Diabetes & metabolism最新文献_第6页

Cardiorenal outcomes and safety of SGLT2 inhibitors in patients with diabetes secondary to disorders of the exocrine pancreas: a nationwide population-based study SGLT2抑制剂治疗继发于外分泌胰腺疾病的糖尿病患者的心肾结局和安全性：一项基于全国人群的研究

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-30 DOI: 10.1016/j.diabet.2025.101668

Kyoung Hwa Ha , Minae Park , Yujin Lee , Dae Jung Kim , Seung Jin Han

Aims

Limited data are available on the effectiveness of pharmacological treatments for diabetes secondary to disorders of the exocrine pancreas (DEP). This study evaluated the real-world effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in individuals with DEP.

Methods

A retrospective cohort study was conducted using data from the Korean National Health Insurance Service database. Data on 66,120 individuals with DEP who initiated glucose-lowering drugs (GLDs) between September 2014 and December 2022 were analyzed. Patients initiating SGLT2 inhibitors were matched 1:1 with patients initiating other GLDs using propensity-score matching. The effectiveness outcomes included major adverse cardiovascular events (MACEs), heart failure, end-stage kidney disease (ESKD), and all-cause mortality. The safety outcomes included hypoglycemia, diabetic ketoacidosis, genital infections, urinary tract infections, fractures, pancreatitis, and pancreatic cancer.

Results

After matching, 4,128 SGLT2 inhibitor-other GLD user pairs were included in the analysis, with a mean follow-up of 2.3 years. Compared with use of other GLDs, use of SGLT2 inhibitors was associated with a significantly lower risk of MACE (hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.51–0.93), hospitalization for heart failure (HR: 0.70; 95% CI: 0.51–0.95), ESKD (HR: 0.19; 95% CI: 0.06–0.61), and all-cause mortality (HR: 0.38; 95% CI: 0.27–0.53). SGLT2 inhibitor use was associated with a reduced risk of urinary tract infections (HR: 0.87; 95% CI: 0.78–0.96) and pancreatitis (HR 0.71; 95% CI 0.58–0.87).

Conclusions

SGLT2 inhibitors were associated with a reduced risk of adverse cardiorenal outcomes and all-cause mortality and were safely used in patients with DEP.

目的：关于外分泌胰腺（DEP）继发糖尿病的药物治疗有效性的数据有限。本研究评估了钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂在dep患者中的实际有效性和安全性。方法：使用韩国国民健康保险服务数据库的数据进行回顾性队列研究。分析了2014年9月至2022年12月期间66120名开始使用降糖药物（GLDs）的DEP患者的数据。使用倾向评分匹配，启动SGLT2抑制剂的患者与启动其他gld的患者进行1:1匹配。疗效结局包括主要不良心血管事件（mace）、心力衰竭、终末期肾病（ESKD）和全因死亡率。安全性结果包括低血糖、糖尿病酮症酸中毒、生殖器感染、尿路感染、骨折和胰腺炎。结果：匹配后，4128名SGLT2抑制剂-其他GLD用户对被纳入分析，平均随访时间为2.3年。与使用其他GLDs相比，使用SGLT2抑制剂与MACE风险显著降低相关(风险比[HR]: 0.69；95%可信区间[CI]: 0.51-0.93)，心力衰竭住院(HR: 0.70；95% ci: 0.51-0.95), eskd (hr: 0.19；95% CI: 0.06-0.61)和全因死亡率(HR: 0.38；95% ci: 0.27-0.53)。使用SGLT2抑制剂与尿路感染风险降低相关(HR: 0.87；95% CI: 0.78-0.96)和胰腺炎(HR 0.71；95% ci 0.58-0.87)。结论：SGLT2抑制剂与不良心肾结局和全因死亡率的降低相关，并且可以安全地用于DEP患者。

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引用次数: 0

Glucagon-like peptide-1 receptor agonists and acute pancreatitis 胰高血糖素样肽-1受体激动剂与急性胰腺炎。

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-24 DOI: 10.1016/j.diabet.2025.101666

Kuan-Fu Liao , Shih-Wei Lai

引用次数: 0

What the diabetologist needs to know about the risk of non-arteritic anterior ischaemic optic neuropathy and GLP-1 receptor agonist use in patients with type 2 diabetes 糖尿病学家需要了解的关于非动脉性前缺血性视神经病变的风险和GLP-1受体激动剂在2型糖尿病患者中的应用

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-16 DOI: 10.1016/j.diabet.2025.101664

Sylvie Feldman-Billard

Aim

Recent findings have raised concern about a potential association between semaglutide use and non-arteritic anterior ischaemic optic neuropathy (NAION), a rare form of permanent vision loss. This report provides a critical analysis of the current knowledge of GLP-1 receptor agonist (RA) use and risk of NAION in patients with type 2 diabetes (T2D).

