Journal of Diabetes and Metabolic Disorders最新文献

Obesity is a complicated, multifactorial, and highly avoidable disease. There is a complicated relationship between type 2 diabetes mellitus (T2DM) and obesity. Surgical intervention is regarded as one of the greatest efficacious treatments for morbid obesity, where T2DM exhibits remarkable amelioration and remission. The objective of this work is to evaluate endogenous insulin by measuring postprandial C-peptide before and 6 months after LSG. We will also assess metabolic improvement, including remission of T2DM and prediabetes, 6 months after LSG. A total of 60 Egyptian patients, aged 18-60 years, with a body mass index (BMI) > 35, prediabetes, or type 2 diabetes, were recruited from bariatric outpatient clinics at Cairo University Hospitals. The study assessed the postprandial C-peptide, fasting blood sugar, HbA1C, and lipid profile before and 6 months following LSG. A significant improvement was observed in the metabolic profile in the form of reduction of BMI, HbA1c, lipid profile, and control of hypertension 6 months postoperatively. There was a significant reduction of postprandial C-peptide 6 months postoperatively. Fifty-five patients (91.7%) achieved complete remission of prediabetes and diabetes 6 months postoperatively, while 4 patients showed only improvement of diabetes and 1 patient in the prediabetic group did not achieve remission. In conclusion, LSG demonstrates encouraging outcomes in terms of metabolic profile enhancement, insulin resistance improvement as indicated by significant reduction in C-peptide level, remission of prediabetes and T2DM, and effective weight loss.

Objectives: This study evaluated the effects of maximal and submaximal exercise training on serum levels of Asprosin, insulin resistance, and body composition in overweight and obese women.

Methods: 30 overweight/obese women voluntarily participated in the study and were then randomly divided into control, submaximal, and maximal groups. A treadmill high-intensity exercise protocol was applied to MG non-consecutive three days a week for 8 weeks, in four 4-min intervals with an intensity of 70 to 95% of maximum heart rate (HRmax) with 3-min active recovery intervals. SMG performed a moderate-intensity exercise protocol of approximately 25 to 35 min at the treadmill at 50-70% of HRmax non-consecutive days three days per week for 8 weeks. The CG continued their daily routine activities. Anthropometric and body composition measurements such as body weight, height, BMI, and waist-hip ratio (WHR) were performed before and after the 8-week training period. Fasting blood glucose (FGB), insulin, insulin resistance (HOMA-IR), and serum asprosin levels were also measured.

Results: Post-training, there were significant main effects of time and a group-by-time interaction for all body composition and performance variables (p < 0.001). Post hoc analysis revealed that body mass, BMI, WHR, FBG, insulin, HOMA-IR, and serum asprosin were significantly reduced after 8 8-week training program.

Conclusions: The present study showed that maximal and submaximal exercise protocols effectively improved body composition, insulin sensitivity, resistance, and reduced asprosin level. It has been concluded that these effects are more pronounced, especially after maximal exercise protocols.

Objectives: Sarcopenia could be linked to abdominal obesity through various mechanisms. The aim of the current study was to evaluate the association between sarcopenia and abdominal obesity among community-dwelling aged population.

Methods: Data were collected from 1356 eligible older adults (≥ 60 years) who participated in the baseline phase of Birjand Longitudinal Aging Study (BLAS) in 2019. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), a body shape index (ABSI), body roundness index (BRI), and body adiposity index (BAI) were measured. Sarcopenia was assessed based on hand grip strength, appendicular skeletal muscle mass (ASMM) and gait speed.

Results: In the studied population, 834 individuals were sarcopenic. The best predictors of sarcopenia and low gait speed were BAI and WHtR (AUC = 0.61 to 0.65). All abdominal obesity indices were risk factors for sarcopenia, except for WHR. ABSI was significantly and directly associated with sarcopenia, only in the crude model (OR (95%CI): 1.14 (1.02; 1.28), P = 0.02). WHR, WHtR, BMI, and WC increased and ABSI decreased the odds of low handgrip strength.

Conclusions: Most abdominal obesity indices were identified as risk factors for sarcopenia except for WHR. Anthropometric indices can be considered for evaluating the risk of sarcopenia in the elderly.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01616-6.

Objectives: The effect of the duration of medication with metformin and sulfonylurea (SUs) on microvascular complications based on the duration of type 2 diabetes (DM2) is unclear. The aim of this study was to investigate the association of medication time with metformin and SUs and microvascular complications in newly diagnosed DM2 patients.

Methods: In this prospective multi-cohort study, data from 3,904 newly diagnosed DM from three cohorts of the Tehran Lipid and Glucose Study (TLGS), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Atherosclerosis Risk in Communities (ARIC) with a mean age of 59.6 ± 08 years were pooled. Metformin medication time alone, SUs alone, and a combination of both since drug initiation were defined as exposure. The incidence of microvascular complications (diabetic nephropathy or retinopathy) was defined as outcomes. The cumulative exposure to metformin, SUs, aspirin, statin, and anti-hypertensive medication was also determined using the same approach.

