Journal of Diabetes最新文献_第7页

The potential adverse effects of hypodermic glucagon-like peptide -1 receptor agonist on patients with type 2 diabetes: A population-based study 皮下注射胰高血糖素样肽-1 受体激动剂对 2 型糖尿病患者的潜在不良影响：一项基于人群的研究。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-22 DOI: 10.1111/1753-0407.70013

Zhiyuan Cheng, Shuang Wang, Fu-rong Li, Cheng Jin, Chunbao Mo, Jing Zheng, Xia Li, Fengchao Liang, Jinkui Yang, Dongfeng Gu

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a class of injectable antidiabetic drugs, have shown significant efficacies in improving glycemic and weight control in patients with type 2 diabetes (T2D). However, the long-term safety of GLP-1 RAs remains insufficiently studied. This study aimed to provide real-world evidence on potential adverse outcomes associated with GLP-1 RAs use in T2D patients without major chronic diseases including impaired cardiac or renal function.

Methods

We conducted a retrospective cohort study involving 7746 T2D patients on GLP-1 RAs in Shenzhen, China. They were compared with 124 371 metformin-only users and 36 146 insulin-only users, forming two therapy control groups. GLP-1 RAs users were also further 1:2 paired with the control groups. Competing risk survival analyses were conducted to assess the incidence risks, presenting subdistributional hazard ratios (sHRs) with 95% confidence intervals (CIs) for various adverse outcomes associated with GLP-1 RAs use.

Results

Compared with metformin-only users, GLP-1 RAs use was associated with increased risks of various adverse outcomes (sHRs with 95% CIs), including pancreatitis (2.01, 1.24–3.24), acute nephritis (3.20, 2.17–4.70), kidney failure (3.73, 2.74–5.08), thyroid cancer (2.25, 1.23–4.10), and thyroid dysfunction (1.27, 1.00–1.63), respectively; Similar results were also found when compared with insulin-only users. Importantly, long-term (≥12 months) GLP-1 RAs use may further elevate the incidence risks of pancreatitis, acute nephritis, thyroid cancer, and thyroid dysfunction.

Conclusion

Compared with traditional T2D treatments, GLP-1 RAs use may be associated with increased risks of various adverse outcomes in a Chinese population. Cautions were strongly warranted in the use of GLP-1 RAs. Further validation is crucial across diverse populations.

背景：胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）是一类可注射的抗糖尿病药物，在改善 2 型糖尿病（T2D）患者的血糖和体重控制方面具有显著疗效。然而，GLP-1 RAs 的长期安全性研究仍然不足。本研究旨在提供真实世界的证据，说明在无主要慢性疾病（包括心功能或肾功能受损）的 T2D 患者中使用 GLP-1 RAs 可能会导致的不良后果：我们在中国深圳开展了一项回顾性队列研究，涉及7746名服用GLP-1 RAs的T2D患者。他们与124 371名仅使用二甲双胍的患者和36 146名仅使用胰岛素的患者组成了两个治疗对照组。GLP-1 RAs 使用者也与对照组进一步进行了 1:2 配对。我们进行了竞争风险生存分析以评估发病风险，并给出了与使用 GLP-1 RAs 相关的各种不良后果的亚分布危险比（sHRs）及 95% 置信区间（CIs）：与仅使用二甲双胍的患者相比，使用 GLP-1 RAs 会增加各种不良后果的风险（sHRs 与 95% 置信区间），包括胰腺炎（2.01，1.24-3.24）、急性肾炎（3.20，2.胰腺炎（2.01，1.24-3.24）、急性肾炎（3.20，2.17-4.70）、肾衰竭（3.73，2.74-5.08）、甲状腺癌（2.25，1.23-4.10）和甲状腺功能障碍（1.27，1.00-1.63）。重要的是，长期（≥12个月）使用GLP-1 RAs可能会进一步提高胰腺炎、急性肾炎、甲状腺癌和甲状腺功能障碍的发病风险：结论：与传统的 T2D 治疗方法相比，在中国人群中使用 GLP-1 RAs 可能会增加各种不良后果的风险。在使用 GLP-1 RAs 时应谨慎。在不同人群中进一步验证至关重要。

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引用次数: 0

Major adverse cardiovascular events’ reduction and their association with glucose-lowering medications and glycemic control among patients with type 2 diabetes: A retrospective cohort study using electronic health records 2 型糖尿病患者主要不良心血管事件的减少及其与降糖药物和血糖控制的关系：一项利用电子健康记录进行的回顾性队列研究。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-21 DOI: 10.1111/1753-0407.13604

Haowen Hsu, Paul Thomas Kocis, Ariana Pichardo-Lowden, Wenke Hwang

Background

Cardiovascular diseases are a common cause of death among patients with type 2 diabetes (T2DM). Major adverse cardiovascular event (MACE) risks can be significantly reduced under adequate glycemic control (GC). This study aims to identify factors that influence MACE risk among patients with T2DM, including Hemoglobin A1c variability score (HVS) and early use of MACE-preventive glucose-lowering medications (GLMs).

