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Prevalence and clinical implications of diabetes mellitus in autoimmune nodopathies: A systematic review 自身免疫性结节病中糖尿病的患病率和临床影响:系统综述。
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-20 DOI: 10.1016/j.jdiacomp.2024.108883
Anastasios Tentolouris , Maria-Ioanna Stefanou , Anastasia V. Vrettou , Lina Palaiodimou , Christos Moschovos , Marianna Papadopoulou , Panagiotis Kokotis , Ioanna Eleftheriadou , Nikolaos Tentolouris , Georgios Tsivgoulis

Background and aims

Autoimmune nodopathies comprise a newly-established subtype of immune-mediated peripheral neuropathies, characterized by circulating autoantibodies that target nodal-paranodal proteins, including contactin-1 (CNTN1), contactin-associated protein-1 (Caspr1), neurofascin-155 (NF155) and neurofascin-isoforms (NF140 and NF186). Emerging evidence suggests that diabetes mellitus (DM) may confer increased risk for autoimmune nodopathies.

Methods

A systematic search was performed including studies reporting on patients harboring nodal/paranodal antibodies (CNTN1, Caspr1, NF155, NF140 and NF186). We sought to evaluate: (1) the prevalence of DM among patients with autoimmune nodopathies; (2) the phenotype of DM-patients harboring different types of nodal/paranodal antibodies; (3) clinical features that allow distinction of autoimmune nodopathies from diabetic peripheral neuropathy (DPN).

Results

Five cohort studies, 3 case-reports and one case-series study were identified comprising 114 patients with autoimmune nodopathies. DM prevalence was documented to range between 10.5 % and 60 %. DM-patients harbored mostly paranodal antibodies; CNTN1: 58.3 %, followed by pan-neurofascin: 33.3 %, and Caspr1: 25 % antibodies. No significant differences in clinical phenotype were uncovered between DM-patients and their non-DM counterparts. Overall, DM patients were refractory to intravenous-immunoglobulins (IVIG), but responded well to escalation immunotherapies. Compared to DPN, distinctive features of autoimmune nodopathy comprised: (i) severe ataxia, tremor, and cranial nerve involvement; (ii) neurophysiological findings indicative of nodal-paranodal pathology, including (reversible) conduction failure and conduction velocity slowing, often accompanied by reduced compound muscle and sensory nerve action potentials; and (iii) marked protein-elevation or albuminocytological dissociation in cerebrospinal fluid analysis.

Conclusions

DM patients fall under the typical clinical phenotype of autoimmune nodopathy, displaying predominantly paranodal antibodies. Early suspicion is crucial, as unlike DPN, diagnosis of autoimmune nodopathy unfolds therapeutic perspectives.
背景和目的:自身免疫性结节病是一种新近确立的免疫介导的周围神经病亚型,其特征是针对结节-副结节蛋白的循环自身抗体,这些蛋白包括接触素-1(CNTN1)、接触素相关蛋白-1(Caspr1)、神经筋膜蛋白-155(NF155)和神经筋膜蛋白异构体(NF140和NF186)。新的证据表明,糖尿病(DM)可能会增加自身免疫性结节病的风险:我们进行了一项系统性检索,包括对携带结节/副结节抗体(CNTN1、Caspr1、NF155、NF140 和 NF186)患者的研究报告。我们试图评估:(1) DM 在自身免疫性结节病患者中的发病率;(2) 携带不同类型结节/副结节抗体的 DM 患者的表型;(3) 可将自身免疫性结节病与糖尿病周围神经病变 (DPN) 区分开来的临床特征:结果:共发现 5 项队列研究、3 项病例报告和 1 项病例系列研究,包括 114 名自身免疫性结节病患者。据记录,糖尿病的发病率在 10.5% 到 60% 之间。DM患者主要携带副结节抗体;CNTN1抗体:58.3%,其次是泛神经鞘磷脂抗体:33.3%,Caspr1抗体:25%。DM患者与非DM患者的临床表型无明显差异。总体而言,DM患者对静脉注射免疫球蛋白(IVIG)难治,但对升级免疫疗法反应良好。与DPN相比,自身免疫性结节病的显著特点包括:(i) 严重共济失调、震颤和颅神经受累;(ii) 神经电生理结果表明结节-副结节病变,包括(可逆的)传导衰竭和传导速度减慢,通常伴有复合肌肉和感觉神经动作电位降低;(iii) 脑脊液分析中明显的蛋白升高或白蛋白细胞学分离:结论:DM 患者属于典型的自身免疫性结节病临床表型,主要表现为结节旁抗体。早期怀疑至关重要,因为与 DPN 不同,自身免疫性结节病的诊断为治疗提供了前景。
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引用次数: 0
Prognostic value of pulse wave velocity for cardiovascular disease risk stratification in diabetic patients: A systematic review and meta-analysis 脉搏波速度对糖尿病患者心血管疾病风险分层的预后价值:系统回顾和荟萃分析。
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-19 DOI: 10.1016/j.jdiacomp.2024.108894
Siao Suan Cheong , Nazirah Samah , Nur Aishah Che Roos , Azizah Ugusman , Mohd Shawal Faizal Mohamad , Boon Cong Beh , Isa Azzaki Zainal , Amilia Aminuddin

