Diabetes, Obesity & Metabolism最新文献_第9页

Individual and combined effects of muscle strength and visceral adiposity on incident prediabetes and type 2 diabetes in a longitudinal cohort of midlife Asian women. 中年亚洲女性纵向队列中肌肉力量和内脏脂肪对糖尿病前期和 2 型糖尿病发病率的单独和综合影响。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-04 DOI: 10.1111/dom.15995

Beverly W X Wong, Darren Y Z Tan, Ling-Jun Li, Eu-Leong Yong

Aim: To investigate the independent and combined effects of muscle strength and visceral adiposity on prediabetes and type 2 diabetes incidence among midlife women.

Materials and methods: In this prospective study of midlife women (mean age 56.4 years), visceral adiposity, defined as visceral adipose tissue (VAT) >131 cm² measured by dual energy X-ray absorptiometry, and poor combined muscle strength, defined as handgrip strength <18 kg and/or five-time repeated chair stand test performance ≥12 s, were determined at baseline between 2014 and 2016. After 6.6 years, the effects of VAT and muscle strength on risk of incident prediabetes (fasting blood glucose 5.6-6.9 mmol/L) and type 2 diabetes (fasting blood glucose levels ≥7 mmol/L, medication use, or physician diagnosis) were examined using modified Poisson regression analysis.

Results: Among the 733 initially normoglycaemic participants, 150 (20.5%) developed prediabetes or type 2 diabetes. Women with both poor combined muscle strength and high VAT had the highest risk for both prediabetes and type 2 diabetes (adjusted relative risk [aRR] 2.63, 95% confidence interval [CI] 1.81-3.82). In comparison, high VAT alone increased risk by 1.78-fold (95% CI 1.12-2.84). Stratification analyses showed that among women with low muscle strength, high VAT demonstrated increased risks of prediabetes and type 2 diabetes (aRR 2.84, 95% CI 1.95-4.14) compared to those with normal strength (aRR 1.66, 95% CI 1.04-2.65).

Conclusions: Low combined muscle strength with high VAT poses a greater risk for the development of prediabetes and type 2 diabetes than high VAT alone. Muscle strengthening should be promoted alongside weight loss in diabetes prevention.

目的：研究肌肉力量和内脏脂肪对中年女性糖尿病前期和 2 型糖尿病发病率的独立和综合影响：在这项针对中年女性（平均年龄 56.4 岁）的前瞻性研究中，通过双能 X 射线吸收测量法测量的内脏脂肪组织（VAT）>131 平方厘米和以手握力定义的肌肉力量低下的综合影响结果：在 733 名最初血糖正常的参与者中，有 150 人（20.5%）发展为糖尿病前期或 2 型糖尿病。同时具有综合肌力差和高 VAT 的女性罹患糖尿病前期和 2 型糖尿病的风险最高（调整后相对风险 [aRR] 2.63，95% 置信区间 [CI] 1.81-3.82）。相比之下，单纯的高 VAT 会使风险增加 1.78 倍（95% 置信区间为 1.12-2.84）。分层分析显示，在低肌力女性中，与正常肌力女性（aRR 1.66，95% CI 1.04-2.65）相比，高VAT增加了糖尿病前期和2型糖尿病的风险（aRR 2.84，95% CI 1.95-4.14）：结论：与单纯的高 VAT 相比，低综合肌力和高 VAT 更容易导致糖尿病前期和 2 型糖尿病。在预防糖尿病的过程中，应在减轻体重的同时加强肌肉力量。

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引用次数: 0

The liver fibrosis-8 index is a predictor for all-cause mortality in cardiovascular disease patients: A cohort study 肝纤维化-8 指数是心血管疾病患者全因死亡率的预测指标：一项队列研究。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-04 DOI: 10.1111/dom.15971

Xian Yang MBBS, Jiaxin Wang MD, Xiaofang Zhang MD, Liangyan Wu MD, Ruxin Wang MD, Jianrong Lu MBBS, Lihong Wang MD

Aims

Participants with cardiovascular diseases (CVD) often exhibit liver function abnormalities, hepatic fibrosis and cirrhosis. The extent of liver fibrosis is closely related to the prognosis of CVD. However, the association between the liver fibrosis-8 (FIB-8) index, a marker of liver fibrosis, and all-cause mortality in CVD participants remains unclear. This study aims to investigate the relationship between the FIB-8 index and all-cause mortality among individuals with CVD.

