Obesity Medicine最新文献_第3页

Leptin receptor polymorphisms: Unravelling the genetic modulators of metabolically healthy and unhealthy obesity 瘦素受体多态性：揭示代谢健康和不健康肥胖的遗传调节剂

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100660

Isar Sharma , Ritu Mahajan , Nisha Kapoor

Obesity, a widespread health concern, presents a clinical paradox: not everyone carrying excess weight develops the same metabolic complications. Some individuals remain metabolically healthy (MHO), while others progress to metabolically unhealthy obesity (MUO), facing severe risks like diabetes and heart disease. This critical review assesses the genetic underpinnings of this crucial distinction, focusing on the leptin receptor (LEPR), a key component in the regulation of our body's energy balance. Leptin, a hormone from fat cells, signals satiety through the LEPR. When genetic variations (polymorphisms) in LEPR disrupt this delicate signalling, it can lead to leptin resistance, a state contributing to weight gain and metabolic dysfunction. This review critically evaluates the evidence for how specific LEPR polymorphisms may influence the phenotypic divergence between MHO and MUO, highlighting the complex and population-specific nature of these associations. While variants like Q223R show inconsistent associations, others, such as K656N (rs8179183) and rs3790435, appear to directly contribute to the MUO phenotype by affecting fat distribution and inflammatory pathways. Understanding these genetic influences is paramount, as it shifts our view of obesity from a monolithic condition to a spectrum, revealing how individual genetic predispositions can dictate metabolic resilience or vulnerability. This work is crucial for developing more precise risk assessments and personalized interventions, ultimately paving the way for more effective strategies to promote metabolic health and mitigate the diverse impacts of obesity.

肥胖是一个普遍存在的健康问题，但它在临床上却存在一个悖论：并不是每个超重的人都会出现同样的代谢并发症。一些人保持代谢健康（MHO），而另一些人则发展为代谢不健康肥胖（MUO），面临糖尿病和心脏病等严重风险。这篇重要的综述评估了这一关键区别的遗传基础，重点关注瘦素受体（LEPR），这是调节我们身体能量平衡的关键组成部分。瘦素是一种来自脂肪细胞的激素，通过LEPR发出饱腹感的信号。当LEPR的遗传变异（多态性）破坏这种微妙的信号传导时，它会导致瘦素抵抗，这种状态会导致体重增加和代谢功能障碍。这篇综述批判性地评估了特异性LEPR多态性如何影响MHO和MUO之间表型差异的证据，强调了这些关联的复杂性和群体特异性。虽然Q223R等变异显示出不一致的关联，但其他变异，如K656N （rs8179183）和rs3790435，似乎通过影响脂肪分布和炎症途径直接促进了MUO表型。了解这些遗传影响是至关重要的，因为它将我们对肥胖的看法从一个整体转变为一个范围，揭示了个体遗传倾向如何决定代谢的恢复能力或脆弱性。这项工作对于制定更精确的风险评估和个性化干预措施至关重要，最终为制定更有效的策略来促进代谢健康和减轻肥胖的各种影响铺平道路。

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引用次数: 0

Real-world weight change pattern after glucagon-like peptide-1 receptor agonist discontinuation: A 1-year observational study 胰高血糖素样肽-1受体激动剂停用后的真实体重变化模式：一项为期1年的观察研究

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100658

Mona Abdel-Bary , Andrea Brody , Jenna Schmitt , Karen Prieto , Amy Wetzel , Yen-Yi Juo

Introduction

Nearly half of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) usage were discontinued within two years. We seek to investigate the reasons and consequences of unplanned GLP1RA discontinuation.

Materials and methods

This is a retrospective cohort study of adults who discontinued GLP1RA obesity treatment between 2022 and 2024.

Results

A total of 130 patients fitted our inclusion criteria. At the time GLP1RA was discontinued, the mean (Standard Deviation) total weight loss was −2.26 (8.20)%, ranging from −24.52 % to 11.79 %. Over the next twelve months, 85 patients (65.38 %) gained weight, with mean (SD) weight gain percentage at 1, 3, 6, and 12 months being −1.53 (2.33)%, 2.75 (4.19)%, 3.46 (7.38)%, and 24.44 (10.06)%. Of the 75 patients that had previously lost weight, 37 patients (49.33 %) had exceeded their original weight within a year. A significantly higher proportion of patients without T2DM gained weight than those with T2DM (70.75 % vs 41.67 %, p = .007). Besides diabetes, weight again appeared to occur with no association to demographic, socioeconomic and comorbidity factors.

