Journal of diabetes and its complications最新文献

{"title":"The prevalence and correlates of advanced fibrosis in patients with and without diabetes mellitus and metabolic dysfunction-associated steatotic liver disease: A cross-sectional study.","authors":"Emir Muzurović, Goran Topić, Nevena Todorović, Manfredi Rizzo, Ksenija Zečević","doi":"10.1016/j.jdiacomp.2025.109147","DOIUrl":"10.1016/j.jdiacomp.2025.109147","url":null,"abstract":"<p><strong>Background: </strong>The severity of liver fibrosis serves as a crucial prognostic indicator, reflecting liver-related and cardiovascular-related outcomes, as well as mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Type 2 diabetes mellitus (T2DM) is a major risk factor for developing metabolic dysfunction-associated steatohepatitis (MASH), and in patients with both T2DM and MASH, identifying those with advanced fibrosis is critical.</p><p><strong>Methods: </strong>This cross-sectional study included 162 MASLD patients (47 with T2DM, 38 with prediabetes and 77 individuals without diabetes). The aim of this study was to determine the prevalence of advanced fibrosis in MASLD patients with and without DM and prediabetes, using a 2-step approach with fibrosis-4 index followed by liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE), and to evaluate the predictive cardiometabolic risk factors for the development of advanced fibrosis in these patients.</p><p><strong>Results: </strong>Among patients with prediabetes and T2DM, 12.9 % were identified with F3 stage fibrosis, 6.5 % had F4 stage, totaling 19.4 % with advanced fibrosis or cirrhosis, assessed by VCTE. In contrast, among individuals without diabetes, 1.78 % was found to have F3 stage fibrosis, while 7.14 % had F4. In patients with T2DM or prediabetes, body mass index (BMI) was a significant predictor of advanced fibrosis (p = 0.02), with each unit increase in BMI linked to a 1.3-fold higher risk of advanced fibrosis and cirrhosis, and higher high-density lipoprotein cholesterol (HDL-C) levels were associated with lower odds of having F3 or F4 stage fibrosis (p = 0.04). In MASLD patients without diabetes, triglycerides (TGs) showed a significant positive correlation with liver stiffness (p = 0.04), male sex was significantly associated with a higher susceptibility to increased liver stiffness (p = 0.04), and males had 0.91 times the odds of developing advanced fibrosis and cirrhosis (p = 0.02). No significant correlations were observed between liver stiffness and age, sex, aspartate aminotransferase (AST), alanine aminotransferase (ALT), glucose levels, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), or TGs in patients with T2DM or prediabetes. In MASLD patients without diabetes, no significant correlations were found between liver stiffness and factors such as age, BMI, AST, ALT, TC, LDL-C, HDL-C, or glucose levels.</p><p><strong>Conclusion: </strong>In conclusion, the prevalence of advanced fibrosis or cirrhosis in patients with both, MASLD and T2DM, is very high. In MASLD patients with T2DM or prediabetes, higher BMI and lower levels of HDL-C are significant predictors of advanced fibrosis or cirrhosis.</p>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"109147"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812076","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}

{"title":"Response to letter to the editor regarding “High rate of complications in a real-world cohort of youth with T2D: A multicenter analysis”","authors":"Risa M. Wolf ,&nbsp;Roomasa Channa ,&nbsp;Amy S. Shah","doi":"10.1016/j.jdiacomp.2025.109138","DOIUrl":"10.1016/j.jdiacomp.2025.109138","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109138"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731585","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}

{"title":"What type 1 diabetes endotype is most suitable for anti-CD3 antibodies prevention trials?","authors":"Roma-Wilson Maria Aurora ,&nbsp;Pozzilli Paolo","doi":"10.1016/j.jdiacomp.2025.109132","DOIUrl":"10.1016/j.jdiacomp.2025.109132","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109132"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665578","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}

