Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献_第3页

Early detection of altered cold perception in elderly with type 2 diabetes using a novel Quantitative Sensory Testing method 利用新型定量感官测试方法及早发现患有 2 型糖尿病的老年人对寒冷感知的改变。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103097

Aim

To compare the effectiveness of two methods for measuring cold detection thresholds in screening for temperature-perception deficits in elderly individuals with type 2 diabetes (T2 diabetes).

Methods

Cold threshold measurements were performed on seven body regions of participants with diabetes without neuropathy (n = 30; mean age, 70.9 ± 6.5 years) and healthy participants (n = 73; mean age, 68 ± 5 years). Two protocols applying the Levels Method were used: the first used skin temperature as the starting point; the second used 40 °C.

Results

Cold detection thresholds were significantly higher in subjects with diabetes, particularly on the foot. For CDT TSk, values were −2.22 ± 1.91 °C in non-diabetic and −3.27 ± 3.33 °C in diabetic groups (p = 0.023); for CDT 40, values were −9.82 ± 3.5 °C and −12.18 ± 4.5 °C (p = 0.003). However, after adjusting for age, the group effect on cold threshold with skin temperature as baseline disappeared. Sensory screens showed that the Area Under Curve of the method using a 40 °C baseline was 0.69 (p = 0.002).

Conclusion

Measuring the cold detection threshold on the foot with a 40 °C baseline is more effective than using skin temperature as a baseline for screening sensory alterations in elderly subjects with type 2 diabetes before neuropathy onset.

Significance

These findings highlight the importance of selecting the appropriate cold detection threshold method for elderly individuals with type 2 diabetes. The optimal method can facilitate early identification of sensory changes, minimizing complications and improving overall well-being.

目的：比较两种测量冷阈值的方法在筛查老年 2 型糖尿病（T2 型糖尿病）患者温度感知障碍方面的有效性：对无神经病变的糖尿病患者（n = 30；平均年龄为 70.9 ± 6.5 岁）和健康患者（n = 73；平均年龄为 68 ± 5 岁）的七个身体区域进行冷阈值测量。采用了两种应用水平法的方案：第一种方案以皮肤温度为起点；第二种方案以 40 °C 为起点：结果：糖尿病患者的冷检测阈值明显较高，尤其是脚部。对于 CDT TSk，非糖尿病组的值为 -2.22 ± 1.91 °C，糖尿病组为 -3.27 ± 3.33 °C（p = 0.023）；对于 CDT 40，非糖尿病组的值为 -9.82 ± 3.5 °C，糖尿病组为 -12.18 ± 4.5 °C（p = 0.003）。然而，在对年龄进行调整后，以皮肤温度为基线的冷阈值的群体效应消失了。感官屏幕显示，以 40 °C 为基线的方法的曲线下面积为 0.69（p = 0.002）：结论：以 40 °C为基线测量足部冷检测阈值比以皮肤温度为基线在神经病变发生前筛查老年 2 型糖尿病患者的感觉改变更有效：这些发现强调了为老年 2 型糖尿病患者选择合适的低温检测阈值方法的重要性。最佳方法有助于早期识别感觉变化，最大限度地减少并发症，改善整体健康。

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引用次数: 0

Trabecular and cortical bone microarchitecture using high-resolution peripheral quantitative computed tomographic imaging in diabetic peripheral neuropathy 利用高分辨率外周定量计算机断层扫描成像研究糖尿病周围神经病变的骨小梁和皮质骨微结构

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103109

Context

Type 2 Diabetes Mellitus (T2D) is associated with an increased risk of fragility fracture despite normal areal bone mineral density (BMD). The contribution of diabetic peripheral neuropathy (PN) to volumetric BMD (vBMD) and bone microarchitecture in T2D is not explored.

Objective

To assess vBMD and microarchitectural properties of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients of T2D with or without PN.

Design

This is a cross-sectional study of patients of T2D divided into two groups [patients with T2D without PN (Group A) and T2D with PN (Group B)]. All patients underwent clinical examination, biochemical evaluation, dual-energy X-ray absorptiometry (DXA), and HR-pQCT of the radius and tibia.