Materials and Methods

A total of 1727 CVD American participants were enrolled from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. Initially, we constructed weighted COX regression models and performed sensitivity analyses to examine the correlation between the FIB-8 index and all-cause mortality in CVD participants. Subsequently, we employed restricted cubic spline (RCS) to visualize their linear relationship. Finally, the stratified analyses and interaction tests of covariates were performed and presented in the forest plot.

Results

A total of 1727 participants were included in our study, with a mean age of 61.68 ± 0.47 years, with men accounting for 59.19%. After adjustment for relevant covariables, weighted COX regression models indicated that the hazard ratio (HR) and 95% confidence interval (95% CI) for the association between the FIB-8 index and all-cause mortality in CVD participants was 1.21 (1.12, 1.30). Sensitivity analysis was then conducted, revealing that the results remained stable. In fully adjusted model, individuals in quartiles 3 and 4 demonstrated significant statistical differences compared to the lowest FIB-8 index quartile, with HR (95% CI) values of 1.88 (1.23, 2.87) and 2.17 (1.33, 3.53), respectively. Subsequently, RCS showed a linear relationship between the FIB-8 index and all-cause mortality among CVD participants. Finally, the interaction test revealed that no other covariables had significant interactions with the FIB-8 index in this study.

Conclusions

A positive and linear correlation was observed between the FIB-8 index and all-cause mortality among CVD adult participants in NHANES from 1999 to 2018. Our findings indicated that the FIB-8 index could serve as an excellent indicator for assessing all-cause mortality within the CVD population. The lower the FIB-8 index, the lower the all-cause mortality among CVD participants.

目的：心血管疾病（CVD）患者通常会出现肝功能异常、肝纤维化和肝硬化。肝纤维化的程度与心血管疾病的预后密切相关。然而，作为肝纤维化标志物的肝纤维化-8（FIB-8）指数与心血管疾病参与者全因死亡率之间的关系仍不清楚。本研究旨在调查 FIB-8 指数与心血管疾病患者全因死亡率之间的关系：从1999年至2018年的美国国家健康与营养调查（NHANES）中共招募了1727名心血管疾病美国参与者。最初，我们构建了加权 COX 回归模型，并进行了敏感性分析，以研究心血管疾病参与者的 FIB-8 指数与全因死亡率之间的相关性。随后，我们采用受限立方样条曲线（RCS）来直观地显示它们之间的线性关系。最后，我们对协变量进行了分层分析和交互检验，并以森林图的形式展示了结果：本研究共纳入 1727 名参与者，平均年龄为（61.68±0.47）岁，其中男性占 59.19%。在对相关协变量进行调整后，加权 COX 回归模型显示，FIB-8 指数与心血管疾病参与者全因死亡率之间的危险比（HR）和 95% 置信区间（95% CI）为 1.21（1.12，1.30）。随后进行了敏感性分析，结果保持稳定。在完全调整模型中，四分位数 3 和 4 的个体与 FIB-8 指数最低的四分位数相比具有显著的统计学差异，HR（95% CI）值分别为 1.88（1.23，2.87）和 2.17（1.33，3.53）。随后，RCS 显示 FIB-8 指数与心血管疾病参与者的全因死亡率之间存在线性关系。最后，交互检验显示，在本研究中，其他协变量与 FIB-8 指数之间没有显著的交互作用：在1999年至2018年的NHANES中，观察到FIB-8指数与心血管疾病成年参与者的全因死亡率之间存在正线性相关。我们的研究结果表明，FIB-8指数可作为评估心血管疾病人群全因死亡率的极佳指标。FIB-8指数越低，心血管疾病参与者的全因死亡率越低。

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引用次数: 0

Diabetes, Obesity and Metabolism 糖尿病、肥胖症和新陈代谢

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-04 DOI: 10.1111/dom.15136

引用次数: 0

Association of metabolic score for visceral fat with all-cause mortality, cardiovascular mortality, and cancer mortality: A prospective cohort study 内脏脂肪代谢评分与全因死亡率、心血管死亡率和癌症死亡率的关系：一项前瞻性队列研究。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-03 DOI: 10.1111/dom.15959

Shanshan Jia PhD, Xingwei Huo PhD, Xianghao Zuo PhD, Liming Zhao MMed, Lu Liu PhD, Lirong Sun MMed, Xiaoping Chen MMed

Aim

Our study aimed to evaluate the association between the metabolic score for visceral fat (METS-VF) and mortality.

