American Journal of the Medical Sciences最新文献

In untreated non-diabetic subjects, obesity is accompanied by greater associations of blood viscosity with glucose and oxidative metabolism 在未经治疗的非糖尿病受试者中，肥胖伴随着血液粘度与葡萄糖和氧化代谢的更大关联。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.09.006

Fumihiro Tomoda M.D., Ph.D. , Hiroko Kurosaki M.D., Ph.D. , Hiroko Sugimori M.D., Ph.D. , Tsutomu Koike M.D., Ph.D. , Maiko Ohara M.D., Ph.D. , Atsumi Nitta Ph.D. , Koichiro Kinugawa M.D., Ph.D.

Background

The influences of blood viscosity on metabolism and the peripheral circulation have not been fully explored in obesity. We evaluated the impact of obesity on the associations of blood viscosity with those two systems in non-diabetic subjects.

Methods

In 119 obese and 163 non-obese non-diabetic subjects, blood viscosity was measured using a falling-ball microviscometer. Homeostasis model assessment of insulin resistance (HOMA-IR) and blood lactate were also determined as indices for insulin resistance and anaerobic metabolism, respectively.

Results

Blood viscosity was significantly greater in the obese group than in the non-obese group (4.25±0.46 versus 4.14±0.44 mPa·S, p = 0.032). Blood viscosity was independently positively associated with log HOMA-IR and log blood lactate in the obese group, but not in the non-obese group. In all subjects, the body mass index status (i.e., non-obese or obese = 0 or 1) × blood viscosity interaction was significantly associated with log HOMA-IR and log blood lactate (partial r = 0.130, p = 0.029 and partial r = 0.173, p = 0.013). Thus, greater influences of blood viscosity on glucose and oxidative metabolism were observed in the obese group than the non-obese group. However, only approximately 9 to 11 % of the variance in blood viscosity was attributable to differences in log HOMA-IR or log blood lactate in the obese group. Contrastingly, blood viscosity did not relate with blood pressure in either group.

Conclusions

In non-diabetic obesity, blood viscosity elevates, and such hemorheological change could at least partially contribute to the aggravations of insulin resistance and anaerobic metabolism.

背景：血液黏稠度对肥胖患者代谢和外周循环的影响尚未得到充分探讨。我们评估了肥胖对非糖尿病受试者血液粘度与这两个系统的关联的影响。方法：对119例肥胖患者和163例非肥胖非糖尿病患者采用落球式微粘度计测定血液粘度。胰岛素抵抗的稳态模型评估（HOMA-IR）和血乳酸分别作为胰岛素抵抗和无氧代谢的指标。结果：肥胖组血黏度明显高于非肥胖组（4.25±0.46比4.14±0.44 mPa·S, p= 0.032）。在肥胖组中，血液粘度与对数HOMA-IR和对数血乳酸呈独立正相关，但在非肥胖组中没有。在所有受试者中，身体质量指数状态（即非肥胖或肥胖 = 0或1） × 血液粘度相互作用与对数HOMA-IR和对数血乳酸显著相关（偏r= 0.130, p= 0.029，偏r= 0.173, p= 0.013）。因此，肥胖组的血液粘度对葡萄糖和氧化代谢的影响大于非肥胖组。然而，在肥胖组中，只有大约9%到11%的血液粘度差异可归因于对数HOMA-IR或对数血乳酸的差异。相比之下，两组的血液粘度与血压无关。结论：在非糖尿病性肥胖中，血液黏度升高，这种血液流变学变化至少部分导致胰岛素抵抗和无氧代谢的加重。

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引用次数: 0

Cumulative burden of non-medical drivers of health and their associations with hospital utilization 非医疗健康驱动因素累积负担及其与医院利用的关系

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.014

Jemima C. John Ph.D , Mallika Mathur Ph.D , Shreela V. Sharma Ph.D , Winston Liaw MD , Angela L. Stotts Ph.D , Thomas F. Northrup Ph.D , Thomas J. Murphy MD

Background

Vulnerable populations experience multiple adverse non-medical drivers of health (NMDOH) that contribute to poorer health outcomes and increased healthcare utilization. This cross-sectional study examined the associations between NMDOH and hospital-based outcomes in a 2018 Medical Legal Partnership pilot study.

Methods

Composite scores generated for socio-economic and housing-environmental conditions were categorized to reflect the cumulative burden of unmet needs. Logistic regression models examined associations between these scores and the number of ED visits (≥3 visits in the past year) and Hospital stays (≥2 days in the past year), controlling for age, sex, race, and income.

Results

In this sample of 174 participants (mean age=52.5 years; 68.2 % female; 55 % Black, 28 % Hispanic; and average monthly income =$1,196), 74 % were food insecure, 68.3 % had ≥2 social and economic needs, and 47.6 % reported >1 housing-environmental concern. There were significantly greater odds of ≥3 ED visits (AOR: 7.3; P = 0.003) and similarly greater odds of a Hospital stay of ≥2 days. (AOR: 5.6; P = 0.032) among those with ≥4 vs. <4 personal SDOH needs.

