Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

Association of dietary manganese intake with new-onset chronic kidney disease in participants with diabetes 膳食锰摄入量与糖尿病患者新发慢性肾病的关系

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103138

Background

We explored the association of dietary manganese (Mn) with new-onset chronic kidney disease (CKD) in participants with diabetes on different glycemia control status and potential mechanisms.

Methods

The study included 7248 adults with diabetes from the UK Biobank who had complete dietary data and were free of CKD at baseline. Dietary information was collected by the online 24-h diet recall questionnaires. The primary outcome was new-onset CKD.

Results

565 (7.8 %) participants developed new-onset CKD during a median follow-up of 11.96 years. Overall, there was a significantly inverse relationship of dietary Mn intake with new-onset CKD in individuals with diabetes at glycated hemoglobin (HbA1c) ≥6.5 % (per SD increment, HR [95%CI]: 0.79 [0.68-0.91]), but not in people with diabetes at HbA1c <6.5 % (per SD increment, HR [95%CI]: 1.07 [0.90-1.29]; P for interaction = 0.004). In individuals with diabetes at HbA1c ≥6.5 %, body mass index and waist circumference significantly mediated the association between dietary Mn intake and new-onset CKD, with mediated proportions of 17.5 % and 17.4 %, respectively.

Conclusions

Higher dietary Mn intake was significantly associated with a lower new-onset CKD risk in participants with diabetes at poor glycemic control status. The inverse association was mainly mediated by obesity. If further confirmed, our findings underscore the importance of maintaining adequate dietary Mn intake for the primary prevention of new-onset CKD in patients with diabetes, especially those with poor glycemic control.

背景我们探讨了膳食中的锰（Mn）与不同血糖控制状况的糖尿病患者新发慢性肾病（CKD）之间的关系以及潜在的机制。方法该研究纳入了英国生物库中的 7248 名成人糖尿病患者，他们拥有完整的膳食数据，基线时无 CKD。饮食信息通过在线 24 小时饮食回忆问卷收集。结果在中位 11.96 年的随访期间，有 565 人（7.8%）患上了新发的慢性肾脏病。总体而言，在糖化血红蛋白（HbA1c）≥6.5%的糖尿病患者中，膳食中锰的摄入量与新发慢性肾脏病之间存在明显的反向关系（每标准差增量，HR [95%CI]：0.79 [0.68-0.91]），但在 HbA1c <6.5% 的糖尿病患者中则没有这种关系（每标准差增量，HR [95%CI]：1.07 [0.90-1.29]；交互作用的 P = 0.004）。在 HbA1c ≥6.5 % 的糖尿病患者中，体重指数和腰围对膳食锰摄入量与新发 CKD 之间的关系有显著的中介作用，中介作用比例分别为 17.5 % 和 17.4 %。这种反向关联主要是由肥胖介导的。如果得到进一步证实，我们的研究结果强调了保持足够的膳食锰摄入量对于糖尿病患者，尤其是血糖控制不佳的患者预防新发慢性肾脏病的重要性。

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引用次数: 0

Role of patatin-like phospholipase domain-containing 3 gene for decreasing kidney function in recently diagnosed diabetes mellitus 含拍蛋白样磷脂酶域的 3 基因在降低新诊断糖尿病患者肾功能中的作用

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103137

Aims

We examined the association of the G allele in the single-nucleotide polymorphism (SNP) rs738409 in the third exon of patatin-like phospholipase domain-containing 3 gene (PNPLA3) gene, with chronic kidney disease in diabetes endotypes.

Methods

Participants with recent-onset diabetes (n = 707) from the prospective German Diabetes Study (GDS) underwent cluster assignment, detailed phenotyping, genotyping and magnetic resonance spectroscopy to quantify hepatocellular lipid content (HCL).