Methods

A literature search strategy was conducted for all English-language literature with a systematic review of key references up to April 2025.

Results

Across studies including patients with T2D, the relative increase in NAION risk associated with the use of a GLP-1 RA, mainly semaglutide, ranged from nonsignificant to fourfold, while the absolute number of affected patients remained low. Given the retrospective design of the main studies, no causal link could be established between the use of GLP-1RAs and NAION. Some mechanistic hypotheses have been put forward without any being formally demonstrated to date. The profound metabolic and haemodynamic changes induced by GLP-1RAs might be the trigger of NAION in predisposed patients with an optic “disc-at-risk”, a potent anatomical risk factor easily detected by ocular examination.

Conclusion

Pending studies clarifying this risk, these findings call for cautious use of GLP-1 RAs, particularly in patients with ocular risk factors. Given the widespread use of GLP-1RAs, clinicians should be aware of this potential risk, without overshadowing the remarkable benefit of GLP-1RAs in patients with type 2 diabetes.

目的：最近的研究结果引起了人们对使用西马鲁肽与非动脉性前缺血性视神经病变（NAION）之间的潜在关联的关注，NAION是一种罕见的永久性视力丧失。本报告对GLP-1受体激动剂（RA）在2型糖尿病（T2D）患者中的使用和NAION风险的当前知识进行了批判性分析。方法：采用文献检索策略，对截至2025年4月的所有英文文献进行系统综述。结果：在包括T2D患者的研究中，与使用GLP-1 RA（主要是西马鲁肽）相关的NAION风险的相对增加从不显著到四倍不等，而受影响患者的绝对数量仍然很低。考虑到主要研究的回顾性设计，GLP-1RAs的使用与NAION之间没有因果关系。有人提出了一些机械性的假设，但迄今为止还没有得到正式证明。GLP-1RAs诱导的深刻的代谢和血流动力学变化可能是易患视神经“危险盘”的患者发生NAION的触发因素，这是一个很容易通过眼部检查发现的强大的解剖学危险因素。结论：有待研究澄清这一风险，这些发现呼吁谨慎使用GLP-1 RAs，特别是在有眼部危险因素的患者中。鉴于GLP-1RAs的广泛使用，临床医生应该意识到这种潜在的风险，而不是掩盖GLP-1RAs在2型糖尿病患者中的显着益处。

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引用次数: 0

SGLT2 inhibitor, GLP-1 receptor agonist, and dementia risk SGLT2抑制剂、GLP-1受体激动剂与痴呆风险。

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-11 DOI: 10.1016/j.diabet.2025.101663

Shih-Wei Lai

引用次数: 0

Global Burden of type 2 diabetes in non-elderly individuals 1990 to 2021 and projections for 2050: a systematic analysis of the 2021 Global Burden of Disease 1990 - 2021年非老年人2型糖尿病全球负担及2050年预测：2021年全球疾病负担的系统分析

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-08 DOI: 10.1016/j.diabet.2025.101660

Qian He , Wenjing Wu , Junnian Chen , Haofeng Zhou , Gangyu Ding , Shuiqing Lai , AndyY.T. Kuo , Heng Wan , Beisi Lin , Hongjiang Wu , AliceP.S. Kong , Haixia Guan , Huanyi Cao

Background

Type 2 diabetes (T2D) is increasingly becoming a major global health challenge. However, research on T2D in non-elderly populations remains insufficient.

Methods

We analyzed data from the Global Burden of Disease (GBD) study in 2021, focusing on diabetes-related indicators among individuals aged 15 to 59 across 204 countries and regions. This included prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs), categorized into 21 GBD regions according to the Sociodemographic Index (SDI). We employed join-point regression and Bayesian Age-Period-Cohort models to assess trends from 1990 to 2021 and forecast from 2021 to 2050.