Methods

We conducted a cohort study comprising 11,120 participants. We employed weighted multivariable Cox regression analysis to assess the relationship between METS-VF and mortality. Restricted cubic spline analyses were used to investigate potential non-linear associations. Receiver operating characteristic curves were used to evaluate the predictive value of METS-VF and other obesity-related indicators for mortality. Subgroup analysis and sensitivity analysis were performed to confirm the robustness of the results. Mendelian randomization analysis was utilized to assess potential causality.

Results

Over a median follow-up duration of 83 months, a total of 1014 all-cause deaths, 301 cardiovascular deaths, and 262 cancer deaths occurred. For every 0.2-unit increase in METS-VF, the hazard ratios(HRs) of all-cause mortality, cardiovascular mortality, and cancer mortality were 1.13 [95% confidence interval (CI): 1.06, 1.20], 1.18 (95% CI: 1.06, 1.31), and 1.13 (95% CI: 1.03, 1.25), respectively. In addition, restricted cubic spline analyses revealed no significant non-linear associations between METS-VF and all-cause mortality, cardiovascular mortality, and cancer mortality. In multivariate Cox regression models, hazard ratios of all-cause mortality, cardiovascular mortality and cancer mortality were higher in the highest METS-VF group compared to the reference group. Subgroup and sensitivity analyses confirmed that our results were robust. Receiver operating characteristic curves indicated that METS-VF predicted mortality better than other obesity-related indicators. Mendelian randomization analysis confirmed significant causal relationships.

Conclusions

METS-VF was positively associated with all-cause mortality, cardiovascular mortality, and cancer mortality. These findings suggest that METS-VF could serve as a straightforward, reliable, and cost-effective marker for identifying individuals at high risk of mortality.

目的：我们的研究旨在评估内脏脂肪代谢评分（METS-VF）与死亡率之间的关系：我们进行了一项由 11120 名参与者组成的队列研究。我们采用加权多变量 Cox 回归分析来评估 METS-VF 与死亡率之间的关系。限制立方样条分析用于研究潜在的非线性关系。受体操作特征曲线用于评估 METS-VF 和其他肥胖相关指标对死亡率的预测价值。进行了分组分析和敏感性分析，以确认结果的稳健性。采用孟德尔随机分析法评估潜在的因果关系：中位随访时间为 83 个月，共有 1014 例全因死亡、301 例心血管疾病死亡和 262 例癌症死亡。METS-VF 每增加 0.2 个单位，全因死亡率、心血管死亡率和癌症死亡率的危险比（HRs）分别为 1.13 [95% 置信区间 (CI)：1.06, 1.20]、1.18 (95% CI：1.06, 1.31) 和 1.13 (95% CI：1.03, 1.25)。此外，限制性三次样条分析显示，METS-VF 与全因死亡率、心血管死亡率和癌症死亡率之间没有显著的非线性关联。在多变量 Cox 回归模型中，与参照组相比，METS-VF 最高组的全因死亡率、心血管死亡率和癌症死亡率的危险比更高。亚组和敏感性分析证实我们的结果是可靠的。接收者操作特征曲线显示，METS-VF 预测死亡率的效果优于其他肥胖相关指标。孟德尔随机分析证实了两者之间存在显著的因果关系：结论：METS-VF 与全因死亡率、心血管死亡率和癌症死亡率呈正相关。这些研究结果表明，METS-VF 可作为一种直接、可靠且经济有效的指标，用于识别高死亡率风险人群。

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引用次数: 0

Metabolic risk factor targets in relation to clinical characteristics and comorbidities among individuals with type 2 diabetes treated in primary care - The countrywide cross-sectional AUSTRO-PROFIT study. 在初级医疗机构接受治疗的 2 型糖尿病患者中，代谢风险因素目标与临床特征和并发症的关系--全国横断面 AUSTRO-PROFIT 研究。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-03 DOI: 10.1111/dom.15988

Harald Sourij, Kehkishan Azhar, Faisal Aziz, Harald Kojzar, Caren Sourij, Peter Fasching, Martin Clodi, Bernhard Ludvik, Julia K Mader, Michael Resl, Gersina Rega-Kaun, Claudia Ress, Lars Stechemesser, Harald Stingl, Norbert J Tripolt, Thomas Wascher, Susanne Kaser

Aims: This study assessed the achievement rates of metabolic risk factor targets and their association with clinical characteristics and comorbidities among individuals with type 2 diabetes (T2D) treated in the primary care in Austria.

