Endocrinology, Diabetes and Metabolism最新文献

Trends in Alzheimer's-Related Mortality Among Type 2 Diabetes Patients in the United States: 1999–2019

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-02-03 DOI: 10.1002/edm2.70032

Saad Ahmed Waqas, Dua Ali, Taimor Mohammed Khan, Shaheer Qureshi, Hibah Siddiqui, Maryam Sajid, Zahra Imran, Hussain Salim, Muhammad Umer Sohail, Raheel Ahmed, Shayan Marsia

Background

Recent research has shown that type 2 diabetes mellitus (T2DM) has increased the burden of Alzheimer's disease (AD) in the US aging population. However, trends in mortality from this comorbidity among adults aged ≥ 65 years have not been investigated.

Objectives

This study examined trends and disparities in AD-related mortality among older US adults with T2DM from 1999 to 2019.

Methods

Data from the CDC WONDER database were analysed to assess AD-related mortality in patients with T2DM aged ≥ 65 between 1999 and 2019. Age-adjusted mortality rates (AAMRs) per 100,000 people and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, age, urbanisation and geographical region.

Results

From 1999 to 2019, there were 71,550 deaths with T2DM and AD among adults aged ≥ 65. AAMRs rose from 4.12 in 1999 to 11.65 in 2019, with the sharpest increase between 2014 and 2017 (APC: 10.81; 95% CI: −3.20 to 13.43). Women had slightly higher AAMRs than men, with rates increasing from 4.71 in 1999 to 11.61 in 2019 for women, and from 4.08 to 11.70 for men. Hispanic individuals saw the highest increase in AAMR (11.15), followed by non-Hispanic Black (9.30) and White populations (7.92). AAMRs were highest in the West (10.91) and the Midwest (9.62), while the Northeast (4.70) had the lowest. Nonmetropolitan areas had consistently higher AAMRs (10.74) than large metropolitan areas (6.68) and small/medium metropolitan areas (9.25). States in the top 90th percentile for T2DM–AD mortality included California, South Dakota and Kentucky, where rates were approximately eight times higher than in states in the lowest 10th percentile.

Conclusions

This study reveals a significant rise in T2DM–AD comorbidity-related mortality among older adults, especially among Hispanics, women and rural residents. These findings underscore the need for targeted interventions to reduce the burden in vulnerable populations.

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引用次数: 0

Association Between TyG-BMI Index and Hyperuricemia in Adult Women

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-02-03 DOI: 10.1002/edm2.70028

Kelibinuer Mutailipu, Junwei Guo, Jiajing Yin, Yue Wang, Liesheng Lu, Xuyang Jia, Jie Zhang, Shen Qu, Haibing Chen, Le Bu

Purpose

This study aimed to explore the relationship between hyperuricemia (HUA), the triglyceride-glucose index (TyG) and its derivatives in adult women.

Methods

A cross-sectional analysis was conducted on 1105 female patients from Shanghai Tenth People's Hospital. Participants were divided into HUA (n = 331) and non-HUA (n = 774) groups. Clinical and laboratory data were collected, and indices such as body mass index (BMI), TyG and TyG-BMI were calculated. Statistical analyses included univariate and multivariate logistic regression and receiver operating characteristic (ROC) curve analysis.

Results

The HUA group showed higher BMI, blood pressure and metabolic parameters. TyG, TyG-BMI and BMI were positively correlated with uric acid levels. ROC analysis revealed that TyG-BMI (AUC = 0.877) had better predictive power for HUA than TyG (AUC = 0.829) or BMI (AUC = 0.867). Multivariate analysis showed TyG-BMI and BMI as independent predictors, with women in the highest quartiles having a 3.111-fold and 2.779-fold higher risk for HUA, respectively.

Conclusion

TyG-BMI is the most effective predictor of HUA in women, surpassing TyG and BMI alone. It offers a practical tool for early identification and intervention in women at risk of HUA.