Methods

We conducted a longitudinal cohort study to retrospectively review electronic health records between 2011 and 2022. Patients with T2DM ≥18 years without previous stroke or acute myocardial infarction (AMI) were included. Cox regression was utilized to investigate MACE risk factors and compare MACE risk reduction associated with early use of MACE-preventive GLMs.

Results

A total of 19 685 subjects were included, with 5431 having MACE, including 4453 strokes, 977 AMI, and 1 death. There were 11 123 subjects with good baseline GC. Subjects with good baseline GC had 0.837 (confidence interval [CI]: 0.782–0.895) times lower MACE risk than their counterpart. Subjects with a single MACE-preventive GLM at baseline with continuous use >365 days showed a decreased MACE hazard ratio (0.681; CI: 0.635–0.731). Among all MACE-preventive GLMs, semaglutide provided a more significant MACE-preventive effect.

Conclusions

This study identified that GLM, early GC, and HVS are MACE determinants among patients with T2DM. Novel GLM, adequate GC, and reduction of HVS can benefit MACE outcomes.

背景：心血管疾病是 2 型糖尿病（T2DM）患者的常见死因：心血管疾病是 2 型糖尿病（T2DM）患者的常见死因。在适当的血糖控制（GC）下，主要不良心血管事件（MACE）风险可显著降低。本研究旨在确定影响T2DM患者MACE风险的因素，包括血红蛋白A1c变异性评分（HVS）和早期使用预防MACE的降糖药物（GLMs）：我们开展了一项纵向队列研究，回顾性查看了 2011 年至 2022 年间的电子健康记录。研究纳入了年龄≥18 岁、既往无中风或急性心肌梗死（AMI）的 T2DM 患者。采用 Cox 回归研究 MACE 风险因素，并比较早期使用预防 MACE 的 GLMs 可降低的 MACE 风险：共纳入 19 685 例受试者，其中 5431 例发生 MACE，包括 4453 例中风、977 例急性心肌梗死和 1 例死亡。基线GC良好的受试者有11 123人。基线 GC 良好的受试者发生 MACE 的风险比同类受试者低 0.837 倍（置信区间 [CI]：0.782-0.895）。基线时连续使用单个可预防 MACE 的 GLM 超过 365 天的受试者的 MACE 危险比降低（0.681；CI：0.635-0.731）。在所有MACE预防性GLM中，塞马鲁肽的MACE预防效果更为显著：本研究发现，GLM、早期 GC 和 HVS 是 T2DM 患者发生 MACE 的决定因素。新颖的 GLM、适当的 GC 和降低 HVS 可使 MACE 结局获益。

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引用次数: 0

Interactive correlations between artificial light at night, health risk behaviors, and cardiovascular health among patients with diabetes: A cross-sectional study 糖尿病患者夜间人造光、健康风险行为与心血管健康之间的互动关系：横断面研究

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-13 DOI: 10.1111/1753-0407.70008

Yi Zhang, Keyan Hu, Ying Tang, Qing Feng, Tian Jiang, Liwen Chen, Xin Chen, Chunhan Shan, Chen Han, Wenhui Chu, Nanzhen Ma, Honglin Hu, Hui Gao, Qiu Zhang

Background

Artificial light at night (ALAN) is a common phenomenon and contributes to the severe light pollution suffered by more than 80% of the world's population. This study aimed to evaluate the relationship between outdoor ALAN exposure and cardiovascular health (CVH) in patients with diabetes and the influence of various modifiable factors.

Methods

A survey method based on the China Diabetes and Risk Factor Monitoring System was adopted. Study data were extracted for 1765 individuals with diabetes in Anhui Province. Outdoor ALAN exposure (nW/cm²/sr) within 1000 m of each participant's residential address was obtained from satellite imagery data, with a resolution of ~1000 m. Health risk behaviors (HRBs) were measured via a standardized questionnaire. A linear regression model was employed to estimate the relationship between outdoor ALAN, HRBs, and CVH.

Results

Participants' mean age was 59.10 ± 10.0 years. An association was observed between ALAN and CVH in patients with diabetes (β = 0.205) and exercise (β = −1.557), moderated by HRBs, or metabolic metrics. There was an association between ALAN, ALAN, vegetable intake, and CVH.

Conclusions

Exploring the relationship between ALAN exposure and cardiovascular and metabolic health provides policy data for improving light pollution strategies and reducing the risk of cardiovascular and metabolic disease in patients with diabetes.

背景夜间人造光（ALAN）是一种普遍现象，导致全球 80% 以上的人口遭受严重的光污染。本研究旨在评估户外 ALAN 暴露与糖尿病患者心血管健康（CVH）之间的关系以及各种可改变因素的影响。方法采用基于中国糖尿病及危险因素监测系统的调查方法。提取了安徽省 1765 名糖尿病患者的研究数据。从分辨率为 ~1000 m 的卫星图像数据中获取每位受试者住址周围 1000 m 范围内的户外 ALAN 暴露量（nW/cm2/sr）。健康风险行为 (HRB) 通过标准化问卷进行测量。采用线性回归模型来估计户外 ALAN、HRBs 和 CVH 之间的关系。结果参与者的平均年龄为 59.10 ± 10.0 岁。在糖尿病患者（β = 0.205）和运动患者（β = -1.557）中，观察到 ALAN 与 CVH 之间存在关联，但受 HRBs 或代谢指标的调节。ALAN、ALAN、蔬菜摄入量和 CVH 之间存在关联。结论探索 ALAN 暴露与心血管和代谢健康之间的关系可为改进光污染策略和降低糖尿病患者罹患心血管和代谢疾病的风险提供政策数据。