Results: Metformin alone, SUs alone, and the combination of both reduced the hazard of microvascular complications by 8%(HR_Adj: 0.92, 95% CI: 0.89, 0.96, P: 0.001), 6%(HR_Adj: 0.94, 95% CI: 0.92, 0.97, P: 0.004), and 9%(HR_Adj: 0.91, 95% CI: 0.89, 0.94, P: 0.001) for each year of use, respectively (p < 0.05). The protective effect of metformin and SUs, individually or in combination, on microvascular complications started approximately five years after the initial treatment and continued until approximately 15 years after the initial treatment and then reached a plato.

Conclusion: long-term use of metformin and SUs individually and in combination was associated with a decrease in the risk of microvascular outcomes in newly diagnosed DM for up to about one decade. These findings highlight the importance of choosing an appropriate treatment regimen for new patients with type 2 diabetes. Appropriate oral therapy can minimize microvascular complications and improve overall well-being.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01577-w.

Objectives: Diabetes mellitus (DM) is often accompanied by various comorbidities, including cardiovascular diseases, Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), renal dysfunction, polycystic ovary syndrome (PCOS), neurological disorders, psychiatric conditions, and others. These comorbidities complicate diabetes management and contribute to worsened health outcomes. This narrative review explores the efficacy of glucagon-like peptide-1 (GLP-1) receptor agonists in managing a broad range of diabetes-related comorbidities, assessing their therapeutic potential beyond glycemic control.

Methods: A comprehensive review of the literature was conducted by searching scientific databases including PubMed, Scopus, and Web of Science. Additionally, AI-based tools like ChatGPT were employed from September 2024 to January 2025 to enhance the accuracy of data collection and analysis. The search was conducted using keywords such as "GLP-1 receptor agonists", "diabetes and comorbidities", "cardiovascular diseases", "MASLD", "renal dysfunction", "PCOS", "neurological disorders", "psychiatric disorders", "sleep apnea", "osteoarthritis", and "diabetic retinopathy". Boolean operators (AND/OR) were used to combine the keywords for efficient searching. Studies were selected and analyzed based on predefined criteria to evaluate the efficacy of GLP-1 receptor agonists (GLP1RAs) in managing diabetes-related comorbidities.

Results: GLP1RAs have demonstrated significant benefits in managing various comorbidities, including cardiovascular diseases, liver conditions (such as MASLD), renal dysfunction, and metabolic disorders like PCOS. They also show promise in addressing neurological and psychiatric disorders, likely due to their anti-inflammatory, neuroprotective, and metabolic effects.

Conclusion: GLP1RAs offer a multifaceted approach to treating not only diabetes but also its associated comorbidities, improving patient outcomes across multiple health domains. However, further research is required to confirm these benefits and optimize treatment strategies for diverse patient populations.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01604-w.

Heart Arrhythmias (HA) is one of the heart diseases that occurs due to heart dysfunction or contraction of myocardial cells. Long non-coding RNAs (LncRNAs) are one of the factors that play a role in the physiopathology of HA. TGF-β plays a pivotal role in the pathogenesis of HA. Recently, it has been shown that linc-PINT can play a role in regulating TGF-β expression. However, the interaction of these two molecules in HA has not been investigated in silico, so we evaluated this issue in this study. We accessed the GSE133420 (platform: GPL20795 HiSeq X Ten (Homo sapiens)) dataset containing RNA-seq data from human atrial appendage tissues from patients with atrial fibrillation (AF) and healthy controls. It deals with RNA isolates obtained from plasma samples. To identify potential binding sites for linc-PINT within the promoters of TGF-β signaling genes, we used LncRRIsearch. To further validate and supplement these predictions, we also referenced target genes from LncTar and starBase, which were then integrated into the protein-protein interaction (PPI) network. The results showed that the expression of linc-PINT was significantly decreased in patients compared to the control group (p < 0.01). On the other hand, the expression of SMAD2, SMAD3, SMAD5 and TGF-βR1 genes was significantly increased in patients compared to the control group. The expression of SMAD6 in both groups was almost equal and there was no significant relationship between them (P > 0.05). It can be said that examining the expression of TGF-β and linc-PINT can be helpful in identifying patients at high risk of HA, and by applying therapeutic strategies, clinical symptoms can be improved.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01609-5.

Background: There little known about bariatric surgeries performed in Poland. We aimed to analyze trends in bariatric surgery performed in public health system in Poland.

Methods: Data was obtained from the National Health Fund (NFZ) database of aggregated statistics for the years 2017-2022. We retrieved data about hospitalizations during which bariatric surgery was performed. We performed descriptive statistics.

Results: From 2017 to 2022, the number of bariatric surgeries in Poland's public healthcare system increased from 3,278 to 5,580, with a temporary decline in 2020. The number of procedures per 100,000 residents increased from 8.5 in 2017 to 14.7 in 2022. The majority of surgeries (73.3%) were performed on women. Sleeve gastrectomy was the most frequently reported procedure. The median duration of hospitalizations was 3 days. The in-hospital mortality rate was equal to 0.057.