Materials and methods: A countrywide cross-sectional study, the AUSTRO-PROFIT, was conducted in Austria from 2021 to 2023 on 635 individuals with T2D. Metabolic risk factor targets were defined as the percentage of people achieving low-density lipoprotein cholesterol (LDL-C) <70 mg/dL (or < 55 mg/dL if cardiovascular or microvascular disease was present), glycated haemoglobin (HbA1c) <7% (53 mmol/mol) and blood pressure < 140/90 mmHg.

Results: The mean age of the participants was 65.7 ± 11.2 years; the median duration of T2D was 8 (4-14) years; and 58.7% of the participants were male. The percentages of participants achieving LDL-C, HbA1c, blood pressure and all targets were 44%, 53%, 57% and 13%, respectively. Older age, longer T2D duration, cardiovascular disease and microvascular complications were associated with suboptimal achievement of metabolic risk factor targets.

Conclusions: The AUSTRO-PROFIT study revealed notable variations in metabolic targets achievement with respect to clinical characteristics and comorbidities. These findings underscore the importance of establishing national diabetes registries and implementing multifactorial targeted and individualized interventions to further improve the quality of T2D care in primary care settings in Austria.

目的：本研究评估了奥地利接受初级保健治疗的2型糖尿病（T2D）患者的代谢风险因素目标实现率及其与临床特征和合并症的关系：2021 年至 2023 年期间，在奥地利对 635 名 2 型糖尿病患者进行了一项全国性横断面研究，即 AUSTRO-PROFIT。代谢风险因素目标被定义为低密度脂蛋白胆固醇（LDL-C）达标率：参与者的平均年龄为 65.7 ± 11.2 岁；T2D 中位持续时间为 8（4-14）年；58.7% 的参与者为男性。达到 LDL-C、HbA1c、血压和所有目标的参与者比例分别为 44%、53%、57% 和 13%。年龄较大、T2D持续时间较长、心血管疾病和微血管并发症与代谢风险因素目标达标情况不理想有关：AUSTRO-PROFIT研究显示，在实现代谢目标方面，临床特征和合并症存在显著差异。这些发现强调了建立全国糖尿病登记册和实施多因素、有针对性和个性化干预措施的重要性，以进一步提高奥地利初级医疗机构的 T2D 护理质量。

{"title":"Metabolic risk factor targets in relation to clinical characteristics and comorbidities among individuals with type 2 diabetes treated in primary care - The countrywide cross-sectional AUSTRO-PROFIT study.","authors":"Harald Sourij, Kehkishan Azhar, Faisal Aziz, Harald Kojzar, Caren Sourij, Peter Fasching, Martin Clodi, Bernhard Ludvik, Julia K Mader, Michael Resl, Gersina Rega-Kaun, Claudia Ress, Lars Stechemesser, Harald Stingl, Norbert J Tripolt, Thomas Wascher, Susanne Kaser","doi":"10.1111/dom.15988","DOIUrl":"https://doi.org/10.1111/dom.15988","url":null,"abstract":"<p><strong>Aims: </strong>This study assessed the achievement rates of metabolic risk factor targets and their association with clinical characteristics and comorbidities among individuals with type 2 diabetes (T2D) treated in the primary care in Austria.</p><p><strong>Materials and methods: </strong>A countrywide cross-sectional study, the AUSTRO-PROFIT, was conducted in Austria from 2021 to 2023 on 635 individuals with T2D. Metabolic risk factor targets were defined as the percentage of people achieving low-density lipoprotein cholesterol (LDL-C) <70 mg/dL (or < 55 mg/dL if cardiovascular or microvascular disease was present), glycated haemoglobin (HbA1c) <7% (53 mmol/mol) and blood pressure < 140/90 mmHg.</p><p><strong>Results: </strong>The mean age of the participants was 65.7 ± 11.2 years; the median duration of T2D was 8 (4-14) years; and 58.7% of the participants were male. The percentages of participants achieving LDL-C, HbA1c, blood pressure and all targets were 44%, 53%, 57% and 13%, respectively. Older age, longer T2D duration, cardiovascular disease and microvascular complications were associated with suboptimal achievement of metabolic risk factor targets.</p><p><strong>Conclusions: </strong>The AUSTRO-PROFIT study revealed notable variations in metabolic targets achievement with respect to clinical characteristics and comorbidities. These findings underscore the importance of establishing national diabetes registries and implementing multifactorial targeted and individualized interventions to further improve the quality of T2D care in primary care settings in Austria.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Associations of metabolic syndrome with cognitive function and dementia risk: Evidence from the UK Biobank cohort 代谢综合征与认知功能和痴呆症风险的关系：来自英国生物库队列的证据。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-03 DOI: 10.1111/dom.15977