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引用次数: 0

Physical activity modifies the association between atherogenic index of plasma and prediabetes and diabetes: A cross-sectional analysis 体育锻炼可改变血浆致动脉粥样硬化指数与糖尿病前期和糖尿病之间的关系：横断面分析

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-13 DOI: 10.1111/1753-0407.70006

Shenglan Yang, Xinyu Gou, Hui Dong, Limei Chen, Yiyan Wang, Jing Wu

Background

Although research has explored the association between atherogenic index of plasma (AIP) and prediabetes and diabetes, there is still not sufficient available evidence the role of physical activity (PA) in this relationship. Our purpose is to examine the complex connections between AIP, PA, and prediabetes and diabetes in a young and middle-aged population.

Methods

This study included 2220 individuals from the general population, aged 20–60 years. AIP was calculated from the logarithm of the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. PA was assessed depending to the American Heart Association (AHA) criteria and categorized into medium-high and low PA levels. We used binary logistic regression to explore associations and subsequently performed sensitivity and subgroup analyses.

Results

The 2220 participants had a mean age of 38 years, with a mean AIP of −0.1185, and a prediabetes and diabetes prevalence of 7.2%. After adjusting for auxiliary variables, AIP was positively correlated with prediabetes and diabetes (odds ratio [OR]: 3.447, 95% confidence interval [CI]: 1.829–6.497). In the low PA population, the prevalence of prediabetes and diabetes raised significantly with higher AIP (OR: 3.678, 95% CI: 1.819–7.434). This association was not meaningful in the medium to high PA population (OR: 1.925, 95% CI: 0.411–9.007). Joint and sensitivity analyze results also showed agreement. Restricted cubic spline identified a linear relationship between AIP and the prevalence of prediabetes and diabetes. Notably, the prevalence significantly increases when AIP values exceed −0.16 (p for linearity <0.05). The findings revealed heterogeneity across subgroups stratified by sex and age.

Conclusions

PA may modify the link as regards AIP with prediabetes and diabetes in young and middle-aged populations. Adherence to PA prevents the adverse effects of abnormal glucose metabolism caused by dyslipidemia, particularly in women.

背景虽然已有研究探讨了血浆致动脉粥样硬化指数（AIP）与糖尿病前期和糖尿病之间的关系，但仍没有足够的证据表明体力活动（PA）在这一关系中的作用。我们的目的是在中青年人群中研究 AIP、PA 与糖尿病前期和糖尿病之间的复杂关系。方法这项研究包括 2220 名 20-60 岁的普通人群。AIP根据甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比率的对数计算。活动量根据美国心脏协会（AHA）的标准进行评估，并分为中高和低活动量水平。我们使用二元逻辑回归来探讨相关性，随后进行了敏感性和亚组分析。结果 2220 名参与者的平均年龄为 38 岁，平均 AIP 为-0.1185，糖尿病前期和糖尿病患病率为 7.2%。对辅助变量进行调整后，AIP 与糖尿病前期和糖尿病呈正相关（比值比 [OR]：3.447，95% 置信区间 [CI]：1.829-6.497）。在低 PA人群中，糖尿病前期和糖尿病的患病率随着 AIP 的增加而显著上升（OR：3.678，95% 置信区间：1.819-7.434）。而在中高运动量人群中，这种关联并不明显（OR：1.925，95% CI：0.411-9.007）。联合分析和敏感性分析结果也显示出一致性。限制立方样条曲线确定了 AIP 与糖尿病前期和糖尿病患病率之间的线性关系。值得注意的是，当 AIP 值超过-0.16 时，患病率会明显增加（线性相关系数为 0.05）。研究结果显示，按性别和年龄划分的亚组之间存在异质性。结论在中青年人群中，PA 可改变 AIP 与糖尿病前期和糖尿病之间的联系。坚持体育锻炼可防止血脂异常引起的糖代谢异常的不良影响，尤其是对女性而言。

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引用次数: 0

Association between coffee consumption and metabolic syndrome: A cross-sectional and Mendelian randomization study 饮用咖啡与代谢综合征之间的关系：一项横断面和孟德尔随机研究。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-10 DOI: 10.1111/1753-0407.70004

Tommy Hon Ting Wong, Shan Luo, Shiu Lun Au Yeung, Jimmy Chun Yu Louie

Background

This study investigates the associations between coffee consumption and metabolic syndrome and its components, as well as the effect of milk, sugar, and artificial sweeteners on these associations.

Methods

A cross-sectional analysis was conducted with 351805 UK Biobank participants. Coffee consumption data were collected via food frequency questionnaires and 24-h recall. Metabolic syndrome was identified through blood biochemistry and self-reported medication use. Odds ratios were calculated using multivariable logistic regression, and results were verified with two-sample Mendelian randomization.

