Endocrinology, Diabetes and Metabolism最新文献_第7页

Efficacy and Safety of Aldosterone Synthase Inhibitors in Hypertension: A Systematic Review and Meta-Analysis 醛固酮合成酶抑制剂治疗高血压的疗效和安全性：系统综述和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-12 DOI: 10.1002/edm2.70094

Jia Shen Goh, Sameen Sohail, Haroon Ayub, Zian Zafar Cheema, Nitish Behary Paray, Sanka Adikari, Ahmad Mesmar, Mohammad Atout, Abdul Rehman Qazi, Ahmad Aldalqamouni, Bilal Younas, Muhammad Atif Rauf, Muhammad Azhar Waheed Khan, Aya Abouayana, Ahmed Eid Ahmed Abouayana, Ali Hasan, Maryam Shahzad, Mushood Ahmed, Raheel Ahmed, Saeed Ahmed

Background

Hypertension remains a major contributor to global cardiovascular morbidity and mortality. Aldosterone, a key hormone in blood pressure regulation, plays a significant role in hypertension pathophysiology. This has led to growing interest in aldosterone synthase inhibitors (ASIs) as a potential treatment. This meta-analysis aims to evaluate the efficacy and safety of ASIs in managing hypertension.

Methods

A systematic search of PubMed, Google Scholar and Cochrane Central was conducted up to 13 July 2025, to identify randomised controlled trials (RCTs) evaluating ASIs in hypertensive adults. Data were analysed using RevMan version 5.4, employing random-effects models with significance set at p < 0.05.

Results

A total of 8 RCTs were included, with a total of 2003 participants in the ASI group and 650 participants in the placebo group. ASIs significantly reduced systolic blood pressure (SBP) compared to placebo (MD: −6.01 mmHg; 95% confidence interval [CI]: −9.31 to −2.71; I² = 85%; p = 0.0004); diastolic blood pressure (DBP) was found to be comparable between the two groups (MD: −2.20 mmHg; 95% CI: −4.46 to 0.06; I² = 69%; p = 0.06). There was a significant reduction in serum aldosterone levels favouring ASI use (MD: −1.46; 95% CI: −2.76 to −0.16; I² = 99%; p < 0.00001). The risk of serious (RD: 0.00; 95% CI: −0.01 to 0.02; I² = 30%; p = 0.75) and non-serious adverse events (RD: 0.05; 95% CI: −0.02 to 0.12; I² = 64%; p = 0.20) did not differ significantly between ASI and placebo groups. However, ASI use was associated with a significantly higher risk of hyperkalemia (RD: 0.04; 95% CI: 0.02 to 0.06; I² = 70%; p = 0.002).

Conclusion

ASIs effectively lower SBP and serum aldosterone in adults with hypertension. They appear safe overall but may increase the risk of hyperkalemia.

背景：高血压仍然是全球心血管发病率和死亡率的主要原因。醛固酮是调节血压的关键激素，在高血压病理生理中起着重要作用。这使得人们对醛固酮合成酶抑制剂（ASIs）作为一种潜在的治疗方法越来越感兴趣。本荟萃分析旨在评估ASIs治疗高血压的有效性和安全性。方法系统检索PubMed、b谷歌Scholar和Cochrane Central，检索截至2025年7月13日的随机对照试验（RCTs），以评估成人高血压患者的ASIs。数据分析使用RevMan version 5.4，采用随机效应模型，显著性设置为p <； 0.05。结果共纳入8项随机对照试验，ASI组共2003名受试者，安慰剂组650名受试者。与安慰剂相比，ASIs显著降低收缩压（SBP）（MD: - 6.01 mmHg； 95%可信区间[CI]: - 9.31至- 2.71;I2 = 85%; p = 0.0004）；发现两组舒张压（DBP）具有可比性（MD: - 2.20 mmHg; 95% CI: - 4.46 ~ 0.06; I2 = 69%; p = 0.06）。血清醛固酮水平显著降低，有利于使用ASI （MD: - 1.46; 95% CI: - 2.76至- 0.16;I2 = 99%; p < 0.00001）。严重不良事件（RD: 0.00; 95% CI:−0.01 ~ 0.02;I2 = 30%; p = 0.75）和非严重不良事件（RD: 0.05; 95% CI:−0.02 ~ 0.12;I2 = 64%; p = 0.20）的风险在ASI组和安慰剂组之间无显著差异。然而，ASI的使用与高钾血症的风险显著增高相关（RD: 0.04; 95% CI: 0.02 ~ 0.06; I2 = 70%; p = 0.002）。结论ASIs能有效降低成人高血压患者的收缩压和血清醛固酮。总的来说，它们似乎是安全的，但可能会增加高钾血症的风险。

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引用次数: 0

Correction to ‘Clinical Outcomes of Patients With Bethesda III or IV Cytology on Fine Needle Aspiration of Thyroid Nodules—A Retrospective Study’ 纠正“Bethesda III或IV细胞学检查患者细针穿刺甲状腺结节的临床结果-回顾性研究”

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-12 DOI: 10.1002/edm2.70106

Khan AA, Jasim NKE, Al-Mannai NEAH, Ata F, Goyal R, Jaber T. Clinical Outcomes of Patients With Bethesda III or IV Cytology on Fine Needle Aspiration of Thyroid Nodules-A Retrospective Study. Endocrinol Diabetes Metab. 2025;8(5):e70076.