Results

A total of 296 patients were included in the study [Group A (n = 98), Group B (n = 198)]. HR-pQCT demonstrated a significant difference in total vBMD[mg/cm³] at tibia (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003); cortical vBMD[mg/cm³] at tibia [912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000], among groups A and B respectively. Among the microarchitecture parameters, there was a significant difference in cortical porosity at the tibia (2.5% ±1.7% vs. 3%±1.7%; p-0.004), trabecular number[mm^-1] at the tibia [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045] and trabecular thickness[mm] at the radius [0.228 (0.217, 0.247) Vs. 0.238 (0.224, 0.253); p-0.006], among groups A and B respectively.

Conclusion

Despite comparable areal BMD, T2D patients with PN have diminished vBMD and deteriorated skeletal microarchitecture, compared to those without PN.

背景2型糖尿病（T2D）与脆性骨折风险增加有关，尽管其总体骨矿物质密度（BMD）正常。目的使用高分辨率外周定量计算机断层扫描（HR-pQCT）评估有无 PN 的 T2D 患者的体积骨密度（vBMD）和骨微结构特性。所有患者均接受了临床检查、生化评估、双能 X 射线吸收测定（DXA）以及桡骨和胫骨的 HR-pQCT 检查。HR-pQCT显示，A组和B组胫骨总vBMD[mg/cm3] (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003)、胫骨皮质vBMD[mg/cm3] (912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000)分别存在显著差异。在微结构参数中，胫骨皮质孔隙率（2.5%±1.7% vs. 3%±1.7%; p-0.004）、胫骨小梁数[mm-1] [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045]和桡骨小梁厚度[mm] [0.结论与无 PN 的 T2D 患者相比，尽管总 BMD 相当，但有 PN 的 T2D 患者 vBMD 减少，骨骼微结构恶化。

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引用次数: 0

Glycemic variability in chronic calcific pancreatitis with diabetes mellitus and its possible determinants 慢性钙化性胰腺炎合并糖尿病的血糖变异性及其可能的决定因素

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103100

Aims

To study glycemic patterns and variability in patients with pancreatic diabetes or type 3c Diabetes mellitus (DM) due to chronic pancreatitis and its subtypes and assess the role of pancreatic enzyme replacement therapy (ERT) in modulating glycemic variability.

Methods

Patients having type 3c DM due to chronic pancreatitis, and on insulin underwent Flash continuous-glucose-monitoring (CGM) for 14 days. Parameters were compared between patients with fibrocalculous pancreatic diabetes (FCPD) and non-FCPD-chronic calcific pancreatitis (non-FCPD) and between the recipients and non-recipients of pancreatic enzyme-replacement-therapy (ERT).

Results

Out of 54 patients with pancreatic diabetes, 35 patients had chronic calcific pancreatitis. They underwent CGM, median HbA1c 9.20 % (77 mmol/mol) and mean Time-In-Range (TIR) being 41.21 % (23.48). Only 5 (15.2 %) patients achieved target TIR>70 % while 16 (48.5 %) patients had high glycemic-variability [Coefficient-of-variation (CV) > 36 %]. Patients with FCPD (n = 14) had higher hypoglycemia-indices like Time-Below-Range (18.92 % vs 8.20 %; p = 0.03) and Low-Blood-Glucose-Index (18.14 % vs 6.04 %; p = 0.02) compared to non-FCPD (n = 21). HbA1c% and hyperglycemic excursions were similar in both groups. Recipients of ERT (n = 20) had lower glycemic-variability [Standard Deviation (SD) 52.15 % vs 68.14 % and CV 32.59 % vs 41.79 %, p < 0.05 for both) than non-recipients. ERT-recipients had no serious hypoglycemia within the 14 days. On subgroup analysis, lower glycemic-variability and hypoglycemia with ERT were seen only in FCPD but not in non-FCPD subgroup (50.13 vs 77.91, 30.09 vs 48.36 for SD and CV respectively, p < 0.05).

