Journal of Diabetes Investigation最新文献_第5页

Association between glycated albumin and adverse outcomes in patients with heart failure 糖化白蛋白与心力衰竭患者不良预后之间的关系。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-07-05 DOI: 10.1111/jdi.14255

Senmiao Chen, Guanzhong Chen, Yu Jin, Shiyu Zhu, Liangliang Jia, Chengchen Zhao, Chunna Jin, Meixiang Xiang

Aims/Introduction

Diabetes mellitus is a traditional risk factor for heart failure (HF), and glycated albumin (GA) is a marker to assess short-term glycemic control. Whether GA has prognostic significance in patients with HF remains unclear.

Materials and Methods

A total of 717 patients with HF were enrolled in the prospective cohort study. Patients were grouped by the normal upper limit of GA (17%). Kaplan–Meier analysis and Cox proportional hazards regression were used to evaluate the association between GA and prognosis.

Results

During a mean follow-up of 387 days, 232 composite endpoint events of hospitalization for HF or all-cause death occurred. Kaplan–Meier analysis showed a higher rate of adverse events in the higher GA group (GA >17%; log-rank test P < 0.001). GA was an independent predictor of adverse events, both as a continuous variable (per 1% change: hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.00–1.06, P = 0.030) and as a categorical variable (GA >17%: HR 1.36, 95% CI 1.03–1.80, P = 0.032). Restricted cubic splines showed a linear association between GA and adverse events (P for non-linearity = 0.231). There was no significant difference in adverse outcome risk between those with diabetes and GA ≤17% and those without diabetes, whereas the prognosis was worse in those with diabetes and GA >17% (HR 1.56, 95% CI 1.16–2.11, P = 0.004). Compared to the group with normal levels of GA and glycated hemoglobin, the group with GA >17% and glycated hemoglobin >6.5% had a higher risk of adverse events (HR 1.49, 95% CI 1.06–2.10, P = 0.022).

Conclusions

GA was an independent predictor of HF prognosis. Combining GA and glycated hemoglobin might improve the predictive power of adverse outcomes in patients with HF.

目的/简介：糖尿病是心力衰竭（HF）的传统危险因素，糖化白蛋白（GA）是评估短期血糖控制的标志物。糖化白蛋白对心力衰竭患者的预后是否有意义仍不清楚：这项前瞻性队列研究共纳入了 717 名心房颤动患者。患者按GA的正常上限（17%）分组。采用卡普兰-梅耶分析和考克斯比例危险回归评估GA与预后之间的关系：结果：在平均 387 天的随访期间，发生了 232 起因心房颤动住院或全因死亡的复合终点事件。Kaplan-Meier分析显示，GA较高的组别不良事件发生率较高（GA>17%；log-rank检验P 17%：HR 1.36，95% CI 1.03-1.80，P = 0.032）。限制性三次样条显示 GA 与不良事件之间存在线性关系（非线性 P = 0.231）。GA≤17%的糖尿病患者与非糖尿病患者的不良后果风险无明显差异，而GA>17%的糖尿病患者预后较差（HR 1.56，95% CI 1.16-2.11，P = 0.004）。与GA和糖化血红蛋白水平正常的人群相比，GA>17%和糖化血红蛋白>6.5%的人群发生不良事件的风险更高（HR 1.49，95% CI 1.06-2.10，P = 0.022）：结论：GA是心房颤动预后的独立预测因子。结论：GA是预测HF预后的独立指标，将GA与糖化血红蛋白相结合可提高对HF患者不良预后的预测能力。

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引用次数: 0

Risk factors for chronic kidney disease progression over 20 years for primary prevention in Japanese individuals at a preventive medicine research center: Focus on the influence of plasma glucose levels 预防医学研究中心对日本人进行 20 年慢性肾病进展的风险因素进行初级预防：关注血浆葡萄糖水平的影响。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-07-02 DOI: 10.1111/jdi.14259

Kento Minami, Yukie Sakuma, Kaoru Ogawa, Koji Takemura, Haruo Takahashi, Takeshi Inoue, Yoshifumi Suzuki, Hidenori Takahashi, Haruhisa Shimura, Yasunori Sato, Saburo Watanabe, Shouji Yoshida, Jun Ogino, Naotake Hashimoto

Aims/Introduction

Chronic kidney disease (CKD) is a very important issue globally because of the risk of its progressing to end-stage renal disease. We aimed to identify factors contributing to long-term estimated glomerular filtration rate (eGFR) decline to determine an early diagnosis and prevent CKD progression.