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引用次数: 0

The Role of Serum Free Fatty Acids in Endothelium-Dependent Microvascular Function

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-31 DOI: 10.1002/edm2.70031

Alexander E. Sullivan, Meaghan C. S. Courvan, Aaron W. Aday, David H. Wasserman, Kevin D. Niswender, Emily M. Shardelow, Emily K. Wells, Quinn S. Wells, Matthew S. Freiberg, Joshua A. Beckman

Background

Elevated serum free fatty acid (FFA) concentration is associated with insulin resistance and is a hallmark of metabolic syndrome. A pathological feature of insulin resistance is impaired endothelial function.

Objective

To investigate the effect of FFA reduction with either acipimox, a nicotinic acid derivative that impairs lipolysis, or salsalate, a salicylate that reduces basal and inflammation-induced lipolysis, on insulin-mediated endothelium-dependent vasodilation.

Methods

This was a post hoc, combined analysis of two randomised, double-blind, placebo-controlled crossover trials. Sixteen subjects were recruited (6 with metabolic syndrome and 10 controls) and randomised to acipimox 250 mg orally every 6 h for 7 days or placebo. Nineteen subjects were recruited (13 with metabolic syndrome and 6 controls) and randomised to receive salsalate 4.5 g/day for 4 weeks or placebo. The primary outcome was the association between FFA concentration and insulin-mediated vasodilation, measured by venous-occlusion strain-gauge plethysmography at baseline and following FFA modulation with the study drugs.

Results

At baseline, FFA concentration (R = −0.35, p = 0.043) and insulin sensitivity (HOMA-IR: R = −0.42, p = 0.016, Adipo-IR: R = −0.39, p = 0.025) predicted insulin-mediated vasodilation. FFA levels were significantly reduced after drug pretreatment (0.604 vs. 0.491 mmol/L, p = 0.036) while insulin levels, insulin sensitivity and inflammatory markers were unchanged. Despite a reduction in circulating FFA with drug therapy, neither insulin-stimulated vasodilation nor insulin sensitivity improved.

Conclusions

Short-term reduction of FFA concentration does not improve insulin-stimulated vasodilation in patients with metabolic syndrome.

Trial Registration

ClinicalTrials.gov identifier: NCT00759291 and NCT00760019 (formerly NCT00762827)

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引用次数: 0

Association of Albumin-To-Creatinine Ratio With Diabetic Retinopathy Among US Adults (NHANES 2009–2016) 美国成人中白蛋白与肌酐比值与糖尿病视网膜病变的关系（NHANES 2009-2016）。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-18 DOI: 10.1002/edm2.70029

Han Dai, Ling Liu, Weiwei Xu

<div> <section> <h3> Objective</h3> <p>This study investigates the relationship between the albumin-to-creatinine ratio and diabetic retinopathy (DR) in US adults using NHANES data from 2009 to 2016. This study assesses the predictive efficacy of the urinary serum albumin-to-creatinine ratio (UACR/SACR Ratio) against traditional biomarkers such as the serum albumin-to-creatinine ratio (SACR) and urinary albumin-to-creatinine ratio (UACR) for evaluating DR risk. Additionally, the study explores the potential of these biomarkers, both individually and in combination with HbA1c, for early detection and risk stratification of DR.</p> </section> <section> <h3> Methods</h3> <p>This cross-sectional study analysed data from 2594 diabetic adults in the National Health and Nutrition Examination Survey (NHANES 2009–2016). Multivariate logistic regression models, adjusted for demographic (sex, age, race and education) and clinical factors (WBC, PLT, RDW, HbA1c, HBP and CHD), examined the associations between biomarkers and DR. Biomarkers were analysed both continuously and in quartiles to assess dose–response relationships. Receiver operating characteristic (ROC) curve analysis evaluated the predictive accuracy of individual biomarkers and combined models.</p> </section> <section> <h3> Results</h3> <p>Elevated SACR levels were inversely related to DR risk, while UACR showed a positive correlation. The UACR/SACR ratio demonstrated superior predictive capability for DR compared to SACR and UACR alone. The most accurate predictive model combined SACR, UACR, UACR/SACR ratio and HbA1c (AUC = 0.614), highlighting DR development complexity. Subgroup analyses revealed stronger associations in participants aged < 60 years and those with hypertension (both <i>p</i> < 0.05), with more pronounced effects observed in males and Mexican Americans, while lifestyle factors showed no significant modifying effect.</p> </section> <section> <h3> Conclusion</h3> <p>The UACR/SACR Ratio emerged as a potentially superior DR predictor, particularly in younger patients and those with hypertension, suggesting its utility in enhancing early detection and risk stratification. Comprehensive evaluation of renal function and glycaemic control biomarkers, considering age- and comorbidity-specific patterns, could improve DR risk prediction and management. Future longitudinal studies should validate these findings, particularly in identified high-risk subgroups, and investigate underlying mechanisms, potentially advancing personalised DR prediction and management strategies.</p>