Aim

Arterial stiffness, a significant cardiovascular risk marker, is particularly important in patients with diabetes mellitus (DM). Pulse wave velocity (PWV), a non-invasive measure of arterial stiffness, has emerged as an independent predictor of cardiovascular morbidity and mortality. However, its precise prognostic value in DM patients for cardiovascular risk stratification remains unclear. To address this, a systematic review was conducted.

Method

A thorough search of Ovid and Scopus databases was performed for cohort studies on PWV measurements for cardiovascular risk stratification in DM patients. Nine studies were included, examining the relationship between PWV and cardiovascular events or composite endpoints in DM patients asymptomatic of cardiovascular diseases (CVD).

Results

The review revealed that optimal PWV cutoffs to predict composite cardiovascular events ranged from 10 to 12.16 m/s (aortic PWV) and 14 to 16.72 m/s (brachial-ankle PWV). In addition, meta-analysis yielded a HR of 1.15 (95 % CI 1.07–1.24, p < 0.001, I2 = 70 %) for aortic PWV in predicting cardiovascular events.

Conclusion

The assessment of arterial stiffness via PWV shows promise as an early diagnostic marker for CVD in DM patients, aiding in improved disease management. This underscores the potential of PWV in enhancing cardiovascular risk assessment and guiding clinical decisions in this high-risk population, without invasive procedures or radiation exposure.
目的:动脉僵化是一个重要的心血管风险指标,对糖尿病(DM)患者尤为重要。脉搏波速度(PWV)是动脉僵化的一种无创测量方法,已成为心血管发病率和死亡率的独立预测指标。然而,脉搏波速度对糖尿病患者进行心血管风险分层的确切预后价值仍不清楚。为此,我们进行了一项系统性综述:方法:对 Ovid 和 Scopus 数据库进行了全面检索,以了解有关脉搏波速度测量用于 DM 患者心血管风险分层的队列研究。共纳入了九项研究,这些研究探讨了无症状心血管疾病(CVD)的糖尿病患者的脉搏波速度与心血管事件或复合终点之间的关系:综述显示,预测复合心血管事件的最佳脉搏波速度临界值介于 10 至 12.16 m/s(主动脉脉搏波速度)和 14 至 16.72 m/s(肱踝脉搏波速度)之间。此外,荟萃分析得出主动脉脉搏波速度预测心血管事件的 HR 为 1.15(95 % CI 1.07-1.24,p 2 = 70 %):结论:通过脉搏波速度评估动脉僵化有望成为糖尿病患者心血管疾病的早期诊断指标,有助于改善疾病管理。这凸显了脉搏波速度在加强心血管风险评估和指导高危人群临床决策方面的潜力,而且无需侵入性程序或辐射暴露。
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引用次数: 0
Subcutaneous rapid-acting insulin analogues in mild to moderate diabetic ketoacidosis: A meta-analysis of randomized controlled trials 皮下速效胰岛素类似物治疗轻中度糖尿病酮症酸中毒:随机对照试验荟萃分析。
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-16 DOI: 10.1016/j.jdiacomp.2024.108882
Maria L.R. Defante , Mariana de Moura de Souza , Beatriz Ximenes Mendes , Beatriz A. de A. De Hollanda Morais , Vitória M. Prizão , Salma Ali El Chab Parolin , Hugo Valinho Francisco

Introduction

Diabetic Ketoacidosis (DKA) is commonly treated with intravenous (IV) regular insulin. However, patients with less severe DKA may benefit from a subcutaneous (SC) scheme.

Methods

We systematically searched PubMed, Cochrane, and Embase for randomized controlled trials (RCTs) comparing SC rapid-acting insulin analogue (RAIAs) with IV regular insulin. Risk ratios (RR) were used to compare treatment effects for binary outcomes and mean differences (MD) for continuous data with the corresponding 95 % confidence intervals (CI). P values <0.05 were considered statistically significant. We used the R version 4.3.2 for statistical analyses.

