Journal of diabetes and its complications最新文献_第5页

Levels of diabetes distress and its sources among older adults with type 1 diabetes and relationships to diabetes duration 老年1型糖尿病患者糖尿病痛苦水平及其来源及其与糖尿病病程的关系

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-17 DOI: 10.1016/j.jdiacomp.2025.109198

Adriana Wisniewski , Justin DeMonte , Angelica Cristello Sarteau , Angela Fruik , Ruth S. Weinstock , Anna R. Kahkoska

Objective

Characterize diabetes distress (DD) in older adults with type 1 diabetes (T1D) and explore associations with individual-level characteristics.

Research design & methods

Adults ≥65 years with T1D (n = 337; mean 70.7 years) were recruited from the T1D Exchange (08/27/2024–11/05/2024) to complete an electronic survey, including the Type 1 Diabetes Distress Assessment System. Univariable linear regressions were used to assess cross-sectional associations between DD and self-reported sociodemographic, clinical, and diabetes-related variables. Select variables were explored further using bar graphs of DD core and source scores.

Results

The median (IQR) DD core score was 1.75 (1.375–2.5), and 36.5 % of respondents had a clinically significant DD core score. DD was positively associated with being female (β = 0.37; 95 % CI: 0.20–0.55), higher HbA1c (β = 0.32; 95 % CI: 0.21–0.43), and an emergency room (ER) visit in the past year (β = 0.33; 95 % CI: 0.12–0.53). DD was negatively associated with longer T1D duration (β = −0.01; 95 % CI: −0.02 to −0.01). The most prominent sources of DD were financial, management, and complication worries, and the least prominent were interpersonal, shame, and resources.

Conclusions

In addition to known correlates of DD among individuals with T1D (e.g., HbA1c), this study revealed novel correlates of DD among older adults, including older age at diagnosis, at least one ER visit within the last 12 months, and shorter T1D duration. Limitations include self-reported variables, the cross-sectional nature, and a relatively homogeneous sample by race, high prevalence of technology use, and HbA1c levels largely at goal.

目的：描述老年1型糖尿病（T1D）患者的糖尿病窘迫（DD）特征，并探讨其与个体水平特征的关系。研究设计与方法：从T1D交流中心（2024年8月27日- 2024年11月5日）招募≥65岁T1D成人（n = 337，平均70.7岁）完成一项电子调查，包括1型糖尿病困扰评估系统。单变量线性回归用于评估DD与自我报告的社会人口学、临床和糖尿病相关变量之间的横断面关联。使用DD核心和源分数的柱状图进一步探索选择变量。结果：中位（IQR） DD核心评分为1.75(1.375-2.5)，36.5%的应答者具有临床显著的DD核心评分。DD与女性（β = 0.37; 95% CI: 0.20-0.55）、较高的HbA1c （β = 0.32; 95% CI: 0.21-0.43）和过去一年的急诊室就诊（β = 0.33; 95% CI: 0.12-0.53）呈正相关。DD与T1D持续时间较长呈负相关（β = -0.01; 95% CI: -0.02 ~ -0.01）。最突出的DD来源是财务、管理和并发症担忧，最不突出的是人际关系、羞耻感和资源。结论：除了已知的T1D患者DD的相关因素（如HbA1c）外，本研究还揭示了老年人DD的新相关因素，包括诊断年龄较大，过去12个月内至少有一次急诊室就诊，以及T1D持续时间较短。局限性包括自我报告变量、横断面性质、种族相对均匀的样本、技术使用的高流行率以及HbA1c水平基本达到目标。

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引用次数: 0

Gender differences in the distribution of IDL, LDL, and HDL lipoprotein subfractions in MODY compared to type 2 diabetes: Data from the MODY-Ist study 与2型糖尿病相比，MODY中IDL、LDL和HDL脂蛋白亚组分分布的性别差异：来自MODY- ist研究的数据

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-15 DOI: 10.1016/j.jdiacomp.2025.109196

Hulya Yilmaz Aydogan , Deniz Kanca Demirci , Nurdan Gul , Fatih Yanar , Sukran Poyrazoglu , Seda Gulec Yilmaz , Mete Bora Tuzuner , Turgay Isbir , Oguz Ozturk , Ilhan Satman

Background

The distribution of intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions specific to diabetes types and changes under dyslipidemia conditions have been well characterised. Research into the distribution of lipoprotein subfractions in Maturity-Onset Diabetes of the Young (MODY) has hitherto been confined to certain subtypes, with gender-based differences remaining to be elucidated. The objective of this study was to comparatively evaluate the distribution of lipoprotein subfractions according to gender in MODY, T2DM patients, and control groups.