目的：本研究利用2009年至2016年的NHANES数据，调查美国成年人白蛋白与肌酐比值与糖尿病视网膜病变（DR）的关系。本研究评估了尿白蛋白与肌酐比值（UACR/SACR ratio）与传统生物标志物（如血清白蛋白与肌酐比值（SACR）和尿白蛋白与肌酐比值（UACR））在评估DR风险方面的预测效果。此外，该研究还探讨了这些生物标志物（单独使用或与HbA1c联合使用）在dr早期检测和风险分层中的潜力。方法：该横断面研究分析了全国健康与营养检查调查（NHANES 2009-2016）中2594名糖尿病成年人的数据。调整了人口统计学（性别、年龄、种族和教育程度）和临床因素（WBC、PLT、RDW、HbA1c、HBP和CHD）的多变量logistic回归模型检验了生物标志物和dr之间的关联。生物标志物进行了连续分析和四分位数分析，以评估剂量-反应关系。受试者工作特征（ROC）曲线分析评估了单个生物标志物和组合模型的预测准确性。结果：SACR水平升高与DR风险呈负相关，UACR水平升高与DR风险呈正相关。与单独的SACR和UACR相比，UACR/SACR比值对DR的预测能力更强。最准确的预测模型结合了SACR、UACR、UACR/SACR比值和糖化血红蛋白（AUC = 0.614），突出了DR发展的复杂性。结论：UACR/SACR比值是潜在的更好的DR预测指标，特别是在年轻患者和高血压患者中，表明其在加强早期发现和风险分层方面的效用。综合评估肾功能和血糖控制生物标志物，考虑年龄和合并症特异性模式，可以改善DR风险预测和管理。未来的纵向研究应该验证这些发现，特别是在确定的高风险亚群中，并调查潜在的机制，潜在地推进个性化的DR预测和管理策略。

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引用次数: 0

Exploring the Predictive Role of 11-Oxyandrogens in Diagnosing Polycystic Ovary Syndrome 探讨11-氧雄激素在多囊卵巢综合征诊断中的预测作用。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-15 DOI: 10.1002/edm2.70022

Armaiti Parvez Mody, Maya Beth Lodish, Richard Joseph Auchus, Adina F. Turcu, Fei Jiang, Heather Gibson Huddleston

