Journal of Diabetes and Metabolic Disorders最新文献

Depression is a prevalent yet often underdiagnosed neuropsychiatric comorbidity of type 2 diabetes mellitus (T2DM), significantly complicating disease management, treatment adherence, and overall well-being. Emerging evidence suggests that gut microbiota dysbiosis plays a pivotal role in linking T2DM and depression through mechanisms such as epithelial barrier dysfunction, systemic inflammation, neurotransmitter imbalances, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and impaired neurogenesis. This review aims to explore the mechanistic pathways through which diabetes-induced dysbiosis contributes to depression and to appraise the therapeutic potential of microbiota-targeted interventions, including probiotics, prebiotics, and fecal microbiota transplantation, in mitigating depressive symptoms and improving metabolic outcomes. Understanding this gut-brain interplay may provide novel insights into therapeutic strategies for managing the dual burden of diabetes and depression.

Diabetes mellitus, encompassing both T1DM and T2DM, represents a global health challenge. While traditional therapies focus on managing symptoms, emerging stem cell therapies, particularly MSCs, offer potential curative approaches. This review explores advancements in diabetes research with an emphasis on mesenchymal stem cells (MSCs). Additionally, we discuss clinical trials and applications of MSCs in diabetes treatment, providing a comprehensive analysis of this promising therapeutic frontier. MSCs have been shown to provide immunomodulatory effects, delay disease progression and reverse insulin resistance in preclinical and clinical studies. MSC-derived EVs have been extensively studied as well, exhibiting similar therapeutic benefits while also possibly having lower immunogenicity than MSCs. Phase I and II clinical studies have demonstrated MSCs to be effective in juvenile T1DM and able to significantly reduce HbA1c, fasting blood glucose, insulin demand and plasma blood glucose levels (p < 0.05). There is however a lack of standardisation of protocols across studies, highlighting the need for comparative studies to establish the optimal dosing, treatment schedule, administration route and source of MSCs. Large-scale randomised controlled trials are necessary to establish safety and efficacy in human patients, paving the way for MSC-based therapies in diabetes treatment. Clinical trial number: Not applicable.

Purpose: Linum usitatissimum L. (flaxseed), an herbaceous plant from the Linaceae family, possesses antioxidant and anti-inflammatory properties, making it effective in treating various health conditions. Although numerous studies have explored the benefits of flaxseed, a comprehensive review of its antioxidative and anti-inflammatory effects is lacking. Such a review would provide a clearer perspective on its medical applications. This study aims to comprehensively examine these effects based on research conducted on the management of various disorders.

Method: We conducted a narrative review of flaxseed and its derivatives by systematically searching for the keywords "Linum usitatissimum L., flax, flaxseed, antioxidant", and "anti-inflammatory, oxidative stress, inflammation, herbal medicine, nutraceuticals, cytokines" in reputable international databases, including PubMed, Web of Science, the Cochrane Library, and Scopus, up until October 1, 2024. A total of 2,412 articles were reviewed, of which 2,336 were excluded due to duplication, irrelevance or similarity. The findings were categorized into in vitro, animal, and clinical studies.

Results: Numerous studies indicate that flaxseed and its derivatives reduce inflammatory cytokine levels. Additionally, they exhibit antihyperlipidemic, antihyperglycemic, and cardioprotective properties due to their antioxidative and anti-inflammatory effects. Furthermore, animal and clinical studies suggest that flaxseed extract reduces body fat storage and insulin resistance while offering various therapeutic benefits.

Conclusion: In conclusion, various studies demonstrate the significant potential of flaxseed for prevention and management of diseases. Its efficacy is likely attributable to its antioxidative and anti-inflammatory properties. However, further research is required to fully understand its therapeutic potential.

Introduction: Diabetic foot ulcer (DFU) is a serious complication of diabetes that significantly increases healthcare expenditure worldwide. The aim of this study is to calculate the average costs for patients with and without DFU over a nine-month period.

Methods: This cost-of-illness study comprised 480 patients, including 160 cases (with DFU) and 320 controls (diabetes only), matched 1:2 by age (± 5 years) and sex. Direct and indirect medical costs were collected over a nine-month period using a questionnaire. We used the Mann-Whitney U test for continuous variables and the Pearson chi-square test for categorical variables. The GLM was also used to predict costs based on demographic and clinical factors. All statistical analyzes were performed using SPSS with a significance level of p < 0.05.