In the Acknowledgements section on Page 7 of the manuscript, the APC for publication was attributed to the wrong entity.

Instead of ‘Article processing charges for the publication of this study were provided by the Qatar National Library (QNL)’, we would like to change this to:

Article processing charges for the publication of this study were provided by the Medical Research Center (MRC) at Hamad Medical Corporation (HMC).

We apologise for this error.

Khan AA, Jasim NKE, Al-Mannai NEAH, Ata F, Goyal R, Jaber T.甲状腺结节细针抽吸Bethesda III或IV细胞学检查患者临床结果的回顾性研究。内分泌与糖尿病杂志，2015;8(5):e70076。在手稿第7页的致谢部分，发表的APC被归因于错误的实体。将“本研究发表的文章处理费由卡塔尔国家图书馆（QNL）提供”改为：本研究发表的文章处理费由哈马德医疗公司（HMC）医学研究中心（MRC）提供。我们为这个错误道歉。

引用次数: 0

Quality, Reliability and Accuracy of Hyperthyroidism-Related Content on Social Media Platform TikTok 社交媒体平台TikTok上甲状腺功能亢进相关内容的质量、可靠性和准确性

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-10 DOI: 10.1002/edm2.70105

Aayush Shah, Raika Bourmand, Freddy Albaladejo, Karthik Jarugula, Sofia Olsson, Zainab Farzal, Viraj Shah

Objective(s)

To evaluate the quality, reliability and accuracy of hyperthyroidism-related content on TikTok using validated assessment tools.

Methods

We systematically searched TikTok for ‘hyperthyroid’ and ‘high thyroid’, analysing 115 videos after exclusions. Two independent researchers assessed videos using the Global Quality Scale (GQS, range 0–5) for overall content quality, the modified DISCERN (mDISCERN, range 0–5) for reliability and the Accuracy in Digital Information (ANDI, range 0–4) tool for factual correctness. We categorised creator credentials and content purpose, performing statistical analyses to examine associations with video quality and engagement.

Results

Of the 115 videos analysed, the mean ANDI score was 3.15/4, the mean GQS was 2.72/5, and the mean mDISCERN score was 2.47/5. Educational content (98.3%) demonstrated higher GQS (p = 0.019) and mDISCERN (p = 0.040) scores than non-educational content. Conversely, anecdotal content (35.7%) was associated with significantly lower GQS (p = 0.002) and mDISCERN (p < 0.001) scores. Healthcare professionals (HCPs, 37.4% of creators) produced videos with higher ANDI (p = 0.015), GQS (p < 0.001) and mDISCERN (p < 0.001) scores than non-HCPs. Notably, physician-created videos garnered higher engagement across all metrics (p < 0.05).

Conclusions

While some TikTok content on hyperthyroidism is of high quality, particularly from healthcare professionals, the platform is dominated by lower quality content from non-experts. This underscores the need for increased engagement from healthcare professionals on social media to improve the accuracy and reliability of health information available to the public.

目的：使用经过验证的评估工具评估TikTok上甲状腺功能亢进相关内容的质量、可靠性和准确性。方法：我们系统地在TikTok中搜索“甲状腺功能亢进”和“甲状腺功能亢进”，并对排除后的115个视频进行分析。两名独立研究人员使用全球质量量表（GQS，范围0-5）评估视频的整体内容质量，使用改进的DISCERN （mDISCERN，范围0-5）评估视频的可靠性，使用数字信息准确性（ANDI，范围0-4）评估视频的事实正确性。我们对创作者资质和内容目的进行了分类，并进行了统计分析，以检验视频质量和参与度之间的关系。结果：分析的115个视频中，ANDI平均得分为3.15/4，GQS平均得分为2.72/5，mDISCERN平均得分为2.47/5。教育内容（98.3%）的GQS （p = 0.019）和mDISCERN （p = 0.040）得分高于非教育内容。相反，轶事内容（35.7%）与显著降低的GQS （p = 0.002）和mDISCERN (p)相关。结论：虽然一些关于甲状腺机能亢进的TikTok内容质量高，特别是来自医疗保健专业人员的内容，但该平台主要是来自非专家的低质量内容。这突出表明，卫生保健专业人员需要更多地参与社交媒体，以提高向公众提供的卫生信息的准确性和可靠性。

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引用次数: 0

Peri-Liver Transplant Hyperglycemia: Mechanisms, Associated Factors, Consequences, and Management – A Systematic Review 肝移植周围高血糖：机制，相关因素，后果和管理-系统综述。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-10 DOI: 10.1002/edm2.70107

Yekta Rameshi, Simin Dashti-Khavidaki, Soghra Rabizadeh, Mahta Alimadadi, Alimohammad Moradi, Amir Kasraianfard, Ali Jafarian, Zahra Ahmadinejad

Introduction

Liver transplantation is associated with various metabolic disorders. Peri-transplant hyperglycemia is among the most frequent metabolic disorders among liver transplant recipients. Hyperglycemia following liver transplantation can increase the risk of post-transplant complications, potentially impacting both graft and recipient outcomes. Several studies have compared intensive with standard blood glucose control strategies in liver transplant recipients. However, a comprehensive protocol for managing peri-transplant hyperglycemia remains elusive. This review aimed to synthesise existing literature on the mechanisms, associated factors, and consequences of hyperglycemia after liver transplantation, and to provide recommendations for managing hyperglycemia in this patient population.