<div> <section> <h3> Context</h3> <p>Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS), yet the androgen(s) responsible remain ambiguous. Recent studies have suggested that 11-oxygenated C<sub>19</sub> steroids (11-oxyandrogens), specifically 11-ketotestosterone, may be a good marker for hyperandrogenism in PCOS.</p> </section> <section> <h3> Objective</h3> <p>To investigate the utility of 11-oxyandrogens to differentiate women with and without PCOS relative to classical androgens.</p> </section> <section> <h3> Design Setting</h3> <p>Case–control study performed at a PCOS clinic and research center in an academic setting.</p> </section> <section> <h3> Patients</h3> <p>114 women with PCOS and 78 healthy controls.</p> </section> <section> <h3> Interventions</h3> <p>Using the PCOS Tissue Bank, serum samples and data from 114 women registered from 2013 to 2017 between the ages of 18–40 years, were obtained and classified using Rotterdam PCOS criteria. Data were compared to 78 healthy women of similar age, with serum samples obtained between 2017 and 2020. 11-oxyandrogens and sex steroids were measured using mass spectrometry, and their associations to Rotterdam PCOS, age, and BMI were assessed.</p> </section> <section> <h3> Main Outcome Measures</h3> <p>11-oxyandrogens and sex steroids.</p> </section> <section> <h3> Results</h3> <p>Total testosterone, androstenedione, and four 11-oxyandrogens were significantly elevated in women with PCOS compared to age matched controls, controlling for age and BMI (<i>p</i> < 0.01 for all). When considered together, the four 11-oxyandrogens were more predictive of PCOS compared to testosterone and androstenedione. When all androgens were considered individually, 11-ketoandrostenedione was the most predictive of PCOS. Of the six androgens studied, 11-ketotestosterone was the only androgen that demonstrated a weak association with hirsutism score (<i>r</i> = 0.17; <i>p</i> = 0.07) within the PCOS group.</p> </section> <section> <h3> Conclusion</h3> <p>11-oxyandrogens were statistically higher in women with PCOS and may serve as better predictors of PCOS than testosterone and androstenedione.</p>

背景：雄激素过多是多囊卵巢综合征（PCOS）的标志，但雄激素的作用尚不明确。最近的研究表明，11-氧合C19类固醇（11-氧雄激素），特别是11-酮睾酮，可能是多囊卵巢综合征高雄激素症的一个很好的标志。目的：探讨11-氧雄激素与经典雄激素在鉴别PCOS患者中的应用价值。设计环境：在多囊卵巢综合征诊所和学术研究中心进行病例对照研究。患者：114名多囊卵巢综合征女性和78名健康对照者。干预措施：使用PCOS组织库，获取2013年至2017年登记的114名年龄在18-40岁之间的女性的血清样本和数据，并根据鹿特丹PCOS标准进行分类。研究人员将78名年龄相仿的健康女性的数据与2017年至2020年间获得的血清样本进行了比较。使用质谱法测量11-氧雄激素和性类固醇，并评估其与鹿特丹多囊卵巢综合征、年龄和BMI的关系。主要观察指标：11-氧雄激素和性类固醇。结果：与年龄匹配的对照组相比，PCOS女性的总睾酮、雄烯二酮和4种11-氧雄激素水平显著升高，控制了年龄和BMI (p)。结论：PCOS女性的11-氧雄激素水平有统计学意义高于睾酮和雄烯二酮，可能比睾酮和雄烯二酮更能预测PCOS。

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引用次数: 0

Interventions for Type 2 Diabetes Prevention and Management Among Indigenous Children and Youth: A Systematic Review 土著儿童和青少年预防和管理2型糖尿病的干预措施：一项系统综述。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-13 DOI: 10.1002/edm2.70026

Edmund Wedam Kanmiki, Yaqoot Fatima, Thuy Linh Duong, Roslyn Von Senden, Tolassa W. Ushula, Abdullah A. Mamun

Introduction

Indigenous populations experience a disproportionately higher burden of early onset of type 2 diabetes mellitus (T2DM). To contribute towards addressing this health disparity, evidence-based culturally appropriate interventions are urgently needed. This systematic review examines interventions designed to improve the prevention and management of T2DM among Indigenous children and youth.

Methods

A comprehensive search of five electronic databases was carried out in February 2023 to identify relevant studies published in English. We included studies of all designs involving Indigenous children and youth under 25 years of age. An adapted version of the National Institute of Health (NIH) quality assessment tool for pre-post intervention studies was used for quality assessment. Due to the heterogeneity of methods used by reviewed publications, the convergent integrated approach developed by Joanna Briggs Institute (JBI) for mixed-method systematic reviews was employed in the analysis. Prospero registration ID: CRD42023423671.

