Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.
Methods
PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).
Results
Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; I2 = 88.7 %, p < 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; I2 = 85.3 %, p < 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; I2 = 87.4 %, p < 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; I2 = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; I2 = 87.6 %, p < 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; I2 = 88.1 %, p < 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; I2 = 93.6 %, p < 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; I2 = 96.3 %, p < 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; I2 = 87.2 %, p < 0.001).
Conclusion
Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.
背景和目的大量临床研究表明，亚麻籽补充剂可能对糖尿病患者有效，但研究结果存在争议。因此，本研究旨在探讨亚麻籽对糖尿病患者血压、人体测量和血脂参数的影响。方法截至2024年6月检索spubmed、Cochrane Library、Web of Science、Scopus、Embase和谷歌Scholar数据库。采用随机效应模型分析标准化平均差异（SMDs）。结果对16项试验1136名受试者的荟萃分析显示体重有显著改善(SMD: 0.81；95% CI: 1.54 ~ - 0.09, p = 0.028；I2 = 88.7%, p <；0.001)，腰围(SMD: 1.54；95% CI: 2.77 ~ - 0.31, p = 0.002；I2 = 85.3%, p <；0.001)，甘油三酯(SMD: 0.56；95% CI: 1.02 ~ - 0.10, p = 0.016；I2 = 87.4%, p <；0.001)，但BMI没有(SMD: 0.63；95% CI: 1.28 ~ 0.02, p = 0.058；I2 = 87.9%, p = 0.005)，收缩压(SMD: 0.50；95% CI: 1.25, 0.25, p = 0.193；I2 = 87.6%, p <；0.001)，舒张压(SMD: 0.74；95% CI: 1.51, 0.03, p = 0.060；I2 = 88.1%, p <；0.001)、总胆固醇(SMD: 0.43；95% CI: 0.99 ~ 0.12, p = 0.128；I2 = 93.6%, p <；0.001)，低密度脂蛋白胆固醇(SMD: 0.09；95% CI: 0.87 ~ 0.70, p = 0.830；I2 = 96.3%, p <；0.001)，高密度脂蛋白胆固醇(SMD: 0.08；95% CI: 0.30 ~ 0.46, p = 0.673；I2 = 87.2%, p <；0.001)。结论补充亚麻籽可有效降低2型糖尿病患者的人体测量指数和甘油三酯水平，但对血压和其他血脂参数没有任何益处。因此，进行更广泛、设计良好的试验来验证这些发现是至关重要的。
{"title":"The effect of flaxseed supplementation on anthropometric indices, blood pressure, and lipid profile in diabetic patients: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials","authors":"Vali Musazadeh , Shokufeh Nezamoleslami , Amir Hossein Faghfouri , Farzad Shidfar , Naheed Aryaeian","doi":"10.1016/j.dsx.2025.103241","DOIUrl":"10.1016/j.dsx.2025.103241","url":null,"abstract":"<div><h3>Background and aims</h3><div>Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).</div></div><div><h3>Results</h3><div>Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; <em>I</em><sup>2</sup> = 88.7 %, p < 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; <em>I</em><sup>2</sup> = 85.3 %, p < 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; <em>I</em><sup>2</sup> = 87.4 %, p < 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; <em>I</em><sup>2</sup> = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; <em>I</em><sup>2</sup> = 87.6 %, p < 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; <em>I</em><sup>2</sup> = 88.1 %, p < 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; <em>I</em><sup>2</sup> = 93.6 %, p < 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; <em>I</em><sup>2</sup> = 96.3 %, p < 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; <em>I</em><sup>2</sup> = 87.2 %, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103241"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240566","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}
Pub Date : 2025-05-01Epub Date: 2025-06-11DOI: 10.1016/j.dsx.2025.103252
Laura Suhlrie , Raga Ayyagari , Camille Mba , Kjell Olsson , Harold Torres-Aparcana , Steven James , Elpida Vounzoulaki , Daniel B. Ibsen
Objective
To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.
Methods
Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.
Results
We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I2 = 81 %, nstudies = 17), body mass index (MD -0.71 kg/m2, 95 % CI -1.06,-0.37, I2 = 70 %, nstudies = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I2 = 84 %, nstudies = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I2 = 71 %, nstudies = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.