Conclusion

Real-world weight gain following GLP1RA discontinuation was common, but neither as rapid nor as consistent as predicted by RCT literature. Developing transitional management strategy is crucial for optimizing these patient's weight outcomes.

近一半胰高血糖素样肽-1受体激动剂（GLP1RA）的使用在两年内停止。我们试图调查计划外停用GLP1RA的原因和后果。材料和方法这是一项回顾性队列研究，研究对象是在2022年至2024年间停止GLP1RA肥胖治疗的成年人。结果共有130例患者符合我们的纳入标准。在停用GLP1RA时，平均（标准差）总体重减轻为- 2.26(8.20)%，范围为- 24.52%至11.79%。在接下来的12个月里，85名患者（65.38%）体重增加，在1、3、6和12个月的平均（SD）体重增加百分比分别为- 1.53(2.33)%、2.75(4.19)%、3.46(7.38)%和24.44(10.06)%。在75例减肥患者中，37例（49.33%）患者在一年内体重超过了原来的体重。非T2DM患者体重增加的比例明显高于T2DM患者（70.75% vs 41.67%, p = 0.007）。除糖尿病外，体重似乎与人口统计学、社会经济和合并症因素无关。结论：GLP1RA停药后体重增加是常见的，但不像RCT文献预测的那样迅速和一致。制定过渡性管理策略对于优化这些患者的体重结果至关重要。

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引用次数: 0

From trend to treatment: Regulating anti-obesity medications in India 从趋势到治疗：在印度规范抗肥胖药物

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100661

Tufayl Ahmed Mohammed Shekha, Swathi Suresh

引用次数: 0

Angiopoietins: A potential therapeutic target in the treatment of diabetic nephropathy 血管生成素：治疗糖尿病肾病的潜在治疗靶点

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100659

Komal Thapa , Neha Kanojia , Heena Khan , Amarjot Kaur , Thakur Gurjeet Singh

Diabetic nephropathy (DN) represents one of the most serious complications of diabetes mellitus and is a major contributor to end-stage renal disease (ESRD). In this condition, persistent metabolic and haemodynamic disturbances gradually damage the glomerular filtration barrier. The resulting structural changes include podocyte detachment, thickening of the glomerular basement membrane, reduction in the endothelial glycocalyx, accumulation of extracellular matrix within the mesangium, and progressive glomerulosclerosis. Together, these pathological alterations impair renal function and eventually lead to irreversible kidney failure. Vascular growth factors, particularly angiopoietins (ANGs), play a central role in regulating glomerular structure and function under normal physiological conditions. ANGs are critical for maintaining the stability of blood vessels and preserving the integrity of the glomerular filtration barrier. However, in diabetes, dysregulation of ANG signaling activates multiple pathogenic pathways that contribute to endothelial dysfunction, mesangial expansion, and increased vascular permeability, key features of DN progression. This review highlights the role of ANGs in DN and their potential as therapeutic targets, either directly or through modulation of related signaling pathways. While preclinical evidence is promising, further animal studies are needed to clarify their therapeutic value in managing DN.

糖尿病肾病（DN）是糖尿病最严重的并发症之一，是终末期肾脏疾病（ESRD）的主要诱因。在这种情况下，持续的代谢和血流动力学紊乱逐渐损害肾小球滤过屏障。由此导致的结构改变包括足细胞脱离、肾小球基底膜增厚、内皮糖萼减少、系膜内细胞外基质积聚和肾小球硬化进展。总之，这些病理改变损害肾功能并最终导致不可逆的肾衰竭。在正常生理条件下，血管生长因子，特别是血管生成素（ANGs）在调节肾小球结构和功能方面发挥着核心作用。ANGs对于维持血管的稳定性和保持肾小球滤过屏障的完整性至关重要。然而，在糖尿病中，ANG信号的失调激活了多种致病途径，导致内皮功能障碍、系膜扩张和血管通透性增加，这是DN进展的关键特征。这篇综述强调了ANGs在DN中的作用及其作为治疗靶点的潜力，无论是直接的还是通过相关信号通路的调节。虽然临床前证据是有希望的，但需要进一步的动物研究来阐明它们在治疗DN中的治疗价值。