Conclusion

Patients with type 3c DM due to chronic pancreatitis have high frequency of hyperglycemic and hypoglycemic excursions, with those with FCPD having a particularly higher risk of hypoglycemia and glycemic-variability. Those receiving pancreatic ERT had lesser glycemic variability and hypoglycemia. The small sample size and lack of objective markers of documentation of exocrine pancreatic insufficiency like fecal elastase highlight the need for further larger studies in this field.

目的研究慢性胰腺炎引起的胰源性糖尿病或 3c 型糖尿病（DM）患者及其亚型的血糖模式和变异性，并评估胰酶替代疗法（ERT）在调节血糖变异性方面的作用。方法对慢性胰腺炎引起的 3c 型 DM 患者和使用胰岛素的患者进行为期 14 天的 Flash 连续血糖监测（CGM）。比较了纤维钙化性胰腺糖尿病（FCPD）和非纤维钙化性胰腺糖尿病-慢性钙化性胰腺炎（Non-FCPD）患者之间以及接受和未接受胰酶替代疗法（ERT）患者之间的参数。他们接受了 CGM 检查，中位 HbA1c 为 9.20 %（77 mmol/mol），平均时间范围（TIR）为 41.21 %（23.48）。只有 5 例（15.2%）患者的 TIR 达到了目标值 70%，16 例（48.5%）患者的血糖变异性较高（变异系数为 36%）。与非 FCPD 患者（21 人）相比，FCPD 患者（14 人）的低血糖指数较高，如时间低于范围指数（18.92 % vs 8.20 %；p = 0.03）和低血糖指数（18.14 % vs 6.04 %；p = 0.02）。两组的 HbA1c% 和高血糖偏移量相似。接受 ERT 治疗者（20 人）的血糖变异性[标准差（SD）为 52.15 % vs 68.14 %，CV 为 32.59 % vs 41.79 %，P 均为 0.05]低于非接受 ERT 治疗者。ERT 受试者在 14 天内没有发生严重低血糖。在亚组分析中，只有 FCPD 亚组的血糖变异性和低血糖症发生率较低，而非 FCPD 亚组的发生率较低（SD 和 CV 分别为 50.13 vs 77.91、30.09 vs 48.36，P < 0.05）。结论慢性胰腺炎导致的 3c 型 DM 患者发生高血糖和低血糖的频率很高，其中 FCPD 患者发生低血糖和血糖变异的风险尤其高。接受胰腺 ERT 治疗的患者血糖变异性和低血糖发生率较低。由于样本量较小，且缺乏记录胰腺外分泌功能不全的客观指标（如粪便弹性蛋白酶），因此需要在该领域开展更大规模的研究。

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引用次数: 0

Epidemiology of lipid disturbances in psoriasis: An analysis of trends from 2006 to 2023 银屑病血脂紊乱的流行病学：2006 年至 2023 年趋势分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103098

Introduction

A strong link has been established between psoriasis and lipid disturbances; however, no study has systematically examined their global epidemiology.

Methods

We searched six databases from their inception up to October 1, 2023. Data analysis was conducted using Stata SE 15.1. We performed subgroup, meta-regression, and sensitivity analyses to assess the heterogeneity of the pooled studies.

Results

Our review included 239 studies comprising 15,519,570 participants. The pooled prevalence rate of dyslipidemia among individuals with psoriasis was 38 %.

Conclusion

Patients with severe psoriasis should undergo screening for lipid abnormalities. This can facilitate the early detection of lipid dysfunction and associated cardiovascular comorbidities.

导言：银屑病与血脂紊乱之间存在密切联系；但是，还没有研究对其全球流行病学进行系统研究。数据分析使用 Stata SE 15.1 进行。我们进行了分组分析、元回归分析和敏感性分析，以评估汇总研究的异质性。结论严重银屑病患者应进行血脂异常筛查。结论严重银屑病患者应接受血脂异常筛查，这有助于及早发现血脂功能障碍和相关的心血管并发症。

引用次数: 0

Exploring the therapeutic targets of stevioside in management of type 2 diabetes by network pharmacology and in-silico approach 通过网络药理学和分子内方法探索甜菊糖苷治疗 2 型糖尿病的靶点

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103111

Aims

The main objective of the current study is to investigate the pathways and therapeutic targets linked to stevioside in the management of T2D using computational approaches.