Results

The search identified 1127 publications, and 25 studies with a total of 4594 participants from four countries were eligible after screening. Notably, most (80%) originated from North America. Most interventions involved < 100 participants and lasted 6 months or less (58%). While knowledge and behaviours improved for most interventions, longer and culturally responsive interventions, often combining both community and school-based elements, demonstrated a greater effect on key anthropometrics and biomarkers associated with the risk of T2DM.

Conclusion

This review highlights the urgent need for more research to address T2DM among Indigenous youth. Future research should prioritise culturally appropriate, long-term interventions that engage communities and empower Indigenous youth to make healthy choices.

土著居民经历了不成比例的高负担早发型2型糖尿病（T2DM）。为了帮助解决这种健康差距，迫切需要以证据为基础的文化上适当的干预措施。本系统综述探讨了旨在改善土著儿童和青少年2型糖尿病预防和管理的干预措施。方法：综合检索5个电子数据库，于2023年2月检索已发表的相关英文文献。我们纳入了涉及土著儿童和25岁以下青年的所有设计的研究。采用美国国立卫生研究院（NIH）干预前后研究质量评估工具的改编版本进行质量评估。由于被审查出版物使用的方法的异质性，在分析中采用了乔安娜布里格斯研究所（JBI）为混合方法系统评价开发的收敛集成方法。普洛斯彼罗注册ID: CRD42023423671。结果：检索确定了1127份出版物，筛选后，来自四个国家的25项研究共4594名参与者符合条件。值得注意的是，大多数（80%）来自北美。结论：这篇综述强调了迫切需要更多的研究来解决土著青年的2型糖尿病问题。未来的研究应优先考虑文化上适当的长期干预措施，使社区参与并使土著青年能够做出健康的选择。

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引用次数: 0

Diagnosis Osteoporosis Risk: Using Machine Learning Algorithms Among Fasa Adults Cohort Study (FACS) 诊断骨质疏松风险：在Fasa成人队列研究（FACS）中使用机器学习算法。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-06 DOI: 10.1002/edm2.70023

Saghar Tabib, Seyed Danial Alizadeh, Aref Andishgar, Babak Pezeshki, Omid Keshavarzian, Reza Tabrizi

Introduction

In Iran, the assessment of osteoporosis through tools like dual-energy X-ray absorptiometry poses significant challenges due to their high costs and limited availability, particularly in small cities and rural areas. Our objective was to employ a variety of machine learning (ML) techniques to evaluate the accuracy and precision of each method, with the aim of identifying the most accurate pattern for diagnosing the osteoporosis risks.

Methods

We analysed the data related to osteoporosis risk factors obtained from the Fasa Adults Cohort Study in eight ML methods, including logistic regression (LR), baseline LR, decision tree classifiers (DT), support vector classifiers (SVC), random forest classifiers (RF), linear discriminant analysis (LDA), K nearest neighbour classifiers (KNN) and extreme gradient boosting (XGB). For each algorithm, we calculated accuracy, precision, sensitivity, specificity, F1 score and area under the curve (AUC) and compared them.

Results

The XGB model with an AUC of 0.78 (95% confidence interval [CI]: 0.74–0.82) and an accuracy of 0.79 (0.75–0.83) demonstrated the best performance, while AUC and accuracy values of RF were achieved (0.78 and 0.77), LR (0.78 and 0.77), LDA (0.78 and 0.76), DT (0.76 and 0.79), SVC (0.71 and 0.64), KNN (0.63 and 0.59) and baseline LR (0.72 and 0.82), respectively.

Conclusion

The XGB model had the best performance in assessing the risk of osteoporosis in the Iranian population. Given the disadvantages and challenges associated with traditional osteoporosis diagnostic tools, the implementation of ML algorithms for the early identification of individuals with osteoporosis can lead to a significant reduction in morbidity and mortality related to this condition. This advancement not only alleviates the substantial financial burden placed on the healthcare systems of various countries due to the treatment of complications arising from osteoporosis but also encourages health policies to shift toward more preventive approaches for managing this disease.