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引用次数: 0

Flavonoids as a potential therapeutic intervention targeting pancreatic lipase for obesity: Current updates on the mechanistic insights, pharmacological activity, and drug delivery challenges 黄酮类化合物作为针对胰腺脂肪酶治疗肥胖症的潜在治疗干预：机制见解，药理活性和药物传递挑战的最新进展

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100662

A. Pon Arasi , Rajan Logesh

Obesity is a major health problem around the globe that is defined by high levels of fat storage and the related metabolic issues. Despite their effectiveness in most contexts, current pharmacological treatments tend to cause adverse effects, which leads to the desire to find safer methods. Flavonoid acts as a powerful anti-obesity effect mediated by several ways, including inhibition of adipogenesis, control of lipid metabolism, and deflation of inflammation and oxidative stress, but altering the lipid metabolism by inhibiting the pancreatic lipase enzyme could be an interesting target. Although there are encouraging advances, their use in clinical practice is limited by a lack of aqueous solubility, instability in physiological conditions, and low oral bioavailability. New developments in nanotechnology, like lipid carriers, nanogels, nanoemulsions, and cyclodextrin complexes, have shown a great aptitude to improve flavonoids' stability, absorption, site-specific delivery, and controlled liberation. Their treatment activity is evidenced by in vitro, in vivo, and clinical studies, especially when they are combined with bioavailability-enhancing strategies. The latest benefits of flavonoids in managing obesity, their pharmacokinetics and pharmacodynamics, and recent trends in utilising various nanotechnological applications to enhance their clinical use have all been reviewed here (2017–2025). Further, a large-scale clinical validation and long-term safety profiling, optimisation of cost-effective, regulatory-compliant delivery systems to help realise the potential of flavonoid-based therapeutics as practical interventions against the challenge of obesity.

肥胖是全球范围内的一个主要健康问题，由高水平的脂肪储存和相关的代谢问题所定义。尽管它们在大多数情况下是有效的，但目前的药物治疗往往会引起不良反应，这导致人们希望找到更安全的方法。黄酮类化合物具有强大的抗肥胖作用，其途径包括抑制脂肪生成、控制脂质代谢、抑制炎症和氧化应激，但通过抑制胰脂肪酶来改变脂质代谢可能是一个有趣的目标。尽管取得了令人鼓舞的进展，但由于缺乏水溶性、生理条件不稳定和口服生物利用度低，它们在临床实践中的应用受到限制。纳米技术的新发展，如脂质载体、纳米凝胶、纳米乳液和环糊精配合物，已经显示出极大的潜力来改善黄酮类化合物的稳定性、吸收、位点特异性传递和控制释放。体外、体内和临床研究证明了它们的治疗活性，特别是当它们与提高生物利用度的策略结合使用时。本文回顾了类黄酮在控制肥胖方面的最新益处、它们的药代动力学和药效学，以及利用各种纳米技术应用来增强其临床应用的最新趋势（2017-2025）。此外，大规模的临床验证和长期安全性分析，优化成本效益，符合法规的输送系统，以帮助实现基于黄酮类化合物的治疗方法作为对抗肥胖挑战的实际干预措施的潜力。

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引用次数: 0

Corrigendum to “The various pathological roles of Oxidized LDL in diseases” [Obesity Med. 57 (2025) 100646] “氧化LDL在疾病中的各种病理作用”的勘误表[Obesity Med. 57 (2025) 100646]

Q2 Medicine

Obesity Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.obmed.2025.100655

Abdullatif Taha Babakr

引用次数: 0

Artificial intelligence for obesity management: A review of applications, opportunities, and challenges 人工智能在肥胖管理中的应用、机遇和挑战

Q2 Medicine

Obesity Medicine

Pub Date : 2025-10-15 DOI: 10.1016/j.obmed.2025.100657

Jennifer Teke , Maines Msiska , Oluronke Abisoye Adanini , Eghosasere Egbon , Augustus Osborne , David B. Olawade

