Diabetes osteoporosis is a debilitating condition that significantly impacts human health. However, it is often underdiagnosed and not addressed in a timely or appropriate manner.
Methods
Recent studies were reviewed to explore the roles of energy metabolism, sarcopeina, low-grade inflammation and gut microbiota in the development of diabetes osteoporosis.
Results
Osteoporosis in diabetic patients differs from primary osteoporosis. Novel biomarkers and risk factors that are biologically, physiologically, and pathologically linked to the development of diabetes osteoporosis are emerging, necessitating a shift in strategies for diagnosis, risk stratification, and prevention of diabetes osteoporosis.
Conclusions
There is an urgent need to approach this disorder from a fresh perspective, initiating a range of basic research and clinical investigations.
{"title":"New Evidence, Creative Insights, and Strategic Solutions: Advancing the Understanding and Practice of Diabetes Osteoporosis","authors":"Bei Tao, Ximei Shen, Guangfei Li, Xiyu Wu, Yuying Yang, Chunxiang Sheng, Yun Zhang, Ling Wang, Zhiyun Zhao, Qi Song, Dewen Yan, Sunjie Yan, Youjia Xu, Huijuan Yuan, Houde Zhou, Jianmin Liu","doi":"10.1111/1753-0407.70091","DOIUrl":"https://doi.org/10.1111/1753-0407.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes osteoporosis is a debilitating condition that significantly impacts human health. However, it is often underdiagnosed and not addressed in a timely or appropriate manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recent studies were reviewed to explore the roles of energy metabolism, sarcopeina, low-grade inflammation and gut microbiota in the development of diabetes osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Osteoporosis in diabetic patients differs from primary osteoporosis. Novel biomarkers and risk factors that are biologically, physiologically, and pathologically linked to the development of diabetes osteoporosis are emerging, necessitating a shift in strategies for diagnosis, risk stratification, and prevention of diabetes osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is an urgent need to approach this disorder from a fresh perspective, initiating a range of basic research and clinical investigations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yifei Wang, Shiya Gu, Zhixuan Xie, Zhiyong Xu, Wenfang He, Yexiang Chen, Juan Jin, Qiang He
Background
This study analyzes the trends in the burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in China from 1990 to 2021, evaluates variations in risk factors, and projects the disease burden through 2036.
Method
Estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for CKD-T2D were retrieved along with their 95% uncertainty intervals (UIs). Age-period-cohort analysis was used to assess burden trends from 1990 to 2021, identify risk factor population attributable fractions (PAFs), and project the burden through 2036.
Results
In 2021, there were 20 911 520 CKD-T2D cases in China, with an age-standardized prevalence rate (ASPR) of 1053.92 per 100 000, an incidence rate (ASIR) of 23.07, an age-standardized mortality rate (ASMR) of 5.72, and an age-standardized DALY rate (ASDR) of 122.15. Although the overall burden showed a slow decline from 1990 to 2021, incidence continued to rise. The 2021 data revealed a marked age effect, with the burden rising with age. Period effects also contributed to an increased risk, with metabolic risk factors such as high fasting plasma glucose and BMI contributing the most. Projections suggest a decline in mortality and DALYs by 2036, while incidence will keep increasing.
Conclusion
Despite declines in ASMR and ASDR, CKD-T2D incidence and cases continue to rise, especially among males and the elderly. This increasing burden is driven by aging and metabolic risk factors. Early screening, education, and risk management are essential for addressing CKD-T2D in China.
{"title":"Trends and Disparities in the Burden of Chronic Kidney Disease due to Type 2 Diabetes in China From 1990 to 2021: A Population-Based Study","authors":"Yifei Wang, Shiya Gu, Zhixuan Xie, Zhiyong Xu, Wenfang He, Yexiang Chen, Juan Jin, Qiang He","doi":"10.1111/1753-0407.70084","DOIUrl":"https://doi.org/10.1111/1753-0407.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study analyzes the trends in the burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in China from 1990 to 2021, evaluates variations in risk factors, and projects the disease burden through 2036.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for CKD-T2D were retrieved along with their 95% uncertainty intervals (UIs). Age-period-cohort analysis was used to assess burden trends from 1990 to 2021, identify risk factor population attributable fractions (PAFs), and project the burden through 2036.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, there were 20 911 520 CKD-T2D cases in China, with an age-standardized prevalence rate (ASPR) of 1053.92 per 100 000, an incidence rate (ASIR) of 23.07, an age-standardized mortality rate (ASMR) of 5.72, and an age-standardized DALY rate (ASDR) of 122.15. Although the overall burden showed a slow decline from 1990 to 2021, incidence continued to rise. The 2021 data revealed a marked age effect, with the burden rising with age. Period effects also contributed to an increased risk, with metabolic risk factors such as high fasting plasma glucose and BMI contributing the most. Projections suggest a decline in mortality and DALYs by 2036, while incidence will keep increasing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite declines in ASMR and ASDR, CKD-T2D incidence and cases continue to rise, especially among males and the elderly. This increasing burden is driven by aging and metabolic risk factors. Early screening, education, and risk management are essential for addressing CKD-T2D in China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Globally, diabetic retinopathy (DR) is estimated to have affected 103 persons in 2020, with projections of 130 and 161 million in 2030 and 2045, respectively. The respective prevalences of vision-threatening DR, are 29, 36, and 45 million persons in 2020, 2030, and 2045, and of clinically significant diabetic macular edema (DME), 19, 24, and 29 million persons [<span>1</span>]. Glucagon-like peptide-1 Receptor Activators (GLP-1RA) have become more widely used in the treatment of type 2 diabetes (T2D), with analysis of the TriNetX dataset showing that the prevalence of GLP-1RA use in the US increased from 6.4% in 2018 to 14.9% in 2022 among T2D with ASCVD [<span>2</span>]. 