Materials and Methods

From January 2003 to December 2006, 5,507 individuals underwent health checkups at our hospital's Preventive Medicine Research Center. We ultimately enrolled 2,175 individuals. The eGFR was ≥60 mL/min/1.73 m² at the start of observation period, which was 20 years. The event onset time was the day that the eGFR became <30 mL/min during the 20-year period. Baseline risk factors – in particular, the effect of plasma glucose levels on the eGFR – were extracted and evaluated by using Fine and Gray analysis.

Results

During the 20-year observation, the hazard ratio (HR) of CKD progression was examined. A fasting plasma glucose (FPG) level ≥105 mg/dL was significantly associated with the risk of CKD progressing to an eGFR <30 mL/min. This trend was similar in the slope of eGFR. An FPG ≥105 mg/dL or an glycated hemoglobin level ≥6.5% was useful for intervening in CKD progression. Multivariate analysis showed that independent risk factors were an FPG level ≥105 mg/dL (HR 1.9; P < 0.001), age ≥60 years (HR 3.86; P < 0.001), obesity (HR 1.61; P < 0.01) and urinary protein (HR 1.55; P < 0.01).

Conclusions

For early intervention against a reduction in the eGFR, detecting mild increases in FPG ≥105 mg/dL in patients with CKD with or without diabetes is useful.

目的/引言：慢性肾脏病（CKD）是全球范围内一个非常重要的问题，因为它有发展为终末期肾脏病的风险。我们旨在找出导致估计肾小球滤过率（eGFR）长期下降的因素，以确定早期诊断并预防 CKD 的发展：从 2003 年 1 月到 2006 年 12 月，共有 5507 人在我院预防医学研究中心接受了健康检查。我们最终招募了 2175 人。观察期开始时，eGFR≥60 mL/min/1.73 m2，观察期为20年。事件发生时间为 eGFR 出现结果的当天：在 20 年的观察期间，对 CKD 进展的危险比（HR）进行了研究。空腹血浆葡萄糖（FPG）水平≥105 mg/dL 与慢性肾功能衰竭进展为 eGFR 的风险显著相关：无论是否患有糖尿病，在 CKD 患者中检测出 FPG ≥105 mg/dL 的轻度升高对早期干预 eGFR 的降低都非常有用。

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引用次数: 0

A sneak peek into chronic glucose exposure and insulin secretion impairment through translatome 通过易位体窥探慢性葡萄糖暴露和胰岛素分泌损伤。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-07-01 DOI: 10.1111/jdi.14258

Grace Aprilia Helena, Shoen Kume

Diabetes is an epidemic caused by a multitude of factors. Despite the studies attempting to unravel its mechanism, there is still more to discover about glucose–insulin dynamics. In a recent issue of the Journal of Clinical Investigation, Cheruiyot et al. uncovered a translational regulatory circuit during β-cell glucose toxicity that inherently affects the translational makeup and protein expression in functioning β-cells.Journal of Clinical Investigation, Cheruiyot et al. uncovered a translational regulatory circuit during β-cell glucose toxicity that inherently affects the translational makeup and protein expression in functioning β-cells. Their multiomics approach might provide a deeper understanding of high glucose and translational regulation of genes involved in β-cell insulin impairment caused by prolonged high-glucose exposure.

糖尿病是一种由多种因素引起的流行病。尽管有很多研究试图揭示其机理，但关于葡萄糖-胰岛素的动力学仍有更多的发现。在最近一期《临床研究杂志》（Journal of Clinical Investigation）上，Cheruiyot 等人发现了β细胞葡萄糖毒性过程中的翻译调控回路，它本质上影响着功能正常的β细胞的翻译组成和蛋白质表达。他们的多组学方法可能会让人们更深入地了解高葡萄糖以及长期暴露于高葡萄糖导致的β细胞胰岛素损伤所涉及基因的翻译调控。

引用次数: 0

Regulatory T cells protect against diabetic cardiomyopathy in db/db mice 调节性 T 细胞可保护 db/db 小鼠免受糖尿病心肌病的侵害。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-29 DOI: 10.1111/jdi.14251

Kai Zhang, Yunyi Li, Xiao Ge, Linlin Meng, Jing Kong, Xiao Meng

Aims/Introduction

Regulatory T cells (Tregs) have protected against many cardiovascular diseases. This study was intended to explore the effect of Tregs on diabetic cardiomyopathy (DCM) using a db/db mouse model.