Traditional obesity management approaches, including dietary interventions, physical activity programmes, pharmacotherapy, and behavioural therapies, face significant limitations in scalability, personalisation, and long-term adherence rates. The emergence of artificial intelligence (AI) technologies, particularly machine learning and deep learning algorithms, has opened new frontiers for transforming obesity prevention, diagnosis, and management strategies. This comprehensive narrative review synthesises current evidence on AI applications in obesity management, examining technological innovations from predictive risk models to personalised digital therapeutics. The review explores AI-based diagnostic tools utilising computer vision for body composition analysis, predictive algorithms identifying high-risk individuals using electronic health records, personalised behavioural interventions powered by reinforcement learning, and remote monitoring systems integrating wearable technologies with intelligent data analytics. Furthermore, it investigates clinical effectiveness of AI-driven digital therapeutics platforms and examines AI integration within clinical decision support systems. The analysis reveals significant benefits including enhanced scalability for population-level interventions, improved personalisation through real-time data integration, increased precision in risk stratification, and potential cost-effectiveness through optimised resource allocation. However, substantial challenges remain, including data privacy and security concerns, algorithmic bias that may exacerbate health disparities, limited large-scale clinical validation, declining user engagement over time, and complex regulatory and ethical considerations. Addressing these challenges through multidisciplinary collaboration, robust validation studies, and ethical frameworks will be critical for successfully integrating AI technologies into routine obesity care and achieving equitable health outcomes across diverse populations.

传统的肥胖管理方法，包括饮食干预、身体活动规划、药物治疗和行为治疗，在可扩展性、个性化和长期坚持率方面面临重大限制。人工智能（AI）技术的出现，特别是机器学习和深度学习算法的出现，为改变肥胖预防、诊断和管理策略开辟了新的领域。这篇全面的叙述性综述综合了人工智能在肥胖管理中的应用的当前证据，研究了从预测风险模型到个性化数字治疗的技术创新。该综述探讨了基于人工智能的诊断工具，利用计算机视觉进行身体成分分析，使用电子健康记录识别高风险个体的预测算法，通过强化学习提供个性化行为干预，以及将可穿戴技术与智能数据分析相结合的远程监控系统。此外，它还研究了人工智能驱动的数字治疗平台的临床有效性，并研究了人工智能在临床决策支持系统中的集成。分析显示了显著的好处，包括增强了人群水平干预的可扩展性，通过实时数据集成提高了个性化，提高了风险分层的精确度，以及通过优化资源分配提高了潜在的成本效益。然而，仍然存在重大挑战，包括数据隐私和安全问题、可能加剧健康差距的算法偏见、有限的大规模临床验证、随着时间的推移用户参与度下降，以及复杂的监管和伦理考虑。通过多学科合作、强有力的验证研究和伦理框架来应对这些挑战，对于将人工智能技术成功整合到常规肥胖治疗中，并在不同人群中实现公平的健康结果至关重要。

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引用次数: 0

Impact of bariatric surgery on Type 2 Diabetes Mellitus: A comprehensive 5-year analysis of weight loss, glycemic control, and cardiometabolic outcomes 减肥手术对2型糖尿病的影响：一项关于体重减轻、血糖控制和心脏代谢结果的5年综合分析

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-29 DOI: 10.1016/j.obmed.2025.100656

Adnan Agha , Bachar Afandi , Waad Ibrahim Alhammadi , Hamad Talal Jumaa Mubarak Almaskari , Asma Alshamsi , Mohammed Saleem , Juma Al Kaabi

Background

Bariatric surgery has emerged as a potent intervention for patients with obesity and Type 2 Diabetes Mellitus (T2DM).

Objectives

To assess 5-year outcomes of bariatric surgery in Middle Eastern patients with T2DM and develop a predictive model for diabetes remission.

Setting

Tertiary care center, United Arab Emirates.

Methods

We conducted a retrospective cohort study of 238 T2DM patients (161 females, 67.6 %; mean age 46.8 ± 11.6 years) who underwent bariatric surgery from 2013 to 2019. Procedures included laparoscopic sleeve gastrectomy (LSG; n = 138, 58.0 %), Roux-en-Y gastric bypass (RYGB; n = 85, 35.7 %), and adjustable gastric banding (AGB; n = 15; 6.3 %). Clinical, biochemical and cardiometabolic parameters were followed for 5 years. Multivariate logistic regression analysis identified independent predictors of diabetes remission.

Results

Sustained total weight loss of 26.2 %, 29.2 %, and 27.2 % was achieved at 1, 3, and 5 years respectively. HbA1c decreased from 7.8 ± 1.5 % to 6.1 ± 1.0 % at 5 years (p < 0.001). By 5 years, 95.4 % of patients discontinued diabetes medications. Complete diabetes remission (HbA1c <6.0 % without medications) was achieved in 52.9 %, exceeding rates typically reported in randomized controlled trials of bariatric surgery (23–29 %) in Western populations. Multivariate analysis revealed baseline HbA1c <8 % (OR 2.84, 95 % CI 1.52–5.31, p = 0.001), diabetes duration <5 years (OR 3.21, 95 % CI 1.78–5.79, p < 0.001), and weight loss >20 % at 1 year (OR 4.15, 95 % CI 2.23–7.72, p < 0.001) as independent predictors of sustained remission (C-statistic = 0.842).