Method

PubMed, Scopus, and UpToDate databases and American Diabetes Association guidelines were searched without time limitations until February 2025.

Results

Peri-liver transplant hyperglycemia can be attributed to several factors, including post-reperfusion hepatocyte injury, insulin resistance stemming from underlying liver disease, surgical stress, and the use of immunosuppressive drugs. Various factors associated with peri-transplant hyperglycemia can be categorised into pre-transplant recipient factors, intraoperative factors, and donor-related factors. Research has shown that inadequate glycemic control during the peri-transplant period may have detrimental effects on post-transplant outcomes, including an increased incidence of infections, graft rejection, acute kidney injury, prolonged hospital stays, and higher overall mortality.

Conclusion

The suggestions presented in this article, which consider the recipient's medical history and clinical conditions, can serve as a framework for healthcare providers to manage peri-liver transplant hyperglycemia effectively.

肝移植与多种代谢紊乱有关。移植期高血糖是肝移植受者中最常见的代谢紊乱之一。肝移植术后高血糖可增加移植后并发症的风险，潜在地影响移植物和受体的预后。几项研究比较了肝移植受者强化与标准血糖控制策略。然而，治疗移植期高血糖的综合方案仍然难以捉摸。本综述旨在综合有关肝移植术后高血糖的机制、相关因素和后果的现有文献，并为该患者群体的高血糖治疗提供建议。方法：检索PubMed， Scopus和UpToDate数据库和美国糖尿病协会指南，无时间限制，直到2025年2月。结果：肝移植周围高血糖可归因于几个因素，包括再灌注后肝细胞损伤、潜在肝脏疾病引起的胰岛素抵抗、手术应激和免疫抑制药物的使用。与移植期高血糖相关的各种因素可分为移植前受体因素、术中因素和供体相关因素。研究表明，移植期血糖控制不充分可能对移植后的预后产生不利影响，包括感染发生率增加、移植排斥反应、急性肾损伤、住院时间延长和总体死亡率升高。结论：本文提出的建议考虑了受者的病史和临床条件，可以作为医疗保健提供者有效管理肝移植周围高血糖的框架。

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引用次数: 0

Lipid Accumulation Product Index as a Marker of Metabolic Syndrome in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis 脂质积累产物指数作为多囊卵巢综合征女性代谢综合征的标志物：系统综述和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-04 DOI: 10.1002/edm2.70078

Seyed Arsalan Seyedi, Seyed Ali Nabipoorashrafi, Samira Amin Afshari, Afsoun Mansouri, Dorsa Alizadegan, Sara Hobaby, Fatemeh Esmaeilpur Abianeh, Jeffrey I. Mechanick, Alireza Esteghamati

Background

Lipid accumulation product (LAP) index is a measure of lipid toxicity based on triglyceride and waist circumference. The aim of the current study is to explore the relationship between LAP index and metabolic syndrome (MetS) among women with polycystic ovary syndrome (PCOS) in a systematic review and meta-analysis.

Methods

Web of Science, Embase and PubMed online databases were systematically searched for studies investigating the relationship between LAP index and MetS in PCOS. Ten observational studies, including 12 populations with 2957 individuals, were identified for analysis. Mean difference and bivariate diagnostic test accuracy (DTA) meta-analyses were performed.

Results

A significant LAP index difference of 49.17 was found in women with PCOS with and without MetS (95% CI [40.57, 57.77]). By DTA meta-analysis, the pooled sensitivity and specificity of LAP index for MetS detection were 87% (I² 78%, 95% CI [80%, 92%]) and 88% (I² 78%, 95% CI [83%, 92%]), respectively, with area under the curve of 0.94 (95% CI [0.91, 0.96]).

Conclusion

The LAP index is an affordable, specific and sensitive marker for MetS and may be considered a pragmatic tool for MetS detection among patients with PCOS, particularly those with an insulin resistance endotype.