Materials and methods

Eight-week-old male db/db mice were randomly divided into four groups: the control group, administered 200 μL phosphate-buffered saline; the small-dose Treg group, administered 10⁵ Tregs; the large-dose Treg group, administered 10⁶ Tregs; and the PC group, administered 100 μg anti-CD25 specific antibody (PC61) and 10⁶ Tregs. After 12 weeks, mice were euthanized. Transthoracic echocardiography was carried out at the beginning and end of the experiment. Relevant basic experiments to evaluate the effects of Tregs on DCM were carried out.

Results

Echocardiography showed that the impaired diastolic and systolic functions were significantly improved in mice administered large-dose Tregs. Large-dose Tregs significantly ameliorated myocardial hypertrophy and fibrosis, and decreased hypertrophic gene expression and collagen deposition. The protective effects of Tregs on diabetic hearts were associated with decreased oxidative stress, inflammatory response and apoptosis. In addition, Tregs promoted the activation of the phosphatidylinositol 3-kinase–protein kinase B signaling pathway, whereas they inhibited extracellular signal-regulated kinase 1/2 and Jun N-terminal kinase phosphorylation, which might be responsible for the cardioprotective role of Tregs against DCM.

Conclusions

Tregs ameliorated myocardial hypertrophy and fibrosis, improved cardiac dysfunction, and protected against DCM progression in db/db mice. The mechanisms involved a decrease of inflammatory response, oxidative stress and apoptosis, which might be mediated by phosphatidylinositol 3-kinase–protein kinase B and mitogen-activated protein kinase pathways. Hence, Tregs might serve as a promising therapeutic approach for DCM treatment.

目的/引言：调节性 T 细胞（Tregs）可预防多种心血管疾病。本研究旨在利用 db/db 小鼠模型探讨 Tregs 对糖尿病心肌病（DCM）的影响：将八周大的雄性 db/db 小鼠随机分为四组：对照组，给予 200 μL 磷酸盐缓冲盐水；小剂量 Treg 组，给予 105 个 Tregs；大剂量 Treg 组，给予 106 个 Tregs；PC 组，给予 100 μg 抗 CD25 特异性抗体（PC61）和 106 个 Tregs。12 周后，小鼠被安乐死。在实验开始和结束时进行经胸超声心动图检查。进行了相关的基础实验，以评估 Tregs 对 DCM 的影响：结果：超声心动图显示，服用大剂量 Tregs 的小鼠的舒张和收缩功能明显改善。大剂量 Tregs 能明显改善心肌肥厚和纤维化，减少肥厚基因表达和胶原沉积。Tregs 对糖尿病心脏的保护作用与氧化应激、炎症反应和细胞凋亡的减少有关。此外，Tregs促进了磷脂酰肌醇3-激酶-蛋白激酶B信号通路的激活，而抑制了细胞外信号调节激酶1/2和Jun N-末端激酶的磷酸化，这可能是Tregs对DCM的心脏保护作用的原因：结论：Tregs能改善db/db小鼠的心肌肥厚和纤维化，改善心功能不全，防止DCM恶化。其机制包括减少炎症反应、氧化应激和细胞凋亡，这可能是由磷脂酰肌醇3-激酶-蛋白激酶B和丝裂原活化蛋白激酶途径介导的。因此，Tregs可能是治疗DCM的一种有前途的治疗方法。

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引用次数: 0

A real-world disproportionality analysis of semaglutide: Post-marketing pharmacovigilance data 对塞马鲁肽的真实世界比例失调分析：上市后药物警戒数据。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-29 DOI: 10.1111/jdi.14229

Yikuan Du, Mengting Zhang, Zhenjie Wang, Mianda Hu, Dongxia Xie, Xiuzhu Wang, Zhuoming Guo, Jinfeng Zhu, Weichui Zhang, Ziyi Luo, Chun Yang

Aim/Introduction

The recent adverse reactions associated with semaglutide have led the Food and Drug Administration (FDA) to issue a “black box warning”, and it is necessary to analyze all reports of adverse reactions to improve the safety of its clinical use.