12% of US adults say they have taken a GLP-1 agonist, and 6% say they are taking this currently; the prevalence of such use is 43% among people with diabetes, 25% among those who have been told of heart disease, and 22% among those who have been told by a doctor about being overweight or obese [<span>3</span>].</p><p>We generally would anticipate excellent glycemic treatment to be associated with improved outcomes of most diabetes complications. Indeed, a meta-analysis of 11 randomized controlled trials (RCT) involving 51 469 patients with T2D showed a 15% reduction in DR risk [<span>4</span>]. The GLP-1RA are among the most effective agents used in T2D treatment, having at least as great a glycemic effect as basal insulin [<span>5</span>], with weight loss rather than weight gain and with a lower likelihood of hypoglycemia. A caveat is the recognized potential that with rapid improvement of poorly controlled diabetes conditions similar to the microvascular complications of diabetes can occur. Acute painful peripheral diabetic neuropathy is one such syndrome [<span>6</span>]. Another such condition was seen in the analysis of the initial outcome of the Diabetes Complications and Control Trial (DCCT) of type 1 diabetes, in which early worsening of DR was observed at the 6- and 12-month DCCT visits in 13.1% of 711 patients assigned to intensive treatment and in 7.6% of 728 patients assigned to conventional treatment, particularly in those with higher baseline HbA1c and in those with a greater 6-month reduction in HbA1c [<span>7</span>].</p><p>The effect of GLP-1RA on DR is less clear. Using the TriNetX global research network to assess the development of DR and DME in ~2 million individuals with type 2 diabetes taking insulin, one study using propensity score matching suggested that those receiving GLP-1RA had a 31% increased risk of DR, without significant change in the risk of DME, compared with those receiving neither sodium-glucose co-transporter 2 inhibitors (SGLT2i) nor GLP-1RA, while compared with those receiving SGLT2i, those receiving GLP-1RA had a 20% higher risk of DR and a 13% higher risk of DME [<span>8</span>]. However, another study using TriNetX among 9.9 million patients with T2D, over a 2-year period of observation, found that DME was 23% and 17% less likely w
{"title":"Semaglutide and the Retina","authors":"Zachary T. Bloomgarden","doi":"10.1111/1753-0407.70085","DOIUrl":"https://doi.org/10.1111/1753-0407.70085","url":null,"abstract":"<p>Globally, diabetic retinopathy (DR) is estimated to have affected 103 persons in 2020, with projections of 130 and 161 million in 2030 and 2045, respectively. The respective prevalences of vision-threatening DR, are 29, 36, and 45 million persons in 2020, 2030, and 2045, and of clinically significant diabetic macular edema (DME), 19, 24, and 29 million persons [<span>1</span>]. Glucagon-like peptide-1 Receptor Activators (GLP-1RA) have become more widely used in the treatment of type 2 diabetes (T2D), with analysis of the TriNetX dataset showing that the prevalence of GLP-1RA use in the US increased from 6.4% in 2018 to 14.9% in 2022 among T2D with ASCVD [<span>2</span>]. 12% of US adults say they have taken a GLP-1 agonist, and 6% say they are taking this currently; the prevalence of such use is 43% among people with diabetes, 25% among those who have been told of heart disease, and 22% among those who have been told by a doctor about being overweight or obese [<span>3</span>].</p><p>We generally would anticipate excellent glycemic treatment to be associated with improved outcomes of most diabetes complications. Indeed, a meta-analysis of 11 randomized controlled trials (RCT) involving 51 469 patients with T2D showed a 15% reduction in DR risk [<span>4</span>]. The GLP-1RA are among the most effective agents used in T2D treatment, having at least as great a glycemic effect as basal insulin [<span>5</span>], with weight loss rather than weight gain and with a lower likelihood of hypoglycemia. A caveat is the recognized potential that with rapid improvement of poorly controlled diabetes conditions similar to the microvascular complications of diabetes can occur. Acute painful peripheral diabetic neuropathy is one such syndrome [<span>6</span>]. Another such condition was seen in the analysis of the initial outcome of the Diabetes Complications and Control Trial (DCCT) of type 1 diabetes, in which early worsening of DR was observed at the 6- and 12-month DCCT visits in 13.1% of 711 patients assigned to intensive treatment and in 7.6% of 728 patients assigned to conventional treatment, particularly in those with higher baseline HbA1c and in those with a greater 6-month reduction in HbA1c [<span>7</span>].</p><p>The effect of GLP-1RA on DR is less clear. Using the TriNetX global research network to assess the development of DR and DME in ~2 million individuals with type 2 diabetes taking insulin, one study using propensity score matching suggested that those receiving GLP-1RA had a 31% increased risk of DR, without significant change in the risk of DME, compared with those receiving neither sodium-glucose co-transporter 2 inhibitors (SGLT2i) nor GLP-1RA, while compared with those receiving SGLT2i, those receiving GLP-1RA had a 20% higher risk of DR and a 13% higher risk of DME [<span>8</span>]. However, another study using TriNetX among 9.9 million patients with T2D, over a 2-year period of observation, found that DME was 23% and 17% less likely w","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silke Zimmermann, Kirsten Roomp, Hans-Jonas Meyer, Akash Mathew, Manuel Florian Struck, Matthias Blüher, Hugo N. G. Martin, Maria Keller, Kathrin Landgraf, Antje Körner, Anne Hoffmann, Yvonne Böttcher, Kathleen Biemann, Adhideb Ghosh, Christian Wolfrum, Falko Noé, Berend Isermann, Jochen G. Schneider, Ronald Biemann
Aims
Lifestyle-induced weight loss (LIWL) is considered an effective therapy for the treatment of metabolic syndrome (MetS). The role of differentially expressed genes (DEGs) in adipose tissue function and in the success of LIWL in MetS is still unclear. We investigated the effect of 6 months of LIWL on transcriptional regulation in subcutaneous adipose tissue (SAT). Aiming to identify a LIWL-associated “gene signature” in SAT, DEGs were fitted into a linear regression model.