脂质积累产物（LAP）指数是一种基于甘油三酯和腰围的脂质毒性指标。本研究旨在通过系统综述和荟萃分析，探讨LAP指数与多囊卵巢综合征（PCOS）女性代谢综合征（MetS）之间的关系。方法系统检索Web of Science、Embase和PubMed在线数据库，查询PCOS患者LAP指数与MetS之间关系的相关研究。10项观察性研究，包括12个种群，共2957人。进行了平均差异和双变量诊断测试准确性（DTA）荟萃分析。结果伴有和不伴有met的PCOS患者的LAP指数差异为49.17 （95% CI[40.57, 57.77]）。经DTA meta分析，LAP指数检测MetS的综合敏感性为87% (I2 78%, 95% CI[80%, 92%])，特异性为88% (I2 78%, 95% CI[83%, 92%])，曲线下面积为0.94 （95% CI[0.91, 0.96]）。结论LAP指数是一种经济、特异、敏感的代谢代谢指标，可作为PCOS患者，特别是胰岛素抵抗内型患者检测代谢代谢的实用工具。

{"title":"Lipid Accumulation Product Index as a Marker of Metabolic Syndrome in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","authors":"Seyed Arsalan Seyedi, Seyed Ali Nabipoorashrafi, Samira Amin Afshari, Afsoun Mansouri, Dorsa Alizadegan, Sara Hobaby, Fatemeh Esmaeilpur Abianeh, Jeffrey I. Mechanick, Alireza Esteghamati","doi":"10.1002/edm2.70078","DOIUrl":"https://doi.org/10.1002/edm2.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lipid accumulation product (LAP) index is a measure of lipid toxicity based on triglyceride and waist circumference. The aim of the current study is to explore the relationship between LAP index and metabolic syndrome (MetS) among women with polycystic ovary syndrome (PCOS) in a systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Web of Science, Embase and PubMed online databases were systematically searched for studies investigating the relationship between LAP index and MetS in PCOS. Ten observational studies, including 12 populations with 2957 individuals, were identified for analysis. Mean difference and bivariate diagnostic test accuracy (DTA) meta-analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant LAP index difference of 49.17 was found in women with PCOS with and without MetS (95% CI [40.57, 57.77]). By DTA meta-analysis, the pooled sensitivity and specificity of LAP index for MetS detection were 87% (<i>I</i><sup>2</sup> 78%, 95% CI [80%, 92%]) and 88% (<i>I</i><sup>2</sup> 78%, 95% CI [83%, 92%]), respectively, with area under the curve of 0.94 (95% CI [0.91, 0.96]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LAP index is an affordable, specific and sensitive marker for MetS and may be considered a pragmatic tool for MetS detection among patients with PCOS, particularly those with an insulin resistance endotype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998789","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

Combined Metformin and Baricitinib Therapy Attenuates Inflammation in STZ-Induced Diabetic Rats via AMPK/JAK–STAT Pathway Crosstalk 二甲双胍联合巴西替尼治疗通过AMPK/ JAK-STAT通路串扰减轻stz诱导的糖尿病大鼠炎症

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-09-03 DOI: 10.1002/edm2.70101

Mostafa Allahyari, AbdolJalal Marjani, Marie Saghaeian Jazi, Mehrdad Jahanshahi

Background

Chronic inflammation is a critical factor contributing to diabetes complications. Baricitinib inhibits JAK–STAT signalling, which can contribute to an anti-inflammatory effect. Similarly, metformin demonstrates anti-inflammatory properties by activating the AMPK–SIRT pathway and suppressing the NF-ᴋB signalling pathway. Here, we explored the effects of the coadministration of metformin and baricitinib in diabetic rats.

Methods

Streptozotocin (40 mg/kg body weight) was administered to rats to develop diabetes after 2 weeks of 10% fructose solution consumption. The rats were treated with baricitinib (0.5, 2.5 and 5 mg/kg) and 150 mg/kg metformin for 1 month. A dose of 0.5 mg/kg baricitinib was chosen for combination therapy with metformin.

Key Findings

Baricitinib induced significant weight loss at all three doses (p ≤ 0.05) and significantly increased lipid profile parameters in comparison to the diabetic control group (p ≤ 0.05). Pancreatic NF-ᴋB levels and HOMA-IR were meaningfully reduced in all treatment groups (p ≤ 0.01). Metformin and combination therapy significantly reduced serum TNF-α levels (p ≤ 0.05). Furthermore, baricitinib at different doses and combination therapy significantly elevated serum IL-10 levels (p ≤ 0.05). Additionally, combination therapy significantly upregulated the liver expression of NF-ᴋB, SOCS1, SOCS3, AMPK and SIRT-1 (p ≤ 0.01).

Conclusion

Our results suggest that the coadministration of metformin with baricitinib reduces insulin resistance, improves histopathological alterations in the liver and pancreatic islet cells and counteracts the adverse effects of baricitinib on the lipid profile in diabetic rats. These findings hold particular significance for patients undergoing baricitinib treatment.