Methods

We collected RNA-seq datasets from NCBI, then employed GREIN to retrieve differentially expressed genes (DEGs). Computer-assisted techniques DAVID, STRING and NetworkAnalyst were used to explore common significant pathways and therapeutic targets associated with T2D and stevioside. Molecular docking and dynamics simulations were conducted to validate the interaction between stevioside and therapeutic targets.

Results

Gene ontology and KEGG analysis revealed that prostaglandin synthesis, IL-17 signaling, inflammatory response, and interleukin signaling were potential pathways targeted by stevioside in T2D. Protein-protein interactions (PPI) analysis identified six common hub proteins (PPARG, PTGS2, CXCL8, CCL2, PTPRC, and EDN1). Molecular docking results showed best binding of stevioside to PPARG (−8 kcal/mol) and PTGS2 (−10.1 kcal/mol). Finally, 100 ns molecular dynamics demonstrated that the binding stability between stevioside and target protein (PPARG and PTGS2) falls within the acceptable range.

Conclusions

This study reveals that stevioside exhibits significant potential in controlling T2D by targeting key pathways and stably binding to PPARG and PTGS2. Further research is necessary to confirm and expand upon these significant computational results.

方法我们从 NCBI 收集 RNA-seq 数据集，然后使用 GREIN 检索差异表达基因（DEGs）。计算机辅助技术 DAVID、STRING 和 NetworkAnalyst 被用来探索与 T2D 和甜菊糖相关的共同重要通路和治疗靶点。结果基因本体和 KEGG 分析显示，前列腺素合成、IL-17 信号传导、炎症反应和白细胞介素信号传导是甜菊糖苷在 T2D 中的潜在靶向通路。蛋白质-蛋白质相互作用（PPI）分析确定了六个共同的枢纽蛋白（PPARG、PTGS2、CXCL8、CCL2、PTPRC 和 EDN1）。分子对接结果显示甜菊糖苷与 PPARG（-8 kcal/mol）和 PTGS2（-10.1 kcal/mol）的结合效果最佳。最后，100 ns 分子动力学结果表明，甜菊糖甙与目标蛋白（PPARG 和 PTGS2）之间的结合稳定性在可接受范围内。有必要开展进一步的研究，以确认和扩展这些重要的计算结果。

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引用次数: 0

Gut microbiota interventions in type 2 diabetes mellitus: An umbrella review of glycemic indices 2型糖尿病的肠道微生物群干预：血糖指数综述

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103110

Background

We aimed to explore how probiotics, prebiotics, or synbiotics impact glycemic indices in patients with diabetes mellitus.

Method

A comprehensive search was conducted on PubMed, Scopus, and Web of Science from inception up to April 2023. The random-effects model was employed for the study analysis. Furthermore, sensitivity and subgroup analyses were conducted to investigate potential sources of heterogeneity. AMSTAR2 checklist was used to determine the quality of studies. Comprehensive meta-analysis version 3 was used for the study analysis.

Result

A total of 31 studies were included in the final analysis. Based on the results of the meta-analysis, gut microbial therapy could significantly decrease serum fasting blood glucose levels in patients with type 2 diabetes mellitus (effect size: −0.211; 95 % CI: −0.257, −0.164; P < 0.001). Additionally, significant associations were also found between gut microbial therapy and improved serum levels of fasting insulin, glycated hemoglobin, and homeostatic model assessment for insulin resistance (effect size: −0.087; 95 % confidence interval: −0.120, −0.053; P < 0.001; effect size: −0.166; 95 % confidence interval: −0.200, −0.132; P < 0.001; effect size: −0.230; 95 % confidence interval: −0.288, −0.172; P < 0.001, respectively).

Conclusion

Our results revealed promising effects of gut microbiota modulation on glycemic profile of patients with type 2 diabetes mellitus. The use of these agents as additional treatments can be considered.