Results

Our meta-analysis included eight RCTs encompassing 415 patients. No statistically significant differences were found between RAIAs and IV regular insulin in the treatment of mild to moderate DKA in the pediatric and adult population in the primary outcome of time until DKA resolution (MD 0.00 h; 95 % CI -1.27 to 1.28; P = 1.00). Both treatments showed comparable results in the secondary outcomes total insulin usage (P = 0.65), time until hyperglycemia resolution (P = 0.22), length of hospital stay (P = 0.11), the incidence of hypoglycemia (P = 0.15) and DKA recurrence (P = Not estimable). There were no reports of death, cerebral edema, or venous thrombosis in the studies.

Conclusion

In this meta-analysis of eight RCTs we found that SC RAIAs and regular IV insulin are comparable in resolving mild to moderate DKA in children and adults. PROSPERO registration: CRD42023485032.
简介:糖尿病酮症酸中毒(DKA)通常采用静脉注射(IV)常规胰岛素治疗。然而,病情较轻的 DKA 患者可能会从皮下注射 (SC) 方案中获益:我们系统地检索了 PubMed、Cochrane 和 Embase 中比较皮下注射速效胰岛素类似物 (RAIA) 与静脉注射普通胰岛素的随机对照试验 (RCT)。对二元结果采用风险比(RR)比较治疗效果,对连续数据采用平均差(MD)和相应的95%置信区间(CI)。P 值 结果:我们的荟萃分析包括 8 项 RCT,涉及 415 名患者。在治疗轻中度 DKA 的主要结果(DKA 缓解时间)方面,RAIAs 与静脉注射普通胰岛素在儿童和成人中的差异无统计学意义(MD 0.00 h; 95 % CI -1.27 to 1.28; P = 1.00)。在次要结果中,两种疗法在胰岛素总用量(P = 0.65)、高血糖缓解时间(P = 0.22)、住院时间(P = 0.11)、低血糖发生率(P = 0.15)和 DKA 复发率(P = 无法估计)方面的结果相当。研究中没有死亡、脑水肿或静脉血栓的报道:在这项对 8 项研究进行的荟萃分析中,我们发现 SC RAIAs 和普通静脉注射胰岛素在缓解儿童和成人轻度至中度 DKA 方面效果相当。PROSPERO 注册:CRD42023485032。
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引用次数: 0
Individual and joint effects of diabetes and depression on incident cardiovascular diseases and all-cause mortality: Results from a population-based cohort study 糖尿病和抑郁症对心血管疾病和全因死亡率的个体和联合影响:基于人群的队列研究结果
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-12 DOI: 10.1016/j.jdiacomp.2024.108878
Qiang Tu , Karice Hyun , Shuanglan Lin , Nashid Hafiz , Deborah Manandi , Qian Zhang , Xinzheng Wang , Na Zhang , Haisheng Wu , Julie Redfern

Aims

To assess the individual and joint effects of diabetes and depression on all-cause mortality and cardiovascular disease (CVD) in the middle-aged and elderly Chinese populations.

Methods

9105 individuals without CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included and followed up for 9 years. Participants were divided into four comparative groups: diabetes alone, depression alone, both conditions, and neither condition. Multivariate binary logistic regression models were performed to compare the risks of all-cause mortality and CVD among the four groups.

Results

When compared to those without diabetes and depression, the multivariate adjusted odds ratios (aORs) for CVD in individuals who had diabetes only, depression only, and both diabetes and depression were 1.245 (95 % CI 1.023 to 1.515), 1.318 (95 % CI 1.171 to 1.485) and 1.722 (95 % CI 1.361 to 2.178), respectively. The aORs for all-cause mortality were 1.366 (95 % CI 1.035–1.804) for diabetes alone, 1.082 (95 % CI 0.916–1.279) for depression alone, and 1.590 (95 % CI 1.152–2.195) for both conditions when compared with those with neither condition.