Qianlin Zuo PhD, Lingling Song PhD, Xinxin Gao PhD, Manqiu Cen PhD, Xihang Fu PhD, Shifan Qin PhD, Jing Wu PhD

Aim

To investigate the associations of metabolic syndrome (MetS) with cognitive function, dementia and its subtypes.

Methods

Based on the participants recruited by UK Biobank, this study aims to investigate the associations of MetS with cognitive function, dementia and its subtypes. Generalized estimating equations, Cox proportional risk models, and multiple linear regression models were respectively used to assess associations between MetS and dementia-related outcomes.

Results

Among the 363,231 participants, 95,713 had MetS at baseline. The results showed that MetS was significantly associated with cognitive function related to fluid intelligence and prospective memory at follow-up. Among participants aged ≥60 years, MetS was correlated with elevated risk of all-cause dementia, particularly vascular dementia (VaD) [hazard ratio 1.115 (95% confidence interval: 1.047, 1.187), hazard ratio 1.393 (95% confidence interval: 1.233, 1.575), respectively]. With increasing MetS components, the risk of all-cause dementia and VaD tended to be elevated. MetS has also been associated with dementia-related structural changes in the brain, including alterations in overall brain volume, white matter volume, grey matter volume and white matter integrity.

Conclusion

MetS was associated with poorer cognitive performance and might increase the risk of all-cause dementia as well as VaD, but the effect on Alzheimer's disease was not significant. Holistic control of the MetS may benefit the prevention and control of cognitive impairment and dementia.

目的：研究代谢综合征（MetS）与认知功能、痴呆症及其亚型的关系：本研究以英国生物数据库（UK Biobank）招募的参与者为基础，旨在探讨代谢综合征与认知功能、痴呆症及其亚型之间的关系。研究分别采用了广义估计方程、Cox比例风险模型和多元线性回归模型来评估MetS与痴呆症相关结果之间的关系：在 363 231 名参与者中，有 95 713 人在基线时患有 MetS。结果显示，MetS与随访时与流体智力和前瞻性记忆相关的认知功能有显著关联。在年龄≥60 岁的参与者中，MetS 与全因痴呆，尤其是血管性痴呆（VaD）的风险升高相关[危险比分别为 1.115（95% 置信区间：1.047, 1.187）、1.393（95% 置信区间：1.233, 1.575）]。随着 MetS 成分的增加，全因痴呆症和 VaD 的风险也呈上升趋势。MetS还与痴呆症相关的大脑结构变化有关，包括大脑总体积、白质体积、灰质体积和白质完整性的改变：结论：MetS 与较差的认知能力有关，可能会增加全因痴呆症和 VaD 的风险，但对阿尔茨海默氏症的影响并不显著。全面控制 MetS 可能有利于预防和控制认知障碍和痴呆症。

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引用次数: 0

iGlarLixi effectively reduces residual hyperglycaemia in Chinese people with type 2 diabetes on basal insulin: A post hoc analysis of the LixiLan-L-CN study iGlarLixi 能有效降低使用基础胰岛素的中国 2 型糖尿病患者的残余高血糖：利喜兰-L-CN研究的事后分析。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-03 DOI: 10.1111/dom.15968

Xiaoyong Yuan MD, Dongmei Li MD, Kun Wang MD, Felipe Lauand MD, Minlu Zhang MPH, Hexin Fang MD, Qin Du MD, Lei Kang MD, Agustina Alvarez MD, Xiaohui Guo MD

Aim

To compare the effects of iGlarLixi versus insulin glargine 100 U/mL (iGlar) on residual hyperglycaemia in Chinese people with uncontrolled type 2 diabetes (T2D) on prior basal insulin (BI) therapy ± oral antidiabetic drugs in the LixiLan-L-CN study (NCT03798080).