Results

The global age-standardized incidence rate increased from 196.3 per 100,000 (95 % UI, 145.2–257.4) in 1990 to 361.1 per 100,000 (95 % UI, 275.2–458.4) in 2021. The prevalence, mortality rate, and DALYs exhibit a similar upward trend. Although both men and women have experienced rises in prevalence, incidence, mortality rate, and DALYs, men continue to lead these metrics across nearly all age groups. Low-middle SDI countries bear the most severe disease burden. A high body mass index is a major risk factor in this population. It is estimated that by 2050, approximately 1.195 billion non-elderly individuals worldwide will have T2D, with epidemiological changes being the primary driver of this disease burden.

Conclusions

This study on the burden of T2D reveals that its prevalence among non-elderly individuals is steadily increasing and is projected to affect over a billion people worldwide by 2050. Targeted measures are crucial to tackle this global health challenge for this population.

背景：2型糖尿病（T2D）正日益成为一个主要的全球健康挑战。然而，对非老年人群T2D的研究仍然不足。方法：我们分析了2021年全球疾病负担（GBD）研究的数据，重点关注204个国家和地区15至59岁人群的糖尿病相关指标。这包括患病率、发病率、死亡率和残疾调整生命年（DALYs），根据社会人口指数（SDI）分为21个GBD地区。我们采用联结点回归和贝叶斯年龄-时期-队列模型来评估1990年至2021年的趋势，并预测2021年至2050年的趋势。结果：全球年龄标准化发病率从1990年的196.3 / 10万（95% UI, 145.2-257.4）上升到2021年的361.1 / 10万（95% UI, 275.2-458.4）。患病率、死亡率和伤残调整生命年也呈现出类似的上升趋势。尽管男性和女性的患病率、发病率、死亡率和伤残调整生命年都有所上升，但在几乎所有年龄组中，男性仍然在这些指标上处于领先地位。SDI中低水平国家的疾病负担最为严重。高体重指数是这一人群的主要危险因素。据估计，到2050年，全世界约有11.95亿非老年人将患有T2D，流行病学变化是这种疾病负担的主要驱动因素。结论：这项关于T2D负担的研究表明，其在非老年人中的患病率正在稳步上升，预计到2050年全球将有超过10亿人受到影响。有针对性的措施对于应对这一人群面临的全球健康挑战至关重要。

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引用次数: 0

Diabetes prevalence, awareness, and control in the United States, 2017-2023 2017-2023年美国糖尿病患病率、认知和控制

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-06 DOI: 10.1016/j.diabet.2025.101659

Jessica L Harding , Chengcheng Hu , Jithin Sam Varghese , Rodrigo M Carrillo-Larco , Mohammed K Ali

Introduction

We compared diabetes prevalence, awareness, and control pre versus post the Covid-19 pandemic.

Methods

This was a cross-sectional analysis of the U.S. National Health and Nutrition Examination Surveys pre (2017–2020) and post (2021–2023) the pandemic. We included all non-pregnant adults (aged ≥ 20 years) who had undergone biomedical testing. Diagnosed and undiagnosed diabetes was defined as self-reported diabetes and no self-reported diabetes with HbA1c >6.5 % or fasting plasma glucose ≥126 mg/dL, respectively. Among diagnosed diabetes, we estimated proportions achieving glycemic (HbA1c < 7.0 %), blood pressure (< 130/80 mmHg), and cholesterol control (non-high-density lipoprotein < 130mg/dl), and use of blood pressure and lipid lowering medications.

Results

The prevalence of total diabetes, diagnosed diabetes, undiagnosed diabetes, and proportion of diabetes that was undiagnosed remained stable between pre and post pandemic periods: from 16.2 % [95 %CI: 14.3–18.1] to 15.8 % [13.7–17.9], from 11.7 % [10.1–13.2] to 11.3 % [9.4–13.2], from 4.6 % [3.8–5.3]) to 4.5 % [3.4–5.6]), and from 28.1 % [24.3–31.8] to 28.4 % [21.9–35.0], respectively. Among those with diagnosed diabetes, glycemia, blood pressure, lipid control, and use of blood pressure or lipid medication did not significantly change.