Conclusions

Individuals with both diabetes and depression had greater risk of CVD and all-cause mortality when compared to those with diabetes or depression alone, or those without either condition.
目的 评估糖尿病和抑郁症对中国中老年人群全因死亡率和心血管疾病(CVD)的个体和联合影响。参与者被分为四个比较组:单纯糖尿病组、单纯抑郁症组、两种情况都有组和两种情况都没有组。研究人员采用多变量二元逻辑回归模型比较了四个组别的全因死亡率和心血管疾病风险。结果与未患有糖尿病和抑郁症的患者相比,仅患有糖尿病、仅患有抑郁症以及同时患有糖尿病和抑郁症的患者心血管疾病的多变量调整几率比(aORs)分别为 1.245(95 % CI 1.023 至 1.515)、1.318(95 % CI 1.171 至 1.485)和 1.722(95 % CI 1.361 至 2.178)。与同时患有糖尿病和抑郁症的人相比,同时患有糖尿病和抑郁症的人患心血管疾病和全因死亡的风险更大。
{"title":"Individual and joint effects of diabetes and depression on incident cardiovascular diseases and all-cause mortality: Results from a population-based cohort study","authors":"Qiang Tu ,&nbsp;Karice Hyun ,&nbsp;Shuanglan Lin ,&nbsp;Nashid Hafiz ,&nbsp;Deborah Manandi ,&nbsp;Qian Zhang ,&nbsp;Xinzheng Wang ,&nbsp;Na Zhang ,&nbsp;Haisheng Wu ,&nbsp;Julie Redfern","doi":"10.1016/j.jdiacomp.2024.108878","DOIUrl":"10.1016/j.jdiacomp.2024.108878","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the individual and joint effects of diabetes and depression on all-cause mortality and cardiovascular disease (CVD) in the middle-aged and elderly Chinese populations.</div></div><div><h3>Methods</h3><div>9105 individuals without CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included and followed up for 9 years. Participants were divided into four comparative groups: diabetes alone, depression alone, both conditions, and neither condition. Multivariate binary logistic regression models were performed to compare the risks of all-cause mortality and CVD among the four groups.</div></div><div><h3>Results</h3><div>When compared to those without diabetes and depression, the multivariate adjusted odds ratios (aORs) for CVD in individuals who had diabetes only, depression only, and both diabetes and depression were 1.245 (95 % CI 1.023 to 1.515), 1.318 (95 % CI 1.171 to 1.485) and 1.722 (95 % CI 1.361 to 2.178), respectively. The aORs for all-cause mortality were 1.366 (95 % CI 1.035–1.804) for diabetes alone, 1.082 (95 % CI 0.916–1.279) for depression alone, and 1.590 (95 % CI 1.152–2.195) for both conditions when compared with those with neither condition.</div></div><div><h3>Conclusions</h3><div>Individuals with both diabetes and depression had greater risk of CVD and all-cause mortality when compared to those with diabetes or depression alone, or those without either condition.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 11","pages":"Article 108878"},"PeriodicalIF":2.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
All-cause mortality and factors associated with it in Finnish patients with type 1 diabetes 芬兰 1 型糖尿病患者的全因死亡率及其相关因素。
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-12 DOI: 10.1016/j.jdiacomp.2024.108881
Elena Putula , Tuuli Kauppala , Sini Vanhamäki , Jaason Haapakoski , Tiina Laatikainen , Saara Metso

Aims

To assess the effect of comorbidities, risk classification for chronic kidney disease (CKD) according to albuminuria and eGFR, HbA1c and LDL-cholesterol levels on all-cause mortality in patients with type 1 diabetes (DM1).

Methods

The study included all 45,801 DM1 patients from the Finnish Diabetes Registry during 2018–2022. Mortality of patients with DM1 was compared with mortality in non-diabetic population in Finland by estimating standardized mortality rates (SMRs). Poisson regression model was used to estimate the effect of risk factors on the SMR.

Results

A total of 2469 patients died during follow-up. SMR for the total cohort was 1.84 (95 % CI 1.77–1.92) peaking at the age of 30–49 years. The coverage of HbA1c values was 98 %, that of LDL-cholesterol 94 %, and U-ACR and eGFR 80 %. In a multivariate analysis, assessing the effect on mortality, the rate ratio for end-stage renal disease was 2.66, cardiovascular diseases 1.92, mental and behavioural disorders 1.64, foot complications 1.51, high or very high risk for CKD 3.64, LDL-cholesterol ≥2.6 mmol/l 1.33, and HbA1c ≥8 % (64 mmol/mol) 1.27.