Results

Severe insulin-resistant diabetes (SIRD) had the lowest glomerular filtration rates (eGFR) and highest HCL compared to severe insulin-deficient, moderate obesity-related, moderate age-related and severe autoimmune diabetes endotypes (all p < 0.05). HCL was negatively associated with eGFR (r = −0.287, p < 0.01) across all groups. Stratification by G-allele carrier status did not reveal any association between HCL and eGFR among the endotypes. However, the proportion of G-allele carriers increased from 44 % for eGFR >60 ml/min to 52 % for eGFR <60 ml/min (p < 0.05).

Conclusions

The PNPLA3 polymorphism may contribute to declining kidney function independently of liver lipids.

目的：我们研究了单核苷酸多态性（SNP）rs738409中的G等位基因与糖尿病内型中慢性肾脏疾病的关系：方法：对前瞻性德国糖尿病研究（GDS）中新近发病的糖尿病患者（n = 707）进行分组、详细表型分析、基因分型和磁共振波谱分析，以量化肝细胞脂质含量（HCL）：结果：与重度胰岛素缺乏、中度肥胖相关、中度年龄相关和重度自身免疫性糖尿病内型相比，重度胰岛素抵抗性糖尿病（SIRD）的肾小球滤过率（eGFR）最低，HCL最高（eGFR结论均为60毫升/分钟至52%）：PNPLA3多态性可能会导致肾功能下降，而与肝脏血脂无关。

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引用次数: 0

Determinants of and barriers to diabetes care among patients with serious mental illness: A scoping review with recommendations 重症精神病患者接受糖尿病护理的决定因素和障碍：范围界定审查及建议

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103139

Aim

We performed a scoping review to identify the diabetes care determinants and barriers in patients with serious mental illness (SMI), in view of limited evidence and clarity.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, and Scopus were searched from inception to September 2023 to identify eligible studies. Observational studies that reported the determinants of and barriers to diabetes care among SMI patients were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence.

Results

Of the 8727 non-duplicate records, only 10 studies that met the inclusion criteria were considered for this review. Of these, four were cohort, two were case-control, and four were cross-sectional in design. All 10 studies were observed to have robust methodologies. Diabetes measures examined in these studies included not only the Healthcare Effectiveness Data and Information Set (HEDIS) measures (HbA1c, retinopathy, nephropathy, and blood pressure), but also lipid, foot, and BMI. Factors contributing to inadequate diabetes care can be attributed to the healthcare system, healthcare providers, and at the patient-level.

Conclusion

Currently, there is lack of evidence on determinants of quality diabetes care among SMI patients. Further, adequately powered long term follow-up studies are needed to understand the impact of diabetes care on their clinical outcomes.

目的鉴于证据有限且不明确，我们进行了一项范围界定综述，以确定严重精神疾病（SMI）患者的糖尿病护理决定因素和障碍。方法我们遵循了《范围界定综述的系统综述和元分析首选报告项目》（PRISMA-ScR）指南。我们检索了从开始到 2023 年 9 月的 PubMed、EMBASE 和 Scopus，以确定符合条件的研究。研究考虑了报告 SMI 患者糖尿病护理的决定因素和障碍的观察性研究。对综述结果进行了叙述性综合，以收集证据。结果在 8727 条非重复记录中，仅有 10 项符合纳入标准的研究被纳入本次综述。其中，4 项为队列研究，2 项为病例对照研究，4 项为横断面研究。据观察，所有 10 项研究都采用了可靠的方法。这些研究中考察的糖尿病指标不仅包括医疗保健有效性数据和信息集（HEDIS）指标（HbA1c、视网膜病变、肾病和血压），还包括血脂、足部和体重指数。导致糖尿病护理不足的因素可归因于医疗保健系统、医疗保健提供者以及患者层面。此外，还需要进行充分的长期跟踪研究，以了解糖尿病护理对其临床疗效的影响。

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引用次数: 0

The effectiveness of delivery modalities of non-pharmacological diabetes prevention programs: A systematic review and component network meta-analysis 非药物性糖尿病预防计划实施模式的有效性：系统综述和成分网络荟萃分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103136