背景我们旨在探讨益生菌、益生元或合成益生菌如何影响糖尿病患者的血糖指数。方法在PubMed、Scopus和Web of Science上进行了从开始到2023年4月的全面搜索。研究分析采用随机效应模型。此外，还进行了敏感性分析和亚组分析，以调查潜在的异质性来源。采用 AMSTAR2 核对表确定研究质量。结果共有 31 项研究被纳入最终分析。根据荟萃分析结果，肠道微生物疗法可显著降低 2 型糖尿病患者的血清空腹血糖水平（效应大小：-0.211；95 % CI：-0.257，-0.164；P <；0.001）。此外，研究还发现，肠道微生物疗法与空腹胰岛素、糖化血红蛋白和胰岛素抵抗稳态模型评估的血清水平改善之间存在明显关联（效应大小：-0.087；95 % CI：-0.164；P <；0.001）：-0.087；95% 置信区间：-0.120，-0.053；P <；0.001；效应大小：-0.166；95 % 置信区间：-0.053；P <；0.001）：效应大小：-0.166；95 % 置信区间：-0.200，-0.053；P < 0.001-0.166；95 % 置信区间：-0.200，-0.132；P <；0.001；效应大小：-0.230；95 % 置信区间：-结论我们的研究结果表明，调节肠道微生物群对 2 型糖尿病患者的血糖状况具有良好的影响。可以考虑使用这些制剂作为额外的治疗方法。

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引用次数: 0

Predictors of stigma perception by people with type 1 diabetes: A cross-sectional analysis of the BETTER registry 1 型糖尿病患者耻辱感的预测因素：BETTER 登记的横断面分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103112

Aims

This study investigates stigma predictors across ages and genders, addressing a critical gap in understanding diverse populations to reduce related suboptimal clinical and psychosocial outcomes.

Methods

Cross-sectional analysis of self-reported data from BETTER, a Canadian registry of people with type 1 diabetes. Participants (n = 709) completed the 19-item-Diabetes-Stigma Assessment-Scale (DSAS-1) categorized into treated differently, blame and judgment, and identity concerns sub-scales. Associations with diabetes distress (DDS-17-score/102), depression (PHQ-9-score/27), social-support (ESSI-score/34), fear of hypoglycemia (HFS-II-score/132), and hyperglycemia-avoidance-behaviours (HAS-score/88) were computed.

Results

Perceived stigma was highest in youth aged 14–24 years (46·0 ± 15·6, p < 0·001) and women (41·2 ± 15·7, p = 0·009), compared to other age groups and men. Blame and Judgment contributed to most of stigma perception. Youth perceived significantly more blame and judgment (p < 0·001) and identity concerns (p = 0·001) compared to middle-aged adults and seniors. Women perceive significantly more blame and judgment compared to men (p < 0·001). The perception of being treated differently was not reported to be an issue across ages and genders. Participants with higher scores of depression, diabetes-distress, fear of hypoglycemia, hyperglycemia-avoidance behaviours, and lesser social-support, reported increased stigma.

Conclusions

Stigma varies by age and gender, underscoring the need for targeted interventions to reduce it. Challenging stereotypes and reducing stigma-related stressors are essential for better outcomes.

目的本研究调查了不同年龄和性别人群的成见预测因素，以解决在了解不同人群以减少相关的次优临床和社会心理结果方面存在的关键差距。方法对来自加拿大 1 型糖尿病患者登记处 BETTER 的自我报告数据进行横断面分析。参与者（n = 709）完成了 19 个项目的糖尿病耻辱感评估量表（DSAS-1），该量表分为区别对待、指责和评判以及身份关切子量表。计算了与糖尿病困扰（DDS-17-得分/102）、抑郁（PHQ-9-得分/27）、社会支持（ESSI-得分/34）、低血糖恐惧（HFS-II-得分/132）和高血糖回避行为（HAS-得分/88）之间的关联。结果与其他年龄组和男性相比，14-24 岁青少年（46-0 ± 15-6，p < 0-001）和女性（41-2 ± 15-7，p = 0-009）感受到的耻辱感最高。指责和评判是造成成见感的主要原因。与中年人和老年人相比，青年人明显感受到更多的责备和评判（p < 0-001）以及对身份的担忧（p = 0-001）。与男性相比，女性明显感受到更多的指责和评判（p = 0-001）。不同年龄和性别的人都不认为自己受到了区别对待。抑郁、糖尿病压力、低血糖恐惧、高血糖回避行为和社会支持较少的参与者的耻辱感得分更高。挑战陈规定型观念和减少与成见相关的压力因素对于取得更好的结果至关重要。