Conclusions

There's substantial excess mortality due to DM1 in Finland. Interventions should focus on addressing both renal and cardiovascular risk factors but also pay more attention to mental health.
目的:评估合并症、根据白蛋白尿和 eGFR 进行的慢性肾脏病(CKD)风险分类、HbA1c 和低密度脂蛋白胆固醇水平对 1 型糖尿病(DM1)患者全因死亡率的影响:研究纳入了2018-2022年间芬兰糖尿病登记处的所有45801名DM1患者。通过估算标准化死亡率(SMR),将DM1患者的死亡率与芬兰非糖尿病人群的死亡率进行比较。采用泊松回归模型估算风险因素对标准化死亡率的影响:结果:共有 2469 名患者在随访期间死亡。整个队列的标准化死亡率为 1.84 (95 % CI 1.77-1.92),在 30-49 岁年龄段达到高峰。HbA1c 值的覆盖率为 98%,低密度脂蛋白胆固醇的覆盖率为 94%,U-ACR 和 eGFR 的覆盖率为 80%。在评估对死亡率影响的多变量分析中,终末期肾病的比率为 2.66,心血管疾病为 1.92,精神和行为障碍为 1.64,足部并发症为 1.51,慢性肾脏病高风险或极高风险为 3.64,低密度脂蛋白胆固醇≥2.6 mmol/l 为 1.33,HbA1c ≥8 %(64 mmol/mol)为 1.27:在芬兰,DM1导致的死亡率过高。干预措施应侧重于解决肾脏和心血管风险因素,同时也要更加关注心理健康。
{"title":"All-cause mortality and factors associated with it in Finnish patients with type 1 diabetes","authors":"Elena Putula ,&nbsp;Tuuli Kauppala ,&nbsp;Sini Vanhamäki ,&nbsp;Jaason Haapakoski ,&nbsp;Tiina Laatikainen ,&nbsp;Saara Metso","doi":"10.1016/j.jdiacomp.2024.108881","DOIUrl":"10.1016/j.jdiacomp.2024.108881","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the effect of comorbidities, risk classification for chronic kidney disease (CKD) according to albuminuria and eGFR, HbA1c and LDL-cholesterol levels on all-cause mortality in patients with type 1 diabetes (DM1).</div></div><div><h3>Methods</h3><div>The study included all 45,801 DM1 patients from the Finnish Diabetes Registry during 2018–2022. Mortality of patients with DM1 was compared with mortality in non-diabetic population in Finland by estimating standardized mortality rates (SMRs). Poisson regression model was used to estimate the effect of risk factors on the SMR.</div></div><div><h3>Results</h3><div>A total of 2469 patients died during follow-up. SMR for the total cohort was 1.84 (95 % CI 1.77–1.92) peaking at the age of 30–49 years. The coverage of HbA1c values was 98 %, that of LDL-cholesterol 94 %, and U-ACR and eGFR 80 %. In a multivariate analysis, assessing the effect on mortality, the rate ratio for end-stage renal disease was 2.66, cardiovascular diseases 1.92, mental and behavioural disorders 1.64, foot complications 1.51, high or very high risk for CKD 3.64, LDL-cholesterol ≥2.6 mmol/l 1.33, and HbA1c ≥8 % (64 mmol/mol) 1.27.</div></div><div><h3>Conclusions</h3><div>There's substantial excess mortality due to DM1 in Finland. Interventions should focus on addressing both renal and cardiovascular risk factors but also pay more attention to mental health.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108881"},"PeriodicalIF":2.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing the relationship between social determinants of health and risk of albuminuria among children with type 1 diabetes 描述 1 型糖尿病患儿健康的社会决定因素与白蛋白尿风险之间的关系
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1016/j.jdiacomp.2024.108880
Jia Xin Huang , T. Charles Casper , Casey Pitts , Sage R. Myers , Rebecca Lynch , Lindsey Loomba , Janani Ramesh , Nathan Kuppermann , Elaine Ku , Nicole Glaser
In a cohort of 2303 children with type 1 diabetes (T1D), we found that non-English speaking status (HR 2.82, 95% CI 1.54–5.18) and public insurance (HR 1.48, 95% CI 1.07–2.05) were associated with an increased risk of incident albuminuria, after adjusting for T1D-related variables (age, hemoglobin A1c, diabetic ketoacidosis episodes with acute kidney injury).
在一个由2303名1型糖尿病(T1D)儿童组成的队列中,我们发现,在调整了T1D相关变量(年龄、血红蛋白A1c、糖尿病酮症酸中毒发作和急性肾损伤)后,非英语状态(HR 2.82,95% CI 1.54-5.18)和公共保险(HR 1.48,95% CI 1.07-2.05)与发生白蛋白尿的风险增加有关。
{"title":"Characterizing the relationship between social determinants of health and risk of albuminuria among children with type 1 diabetes","authors":"Jia Xin Huang ,&nbsp;T. Charles Casper ,&nbsp;Casey Pitts ,&nbsp;Sage R. Myers ,&nbsp;Rebecca Lynch ,&nbsp;Lindsey Loomba ,&nbsp;Janani Ramesh ,&nbsp;Nathan Kuppermann ,&nbsp;Elaine Ku ,&nbsp;Nicole Glaser","doi":"10.1016/j.jdiacomp.2024.108880","DOIUrl":"10.1016/j.jdiacomp.2024.108880","url":null,"abstract":"<div><div>In a cohort of 2303 children with type 1 diabetes (T1D), we found that non-English speaking status (HR 2.82, 95% CI 1.54–5.18) and public insurance (HR 1.48, 95% CI 1.07–2.05) were associated with an increased risk of incident albuminuria, after adjusting for T1D-related variables (age, hemoglobin A1c, diabetic ketoacidosis episodes with acute kidney injury).</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108880"},"PeriodicalIF":2.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Endothelial dysfunction markers syndecan-1 and thrombomodulin are associated with higher albuminuria levels in type 2 diabetes with no history of clinical cardiovascular disease 内皮功能障碍标志物辛迪加-1 和血栓调节蛋白与无临床心血管疾病史的 2 型糖尿病患者较高的白蛋白尿水平有关
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1016/j.jdiacomp.2024.108879
Luis F. Ferreira-Divino , Christina G. Poulsen , Viktor Rotbain Curovic , Oliver B. Pedersen , Nete Tofte , Marie Frimodt-Møller , Tine W. Hansen , Anne-Mette Hvas , Peter Rossing