慢性炎症是导致糖尿病并发症的重要因素。Baricitinib抑制JAK-STAT信号传导，这有助于抗炎作用。类似地，二甲双胍通过激活AMPK-SIRT通路和抑制NF- k - B信号通路显示出抗炎特性。在这里，我们探讨了二甲双胍和巴西替尼共同给药对糖尿病大鼠的影响。方法采用链脲佐菌素（40 mg/kg体重）治疗大鼠糖尿病。大鼠分别给予巴西替尼（0.5、2.5、5 mg/kg）和二甲双胍150 mg/kg治疗1个月。巴西替尼与二甲双胍联合治疗，剂量为0.5 mg/kg。与糖尿病对照组相比，Baricitinib在三个剂量下均能显著减轻体重（p≤0.05），并显著增加血脂参数（p≤0.05）。各治疗组胰腺NF- s - B水平和HOMA-IR均显著降低（p≤0.01）。二甲双胍联合用药显著降低血清TNF-α水平（p≤0.05）。此外，巴西替尼不同剂量及联合治疗均显著提高血清IL-10水平（p≤0.05）。此外，联合治疗显著上调了肝脏中NF- salb、SOCS1、SOCS3、AMPK和SIRT-1的表达（p≤0.01）。结论二甲双胍联合巴西替尼可降低糖尿病大鼠的胰岛素抵抗，改善肝脏和胰岛细胞的组织病理学改变，抵消巴西替尼对糖尿病大鼠血脂的不良影响。这些发现对接受巴西替尼治疗的患者具有特别的意义。

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引用次数: 0

Trifolium pratense-Derived Exosome Improved Serum Biochemical Parameters and Pancreatic Genes in STZ-Induced Diabetic Rats 三叶草来源的外泌体改善stz诱导的糖尿病大鼠血清生化指标和胰腺基因

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-08-31 DOI: 10.1002/edm2.70103

Amir Hossein Khazaei, Azam Bozorgi, Elham Ghanbari, Maryam Bozorgi, Mozafar Khazaei

Introduction

Plant-derived exosomes (PDEs) are promising nanotherapeutics for improving chronic diseases, such as diabetes mellitus. Trifolium pratense (TP) is a flowering herb with potent antioxidant and antidiabetic properties. The present study aimed to explore the diabetic-healing effects of TP-derived exosomes (TPDEs) in streptozotocin (STZ)-induced diabetic rats.

Methods

TPDEs were isolated using polyethylene glycol precipitation and serial centrifugation and characterised. STZ-induced diabetic rats were treated with TPDE doses (0, 100, 200, and 400 μg/kg) for 28 days. Biochemical factors (fasting blood sugar (FBS), insulin, C-peptide, total antioxidant capacity (TAC), and nitric oxide (NO)) were evaluated in serum samples. Also, the expression of PDX1, insulin, NGN3, and SIRT1 genes in pancreas tissues was assessed using real-time PCR.

Results

TPDE treatment decreased the serum levels of FBS and NO while increasing c-peptide, insulin, and TAC levels. It also significantly enhanced the expression of insulin, PDX1, NGN3, and SIRT1 genes. TPDEs at doses of 100 to 200 μg/kg showed the most significant antidiabetic effects.

Conclusion

TPDEs significantly improved diabetes-induced alterations in serum insulin levels, antioxidant status, and pancreas-related gene expression. It can be considered a novel complementary treatment for diabetes.

植物源性外泌体（PDEs）是一种很有前途的治疗慢性疾病的纳米药物，如糖尿病。三叶Trifolium pratense （TP）是一种具有有效抗氧化和抗糖尿病特性的开花草本植物。本研究旨在探讨tp衍生外泌体（TPDEs）对链脲佐菌素（STZ）诱导的糖尿病大鼠的糖尿病愈合作用。方法采用聚乙二醇沉淀法和连续离心法分离TPDEs，并对其进行表征。分别以0、100、200、400 μg/kg剂量的TPDE治疗stz诱导的糖尿病大鼠28 d。测定血清生化指标（空腹血糖（FBS）、胰岛素、c肽、总抗氧化能力（TAC）、一氧化氮（NO））。同时，采用实时荧光定量PCR检测胰腺组织中PDX1、胰岛素、NGN3和SIRT1基因的表达。结果TPDE治疗可降低血清FBS和NO水平，升高c肽、胰岛素和TAC水平。胰岛素、PDX1、NGN3、SIRT1基因的表达也显著增强。剂量为100 ~ 200 μg/kg的TPDEs抗糖尿病效果最显著。结论TPDEs可显著改善糖尿病诱导的血清胰岛素水平、抗氧化状态和胰腺相关基因表达的改变。它可以被认为是糖尿病的一种新的补充治疗方法。

{"title":"Trifolium pratense-Derived Exosome Improved Serum Biochemical Parameters and Pancreatic Genes in STZ-Induced Diabetic Rats","authors":"Amir Hossein Khazaei, Azam Bozorgi, Elham Ghanbari, Maryam Bozorgi, Mozafar Khazaei","doi":"10.1002/edm2.70103","DOIUrl":"https://doi.org/10.1002/edm2.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Plant-derived exosomes (PDEs) are promising nanotherapeutics for improving chronic diseases, such as diabetes mellitus. <i>Trifolium pratense</i> (<i>TP</i>) is a flowering herb with potent antioxidant and antidiabetic properties. The present study aimed to explore the diabetic-healing effects of <i>TP</i>-derived exosomes (<i>TPDEs</i>) in streptozotocin (STZ)-induced diabetic rats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><i>TPDEs</i> were isolated using polyethylene glycol precipitation and serial centrifugation and characterised. STZ-induced diabetic rats were treated with <i>TPDE</i> doses (0, 100, 200, and 400 μg/kg) for 28 days. Biochemical factors (fasting blood sugar (FBS), insulin, C-peptide, total antioxidant capacity (TAC), and nitric oxide (NO)) were evaluated in serum samples. Also, the expression of <i>PDX1, insulin, NGN3</i>, and <i>SIRT1</i> genes in pancreas tissues was assessed using real-time PCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>TPDE</i> treatment decreased the serum levels of FBS and NO while increasing c-peptide, insulin, and TAC levels. It also significantly enhanced the expression of <i>insulin, PDX1, NGN3,</i> and <i>SIRT1</i> genes. <i>TPDEs</i> at doses of 100 to 200 μg/kg showed the most significant antidiabetic effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TPDEs significantly improved diabetes-induced alterations in serum insulin levels, antioxidant status, and pancreas-related gene expression. It can be considered a novel complementary treatment for diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923787","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