Materials and Methods
The study is embedded in a prospective, two-arm, controlled, monocentric, randomized, 6-month interventional trial in individuals with MetS following LIWL. The trial included 43 nonsmoking, nondiabetic men aged 45–55 years with MetS.
Results
In total, we identified 642 DEGs in SAT after 6 months of LIWL. The identified DEGs were validated in two cross-sectional cohorts analyzing SAT from individuals with and without obesity. Gene enrichment analysis of the DEGs revealed the strongest association with cholesterol metabolic processes. Accordingly, DEGs were correlated with the lipid parameters HDL cholesterol, LDL cholesterol, and triglycerides in corresponding serum samples. We identified 3 genes with an AUC of 0.963 (95% CI: 0.906–1.0) associated with a loss of more than 10% of initial body weight that was maintained for at least 12 months after LIWL, namely SUMO3 (Small ubiquitin-related modifier 3), PRKG2 (Protein Kinase CGMP-Dependent 2), and ADAP2 (ArfGAP with Dual PH Domains 2).
Conclusion
In summary, we have identified DEGs in SAT after LIWL, which may play an important role in metabolic functions. In particular, altered gene expression in SAT may predict sustained weight loss.
{"title":"Association of Lifestyle-Induced Weight Loss With Gene Expression in Subcutaneous Adipose Tissue in Metabolic Syndrome","authors":"Silke Zimmermann, Kirsten Roomp, Hans-Jonas Meyer, Akash Mathew, Manuel Florian Struck, Matthias Blüher, Hugo N. G. Martin, Maria Keller, Kathrin Landgraf, Antje Körner, Anne Hoffmann, Yvonne Böttcher, Kathleen Biemann, Adhideb Ghosh, Christian Wolfrum, Falko Noé, Berend Isermann, Jochen G. Schneider, Ronald Biemann","doi":"10.1111/1753-0407.70083","DOIUrl":"https://doi.org/10.1111/1753-0407.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Lifestyle-induced weight loss (LIWL) is considered an effective therapy for the treatment of metabolic syndrome (MetS). The role of differentially expressed genes (DEGs) in adipose tissue function and in the success of LIWL in MetS is still unclear. We investigated the effect of 6 months of LIWL on transcriptional regulation in subcutaneous adipose tissue (SAT). Aiming to identify a LIWL-associated “gene signature” in SAT, DEGs were fitted into a linear regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study is embedded in a prospective, two-arm, controlled, monocentric, randomized, 6-month interventional trial in individuals with MetS following LIWL. The trial included 43 nonsmoking, nondiabetic men aged 45–55 years with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, we identified 642 DEGs in SAT after 6 months of LIWL. The identified DEGs were validated in two cross-sectional cohorts analyzing SAT from individuals with and without obesity. Gene enrichment analysis of the DEGs revealed the strongest association with cholesterol metabolic processes. Accordingly, DEGs were correlated with the lipid parameters HDL cholesterol, LDL cholesterol, and triglycerides in corresponding serum samples. We identified 3 genes with an AUC of 0.963 (95% CI: 0.906–1.0) associated with a loss of more than 10% of initial body weight that was maintained for at least 12 months after LIWL, namely <i>SUMO3</i> (<i>Small ubiquitin-related modifier 3</i>), <i>PRKG2</i> (<i>Protein Kinase CGMP-Dependent 2</i>), and <i>ADAP2 (ArfGAP with Dual PH Domains 2</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, we have identified DEGs in SAT after LIWL, which may play an important role in metabolic functions. In particular, altered gene expression in SAT may predict sustained weight loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Dulaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been approved for improving glycemic control and reducing the risk of cardiovascular (CV) adverse events. A previous result in healthy Chinese male subjects demonstrated the pharmacokinetic (PK) similarity of LY05008 and the licensed product dulaglutide, with comparable safety and immunogenicity profiles. A well-controlled phase 3 study with an adequate sample size was subsequently conducted for safety and efficacy evaluation.</p> </section> <section> <h3> Methods</h3> <p>In a multicenter, randomized, open-label, active comparator phase 3 study, Chinese adults diagnosed with type 2 diabetes mellitus (T2DM) were randomly assigned 1:1 to receive a subcutaneous injection of 1.5 mg LY05008 or dulaglutide once weekly for 24 weeks. The primary endpoint was the mean change in HbA1c from baseline to Week 24. The secondary endpoints included the mean change in HbA1c from baseline to Week 12; the proportion of patients who had achieved HbA1c ≤ 6.5% at Weeks 12 and 24; and the mean change in body weight, fasting plasma glucose (FPG) level, and 2-h postprandial plasma glucose (PPG) level from baseline to Weeks 12 and 24. Safety, PK, and immunogenicity profiles were also included for data analysis.