Introduction

Individuals with type 2 diabetes and increased albuminuria, a well-established marker of microvascular complications, are at a higher risk for cardiovascular disease (CVD) and premature mortality. Therefore, a better understanding of the underlying pathophysiology is needed to improve risk stratification and tailor prevention and intervention.

Methods

We conducted a cross-sectional study including 463 individuals with type 2 diabetes, various degrees of albuminuria and without CVD. We analysed the association between albuminuria and markers of endothelial function (thrombomodulin and syndecan-1), thrombin generation (thrombin-antithrombin complex, prothrombin fragment 1 + 2), fibrinogen, platelet function (activation using soluble plasma selectin and aggregation using Multiplate® Analyzer) using regression models.

Results

In the study cohort 33 % were women, the mean ± SD age was 65 ± 9 years, and median [IQR] diabetes duration was 15 [9–20] years. In total, 344 (74 %) individuals had normal albuminuria, 87 (19 %) moderately- and 32 (7 %) severely increased albuminuria levels. Higher markers of endothelial function and fibrinogen were independently associated with higher albuminuria levels (p < 0.01). No association between albuminuria and markers of thrombin generation and platelet was demonstrated.

Conclusion

We demonstrated an independent association between albuminuria and markers of endothelial function and fibrinogen in individuals with type 2 diabetes and no history of CVD.
导言:白蛋白尿是微血管并发症的公认标志,2 型糖尿病患者白蛋白尿增加,患心血管疾病(CVD)和过早死亡的风险更高。因此,需要更好地了解其潜在的病理生理学,以改善风险分层,并进行有针对性的预防和干预。我们使用回归模型分析了白蛋白尿与内皮功能(血栓调节蛋白和辛迪加-1)、凝血酶生成(凝血酶-抗凝血酶复合物、凝血酶原片段 1 + 2)、纤维蛋白原、血小板功能(使用可溶性血浆选择素激活和使用 Multiplate® 分析仪分析聚集)等指标之间的关系。结果 在研究队列中,33%为女性,平均(±SD)年龄为65±9岁,糖尿病病程中位数[IQR]为15[9-20]年。共有 344 人(74%)的白蛋白尿水平正常,87 人(19%)的白蛋白尿水平中度升高,32 人(7%)的白蛋白尿水平严重升高。较高的内皮功能指标和纤维蛋白原与较高的白蛋白尿水平独立相关(p < 0.01)。结论我们发现,在没有心血管疾病史的 2 型糖尿病患者中,白蛋白尿与内皮功能和纤维蛋白原指标之间存在独立关联。
{"title":"Endothelial dysfunction markers syndecan-1 and thrombomodulin are associated with higher albuminuria levels in type 2 diabetes with no history of clinical cardiovascular disease","authors":"Luis F. Ferreira-Divino ,&nbsp;Christina G. Poulsen ,&nbsp;Viktor Rotbain Curovic ,&nbsp;Oliver B. Pedersen ,&nbsp;Nete Tofte ,&nbsp;Marie Frimodt-Møller ,&nbsp;Tine W. Hansen ,&nbsp;Anne-Mette Hvas ,&nbsp;Peter Rossing","doi":"10.1016/j.jdiacomp.2024.108879","DOIUrl":"10.1016/j.jdiacomp.2024.108879","url":null,"abstract":"<div><h3>Introduction</h3><div>Individuals with type 2 diabetes and increased albuminuria, a well-established marker of microvascular complications, are at a higher risk for cardiovascular disease (CVD) and premature mortality. Therefore, a better understanding of the underlying pathophysiology is needed to improve risk stratification and tailor prevention and intervention.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study including 463 individuals with type 2 diabetes, various degrees of albuminuria and without CVD. We analysed the association between albuminuria and markers of endothelial function (thrombomodulin and syndecan-1), thrombin generation (thrombin-antithrombin complex, prothrombin fragment 1 + 2), fibrinogen, platelet function (activation using soluble plasma selectin and aggregation using Multiplate® Analyzer) using regression models.</div></div><div><h3>Results</h3><div>In the study cohort 33 % were women, the mean ± SD age was 65 ± 9 years, and median [IQR] diabetes duration was 15 [9–20] years. In total, 344 (74 %) individuals had normal albuminuria, 87 (19 %) moderately- and 32 (7 %) severely increased albuminuria levels. Higher markers of endothelial function and fibrinogen were independently associated with higher albuminuria levels (<em>p</em> &lt; 0.01). No association between albuminuria and markers of thrombin generation and platelet was demonstrated.