Background and aims

Type 2 diabetes prevention programs are effective but costly and intensive, making translation into routine primary care and community settings challenging. Identifying drivers of intervention effectiveness can inform pragmatic future implementation whilst maintaining effectiveness. Translational studies have demonstrated that delivery modalities impact their effectiveness. This systematic review and component network meta-analysis assessed which delivery modality components of non-pharmacological diabetes prevention programs are associated with reductions in type 2 diabetes incidence for individuals at high risk of type 2 diabetes (or pre-diabetes).

Methods

We searched MEDLINE, The Cochrane Library, Opengrey and clinicaltrials.gov from inception to November 17, 2022 for translational studies comparing lifestyle interventions with a minimum 12-month follow-up. Two investigators extracted the data. Random effects network meta-analyses and component network meta-analyses estimated the intervention effects.

Results

We identified 50 eligible studies involving 29,286 participants including thirty-six (72.0 %) randomized controlled trials, 10 (20.0 %) cluster randomized controlled trials, and four (8.0 %) observational studies. Component network meta-analyses found in-person (individually) delivery was associated with greater reduction in incidence of type 2 diabetes (hazard ratio: 0.66, 95 % credible interval: 0.41, 0.96) and in-person (group-based) delivery was associated with greater reductions in weight (mean difference: −1.53 kg, 95 % credible interval: −2.18, −0.85) and HbA1c (mean difference: −0.74 mmol/mol, 95 % credible interval: −1.28, −0.17), relative to usual care.

Conclusions

This analysis suggests in-person delivery modalities are most effective for diabetes prevention. Future research should focus on improving the effectiveness of digital programs and ensuring preferential delivery for target populations to reduce health inequalities.

背景和目的2型糖尿病预防计划效果显著，但成本高昂且强度大，因此将其转化为常规初级保健和社区环境具有挑战性。确定干预效果的驱动因素可以为今后的务实实施提供依据，同时保持有效性。转化研究表明，实施方式会影响其有效性。本系统综述和成分网络荟萃分析评估了非药物糖尿病预防计划的哪些实施方式与降低 2 型糖尿病（或糖尿病前期）高风险人群的 2 型糖尿病发病率有关。方法我们检索了 MEDLINE、The Cochrane Library、Opengrey 和 clinicaltrials.gov 中从开始到 2022 年 11 月 17 日至少随访 12 个月的比较生活方式干预的转化研究。两名研究人员提取了数据。结果我们发现了50项符合条件的研究，涉及29286名参与者，其中包括36项（72.0%）随机对照试验、10项（20.0%）分组随机对照试验和4项（8.0%）观察性研究。成分网络荟萃分析发现，面对面（单独）给药与 2 型糖尿病发病率的更大降低相关（危险比：0.66，95 % 可信区间：0.41, 0.96），面对面（集体）给药与体重的更大降低相关（平均差异：-1.结论这项分析表明，面对面服务模式对预防糖尿病最有效。未来的研究应侧重于提高数字化项目的有效性，并确保为目标人群优先提供服务，以减少健康不平等现象。

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引用次数: 0

Serum lipid peroxidation potential as a biomarker for risk-stratification of coronary artery disease in patients with type 2 diabetes mellitus 血清脂质过氧化潜能作为 2 型糖尿病患者冠状动脉疾病风险分级的生物标志物

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103143

Aim

We examined the serum lipid peroxidation potential as an estimate of systemic oxidative stress levels in people with type 2 diabetes (T2D) for coronary artery disease (CAD) risk stratification.

Methods

We prospectively recruited patients and categorized them into four subgroups based on diabetes and severity of CAD [Gensini score <20, non-significant CAD; Gensini score >20, significant CAD]: non-diabetics with non-significant CAD, diabetics with non-significant CAD, non-diabetics with significant CAD and diabetics with significant CAD. Lipid profile, HbA1c, fasting blood glucose, and oxidized LDL were assessed. A newly developed assay estimated serum lipid peroxidation potential.