Conclusions
Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.
目的评价远程医疗饮食和/或运动干预对高危人群预防2型糖尿病（T2D）的有效性。方法检索sembase（通过Ovid）、Medline（通过Ovid）、Web of Science、CINAHL、Scopus和SciELO，检索2010年1月至2020年12月通过远程医疗提供的饮食和/或运动干预对高危人群预防T2D的干预研究。对平行随机对照试验进行meta分析，并对其他干预设计进行叙述性综合。结果：我们通过数据库检索确定了11,645项研究，其中226项是全文筛选，包括52项干预措施；32例纳入元分析，20例纳入叙事综合。远程医疗干预降低了体重（平均差值（MD）： - 1.66 kg， 95%可信区间（CI）： - 2.48,-0.90, I2 = 81%, nstudies = 17），体重指数（MD -0.71 kg/m2, 95% CI -1.06,-0.37, I2 = 70%, nstudies = 11），腰围（MD -2.82 cm, 95% CI -5.16,-2.35, I2 = 84%, nstudies = 8）和糖化血红蛋白（MD - 0.07%, 95% CI -0.14,0.00, I2 = 71%, nstudies = 11）。其他临床结果未发现显著影响。叙事综合支持了结果。最长随访时间达24个月。我们的研究证明了远程医疗干预在高危人群，特别是超重/肥胖人群中预防T2D的有效性。
{"title":"The effectiveness of telemedicine in the prevention of type 2 diabetes mellitus: a systematic review and meta-analysis of interventions","authors":"Laura Suhlrie , Raga Ayyagari , Camille Mba , Kjell Olsson , Harold Torres-Aparcana , Steven James , Elpida Vounzoulaki , Daniel B. Ibsen","doi":"10.1016/j.dsx.2025.103252","DOIUrl":"10.1016/j.dsx.2025.103252","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.</div></div><div><h3>Methods</h3><div>Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I<sup>2</sup> = 81 %, n<sub>studies</sub> = 17), body mass index (MD -0.71 kg/m<sup>2</sup>, 95 % CI -1.06,-0.37, I<sup>2</sup> = 70 %, n<sub>studies</sub> = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I<sup>2</sup> = 84 %, n<sub>studies</sub> = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I<sup>2</sup> = 71 %, n<sub>studies</sub> = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103252"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291007","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}
Pub Date : 2025-05-01Epub Date: 2025-06-04DOI: 10.1016/j.dsx.2025.103249
Naveed Sattar FMedSci , Anoop Misra MD
{"title":"Adiposity at the core of the rising tide of young-onset type 2 diabetes worldwide","authors":"Naveed Sattar FMedSci , Anoop Misra MD","doi":"10.1016/j.dsx.2025.103249","DOIUrl":"10.1016/j.dsx.2025.103249","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103249"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263209","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}
Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.
Methods
Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.
Results
Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).
Conclusion
Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.
{"title":"Prevalence of cardiovascular risk and atherosclerotic cardiovascular disease in people with type 2 diabetes in the United Arab Emirates: Results from the prevalence of atherosclerotic cardiovascular disease in patients with type 2 diabetes across Middle East and African countries (PACT-MEA) study","authors":"Fatheya Al. Awadi , Fauzia Rashid , Ghada Awada , Haitham Seifeldin , Hani Sabbour , Hazem Aly , Jalal Nafach , Khadija Hafidh , Loai Abudaqa , Mahir K. Jallo , Wael Almahmeed , Zufana Nazir","doi":"10.1016/j.dsx.2025.103224","DOIUrl":"10.1016/j.dsx.2025.103224","url":null,"abstract":"<div><h3>Aim</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.</div></div><div><h3>Methods</h3><div>Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.</div></div><div><h3>Results</h3><div>Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).</div></div><div><h3>Conclusion</h3><div>Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103224"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834272","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}
This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).
Methods
This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUCHbA1c ≥ 6 %) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUCHbA1c ≥ 6 %.
Results
The relationship between AUCHbA1c ≥ 6 % and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.
Conclusions
We developed an AUCHbA1c ≥ 6 %-based model to predict renal function decline in patients with T2D, showing that AUCHbA1c ≥ 6 % may serve as a quantitative indicator of metabolic memory.