Materials and Methods

Statistical analyses and signal mining were performed by obtaining the adverse event reports related to semaglutide in the FAERS database from the first quarter of 2018 to the fourth quarter of 2023. We used disproportionality and Bayesian analysis to examine clinical and demographic attributes, trends reported quarterly, and contrasts between two distinct indications (obesity and type 2 diabetes).

Results

We found 10 unexpected adverse signals related to “pancreatic cancer”, “intestinal obstruction”, “cholecystitis”, and “polycystic ovary” and both the two different indications had the same serious adverse reaction events occurring.

Conclusions

This study identified many unexpected signals of serious adverse reactions, suggesting the importance of continuous post-marketing surveillance of semaglutide to understand its potential risks.

目的/引言：近期与舍马鲁肽相关的不良反应导致美国食品药品管理局（FDA）发布了 "黑框警告"，因此有必要对所有不良反应报告进行分析，以提高其临床使用的安全性：通过获取2018年第一季度至2023年第四季度FAERS数据库中与semaglutide相关的不良事件报告，进行统计分析和信号挖掘。我们使用了不对称和贝叶斯分析法来研究临床和人口学属性、季度报告趋势以及两种不同适应症（肥胖症和 2 型糖尿病）之间的对比：我们发现了与 "胰腺癌"、"肠梗阻"、"胆囊炎 "和 "多囊卵巢 "有关的 10 个意外不良信号，而且这两种不同适应症都发生了相同的严重不良反应事件：本研究发现了许多意想不到的严重不良反应信号，表明对塞马鲁肽上市后进行持续监测以了解其潜在风险的重要性。

{"title":"A real-world disproportionality analysis of semaglutide: Post-marketing pharmacovigilance data","authors":"Yikuan Du, Mengting Zhang, Zhenjie Wang, Mianda Hu, Dongxia Xie, Xiuzhu Wang, Zhuoming Guo, Jinfeng Zhu, Weichui Zhang, Ziyi Luo, Chun Yang","doi":"10.1111/jdi.14229","DOIUrl":"10.1111/jdi.14229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim/Introduction</h3>\u0000 \u0000 <p>The recent adverse reactions associated with semaglutide have led the Food and Drug Administration (FDA) to issue a “black box warning”, and it is necessary to analyze all reports of adverse reactions to improve the safety of its clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Statistical analyses and signal mining were performed by obtaining the adverse event reports related to semaglutide in the FAERS database from the first quarter of 2018 to the fourth quarter of 2023. We used disproportionality and Bayesian analysis to examine clinical and demographic attributes, trends reported quarterly, and contrasts between two distinct indications (obesity and type 2 diabetes).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found 10 unexpected adverse signals related to “pancreatic cancer”, “intestinal obstruction”, “cholecystitis”, and “polycystic ovary” and both the two different indications had the same serious adverse reaction events occurring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified many unexpected signals of serious adverse reactions, suggesting the importance of continuous post-marketing surveillance of semaglutide to understand its potential risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141464659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship between circulating thrombospondin-1 messenger ribonucleic acid and microribonucleic acid-194 levels in Chinese patients with type 2 diabetic kidney disease: The outcomes of a case–control study 中国 2 型糖尿病肾病患者循环血栓蛋白-1 信使核糖核酸与微核糖核酸-194 水平之间的关系：一项病例对照研究的结果。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-26 DOI: 10.1111/jdi.14252

Ning Ma, Weiwei Liu, Ning Xu, Dong Yin, Ping Zheng, Guofeng Wang, Yuan Hui, Jiping Zhang, Guanjun Han, Chuanhui Yang, Yan Lu, Xingbo Cheng

Aims/Introduction

We investigated the relationship of circulating TSP-1 mRNA and miR-194 with diabetic kidney disease’s degree.