{"title":"The impact of glycemic variability on the 28-day prognosis of patients with cardiogenic shock with or without diabetes mellitus: A retrospective cohort study","authors":"Jing Tian ,&nbsp;Chenming Zhao,&nbsp;Yulu Li,&nbsp;Yi Han","doi":"10.1016/j.jdiacomp.2025.109151","DOIUrl":"10.1016/j.jdiacomp.2025.109151","url":null,"abstract":"<div><div>Glycaemic variability (GV) may reflect sharp rises and acute fluctuations in blood glucose, which are associated with adverse cardiovascular events. The aim of this study was to investigate the effect of GV on 28-day outcome in patients with cardiogenic shock (CS) with or without diabetes mellitus (DM).</div></div><div><h3>Methods</h3><div>This retrospective cohort study adhered to the RECORD (REporting of studies Conducted using Observational Routinely-collected Data) guidelines. We used clinical data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. GV was assessed using the coefficient of variation of blood glucose levels and statistically analysed by dividing patients into three groups according to GV tertiles (GV1, GV2 and GV3), with a primary outcome of 28-day prognosis and secondary outcomes of mechanical ventilation status, length of hospital stay and length of ICU stay.</div></div><div><h3>Results</h3><div>A total of 1091 patients from the MIMIC-IV database with CS were included, of which a total of 409 (37.49 %) were male patients and 682 (62.51 %) were female patients. Based on GV levels, three groups were classified as GV1 (&lt;16.2 %, <em>n</em> = 318), GV2 (16.2 %–25.3 %, <em>n</em> = 388), and GV3 (&gt;25.3 %, <em>n</em> = 385). According to the Kaplan-Meier curves, the 28-day prognosis was significantly better in GV1 patients than in GV3 [220 (69.2 %) vs. 234 (60.8 %), <em>P</em> = 0.044], and the same was true in the Non-DM subgroup [188 (73.7 %) vs. 108 (61.4 %), <em>P</em> = 0.016]. In a multifactorial COX analysis, GV was significantly associated with the risk of 28-day mortality in patients [HR 1.42, 95 % CI 1.10–1.60, <em>P</em> = 0.012]. In the subgroup analyses, the risk of death was highest in the DM subgroup of patients with GV3 (HR: 1.53, <em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>GV significantly increases the 28-day risk of death in patients with CS, especially in DM patients. Future optimisation of glucose monitoring techniques and exploration of GV modulation strategies are needed to improve patient prognosis.</div><div><strong>What is known about this research topic:</strong></div><div>Glycaemic variability (GV) significantly increases the 28-day risk of death in patients with cardiogenic shock (CS).</div><div>GV level (16.2 %–25.3 %) was an independent risk factor for 28-day mortality in patients with DM and CS, and GV (&gt;25.3 %) was an independent risk factor for 28-day mortality in Non-DM patients with CS.</div><div><strong>What this study adds and its future implications:</strong></div><div>More optimal glucose monitoring techniques and GV modulation strategies need to be refined to improve patient outcomes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109151"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861139","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}

{"title":"Risk assessment modeling for diabetes-related lower extremity amputation using socioeconomic and behavioral health indicators","authors":"Kelsey A. Schmittling","doi":"10.1016/j.jdiacomp.2025.109153","DOIUrl":"10.1016/j.jdiacomp.2025.109153","url":null,"abstract":"<div><div>Lower extremity amputation (LEA) is a costly complication of diabetes, with disproportionate impacts among socially and medically vulnerable populations. While clinical predictors of LEA are well established, the role of behavioral health comorbidities, particularly alongside socioeconomic disparities, in amputation risk is unexplored. To evaluate sociodemographic and behavioral health predictors of LEA, a retrospective analysis of adult patients with diabetes was performed utilizing the Nationwide Inpatient Sample from 2018 to 2022. Sociodemographic and behavioral health characteristics were compared between patients that did and did not undergo LEA. Multivariable logistic regression was used to identify independent predictors of LEA using 2018–2021 data and was then tested on the 2022 validation cohort. Among 7.5 million adult patients with diabetes with inpatient events, patients undergoing LEA were significantly younger, more likely to be male, from lower income quartiles, and disproportionately Black, Hispanic, and Native American (<em>p</em> &lt; 0.001). Substance use disorder was significantly more common among LEA patients (16.0 % vs 11.6 %). In adjusted analysis, several behavioral health conditions were independently associated with increased LEA risk. The model demonstrated modest predictive performance in the testing cohort (AUC = 0.658). While not yet suitable for standalone clinical use, this model highlights that behavioral risk factors, especially in the context of sociodemographic characteristics, warrants increased attention in limb preservation strategies.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109153"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863837","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}

{"title":"Low imaging-detected muscle mass as a prognostic factor for overall and amputation-free survival in patients undergoing lower extremity amputation","authors":"Elli Kykkänen ,&nbsp;Ilkka Kaartinen ,&nbsp;Otso Arponen ,&nbsp;Miska Vuorlaakso","doi":"10.1016/j.jdiacomp.2025.109119","DOIUrl":"10.1016/j.jdiacomp.2025.109119","url":null,"abstract":"<div><h3>Background</h3><div>Amputations and sarcopenia are both increasing globally. This study investigates the association between imaging-detected muscle mass and outcomes after lower extremity amputation.</div></div><div><h3>Methods</h3><div>The sample population included patients undergoing amputation with abdominal computed tomography (CT) scans. The psoas muscle index (PMI) and skeletal muscle index (SMI) were evaluated at the level of the 3rd lumbar vertebra. Overall survival (OS) and amputation-free survival (AFS) were evaluated.</div></div><div><h3>Results</h3><div>A total of 72 patients (mean age: 66.4 ± 18.5 years) were evaluated in the study. Lower PMI and SMI were associated with decreased OS (PMI/SMI: HR 4.120, 95 % confidence interval [CI]: 1.692–10.032/HR 2.487, 95 % CI: 1.091–5.666) and AFS after the first amputation (PMI/SMI: HR 3.561, 95 % CI: 0.938–13.516/HR 3.982, 95 % CI: 1.080–14.677) in univariate models. Low PMI and SMI remained significant in multivariable models adjusted for age, sex, and amputation level.</div></div><div><h3>Conclusions</h3><div>Imaging-detected low muscle mass is associated with impaired OS and AFS in patients undergoing lower extremity amputation. Evaluation of muscle mass from available CT scans may provide useful information for clinical decision-making.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109119"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536218","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}