Results: The average total direct medical costs (inpatient and outpatient) were PPP$ 3,493.64 (SD: 2,714.66) for the DFU group and PPP$ 1,353.44 (SD: 110.85) for the diabetes-only group. Medication expenditures were the highest outpatient costs in the DFU group, with a mean of PPP$ 1,079.59 (SD: 247.13) (P < 0.001). Mean transportation costs in the DFU group were PPP$ 299.66 (SD: 240.49), compared with PPP$ 96.01 (SD: 7.83) in the control group. The mean indirect costs were PPP$ 2,256.31 (SD: 1,332.39) for the DFU group and PPP$ 100.78 (SD: 24.63) for the control group. Patients with more advanced ulcer stages (B = 9050.275, p < 0.05) and with middle education levels (B = 208.77, p < 0.05) had significantly higher costs. In contrast, retired individuals had significantly lower costs (B = -459.77, p < 0.05).

Conclusions: Patients with DFU incur substantially higher direct and indirect costs compared to those with diabetes alone. Medication and other service utilization-including blood glucose self-monitoring and consumables such as test strips, blood glucose meters, lancets, and syringes-are key contributors to outpatient expenses. The elevated indirect costs in DFU patients primarily reflect lost productivity. These higher overall costs are largely driven by the severity of the complication. Optimizing treatment strategies to prevent disease progression and avoid costly complications is essential for reducing the financial burden associated with DFU.

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder characterized by glucose intolerance that develops during pregnancy. Recent studies have begun to elucidate the role of MicroRNAs (miRNAs) in the pathophysiology of GDM, suggesting that these non-coding RNAs could serve as potential biomarkers for the condition. This study aimed to investigate the clinical diagnostic value of miR-520g-3p in GDM patients.

Methods: GSE104297 dataset was downloaded and analyzed by R software to obtain the differentially expressed miRNAs. A total of 110 GDM patients and 110 healthy pregnant women were recruited and the serum samples were collected. The expressions of miRNAs in the serum samples were detected by qRT-PCR assay. Then, the diagnostic value of miR-520g-3p in GDM patients were analyzed by receiver operating curve (ROC) analysis. The correlation between miR-520g-3p expression and patient clinical information was analyzed using Pearson analysis.

Results: Through the GSE104297 dataset, we obtained a total of 15 upregulated and 15 downregulated miRNAs in the feto-placental endothelial cells of GDM patients. Then, in the serum of GDM patients, miR-520g-3p, miR-519d-3p, miR-145-3p, miR-1246 and miR-671-3p expression levels were significantly increased, while miR-579-3p and miR-378a-5p were decreased. Among them, the change in miR-520g-3p is the most significant. Furthermore, the results of ROC analysis showed that the AUCs of miR-520g-3p in GDM patients from normal pregnant women were 0.861. miR-520g-3p levels was significantly positively correlated with FBG, OGTT (1 h and 2 h) and TG.

Conclusion: This study identifies miR-520g-3p might be a promising biomarker for GDM, demonstrating significant correlations with clinical characteristics and diagnostic potential.

Background: Pediatric Cushing Syndrome (CS) is rare and difficult to diagnose, especially when distinguishing ACTH-dependent subtypes. Bilateral inferior petrosal sinus sampling (BIPSS) is an essential but technically challenging procedure for this purpose. Because corticotropin-releasing hormone (CRH), the standard stimulant, has limitations, desmopressin is being explored as an alternative. This study assesses desmopressin-stimulated BIPSS for its diagnostic accuracy and tumor localization in pediatric CS within an Iranian cohort, addressing a gap in pediatric-specific diagnostic strategies and offering insights into the applicability of desmopressin in this context.

Methods: Four pediatric patients with inconclusive pituitary imaging and suspected Cushing's disease (CD) underwent BIPSS with desmopressin at Taleghani Hospital, Tehran, Iran, between August 2015 and March 2019. Sensitivity of BIPSS for CD diagnosis was assessed, and tumor localization accuracy was evaluated during surgery.

Results: Bilateral IPSS demonstrated a sensitivity of 100% for diagnosing CD in pediatric patients. However, accuracy for tumor lateralization was moderate, with only 50% concordance between BIPSS lateralization and surgical findings. Specifically, two out of four patients had correct lateralization confirmed during surgery, while one patient with left lateralization was consistent with hypophysectomy findings. These discrepancies highlight challenges such as anatomical and drainage variations that can lead to mislocalization.

Conclusion: Desmopressin enhances the sensitivity of BIPSS for diagnosing pediatric CD, presenting as a viable alternative to CRH stimulation. Despite high sensitivity, caution is advised when interpreting BIPSS results for tumor localization. Further research is needed to optimize diagnostic strategies for pediatric CS management.

Objective: Type II diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia resulting from impaired insulin secretion, action, or both. Diabetic peripheral neuropathy is among the most common complications of disease, with its incidence linked to various risk factors. This study aims to evaluate the risk factors associated with peripheral neuropathy among patients with Diabetes Mellitus in Padang City.

Method: Using a descriptive, cross-sectional design with stratified random sampling, 390 T2DM patients were assessed. Research instruments included the Global Physical Activity Questionnaire, the Patient Health Questionnaire-9, and the Michigan Neuropathy Screening Instrument. Data analysis employed chi-square tests and multiple logistic regression.