Results

Circulatory oxidized LDL levels were significantly higher in patients with severe CAD compared to non-diabetics with non-significant CAD, however no significant differences were observed across the four subgroups. Diabetics with non-significant CAD demonstrated significantly elevated serum lipid peroxidation potential compared to non-diabetics with non-significant CAD. Intriguingly, serum lipid peroxidation potential was markedly elevated in diabetics with non-significant CAD compared to both diabetics and non-diabetics with significant CAD. Poor glycemic control and reduced blood total antioxidant capacity were the primary factors contributing to increased serum lipid peroxidation potential in diabetics with non-significant CAD group.

Conclusions

We found that people with T2D who are associated with non-significant CAD are more vulnerable to oxidative stress than those with significant CAD. The study demonstrates the application of 'serum lipid peroxidation potential' assay for risk-stratification of CAD in people with T2D.

目的我们研究了用于冠状动脉疾病（CAD）风险分层的 2 型糖尿病（T2D）患者血清脂质过氧化潜能，作为全身氧化应激水平的估计值。方法我们前瞻性地招募了患者，并根据糖尿病和CAD严重程度[Gensini评分<20，非显著性CAD；Gensini评分>20，显著性CAD]将他们分为四个亚组：非显著性CAD的非糖尿病患者、非显著性CAD的糖尿病患者、显著性CAD的非糖尿病患者和显著性CAD的糖尿病患者。对血脂概况、HbA1c、空腹血糖和氧化低密度脂蛋白进行了评估。新开发的检测方法可估算血清脂质过氧化潜能值。结果与无明显CAD的非糖尿病患者相比，严重CAD患者的循环氧化低密度脂蛋白水平明显较高，但在四个亚组中未观察到明显差异。与患有非明显 CAD 的非糖尿病患者相比，患有非明显 CAD 的糖尿病患者的血清脂质过氧化潜能明显升高。耐人寻味的是，与患有明显 CAD 的糖尿病患者和非糖尿病患者相比，患有非明显 CAD 的糖尿病患者的血清脂质过氧化潜能值明显升高。血糖控制不佳和血液总抗氧化能力降低是导致非显著性 CAD 组糖尿病患者血清脂质过氧化潜能值升高的主要因素。这项研究表明，"血清脂质过氧化潜能 "测定可用于对 T2D 患者的 CAD 进行风险分级。

{"title":"Serum lipid peroxidation potential as a biomarker for risk-stratification of coronary artery disease in patients with type 2 diabetes mellitus","authors":"","doi":"10.1016/j.dsx.2024.103143","DOIUrl":"10.1016/j.dsx.2024.103143","url":null,"abstract":"<div><h3>Aim</h3><div>We examined the serum lipid peroxidation potential as an estimate of systemic oxidative stress levels in people with type 2 diabetes (T2D) for coronary artery disease (CAD) risk stratification.</div></div><div><h3>Methods</h3><div>We prospectively recruited patients and categorized them into four subgroups based on diabetes and severity of CAD [Gensini score <20, non-significant CAD; Gensini score >20, significant CAD]: non-diabetics with non-significant CAD, diabetics with non-significant CAD, non-diabetics with significant CAD and diabetics with significant CAD. Lipid profile, HbA1c, fasting blood glucose, and oxidized LDL were assessed. A newly developed assay estimated serum lipid peroxidation potential.</div></div><div><h3>Results</h3><div>Circulatory oxidized LDL levels were significantly higher in patients with severe CAD compared to non-diabetics with non-significant CAD, however no significant differences were observed across the four subgroups. Diabetics with non-significant CAD demonstrated significantly elevated serum lipid peroxidation potential compared to non-diabetics with non-significant CAD. Intriguingly, serum lipid peroxidation potential was markedly elevated in diabetics with non-significant CAD compared to both diabetics and non-diabetics with significant CAD. Poor glycemic control and reduced blood total antioxidant capacity were the primary factors contributing to increased serum lipid peroxidation potential in diabetics with non-significant CAD group.</div></div><div><h3>Conclusions</h3><div>We found that people with T2D who are associated with non-significant CAD are more vulnerable to oxidative stress than those with significant CAD. The study demonstrates the application of 'serum lipid peroxidation potential' assay for risk-stratification of CAD in people with T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical effectiveness and safety of preoperative oral carbohydrate loading in patients with diabetes: A systematic review 糖尿病患者术前口服碳水化合物负荷的临床有效性和安全性：系统综述