Methods

Lipoprotein subfractions in 119 serum samples of the study groups were analyzed using the Lipoprint-System.

Results

The midbands of IDL (MID-A to C) in female MODY cases, and the HDL-small fraction in male MODY cases, were found to be lower compared to female and male T2DM cases, respectively. In the T2DM group, age was positively correlated with MID-C and MID-B in both genders, while it was negatively correlated with MID-A in female cases. ROC analysis demonstrated that the decrease in the MID-C fraction in female MODY subjects (AUC:0.809, p = 0.0001) and the decrease in the HDL-small fraction in male MODY subjects (AUC:0.818, p = 0.002) were significantly associated with the likelihood of MODY.

Conclusion

Given that a considerable proportion of MODY patients are frequently misdiagnosed as T2DM, low levels of MID-C and HDL-small fractions, both of which are triglyceride-rich, may have potential as a diagnostic value for female and male MODY patients, respectively.

背景：中密度脂蛋白（IDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚组分的分布已经很好地表征了糖尿病类型和血脂异常条件下的变化。迄今为止，对成熟型糖尿病（MODY）中脂蛋白亚组分分布的研究仅限于某些亚型，性别差异仍有待阐明。本研究的目的是比较评价MODY、T2DM和对照组中不同性别的脂蛋白亚组分分布。方法采用脂印系统对119份研究组血清中的脂蛋白亚组分进行分析。结果女性MODY患者的IDL中带（MID-A ~ C）和男性MODY患者的HDL-small比例分别低于女性和男性T2DM患者。在T2DM组中，年龄与男女MID-C、MID-B呈正相关，与女性MID-A呈负相关。ROC分析显示，女性MODY受试者中MID-C分数的降低（AUC:0.809, p = 0.0001）和男性MODY受试者中hdl -小分数的降低（AUC:0.818, p = 0.002）与MODY发生的可能性显著相关。鉴于相当比例的MODY患者经常被误诊为T2DM，低水平的中c和高密度脂蛋白小分数（两者都富含甘油三酯）可能分别对女性和男性MODY患者具有潜在的诊断价值。

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引用次数: 0

Criteria of frail older people with type 2 diabetes who are suitable for SGLT-2 inhibitors and GLP-1RA therapy 适合SGLT-2抑制剂和GLP-1RA治疗的虚弱老年2型糖尿病患者的标准

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-15 DOI: 10.1016/j.jdiacomp.2025.109193

A.H. Abdelhafiz , I. Siqueira , A.J. Sinclair

Frailty is a metabolically heterogeneous condition and therefore, frail older people with diabetes are metabolically diverse. Diversity is caused by the varying degrees of insulin resistance, determined by the variability in muscle mass/visceral fat ratio and the overall body weight. This creates a frailty spectrum with sarcopenic/obese at one end to malnourished anorexic individuals at the other end. The sarcopenic obese are likely to have increased insulin resistance and progression of the metabolic syndrome. On the other hand, the anorexic malnourished are likely to have decreased insulin resistance due to significant weight loss and regression of the metabolic syndrome. The current evidence showed benefits of SGLT-2 inhibitors and GLP-1RA in frail older people with diabetes, and these benefits increased with increasing frailty. However, the majority of the population who benefited from this therapy were either overweight or obese. There is no evidence of benefits of such therapy in the anorexic malnourished end of the frailty spectrum such as people residents in care homes who were likely excluded from clinical trials. As the sarcopenic obese frail individuals are likely to have high burden of atherosclerotic vascular disease, we suggest that triple therapy of metformin, SGLT-2 inhibitors and GLP-1RA to be initiated as first line therapy in this group of patients if tolerated. On the other hand, this therapy is better avoided in the malnourished frail individuals due to significant weight loss, high risk of adverse events and, due to regression of the metabolic syndrome, the cardiovascular benefits are uncertain.