Results

Consuming up to two cups of coffee per day was inversely associated with metabolic syndrome (1 cup/day: odds ratio [OR]: 0.88, 95% confidence interval [CI]: 0.85–0.92; 2 cups/day: OR: 0.90, 95% CI: 0.86–0.93). Higher intakes showed near-null associations. Mendelian randomization did not support a causal link between coffee intake and metabolic syndrome. Both self-reported and genetically predicted high coffee consumption (four cups per day or more) were associated with central obesity. The inverse association between coffee consumption and metabolic syndrome was more profound among drinkers of ground coffee than those of instant coffee. Results were similar when stratified by the use of milk and sugar, yet the use of artificial sweetener with coffee was positively associated with metabolic syndrome and all component conditions.

Conclusions

Coffee consumption may increase the risk of central obesity but is unlikely to impact the risk of metabolic syndrome. The potential health effects of artificial sweeteners in coffee need further investigation.

研究背景本研究调查了饮用咖啡与代谢综合征及其组成部分之间的关系，以及牛奶、糖和人工甜味剂对这些关系的影响：对 351805 名英国生物库参与者进行了横断面分析。通过食物频率问卷和 24 小时回忆收集了咖啡消费数据。通过血液生化指标和自我报告的药物使用情况确定代谢综合征。使用多变量逻辑回归法计算了患病率，并使用双样本孟德尔随机法对结果进行了验证：结果：每天最多饮用两杯咖啡与代谢综合征成反比（每天一杯：几率比 [OR]：0.88，95% 置信区间：0.88，95%置信区间[CI]：0.85-0.92；2杯/天：OR：0.90，95% 置信区间：0.86-0.93）。摄入量越高，相关性越低。孟德尔随机法不支持咖啡摄入量与代谢综合征之间的因果关系。自我报告和基因预测的高咖啡摄入量（每天四杯或更多）均与中心性肥胖有关。饮用研磨咖啡的人比饮用速溶咖啡的人更容易患上代谢综合征。根据牛奶和糖的使用情况进行分层后，结果相似，但在喝咖啡时使用人工甜味剂与代谢综合征和所有构成条件呈正相关：结论：饮用咖啡可能会增加中心性肥胖的风险，但不太可能影响代谢综合征的风险。咖啡中的人工甜味剂对健康的潜在影响还需要进一步研究。

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引用次数: 0

The association of ideal cardiovascular health and its change with subclinical atherosclerosis according to glucose status: A prospective cohort study 理想心血管健康状况及其变化与亚临床动脉粥样硬化的关系（根据血糖状况）：前瞻性队列研究

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-10 DOI: 10.1111/1753-0407.70007

Xiaojing Jia, Yilan Ding, Chunyan Hu, Hong Lin, Lin Lin, Xueyan Wu, Hongyan Qi, Shuangyuan Wang, Ruizhi Zheng, Jie Zheng, Min Xu, Yu Xu, Tiange Wang, Zhiyun Zhao, Yuhong Chen, Mian Li, Guang Ning, Weiqing Wang, Weiguo Hu, Yufang Bi, Jieli Lu

Background

An updated definition was developed to better evaluate cardiovascular health (CVH). We aimed to investigate whether optimal or improvement of six CVH metrics defined by new Life's Essential 8 (LE8) may counteract the risk of subclinical atherosclerosis among patients with hyperglycemia.

Methods

We conducted a prospective analysis of 5225 participants without prior cardiovascular diseases, of whom 4768 had complete data on CVH change. Subjects with CVH scores of 0–49, 50–79, and 80–100 points were categorized as having low, moderate, or high CVH, respectively. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity, pulse pressure and albuminuria, both separately and in combination.

Results

Of the 5225 participants, 1937 (37.1%) had normal glucose regulation, while 3288 (62.9%) had hyperglycemia. The multivariable-adjusted odds ratio (OR) for composite subclinical atherosclerosis was 2.34 (95% confidence interval [CI], 1.88–2.91), 1.43 (95% CI, 1.21–1.70), and 0.74 (95% CI, 0.46–1.18), for participants with hyperglycemia who had low, moderate, or high overall CVH scores, respectively, compared with participants with normal glucose regulation. In addition, compared with those with stable CVH and normal glucose regulation, participants who exhibited greater improvements in overall CVH from 2010 to 2014 had a reduced risk of composite subclinical atherosclerosis with an OR of 0.72 (95% CI, 0.53–0.98) for those with normal glucose regulation, and 1.13 (95% CI, 0.87–1.48) for those with hyperglycemia.

Conclusions

The novel defined CVH using six metrics was inversely associated with subsequent risk of subclinical atherosclerosis. Both the status of CVH and its changes modified the relationship between hyperglycemia and subclinical atherosclerosis.

