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Effect of colchicine on platelet aggregation in patients with type 2 diabetes: Results from a randomized placebo-controlled trial 秋水仙碱对2型糖尿病患者血小板聚集的影响:一项随机安慰剂对照试验的结果
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-25 DOI: 10.1016/j.jdiacomp.2025.109141
Jonathan M. Baier , Kristian L. Funck , Liv Vernstrøm , Søren Gullaksen , Per L. Poulsen , Esben Laugesen

Background

Patients with type 2 diabetes face an increased risk of cardiovascular disease (CVD), partly due to a prothrombotic state with increased platelet reactivity. Colchicine, an anti-inflammatory drug, has shown promise in reducing cardiovascular events, but its effects on platelet function remain unclear. This trial evaluated the effect of low-dose colchicine on platelet aggregation and platelet activation indices in patients with type 2 diabetes.

Methods

In this double-blind, randomized, placebo-controlled trial, 100 participants with type 2 diabetes and previous CVD or a least one cardiovascular risk factor were randomized in a 1:1 ratio to receive either colchicine (0.5 mg/day) or placebo for 26 weeks. Platelet aggregation was assessed using multiple electrode aggregometry expressed as aggregation units (AU) × minutes (mins). Adenosine diphosphate (ADP), arachidonic acid (AA), and thrombin-receptor-activating peptide (TRAP) were used as agonists.

Results

A total of 95 participants completed the trial. After 26 weeks, no significant differences were observed between the colchicine and placebo groups in platelet aggregation induced by ADP (ΔADP-aggregation: 49, 95 % CI: −15;113 AU x mins, p = 0.08), AA (ΔAA-aggregation: −4, 95 % CI: −24;16 %, p = 0.69), or TRAP (ΔTRAP-aggregation: −3, 95 % CI: −11;4 %, p = 0.39). Similarly, no between-group differences were found in platelet parameters, including platelet count mean platelet volume, and immature platelet fraction.

Conclusions

Low-dose colchicine did not significantly alter platelet aggregation or platelet activation indices in patients with type 2 diabetes. These findings suggest that colchicine's cardioprotective effects are not mediated through direct effects on platelet function.

Clinical trial registration information

EudraCT-no.: 2021-003525-30
Link: https://www.clinicaltrialsregister.eu/ctr-search/trial/2021-003525-30/DK
背景:2型糖尿病患者患心血管疾病(CVD)的风险增加,部分原因是血小板反应性增高的血栓形成前状态。秋水仙碱是一种抗炎药物,在减少心血管事件方面有希望,但它对血小板功能的影响尚不清楚。本试验评估了低剂量秋水仙碱对2型糖尿病患者血小板聚集和血小板活化指标的影响。方法在这项双盲、随机、安慰剂对照试验中,100名患有2型糖尿病和既往心血管疾病或至少一种心血管危险因素的参与者按1:1的比例随机接受秋水仙碱(0.5 mg/天)或安慰剂治疗26周。血小板聚集用多电极聚集法评估,聚集单位(AU) ×分钟(min)。二磷酸腺苷(ADP)、花生四烯酸(AA)和凝血酶受体激活肽(TRAP)作为激动剂。结果共有95名参与者完成了试验。26周后,在ADP (ΔADP-aggregation: 49, 95% CI:−15;113 AU x min, p = 0.08)、AA (ΔAA-aggregation:−4,95% CI:−24;16%,p = 0.69)或TRAP (ΔTRAP-aggregation:−3,95% CI:−11;4%,p = 0.39)诱导的血小板聚集方面,秋水仙碱组与安慰剂组之间无显著差异。同样,各组间的血小板参数,包括血小板计数、平均血小板体积和未成熟血小板分数均无差异。结论慢剂量秋水仙碱对2型糖尿病患者血小板聚集和血小板活化指标无显著影响。这些发现表明秋水仙碱的心脏保护作用不是通过直接影响血小板功能介导的。临床试验注册信息链接:https://www.clinicaltrialsregister.eu/ctr-search/trial/2021-003525-30/DK
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引用次数: 0
Author's response to the Letter to the Editor “Glucagon-like Peptide-1 receptor agonists versus dipeptidyl-peptidase 4 inhibitors in advanced chronic kidney disease and end stage kidney disease: Real world effectiveness and persistence of therapy” 作者对致编辑的信的回应“胰高血糖素样肽-1受体激动剂与二肽基肽酶4抑制剂在晚期慢性肾病和终末期肾病中的作用:现实世界的有效性和治疗的持久性”
IF 3.1 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-25 DOI: 10.1016/j.jdiacomp.2025.109143
Shubham Agarwal , F.N.U. Sidra , Ildiko Lingvay
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引用次数: 0
Associations of time in range and glycemic risk index with insulin resistance and diabetic kidney disease in patients with type 2 diabetes 时间范围和血糖危险指数与2型糖尿病患者胰岛素抵抗和糖尿病肾病的关系
IF 3.1 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-24 DOI: 10.1016/j.jdiacomp.2025.109140
Zhe Yang , Baozhen Zheng , Guojing Luo , Xiaoyan Xin , Hongyun Lu