Conclusions

Between 2017–2020 and 2021–2023, there were no significant changes in diabetes prevalence, awareness, and control in the U.S. population.

我们比较了Covid-19大流行前后的糖尿病患病率、意识和控制。方法：本研究是对美国全国健康和营养调查（2017-2020年）和（2021-2023年）大流行前后的横断面分析。我们纳入了所有接受过生物医学检测的未怀孕成人（年龄≥20岁）。确诊和未确诊糖尿病分别定义为HbA1c≥6.5%或空腹血糖≥126 mg/dL的自我报告糖尿病和无自我报告糖尿病。在确诊的糖尿病患者中，我们估计了达到血糖(HbA1c <；7.0%)，血压(<；130/80 mmHg)和胆固醇控制(非高密度脂蛋白<；130毫克/分升)，并使用降血压和降脂药物。结果总糖尿病、确诊糖尿病、未确诊糖尿病和未确诊糖尿病的患病率在大流行前后保持稳定，分别为16.2% [95% CI: 14.3-18.1] ~ 15.8%[13.7-17.9]、11.7%[10.1-13.2]~ 11.3%[9.4-13.2]、4.6%[3.8-5.3]~ 4.5%[3.4-5.6]、28.1%[24.3-31.8]~ 28.4%[21.9-35.0]。在诊断为糖尿病的患者中，血糖、血压、脂质控制和使用血压或脂质药物没有显著变化。在2017-2020年和2021-2023年期间，美国人口中糖尿病患病率、认知和控制没有显著变化。

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引用次数: 0

Glucose management indicator: Do we need device-specific equations? 葡萄糖管理指标：我们需要设备专用方程式吗？

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-05-06 DOI: 10.1016/j.diabet.2025.101661

Tamás Jávorfi , Győző Kocsis , Márk M. Svébis , Viktória Ferencz , Beatrix A. Domján , Árpád Kézdi , Hanna Hankó , Zsuzsanna Putz , Ádám G. Tabák

Aim

Glucose management indicator (GMI) may not perform equally well for different continuous glucose monitoring (CGM) systems. Thus, we aimed to develop device-specific GMI for the Guardian 3 and 4 sensors, compare them to the original GMI, and investigate the association between the glycaemic gap (=HbA1c-GMI) and HbA1c.

Methods

In a single-centre, observational study of adult type 1 diabetes patients using Guardian Sensor 3 (G3) and 4 (G4) CGM devices, we estimated HbA1c using CGM-derived mean glucose for both CGMs using linear mixed models. We compared the estimates and their residuals (G3-gap and G4-gap) to the original GMI and its residuals (Bergenstal-gap) using regression and Bland-Altman plots.

Results

We included 120 adult type 1 diabetes patients (90 with G3 and 30 with G4) and 194 measurement points. We found that for G3 and G4 sensors, GMI significantly underestimated glycaemia in high HbA1c ranges, reaching the clinically significant 0.5 %[4.4 mmol/mol] difference at 7.6 % [60 mmol/mol] for G3 and 8.3 % [67 mmol/mol] for G4 sensors. For G4, GMI significantly overestimated glycaemia in the lower HbA1c range. We found a strong relationship between all 3 gaps and HbA1c, and the slope was steeper for the Bergenstal-gap versus the sensor-specific G3 and G4 gaps. The G3-gap was approximately half as large as the Bergenstal-gap for HbA1c > 7 % [53 mmol/mol], and the G4-gap is approximately half of the Bergenstal-gap for the whole HbA1c range.

Conclusion

Device-specific GMI equations could reduce the risk of clinically significant under- and overestimation of HbA1c, improving clinical decision-making.