虚弱是一种代谢异质性状况，因此，体弱的老年糖尿病患者的代谢是多种多样的。多样性是由不同程度的胰岛素抵抗引起的，由肌肉质量/内脏脂肪比和整体体重的可变性决定。这就形成了一个脆弱的谱系，一端是肌肉减少/肥胖，另一端是营养不良的厌食症患者。肌肉减少型肥胖患者可能有胰岛素抵抗增加和代谢综合征的进展。另一方面，厌食性营养不良患者可能由于体重明显减轻和代谢综合征的消退而降低胰岛素抵抗。目前的证据表明，SGLT-2抑制剂和GLP-1RA对体弱的老年糖尿病患者有益，并且这些益处随着体弱程度的增加而增加。然而，从这种疗法中受益的大多数人要么超重，要么肥胖。目前还没有证据表明这种疗法对身体虚弱的厌食症营养不良患者有好处，比如那些可能被排除在临床试验之外的养老院居民。由于肌肉减少的肥胖虚弱个体可能有较高的动脉粥样硬化性血管疾病负担，我们建议在耐受的情况下，将二甲双胍、SGLT-2抑制剂和GLP-1RA三联治疗作为这组患者的一线治疗。另一方面，由于体重明显减轻，不良事件风险高，并且由于代谢综合征的消退，心血管益处不确定，因此最好避免对营养不良的虚弱个体进行这种治疗。

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引用次数: 0

Association between serum glycated albumin and the risk of sarcopenia and dynapenia in a community-dwelling older Japanese population: the Hisayama Study 日本社区老年人血清糖化白蛋白与肌肉减少症和运动障碍风险之间的关系：Hisayama研究

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-15 DOI: 10.1016/j.jdiacomp.2025.109199

Toshiharu Ninomiya , Hidekazu Konishi , Emi Ueda , Satoko Sakata , Emi Oishi , Yoshihiko Furuta , Saori Ohmae , Hiroyuki Hoshiko , Norifumi Tateishi , Mao Shibata , Jun Hata

Background

Sarcopenia, characterized by a progressive decline in skeletal muscle mass and strength, is increasingly recognized as a major public health concern. Several epidemiological studies have reported that diabetes mellitus is associated with the risk of sarcopenia. The aim of this study is to investigate the association between serum glycated albumin (GA) levels and the risk of developing sarcopenia and dynapenia in a community-dwelling older Japanese population.

Methods

A total of 905 participants aged ≥65 years without sarcopenia at baseline were followed for 5 years. Serum GA levels were categorized into quartiles. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019 criteria, and dynapenia was defined as low grip strength or low gait speed. The odds ratios (ORs) of developing sarcopenia and dynapenia and the mean values of percent change of muscle indices with 95 % confidential intervals (CIs) were estimated by logistic regression analysis and analysis of covariance, respectively.

Results

During the follow-up, 73 participants developed sarcopenia. Higher serum GA levels were significantly associated with greater risks of developing sarcopenia (OR 2.65, 95 %CI 0.95–2.65 in the highest vs. the lowest quartile) and dynapenia (OR 4.15, 95 %CI 2.13–4.15). Higher serum GA levels were related to declines in grip strength and gait speed. This association remained significant even among participants without diabetes or with hemoglobin A1c of <6.0 %.

Conclusions

Higher serum GA is a significant risk factor for both sarcopenia and dynapenia, with a stronger association observed for dynapenia, even in the absence of diabetes.