Materials and Methods

We enrolled 167 hospitalized type 2 diabetes patients in the endocrinology department. Patients were split into three groups according to urinary microalbumin: A, B and C. The control group comprised healthy outpatients (n = 163). The quantities of microribonucleic acid (miR)-194 and thrombospondin-1 (TSP-1) messenger ribonucleic acid (mRNA) in the participants’ circulation were measured using a quantitative real-time polymerase chain reaction.

Results

Circulating TSP-1 mRNA (P = 0.024) and miR-194 (P = 0.029) expressions significantly increased in type 2 diabetes patients. Circulating TSP-1 mRNA (P = 0.040) and miR-194 (P = 0.007) expression levels differed significantly among the three groups; circulating TSP-1 mRNA expression increased with urinary microalbumin. However, miR-194 declined in group B and increased in group C. Circulating TSP-1 mRNA was positively correlated with cystatin-c (r = 0.281; P = 0.021) and microalbumin/creatinine ratio (UmALB/Cr; r = 0.317; P = 0.009); miR-194 was positively correlated with UmALB/Cr (r = 0.405; P = 0.003). Stepwise multivariate linear regression analysis showed cystatin-c (β = 0.578; P = 0.021) and UmALB/Cr (β = 0.001; P = 0.009) as independent factors for TSP-1 mRNA; UmALB/Cr (β = 0.005; P = 0.028) as an independent factor for miR194. Areas under the curve for circulating TSP-1 mRNA and miR194 were 0.756 (95% confidence interval 0.620–0.893; sensitivity 0.69 and specificity 0.71, P < 0.01) and 0.584 (95% confidence interval 0.421–0.748; sensitivity 0.54 and specificity 0.52, P < 0.01), respectively.

Conclusions

Circulating TSP-1 mRNA and miR-194 expressions significantly increased in type 2 diabetes patients. The microalbumin group had lower levels of miR-194 (a risk factor that is valuable for type 2 diabetes kidney disease evaluation).

目的/简介：研究循环中TSP-1 mRNA和miR-194与糖尿病肾病程度的关系：我们在内分泌科登记了 167 名住院的 2 型糖尿病患者。根据尿微量白蛋白将患者分为 A、B 和 C 三组：对照组包括健康的门诊患者（n = 163）。采用定量实时聚合酶链反应法测定了参与者血液循环中的微核糖核酸（miR）-194和血栓软蛋白-1（TSP-1）信使核糖核酸（mRNA）的数量：结果：2 型糖尿病患者循环中的 TSP-1 mRNA（P = 0.024）和 miR-194（P = 0.029）表达量显著增加。循环 TSP-1 mRNA (P = 0.040) 和 miR-194 (P = 0.007) 的表达水平在三组中差异显著；循环 TSP-1 mRNA 的表达随尿微量白蛋白的增加而增加。但 miR-194 在 B 组下降，在 C 组上升。循环 TSP-1 mRNA 与胱抑素-c（r = 0.281；P = 0.021）和微量白蛋白/肌酐比值（UmALB/Cr；r = 0.317；P = 0.009）呈正相关；miR-194 与 UmALB/Cr 呈正相关（r = 0.405；P = 0.003）。逐步多变量线性回归分析显示，胱抑素-c（β = 0.578；P = 0.021）和UmALB/Cr（β = 0.001；P = 0.009）是影响TSP-1 mRNA的独立因素；UmALB/Cr（β = 0.005；P = 0.028）是影响miR194的独立因素。循环 TSP-1 mRNA 和 miR194 的曲线下面积为 0.756（95% 置信区间为 0.620-0.893；灵敏度为 0.69，特异性为 0.71，P2型糖尿病患者的循环TSP-1 mRNA和miR-194表达量明显增加。微量白蛋白组的 miR-194 水平较低（这是一个对 2 型糖尿病肾病评估有价值的风险因素）。

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引用次数: 0

Diminished levels of insulin-like growth factor-1 may be a risk factor for peripheral neuropathy in type 2 diabetes patients 胰岛素样生长因子-1 水平的降低可能是 2 型糖尿病患者发生周围神经病变的风险因素。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-24 DOI: 10.1111/jdi.14260

Jingyi Zhong, Xiaopu Lin, Xiaobin Zheng, Yanting Zhou, Haishan Huang, Lingling Xu

Aims/Introduction

To investigate risk factors for diabetic peripheral neuropathy (DPN) and to explore the connection between insulin-like growth factor-1 (IGF-1) and DPN in individuals with type 2 diabetes.