Conclusions

Bariatric surgery provides sustained improvements in weight loss and glycemic control in Middle Eastern T2DM patients over 5 years. The identification of key predictors enables better patient selection and personalized treatment strategies.

背景：减肥手术已成为肥胖和2型糖尿病（T2DM）患者的有效干预措施。目的评估中东T2DM患者减肥手术的5年预后，并建立糖尿病缓解的预测模型。三级保健中心，阿联酋。方法对2013 - 2019年接受减肥手术的238例T2DM患者（女性161例，67.6%，平均年龄46.8±11.6岁）进行回顾性队列研究。手术包括腹腔镜袖胃切除术（LSG, n = 138, 58.0%）、Roux-en-Y胃旁路术（RYGB, n = 85, 35.7%）和可调节胃束带（AGB, n = 15, 6.3%）。临床、生化及心脏代谢指标随访5年。多因素logistic回归分析确定了糖尿病缓解的独立预测因素。结果1年、3年和5年的持续总体重减轻率分别为26.2%、29.2%和27.2%。5年后，HbA1c从7.8±1.5%降至6.1±1.0% （p < 0.001）。5年后，95.4%的患者停止了糖尿病药物治疗。52.9%的患者实现了糖尿病完全缓解（无药物治疗的HbA1c和lt达到6.0%），超过了西方人群中减肥手术随机对照试验中通常报道的比率（23 - 29%）。多因素分析显示，基线HbA1c <； 8% （OR 2.84, 95% CI 1.52-5.31, p = 0.001）、糖尿病病程<；5年（OR 3.21, 95% CI 1.78-5.79, p < 0.001）和1年体重减轻>； 20% （OR 4.15, 95% CI 2.23-7.72, p < 0.001）是持续缓解的独立预测因子（C-statistic = 0.842）。结论：在中东T2DM患者中，减肥手术提供了5年以上体重减轻和血糖控制的持续改善。关键预测因素的识别使更好的患者选择和个性化的治疗策略。

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引用次数: 0

Traditional East African medicinal plants as modulators of gut microbiota in obesity-associated diabetes: A short communication 东非传统药用植物作为肥胖相关糖尿病肠道微生物群的调节剂：简短的交流

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-25 DOI: 10.1016/j.obmed.2025.100654

Okechukwu Paul-Chima Ugwu , Dominic Terkimbi Swase , Michael Ben Okon , Anyanwu Chinyere Nkemjika , Regan Mujinya

The prevalence of obesity and type 2 diabetes mellitus (T2DM) is rapidly growing in East Africa as a result of urbanisation, changing diets, and sedentary lifestyles. According to the International Diabetes Federation (IDF), 4.2 per cent of the adult population in sub-Saharan Africa (24 million people) has diabetes, which is expected to be more than 55 million by 2045, with East Africa making its fair share of the burden. Gut microbiota dysbiosis, which is observed as the loss of short-chain fatty acid (SCFA)-producing bacteria and a rise in the pro-inflammatory taxa, is a key mechanistic connection between obesity and T2DM. The traditional medications, including metformin, sulfonylureas, insulin, and the new anti-obesity medications, are all clinically effective, but they are expensive, less available, and have low tolerance in the East African population. Conversely, native medicinal plants Moringa oleifera, Warburgia ugandensis, Aloe secundiflora, and Azadirachta indica are clinically accessible, acceptable and have antimicrobial, prebiotic, and anti-inflammatory phytochemicals that can potentially alter the composition and activity of gut microbiota. This short communication narratively reviewed recent discoveries in the fields of ethnopharmacology, phytochemistry, and microbiome science in PubMed, Scopus, Web of Science, and Google Scholar from 2015 to 2025. The discussion focuses on the translational pathways between phytochemical-microbiota interactions and metabolic health outcomes, as well as the existing gaps in the evidence base and the need for systematic methodologies and clinical validation in East African settings. We suggest interdisciplinary trials that include phytochemical standardisation or microbiome sequencing and culturally appropriate community-based approaches.