{"title":"Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study","authors":"Kentaro Oniki , Takuro Shigaki , Ayami Kajiwara-Morita , Keiichi Shigetome , Akira Yoshida , Hideaki Jinnouchi , Junji Saruwatari","doi":"10.1016/j.dsx.2025.103225","DOIUrl":"10.1016/j.dsx.2025.103225","url":null,"abstract":"<div><h3>Aims</h3><div>This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC<sub>HbA1c ≥ 6 %</sub>) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC<sub>HbA1c ≥ 6 %</sub>.</div></div><div><h3>Results</h3><div>The relationship between AUC<sub>HbA1c ≥ 6 %</sub> and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.</div></div><div><h3>Conclusions</h3><div>We developed an AUC<sub>HbA1c ≥ 6 %</sub>-based model to predict renal function decline in patients with T2D, showing that AUC<sub>HbA1c ≥ 6 %</sub> may serve as a quantitative indicator of metabolic memory.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103225"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834273","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}
Pub Date : 2025-04-01Epub Date: 2025-05-31DOI: 10.1016/j.dsx.2025.103240
Ningjian Wang , Anoop Misra
{"title":"Highlights of the current issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2025.103240","DOIUrl":"10.1016/j.dsx.2025.103240","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103240"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184439","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}
Pub Date : 2025-04-01Epub Date: 2025-05-15DOI: 10.1016/j.dsx.2025.103237
Subhasis Neogi , Madhurima Basu , Pradip Mukhopadhyay , Arpita Ray Chaudhury , Nitai P. Bhattacharyya , Sujoy Ghosh
Aims
This study was undertaken to evaluate differences in composite renal outcomes between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) (prospectively performed, biopsy proven), along with predictors of renal outcome in subjects with DKD.
Methods
A composite renal outcome comprising of doubling of creatinine, end stage renal disease (ESRD) or renal death was documented in biopsy proven DKD and NDKD subjects. Differences in outcome (DKD vs. NDKD) were compared. Clinical, biochemical and histopathological parameters were evaluated as possible predictors of composite renal outcome in DKD.
Results
91 subjects (72 DKD and 19 NDKD) were included for analysis. The hazard ratio (HR) for composite renal outcome was 0.27 (0.08–0.9) (p = 0.03) in favour of NDKD. Kaplan-Meier analysis demonstrated NDKD subjects had better composite renal outcome compared to DKD (log rank chi-square 6.69, p = 0.009). Degree of proteinuria and renal pathology society (RPS) class (III/IV) predicted worse outcome in those with DKD.
Conclusions
Composite renal outcomes in NDKD was better as compared to those with DKD. RPS class III/IV on histopathology and degree of proteinuria was associated with poorer composite renal outcome in patients with DKD.
{"title":"Composite renal outcome in prospectively performed biopsy proven diabetic kidney disease versus non-diabetic kidney disease: A longitudinal follow up","authors":"Subhasis Neogi , Madhurima Basu , Pradip Mukhopadhyay , Arpita Ray Chaudhury , Nitai P. Bhattacharyya , Sujoy Ghosh","doi":"10.1016/j.dsx.2025.103237","DOIUrl":"10.1016/j.dsx.2025.103237","url":null,"abstract":"<div><h3>Aims</h3><div>This study was undertaken to evaluate differences in composite renal outcomes between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) (prospectively performed, biopsy proven), along with predictors of renal outcome in subjects with DKD.</div></div><div><h3>Methods</h3><div>A composite renal outcome comprising of doubling of creatinine, end stage renal disease (ESRD) or renal death was documented in biopsy proven DKD and NDKD subjects. Differences in outcome (DKD vs. NDKD) were compared. Clinical, biochemical and histopathological parameters were evaluated as possible predictors of composite renal outcome in DKD.</div></div><div><h3>Results</h3><div>91 subjects (72 DKD and 19 NDKD) were included for analysis. The hazard ratio (HR) for composite renal outcome was 0.27 (0.08–0.9) (p = 0.03) in favour of NDKD. Kaplan-Meier analysis demonstrated NDKD subjects had better composite renal outcome compared to DKD (log rank chi-square 6.69, p = 0.009). Degree of proteinuria and renal pathology society (RPS) class (III/IV) predicted worse outcome in those with DKD.</div></div><div><h3>Conclusions</h3><div>Composite renal outcomes in NDKD was better as compared to those with DKD. RPS class III/IV on histopathology and degree of proteinuria was associated with poorer composite renal outcome in patients with DKD.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103237"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123409","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}
Pub Date : 2025-04-01Epub Date: 2025-04-21DOI: 10.1016/j.dsx.2025.103228
Xiao Liu , Jitao Ling , Yifan Wu , Huilei Zhao , Yuzhe Hu , Zhiwei Yan , Wengen Zhu , Peng Yu , Jinfeng Wang , Yuling Zhang , Tommaso Bucci , Gregory Y.H. Lip
Introduction
Obesity is not a single diagnosis, and the association of ‘metabolically unhealthy’ obesity with cardiovascular disease is well-described. However, the relationship between metabolically healthy obesity (MHO) and atrial fibrillation (AF) is still debated.