</p> </section> <section> <h3> Results</h3> <p>A total of 440 patients were randomized to receive LY05008 (<i>n</i> = 222) or dulaglutide (<i>n</i> = 218). The mean changes in HbA1c from baseline to Week 24 in the LY05008 group and dulaglutide group were −1.44% and −1.41%, respectively, with a least square mean difference (LSMD) and 95% confidence interval (CI) of 0.06% (−0.08, 0.19) (<i>p</i> > 0.05). Efficacy equivalence could be demonstrated since the 95% CI between the reference drug and a biosimilar fell entirely within the range of (−0.4%, 0.4%). The mean changes in HbA1c from baseline to Week 12 in the LY05008 group and dulaglutide group were −1.47% and −1.39% (<i>p</i> > 0.05), respectively. At Week 12, 40.1% of patients who received LY05008 and 42.2% of those who received dulaglutide had a decrease in the HbA1c level to 6.5% or less, and 60.4% and 60.6% of patients in the LY05008 group and the dulaglutide group had a decrease in the HbA1C level < 7%, respectively. At Week 24, 41.0% and 43.6% of patients achieved an HbA1c ≤ 6.5%. 55.9% and 66.5% of patients in the LY05008 group and the dulaglutide group achieved the HbA1c goal of < 7%, respectively. The mean changes in body weight from baseline to Weeks 12 and 24 in the LY05008 group and dulaglutide group were −2.01 and −1.71 kg (<i>p</i> > 0.05) and −2.68 and −2.42 kg (<i>p</i> > 0.05
{"title":"Efficacy and Safety of Dulaglutide Biosimilar LY05008 Versus the Reference Product Dulaglutide (Trulicity) in Chinese Adults With Type 2 Diabetes Mellitus: A Randomized, Open-Label, Active Comparator Study","authors":"Li Liu, Zhifeng Cheng, Lianwei Wang, Lili Zhang, Shunbin Li, Shu Li, Shuguang Pang, Qifu Li, Fang Bian, Junling Gu, Jie Shen, Liujun Fu, Baiping Sun, Yanyan Zhao, Changlin Dou, Zhaoyang Zeng, Lixin Guo","doi":"10.1111/1753-0407.70077","DOIUrl":"https://doi.org/10.1111/1753-0407.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dulaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been approved for improving glycemic control and reducing the risk of cardiovascular (CV) adverse events. A previous result in healthy Chinese male subjects demonstrated the pharmacokinetic (PK) similarity of LY05008 and the licensed product dulaglutide, with comparable safety and immunogenicity profiles. A well-controlled phase 3 study with an adequate sample size was subsequently conducted for safety and efficacy evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a multicenter, randomized, open-label, active comparator phase 3 study, Chinese adults diagnosed with type 2 diabetes mellitus (T2DM) were randomly assigned 1:1 to receive a subcutaneous injection of 1.5 mg LY05008 or dulaglutide once weekly for 24 weeks. The primary endpoint was the mean change in HbA1c from baseline to Week 24. The secondary endpoints included the mean change in HbA1c from baseline to Week 12; the proportion of patients who had achieved HbA1c ≤ 6.5% at Weeks 12 and 24; and the mean change in body weight, fasting plasma glucose (FPG) level, and 2-h postprandial plasma glucose (PPG) level from baseline to Weeks 12 and 24. Safety, PK, and immunogenicity profiles were also included for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 440 patients were randomized to receive LY05008 (<i>n</i> = 222) or dulaglutide (<i>n</i> = 218). The mean changes in HbA1c from baseline to Week 24 in the LY05008 group and dulaglutide group were −1.44% and −1.41%, respectively, with a least square mean difference (LSMD) and 95% confidence interval (CI) of 0.06% (−0.08, 0.19) (<i>p</i> > 0.05). Efficacy equivalence could be demonstrated since the 95% CI between the reference drug and a biosimilar fell entirely within the range of (−0.4%, 0.4%). The mean changes in HbA1c from baseline to Week 12 in the LY05008 group and dulaglutide group were −1.47% and −1.39% (<i>p</i> > 0.05), respectively. At Week 12, 40.1% of patients who received LY05008 and 42.2% of those who received dulaglutide had a decrease in the HbA1c level to 6.5% or less, and 60.4% and 60.6% of patients in the LY05008 group and the dulaglutide group had a decrease in the HbA1C level < 7%, respectively. At Week 24, 41.0% and 43.6% of patients achieved an HbA1c ≤ 6.5%. 55.9% and 66.5% of patients in the LY05008 group and the dulaglutide group achieved the HbA1c goal of < 7%, respectively. The mean changes in body weight from baseline to Weeks 12 and 24 in the LY05008 group and dulaglutide group were −2.01 and −1.71 kg (<i>p</i> > 0.05) and −2.68 and −2.42 kg (<i>p</i> > 0.05","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The cardioprotective effects of glucagon-like peptide-1 receptor agonist (GLP-1RA)-based therapies in nondiabetic individuals with overweight or obesity remain underexplored. This meta-analysis evaluates their impact on cardiovascular events and metabolic parameters in this population.