Aims

Effective glycemic control is essential for preventing complications and improving quality of life in patients with type 2 diabetes mellitus (T2DM). Identifying reliable glycemic indicators for the assessment of islet function and renal complications remains a major challenge in diabetology. Time in Range (TIR) and Glycemia Risk Index (GRI), two continuous glucose monitoring (CGM)-based metrics, have recently emerged as potential tools for assessing glycemic control beyond HbA1c. This study aims to assess the predictive value of TIR and GRI for islet function impairment and diabetic kidney disease (DKD) in patients with T2DM.

Methods

A retrospective analysis of a total of 422 patients with T2DM was performed, who were admitted to Zhuhai People's Hospital between January 2021 and December 2022. Continuous glucose monitoring (CGM) data were collected to get TIR and GRI. Additionally, the C-peptide release, random urine biochemistry analysis, and C-reactive protein (CRP) were obtained to calculate HOMA-IR, HOMA-β, ISIstumvoll index, Stumvoll 1-phase and 2-phase index, and insulin resistance. The Urinary Albumin/Creatinine Ratio (UACR) was ascertained as a diagnostic marker of DKD.

Results

TIR and GRI demonstrated significant correlations with HOMA-IR, HOMA-β, and UACR; however, CRP exhibited a limited correlation with HOMA-IR and UACR. After adjustment for potential confounding factors, the odds ratios (ORs) for pancreatic β-cell function were: TIR 0.174 (95 % CI 0.051–0.592), GRI 1.010 (95 % CI 1.001–1.020). For DKD: TIR 0.182 (95 % CI 0.052–0.639), GRI 1.017 (95 % CI 1.007–1.027). TIR levels of 71 %–85 % and 41 %–70 % were associated with a 4.763-fold and 5.079-fold higher risk of insulin resistance, respectively, compared with TIR > 85 %. Similarly, GRI levels of 21–30, 31–45, and 46–100 were associated with 2.553-fold, 2.597-fold, and 3.394-fold increases in insulin resistance risk compared with GRI ≤20. Despite excluding CRP, TIR and GRI differences in DKD and islet function were significant (P < 0.05). In the regression analysis of DKD and islet function, excluding the CRP, TIR and GRI groups, the differences remained statistically significant (P < 0.05).