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103140

Background

The effectiveness and safety of preoperative oral carbohydrate (POC) for people with diabetes remain controversial.

Methods

We systematically reviewed studies comparing POC to fasting or placebo in elective surgery for diabetic adults, focusing on gastric volume, postoperative complications, hospital stay, and glycemic control.

Results

Fourteen studies (n = 1870 patients) were included. POC did not significantly increase gastric volume or aspiration risk in well-controlled type 2 diabetes. Effects on perioperative glucose control varied. POC improved patient comfort and reduced preoperative hypoglycemia in gestational diabetes. Limited evidence suggested potential benefits in cardiac surgery patients.

Conclusion

POC is safe for well-controlled type 2 diabetics, enhancing comfort and reducing preoperative hypoglycemia without increasing aspiration risk. However, its effects on glucose control and postoperative outcomes vary. Personalized approaches are crucial, particularly for poorly controlled diabetes.

背景糖尿病患者术前口服碳水化合物（POC）的有效性和安全性仍存在争议。方法我们系统回顾了在糖尿病成人择期手术中比较 POC 与禁食或安慰剂的研究，重点关注胃容量、术后并发症、住院时间和血糖控制。在控制良好的 2 型糖尿病患者中，POC 不会明显增加胃容量或吸入风险。对围术期血糖控制的影响各不相同。POC 提高了患者的舒适度，减少了妊娠糖尿病患者术前低血糖的发生。有限的证据表明，POC 对心脏手术患者有潜在的益处。结论 POC 对控制良好的 2 型糖尿病患者是安全的，可提高舒适度并减少术前低血糖，同时不会增加吸入风险。然而，它对血糖控制和术后效果的影响各不相同。个性化方法至关重要，尤其是对于控制不佳的糖尿病患者。

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引用次数: 0

ٍEffects of Sumac Consumption on Blood Pressure, Glycemic Indices, and Body Composition in Adults: A GRADE-assessed Systematic Review and Dose-response Meta-analysis ٍ食用黄栌对成人血压、血糖指数和身体成分的影响：经 GRADE 评估的系统综述和剂量反应元分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103122

Background

Owing to the rich phytochemical content of Rhus coriaria L. (Anacardiaceae), known as Sumac, it may affect blood pressure, glycemic, and anthropometric indices. We, therefore, aimed to examine evidence on effect of Sumac on these factors by conducting a meta-analysis of RCTs.

Methods

A systematic literature search up to January 2024 was completed in PubMed/Medline, Scopus, and Web of Science. Heterogeneity tests of the selected trials were performed using the I² statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences (WMD) with a 95 % confidence interval (CI).

Results

Fifteen RCTs were included in this meta-analysis. Our findings showed that Sumac consumption significantly reduced diastolic blood pressure (DBP) (WMD = −2.88 mmHg; 95 %CI, −4.22 to −1.54; P = 0.001), fasting blood glucose (FBG) (WMD = −5.15 mg/dL; 95 %CI, −8.73 to −1.57; P = 0.005), insulin (WMD = −1.95 uIU/ml; 95 %CI, 3.11 to −0.79; P = 0.001), Hemoglobin A1c (WMD = −0.48 %; 95 %CI -0.84 to −0.12; P = 0.001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (WMD = −0.71; 95 %CI, −1.14 to −0.27; P = 0.001), and waist to hip ratio (WHR) (WMD = −0.01; 95 %CI, −0.02 to −0.00; P = 0.017). Sumac consumption had no significant effects on weight, body mass index, and waist circumference.