背景：骨骼肌减少症，以骨骼肌质量和力量的逐渐下降为特征，越来越被认为是一个主要的公共卫生问题。一些流行病学研究报道，糖尿病与肌肉减少症的风险有关。本研究的目的是调查血清糖化白蛋白（GA）水平与社区居住的日本老年人发生肌肉减少症和运动障碍的风险之间的关系。方法：共有905名年龄≥65岁、基线时无肌肉减少症的参与者，随访5年。血清GA水平分为四分位数。肌少症是由亚洲肌少症工作组2019年标准定义的，而动力不足被定义为握力低或步态速度低。分别采用logistic回归分析和协方差分析估计发生肌肉减少症和动力不足的比值比（ORs）和95%置信区间（ci）下肌肉指数百分比变化的平均值。结果：在随访期间，73名参与者出现了肌肉减少症。较高的血清GA水平与发生肌肉减少症（最高四分位数比为2.65,95% CI 0.95-2.65）和运动障碍（OR 4.15, 95% CI 2.13-4.15）的风险显著相关。血清GA水平升高与握力和步态速度下降有关。结论：血清GA升高是肌肉减少症和运动障碍的重要危险因素，即使在没有糖尿病的情况下，运动障碍的相关性也更强。

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引用次数: 0

The effects of Bifidobacterium animalis subsp. lactis BLa80 on glycemic control and gut microbiota in patients with T2DM: a randomized, double-blind, placebo-controlled trial 动物双歧杆菌亚种的作用。乳酸BLa80对T2DM患者血糖控制和肠道微生物群的影响：一项随机、双盲、安慰剂对照试验

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-11 DOI: 10.1016/j.jdiacomp.2025.109195

Chao Zhao , Xin Lu , Xiaoling Deng , Wenbo Xia , Tingting Sun , Di Huo , Lili Shi

To evaluate the effect of Bifidobacterium subsp. lactis BLa80 on glycemic control and gut microbiota composition in patients with type 2 diabetes mellitus (T2DM), a randomized, placebo-controlled clinical trial was conducted in 80 patients. Participants were randomly assigned to receive either BLa80 supplementation or placebo (n = 40 per group) in addition to standard metformin therapy for 12 weeks. Fasting blood and stool samples were collected at baseline and at the end of the intervention. The results showed that BLa80 supplementation significantly reduced fasting blood glucose and high-density lipoprotein cholesterol (HDL-C) levels, while low-density lipoprotein cholesterol (LDL-C) levels were increased. Furthermore, BLa80 modulated the diversity and composition of the gut microbiota after 12 weeks of intervention. In conclusion, BLa80 supplementation may improve glycemic control and modulate the gut microbiota in patients with T2DM, suggesting its potential as an adjunctive therapy in diabetes management.

目的：评价双歧杆菌亚种的作用。本研究在80例2型糖尿病（T2DM）患者中开展了一项随机、安慰剂对照的临床试验，研究了BLa80对2型糖尿病患者血糖控制和肠道微生物群组成的影响。除了标准的二甲双胍治疗外，参与者被随机分配接受BLa80补充剂或安慰剂（每组n = 40），为期12周。在基线和干预结束时收集空腹血液和粪便样本。结果表明，添加BLa80可显著降低空腹血糖和高密度脂蛋白胆固醇（HDL-C）水平，提高低密度脂蛋白胆固醇（LDL-C）水平。此外，干预12周后，BLa80调节了肠道微生物群的多样性和组成。总之，补充BLa80可以改善T2DM患者的血糖控制和调节肠道微生物群，提示其作为糖尿病管理的辅助治疗的潜力。

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引用次数: 0

Gestational diabetes mellitus and the subsequent risk of chronic kidney disease: A systematic review and meta-analysis 妊娠期糖尿病和随后的慢性肾脏疾病风险：一项系统回顾和荟萃分析。

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-10 DOI: 10.1016/j.jdiacomp.2025.109197

Qin Zhou, Hao Yang, Xi-shao Xie, Ren-ding Wang

Aims

The evidence regarding a relationship between gestational diabetes mellitus (GDM) and the risk of chronic kidney disease (CKD) in later life has been inconsistent. We systematically evaluated whether such an association exists.

Methods

We searched the PubMed, Embase, and Cochrane Library databases from their inception to 18 May 2025. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated to assess the association between GDM and subsequent CKD.