Prevalence of Erectile Dysfunction in Malagasy Patients With Diabetes Mellitus and Its Associations With Atherosclerotic Cardiovascular Diseases: A Cross-Sectional Study 马达加斯加糖尿病患者勃起功能障碍患病率及其与动脉粥样硬化性心血管疾病的关系：一项横断面研究

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-08-25 DOI: 10.1002/edm2.70098

Sitraka Angelo Raharinavalona, Tafitarilova Dorland Ranjandriarison, Thierry Razanamparany, Romuald Randriamahavonjy, Andrianirina Dave Patrick Rakotomalala

Objectives

Our study aims to determine the prevalence of erectile dysfunction (ED) and its associations with atherosclerotic cardiovascular disease (ASCVD) in Malagasy patients with diabetes mellitus (DM).

Methods

This cross-sectional study was conducted over a period of 3 years at the Soavinandriana Hospital Center. Erectile function was assessed using the International Index of Erectile Function 5-item version (IIEF-5) questionnaire, with a score of less than 22 indicating ED. The presence of ASCVD was confirmed in cases where carotid atherosclerosis (CAS), lower limb arteriopathy (LLA), coronary heart disease (CHD) and/or ischaemic stroke were present.

Results

The study population included 305 patients diagnosed with diabetes mellitus (DM). The prevalence of erectile dysfunction (ED) was 73.4%. According to the bivariate analysis, the risk factors for ED were age ≥ 55 years (odds ratio [OR] 12.0 (6.34–23.4)), hypertension (OR 6.02 (3.27–11.3)), physical inactivity (OR 8.86 (4.85–16.6)), smoking (OR 2.53 (1.32–5.09)), dyslipidemia (OR 4.11 (2.33–7.32)), type 2 DM (OR 8.80 (1.53–91.0)) and diabetes duration ≥ 10 years (OR 2.24 (1.11–4.87)), renin-angiotensin-aldosterone system blockers (OR 6.27 (3.43–11.6)), calcium-channel blockers (OR 3.01 (1.69–5.48)), diuretics (OR 2.14 (1.06–4.66)) and beta-blockers (OR 4.55 (1.85–13.5)). After adjusting for age, hypertension, physical inactivity, smoking and dyslipidemia, ED was significantly associated with ASCVD (OR 1.88 (1.01–3.69)), and CAS (OR 1.89 (1.03–3.22)). Adjusting for age, type and duration of DM, ED was found to be significantly associated with ASCVD (OR 1.91 (1.01–3.58)) and CAS (OR 2.31 (1.11–4.85)). However, there was no statistically significant association between ED, LLA, CHD and ischaemic stroke.

Conclusion

ED was very common and may be a predictor of ASCVD in patients with DM, particularly CAS. Consequently, the presence of ED should prompt the search for ASCVD, and vice versa.

本研究旨在确定马达加斯加糖尿病（DM）患者的勃起功能障碍（ED）患病率及其与动脉粥样硬化性心血管疾病（ASCVD）的关系。方法在Soavinandriana医院中心进行了为期3年的横断面研究。使用国际勃起功能指数5项版（IIEF-5）问卷评估勃起功能，得分低于22表示ED。在存在颈动脉粥样硬化（CAS）、下肢动脉病变（LLA）、冠心病（CHD）和/或缺血性卒中的病例中确认ASCVD的存在。结果纳入305例糖尿病（DM）患者。勃起功能障碍（ED）患病率为73.4%。根据双因素分析，ED的危险因素为年龄≥55岁（比值比为12.0(6.34-23.4)）、高血压（比值比为6.02(3.27-11.3)）、缺乏运动（比值比为8.86(4.85-16.6)）、吸烟（比值比为2.53(1.32-5.09)）、血脂异常（比值比为4.11(2.33-7.32)）、2型糖尿病（比值比为8.80(1.53-91.0)）、糖尿病病程≥10年（比值比为2.24(1.11-4.87)）、肾素-血管紧张素-醛固酮系统阻滞剂（比值比为6.27(3.43-11.6)）、钙通道阻滞剂（比值比为3.01(1.69-5.48)）、利尿剂（OR 2.14(1.06-4.66)）和受体阻滞剂（OR 4.55(1.85-13.5)）。在调整了年龄、高血压、缺乏运动、吸烟和血脂异常等因素后，ED与ASCVD （OR 1.88(1.01-3.69)）和CAS （OR 1.89(1.03-3.22)）显著相关。调整DM的年龄、类型和病程后，发现ED与ASCVD （OR 1.91(1.01-3.58)）和CAS （OR 2.31(1.11-4.85)）显著相关。然而，ED、LLA、CHD与缺血性脑卒中之间无统计学意义的相关性。结论ED非常常见，可能是糖尿病患者ASCVD的预测因子，尤其是CAS患者。因此，ED的存在应该提示寻找ASCVD，反之亦然。