Materials and Methods

In this post hoc analysis, residual hyperglycaemia (i.e. HbA1c ≥ 7.0% [≥ 53 mmol/mol] and fasting plasma glucose [FPG] < 7.0 mmol/L) were assessed over 30 weeks. Outcomes were assessed at week 30 in participants with baseline residual hyperglycaemia, including changes from baseline in HbA1c, FPG, 2-hour postprandial glucose (PPG) and daily BI dose, the proportion of participants with HbA1c less than 7.0% (< 53 mmol/mol) and FPG less than 7.0 mmol/L and the incidence of hypoglycaemia.

Results

Of 421 participants, 124 (29.5%) had baseline residual hyperglycaemia (iGlarLixi, n = 64 [31.7%]; iGlar, n = 60 [29.1%]). At week 30, the residual hyperglycaemia rate decreased to 7.0% with iGlarLixi and increased to 43.3% with iGlar. Among participants with baseline residual hyperglycaemia, a greater proportion achieved both HbA1c and FPG targets at week 30 with iGlarLixi versus iGlar (43.8% vs. 16.7%), and iGlarLixi provided greater reductions in HbA1c (least squares mean [LSM] difference, −0.9% [−9.4 mmol/mol]) and 2-hour PPG (LSM difference, −4.7 mmol/L; both P < .001). Daily BI dose and incidence of hypoglycaemia were similar in the two groups.

Conclusions

The findings of this post hoc analysis suggest that iGlarLixi had greater benefits than iGlar in reducing the rate of residual hyperglycaemia over 30 weeks in Chinese people with suboptimally controlled T2D on prior BI-based therapy.

目的：比较 iGlarLixi 与胰岛素格列卫 100 U/mL（iGlar）对利昔兰-L-CN 研究（NCT03798080）中既往接受基础胰岛素（BI）治疗又口服抗糖尿病药物但血糖未得到控制的中国 2 型糖尿病（T2D）患者残余高血糖的影响：在这项事后分析中，残余高血糖（即 HbA1c ≥ 7.0% [≥ 53 mmol/mol] 和空腹血浆葡萄糖 [FPG] 结果：在 421 名参与者中，124 人（29.5%）有基线残余高血糖（iGlarLixi，n = 64 [31.7%]；iGlar，n = 60 [29.1%]）。第30周时，iGlarLixi的残余高血糖率降至7.0%，iGlar则升至43.3%。在基线残留高血糖的参与者中，使用iGlarLixi与iGlar相比，在第30周达到HbA1c和FPG目标的比例更高（43.8%对16.7%），而且iGlarLixi降低HbA1c（最小二乘法均值[LSM]差异，-0.9%[-9.4 mmol/mol]）和2小时PPG（LSM差异，-4.7 mmol/L；均为P 结论：iGlarLixi与iGlar相比，在基线残留高血糖的参与者中，在第30周达到HbA1c和FPG目标的比例更高（43.8%对16.7%）：这项事后分析的结果表明，与 iGlar 相比，iGlarLixi 能在 30 周内降低曾接受 BI 治疗但血糖控制不理想的中国 T2D 患者的残余高血糖率。

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引用次数: 0

Key biomarkers in type 2 diabetes patients: A systematic review. 2 型糖尿病患者的关键生物标志物：系统综述。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-02 DOI: 10.1111/dom.15991

Thien Ngoc Le, Richard Bright, Vi-Khanh Truong, Jordan Li, Rajiv Juneja, Krasimir Vasilev

Type 2 diabetes mellitus (T2DM) is not just a local health issue but a significant global health burden, affecting patient outcomes and clinical management worldwide. Despite the wealth of studies reporting T2DM biomarkers, there is an urgent need for a comparative review. This review aims to provide a comprehensive analysis based on the reported T2DM biomarkers and how these are linked with other conditions, such as inflammation and wound healing. A comparative review was conducted on 24 001 study participants, including 10 024 T2DM patients and 13 977 controls (CTL; age 30-90 years). Four main profiles were extracted and analysed from the clinical reports over the past 11 years: haematological (1084 cases vs. 1458 CTL), protein (6753 cases vs. 9613 CTL), cytokine (975 cases vs. 1350 CTL) and lipid (1212 cases vs. 1556 CTL). This review provides a detailed analysis of the haematological profile in T2DM patients, highlighting fundamental changes such as increased white blood cells and platelet counts, accompanied by decreases in red blood cell counts and iron absorption. In the serum protein profile, a reduction in albumin and anti-inflammatory cytokines was noted along with an increase in globulin levels and pro-inflammatory cytokines. Furthermore, changes in lipid profiles were discussed, specifically the decreases in high-density lipoprotein (HDL) and the increases in low-density lipoprotein (LDL) and triglycerides. Understanding the changes in these four biomarker profiles is essential for developing innovative strategies to create diagnostic and prognostic tools for diabetes management.