Results: The findings revealed significant associations between Diabetic peripheral neuropathy and factors such as diabetes duration, socioeconomic status, smoking, glycemic control, dyslipidemia, physical activity, and depressive symptoms (p < 0.05). Conversely, no significant relationship was observed for sex or hypertension (p > 0.05). Dyslipidemia emerged as Diabetic peripheral neuropathy's most influential risk factor (p = 0.000, OR = 3.295).

Conclusion: This study emphasizes the importance of early detection through routine screening and regular follow-up care. Targeting modifiable risk factors through health education and improved disease management strategies could significantly reduce the burden of Diabetic peripheral neuropathy among Type 2 Diabetes Mellitus patients.

Background: This systematic review and meta-analysis aimed to evaluate the association between gestational diabetes mellitus (GDM) and the risk of various cancers, including breast, cervical, and uterine cancers, using data from studies published between 1998 and 2025.

Methods: A comprehensive search of international databases identified 1,207 unique records, from which 23 studies were included, comprising both case-control and cohort designs. The studies, conducted across multiple countries, investigated GDM's association with different types of cancers. Data were pooled and analyzed using random-effects models, and heterogeneity, publication bias, and subgroup analyses were assessed.

Results: The meta-analysis revealed no significant association between GDM and breast cancer risk (RR: 0.97, 95% CI: 0.89-1.06), with considerable heterogeneity (I² = 70.21%). For cervical cancer, no significant association was found (RR: 0.92, 95% CI: 0.76-1.10), with minimal heterogeneity (I² = 0.25%). Uterine cancer also showed no significant association with GDM (RR: 1.03, 95% CI: 0.72-1.47). The analysis revealed consistent findings across different diagnostic methods for GDM and cancer, with no significant publication bias detected.

Conclusion: This systematic review and meta-analysis found no significant overall association between GDM and the risk of breast, cervical, or uterine cancers. However, variations across studies suggest that factors such as geographic region, study design, and diagnostic methods may influence the observed associations. Further research with larger, more homogeneous samples is needed to clarify the potential links between GDM and cancer risk.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01633-5.

Introduction: One effective factor is a person`s sense of taste. This study compared the taste perception of dental students with different body mass index (BMI).

Methods and materials: In this cross-sectional study, 100 dental students aged 21 to 25 years were evaluated. Participants were assessed on three BMI groups people, normal weight (BMI < 25) (kg/m²), overweight (25 ≤ BMI < 30) (kg/m²), and obesity (BMI ≥ 30) (kg/m²). Taste perception was measured using four different concentrations of basic tastes. The taste perception was measured using swabs impregnated with 4 different concentrations of the four main tastes studied on the protruded tongue. Subjects were asked to inform the researcher when they sensed the taste. Statistical analysis of the results was obtained using the Kruskal-Wallis test (P < 0.05).

Results: Of the participants, 54% were male and 46% were female, 71 people had normal weight, 23 people were overweight, and 6 were obese people. There are significant differences in taste threshold scores of main tastes except salty between genders for BMI groups (p-value < 0.05). The present study showed a significant difference in bitter and sour taste according to the BMI group. There was a significant difference between the taste perception and BMI group in sweet and bitter tastes in women. There was a significant difference in the sour taste perception and BMI group in men.

Conclusion: Our results would present important insights into taste perception. The BMI may influence how sourness and bitterness are perceived. There was a noticeable difference in women's sweet and bitter taste perception based on BMI.

Trial registration number: Not applicable.

Background: The specific link between thyroid nodules and vascular aging remains less explored. This gap underscores the necessity for further investigation to deepen our understanding of how thyroid health intersects with vascular aging and cardiovascular risks.

Methods: A cross-sectional observational study was conducted within the Persian organizational cohort study in Mashhad, Iran, comprising 2,857 participants. The association between pulse wave velocity (PWV), augmentation index (AIx), serum TSH levels, and the prevalence of thyroid nodules was assessed.

Results: In a cohort of 2,857 participants, a critical correlation was found between the presence of thyroid nodules and changes in cardiovascular indices, with significant relationships observed between nodular characteristics and both AIx and PWV. TSH levels were correlated with both the augmentation index (R = 0.072; p < 0.01) and PWV (R = -0.070; p < 0.01). Both AIx and PWV were significantly higher in the presence of thyroid nodules (28.76 vs. 26.80, p < 0.01) and (7.25 vs. 7.07, p < 0.01), respectively.

Conclusion: This study found no significant correlation between TSH levels or thyroid volume and AIx or PWV. However, AIx and PWV were significantly higher in the presence of thyroid nodules, indicating their potential as important indicators of cardiovascular risk.