导言：在伊朗，通过双能x线吸收仪等工具评估骨质疏松症面临着巨大的挑战，因为它们的成本高，可用性有限，特别是在小城市和农村地区。我们的目标是采用各种机器学习（ML）技术来评估每种方法的准确性和精密度，目的是确定诊断骨质疏松症风险的最准确模式。方法：采用logistic回归（LR）、基线LR、决策树分类器（DT）、支持向量分类器（SVC）、随机森林分类器（RF）、线性判别分析（LDA）、K近邻分类器（KNN）和极限梯度增强（XGB）等8种ML方法分析Fasa成人队列研究中与骨质疏松症危险因素相关的数据。对于每种算法，我们计算准确率、精密度、灵敏度、特异性、F1评分和曲线下面积（AUC）并进行比较。结果：XGB模型的AUC为0.78(95%置信区间[CI]: 0.74 ~ 0.82)，准确率为0.79(0.75 ~ 0.83)，其中RF模型的AUC和准确率分别为0.78和0.77、LR（0.78和0.77）、LDA（0.78和0.76）、DT（0.76和0.79）、SVC（0.71和0.64）、KNN（0.63和0.59）和基线LR（0.72和0.82）。结论：XGB模型是评估伊朗人群骨质疏松风险的最佳方法。考虑到传统骨质疏松症诊断工具的缺点和挑战，实现ML算法对骨质疏松症患者进行早期识别可以显著降低与此相关的发病率和死亡率。这一进展不仅减轻了由于治疗骨质疏松症引起的并发症而给各国卫生保健系统带来的巨大经济负担，而且还鼓励卫生政策转向更多的预防方法来管理这种疾病。

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引用次数: 0

Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis 妊娠中期和妊娠期糖尿病的血细胞参数：一项系统综述和荟萃分析。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-01-03 DOI: 10.1002/edm2.70024

Vida Ghasemi, Mojdeh Banaei, Zahra Kiani, Fahimeh Ramezani Tehrani, Marzieh Saei Ghare Naz

Objective

Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.

Methods

Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).

Results

Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134–0.553] p = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343–0.315] p = 0.01), red blood cell (0.387 [95% CI 0.224–0.550] p < 0.001), mean platelet volume (0.498 [95% CI 0.165–0.831] p = 0.003), white blood cell count (0.351 [95% CI 0.0882–0.615] p = 0.009) and neutrophil–lymphocyte ratio (0.534 [95% CI 0.127–0.941] p = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (−0.249 [95% CI −0.386–−0.112] p < 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8–1.86] I² = 57.2%).

Conclusions

Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.

目的：妊娠期糖尿病（GDM）是妊娠期最常见的并发症之一。以往关于孕妇血液和炎症参数水平及其与GDM关系的研究并不一致。本研究旨在探讨与GDM相关的血液参数之间的关系。方法：截至2024年5月，通过PubMed、Web of Science、Epistemonikos、Scopus、Scientific Information Database、Magiran等数据库进行系统文献检索。采用标准均值偏差（SMDs）和95%置信区间（ci）确定血清血液参数水平的效应大小。结果：本研究共纳入30篇文章。荟萃分析显示，与对照组相比，GDM女性血红蛋白（0.343 [95% CI 0.134-0.553] p = 0.01，敏感性分析：0.174 [95% CI 0.0343-0.315] p = 0.01）、红细胞（0.387 [95% CI 0.224-0.550] p 2 = 57.2%）水平显著升高。结论：研究结果支持妊娠中期GDM妇女较高的血液参数（Hb、RBC、WBC、NLR和MPV）水平。未来的研究应该调查这些血液学标志物作为不良妊娠结局预测工具的潜在作用，并评估针对这些参数的治疗干预措施，以增强孕产妇和胎儿的健康。