Methods
A meta-analysis was conducted using PubMed, Embase, Cochrane, and Web of Science databases from inception to June 18, 2024. Eligible studies were randomized controlled trials (RCTs) enrolling nondiabetic adults with overweight or obesity. These studies compared GLP-1RA-based therapies with placebo and reported cardiovascular events and metabolic parameters.
Results
A total of 29 RCTs involving 9 GLP-1RA-based drugs and 37 348 eligible participants were included. Compared to placebo, GLP-1RA-based therapies significantly reduced the risk of total cardiovascular events (relative risk: 0.81, 95% confidence interval [CI]: [0.76, 0.87]), major adverse cardiovascular events (0.80, [0.72, 0.89]), myocardial infarction (0.72, [0.61, 0.85]), and all-cause mortality (0.81, [0.71, 0.93]). No significant differences were observed in cardiovascular death or stroke. Additionally, GLP-1RA-based therapies were associated with significant reductions in some cardiometabolic parameters. Among GLP-1RA-based therapies, orfroglipron demonstrated strong benefits in reducing systolic blood pressure (mean difference: −7.10 mmHg, 95% CI: [−11.00, −2.70]). Tirzepatide induced the greatest reduction in body mass index (−6.50 kg/m2, [−7.90, −5.10]) and hemoglobin A1c concentrations (−0.39%, [−0.52, −0.26]). Retatrutide and semaglutide were most effective in improving lipid profiles and reducing C-reactive protein levels (−1.20 mg/dL, [−1.80, −0.63]), respectively.
Conclusions
In nondiabetic individuals with overweight or obesity, GLP-1RA-based therapies significantly reduce cardiovascular events and improve cardiometabolic parameters. These findings underscore the potential for individualized GLP-1RA-based therapies targeting cardiovascular risk factors.
{"title":"Efficacy of GLP-1 Receptor Agonist-Based Therapies on Cardiovascular Events and Cardiometabolic Parameters in Obese Individuals Without Diabetes: A Meta-Analysis of Randomized Controlled Trials","authors":"Yue Yin, Minghan Zhang, Qiuyu Cao, Lin Lin, Jieli Lu, Yufang Bi, Yuhong Chen","doi":"10.1111/1753-0407.70082","DOIUrl":"https://doi.org/10.1111/1753-0407.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The cardioprotective effects of glucagon-like peptide-1 receptor agonist (GLP-1RA)-based therapies in nondiabetic individuals with overweight or obesity remain underexplored. This meta-analysis evaluates their impact on cardiovascular events and metabolic parameters in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A meta-analysis was conducted using PubMed, Embase, Cochrane, and Web of Science databases from inception to June 18, 2024. Eligible studies were randomized controlled trials (RCTs) enrolling nondiabetic adults with overweight or obesity. These studies compared GLP-1RA-based therapies with placebo and reported cardiovascular events and metabolic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 29 RCTs involving 9 GLP-1RA-based drugs and 37 348 eligible participants were included. Compared to placebo, GLP-1RA-based therapies significantly reduced the risk of total cardiovascular events (relative risk: 0.81, 95% confidence interval [CI]: [0.76, 0.87]), major adverse cardiovascular events (0.80, [0.72, 0.89]), myocardial infarction (0.72, [0.61, 0.85]), and all-cause mortality (0.81, [0.71, 0.93]). No significant differences were observed in cardiovascular death or stroke. Additionally, GLP-1RA-based therapies were associated with significant reductions in some cardiometabolic parameters. Among GLP-1RA-based therapies, orfroglipron demonstrated strong benefits in reducing systolic blood pressure (mean difference: −7.10 mmHg, 95% CI: [−11.00, −2.70]). Tirzepatide induced the greatest reduction in body mass index (−6.50 kg/m<sup>2</sup>, [−7.90, −5.10]) and hemoglobin A1c concentrations (−0.39%, [−0.52, −0.26]). Retatrutide and semaglutide were most effective in improving lipid profiles and reducing C-reactive protein levels (−1.20 mg/dL, [−1.80, −0.63]), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In nondiabetic individuals with overweight or obesity, GLP-1RA-based therapies significantly reduce cardiovascular events and improve cardiometabolic parameters. These findings underscore the potential for individualized GLP-1RA-based therapies targeting cardiovascular risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jinzhou Liu, Min Guo, Xiaobin Yuan, Xiao Fan, Jin Wang, Xiangying Jiao
Background
Diabetic nephropathy (DN) is a severe microvascular complication of diabetes with a complex pathogenesis.