Objective
Our objective is to investigate the association between MHO and the risk of AF.
Methods
A comprehensive search of databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library regarding longitudinal studies of MHO and risk of AF was performed. Random effects were used to pool the effect estimates.
Results
Nine cohort studies comprising 4,250,557 participants were included. The pooled results revealed that individuals with MHO were associated with a greater incidence of AF than those with a metabolically healthy normal weight (HR: 1.34, 95 % CI: 1.26 to 1.42) with moderate certainty according to the Grading of Recommendations Assessment, Development, and Evaluation assessment. Individuals with MHO were associated with a lower risk of AF compared with participants with metabolically unhealthy obesity (RR: 0.48, 95 % CI: 0.36 to 0.64). Individuals with MHO were not significantly associated with the risk of AF as compared to metabolically unhealthy normal weight (HR: 1.04, 95 % CI: 0.89 to 1.22).
Conclusion
MHO is associated with a greater incidence of AF, highlighting the importance of weight reduction in individuals without metabolic disorders in reducing the risk of AF.
{"title":"Association between metabolically healthy obesity and atrial fibrillation: A systematic review and meta-analysis of longitudinal studies","authors":"Xiao Liu , Jitao Ling , Yifan Wu , Huilei Zhao , Yuzhe Hu , Zhiwei Yan , Wengen Zhu , Peng Yu , Jinfeng Wang , Yuling Zhang , Tommaso Bucci , Gregory Y.H. Lip","doi":"10.1016/j.dsx.2025.103228","DOIUrl":"10.1016/j.dsx.2025.103228","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is not a single diagnosis, and the association of ‘metabolically unhealthy’ obesity with cardiovascular disease is well-described. However, the relationship between metabolically healthy obesity (MHO) and atrial fibrillation (AF) is still debated.</div></div><div><h3>Objective</h3><div>Our objective is to investigate the association between MHO and the risk of AF.</div></div><div><h3>Methods</h3><div>A comprehensive search of databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library regarding longitudinal studies of MHO and risk of AF was performed. Random effects were used to pool the effect estimates.</div></div><div><h3>Results</h3><div>Nine cohort studies comprising 4,250,557 participants were included. The pooled results revealed that individuals with MHO were associated with a greater incidence of AF than those with a metabolically healthy normal weight (HR: 1.34, 95 % CI: 1.26 to 1.42) with moderate certainty according to the Grading of Recommendations Assessment, Development, and Evaluation assessment. Individuals with MHO were associated with a lower risk of AF compared with participants with metabolically unhealthy obesity (RR: 0.48, 95 % CI: 0.36 to 0.64). Individuals with MHO were not significantly associated with the risk of AF as compared to metabolically unhealthy normal weight (HR: 1.04, 95 % CI: 0.89 to 1.22).</div></div><div><h3>Conclusion</h3><div>MHO is associated with a greater incidence of AF, highlighting the importance of weight reduction in individuals without metabolic disorders in reducing the risk of AF.</div></div><div><h3>Registration</h3><div>PROSPERO - registration number CRD42023432195.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103228"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882965","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}
Pub Date : 2025-04-01Epub Date: 2025-04-16DOI: 10.1016/j.dsx.2025.103226
Anoop Misra
{"title":"Rational application of weight loss therapies according to new obesity guidelines in Asian Indians: A perspective for low-income settings","authors":"Anoop Misra","doi":"10.1016/j.dsx.2025.103226","DOIUrl":"10.1016/j.dsx.2025.103226","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103226"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879142","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}
Pub Date : 2025-04-01Epub Date: 2025-05-13DOI: 10.1016/j.dsx.2025.103238
Ramona Di Stefano , Lorenzo V. Rindi , Valentina Baldini , Rodolfo Rossi , Francesca Pacitti , Emmanuele A. Jannini , Alessandro Rossi
Aims
Suicide is a global public health concern, accounting for nearly 700,000 deaths annually. Although well-established risk factors, including mental health disorders, are widely recognized, emerging concerns have surfaced regarding a potential association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the dual Gastric Inhibitory Polypeptide (GIP)/GLP-1 Receptor Agonist tirzepatide and suicidal behavior. This systematic review aims to synthesize the available evidence on the potential association between these drugs and suicidal behavior.