Conclusion

TIR was identified as a protective factor for pancreatic β-cell function, while GRI was associated with an increased risk of dysfunction. Furthermore, longer disease duration, higher HbA1c, elevated BMI, high GRI, and low TIR were associated with increased insulin resistance. A higher GRI and lower TIR also contributed to an elevated risk of DKD.
目的有效控制血糖对于预防2型糖尿病(T2DM)患者并发症和改善生活质量至关重要。确定可靠的血糖指标来评估胰岛功能和肾脏并发症仍然是糖尿病学的一个主要挑战。范围时间(TIR)和血糖风险指数(GRI)是两种基于连续血糖监测(CGM)的指标,最近成为评估HbA1c以外血糖控制的潜在工具。本研究旨在评估TIR和GRI对T2DM患者胰岛功能损害和糖尿病肾病(DKD)的预测价值。方法对珠海市人民医院2021年1月至2022年12月收治的422例T2DM患者进行回顾性分析。采集连续血糖监测(CGM)数据,获得TIR和GRI。此外,获取c肽释放量、随机尿液生化分析和c反应蛋白(CRP),计算HOMA- ir、HOMA-β、ISIstumvoll指数、Stumvoll 1期和2期指数以及胰岛素抵抗。尿白蛋白/肌酐比值(UACR)被确定为DKD的诊断指标。结果stir、GRI与HOMA- ir、HOMA-β、UACR呈显著相关;然而,CRP与HOMA-IR和UACR的相关性有限。校正潜在混杂因素后,胰腺β细胞功能的比值比(or)为:TIR 0.174 (95% CI 0.051-0.592), GRI 1.010 (95% CI 1.001-1.020)。对于DKD: TIR 0.182 (95% CI 0.052-0.639), GRI 1.017 (95% CI 1.007-1.027)。与TIR水平相比,71% - 85%和41% - 70%的胰岛素抵抗风险分别增加了4.763倍和5.079倍。85%。同样,与GRI≤20相比,21-30、31-45和46-100的GRI水平与胰岛素抵抗风险增加2.553倍、2.597倍和3.394倍相关。尽管排除CRP,但TIR和GRI在DKD和胰岛功能方面的差异具有统计学意义(P <;0.05)。在DKD与胰岛功能的回归分析中,排除CRP、TIR、GRI组,差异仍有统计学意义(P <;0.05)。结论tir是胰腺β细胞功能的保护因子,而GRI与功能障碍风险增加相关。此外,病程延长、HbA1c升高、BMI升高、GRI高、TIR低与胰岛素抵抗增加相关。较高的GRI和较低的TIR也会增加DKD的风险。
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引用次数: 0
Response to letter to the editor regarding “High rate of complications in a real-world cohort of youth with T2D: A multicenter analysis” 回复编辑关于“现实世界中青少年T2D患者的高并发症发生率:一项多中心分析”的信。
IF 3.1 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-22 DOI: 10.1016/j.jdiacomp.2025.109138
Risa M. Wolf , Roomasa Channa , Amy S. Shah
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引用次数: 0
Relationship between relative fat mass and coronary artery calcification in patients with type 2 diabetes 2型糖尿病患者相对脂肪量与冠状动脉钙化的关系
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-22 DOI: 10.1016/j.jdiacomp.2025.109133
Jingjing Ye , Yu Qin , Li Zhao , Ling Yang , Guoyue Yuan , Meiqing Dai , Shaohua Wang

Aims

Relative fat mass (RFM) is a promising tool for identifying individuals with obesity-related health risks. Given the unclear correlation, we aimed to investigate the association between RFM and coronary artery calcification (CAC) in individuals with T2DM.

Methods

We included hospitalized individuals aged 20–80 years with T2DM (n = 278) in this single-center cross-sectional study. We explored the correlation between RFM and the CAC score (CACS), mechanisms underlying the association between RFM and CAC, and prediction models of coronary artery stenosis (CAS).

Results

Compared to the non-CAC group, the CAC group had a higher RFM. The CACS and RFM were positively correlated. The RFM independently increased the risk of CAC in individuals with T2DM. Using RFM to predict CAC resulted in an area under the curve of 0.598 (95 % CI [0.531–0.664], p < 0.01); RFM was not inferior to visceral fat area for predicting CAC. Insulin resistance, systolic blood pressure, and estimated glomerular filtration rate mediated the association between RFM and CAS with proportions of 9.38 %, 18.82 %, and 11.36 %, respectively.