背景为更好地评估心血管健康（CVH），我们制定了最新的定义。我们的目的是研究新的 "生命必需 8 项指标"（LE8）所定义的六项 CVH 指标的优化或改善是否可以抵消高血糖患者亚临床动脉粥样硬化的风险。方法我们对 5225 名无心血管疾病史的参与者进行了前瞻性分析，其中 4768 人有完整的 CVH 变化数据。CVH评分为0-49分、50-79分和80-100分的受试者分别被划分为低度、中度和高度CVH。亚临床动脉粥样硬化通过肱-踝脉搏波速度、脉压和白蛋白尿进行评估，既可单独评估，也可合并评估。结果在 5225 名参与者中，1937 人（37.1%）血糖调节正常，3288 人（62.9%）血糖过高。与血糖调节正常的参试者相比，CVH 总分低、中或高的高血糖参试者发生复合亚临床动脉粥样硬化的多变量调整后的几率比（OR）分别为 2.34（95% 置信区间 [CI]，1.88-2.91）、1.43（95% CI，1.21-1.70）和 0.74（95% CI，0.46-1.18）。此外，与 CVH 稳定且血糖调节正常的参与者相比，2010 年至 2014 年期间总体 CVH 有较大改善的参与者发生复合亚临床动脉粥样硬化的风险降低，血糖调节正常者的 OR 值为 0.72（95% CI，0.53-0.98），高血糖者的 OR 值为 1.13（95% CI，0.87-1.48）。结论采用六项指标对 CVH 进行的新定义与亚临床动脉粥样硬化的后续风险成反比。CVH的状态及其变化都会改变高血糖与亚临床动脉粥样硬化之间的关系。

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引用次数: 0

National burden and risk factors of diabetes mellitus in China from 1990 to 2021: Results from the Global Burden of Disease study 2021 1990 至 2021 年中国糖尿病的全国负担和风险因素：2021年全球疾病负担研究结果》。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-07 DOI: 10.1111/1753-0407.70012

Wenzhen Deng, Li Zhao, Cheng Chen, Ziyu Ren, Yuanyuan Jing, Jingwen Qiu, Dongfang Liu

Background

In recent years, the prevalence and mortality rates of diabetes have been rising continuously, posing a significant threat to public health and placing a heavy burden on the population. This study was conducted to describe and analyze the burden of diabetes in China from 1990 to 2021 and its attributable risk factors.

Methods

Utilizing data from the Global Burden of Disease Study 2021, we analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in China from 1990 to 2021. We extracted sex- and age-specific data on diabetes, focusing on DALYs, years lived with disability, and years of life lost. Bayesian meta-regression and spatiotemporal Gaussian process regression were used to estimate disease parameters. Age-standardized rates (ASRs) and estimated annual percentage changes (EAPC) were calculated using direct standardization and log-linear regression. The population-attributable fractions were also determined for each risk factor.

Results

In 2021, the absolute number of incident diabetes mellitus (DM) cases was estimated at 4003543.82, including 32 000 T1DM and 3971486.24 T2DM cases. The ASRs were 244.57 for DM, 2.67 for T1DM, and 241.9 for T2DM (per 100 000 population). The absolute number of prevalent DM cases was 117288553.93, including 1442775.09 T1DM and 115845778.84 T2DM cases. The ASRs were 6142.29 for DM, 86.78 for T1DM, and 6055.51 for T2DM (per 100 000 population). In 2021, there were 178475.73 deaths caused by DM, with an ASR of mortality of 8.98 per 100 000 population. The DALYs due to DM in 2021 were 11713613.86, with an ASR of 585.43 per 100 000 population and an EAPC of 0.57. This increase can be attributed to several factors, including high body mass index, air pollution, and dietary habits.

Conclusions

The burden of diabetes is considerable, with high prevalence and incidence rates, highlighting the urgent need for public health interventions. Addressing factors like high fasting plasma glucose, body mass index, air pollution, and dietary risks through effective interventions is critical.

背景：近年来，糖尿病的患病率和死亡率持续上升，对公众健康构成了重大威胁，给人口带来了沉重负担。本研究旨在描述和分析1990-2021年中国糖尿病负担及其可归因风险因素：利用《2021 年全球疾病负担研究》（Global Burden of Disease Study 2021）的数据，我们分析了 1990 年至 2021 年中国 1 型糖尿病（T1DM）和 2 型糖尿病（T2DM）的发病率、患病率和残疾调整生命年（DALYs）。我们提取了糖尿病的性别和年龄特异性数据，重点关注残疾调整生命年、残疾生存年数和生命损失年数。贝叶斯元回归和时空高斯过程回归用于估算疾病参数。采用直接标准化和对数线性回归法计算年龄标准化率（ASRs）和估计年度百分比变化（EAPC）。此外，还确定了每个风险因素的人口可归因分数：结果：2021 年，糖尿病（DM）发病绝对数估计为 4003543.82 例，包括 32 000 例 T1DM 和 3971486.24 例 T2DM。糖尿病的 ASR 为 244.57，T1DM 为 2.67，T2DM 为 241.9（每 100 000 人）。DM 发病率的绝对数为 117288553.93 例，其中 T1DM 为 1442775.09 例，T2DM 为 115845778.84 例。DM 的 ASR 为 6142.29，T1DM 为 86.78，T2DM 为 6055.51（每 10 万人）。2021 年，因糖尿病导致的死亡人数为 178475.73 人，死亡率的 ASR 为每 10 万人 8.98 例。2021 年因糖尿病导致的残疾调整寿命年数为 11713613.86 年，每 100 000 人口的反年龄比率为 585.43，EAPC 为 0.57。这一增长可归因于几个因素，包括高体重指数、空气污染和饮食习惯：糖尿病的负担相当沉重，患病率和发病率都很高，因此迫切需要采取公共卫生干预措施。通过有效的干预措施来解决高空腹血浆葡萄糖、体重指数、空气污染和饮食风险等因素至关重要。