{"title":"Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis","authors":"Vida Ghasemi, Mojdeh Banaei, Zahra Kiani, Fahimeh Ramezani Tehrani, Marzieh Saei Ghare Naz","doi":"10.1002/edm2.70024","DOIUrl":"10.1002/edm2.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134–0.553] <i>p</i> = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343–0.315] <i>p</i> = 0.01), red blood cell (0.387 [95% CI 0.224–0.550] <i>p</i> < 0.001), mean platelet volume (0.498 [95% CI 0.165–0.831] <i>p</i> = 0.003), white blood cell count (0.351 [95% CI 0.0882–0.615] <i>p</i> = 0.009) and neutrophil–lymphocyte ratio (0.534 [95% CI 0.127–0.941] <i>p</i> = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (−0.249 [95% CI −0.386–−0.112] <i>p</i> < 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8–1.86] <i>I</i><sup>2</sup> = 57.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting Time in Range Without Hypoglycaemia Using a Risk Calculator for Intermittently Scanned CGM in Type 1 Diabetes 用风险计算器预测1型糖尿病间歇扫描CGM患者无低血糖的时间范围

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-12-24 DOI: 10.1002/edm2.70020

Fernando Sebastian-Valles, Jose Alfonso Arranz Martin, Julia Martínez-Alfonso, Jessica Jiménez-Díaz, Iñigo Hernando Alday, Victor Navas-Moreno, Teresa Armenta Joya, Maria del Mar del Fandiño García, Gisela Liz Román Gómez, Jon Garai Hierro, Luis Eduardo Lander Lobariñas, Carmen González-Ávila, Purificación de Martinez de Icaya, Vicente Martínez-Vizcaíno, Miguel Antonio Sampedro-Nuñez, Mónica Marazuela

Purpose

To investigate the impact of clinical and socio-economic factors on glycaemic control and construct statistical models to predict optimal glycaemic control (OGC) after implementing intermittently scanned continuous glucose monitoring (isCGM) systems.

Methods

This retrospective study included 1072 type 1 diabetes patients (49.0% female) from three centres using isCGM systems. Clinical data and net income from the census tract were collected for each individual. OGC was defined as time in range > 70%, with time below 70 mg/dL < 4%. The sample was randomly split in two equal parts. Logistic regression models to predict OGC were developed in one of the samples, and the best model was selected using the Akaike information criterion and adjusted for Pearson's and Hosmer–Lemeshow's statistics. Model reliability was assessed via external validation in the second sample and internal validation using bootstrap resampling.

Results

Out of 2314 models explored, the most effective predictor model included annual net income per person, sex, age, diabetes duration, pre-isCGM HbA1c, insulin dose/kg, and the interaction between sex and HbA1c. When applied to the validation cohort, this model demonstrated 72.6% specificity, 67.3% sensitivity, and an area under the curve (AUC) of 0.736. The AUC through bootstrap resampling was 0.756. Overall, the model's validity in the external cohort was 80.4%.

Conclusions

Clinical and socio-economic factors significantly influence OGC in type 1 diabetes. The application of statistical models offers a reliable means of predicting the likelihood of achieving OGC following isCGM system implementation.

目的：探讨临床和社会经济因素对血糖控制的影响，并建立统计模型预测间歇扫描连续血糖监测（isCGM）系统实施后的最佳血糖控制（OGC）。方法：本回顾性研究包括来自三个使用isCGM系统的中心的1072例1型糖尿病患者（49.0%为女性）。从人口普查区收集每个人的临床数据和净收入。结果：在2314个模型中，最有效的预测模型包括人均年净收入、性别、年龄、糖尿病病程、iscgm前HbA1c、胰岛素剂量/kg以及性别与HbA1c之间的相互作用。当应用于验证队列时，该模型的特异性为72.6%，敏感性为67.3%，曲线下面积（AUC）为0.736。自举重采样的AUC为0.756。总体而言，该模型在外部队列中的效度为80.4%。结论：临床和社会经济因素对1型糖尿病OGC有显著影响。统计模型的应用为预测isCGM系统实施后实现OGC的可能性提供了可靠的手段。