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引用次数: 0

The effect of microbiome-modulating therapeutics on glucose homeostasis in metabolic syndrome: A systematic review, meta-analysis, and meta-regression of clinical trials 微生物调节疗法对代谢综合征患者葡萄糖稳态的影响：临床试验的系统回顾、荟萃分析和荟萃回归

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103118

Background

Metabolic syndrome (MetS) is a chronic disorder featuring overweight/obesity, high blood pressure, and dysfunction of lipid and carbohydrate metabolism. Microbiome-modulating probiotics, prebiotics, synbiotics and fecal microbiota transplant (FMT) are promising adjunct therapies for improving parameters of glucose homeostasis and insulinemia.

Methods

We conducted a comprehensive systematic review, meta-analyses, and meta-regressions to investigate the effect of the abovementioned microbiome therapies on various biomarkers after screening clinical trials published through April 2023. We pooled data using random effects meta-analyses, reporting them as mean differences (MDs) with 95 % confidence intervals (CIs), and conducting univariate linear model meta-regressions.

Results

Data from 21 trial comparisons across 19 studies (n = 911) revealed that, compared to placebo/control, microbiome-modulating therapies were associated with statistically significant changes in fasting plasma glucose (MD: 4.03 mg/dL [95%CI: 6.93; −1.13]; p _effect = 0.006, I² = 89.8 %), and fasting insulin (MD: 2.56 μU/mL [95%CI: 4.28; −0.84]; p _effect = 0.004, I² = 87.9 %), but not insulin resistance or sensitivity indices and HbA1c. Age, baseline BMI, baseline biomarker value, pro/synbiotic dosage, trial duration, nutraceutical type, and WHO region were factors affecting the efficacy of these interventions at producing changes in biomarkers, signaling the potential role of personalized precision medicine adjunct therapy for deranged glucose homeostasis in patients with MetS. Nevertheless, presence of heterogeneity calls for further investigation before their clinical application.

Conclusions

Probiotics, prebiotics, synbiotics and FMT supplementation improved fasting glucose and insulin in patients with MetS. Further large-scale and high-quality trials are required before potential clinical applications.

背景代谢综合征（MetS）是一种以超重/肥胖、高血压、脂质和碳水化合物代谢障碍为特征的慢性疾病。微生物组调节益生菌、益生元、合成益生菌和粪便微生物组移植（FMT）是改善葡萄糖稳态和胰岛素血症参数的有前途的辅助疗法。方法我们对 2023 年 4 月之前发表的临床试验进行了全面的系统综述、荟萃分析和荟萃回归，以研究上述微生物组疗法对各种生物标志物的影响。我们使用随机效应荟萃分析对数据进行了汇总，以平均差（MD）和 95% 置信区间（CI）的形式报告数据，并进行了单变量线性模型荟萃回归。结果来自 19 项研究（n = 911）中 21 项试验比较的数据显示，与安慰剂/对照组相比，微生物组调节疗法与空腹血浆葡萄糖的统计学显著变化相关（MD：4.03 mg/dL [95%CI: 6.93; -1.13]; p effect = 0.006, I2 = 89.8 %）和空腹胰岛素（MD：2.56 μU/mL [95%CI: 4.28; -0.84]；p effect = 0.004, I2 = 87.9 %）发生了统计学意义上的显著变化，但胰岛素抵抗或敏感性指数和 HbA1c 没有发生变化。年龄、基线体重指数（BMI）、基线生物标志物值、益生菌剂量、试验持续时间、营养保健品类型和世界卫生组织地区是影响这些干预措施在生物标志物变化方面疗效的因素，这表明个性化精准医学辅助疗法在治疗 MetS 患者血糖平衡失调方面具有潜在作用。结论补充益生菌、益生元、合成益生菌和 FMT 可改善 MetS 患者的空腹血糖和胰岛素。在潜在的临床应用之前，还需要进一步开展大规模、高质量的试验。