Materials and Methods

A total of 790 patients with type 2 diabetes participated in a cross-sectional study, divided into two groups: those with DPN (DPN) and those without DPN (non-DPN). Blood samples were taken to measure IGF-1 levels and other biochemical markers. Participants underwent nerve conduction studies and quantitative sensory testing.

Results

Patients with DPN exhibited significantly lower levels of IGF-1 compared with non-DPN patients (P < 0.001). IGF-1 was positively correlated with the average amplitude of both motor (P < 0.05) and sensory nerves (P < 0.05), but negatively correlated with the vibration perception threshold (P < 0.05). No significant difference was observed between IGF-1 and nerve conduction velocity (P > 0.05), or the temperature detection threshold (P > 0.05). Multivariate regression analysis identified diabetes duration, HbA_1c, and the low levels of IGF-1 as independent risk factors (P < 0.001). Receiver operating characteristic analysis determined that at 8 years duration of diabetes, 8.5% (69.4 mmol/mol) HbA_1c and 120 ng/mL IGF-1, the optimal cut-off points, indicated DPN (P < 0.001).

Conclusions

A reduction of IGF-1 in patients with DPN suggests a potential protective role against axon injury in large fiber nerves of type 2 diabetes patients.

目的/简介：研究2型糖尿病患者发生糖尿病周围神经病变（DPN）的风险因素，并探讨胰岛素样生长因子-1（IGF-1）与DPN之间的联系：共有 790 名 2 型糖尿病患者参加了横断面研究，分为两组：DPN 患者（DPN）和无 DPN 患者（非 DPN）。研究人员采集了血液样本，以测量 IGF-1 水平和其他生化指标。参与者接受了神经传导研究和定量感觉测试：结果：与非 DPN 患者相比，DPN 患者的 IGF-1 水平明显较低（P 0.05），温度检测阈值也明显较低（P > 0.05）。多变量回归分析发现，糖尿病病程、HbA1c 和低水平 IGF-1 是独立的风险因素（P 1c 和 120 纳克/毫升 IGF-1 是最佳临界点，表明存在 DPN（P 结论：DPN 患者的 IGF-1 水平降低，可能与糖尿病病程、HbA1c 和 IGF-1 水平有关：DPN患者体内IGF-1的降低表明，IGF-1对2型糖尿病患者的大纤维神经轴突损伤具有潜在的保护作用。

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引用次数: 0

Effect of intermittent fasting 16:8 and 14:10 compared with control-group on weight reduction and metabolic outcomes in obesity with type 2 diabetes patients: A randomized controlled trial 间歇性禁食 16:8 和 14:10 与对照组相比对肥胖 2 型糖尿病患者减轻体重和代谢结果的影响：随机对照试验。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-24 DOI: 10.1111/jdi.14186

Naparat Sukkriang, Supawan Buranapin

Aims/Introduction

To compare the percent weight change and metabolic outcomes among diabetic participants with obesity on intermittent fasting (IF) 16:8, IF 14:10, or normal controlled diets.

Materials and Methods

A randomized controlled trial was conducted to randomize participants into three groups. Each group followed IF 16:8, IF 14:10, according to the protocol 3 days/week for 3 months or a control group.

Results

A total of 99 participants completed the study. The percentage weight change from baseline was −4.02% (95% CI, −4.40 to −3.64) in IF 16:8, −3.15% (95% CI, −3.41 to −2.89) in IF 14:10, and −0.55% (95% CI, −1.05 to −0.05) in the control group. The percentage weight loss from baseline was significantly more in both IF groups (P < 0.001, both) when compared with the control group. Weight loss was significantly more in the IF 16:8 group than in that of the IF 14:10 group (P < 0.001). Metabolic outcomes (decrease in FBS and HbA1C, and improvement in lipid profiles) were significantly improved from baseline in both IF groups in comparison with the control group.

Conclusions

Either IF 16:8 or 14:10 had a benefit in the percentage weight change, glucose and lipid profiles in obese diabetic patients compared with the control group when consumed for 3 days a week for 3 months.