在东非，由于城市化、饮食改变和久坐不动的生活方式，肥胖和2型糖尿病（T2DM）的患病率正在迅速上升。根据国际糖尿病联合会（IDF）的数据，撒哈拉以南非洲地区4.2%的成年人口（2400万人）患有糖尿病，预计到2045年将超过5500万人，东非将承担公平的负担。肠道菌群失调，即产生短链脂肪酸（SCFA）的细菌的减少和促炎菌群的增加，是肥胖和2型糖尿病之间的关键机制联系。传统的药物，包括二甲双胍、磺脲类药物、胰岛素和新的抗肥胖药物，在临床上都是有效的，但它们价格昂贵，不易获得，而且在东非人口中耐受性低。相反，本地药用植物辣木、乌干达瓦布吉、芦荟和印楝在临床上是可获得的、可接受的，它们具有抗菌、益生元和抗炎的植物化学物质，可能会改变肠道微生物群的组成和活性。这篇短文叙述性地回顾了2015年至2025年在PubMed、Scopus、Web of science和谷歌Scholar上在民族药理学、植物化学和微生物组科学领域的最新发现。讨论的重点是植物化学-微生物群相互作用与代谢健康结果之间的转化途径，以及证据基础中的现有差距和东非环境中系统方法和临床验证的需求。我们建议跨学科试验，包括植物化学标准化或微生物组测序和文化上合适的社区方法。

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引用次数: 0

Diabetes mellitus: Complications, emerging therapeutic targets, and evolving treatment approaches 糖尿病：并发症，新出现的治疗靶点和不断发展的治疗方法

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-23 DOI: 10.1016/j.obmed.2025.100652

Sharfuddin Mohd, Lekkala Lithin Kumar, Vancha Harish, Rakesh Kumar, Aakriti Chaudhary, Vikas Sharma

Diabetes Mellitus (DM) is a chronic metabolic disorder effecting the carbohydrate, protein and lipid metabolism, primarily caused by elevated blood glucose levels, due to the insulin deficiency or impaired glucose uptake by the body cells. Its clinical manifestations including polydipsia, polyuria, polyphagia, blurry vision, extreme fatigue can lead to severe complications such as diabetic nephropathy, neuropathy, retinopathy, and cardiomyopathy imposing substantial global health and economic burdens. This review synthesizes current evidence on the pathophysiology and clinical spectrum of DM complications, highlighting the roles of glucotoxicity, lipotoxicity, oxidative stress, advanced glycation end-products, mitochondrial dysfunction, maladaptive inflammation, and microvascular rarefaction. Additionally, emerging biomarkers linked to the pathogenesis of diabetic complications are summarized and reviewed. The novel therapeutic targets, include glucokinase, AMPK, SIRT1, SIRT3, GPR120 activators, TGR5, GPR119 agonists, PTP1B and G-FAT inhibitors as next generation drugs. Advanced treatment strategies encompass gene and cell-based approaches next-generation drug delivery systems-nanocarriers, nanopumps, closed-loop “smart” insulin technologies. We also review applications of artificial intelligence and machine learning for early detection, progression prediction, treatment optimization and personalized care, alongside insights from recent clinical trials and innovation trends in the patent landscape.

糖尿病（DM）是一种影响碳水化合物、蛋白质和脂质代谢的慢性代谢紊乱，主要由胰岛素缺乏或身体细胞葡萄糖摄取受损引起的血糖水平升高引起。其临床表现包括多饮、多尿、多食、视力模糊、极度疲劳等，可导致糖尿病肾病、神经病变、视网膜病变和心肌病等严重并发症，给全球健康和经济带来沉重负担。这篇综述综合了糖尿病并发症的病理生理学和临床谱的最新证据，强调了糖毒性、脂肪毒性、氧化应激、晚期糖基化终产物、线粒体功能障碍、适应性不良炎症和微血管疏松的作用。此外，总结和回顾了与糖尿病并发症发病机制相关的新兴生物标志物。新的治疗靶点包括葡萄糖激酶、AMPK、SIRT1、SIRT3、GPR120激活剂、TGR5、GPR119激动剂、PTP1B和G-FAT抑制剂等下一代药物。先进的治疗策略包括基于基因和细胞的方法——下一代药物输送系统——纳米载体、纳米泵、闭环“智能”胰岛素技术。我们还回顾了人工智能和机器学习在早期检测、进展预测、治疗优化和个性化护理方面的应用，以及最近临床试验和专利领域创新趋势的见解。

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引用次数: 0