2 型糖尿病（T2DM）不仅是一个地方性健康问题，也是一个重大的全球性健康负担，影响着全世界患者的治疗效果和临床管理。尽管有大量研究报告了 T2DM 的生物标志物，但仍迫切需要进行比较综述。本综述旨在根据已报道的 T2DM 生物标志物以及这些生物标志物与炎症和伤口愈合等其他疾病之间的联系进行全面分析。我们对 24 001 名研究参与者进行了比较审查，其中包括 10 024 名 T2DM 患者和 13 977 名对照组（CTL；年龄 30-90 岁）。从过去 11 年的临床报告中提取并分析了四个主要特征：血液（1084 例与 1458 例 CTL）、蛋白质（6753 例与 9613 例 CTL）、细胞因子（975 例与 1350 例 CTL）和脂质（1212 例与 1556 例 CTL）。这篇综述详细分析了 T2DM 患者的血液学特征，突出强调了一些基本变化，如白细胞和血小板计数增加，同时红细胞计数和铁吸收减少。在血清蛋白谱中，白蛋白和抗炎细胞因子减少，球蛋白水平和促炎细胞因子增加。此外，还讨论了血脂谱的变化，特别是高密度脂蛋白（HDL）的减少以及低密度脂蛋白（LDL）和甘油三酯的增加。了解这四种生物标志物特征的变化对于制定创新战略以创建糖尿病管理的诊断和预后工具至关重要。

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引用次数: 0

Association of a composite trait for anthropometrics, adiposity and energy expenditure with cardiometabolic diseases: An age-stratified cohort and genetic risk score analysis 人体测量、脂肪和能量消耗的复合特征与心脏代谢疾病的关系：年龄分层队列和遗传风险评分分析。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-02 DOI: 10.1111/dom.15966

Fleur L. Meulmeester MSc, Ko Willems van Dijk, Diana van Heemst, Raymond Noordam

Aim

Various anthropometric measures capture distinct as well as overlapping characteristics of an individual's body composition. To characterize independent body composition measures, we aimed to reduce easily-obtainable individual measures reflecting adiposity, anthropometrics and energy expenditure into fewer independent constructs, and to assess their potential sex- and age-specific relation with cardiometabolic diseases.

Methods

Analyses were performed within European ancestry participants from UK Biobank (N = 418,963, mean age 58.0 years, 56% women). Principal components (PC) analyses were used for the dimension reduction of 11 measures of adiposity, anthropometrics and energy expenditure. PCs were studied in relation to incident type 2 diabetes mellitus (T2D) and coronary artery disease (CAD). Multivariable-adjusted Cox regression analyses, adjusted for confounding factors, were performed in all and stratified by age. Genome-wide association studies were performed in half of the cohort (N = 156,295) to identify genetic variants as instrumental variables. Genetic risk score analyses were performed in the other half of the cohort stratified by age of disease onset (N = 156,295).

Results

We identified two PCs, of which PC1 reflected lower overall adiposity (negatively correlated with all adiposity aspects) and PC2 reflected more central adiposity (mainly correlated with higher waist–hip ratio, but with lower total body fat) and increased height, collectively capturing 87.8% of the total variance. Similar to that observed in the multivariable-adjusted regression analyses, we found associations between the PC1 genetic risk score and lower risks of CAD and T2D [CAD cases <50 years, odds ratio: 0.91 (95% confidence interval 0.87, 0.94) per SD; T2D cases <50 years, odds ratio: 0.76 (0.72, 0.81)], which attenuated with higher age (p-values 8.13E-4 and 2.41E-6, respectively). No associations were found for PC2.

Conclusions

The consistently observed weaker associations of the composite traits with cardiometabolic disease suggests the need for age-specific cardiometabolic disease prevention strategies.