Results

Eight articles involving 21,806,683 pregnant women were included in our meta-analysis. The overall risk of CKD in the GDM group was significantly higher than in the control group (OR = 1.79, 95 % CI = 1.16–2.78, P = 0.009). Further analyses restricted to high-quality studies (OR = 2.75, 95 % CI = 1.68–4.52, P < 0.01, I² = 96.8 %) or to studies adjusting for key confounders (OR = 2.76, 95 % CI = 1.67–4.52, P = 0.001, I² = 65.9 %) also demonstrated a significant association. Most subgroup analysis results were consistent with the overall findings.

Conclusions

This systematic review and meta-analysis support a significant association between GDM and future CKD risk, suggesting that GDM may serve as an early warning sign for renal disease. However, confidence in the results was reduced by the considerable heterogeneity and more work is needed to understand this variability.

目的：关于妊娠期糖尿病（GDM）与以后生活中慢性肾脏疾病（CKD）风险之间关系的证据一直不一致。我们系统地评估了这种关联是否存在。方法：我们检索了PubMed、Embase和Cochrane图书馆数据库，从它们建立到2025年5月18日。计算优势比（ORs）和95%置信区间（ci）来评估GDM和随后的CKD之间的关系。结果：我们的meta分析纳入了8篇涉及21,806,683名孕妇的文章。GDM组发生CKD的总风险显著高于对照组（OR = 1.79, 95% CI = 1.16-2.78, P = 0.009）。进一步的分析仅限于高质量研究（OR = 2.75, 95% CI = 1.68-4.52, P 2 = 96.8%）或调整了关键混杂因素的研究（OR = 2.76, 95% CI = 1.67-4.52, P = 0.001, I2 = 65.9%）也显示了显著的相关性。大多数亚组分析结果与总体结果一致。结论：本系统综述和荟萃分析支持GDM与未来CKD风险之间的显著关联，提示GDM可能作为肾脏疾病的早期预警信号。然而，对结果的信心由于相当大的异质性而降低，需要更多的工作来理解这种可变性。

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引用次数: 0

Diabetes, anxiety, and mortality risk among middle and older-aged Americans 美国中老年人群的糖尿病、焦虑和死亡风险

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-10 DOI: 10.1016/j.jdiacomp.2025.109194

Srikanta Banerjee , Jagdish Khubchandani , Rafael Gonzales-Lagos

Background

Type 2 Diabetes (T2D) continues to be a major cause of morbidity and a leading cause of mortality in the United States. Also, anxiety ranks among the topmost common mental health problems in the U.S. While the burden of anxiety among individuals with T2D is well known, the long-term impact of anxiety among adults with T2D has not been well explored. Thus, the purpose of this national study was to ascertain the impact of anxiety on mortality among Americans with T2D.

Methods

Data from the U.S. National Health and Nutrition Examination Survey (years 2007–2012) were linked with mortality data from the National Death Index up to December 31st, 2019.

Results

A total of 14,137 adults (aged 50 years and older) were included in the study sample, with more than a tenth (12.8 %) having T2D and more than a fifth (22.6 %) having anxiety. The unadjusted hazard ratio (HR) for all-cause mortality risk among those with T2D was 2.08 (95 % confidence interval [CI], 1.83–2.35, p < 0.01) compared to those without T2D. In the adjusted analysis, the risk of all-cause mortality was highest among individuals with both anxiety and T2D [AHR = 1.81 (95 % CI 1.37–2.40, p < 0.01)] compared to those with anxiety or T2D alone.

Conclusions

Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with T2D and anxiety. Also, given the higher risk of mortality with co-occurring T2D and anxiety, collaborative healthcare practices should help with widespread screening for and treatment of anxiety among middle and older-age adults with Type 2 Diabetes.