Conclusion

We found that Sumac consumption could improve DBP, glycemic indices, and WHR. Also, supplementation of this herb in higher doses or longer durations had more promising effects on FBG, HOMA-IR, and WHR.

背景由于黄栌（Rhus coriaria L.，Anacardiaceae）含有丰富的植物化学物质，可能会影响血压、血糖和人体测量指数。因此，我们旨在通过对研究性临床试验进行荟萃分析，研究黄栌对这些因素影响的证据。方法在 PubMed/Medline、Scopus 和 Web of Science 上完成了截至 2024 年 1 月的系统文献检索。使用 I2 统计量对所选试验进行异质性检验。根据异质性检验结果评估随机效应模型，并以加权平均差（WMD）和 95 % 置信区间（CI）确定汇总数据。我们的研究结果表明，服用苏木可明显降低舒张压 (DBP) (WMD = -2.88 mmHg; 95 %CI, -4.22 to -1.54; P = 0.001)、空腹血糖 (FBG) (WMD = -5.15 mg/dL; 95 %CI, -8.73 to -1.57; P = 0.005)、胰岛素 (WMD = -1.95 uIU/ml; 95 %CI, 3.11 至 -0.79；P = 0.001）、血红蛋白 A1c（WMD = -0.48 %；95 %CI，-0.84 至 -0.12；P = 0.001）、胰岛素抵抗静态模型评估（HOMA-IR）（WMD = -0.71；95 %CI，-1.14 至 -0.27；P = 0.001）和腰臀比（WHR）（WMD = -0.01；95 %CI，-0.02 至 -0.00；P = 0.017）。结论我们发现，服用黄栌可改善DBP、血糖指数和WHR。此外，补充较高剂量或较长时间的这种草药对 FBG、HOMA-IR 和 WHR 有更大的影响。

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引用次数: 0

Decreased risk of recurrent acute pancreatitis with semaglutide and tirzepatide in people with type 2 diabetes or obesity with a history of acute pancreatitis: A propensity matched global federated TriNetX database-based retrospective cohort study 有急性胰腺炎病史的 2 型糖尿病或肥胖症患者使用塞马鲁肽和替扎帕肽可降低复发急性胰腺炎的风险：基于TriNetX数据库的倾向匹配全球联合回顾性队列研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103116

Background

Acute pancreatitis (AP) is a significant health concern with potential for recurrent episodes and serious complications. The risk of recurrence in type 2 diabetes (T2D) or obesity can be influenced by various factors and treatments, including GLP-1 receptor agonists (GLP-1RAs). This study evaluates the risk of recurrent AP among patients with a history of the condition, focusing on the effects of different GLP-1RA treatments.

Objectives

Our objective is to compare the recurrence risks of AP between patients treated with different GLP-1RAs.

Methods

We conducted a retrospective cohort study using the TriNetX platform, encompassing 258,238 individuals with T2D or obesity who have a history of AP. We assessed the recurrence of AP over a five-year period, analyzing data on treatment regimens, with a focus on the use of Semaglutide, Tirzepatide, and other GLP-1RAs.

Results

GLP-1RA users experienced significantly lower recurrence rates of AP, with those without risk factors showing GLP-1RA users had a recurrence rate of 13.8 % compared to 40.9 % for non-users. Semaglutide and Tirzepatide showed the most favorable outcomes; Semaglutide users had lower recurrence rates than Exenatide (10.1 % vs. 27 %) and slightly lower than Dulaglutide (13.6 % vs. 15.4 %), though not statistically significant with Dulaglutide. Tirzepatide users displayed the lowest recurrence risk at 6.2 %, significantly lower than those on Semaglutide (11.7 %).