Methods
Recent studies were reviewed to explore the role of gut microbiota and its metabolites in DN development.
Results
Dysbiosis of gut bacteria contributes to pathological changes such as glomerular sclerosis and renal tubule injury. Microbial metabolites are involved in DN through immune and inflammatory pathways.
Conclusions
Understanding the relationship between gut microbiota, its metabolites, and DN may offer potential implications for DN diagnosis, prevention, and treatment. Translating this knowledge into clinical practice presents challenges and opportunities.
{"title":"Gut Microbiota and Their Metabolites: The Hidden Driver of Diabetic Nephropathy? Unveiling Gut Microbe's Role in DN","authors":"Jinzhou Liu, Min Guo, Xiaobin Yuan, Xiao Fan, Jin Wang, Xiangying Jiao","doi":"10.1111/1753-0407.70068","DOIUrl":"https://doi.org/10.1111/1753-0407.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic nephropathy (DN) is a severe microvascular complication of diabetes with a complex pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recent studies were reviewed to explore the role of gut microbiota and its metabolites in DN development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dysbiosis of gut bacteria contributes to pathological changes such as glomerular sclerosis and renal tubule injury. Microbial metabolites are involved in DN through immune and inflammatory pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding the relationship between gut microbiota, its metabolites, and DN may offer potential implications for DN diagnosis, prevention, and treatment. Translating this knowledge into clinical practice presents challenges and opportunities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Assefa Mulu Baye, Teferi Gedif Fenta, Suvi Karuranga, Ifeyinwa Dorothy Nnakenyi, Ekenechukwu Esther Young, Colin Palmer, Ewan R. Pearson, Ifeoma Isabella Ulasi, Adem Y. Dawed
Aims
We aimed to determine the prevalence of diabetes and the clinical profiles of Type 2 diabetes in Ethiopia and Nigeria.
Methods
A community-based cross-sectional study was carried out from November 01, 2020 to October 21, 2021 among 1727 participants using a multistage sampling method. The WHO's STEPs tool was employed. Both fasting and oral glucose tolerance tests were used for screening and American Diabetes Association's (ADA's) diagnostic criteria was used. Stata version 17 was used for analysis. Analysis of Variance (ANOVA) and the Chi-square test were used to compare variables. Significance was declared at a p-value less than 0.05.
Result
Of the surveyed participants, 872 (50.5%) were men and the mean age was 44.6 years. The overall prevalence of prediabetes and diabetes was 15.8% and 7.0%, respectively. Impaired fasting glycaemia and glucose tolerance were 11.8% and 11.5%, respectively. The prevalence of newly diagnosed diabetes was 3.4% by fasting and 4.0% by oral glucose tolerance test. Participants with normal blood glucose were younger and had a lower weight, body mass index (BMI), waist circumference, diastolic, and systolic blood pressure, and history of hypertension than those with prediabetes and diabetes.
Conclusion
In the present study, there is a notably high diabetes and prediabetes prevalence in the study settings. Individuals with diabetes in Ethiopia compared to Nigeria and the West have different anthropometric and clinical profiles characterized by a young age of onset, leanness, lower BMI, and waist circumference. Hence, the management of diabetes shall be tailored to the unique physiologic and clinical profiles of the population.
目的：我们旨在确定埃塞俄比亚和尼日利亚2型糖尿病的患病率和临床概况。方法采用多阶段抽样方法，于2020年11月1日至2021年10月21日对1727人进行社区横断面研究。采用了世卫组织的STEPs工具。采用空腹和口服葡萄糖耐量试验进行筛查，并采用美国糖尿病协会（ADA）的诊断标准。使用Stata version 17进行分析。采用方差分析（ANOVA）和卡方检验进行变量比较。p值小于0.05时宣布显著性。结果男性872人（50.5%），平均年龄44.6岁。糖尿病前期和糖尿病的总体患病率分别为15.8%和7.0%。空腹血糖和葡萄糖耐量受损分别为11.8%和11.5%。新诊断糖尿病的患病率空腹为3.4%，口服糖耐量试验为4.0%。与糖尿病前期和糖尿病患者相比，血糖正常的参与者更年轻，体重、体重指数（BMI）、腰围、舒张压和收缩压以及高血压病史都更低。结论：在本研究中，研究环境中糖尿病和前驱糖尿病的患病率明显较高。与尼日利亚和西方国家相比，埃塞俄比亚的糖尿病患者具有不同的人体测量学和临床特征，其特点是发病年龄小、身体消瘦、BMI较低、腰围较小。因此，糖尿病的管理应量身定制的独特的生理和临床概况的人口。
{"title":"Comparative Analysis of Type 2 Diabetes Prevalence and Clinical Profiles in Ethiopia and Nigeria","authors":"Assefa Mulu Baye, Teferi Gedif Fenta, Suvi Karuranga, Ifeyinwa Dorothy Nnakenyi, Ekenechukwu Esther Young, Colin Palmer, Ewan R. Pearson, Ifeoma Isabella Ulasi, Adem Y. Dawed","doi":"10.1111/1753-0407.70078","DOIUrl":"https://doi.org/10.1111/1753-0407.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to determine the prevalence of diabetes and the clinical profiles of Type 2 diabetes in Ethiopia and Nigeria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A community-based cross-sectional study was carried out from November 01, 2020 to October 21, 2021 among 1727 participants using a multistage sampling method. The WHO's STEPs tool was employed. Both fasting and oral glucose tolerance tests were used for screening and American Diabetes Association's (ADA's) diagnostic criteria was used. Stata version 17 was used for analysis. Analysis of Variance (ANOVA) and the Chi-square test were used to compare variables. Significance was declared at a <i>p</i>-value less than 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Of the surveyed participants, 872 (50.5%) were