{"title":"Prevalence of Erectile Dysfunction in Malagasy Patients With Diabetes Mellitus and Its Associations With Atherosclerotic Cardiovascular Diseases: A Cross-Sectional Study","authors":"Sitraka Angelo Raharinavalona, Tafitarilova Dorland Ranjandriarison, Thierry Razanamparany, Romuald Randriamahavonjy, Andrianirina Dave Patrick Rakotomalala","doi":"10.1002/edm2.70098","DOIUrl":"https://doi.org/10.1002/edm2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aims to determine the prevalence of erectile dysfunction (ED) and its associations with atherosclerotic cardiovascular disease (ASCVD) in Malagasy patients with diabetes mellitus (DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted over a period of 3 years at the Soavinandriana Hospital Center. Erectile function was assessed using the International Index of Erectile Function 5-item version (IIEF-5) questionnaire, with a score of less than 22 indicating ED. The presence of ASCVD was confirmed in cases where carotid atherosclerosis (CAS), lower limb arteriopathy (LLA), coronary heart disease (CHD) and/or ischaemic stroke were present.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population included 305 patients diagnosed with diabetes mellitus (DM). The prevalence of erectile dysfunction (ED) was 73.4%. According to the bivariate analysis, the risk factors for ED were age ≥ 55 years (odds ratio [OR] 12.0 (6.34–23.4)), hypertension (OR 6.02 (3.27–11.3)), physical inactivity (OR 8.86 (4.85–16.6)), smoking (OR 2.53 (1.32–5.09)), dyslipidemia (OR 4.11 (2.33–7.32)), type 2 DM (OR 8.80 (1.53–91.0)) and diabetes duration ≥ 10 years (OR 2.24 (1.11–4.87)), renin-angiotensin-aldosterone system blockers (OR 6.27 (3.43–11.6)), calcium-channel blockers (OR 3.01 (1.69–5.48)), diuretics (OR 2.14 (1.06–4.66)) and beta-blockers (OR 4.55 (1.85–13.5)). After adjusting for age, hypertension, physical inactivity, smoking and dyslipidemia, ED was significantly associated with ASCVD (OR 1.88 (1.01–3.69)), and CAS (OR 1.89 (1.03–3.22)). Adjusting for age, type and duration of DM, ED was found to be significantly associated with ASCVD (OR 1.91 (1.01–3.58)) and CAS (OR 2.31 (1.11–4.85)). However, there was no statistically significant association between ED, LLA, CHD and ischaemic stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ED was very common and may be a predictor of ASCVD in patients with DM, particularly CAS. Consequently, the presence of ED should prompt the search for ASCVD, and vice versa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894422","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

Exploring Combined Use of Continuous Glucose Monitoring and Anti-Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin 探索连续血糖监测和抗糖尿病药物联合应用于不使用胰岛素的2型糖尿病患者的血糖控制

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-08-25 DOI: 10.1002/edm2.70089

Poorva M. Nemlekar, Katia L. Hannah, Courtney R. Green, Gregory J. Norman

Introduction

Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non-insulin, anti-diabetes medications. This study aimed to evaluate whether CGM use in combination with anti-diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin.

Materials and Methods

This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6-month baseline and follow-up periods. CGM use in conjunction with ≥ 1 of five anti-diabetes medication classes: metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors and/or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti-diabetes medication.

Results

Overall, 52,394 CGM-naïve adults with non-insulin-treated type 2 diabetes using anti-diabetes medications were identified (4086 CGM users; 48,308 CGM non-users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non-users (p < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non-users with all medications, but statistically significant interactions showed that for DPP-4 inhibitors, GLP-1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non-users who were taking the medication compared to CGM users vs. CGM non-users who were not taking the medication. A1c change between CGM users vs. CGM non-users did not vary by metformin or SGLT2 inhibitor use.

Discussion

The findings suggest that CGM use could augment the glycaemic benefits of anti-diabetes medications in people with non-insulin treated type 2 diabetes. These results support broader adoption of CGM.