Conclusions: Between 2017 and 2022, bariatric surgeries in the Polish public healthcare system increased by about 70%, with a temporary drop in 2020. Nevertheless, Poland still reports fewer procedures per 100,000 residents compared to other developed countries. A key limitation of this study is the absence of data from private sector.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01600-0.

Objectives: This review assessed the role of Branched-Chain Amino Acid Transaminase (BCAT) enzymes in human metabolism, and their involvement in the catabolism of branched-chain amino acids (BCAAs) and exploring the association between Type 2 Diabetes Mellitus (T2DM) and Alzheimer's disease (AD) through insulin resistance.

Methods: The analysis involves a comprehensive literature review of recent research findings related to BCAT enzymes, BCAA metabolism, T2DM, and AD. Relevant studies and articles were identified through systematic searches in databases such as PubMed, ScienceDirect, and other scholarly resources. Inclusion criteria encompassed research articles, reviews, and studies published in peer-reviewed journals, with a focus on human metabolism, BCAT enzymes, and the interplay between BCAA metabolism, T2DM, and AD.

Results: The association between T2DM and AD suggests a potential metabolic link, particularly through dysregulated BCAA metabolism leading to insulin resistance. The impact of impaired insulin signaling is implicated in brain function and the accumulation of amyloid plaques facilitated by BCAT.

Conclusion: The identified link between BCAT, BCAA metabolism, T2DM, and AD suggests that disruptions in BCAT levels could serve as valuable indicators for early detection of insulin resistance and cognitive impairment as observed in Type 3 Diabetes which may present a promising therapeutic target.

Objectives: The aim of this study was to investigate the association of wrist circumference (WrC) and neck circumferences (NC) with Insulin Resistance (IR) in obese and overweight children and adolescents.

Methods: This cross-sectional study included 227 overweight and obese children. Anthropometric indices such as NC and WrC were measured. Laboratory parameters such as fasting blood glucose (FBS) and insulin were measured after 12 h of overnight fasting. IR was determined by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) using formula and HOMA-IR ≥ 2.6 defined as IR. The predictive power of NC and WrC for IR was assessed using receiver operating characteristic (ROC) analyses and the area under ROC curve (AUC) > 0.65 were considered as highly accurate tests.

Results: Among the 227 included samples, 52.4% were girls, and 67.4% were classified as obese. IR was detected in 48.5% of the participants without a significant association with gender (48.8% in girls and 48.1% in boys) and weight status (43.2% in overweight and 51% in obese). The AUCs of WrC and NC in detecting IR were 0.78 (95% CI: 0.72-0.84) and 0.72 (95% CI: 0.65-0.78) in overweight and obese children respectively. The Chi-square test shows that the AUC of WrC in predicting IR was statistically higher than NC (Chi-square: 4.47, P: 0.03).

Conclusions: Our findings showed that WrC and NC are two useful indices for predicting IR in overweight and obese children and adolescents. Therefore they could be used as a clinical indicators of IR in children and adolescents.

Objectives: This study aimed to implement a multi-state risk prediction model to predict the progression of COVID-19 cases among hospitalized patients in Kurdistan province by analyzing hospital care data.

Methods: This retrospective analysis consisted of data from 17,286 patients admitted to hospitals with COVID-19 from March 23, 2019, to December 19, 2021, in various areas in the Kurdistan province. A multi-state prediction model was used to show that each transition is predicted by a different set of variables. These variables include underlying diseases (like diabetes, hypertension, etc.) and sociodemographic information (like sex and age). Model aims to predict the likelihood of recovery, the need for critical care intervention (e.g., transfer to isolation units or the ICU), or exits from the hospitalization course. We performed the statistical analysis using R software and the mstate package.

Results: Of the hospitalized patients studied, 5.6% died of the disease, 6.6% were admitted to ICUs, and 38.72% were treated in isolation units. Mortality rates in general wards, isolation units, and the ICU were 3.48%, 4.56%, and 26.6%, respectively. Significant predictors for ICU admission include age over 60 years (HR: 1.46, 95% CI 1.37-1.55), kidney-related conditions (HR: 2.19, 95% CI 1.65-2.91), cardiovascular diseases (HR: 1.68, 95% CI 1.46-1.94), lung disease (HR: 1.89,‏95% CI 1.43-2.05), and cancer (HR: 2.46,‏95% CI 1.77-3.41). The likelihood of in-hospital death is significantly increased by age over 60 years (HR: 2.40, 95% CI 2.09-2.76), diabetes (HR: 1.97, 95% CI 1.45-2.68), high blood pressure (HR: 2.30, 95% CI 1.78-2.97), and history of heart disease (HR: 3.01, 95% CI 2.29-3.95).

Conclusion: The model helps the provider and policymakers to make an informed decision depending on patient management and resource allocation within the health care systems.