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引用次数: 0

Glucagon-like peptide-1 receptor agonists and risk of sight-threatening retinopathy in Taiwanese population: A propensity based cohort study 台湾人群中的胰高血糖素样肽-1 受体激动剂与危及视力的视网膜病变风险：基于倾向的队列研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103099

Aims

To compare the risk of vision-threatening retinopathy between glucagon-like peptide-1 receptor agonists (GLP-1 RA) use and no use in patients with type 2 diabetes.

Methods

Using propensity score matching, we identified 27,506 pairs of GLP-1 RA users and non-users, 3904 pairs of GLP-1 RA and dipeptidyl peptidase-4 inhibitors (DPP-4i) users, 10,985 pairs of GLP-1 RA and sodium-glucose cotransporter-2 inhibitors (SGLT2i) users, 2542 pairs of GLP-1 RA and sulfonylurea, respectively, from Taiwan's National Health Insurance Research Database from January 1, 2009 to December 31, 2018. We used Cox proportional hazards models to compare the risk of vision-threatening retinopathy between GLP-1 RA use and other matched groups.

Results

In the matched cohorts, the time-varying exposure analysis showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to GLP-1 RA non-use (aHR 0.96, 95 % CI 0.89–1.03). New-user and active-comparator analyses showed that GLP-1 RA was associated with a significantly lower risk of vision-threatening retinopathy than DPP-4i (aHR 0.8, 95 % CI 0.66–0.97) but had no significant association with this risk compared to SGLT2i (aHR 1.09, 95 % CI 0.96–1.24) or sulfonylureas (aHR 0.79, 95 % CI 0.49–1.06).

Conclusions

This nationwide cohort study showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to non- GLP-1 RA use, and GLP-1 RA could significantly lower the risk of vision-threatening retinopathy than DPP-4i.

目的：比较2型糖尿病患者使用和不使用胰高血糖素样肽-1受体激动剂（GLP-1 RA）发生视力威胁性视网膜病变的风险：使用倾向得分匹配法，我们从2009年1月1日至2018年12月31日的台湾国民健康保险研究数据库中分别识别出27506对GLP-1 RA使用者和非使用者、3904对GLP-1 RA和二肽基肽酶-4抑制剂（DPP-4i）使用者、10985对GLP-1 RA和钠-葡萄糖共转运体-2抑制剂（SGLT2i）使用者、2542对GLP-1 RA和磺脲类药物使用者。我们使用Cox比例危险模型比较了使用GLP-1 RA和其他匹配组之间发生威胁视力的视网膜病变的风险：在匹配队列中，时变暴露分析表明，与不使用 GLP-1 RA 相比，使用 GLP-1 RA 与视力威胁性视网膜病变风险增加无关（aHR 0.96，95 % CI 0.89-1.03）。新用户和活跃比较者分析表明，与DPP-4i相比，GLP-1 RA与威胁视力的视网膜病变风险显著降低（aHR 0.8，95 % CI 0.66-0.97），但与SGLT2i（aHR 1.09，95 % CI 0.96-1.24）或磺脲类药物（aHR 0.79，95 % CI 0.49-1.06）相比，GLP-1 RA与该风险无显著关联：这项全国性队列研究表明，与不使用 GLP-1 RA 的患者相比，使用 GLP-1 RA 与视力威胁性视网膜病变风险的增加无关，而且 GLP-1 RA 比 DPP-4i 能显著降低视力威胁性视网膜病变的风险。

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引用次数: 0

Letter to the editor: No increased incidence of retinopathy linked to hydroxychloroquine in RA patients with diabetes 致编辑的信糖尿病 RA 患者的视网膜病变发生率与羟氯喹无关

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-08-01 DOI: 10.1016/j.dsx.2024.103101

引用次数: 0