Conclusions

RFM was associated with CAC in individuals with T2DM. Given its potential role in predicting cardiovascular complications, incorporating RFM into clinical practice may facilitate the prevention and management of cardiovascular complications in T2DM.
目的相对脂肪量(RFM)是一种很有前景的识别肥胖相关健康风险个体的工具。鉴于不明确的相关性,我们旨在研究T2DM患者RFM与冠状动脉钙化(CAC)之间的关系。方法在这项单中心横断面研究中,我们纳入了20-80岁住院的T2DM患者(n = 278)。我们探讨了RFM与CAC评分(CACS)之间的相关性,RFM与CAC之间关联的机制,以及冠状动脉狭窄(CAS)的预测模型。结果与非CAC组相比,CAC组的RFM更高。CACS与RFM呈正相关。RFM单独增加了2型糖尿病患者患CAC的风险。使用RFM预测CAC的曲线下面积为0.598 (95% CI [0.531-0.664], p <;0.01);RFM在预测CAC方面不逊于内脏脂肪面积。胰岛素抵抗、收缩压和估计的肾小球滤过率介导了RFM和CAS之间的关联,其比例分别为9.38%、18.82%和11.36%。结论srfm与T2DM患者的CAC相关。考虑到RFM在预测心血管并发症方面的潜在作用,将RFM纳入临床实践可能有助于预防和管理T2DM心血管并发症。
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引用次数: 0
What type 1 diabetes endotype is most suitable for anti-CD3 antibodies prevention trials? 哪种1型糖尿病内型最适合抗cd3抗体预防试验?
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-15 DOI: 10.1016/j.jdiacomp.2025.109132
Roma-Wilson Maria Aurora , Pozzilli Paolo
Type 1 diabetes (T1D) is a heterogeneous autoimmune disease with multiple endotypes, each demonstrating distinct clinical and immunological characteristics. Teplizumab, an anti-CD3 monoclonal antibody, has emerged as a promising immunomodulatory therapy capable of delaying the progression of T1D in individuals with stage 2 disease. However, variability in therapeutic response suggests that certain endotypes may derive greater benefit from treatment. This review evaluates the suitability of different T1D endotypes (T1DE) for teplizumab prevention trials, with a particular focus on early-onset T1DE1 and T1DE2.
Clinical trials demonstrate that individuals under 15 years of age, who demonstrate the highest immune activity, marked by aggressive T-cell infiltration and rapid pancreatic β-cell destruction, experience the most significant delay in disease progression following teplizumab treatment, highlighting the importance of early intervention. Furthermore, shifting individuals from the rapidly progressing T1DE1 trajectory to the more gradual T1DE2 course may extend functional insulin production and improve long-term metabolic outcomes.
This paper underscores the need for expanded endotype-specific prevention trials and optimised screening protocols to identify high-risk individuals at the earliest stage. Future research should explore teplizumab's efficacy in younger populations and refine predictive biomarkers to enhance personalised intervention strategies in T1D management.
1型糖尿病(T1D)是一种具有多种内型的异质自身免疫性疾病,每种内型都表现出不同的临床和免疫学特征。Teplizumab是一种抗cd3单克隆抗体,已成为一种有前景的免疫调节疗法,能够延缓2期T1D患者的进展。然而,治疗反应的可变性表明某些内型可能从治疗中获得更大的益处。本综述评估了不同T1D内型(T1DE)在teplizumab预防试验中的适用性,特别关注早发性T1DE1和T1DE2。临床试验表明,15岁以下的个体表现出最高的免疫活性,以侵略性t细胞浸润和快速胰腺β细胞破坏为特征,在接受teplizumab治疗后,疾病进展的延迟最为显著,突出了早期干预的重要性。此外,将个体从快速发展的T1DE1轨迹转变为更缓慢的T1DE2过程可能会延长功能性胰岛素的产生并改善长期代谢结果。这篇论文强调了扩大内源性特异性预防试验和优化筛选方案的必要性,以便在早期阶段识别高风险个体。未来的研究应该探索teplizumab在年轻人群中的疗效,并完善预测性生物标志物,以增强T1D管理的个性化干预策略。
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引用次数: 0
BETTER sleep: Sleep quality among adults living with type 1 diabetes in Canada 更好的睡眠:加拿大成人1型糖尿病患者的睡眠质量
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-13 DOI: 10.1016/j.jdiacomp.2025.109137
Lydi-Anne Vézina-Im , Anne-Frédérique Turcotte , Virginie Messier , Stéphane Turcotte , Ariane Brossard , Jacques Pelletier , Tara Nassar , Rémi Rabasa-Lhoret , Anne-Sophie Brazeau

Aims

Identify correlates of poor sleep quality among people living with type 1 diabetes (PwT1D).

Methods

Data were extracted from the BETTER Registry. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Sociodemographic characteristics (age, biological sex, education, income, ethnicity, body mass index); diabetes-related (diabetes duration, glucose monitoring method, treatment type, hypoglycemia awareness); psychological (fear of hypoglycemia, diabetes-related distress and stigma, depression, social support); and behavioral (snacking before bedtime, caffeine, alcohol and cannabis use, moderate-to-vigorous physical activity [MVPA]) variables were tested in multivariate logistic regression analyses for their association with poor sleep quality (PSQI >5).

Results

A total of 1322 PwT1D (mean age: 45.0 ± 15.0 years; 66.9 % female) had sleep data. The mean PSQI score was 6.0 ± 3.4 and 47.3 % had poor sleep quality. Being female (OR = 1.422; 95 % CI: 1.080–1.873), with overweight/obesity (OR = 1.376; 95 % CI: 1.067–1.775), greater fear of hypoglycemia (OR = 1.016; 95 % CI: 1.008–1.023), having moderate-to-severe depression (OR = 6.160; 95 % CI: 4.250–8.929), always snacking before bedtime (OR = 1.706; 95 % CI: 1.124–2.590), using cannabis (OR = 1.578; 95 % CI: 1.152–2.161), and accumulating <150 min/week of MVPA (OR = 1.563; 95 % CI: 1.107–2.203) were correlates of poor sleep quality.