背景2型糖尿病（T2D）仍然是美国发病率和死亡率的主要原因。此外，在美国，焦虑是最常见的心理健康问题之一。虽然T2D患者的焦虑负担是众所周知的，但焦虑对成人T2D患者的长期影响尚未得到很好的探讨。因此，这项全国性研究的目的是确定焦虑对美国T2D患者死亡率的影响。方法将美国国家健康与营养检查调查（2007-2012年）的数据与截至2019年12月31日的国家死亡指数的死亡率数据相关联。结果共有14137名成年人（50岁及以上）被纳入研究样本，其中超过十分之一（12.8%）患有T2D，超过五分之一（22.6%）患有焦虑症。T2D患者与非T2D患者相比，未调整的全因死亡风险风险比（HR）为2.08（95%可信区间[CI]， 1.83-2.35, p < 0.01）。在调整后的分析中，与单纯焦虑或T2D患者相比，同时患有焦虑和T2D患者的全因死亡风险最高[AHR = 1.81 (95% CI 1.37-2.40, p < 0.01)]。结论sour分析提供了有助于干预措施降低T2D合并焦虑患者死亡风险的重要信息。此外，考虑到并发T2D和焦虑的死亡率较高，协作医疗实践应该有助于广泛筛查和治疗中老年人2型糖尿病患者的焦虑。

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引用次数: 0

Short-term effects of low-dose tirzepatide on lipid profile, glucose homeostasis and hepatic steatosis index in adults with obesity, but without diabetes mellitus: a prospective observational study 低剂量替西肽对无糖尿病成人肥胖患者血脂、葡萄糖稳态和肝脂肪变性指数的短期影响：一项前瞻性观察研究

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-09 DOI: 10.1016/j.jdiacomp.2025.109181

Nikolaos Angelopoulos , Sarantis Livadas , Ioannis Androulakis , Valentina Petkova , Andreas Rizoulis , Anastasios Boniakos , Rodis Paparodis , Ploutarchos Tzoulis , Voula Mentzelopoulou , Dimos Florakis , Evangelos Fousteris , Areti Korakovouni , Dimitra Zianni , Zadalla Mouslech , Manfredi Rizzo , Dimitri P. Mikhailidis , Panagiotis Anagnostis

Background/aims

Tirzepatide has been approved for weight loss in adults with obesity. However, real-world data are still needed. This real-world prospective study is among the first to evaluate the short-term metabolic effects of low-dose tirzepatide in adults with obesity but without diabetes mellitus (DM). Secondary endpoints included associations between these changes and anthropometric or baseline metabolic parameters.

Methods

In this prospective observational study, adults with obesity but without diabetes mellitus received tirzepatide (2.5 mg/week, escalating to 5 mg/week, subcutaneously) for 12 weeks. Body weight, body mass index (BMI), total (TC), low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C), triglycerides, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and hepatic steatosis index (HSI) were measured at baseline and week 12.

Results

Seventy-five participants (mean age 46.9 ± 9.9 years) were included. After 12 weeks, body weight (−8.1 ± 4.3 %) and BMI significantly decreased. TC, LDL-C, triglycerides, FPG, HbA1c, and HSI were significantly reduced and inversely associated with their baseline levels. HbA1c and HSI changes correlated with weight loss. No effect was observed on HDL-C. Statin use had no impact on outcomes.

Conclusion

Short-term low-dose tirzepatide improves the lipid profile, HbA1c, and HSI in obese adults without DM, especially in those with abnormal baseline values. Lipid changes occurred independently of weight loss.

背景/目的：stirzepatide已被批准用于成人肥胖患者的减肥。然而，仍然需要真实世界的数据。这项现实世界的前瞻性研究是首次评估低剂量替西帕肽对肥胖但无糖尿病（DM）的成人的短期代谢影响的研究之一。次要终点包括这些变化与人体测量或基线代谢参数之间的关联。方法在这项前瞻性观察性研究中，肥胖但无糖尿病的成年人接受替西帕肽（2.5 mg/周，逐渐增加到5 mg/周，皮下注射）治疗12周。在基线和第12周测量体重、体重指数（BMI）、总（TC）、低密度（LDL-C）和高密度脂蛋白胆固醇（HDL-C）、甘油三酯、空腹血糖（FPG）、糖化血红蛋白（HbA1c）和肝脂肪变性指数（HSI）。结果纳入75例，平均年龄46.9±9.9岁。12周后，体重（- 8.1±4.3%）和BMI均显著下降。TC、LDL-C、甘油三酯、FPG、HbA1c和HSI均显著降低，且与基线水平呈负相关。HbA1c和HSI变化与体重减轻相关。对HDL-C没有影响。他汀类药物的使用对结果没有影响。结论短期低剂量替西帕肽可改善无糖尿病的肥胖成人的血脂、HbA1c和HSI，尤其是基线值异常的肥胖者。脂质变化与体重减轻无关。