{"title":"National burden and risk factors of diabetes mellitus in China from 1990 to 2021: Results from the Global Burden of Disease study 2021","authors":"Wenzhen Deng, Li Zhao, Cheng Chen, Ziyu Ren, Yuanyuan Jing, Jingwen Qiu, Dongfang Liu","doi":"10.1111/1753-0407.70012","DOIUrl":"10.1111/1753-0407.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In recent years, the prevalence and mortality rates of diabetes have been rising continuously, posing a significant threat to public health and placing a heavy burden on the population. This study was conducted to describe and analyze the burden of diabetes in China from 1990 to 2021 and its attributable risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing data from the Global Burden of Disease Study 2021, we analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in China from 1990 to 2021. We extracted sex- and age-specific data on diabetes, focusing on DALYs, years lived with disability, and years of life lost. Bayesian meta-regression and spatiotemporal Gaussian process regression were used to estimate disease parameters. Age-standardized rates (ASRs) and estimated annual percentage changes (EAPC) were calculated using direct standardization and log-linear regression. The population-attributable fractions were also determined for each risk factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, the absolute number of incident diabetes mellitus (DM) cases was estimated at 4003543.82, including 32 000 T1DM and 3971486.24 T2DM cases. The ASRs were 244.57 for DM, 2.67 for T1DM, and 241.9 for T2DM (per 100 000 population). The absolute number of prevalent DM cases was 117288553.93, including 1442775.09 T1DM and 115845778.84 T2DM cases. The ASRs were 6142.29 for DM, 86.78 for T1DM, and 6055.51 for T2DM (per 100 000 population). In 2021, there were 178475.73 deaths caused by DM, with an ASR of mortality of 8.98 per 100 000 population. The DALYs due to DM in 2021 were 11713613.86, with an ASR of 585.43 per 100 000 population and an EAPC of 0.57. This increase can be attributed to several factors, including high body mass index, air pollution, and dietary habits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The burden of diabetes is considerable, with high prevalence and incidence rates, highlighting the urgent need for public health interventions. Addressing factors like high fasting plasma glucose, body mass index, air pollution, and dietary risks through effective interventions is critical.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379584","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}

引用次数: 0

Increased prevalence of diabetes mellitus and its metabolic risk factors from 2002 to 2017 in Shanghai, China 2002 年至 2017 年中国上海糖尿病及其代谢风险因素患病率的增长。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-07 DOI: 10.1111/1753-0407.70003

Qinping Yang, Jingyan Tian, Yanyun Li, Qinghua Yan, Wenli Xu, Chaowei Fu, Minna Cheng, Yan Shi

<p>The prevalence of diabetes in China continues to climb at an alarmingly rapid rate relative to other Asian countries.<span><sup>1-3</sup></span> And the prevalence in Shanghai was much higher than other areas in China.<span><sup>4-6</sup></span> Diabetes has therefore gradually developed into a significant public health concern affecting the health of Shanghai residents. Interventions on high-risk population of diabetes were very cost-effective for diabetes prevention supported by strong evidence.<span><sup>7</sup></span> It was shown that metabolic factors such as obesity, hypertension, and dyslipidemia may be risk factors for diabetes.<span><sup>8-10</sup></span></p><p>>Data sourced from the 2002, 2009, and 2017 Shanghai Diabetes Mellitus Epidemiological Investigation and the 2013 Shanghai Non-communicable Disease and Risk Factors Surveillance databases were integrated. In these investigations, information on demographic characteristics, lifestyle, personal histories, and family histories of diabetes and other diseases was collected by questionnaires. Heights, weights, waist circumferences, and blood pressures were obtained using a standardized protocol. A venous blood sample was collected from each participant after an overnight fast of at least 10 h in all investigations; for each subject without a history of diabetes, a blood sample was drawn 120 min after an oral glucose tolerance test after imbibing a standard 75-g glucose solution. Compound Annual Growth Rate (CAGR) = (Ending Value/Beginning Value) ^ (1/n) -1, where “n” represents the number of years of observation. Cochran–Armitage trend test was used to analyze the temporal trends. Logistic regression was utilized to estimate the odds ratio (OR). The population attributable risk percentage (PAR%), which can be used to evaluate the possible reduction in the prevalence of diabetes after elimination of risk factors,<span><sup>11</sup></span> was calculated with OR.</p><p>From 2002 to 2017, the standardized prevalence rates of diabetes among Shanghai residents aged 35–74 years old rose from 10.14% to 18.47%. The CAGR was 4.08%, which was higher than that for rural southwest China (3.05%),<span><sup>12</sup></span> New York (1.79%),<span><sup>13</sup></span> Thailand (3.54%),<span><sup>14</sup></span> or India (1.65%–3.83%).<span><sup>15</sup></span> The prevalence of diabetes rose over time for all groups but was higher in men, elderly, and urban residents, a phenomenon also observed in other areas in China.<span><sup>12, 16</sup></span> The gap of prevalence between men and women gradually widened (CAGR: 4.55% vs. 3.37%), which was similar in Shenzhen (a first-tier city in China)<span><sup>16</sup></span> (Figure 1). The prevalence of all metabolic risk factors included in this study increased across years (<i>p</i><sub>trend</sub> <0.05). All four risk factors were positively correlated with diabetes mellitus (<i>p</i> < 0.05), but the ORs did not changed significantly (<i>p</