目的：葡萄糖管理指标（GMI）在不同连续血糖监测（CGM）系统中的表现不尽相同。因此，我们的目标是为Guardian 3和4传感器开发设备特定的GMI，将它们与原始的GMI进行比较，并研究血糖间隙（=HbA1c-GMI）和HbA1c之间的关系。方法：在一项使用Guardian Sensor 3 （G3）和4 (G4) CGM装置的成人1型糖尿病患者的单中心观察研究中，我们使用线性混合模型使用CGM导出的两种CGM的平均葡萄糖来估计HbA1c。我们使用回归和Bland-Altman图将估计值及其残差（G3-gap和G4-gap）与原始GMI及其残差（Bergenstal-gap）进行比较。结果：纳入120例成人1型糖尿病患者（G3 90例，G4 30例），194个测量点。我们发现，对于G3和G4传感器，GMI显著低估了高HbA1c范围内的血糖，在G3的7.6% [60 mmol/mol]和G4传感器的8.3% [67 mmol/mol]的情况下，达到了具有临床意义的0.5%[4.4 mmol/mol]差异。对于G4， GMI显著高估了较低HbA1c范围内的血糖。我们发现所有3个间隙与HbA1c之间存在很强的关系，并且bergenstal间隙的斜率比传感器特定的G3和G4间隙更陡峭。HbA1c的G3-gap约为Bergenstal-gap的一半[53 mmol/mol]， G4-gap约为整个HbA1c范围的Bergenstal-gap的一半。结论：器械特异性GMI方程可降低临床显著的HbA1c过低和过高的风险，改善临床决策。

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引用次数: 0

Methylamine metabolites and progression to kidney failure in type 2 diabetes: An Asian and European prospective study 甲胺代谢物与2型糖尿病肾衰竭进展：一项亚洲和欧洲的前瞻性研究

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-04-30 DOI: 10.1016/j.diabet.2025.101658

Pierre-Jean Saulnier , Jian-Jun Liu , Mikael Croyal , Joe de Keizer , Jiexun Wang , Huili Zheng , Robert G. Nelson , Stéphanie Ragot , Sylvia Liu , Jean-Michel Halimi , Bertrand Cariou , Su Chi Lim , Samy Hadjadj , Singapore KTPH-DKD study group, France SURDIAGENE study group

Aim

Unlike trimethylamine N-oxide (TMAO), the role of methylamine pathway metabolites in diabetic kidney disease (DKD) remains unclear. We investigated the association of circulating methylamines with progression of DKD in a prospective cohort study of patients with type 2 diabetes of two different ethnic backgrounds.

Methods

We analyzed two independent cohorts: a European-origin cohort (SURDIAGENE France; n = 1,357) and an Asian-origin cohort (Khoo Teck Puat Hospital-DKD [KTPH-DKD] Singapore, n = 1,868). The primary composite renal outcome in SURDIAGENE was sustained doubling of serum creatinine or kidney failure with replacement therapy (KFRT), while the secondary outcome was 40% renal function loss (RFL40). In KTPH-DKD, KFRT was the primary outcome. Baseline betaine, carnitine, choline, trimethylamine and TMAO concentrations were measured in plasma by mass-spectrometry. Cox regression models were used to estimate the risk of DKD progression, adjusting for demographics, clinical parameters, and comorbidities.

Results

Over a median follow-up of 7.1 years (IQR 4.5-10.7), we registered 75 composite renal outcomes in SURDIAGENE and over 10.7 years (IQR 7.0-11.8), 149 KFRT in KTPH-DKD. Choline was the only consistently associated with progression of DKD in both cohorts: HR [95%CI] per 1 SD = 1.29 [1.02;1.62], P = 0.033 for composite renal outcome, 1.11 [1.01;1.23], P = 0.028 for RFL40 in SURDIAGENE, and 1.84 [1.30;2.61], P < 0.001 for KFRT in KTPH-DKD.

Conclusion

Plasma choline is an independent risk factor for DKD progression in two independent type 2 diabetes populations. Interventional trials are needed to assess whether reducing dietary choline intake could mitigate severe renal outcomes in type 2 diabetes.