</div></div><div><h3>Conclusion</h3><div>We demonstrated an independent association between albuminuria and markers of endothelial function and fibrinogen in individuals with type 2 diabetes and no history of CVD.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 11","pages":"Article 108879"},"PeriodicalIF":2.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 importance of arterial stiffness in pediatric patients with type 1 diabetes mellitus: What's new? 1 型糖尿病儿童患者动脉僵化的重要性:有什么新发现?
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.jdiacomp.2024.108877
Evangelos C. Rizos , Evangelia E. Ntzani , Imran Rashid Rangraze , Mohamed El-Tanani , Manfredi Rizzo
Youths with type 1 diabetes (T1D) exhibits higher levels of pulse wave velocity (PWV) compared to healthy controls. Higher PWV in T1D subjects is associated with increased hazard of progression in albuminuria, decline in eGFR, cardiovascular (CV) events and mortality. In the recently published work by Georeli et al., increased PWV was associated with poor glycemic control as expressed by time-in-range (TIR) < 50 % in T1D children, adolescents and young adults. This finding is of great interest, since it is well known that glycemic control, as measured by TIR, is an important contributor of CV risk. The duration of TIR < 50 % is not reported by the authors, but is of importance, knowing that CGM provide data for the last 3–6 months, depending on the CGM model. In conclusion, PWV looks promising for risk stratification in T1D, but its exact role in T1D still remains to be fully explored.
与健康对照组相比,1 型糖尿病(T1D)患者的脉搏波速度(PWV)更高。T1D 患者的脉搏波速度越高,白蛋白尿、电子胃泌素抵抗率下降、心血管(CV)事件和死亡率的风险就越高。在 Georeli 等人最近发表的研究中,脉搏波速度增加与血糖控制不佳有关,表现为时间-范围(TIR)
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引用次数: 0
Lower extremity amputation rates in patients with chronic kidney disease: A database study comparing patients with and without diabetes mellitus 慢性肾病患者的下肢截肢率:一项比较有糖尿病和无糖尿病患者的数据库研究。
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-28 DOI: 10.1016/j.jdiacomp.2024.108876
Dhruv Nandakumar , Matthew J. Johnson , Lawrence A. Lavery , Benjamin M. Conover , Katherine M. Raspovic , David H. Truong , Dane K. Wukich
Lower extremity amputation (LEA) is one of the most feared consequences of diabetes mellitus (DM). The purpose of this study was to evaluate the impact of DM on LEA rates in patients at various stages of chronic kidney disease (CKD).
A commercially available de-identified database was searched for patients undergoing LEA and for CKD patients, from 2010 to 2023. Patients with DM and patients without DM who were followed for at least 5 years were included. LEA rates were then compared for patients at all 5 CKD stages in patients with and without diabetes.
Rates of all LEA were found to be significantly higher at all CKD stages for patients with diabetes (overall, minor and major LEA). Compared to patients without DM who have CKD stage 5 (end stage renal disease), patients with DM and CKD stage 5 have a 30 fold increased likelihood of undergoing overall LEA [OR 30.2 (24.48–37.19), p < 0.001], 29 fold increased likelihood of undergoing minor LEA [28.9i (22.91–36.35), p < 0.001] and 40 times fold increased likelihood of undergoing major LEA [40.1 (26.59–60.42), p < 0.001]. For all stages of CKD, independent of diabetes status, minor LEA were performed with greater frequency than major LEA. In patients with DM, LEA rates significantly increased with CKD progression between stages 2–5 with a substantial jump between stages 4 and 5 [OR 2.6 (CI 2.49–2.74), p < 0.001]. However, CKD progression between stages 1 and 2 was not significantly associated with increased LEA rates (OR 1.1 (CI 0.92–1.21), p = 0.24) in patients with diabetes.