Conclusions

GLP-1RAs, particularly Semaglutide and Tirzepatide, are associated with a reduced risk of recurrent AP in people with T2D or obesity. The differential risk profile between these drugs highlights the need for further studies and personalized treatment plans.

背景急性胰腺炎（AP）是一个重大的健康问题，有可能反复发作并引发严重并发症。2型糖尿病（T2D）或肥胖症患者的复发风险会受到各种因素和治疗方法的影响，包括GLP-1受体激动剂（GLP-1RA）。本研究评估了有 AP 病史的患者复发 AP 的风险，重点关注不同 GLP-1RA 治疗方法的影响。方法我们利用 TriNetX 平台开展了一项回顾性队列研究，研究对象包括 258,238 名有 AP 病史的 T2D 或肥胖患者。结果GLP-1RA使用者的AP复发率明显降低，无风险因素者显示GLP-1RA使用者的复发率为13.8%，而非使用者为40.9%。塞马鲁肽和替扎帕肽显示出最有利的结果；塞马鲁肽使用者的复发率低于艾塞那肽（10.1% 对 27%），略低于度拉鲁肽（13.6% 对 15.4%），但度拉鲁肽的复发率在统计学上并不显著。结论 GLP-1RA，尤其是塞马鲁肽和替唑帕肽，可降低 T2D 或肥胖症患者 AP 复发的风险。这些药物之间的风险差异凸显了进一步研究和个性化治疗方案的必要性。

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引用次数: 0

Highlights of the current issue 本期要点

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103141

引用次数: 0

Sex-specific dietary patterns and their association with metabolic syndrome: Insights from a cross-sectional analysis 性别饮食模式及其与代谢综合征的关系：横断面分析的启示

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103123

Aims

This study aims to identify a posteriori dietary patterns with a sex approach and to evaluate their association with metabolic syndrome criteria.

Methods

Cross-sectional study conducted in 6821 men and women between 55 and 75 years of age. Forty-two food groups were analyzed from dietary information collected with food frequency questionnaires, using principal component analysis and cluster analysis and then information from both statistical methods was compared. Prevalences were calculated foreach cluster group, based on the number and types of metabolic syndrome criteria they met.

Results

Following principal component analysis, two dietary patterns labeled “healthy” and “unhealthy” were identified in both men and women, due to the presence of foods that are considered more or less healthy. These same dietary patterns were found in cluster analysis plus an “intermediate” cluster consisting of both healthy and unhealthy foods. The presence of metabolic syndrome is related to the “healthy” dietary pattern in women and to the “unhealthy” dietary pattern in men. Comparison of the two statistical approaches showed a high level of correlation between them (weighted Kappa = 0.703 in women and weighted Kappa = 0.691 in men).

Conclusions

Adherence to both healthy and unhealthy dietary pattern appears to be related to the development of MS. The differences found by sex make it necessary to develop interventions with a sex-specific approach.

方法对 6821 名 55 至 75 岁的男性和女性进行横断面研究。利用主成分分析法和聚类分析法对通过食物频率问卷收集到的膳食信息中的 42 个食物组进行了分析，然后对两种统计方法得出的信息进行了比较。根据符合代谢综合征标准的数量和类型，计算出每个聚类组的患病率。结果经过主成分分析，在男性和女性中都发现了两种饮食模式，分别标注为 "健康 "和 "不健康"，这是因为存在被认为更健康或更不健康的食物。在聚类分析中也发现了这些相同的饮食模式，外加一个由健康和不健康食物组成的 "中间 "聚类。代谢综合征的出现与女性的 "健康 "饮食模式和男性的 "不健康 "饮食模式有关。两种统计方法的比较显示，它们之间存在高度相关性（女性加权 Kappa = 0.703，男性加权 Kappa = 0.691）。由于性别差异，有必要制定针对不同性别的干预措施。

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引用次数: 0