目的：与三甲胺n -氧化物（TMAO）不同，甲胺途径代谢物在糖尿病肾病（DKD）中的作用尚不清楚。我们在一项针对两种不同种族背景的2型糖尿病患者的前瞻性队列研究中调查了循环甲胺与DKD进展的关系。方法：我们分析了两个独立的队列：一个是欧洲裔队列(SURDIAGENE France；n= 1357)和一个亚裔队列（新加坡Khoo Teck Puat Hospital-DKD [KTPH-DKD]， n= 1868）。SURDIAGENE的主要综合肾脏结局是替代治疗（KFRT）时血清肌酐持续翻倍或肾功能衰竭，而次要结局是40%肾功能丧失（RFL40）。在KTPH-DKD中，KFRT是主要转归。用质谱法测定血浆中甜菜碱、肉碱、胆碱、三甲胺和氧化三甲胺的基线浓度。Cox回归模型用于估计DKD进展的风险，并根据人口统计学、临床参数和合并症进行调整。结果：在中位随访7.1年（IQR 4.5-10.7）中，SURDIAGENE组记录了75例复合肾脏结局，在10.7年（IQR 7.0-11.8）中，KTPH-DKD组记录了149例KFRT。在两个队列中，胆碱是唯一与DKD进展一致的相关因素：每1 SD的HR [95%CI] = 1.29[1.02;1.62]，复合肾结局的P = 0.033,1.11 [1.01;1.23]，SURDIAGENE组RFL40的P = 0.028，KTPH-DKD组KFRT的P = 0.028，KTPH-DKD组KFRT的P = 1.84 [1.30;2.61],P < 0.001。结论：血浆胆碱是两个独立2型糖尿病人群中DKD进展的独立危险因素。需要进行干预性试验来评估减少饮食胆碱摄入量是否可以减轻2型糖尿病患者严重的肾脏结局。

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引用次数: 0

Musculoskeletal disorders in type 1 diabetes: Clinical phenotyping and associations with quality of life and glucose control - The French SFDT1 cohort study 1型糖尿病的肌肉骨骼疾病：临床表型及其与生活质量和血糖控制的关系——法国SFDT1队列研究

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-04-23 DOI: 10.1016/j.diabet.2025.101647

Noémie Topalian , Sylvie Picard , Jean-Pierre Riveline , Dulce Canha , Jean-Baptiste Julla , Sandrine Lablanche , Laurence Salle , Emmanuel Sonnet , Aurélie Berot , Didier Gouet , Kalliopi Bilariki , Chloé Amouyal , Lucien Marchand , Sophie Borot , Nicolas Chevalier , Isabela Banu , Emmanuelle Sokol , Emmanuel Cosson , Guy Fagherazzi , Gloria Aguayo

Background

Musculoskeletal disorders (MSDs) are common, but overlooked, complications of type 1 diabetes mellitus (T1DM). This study aims to describe MSD phenotypes (clinical, lifestyle, socio-economic) in adults with T1DM.

Methods

We analyzed adult participants in the SFDT1 cohort study. We assessed the following MSDs: stress fractures, non-traumatic upper-limb disorders, and entrapment syndromes. We performed a cross-sectional analysis of the association between MSDs and various factors. After applying multiple imputations for missing data, we computed logistic regression models with progressive adjustments on confounding factors.

Results

Of 1832 participants (53 % men, median age 38 (IQR 22) years), 34 % reported at least one personal history of MSD: 8 % for stress fractures, 24 % for upper-limb disorders and 15 % for entrapment syndromes. A higher prevalence of MSDs was found in women, with aging and with diabetes duration. In a fully adjusted model, we observed a positive association between current smoking (OR [95 %CI] = 1.50 [1.14;1.97]), non-excessive alcohol consumption (1.45 [1.14;1.85]), neuropathy (1.70 [1.35;2.15]), retinopathy (1.30 [1.02;1.65]), use of automated insulin delivery systems (1.53 [1.06;2.21]) and MSDs. MSDs were associated with reduced global quality of life (0.97 [0.95;0.98]). MSDs were not associated with HbA1c, social vulnerability or physical activity.

Conclusion

We have shown that MSDs are found in 1 in 3 people with T1DM. They are associated with several lifestyle factors, diabetes complications and the use of automated insulin delivery systems. MSDs should be considered in the T1DM assessment to optimize quality of life.