连续血糖监测（CGM）提供了一个详细的血糖管理视图，潜在地提高非胰岛素，抗糖尿病药物的有效性。本研究旨在评估在不使用胰岛素的2型糖尿病患者中，CGM与抗糖尿病药物联合使用是否与A1c变化相关。材料和方法本研究对来自Optum临床信息学数据集市数据库的行政索赔和相关实验室数据进行回顾性、观察性分析。研究观察期为2018年7月1日至2023年6月30日，基线期和随访期为6个月。CGM需要与五种抗糖尿病药物中的≥一种联合使用：二甲双胍、磺脲类药物、钠-葡萄糖共转运蛋白-2 （SGLT2）抑制剂、二肽基肽酶-4 （DPP-4）抑制剂和/或胰高血糖素样肽-1受体激动剂（GLP-1 RAs）。主要终点是A1c较基线的变化。线性回归模型检验了CGM与各种抗糖尿病药物的主效应和交互效应。总体而言，52,394名CGM-naïve成人非胰岛素治疗2型糖尿病患者使用抗糖尿病药物（4086名CGM使用者；48,308名CGM非使用者）。与未使用CGM的患者相比，使用CGM的患者的糖化血红蛋白变化增加-0.45% （p < 0.0001）。在调整协变量后，使用CGM的患者与不使用CGM的患者相比，在使用所有药物的情况下，A1c降低幅度更大，但统计学上显著的相互作用表明，对于DPP-4抑制剂、GLP-1 RAs和磺脲类药物，使用CGM的患者与不使用CGM的患者相比，使用CGM的患者与不使用CGM的患者相比，使用CGM的患者与不使用CGM的患者相比，A1c降低幅度更大。使用CGM的患者与未使用CGM的患者之间的A1c变化不因使用二甲双胍或SGLT2抑制剂而变化。研究结果表明，在非胰岛素治疗的2型糖尿病患者中，使用CGM可以增加抗糖尿病药物的降糖益处。这些结果支持更广泛地采用CGM。

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引用次数: 0

Mortality Trends and Disparities in Cerebrovascular Disease Among Diabetic Population in the United States From 1999 to 2020: A CDC WONDER Analysis 1999年至2020年美国糖尿病人群脑血管疾病死亡率趋势和差异：CDC WONDER分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-08-22 DOI: 10.1002/edm2.70091

Allahdad Khan, Waseef Ullah, Moeen Ikram, Rameez Qasim, Umama Alam, Maheen Sheraz, Ayesha Khan, Kainat Kanwal, Peter Collins, Raheel Ahmed

Background

Diabetes mellitus (DM) significantly increases the risk of cerebrovascular disease (CeVD), a major cause of mortality and long-term disability. Despite improvements in healthcare, disparities in CeVD-related mortality among diabetic populations in the United States persist.

Methods

We conducted a retrospective analysis using the CDC WONDER database from 1999 to 2020 to assess mortality trends related to CeVD among adults aged ≥ 45 years with DM. Deaths were identified using ICD-10 codes I60–I69 (CeVD) and E10–E14 (DM). Age-adjusted mortality rates (AAMRs) were calculated, and trends were analysed using Joinpoint regression, stratified by age, race/ethnicity, geography, urbanisation, and place of death.

Results

A total of 689,846 CeVD-related deaths occurred in diabetic individuals. AAMR decreased from 36.9 in 1999 to 29.3 in 2020, with an average annual percentage change (AAPC) of −1.41%. However, a sharp rise was observed from 2018 to 2020 (APC 14.87%), indicating a concerning reversal in progress. The highest crude mortality rates were in the 75–84 age group, and the lowest in the 45–54 group. Black and Hispanic populations, rural residents, and those in the Southern United States had the highest mortality rates. The Northeast and Asian populations had the lowest, reflecting persistent disparities in access to care and preventive services.

Conclusion

While CeVD mortality in diabetics declined over two decades, the recent reversal highlights emerging challenges, possibly due to healthcare disruptions and socioeconomic disparities. These findings underscore the need for targeted public health interventions to address inequities and improve outcomes in high-risk populations.

糖尿病（DM）显著增加脑血管疾病（CeVD）的风险，CeVD是导致死亡和长期残疾的主要原因。尽管医疗保健有所改善，但美国糖尿病人群中cevd相关死亡率的差异仍然存在。方法利用CDC WONDER数据库对1999年至2020年年龄≥45岁的糖尿病患者进行回顾性分析，评估与CeVD相关的死亡率趋势。使用ICD-10代码I60-I69 （CeVD）和E10-E14 （DM）确定死亡。计算年龄调整死亡率（AAMRs），并使用Joinpoint回归分析趋势，按年龄、种族/民族、地理、城市化和死亡地点分层。结果糖尿病患者cevd相关死亡689,846例。AAMR由1999年的36.9下降到2020年的29.3，年均变化百分比（AAPC）为- 1.41%。然而，从2018年到2020年，APC急剧上升（14.87%），表明正在发生令人担忧的逆转。粗死亡率最高的是75-84岁年龄组，最低的是45-54岁年龄组。黑人和西班牙裔人口、农村居民和美国南部的人死亡率最高。东北亚和亚洲人口最低，反映了在获得护理和预防服务方面的持续差异。虽然糖尿病患者CeVD死亡率在过去二十年中有所下降，但最近的逆转凸显了新出现的挑战，可能是由于医疗保健中断和社会经济差距。这些发现强调需要有针对性的公共卫生干预措施，以解决不公平现象，改善高危人群的结果。

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引用次数: 0