men and the mean age was 44.6 years. The overall prevalence of prediabetes and diabetes was 15.8% and 7.0%, respectively. Impaired fasting glycaemia and glucose tolerance were 11.8% and 11.5%, respectively. The prevalence of newly diagnosed diabetes was 3.4% by fasting and 4.0% by oral glucose tolerance test. Participants with normal blood glucose were younger and had a lower weight, body mass index (BMI), waist circumference, diastolic, and systolic blood pressure, and history of hypertension than those with prediabetes and diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the present study, there is a notably high diabetes and prediabetes prevalence in the study settings. Individuals with diabetes in Ethiopia compared to Nigeria and the West have different anthropometric and clinical profiles characterized by a young age of onset, leanness, lower BMI, and waist circumference. Hence, the management of diabetes shall be tailored to the unique physiologic and clinical profiles of the population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Li, Qiqi You, Menglin Fan, Lingqi Wei, Jingjing Zeng, Bo Chen, Jie Wang, Shaoyong Xu
Background
To investigate whether lower socioeconomic status (SES) was associated with an increased risk of diabetic microvascular complications and to analyze the potential mediating role of several modifiable factors.
Methods
The study included 11 309 patients with type 2 diabetes at baseline from the UK Biobank cohort. SES was grouped based on income, education, and employment status by using latent class analysis. Microvascular complications of diabetes were identified through electronic health records. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for microvascular complications across SES groups. Mediation analysis was applied to explore potential mediators in these associations.
Results
During a median follow-up of 12.2 years, 262, 764, and 1017 participants in the high, medium, and low SES groups were diagnosed with microvascular complications. Compared to participants with high SES, those with low SES had a HR of 1.75 (95% CI: 1.53, 2.01) for total microvascular complications, a HR of 2.11 (95% CI: 1.74, 2.55) for nephropathy, a HR of 1.40 (95% CI: 1.14, 1.72) for retinopathy, and a HR of 1.79 (95% CI: 1.32, 2.43) for neuropathy. Mediation analysis indicated that alcohol consumption, body mass index, triglycerides, high density lipoprotein cholesterol, and glycated hemoglobin mediated the association between SES and microvascular complications, with mediation percentages of 1.3%, 12.2%, 4.4%, 10.9%, and 10.8%, respectively.
Conclusions
Lower SES may be associated with a higher risk of diabetic microvascular complications, and obesity-related indicators and glycated hemoglobin may play important mediating roles in the association.
{"title":"Socioeconomic Status, Modifiable Factors, and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A Cohort Study From the UK Biobank","authors":"Ying Li, Qiqi You, Menglin Fan, Lingqi Wei, Jingjing Zeng, Bo Chen, Jie Wang, Shaoyong Xu","doi":"10.1111/1753-0407.70079","DOIUrl":"https://doi.org/10.1111/1753-0407.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To investigate whether lower socioeconomic status (SES) was associated with an increased risk of diabetic microvascular complications and to analyze the potential mediating role of several modifiable factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 11 309 patients with type 2 diabetes at baseline from the UK Biobank cohort. SES was grouped based on income, education, and employment status by using latent class analysis. Microvascular complications of diabetes were identified through electronic health records. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for microvascular complications across SES groups. Mediation analysis was applied to explore potential mediators in these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 12.2 years, 262, 764, and 1017 participants in the high, medium, and low SES groups were diagnosed with microvascular complications. Compared to participants with high SES, those with low SES had a HR of 1.75 (95% CI: 1.53, 2.01) for total microvascular complications, a HR of 2.11 (95% CI: 1.74, 2.55) for nephropathy, a HR of 1.40 (95% CI: 1.14, 1.72) for retinopathy, and a HR of 1.79 (95% CI: 1.32, 2.43) for neuropathy. Mediation analysis indicated that alcohol consumption, body mass index, triglycerides, high density lipoprotein cholesterol, and glycated hemoglobin mediated the association between SES and microvascular complications, with mediation percentages of 1.3%, 12.2%, 4.4%, 10.9%, and 10.8%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lower SES may be associated with a higher risk of diabetic microvascular complications, and obesity-related indicators and glycated hemoglobin may play important mediating roles in the association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ziyuan Chen, Paul James Collings, Mengyao Wang, Haeyoon Jang, Qiaoxin Shi, Hin Sheung Ho, Shan Luo, Shiu Lun Au Yeung, Youngwon Kim
Objective
To examine the independent and combined associations of genetic risk and muscle strength with the risk of incident type 2 diabetes (T2D) and glycated hemoglobin (HbA1c) among individuals of South Asian ancestry.