Conclusions

Many PwT1D have poor sleep quality, and their sleep is associated with various sociodemographic, psychological, and behavioral factors.
目的探讨1型糖尿病(PwT1D)患者睡眠质量差的相关因素。方法数据从BETTER Registry中提取。使用匹兹堡睡眠质量指数(PSQI)测量睡眠质量。社会人口特征(年龄、生理性别、教育程度、收入、种族、体重指数);糖尿病相关(糖尿病病程、血糖监测方法、治疗类型、低血糖认知);心理(对低血糖的恐惧、糖尿病相关的痛苦和耻辱、抑郁、社会支持);和行为变量(睡前吃零食、咖啡因、酒精和大麻使用、中高强度体育活动[MVPA])在多变量logistic回归分析中测试了它们与睡眠质量差的关系(PSQI >5)。结果PwT1D患者共1322例,平均年龄45.0±15.0岁;66.9%女性)有睡眠数据。平均PSQI评分为6.0±3.4分,睡眠质量差的占47.3%。女性(OR = 1.422;95% CI: 1.080-1.873),超重/肥胖(OR = 1.376;95% CI: 1.067-1.775),对低血糖的更大恐惧(OR = 1.016;95% CI: 1.008-1.023),患有中度至重度抑郁症(OR = 6.160;95% CI: 4.250-8.929),总是在睡前吃零食(OR = 1.706;95% CI: 1.124-2.590),使用大麻(OR = 1.578;95% CI: 1.152-2.161),累积150分钟/周的MVPA (OR = 1.563;95% CI: 1.107-2.203)与睡眠质量差相关。结论许多PwT1D患者睡眠质量较差,其睡眠与多种社会人口学、心理和行为因素有关。
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引用次数: 0
Elevated small dense low-density lipoprotein-cholesterol as a risk factor for lower extremity arterial disease in patients with type 2 diabetes mellitus 小密度低密度脂蛋白-胆固醇升高是2型糖尿病患者下肢动脉疾病的危险因素
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-12 DOI: 10.1016/j.jdiacomp.2025.109136
Delu Zheng , Chenli Cui

Aims

Small dense low-density lipoprotein-cholesterol (sdLDL-C) is an emerging atherogenic lipid marker, but its association with lower extremity arterial disease (LEAD) in type 2 diabetes mellitus (T2DM) remains underexplored. This study aimed to evaluate whether sdLDL-C independently predicts LEAD risk in T2DM patients.

Methods

A cross-sectional study was conducted with 47 healthy controls, 66 T2DM patients, and 120 patients with both T2DM and LEAD. Biochemical markers were compared, and predictive value was assessed using a receiver operating characteristic (ROC) curve. Multivariable logistic regression analyzed the association between sdLDL-C and LEAD after adjusting for conventional risk factors.

Results

sdLDL-C levels were significantly higher in T2DM patients compared to healthy controls (1.06 [0.88–1.25] vs. 0.77 [0.43–1.04] mmol/L, P < 0.001), and even higher in those with both T2DM and LEAD (1.33 [1.17–1.56] mmol/L). sdLDL-C levels were associated with the severity of LEAD and positively correlated with fasting blood glucose, fasting C-peptide, hemoglobin A1c, total cholesterol, triglycerides, LDL-C, apolipoprotein B, and body mass index. ROC analysis yielded an area under the curve of 0.765 (95 % CI: 0.692–0.838, P < 0.0001), indicating good predictive value of sdLDL-C for LEAD in T2DM. Multivariable logistic regression identified sdLDL-C (OR = 7.881, 95%CI: 1.368–45.394, P = 0.021), fasting C-peptide, hemoglobin A1c, apolipoprotein B, diabetes duration, and sedentary lifestyle as significant risk factors for LEAD in T2DM patients.

