = 0.006) and for ASB intake (IRR = 1.38; 95 % CI: 1.18–1.61; P for trend < 0.001). Further adjustment for body mass index (BMI) and waist-to hip ratio (WHR) eliminated the association for SSBs, but not ASBs intake.

Conclusions

Both sugar and artificially sweetened beverages were linked to an increased risk of T2DM. The findings highlight the need for public health measures to control the intake of sweetened beverages.

目的：在全球范围内，从含糖饮料（SSBs）中摄入的糖超过了每日游离糖摄入量的推荐限制。人工加糖饮料（asb）被广泛用于替代ssb，与不良健康结果的联系越来越紧密。因此，我们评估了甜饮料摄入（ssb和asb）与2型糖尿病（T2DM）风险的关系。方法：来自墨尔本合作队列研究（MCCS）的数据，涉及36,608名年龄在40至69岁之间的个体。收集自我报告的糖尿病数据。SSBs和ASBs的使用频率分为：从不或< 1次/月；每月1-3次；每周1-6次；≥1次/天。使用修正泊松回归评估含糖饮料摄入量与T2DM发病率的关系，并根据生活方式、肥胖、社会经济和其他混杂因素进行调整。结果：ssb和asb的摄入与T2DM风险增加相关。高摄入量（≥1次/天）与低摄入量（从不或< 1次/月）相比，SSB摄入增加了T2DM的风险(发病率风险比（IRR） = 1.23；95% ci: 1.05-1.45；趋势P = 0.006)和ASB摄入量P (IRR = 1.38；95% ci: 1.18-1.61；P表示趋势< 0.001)。进一步调整身体质量指数（BMI）和腰臀比（WHR）消除了与ssb的关联，但没有消除与asb摄入量的关联。结论：糖和人工加糖饮料都与2型糖尿病风险增加有关。研究结果强调需要采取公共卫生措施来控制加糖饮料的摄入。

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引用次数: 0

In adults living with type 1 diabetes, additional autoimmune diseases are associated with more chronic complications and depression. A BETTER registry analysis 在患有1型糖尿病的成年人中，额外的自身免疫性疾病与更多的慢性并发症和抑郁症相关。更好的注册表分析。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101667

Cassandra A.A. Locatelli , Meryem K. Talbo , Virginie Messier , Caroline Grou , Maha Lebbar , Erin E. Mulvihill , Anne-Sophie Brazeau , Rémi Rabasa-Lhoret

Aim

People living with type 1 diabetes (T1D) are at elevated risk of additional autoimmune diseases (ADs) than the general population. We aimed to describe the association between additional ADs and T1D-related physical and mental burden in adults.

Methods

This was a cross-sectional analysis using data from the BEhaviors, Therapies, TEchnologies, and hypoglycemic Risk in T1D (BETTER) registry. Using patient reported-outcomes and validated questionnaires, we compared prevalence of vascular complications, hypoglycemia, and mental health issues between those with T1D alone (AD-) and T1D with additional AD (AD+).

Results

Among 3222 participants (66.2 % female, 42.7 ± 15.0 years), 36.3 % reported ≥ 1 AD+. The AD+ group was older (+4.4 years) and more female (+17.7 %) than the AD- group. The AD+ group had similar HbA1c (P = 0.20) but was more likely to report level 2 hypoglycemia in the past month (OR: 1.27 [95 %Cl 1.06–1.52]) and level 3 hypoglycemia since diagnosis (1.22 [1.05–1.42]). The AD+ group reported more cardiovascular disease (1.40 [1.03 to 1.90]), nephropathy (1.49 [1.19–1.86]), neuropathy (1.38 [1.13–1.69]), retinopathy (1.48 [1.22–1.78]), higher depression scores (p = 0.015), and anxiety/depression medication use (1.31 [1.10–1.56]). Number of AD+ was positively associated with depression scores (1 AD+ P = 0.055, 2+ AD+ p = 0.027), level 3 hypoglycemia since diagnosis (1 AD+ p = 0.037, 2+ AD+ P = 0.025), and number of chronic complications (1 AD+ P < 0.001, 2+ AD+ P < 0.001).

Conclusion

For people with T1D, living with additional ADs is associated with higher levels of physical and mental diabetes complications, warranting regular screening in this population.

目的：1型糖尿病（T1D）患者患其他自身免疫性疾病（ADs）的风险高于一般人群。我们的目的是描述额外的ad与成人t1d相关的身体和精神负担之间的关系。方法：这是一项横断面分析，使用来自T1D患者的行为、治疗、技术和低血糖风险（BETTER）登记的数据。使用患者报告的结果和有效的问卷，我们比较了单独T1D （AD-）和T1D合并AD （AD+）患者血管并发症、低血糖和精神健康问题的患病率。结果：在3222名参与者中（66.2%为女性，42.7±15.0岁），36.3%报告≥1 AD+。AD+组比AD-组年龄大（+4.4岁），女性患者多（+ 17.7%）。AD+组HbA1c相似（P = 0.20），但在过去一个月内报告2级低血糖（OR: 1.27 [95% Cl 1.06-1.52]）和诊断后报告3级低血糖（OR: 1.22[1.05-1.42]）的可能性更大。AD+组出现更多心血管疾病（1.40[1.03 ~ 1.90]）、肾病（1.49[1.19 ~ 1.86]）、神经病变（1.38[1.13 ~ 1.69]）、视网膜病变（1.48[1.22 ~ 1.78]）、抑郁评分（p = 0.015）和焦虑/抑郁药物使用（1.31[1.10 ~ 1.56]）。AD+次数与抑郁评分（1 AD+ P = 0.055, 2+ AD+ P = 0.027）、诊断以来3级低血糖（1 AD+ P = 0.037, 2+ AD+ P = 0.025）、慢性并发症次数（1 AD+ P < 0.001, 2+ AD+ P < 0.001）呈正相关。结论：对于T1D患者，患有额外ad的患者与更高水平的身体和精神糖尿病并发症相关，需要对该人群进行定期筛查。

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引用次数: 0