与其他亚洲国家相比，中国的糖尿病患病率以惊人的速度持续攀升1-3 ，而上海的患病率远高于中国其他地区4-6 。7 肥胖、高血压、血脂异常等代谢因素可能是糖尿病的危险因素。8-10>数据来源于 2002 年、2009 年、2017 年上海市糖尿病流行病学调查和 2013 年上海市非传染性疾病及危险因素监测数据库。在这些调查中，通过问卷调查收集了人口学特征、生活方式、个人病史、糖尿病及其他疾病家族史等信息。采用标准化方案测量身高、体重、腰围和血压。在所有调查中，每位受试者都在一夜禁食至少 10 小时后采集静脉血样本；对于无糖尿病史的受试者，则在口服 75 克标准葡萄糖溶液进行葡萄糖耐量试验 120 分钟后采集血样。复合年增长率（CAGR）=（终值/始值）^（1/n）-1，其中 "n "代表观察年数。Cochran-Armitage 趋势检验用于分析时间趋势。利用逻辑回归估算几率比（OR）。人口可归因风险百分比（PAR%）可用于评估消除风险因素后糖尿病患病率可能降低的程度，11 与 OR 一起计算。从 2002 年到 2017 年，上海 35-74 岁居民糖尿病标准化患病率从 10.14% 上升到 18.47%。年均复合增长率为 4.08%，高于中国西南农村地区（3.05%）、12 纽约（1.79%）、13 泰国（3.54%）、14 或印度（1.65%-3.83%）、16 男女患病率的差距逐渐拉大（年均复合增长率：4.55% 对 3.37%），这与深圳（中国一线城市）16 的情况相似（图 1）。本研究中包含的所有代谢风险因素的患病率均逐年上升（ptrend <0.05）。所有四种危险因素均与糖尿病呈正相关（p <0.05），但 ORs 变化不大（ptrend >0.05）。高血压和中心性肥胖的 PAR%高于其他因素。但只有高血压的PAR%呈上升趋势（ptrend <0.05），主要是由于其患病率上升较快（表1）。不同人群的糖尿病患病率均有所上升，但男性上升较快。此外，必须重视对高血压等代谢危险因素的干预和控制，这些因素对糖尿病的发病率有重要影响。在高危人群中实施连续登记、筛查和早期干预措施，对抑制或延缓糖尿病的发生至关重要。

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引用次数: 0

Prevalence and influencing factors of malnutrition in diabetic patients: A systematic review and meta-analysis 糖尿病患者营养不良的患病率和影响因素：系统回顾与荟萃分析。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-04 DOI: 10.1111/1753-0407.13610

Tong Zhang, Jiangxia Qin, Jiali Guo, Jianhui Dong, Junbo Chen, Yuxia Ma, Lin Han

The prevalence of malnutrition in diabetic patients and its influencing factors remain poorly described. We aim to investigate the prevalence of malnutrition and the influencing factors in diabetic patients through meta-analysis. Utilizing search terms, such as diabetes, malnutrition, and prevalence, we systematically searched eight databases, including Embase, PubMed, Web of Science, The Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and VIP Database, from inception to May 4, 2023. The search aimed to identify studies related to the prevalence of malnutrition and its influencing factors in adult patients with diabetes. Cohort studies, case–control studies, and cross-sectional studies that met the inclusion criteria were included in the analysis. Stata 16.0 software was used for meta-analysis. Quality of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). The study protocol is registered with Prospective Register of Systematic Reviews (PROSPERO), CRD42023443649. A total of 46 studies were included, involving 18 062 patients with ages ranging from 18 to 95 years. The overall malnutrition prevalence was 33% (95% confidence interval [CI]: 0.25–0.40), compared with an at-risk prevalence of 44% (95% CI: 0.34–0.54). Sixteen factors associated with malnutrition in diabetic patients were identified. This meta-analysis provides insights into the prevalence of malnutrition and its risk factors in diabetic patients. Regular nutritional screening for patients with risk factors is essential for early detection and intervention.