Methods
This review was conducted following PRISMA guidelines. A systematic search was performed in MEDLINE, Embase, and APA PsycInfo up to September 24, 2024, using terms related to GLP-1 RAs/GIP/GLP-1 RAs and suicidal behavior.Three independent reviewers conducted article screening and data extraction. Risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and ROB2 for RCTs.
Results
The review identified 16 studies published between 2017 and 2024, consisting of 5 observational studies, 2 randomized controlled trials, 8 pharmacovigilance analyses, and 1 post-hoc analysis of RCTs. No consistent evidence indicated an increased suicide risk among GLP-1 RA users. Pharmacovigilance analyses produced mixed findings; while some disproportionality analyses reported higher rates relative to other antihyperglycemic drugs, no causal link was confirmed. Cohort studies involving diabetic and obese populations generally did not demonstrate a significant increase in suicidal behavior.
Conclusions
Although current data do not warrant changes in prescribing practices, further research is needed before definitive conclusions can be drawn. Moreover, the generalizability and reliability of these findings should be interpreted in light of the methodological limitations of the included studies.
{"title":"Glucagon-Like Peptide-1 receptor agonists, dual GIP/GLP-1 receptor agonist tirzepatide and suicidal ideation and behavior: A systematic review of clinical studies and pharmacovigilance reports","authors":"Ramona Di Stefano , Lorenzo V. Rindi , Valentina Baldini , Rodolfo Rossi , Francesca Pacitti , Emmanuele A. Jannini , Alessandro Rossi","doi":"10.1016/j.dsx.2025.103238","DOIUrl":"10.1016/j.dsx.2025.103238","url":null,"abstract":"<div><h3>Aims</h3><div>Suicide is a global public health concern, accounting for nearly 700,000 deaths annually. Although well-established risk factors, including mental health disorders, are widely recognized, emerging concerns have surfaced regarding a potential association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the dual Gastric Inhibitory Polypeptide (GIP)/GLP-1 Receptor Agonist tirzepatide and suicidal behavior. This systematic review aims to synthesize the available evidence on the potential association between these drugs and suicidal behavior.</div></div><div><h3>Methods</h3><div>This review was conducted following PRISMA guidelines. A systematic search was performed in MEDLINE, Embase, and APA PsycInfo up to September 24, 2024, using terms related to GLP-1 RAs/GIP/GLP-1 RAs and suicidal behavior.Three independent reviewers conducted article screening and data extraction. Risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and ROB2 for RCTs.</div></div><div><h3>Results</h3><div>The review identified 16 studies published between 2017 and 2024, consisting of 5 observational studies, 2 randomized controlled trials, 8 pharmacovigilance analyses, and 1 post-hoc analysis of RCTs. No consistent evidence indicated an increased suicide risk among GLP-1 RA users. Pharmacovigilance analyses produced mixed findings; while some disproportionality analyses reported higher rates relative to other antihyperglycemic drugs, no causal link was confirmed. Cohort studies involving diabetic and obese populations generally did not demonstrate a significant increase in suicidal behavior.</div></div><div><h3>Conclusions</h3><div>Although current data do not warrant changes in prescribing practices, further research is needed before definitive conclusions can be drawn. Moreover, the generalizability and reliability of these findings should be interpreted in light of the methodological limitations of the included studies.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103238"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072478","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}
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