目的/简介：比较间歇性禁食（IF）16:8、IF 14:10或正常控制饮食的糖尿病肥胖症参与者的体重变化百分比和代谢结果：随机对照试验将参与者随机分为三组。结果：共有 99 名参与者完成了研究：结果：共有 99 人完成了研究。与基线相比，中频 16:8 组的体重变化百分比为-4.02%（95% CI，-4.40 至-3.64），中频 14:10 组为-3.15%（95% CI，-3.41 至-2.89），对照组为-0.55%（95% CI，-1.05 至-0.05）。IF 组和对照组的体重从基线下降的百分比都明显高于 IF 组（P 结论：IF 16:8 和 IF 14:10 组的体重从基线下降的百分比都高于对照组）：与对照组相比，每周食用 3 天 IF 16:8 或 14:10 3 个月后，肥胖糖尿病患者的体重变化百分比、血糖和血脂状况均有所改善。

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引用次数: 0

External validation of the Hong Kong Chinese non-laboratory risk models and scoring algorithm for case finding of prediabetes and diabetes mellitus in primary care 香港中文非实验室风险模型和评分算法的外部验证，用于在基层医疗中发现糖尿病前期和糖尿病病例

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-21 DOI: 10.1111/jdi.14256

Will HG Cheng, Weinan Dong, Emily TY Tse, Carlos KH Wong, Weng Y Chin, Laura E Bedford, Daniel YT Fong, Welchie WK Ko, David VK Chao, Kathryn CB Tan, Cindy LK Lam

Aims/Introduction

Two Hong Kong Chinese non-laboratory-based prediabetes/diabetes mellitus (pre-DM/DM) risk models were developed using logistic regression (LR) and machine learning, respectively. We aimed to evaluate the models' validity in case finding of pre-DM/DM in a Chinese primary care (PC) population. We also evaluated the validity of a risk-scoring algorithm derived from the LR model.

Materials and Methods

This was a cross-sectional external validation study on Chinese adults, without a prior DM diagnosis, who were recruited from public/private PC clinics in Hong Kong. A total of 1,237 participants completed a questionnaire on the models' predictors. Of that, 919 underwent blood glucose testing. The primary outcome was the models' and the algorithm's sensitivity in finding pre-DM/DM cases. The secondary outcomes were the models' and the algorithm's specificity, positive/negative predictive values, discrimination and calibration.

Results

The models' sensitivity were 0.70 (machine learning) and 0.72 (LR). Both showed good external discrimination (area under the receiver operating characteristic curve: machine learning 0.744, LR 0.739). The risks estimated by the models were lower than the observed incidence, indicating poor calibration. Both models were more effective among participants with lower pretest probabilities; that is, age 18–44 years. The algorithm's sensitivity was 0.77 at the cut-off score of ≥16 out of 41.

Conclusion

This study showed the validity of the models and the algorithm for finding pre-DM/DM cases in a Chinese PC population in Hong Kong. They can facilitate more cost-effective identification of high-risk individuals for blood testing to diagnose pre-DM/DM in PC. Further studies should recalibrate the models for more precise risk estimation in PC populations.

目的/简介我们采用逻辑回归（LR）和机器学习方法分别建立了两个香港中文非实验室糖尿病前期/糖尿病（Pre-DM/DM）风险模型。我们的目的是评估这些模型在中国初级保健（PC）人群中发现糖尿病前期/糖尿病（DM/DM）病例时的有效性。材料与方法这是一项横断面外部验证研究，研究对象是在香港公立/私立 PC 诊所招募的未曾确诊为 DM 的中国成年人。共有 1,237 名参与者填写了关于模型预测因素的问卷。其中 919 人接受了血糖检测。主要结果是模型和算法在发现糖尿病前期/糖尿病病例方面的灵敏度。次要结果是模型和算法的特异性、阳性/阴性预测值、区分度和校准。两者都显示出良好的外部判别能力（接收器工作特征曲线下面积：机器学习 0.744，LR 0.739）。模型估计的风险低于观察到的发病率，表明校准效果不佳。这两种模型对检测前概率较低的参与者（即年龄在 18-44 岁之间）更有效。结论本研究表明，在香港的华裔 PC 人口中发现 DM/DM 前病例的模型和算法是有效的。它们有助于以更具成本效益的方式确定高危人群进行血液检测，以诊断 PC 中的 DM/DM 前期病例。进一步的研究应重新校准模型，以便更精确地估计 PC 群体的风险。