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引用次数: 0

Response to: "Letter to the editor "The role of artificial intelligence in diabetic retinopathy screening in type 1 diabetes: A systematic review". 回复：致编辑的信“人工智能在1型糖尿病视网膜病变筛查中的作用：系统综述”。

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-06 DOI: 10.1016/j.jdiacomp.2025.109180

Giovanni Cangelosi, Francesco Sacchini, Stefano Mancin, Sara Morales Palomares, Gabriele Caggianelli, Francesco Gravante, Fabio Petrelli

引用次数: 0

The prevalence of diabetic neuropathy in Greenland and its association with Inuit genetic ancestry – a cross-sectional study 格陵兰岛糖尿病神经病变的患病率及其与因纽特人遗传祖先的关系-一项横断面研究。

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-10-02 DOI: 10.1016/j.jdiacomp.2025.109179

Marie Mathilde Bjerg Christensen , Christian Stevns Hansen , Jesper Fleischer , Ninna Senftleber , Frederik Filip Stæger , Torben Hansen , Daniel R. Witte , Marit Eika Jørgensen

Aims

Data on diabetic neuropathies in Greenland remains limited. The aim was to estimate the prevalence of diabetic peripheral neuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) among Greenlanders with diabetes and prediabetes and investigate whether Inuit ancestry contributes to higher susceptibility.

Methods

Individuals with diabetes and prediabetes from the Greenland Population Survey 2018 were examined for DPN (Vibration Perception Threshold (VPT) and light pressure) and CAN (Cardiovascular Reflex Tests and Heart Rate Variability). Inuit genetic admixture was included as a determinant in regression models adjusted for age, sex, genetics, diabetes status and residency.

Results

Among 447 participants (1/3 diabetes, median age 61, 57 % female) DPN prevalence was 28 % in diabetes and 25 % in prediabetes. CAN prevalence was 24 % and 15 %, respectively. A 20-percentage point change in Inuit ancestry was associated with a 4 % higher VPT (coefficient: 1.04, 95 % CI: 1.003–1.08) and 51 % higher odds of CAN (OR: 1.51, 95 % CI: 1.09–2.08).

Conclusions

DPN and CAN are common among Greenlanders with diabetes and prediabetes, highlighting the need for improved diagnostics and prevention. The association between Inuit genetic ancestry and neuropathy suggests a predisposition to neuropathy among Inuit, which may be explained by both genetic and lifestyle factors.

目的：格陵兰岛糖尿病神经病变的数据仍然有限。目的是估计格陵兰人糖尿病和前驱糖尿病患者中糖尿病周围神经病变（DPN）和心血管自主神经病变（CAN）的患病率，并调查因纽特人血统是否导致更高的易感性。方法：对2018年格陵兰人口调查中患有糖尿病和前驱糖尿病的个体进行DPN（振动感知阈值（VPT）和光压）和CAN（心血管反射试验和心率变异性）检查。因纽特人的遗传混合被包括在年龄、性别、遗传、糖尿病状况和居住地调整的回归模型中作为决定因素。结果：在447名参与者中（1/3的糖尿病患者，中位年龄61岁，57%的女性），DPN患病率为28%的糖尿病和25%的前驱糖尿病。CAN患病率分别为24%和15%。因纽特人祖先中20个百分点的变化与4%的VPT升高（系数：1.04,95% CI: 1.003-1.08）和51%的CAN几率升高（OR: 1.51, 95% CI: 1.09-2.08）相关。结论：DPN和CAN在格陵兰岛糖尿病和前驱糖尿病患者中很常见，强调了改进诊断和预防的必要性。因纽特人的遗传血统与神经病变之间的联系表明，因纽特人易患神经病变，这可能由遗传和生活方式因素来解释。

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