目的：各种人体测量指标可以捕捉到个人身体成分的不同特征和重叠特征。为了描述独立的身体成分测量指标的特征，我们旨在将易于获得的反映脂肪率、人体测量和能量消耗的个体测量指标简化为较少的独立结构，并评估它们与心脏代谢疾病的潜在性别和年龄特异性关系：分析对象为英国生物库中的欧洲血统参与者（N = 418,963 人，平均年龄 58.0 岁，56% 为女性）。采用主成分（PC）分析法对 11 项脂肪含量、人体测量和能量消耗指标进行降维处理。研究了 PC 与 2 型糖尿病（T2D）和冠状动脉疾病（CAD）的关系。在对混杂因素进行调整后，对所有人进行了多变量调整 Cox 回归分析，并按年龄进行了分层。对半数队列（N = 156,295 人）进行了全基因组关联研究，以确定作为工具变量的遗传变异。在另一半队列中按发病年龄进行了遗传风险评分分析（N = 156 295）：我们发现了两个 PC，其中 PC1 反映了较低的总体脂肪率（与所有脂肪率方面均呈负相关），PC2 反映了较高的中心脂肪率（主要与较高的腰臀比相关，但与较低的总体脂肪率相关）和较高的身高，共占总变异的 87.8%。与多变量调整回归分析中观察到的情况类似，我们发现 PC1 遗传风险评分与较低的 CAD 和 T2D 风险之间存在关联（CAD 病例结论）：综合特征与心血管代谢疾病的关联性一直较弱，这表明需要制定针对特定年龄段的心血管代谢疾病预防策略。

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引用次数: 0

Efficacy of vitamin D supplementation on glycaemic control in type 2 diabetes: An updated systematic review and meta-analysis of randomized controlled trials 补充维生素 D 对控制 2 型糖尿病患者血糖的功效：随机对照试验的最新系统回顾和荟萃分析。

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism

Pub Date : 2024-10-02 DOI: 10.1111/dom.15941

Wei Chen MD, Lili Liu MD, Fang Hu PhD

Aim

To assess the effects of vitamin D interventions on glycaemic control in subjects with type 2 diabetes (T2D).

Methods

We searched PubMed, EMBASE, Web of Science and the Cochrane Library for relevant studies. Serum 25(OH)D, fasting blood glucose (FBG), HbA1c, fasting insulin and Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were analysed.

Results

We identified 39 randomized controlled trials involving 2982 subjects. Results showed a significant decline in the vitamin D group, as shown by the FBG weighted mean difference (WMD; −0.49 [95% confidence interval {CI}: −0.69 to −0.28] mmol/L), HbA1c (WMD −0.30% [95% CI: −0.43 to −0.18]), HOMA-IR (WMD −0.39 [95% CI −0.64 to −0.14]) and insulin (WMD −1.31 [95% CI: −2.06 to −0.56] μIU/mL). Subgroup analyses indicated that the effects of vitamin D supplementation on glycaemic control depend on the dosage and duration of supplementation, baseline 25(OH)D levels and the body mass index of patients with T2D.

Conclusions

Vitamin D supplementation can significantly reduce serum FBG, HbA1c, HOMA-IR and fasting insulin levels in T2D patients; the effects were especially prominent when vitamin D was given in a short-term, high dosage to patients with a vitamin D deficiency, who were overweight, or had an HbA1c of 8% or higher at baseline. Our study suggests that vitamin D supplements can be recommended as complementary treatment for T2D patients.

目的：评估维生素 D 干预措施对 2 型糖尿病（T2D）患者血糖控制的影响：我们检索了 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆的相关研究。分析了血清 25（OH）D、空腹血糖 (FBG)、HbA1c、空腹胰岛素和胰岛素抵抗稳态模型评估 (HOMA-IR)：我们确定了 39 项随机对照试验，涉及 2982 名受试者。结果显示，维生素 D 组的 FBG 加权平均差（WMD；-0.49 [95% 置信区间 {CI}：-0.69 至 -0.28]mmol/L）、HbA1c（WMD -0.30% [95% CI：-0.43 至 -0.18]）、HOMA-IR（WMD -0.39 [95% CI -0.64 至 -0.14]）和胰岛素（WMD -1.31 [95% CI：-2.06 至 -0.56]μIU/mL）均明显下降。亚组分析表明，维生素D补充剂对血糖控制的影响取决于补充剂的剂量和持续时间、基线25（OH）D水平以及T2D患者的体重指数：补充维生素 D 可明显降低 T2D 患者的血清 FBG、HbA1c、HOMA-IR 和空腹胰岛素水平；对维生素 D 缺乏、超重或基线 HbA1c 为 8%或更高的患者短期、高剂量补充维生素 D 的效果尤为突出。我们的研究表明，可以推荐维生素 D 补充剂作为 T2D 患者的辅助治疗。

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引用次数: 0