{"title":"Letter to the editor regarding “High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis”","authors":"Rachana Mehta ,&nbsp;Ranjana Sah","doi":"10.1016/j.jdiacomp.2025.109117","DOIUrl":"10.1016/j.jdiacomp.2025.109117","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109117"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536219","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}

{"title":"Sex specific associations of sex hormones with brain volumes and cerebral blood flow: A cross sectional observational study within the look AHEAD type 2 diabetes cohort","authors":"Dhananjay Vaidya ,&nbsp;Yvette Yeboah-Kordieh ,&nbsp;Marjorie Howard ,&nbsp;Christina E. Hugenschmidt ,&nbsp;Paul A. Nyquist ,&nbsp;Erin D. Michos ,&nbsp;Rita R. Kalyani ,&nbsp;Sevil Yasar ,&nbsp;Brian Andres Robusto ,&nbsp;Hussein N. Yassine ,&nbsp;Jeanne M. Clark ,&nbsp;Mark A. Espeland ,&nbsp;Wendy L. Bennett","doi":"10.1016/j.jdiacomp.2025.109161","DOIUrl":"10.1016/j.jdiacomp.2025.109161","url":null,"abstract":"<div><h3>Background</h3><div>Females have greater brain volume and cerebral blood flow than males when controlling for intracranial volume and age. Brain volume decreases after menopause, suggesting a role of sex hormones. We studied the association of sex hormones with brain volume, white matter hyperintensity volumes and cerebral blood flow in people with Type 2 Diabetes and with overweight and obesity conditions that accelerate brain atrophy.</div></div><div><h3>Methods</h3><div>We analyzed data from 215 participants with overweight or obesity and Type 2 Diabetes from the Look AHEAD Brain Magnetic Resonance Imaging ancillary study (mean age 68 years, 73 % postmenopausal female). Estradiol and total testosterone levels were measured with electrochemoluminescence assays. The ratio of brain measurements to intracranial volume was analyzed to account for body size. We analyzed sex hormones as quantitative measures in males, whereas in females we grouped those with detectable vs. undetectable hormone levels (Estradiol &lt;73 pmol/L [20 pg/mL]: 79 %; Total Testosterone &lt;0.07 mmol/L [0.02 ng/mL]: 37 % undetectable in females).</div></div><div><h3>Results</h3><div>Females with detectable total testosterone levels had higher brain volume to intracranial volume ratio (median [25th, 75th percentile]: 0.85 [0.84, 0.86]) as compared to those with undetectable Total Testosterone levels (0.84 [0.83, 0.86]; rank sum <em>p</em> = 0.04). This association was attenuated after age and body mass index adjustment (<em>p</em> = 0.08). Neither white matter hyperintensity volumes or cerebral blood flow in females, nor any brain measures in males, were significantly associated with Estradiol or Total Testosterone.</div></div><div><h3>Conclusions</h3><div>In postmenopausal females with Type 2 Diabetes with overweight and obesity, detectable levels of total testosterone were associated greater brain volume relative to intracranial volume, suggesting a protective role for testosterone in female brain health. Our findings are limited by a small sample size and low sensitivity of hormone assays. Our suggestive findings can be combined with future larger studies to assess clinically important differences.</div></div><div><h3>Trial registration</h3><div><span><span>NCT00017953</span><svg><path></path></svg></span></div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109161"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917705","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}

{"title":"Identifying predictors of sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide 1 agonist use in hospital among adults with diabetes","authors":"Lai-Ming Kathleen Pak ,&nbsp;Minh V. Le ,&nbsp;Dev Kevat ,&nbsp;Rahul Barmanray","doi":"10.1016/j.jdiacomp.2025.109022","DOIUrl":"10.1016/j.jdiacomp.2025.109022","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109022"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027384","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}

{"title":"Relationship between relative fat mass and coronary artery calcification in patients with type 2 diabetes","authors":"Jingjing Ye ,&nbsp;Yu Qin ,&nbsp;Li Zhao ,&nbsp;Ling Yang ,&nbsp;Guoyue Yuan ,&nbsp;Meiqing Dai ,&nbsp;Shaohua Wang","doi":"10.1016/j.jdiacomp.2025.109133","DOIUrl":"10.1016/j.jdiacomp.2025.109133","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>We included hospitalized individuals aged 20–80 years with T2DM (<em>n</em> = 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).</div></div><div><h3>Results</h3><div>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], <em>p</em> &lt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109133"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696499","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}