Conclusions

Elevated sdLDL-C is independently associated with LEAD in T2DM patients and outperforms conventional LDL-C in risk stratification. sdLDL-C may serve as a valuable biomarker for early detection of LEAD in this high-risk population.
目的:小密度低密度脂蛋白-胆固醇(sdLDL-C)是一种新兴的致动脉粥样硬化脂质标志物,但其与2型糖尿病(T2DM)患者下肢动脉疾病(LEAD)的关系仍未得到充分研究。本研究旨在评估sdLDL-C是否能独立预测T2DM患者的LEAD风险。方法采用横断面研究方法,选取健康对照者47例,T2DM患者66例,T2DM合并LEAD患者120例。比较生化指标,并采用受试者工作特征(ROC)曲线评估预测价值。在调整常规危险因素后,多变量logistic回归分析了sdLDL-C与LEAD之间的关系。结果T2DM患者ldl - c水平显著高于健康对照组(1.06 [0.88-1.25]vs. 0.77 [0.43-1.04] mmol/L, P <;而T2DM和LEAD合并的患者更高(1.33 [1.17-1.56]mmol/L)。sdLDL-C水平与铅的严重程度相关,与空腹血糖、空腹c肽、血红蛋白A1c、总胆固醇、甘油三酯、LDL-C、载脂蛋白B和体重指数呈正相关。ROC分析显示曲线下面积为0.765 (95% CI: 0.692-0.838, P <;0.0001),表明sdLDL-C对T2DM患者的LEAD具有良好的预测价值。多变量logistic回归发现,sdLDL-C (OR = 7.881, 95%CI: 1.368-45.394, P = 0.021)、空腹c肽、糖化血红蛋白、载脂蛋白B、糖尿病病程和久坐生活方式是T2DM患者铅的重要危险因素。结论sdLDL-C升高与T2DM患者的LEAD独立相关,在危险分层上优于常规LDL-C。sdLDL-C可作为这一高危人群早期检测铅的有价值的生物标志物。
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引用次数: 0
The use of fenofibrate in diabetic retinopathy: Narrative review 非诺贝特在糖尿病视网膜病变中的应用:综述
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-10 DOI: 10.1016/j.jdiacomp.2025.109135
Harsha A. Dissanayake , Christine A. Kiire , David Preiss , Garry D. Tan
Diabetic retinopathy (DR) is a leading cause of blindness despite advances in treatment and there remains an unmet need for low-cost interventions to prevent and slow the progression of DR. Fenofibrate has shown promise as a useful adjunct in DR management and is licensed for use in the treatment of DR in a few countries. However, the data supporting the use of fenofibrate for the treatment of DR emerged from subsidiary analyses of the FIELD, ACCORD-LIPID and its sub-study ACCORD-EYE trials, which were primarily designed to evaluate cardiovascular outcomes. The recently concluded LENS trial, designed to evaluate the effect of fenofibrate on progression of DR, has shown clear evidence of benefit over medium-term follow-up (i.e., 4–5 years), and confirmed its safety in people with type 1 or type 2 diabetes. These benefits appear to be independent of fenofibrate's lipid lowering effects and are more likely to be mediated via its direct effects on the eye. In this narrative review on the use of fenofibrate in the treatment of DR, we summarise the possible mechanisms of action, existing evidence from randomised trials, and implications for clinical practice and research.
尽管在治疗方面取得了进展,但糖尿病视网膜病变(DR)仍是导致失明的主要原因,并且对低成本干预措施的需求仍未得到满足,以预防和减缓DR的进展。非诺贝特已显示出作为DR管理的有用辅助手段的前景,并在一些国家获准用于治疗DR。然而,支持使用非诺贝特治疗DR的数据来自FIELD、accord -脂质及其子研究ACCORD-EYE试验的辅助分析,这些试验主要用于评估心血管结局。最近结束的LENS试验旨在评估非诺贝特对DR进展的影响,在中期随访(即4-5年)中显示出明确的益处证据,并证实其对1型或2型糖尿病患者的安全性。这些益处似乎与非诺贝特的降脂作用无关,更有可能是通过其对眼睛的直接作用来调节的。在这篇关于非诺贝特治疗DR的叙述性综述中,我们总结了可能的作用机制、随机试验的现有证据以及对临床实践和研究的影响。
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引用次数: 0
Letter to the Editor “Glucagon-like Peptide-1 receptor agonists versus dipeptidyl-peptidase 4 inhibitors in advanced chronic kidney disease and end stage kidney disease: Real world effectiveness and persistence of therapy” 致编辑的信“胰高血糖素样肽-1受体激动剂与二肽基肽酶4抑制剂在晚期慢性肾病和终末期肾病中的作用:现实世界的有效性和治疗的持久性”。
IF 3.1 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-09 DOI: 10.1016/j.jdiacomp.2025.109134
Joaquín Borrás-Blasco , Alejandro Valcuende-Rosique , Silvia Cornejo-Uixeda
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引用次数: 0
期刊
Journal of diabetes and its complications
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