Patients with comorbid diabetes have elevated risk for LEA at all stages of CKD compared to those without diabetes.
下肢截肢(LEA)是糖尿病(DM)最令人担忧的后果之一。本研究旨在评估糖尿病对处于不同阶段的慢性肾脏病(CKD)患者下肢截肢率的影响。研究人员在一个商业化的去身份化数据库中搜索了 2010 年至 2023 年接受 LEA 的患者和 CKD 患者。其中包括随访至少 5 年的 DM 患者和非 DM 患者。然后比较了CKD所有5个分期中糖尿病患者和非糖尿病患者的LEA率。结果发现,糖尿病患者在所有 CKD 阶段的所有 LEA 率(总体、轻微和严重 LEA)都明显较高。与未患有糖尿病且处于 CKD 第 5 阶段(终末期肾病)的患者相比,患有糖尿病且处于 CKD 第 5 阶段的患者接受总体 LEA 的可能性增加了 30 倍[OR 30.2 (24.48-37.19),p
{"title":"Lower extremity amputation rates in patients with chronic kidney disease: A database study comparing patients with and without diabetes mellitus","authors":"Dhruv Nandakumar ,&nbsp;Matthew J. Johnson ,&nbsp;Lawrence A. Lavery ,&nbsp;Benjamin M. Conover ,&nbsp;Katherine M. Raspovic ,&nbsp;David H. Truong ,&nbsp;Dane K. Wukich","doi":"10.1016/j.jdiacomp.2024.108876","DOIUrl":"10.1016/j.jdiacomp.2024.108876","url":null,"abstract":"<div><div>Lower extremity amputation (LEA) is one of the most feared consequences of diabetes mellitus (DM). The purpose of this study was to evaluate the impact of DM on LEA rates in patients at various stages of chronic kidney disease (CKD).</div><div>A commercially available de-identified database was searched for patients undergoing LEA and for CKD patients, from 2010 to 2023. Patients with DM and patients without DM who were followed for at least 5 years were included. LEA rates were then compared for patients at all 5 CKD stages in patients with and without diabetes.</div><div>Rates of all LEA were found to be significantly higher at all CKD stages for patients with diabetes (overall, minor and major LEA). Compared to patients without DM who have CKD stage 5 (end stage renal disease), patients with DM and CKD stage 5 have a 30 fold increased likelihood of undergoing overall LEA [OR 30.2 (24.48–37.19), <em>p</em> &lt; 0.001], 29 fold increased likelihood of undergoing minor LEA [28.9i (22.91–36.35), <em>p</em> &lt; 0.001] and 40 times fold increased likelihood of undergoing major LEA [40.1 (26.59–60.42), p &lt; 0.001]. For all stages of CKD, independent of diabetes status, minor LEA were performed with greater frequency than major LEA. In patients with DM, LEA rates significantly increased with CKD progression between stages 2–5 with a substantial jump between stages 4 and 5 [OR 2.6 (CI 2.49–2.74), <em>p</em> &lt; 0.001]. However, CKD progression between stages 1 and 2 was not significantly associated with increased LEA rates (OR 1.1 (CI 0.92–1.21), <em>p</em> = 0.24) in patients with diabetes.</div><div>Patients with comorbid diabetes have elevated risk for LEA at all stages of CKD compared to those without diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 11","pages":"Article 108876"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Monitoring the liver as a part of the cardio-renal-metabolic continuum – What is cooking and burning with non-invasive tests and treatment options? 监测肝脏是心-肾-代谢连续体的一部分--无创检测和治疗方案的烹饪和燃烧是什么?
IF 2.9 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-24 DOI: 10.1016/j.jdiacomp.2024.108875
Špela Volčanšek , Andrej Janež , Manfredi Rizzo , Emir Muzurović
{"title":"Monitoring the liver as a part of the cardio-renal-metabolic continuum – What is cooking and burning with non-invasive tests and treatment options?","authors":"Špela Volčanšek ,&nbsp;Andrej Janež ,&nbsp;Manfredi Rizzo ,&nbsp;Emir Muzurović","doi":"10.1016/j.jdiacomp.2024.108875","DOIUrl":"10.1016/j.jdiacomp.2024.108875","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108875"},"PeriodicalIF":2.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
期刊
Journal of diabetes and its complications
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