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引用次数: 0

Reduction of Hepatic Fat Content by Dulaglutide for the Treatment of Diabetes Mellitus: A Two-Centre Open, Single-Arm Trial 杜拉鲁肽治疗糖尿病降低肝脏脂肪含量：一项双中心、单组开放试验。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-12-24 DOI: 10.1002/edm2.70021

Chuanfeng Liu, Yu Xin, Yajing Huang, Lili Xu, Ruizhi Zhou, Yangang Wang, Wei Wang

Background

With the elevated level of NAFLD prevalence, the incidence of diabetes, hypertension, metabolic syndrome and other diseases is also significantly elevated. GLP-1RA can exert weight loss, glucose-lowering effects and various nonglycaemic effects. However, the relationship between quantitative reduction in hepatic fat content and improvement of pancreatic islet function by GLP-1RA is unclear.

Methods

This trial was a single-arm open cohort study. A total of 38 patients with T2DM and NAFLD were enrolled in the GLP-1RA treatment group. The included patients were tested for biochemical and blood glucose levels, adiponectin and FGF21 levels, and liver fat content was measured using MRI. Measure the above indicators again after at least 3 months of GLP-1RA treatment. Divided into Q1 (average decrease of 0.37%) and Q2 (average decrease of 8.6%) groups based on the degree of reduction in liver fat content.

Results

Q2 group showed an average reduction in liver fat content of 8.6%, a decrease in glycated haemoglobin of 18.17%, a weight loss of 7.29% and an increase in fasting c-peptide release by 1.03%, 1-h and 2-h postprandial c-peptide release by 28.86% and 18.28% respectively. In contrast, Q1 group had an average reduction in liver fat content of 0.37%, a decrease in glycated haemoglobin of only 6.53%, a weight loss of 3.41%, a decrease in fasting c-peptide release by 1.91% and an increase in 1-h and 2-h postprandial c-peptide release by 19.18% and 11.66% respectively.

Conclusion

Reduction in liver fat content effectively improves pancreatic islet function secretion, particularly postprandial c-peptide secretion, especially in the first hour after a meal. This improvement leads to a decrease in glycated haemoglobin levels and promotes better compliance with blood glucose control.

背景：随着NAFLD患病率水平的升高，糖尿病、高血压、代谢综合征等疾病的发病率也显著升高。GLP-1RA具有减肥、降血糖和多种非降糖作用。然而，GLP-1RA定量降低肝脏脂肪含量与改善胰岛功能之间的关系尚不清楚。方法：本试验为单组开放队列研究。GLP-1RA治疗组共纳入38例T2DM和NAFLD患者。对纳入的患者进行生化和血糖水平、脂联素和FGF21水平检测，并使用MRI测量肝脏脂肪含量。GLP-1RA治疗至少3个月后再次测量上述指标。根据肝脏脂肪含量降低程度分为Q1组（平均降低0.37%）和Q2组（平均降低8.6%）。结果：Q2组肝脏脂肪含量平均下降8.6%，糖化血红蛋白下降18.17%，体重减轻7.29%，空腹c肽释放增加1.03%，餐后1小时和2小时c肽释放分别增加28.86%和18.28%。相比之下，Q1组肝脏脂肪含量平均下降0.37%，糖化血红蛋白仅下降6.53%，体重减轻3.41%，空腹c肽释放减少1.91%，餐后1小时和2小时c肽释放分别增加19.18%和11.66%。结论：降低肝脏脂肪含量可有效改善胰岛功能分泌，尤其是餐后c肽分泌，尤其是餐后1小时内的分泌。这种改善导致糖化血红蛋白水平的降低，并促进更好地遵守血糖控制。

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引用次数: 0