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引用次数: 0

Sodium–glucose cotransporter 2 inhibitor therapy reduces the administration frequency of steroid injection in patients with diabetic macular edema: A cohort study using the Japanese health insurance claims database 钠-葡萄糖共转运体 2 抑制剂可减少糖尿病黄斑水肿患者注射类固醇的次数：利用日本健康保险索赔数据库进行的一项队列研究。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-06-14 DOI: 10.1111/jdi.14253

Ryoichi Ishibashi, Masaya Koshizaka, Yoko Takatsuna, Tomoaki Tatsumi, Yoshiro Maezawa, Yuki Shiko, Yosuke Inaba, Yohei Kawasaki, Yusuke Kashiwagi, Eiryo Kawakami, Shuichi Yamamoto, Koutaro Yokote

Aims/Introduction

Severe diabetic macular edema (DME) is often resistant to anti-vascular endothelial growth factor therapy. Steroids are particularly effective at reducing edema by suppressing inflammation; they are also used as an alternative to expensive anti-vascular endothelial growth factor therapy in some patients. Therefore, the use of steroids in DME reflects an unmet need for anti-vascular endothelial growth factor therapy. Notably, triamcinolone acetonide (TA) injections are widely used in Japan. Here, we evaluated the frequency of TA as an indicator of the efficacy of sodium–glucose cotransporter 2 inhibitors (SGLT2is) in DME treatment using a health insurance claims database.

Materials and Methods

In this cohort study, we retrospectively analyzed the health insurance claims data of 11 million Japanese individuals from 2005 to 2019. The frequency and duration of TA injection after the initiation of SGLT2is or other antidiabetic drugs were analyzed.

Results

Among the 2,412 matched patients with DME, the incidence rate of TA injection was 63.8 times per 1,000 person-years in SGLT2i users and 94.9 times per 1,000 person-years in non-users. SGLT2is reduced the risk for the first (P = 0.0024, hazard ratio 0.66, 95% confidence interval 0.50–0.87), second (P = 0.0019, hazard ratio 0.53, 95% confidence interval 0.35–0.80) and third TA (P = 0.0053, hazard ratio 0.44, 95% confidence interval 0.25–0.80) injections. A subanalysis of each baseline characteristic of the patients showed that SGLT2is were effective regardless of the background factors.

Conclusions

The use of SGLT2is reduced the frequency of TA injection in patients with DME. Therefore, SGLT2i therapy might be a novel, noninvasive and low-cost adjunctive therapy for DME.

目的/引言：严重的糖尿病黄斑水肿（DME）常常对抗血管内皮生长因子疗法产生抗药性。类固醇通过抑制炎症来减轻水肿，效果尤为显著；在一些患者中，类固醇还可替代昂贵的抗血管内皮生长因子疗法。因此，类固醇在 DME 中的使用反映出抗血管内皮生长因子疗法的需求尚未得到满足。值得注意的是，曲安奈德（TA）注射剂在日本被广泛使用。在此，我们利用医疗保险理赔数据库评估了作为钠-葡萄糖共转运体 2 抑制剂（SGLT2is）在 DME 治疗中疗效指标的 TA 使用频率：在这项队列研究中，我们回顾性分析了 2005 年至 2019 年期间 1100 万日本人的健康保险理赔数据。分析了开始使用 SGLT2is 或其他抗糖尿病药物后注射 TA 的频率和持续时间：结果：在 2412 名匹配的 DME 患者中，SGLT2i 使用者的 TA 注射发生率为每千人年 63.8 次，而非使用者为每千人年 94.9 次。SGLT2i 可降低首次（P = 0.0024，危险比 0.66，95% 置信区间 0.50-0.87）、第二次（P = 0.0019，危险比 0.53，95% 置信区间 0.35-0.80）和第三次 TA 注射（P = 0.0053，危险比 0.44，95% 置信区间 0.25-0.80）的风险。对患者各项基线特征的子分析表明，无论背景因素如何，SGLT2 均有效：结论：使用SGLT2i可减少DME患者注射TA的频率。因此，SGLT2i疗法可能是一种新型、无创、低成本的DME辅助疗法。

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引用次数: 0