背景：肌肉骨骼疾病（MSDs）是1型糖尿病（T1DM）常见但被忽视的并发症。本研究旨在描述成年T1DM患者的MSD表型（临床、生活方式、社会经济）。方法我们分析SFDT1队列研究中的成年参与者。我们评估了以下msd：应力性骨折、非创伤性上肢障碍和夹带综合征。我们对MSDs与各种因素之间的关系进行了横断面分析。在对缺失数据进行了多重输入后，我们计算了对混杂因素进行渐进调整的逻辑回归模型。结果在1832名参与者中（53%为男性，中位年龄38岁（IQR 22））， 34%报告至少有一次个人MSD病史：8%为应力性骨折，24%为上肢疾病，15%为夹带综合征。随着年龄的增长和糖尿病病程的延长，女性中MSDs的患病率更高。在一个完全调整的模型中，我们观察到当前吸烟（OR [95% CI] = 1.50[1.14;1.97]）、非过量饮酒（1.45[1.14;1.85]）、神经病变（1.70[1.35;2.15]）、视网膜病变（1.30[1.02;1.65]）、使用自动胰岛素输送系统（1.53[1.06;2.21]）和msd之间的正相关。MSDs与总体生活质量降低相关（0.97[0.95;0.98]）。MSDs与HbA1c、社会脆弱性或身体活动无关。结论：1 / 3的T1DM患者存在msd。它们与几种生活方式因素、糖尿病并发症和使用自动胰岛素输送系统有关。在T1DM评估中应考虑MSDs，以优化生活质量。

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引用次数: 0

Hip fractures and type 2 diabetes in the elderly: Risk factors analysis of the Nedices cohort 老年髋部骨折和2型糖尿病：ne迪斯队列的危险因素分析

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-04-21 DOI: 10.1016/j.diabet.2025.101656

Federico Hawkins Carranza , Cristina Martín-Arriscado Arroba , Arturo Corbatón-Anchuelo , Guillermo Martínez Díaz-Guerra , Félix Bermejo Pareja

Aim

- To analyze the association between type 2 diabetes (T2D) and the incidence of hip fractures in the elderly, while also considering the influence of socioeconomic status (SES), and other risk factors (RFs).

Methods

- Data were collected from 5278 participants aged ≥ 65 years. The study included a baseline and a follow-up survey 3 years later. Participants completed a questionnaire, anthropometric measurements, blood tests, and physical and cognitive tools. The research was conducted in three Spanish communities with different socioeconomic backgrounds.

Results

- At baseline, there were 874 T2D and 4494 controls. Body mass index (BMI) was slightly higher in individuals with hip fractures. Significant differences were observed in BMI, education level, physical activity, osteoporosis, cataracts, and osteoarthritis. In the follow-up survey, 96 newly, 615 previously T2D, and 2985 controls were compared. Those with hip fractures were associated with lower educational attainment, sedentary life, and higher diagnoses of osteoporosis, cataracts, and osteoarthritis. Charlson index was higher in individuals with hip fractures. A higher proportion of fractures occurred in urban areas. The rate of incidence of T2D between individuals with and without fractures was not different.

Conclusion

- RFs for hip fractures in T2D are similar to those in the general population. Osteoporosis, being female, and advancing age were independent RFs for hip fractures. There was an inverse association between educational level, community allocation, and physical activity which may further contribute to hip fracture risk. These highlights the need for research to better understand the role of T2D and these RFs in hip fracture incidence.

目的：分析2型糖尿病（T2D）与老年人髋部骨折发生率的关系，同时考虑社会经济地位（SES）和其他危险因素（RFs）的影响。方法：数据来自5278名年龄≥65岁的参与者。该研究包括基线和3年后的随访调查。参与者完成了问卷调查、人体测量、血液测试以及身体和认知工具。这项研究是在三个不同社会经济背景的西班牙社区进行的。结果：-基线时，有874例T2D和4,494例对照。髋部骨折患者的身体质量指数（BMI）略高。在BMI、受教育程度、体力活动、骨质疏松、白内障和骨关节炎方面观察到显著差异。在随访调查中，96例新发患者，615例既往T2D患者和2985例对照患者进行比较。髋部骨折患者受教育程度较低，久坐不动，骨质疏松症、白内障和骨关节炎的发病率较高。髋骨骨折患者的Charlson指数更高。骨折发生在城市地区的比例较高。t2dm的发生率在有和没有骨折的个体之间没有差异。结论：t2dm髋部骨折的rf与普通人群相似。骨质疏松、女性和高龄是髋部骨折的独立风险因素。教育水平、社区分配和体育活动之间存在负相关，这可能进一步增加髋部骨折的风险。这些突出表明需要进行研究，以更好地了解T2D和这些RFs在髋部骨折发生率中的作用。

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