关于糖尿病患者营养不良的发生率及其影响因素的描述仍然很少。我们旨在通过荟萃分析研究糖尿病患者营养不良的发生率及其影响因素。利用糖尿病、营养不良和患病率等检索词，我们系统地检索了从开始到2023年5月4日的8个数据库，包括Embase、PubMed、Web of Science、The Cochrane Library、中国知识资源整合数据库（CNKI）、万方数据库、中国生物医学数据库（CBM）和VIP数据库。该检索旨在确定与成年糖尿病患者营养不良患病率及其影响因素相关的研究。符合纳入标准的队列研究、病例对照研究和横断面研究均纳入分析。使用Stata 16.0软件进行荟萃分析。证据质量采用建议、评估、发展和评价分级法（GRADE）进行评估。研究方案已在系统综述前瞻性注册中心（PROSPERO）注册，注册号为 CRD42023443649。共纳入 46 项研究，涉及 18 062 名患者，年龄从 18 岁到 95 岁不等。总体营养不良发生率为 33%（95% 置信区间 [CI]：0.25-0.40），而高危发生率为 44%（95% 置信区间 [CI]：0.34-0.54）。研究发现了 16 个与糖尿病患者营养不良相关的因素。这项荟萃分析提供了有关糖尿病患者营养不良患病率及其风险因素的见解。对存在风险因素的患者进行定期营养筛查对于早期发现和干预至关重要。

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引用次数: 0

Comparing Glucagon-like peptide-1 receptor agonists versus metformin in drug-naive patients: A nationwide cohort study 比较胰高血糖素样肽-1 受体激动剂与二甲双胍对药物过敏患者的疗效：全国性队列研究。

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes

Pub Date : 2024-10-04 DOI: 10.1111/1753-0407.70000

Kathrine Kold Sørensen, Thomas Alexander Gerds, Lars Køber, Emil Loldrup Fosbøl, Henrik Enghusen Poulsen, Amalie Lykkemark Møller, Mikkel Porsborg Andersen, Ulrik Pedersen-Bjergaard, Christian Torp-Pedersen, Bochra Zareini

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are increasingly being prescribed in drug-naive patients. We aimed to contrast add-on therapy, adherence, and changes in biomarkers, 1 year after treatment initiation with GLP-1 RA or metformin.

Methods

Using Danish nationwide registers, we included incident GLP-1 RA or metformin users from 2018 to 2021 with glycated hemoglobin (HbA1c) ≥ 42 mmol/mol. GLP-1 RA initiators were matched to metformin initiators in a ratio of 1:1 to assess outcomes in prediabetes and diabetes. Main outcomes analyzed were 1-year risk of add-on glucose-lowering medication and 1-year risk of nonadherence. One-year risks were estimated with multiple logistic regression and standardized. Multiple linear regression was used to estimate the average differences in biomarker changes.

Results

In total, 1778 individuals initiating GLP-1 RA and metformin were included. After standardizing for various factors, GLP-1 RA compared with metformin was associated with reduced 1-year risk of add-on glucose-lowering treatment in patients with prediabetes (1-year risk ratio [RR]: 0.27, 95% confidence interval [CI]: 0.10–0.44) and diabetes (RR: 0.67, 95% CI: 0.37–0.98). GLP-1 RA was associated with higher 1-year risk of nonadherence among patients with prediabetes (RR: 1.60, 95% CI: 1.45–1.75), but no difference in patients with diabetes (RR: 0.88, 95% CI: 0.70–1.06). Compared to metformin, GLP-1 RA was associated with greater HbA1c reduction (prediabetes: −2.59 mmol/mol 95% CI: −3.10 to −2.09, diabetes: −3.79 mmol/mol, 95% CI: −5.28 to −2.30).

Conclusions

GLP-1 RA was associated with a reduced risk of additional glucose-lowering medication, achieving better glycated hemoglobin control overall. However, among patients with prediabetes, metformin was associated with better adherence.

背景：胰高血糖素样肽-1受体激动剂（GLP-1 RA）越来越多地用于未服药患者。我们旨在对比 GLP-1 RA 或二甲双胍开始治疗 1 年后的附加疗法、依从性和生物标志物的变化：通过丹麦全国范围内的登记，我们纳入了2018年至2021年糖化血红蛋白（HbA1c）≥42 mmol/mol的GLP-1 RA或二甲双胍使用者。GLP-1 RA 启动者与二甲双胍启动者以 1:1 的比例进行匹配，以评估糖尿病前期和糖尿病的结果。分析的主要结果是额外服用降糖药的 1 年风险和不依从的 1 年风险。一年风险用多元逻辑回归估算并标准化。多元线性回归用于估算生物标志物变化的平均差异：结果：共纳入了 1778 名开始服用 GLP-1 RA 和二甲双胍的患者。在对各种因素进行标准化后，GLP-1 RA 与二甲双胍相比，可降低糖尿病前期（1 年风险比 [RR]：0.27，95% 置信区间 [CI]：0.10-0.44）和糖尿病（RR：0.67，95% CI：0.37-0.98）患者接受附加降糖治疗的 1 年风险。在糖尿病前期患者中，GLP-1 RA 与较高的 1 年不依从风险相关（RR：1.60，95% CI：1.45-1.75），但在糖尿病患者中没有差异（RR：0.88，95% CI：0.70-1.06）。与二甲双胍相比，GLP-1 RA与更大的HbA1c降幅相关（糖尿病前期：-2.59 mmol/mol 95% CI：-3.10至-2.09；糖尿病：-3.79 mmol/mol，95% CI：-5.28至-2.30）：GLP-1 RA可降低额外服用降糖药物的风险，并在总体上更好地控制糖化血红蛋白。不过，在糖尿病前期患者中，二甲双胍的依从性更好。

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引用次数: 0