Design and Methods
This study included 5288 South Asian individuals (mean age 52.5 years; 52.3% men) from the UK Biobank study. Baseline assessments were conducted between 2006 and 2010. Muscle strength was assessed through a hand dynamometer and expressed relative to fat-free mass. Sex-and age-specific tertiles were used to classify muscle strength into three categories. Genetic risk of T2D was quantified using a weighted polygenic risk score calculated from 22 distinct South Asian-specific single nucleotide polymorphisms for T2D.
Results
Compared to the bottom tertile of genetic risk for T2D, the highest had increased odds of incident T2D (odds ratio: 1.62; 95% confidence interval [CI]: 1.31–2.00) and HbA1c levels (β: 0.80; 95% CI 0.41–1.19). Compared to high muscle strength, low muscle strength was associated with 89% higher odds of incident T2D (odds ratio: 1.89; 95% CI 1.52–2.35) and higher HbA1c levels (β: 0.95; 95% CI 0.55–1.35), after adjustment for confounders and genetic susceptibility to T2D. Joint analyses revealed lower muscle strength was consistently associated with higher odds of incident T2D and HbA1c levels across all genetic risk strata.
Conclusion
Polygenic risk scores for T2D could have great prognostic value in preemptively identifying individuals of South Asian ancestry at high genetic risk of T2D. Regardless of T2D genetic risk, greater muscle strength is linked to lower T2D risk and HbA1c levels.
目的探讨遗传风险和肌肉力量与南亚血统个体发生2型糖尿病（T2D）和糖化血红蛋白（HbA1c）风险的独立和联合关系。设计与方法本研究纳入5288名南亚个体(平均年龄52.5岁；52.3%男性)，来自英国生物银行研究。基线评估在2006年至2010年期间进行。肌肉力量通过手测力仪评估，并相对于无脂肪质量表示。根据性别和年龄的不同，研究人员将肌肉力量分为三类。T2D的遗传风险采用加权多基因风险评分进行量化，该评分由22种南亚T2D特异性单核苷酸多态性计算得出。结果与T2D遗传风险最低的五分位数相比，最高的人群发生T2D的几率增加(优势比：1.62；95%可信区间[CI]: 1.31-2.00)和HbA1c水平(β: 0.80；95% ci 0.41-1.19)。与高肌力组相比，低肌力组发生T2D的几率高出89%(优势比：1.89；95% CI 1.52-2.35)和更高的HbA1c水平(β: 0.95；95% CI 0.55-1.35)，校正混杂因素和T2D的遗传易感性。联合分析显示，在所有遗传风险层中，较低的肌肉力量始终与较高的T2D和HbA1c发生率相关。结论T2D多基因风险评分对早期识别南亚血统T2D高遗传风险个体具有重要的预后价值。抛开T2D的遗传风险不谈，更大的肌肉力量与较低的T2D风险和HbA1c水平有关。
{"title":"Muscle Strength, Genetic Risk, and Type 2 Diabetes Among Individuals of South Asian Ancestry: A UK Biobank Study","authors":"Ziyuan Chen, Paul James Collings, Mengyao Wang, Haeyoon Jang, Qiaoxin Shi, Hin Sheung Ho, Shan Luo, Shiu Lun Au Yeung, Youngwon Kim","doi":"10.1111/1753-0407.70074","DOIUrl":"https://doi.org/10.1111/1753-0407.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the independent and combined associations of genetic risk and muscle strength with the risk of incident type 2 diabetes (T2D) and glycated hemoglobin (HbA1c) among individuals of South Asian ancestry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>This study included 5288 South Asian individuals (mean age 52.5 years; 52.3% men) from the UK Biobank study. Baseline assessments were conducted between 2006 and 2010. Muscle strength was assessed through a hand dynamometer and expressed relative to fat-free mass. Sex-and age-specific tertiles were used to classify muscle strength into three categories. Genetic risk of T2D was quantified using a weighted polygenic risk score calculated from 22 distinct South Asian-specific single nucleotide polymorphisms for T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the bottom tertile of genetic risk for T2D, the highest had increased odds of incident T2D (odds ratio: 1.62; 95% confidence interval [CI]: 1.31–2.00) and HbA1c levels (<i>β</i>: 0.80; 95% CI 0.41–1.19). Compared to high muscle strength, low muscle strength was associated with 89% higher odds of incident T2D (odds ratio: 1.89; 95% CI 1.52–2.35) and higher HbA1c levels (<i>β</i>: 0.95; 95% CI 0.55–1.35), after adjustment for confounders and genetic susceptibility to T2D. Joint analyses revealed lower muscle strength was consistently associated with higher odds of incident T2D and HbA1c levels across all genetic risk strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Polygenic risk scores for T2D could have great prognostic value in preemptively identifying individuals of South Asian ancestry at high genetic risk of T2D. Regardless of T2D genetic risk, greater muscle strength is linked to lower T2D risk and HbA1c levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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