Conclusions

Having ≥4 social and economic conditions was strongly associated with poor hospital-related outcomes, indicating the need for a strong response and targeting of the NMDOH that impact healthcare utilization outcomes.

背景：弱势群体经历多种不利的非医疗健康驱动因素（NMDOH），导致较差的健康结果和增加的医疗保健利用。这项横断面研究在2018年的一项医疗-法律伙伴关系试点研究中研究了NMDOH与医院结果之间的关系。方法：对社会经济和住房环境条件产生的综合得分进行分类，以反映未满足需求的累积负担。Logistic回归模型检验了这些分数与急诊科就诊次数（过去一年≥3次）和住院时间（过去一年≥2天）之间的关系，控制了年龄、性别、种族和收入。结果：在174名参与者（平均年龄为52.5岁，68.2%为女性，55%为黑人，28%为西班牙裔，平均月收入为1196美元）的样本中，74%的人粮食不安全，68.3%的人有≥2个社会和经济需求，47.6%的人报告有1个住房环境问题。就诊≥3次ED的几率显著增加（AOR: 7.3； P=0.003），住院≥2天的几率也显著增加。（AOR: 5.6； P=0.032）结论：拥有≥4个社会和经济条件与较差的医院相关结果密切相关，表明需要对影响医疗保健利用结果的NMDOH作出强有力的反应和目标。

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引用次数: 0

Causal association between matrix metalloproteinases and gout: A two-sample mendelian randomization study 基质金属蛋白酶与痛风之间的因果关系：一项双样本孟德尔随机研究。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.006

Da-Wei Chen MD , Gaohua Hu MD , Li Mao MS , Guoying Wang MS , Yu Tian MS , Jinxing He MS , Shenyu Qian MS , Wenyu Yang MS , Yinshuang Zheng MS , Lijin Lin MD , Wei Pei MD

Background

Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of gout. However, the causal nature of their associations remains unclear. This study aimed to evaluate the potential causal effects of MMPs on gout.

Methods

The study was performed using two-sample Mendelian randomization (MR) analyses with publicly available genome-wide association study (GWAS) summary statistics of ten MMP types and gout. Four complementary MR methods were employed, with Inverse-variance weighted (IVW) analysis as the primary approach, supplemented by MR-Egger, weighted median, and weighted mode. The robustness of the causal estimates was further evaluated through sensitivity analyses, including MR-Egger intercept, Cochran’s Q test, leave-one-out (LOO) analysis, and the MR pleiotropy residual sum and outlier (MR-PRESSO) test.

Results

Genetically predicted MMPs showed no evidence of a causal effect on gout. In particular, previously reported candidates such as MMP3 and MMP9 demonstrated no significant associations (MMP3: OR = 0.993, 95 % CI: 0.955 - 1.033, P = 0.739; MMP9: OR = 0.974, 95 %CI: 0.928 - 1.022, P = 0.278). Results from MR-Egger, weighted median, and weight mode analyses were consistent with those of IVW. No substantial heterogeneity or horizontal pleiotropy was observed across analyses.

Conclusions

This two-sample MR study provides no evidence supporting a causal relationship between MMPs and gout. Further research is warranted to clarify their potential roles and underlying biological mechanisms.

背景：基质金属蛋白酶（MMPs）与痛风的发病机制有关。然而，它们之间的因果关系尚不清楚。本研究旨在评估MMPs对痛风的潜在因果影响。方法：采用两样本孟德尔随机化（MR）分析和公开的全基因组关联研究（GWAS）汇总统计数据，对10种MMP类型和痛风进行研究。采用4种互补的MR方法，以逆方差加权（IVW）分析为主要方法，MR- egger、加权中位数和加权模式为辅助方法。通过敏感性分析进一步评估因果估计的稳健性，包括MR- egger截距、Cochran’s Q检验、留一分析（LOO）和MR多效性残差和异常值（MR- presso）检验。结果：基因预测的MMPs没有证据表明痛风有因果关系。特别是，先前报道的候选基因如MMP3和MMP9没有显著相关性（MMP3: OR = 0.993,95% CI: 0.955 - 1.033, P = 0.739;MMP9: OR = 0.974,95% CI: 0.928 - 1.022, P = 0.278）。MR-Egger、加权中位数和权重模式分析的结果与IVW一致。在分析中没有观察到实质性的异质性或水平多效性。结论：这项双样本MR研究没有提供证据支持MMPs和痛风之间的因果关系。需要进一步的研究来阐明它们的潜在作用和潜在的生物学机制。

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引用次数: 0

The effects of lifestyle factors on primary biliary cholangitis ascertained by two-sample Mendelian randomization 双样本孟德尔随机化确定生活方式因素对原发性胆道性胆管炎的影响。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.004

Gang Shen MD , Hengchang Sun PhD , Xiaoling Guan BS , Yaqiong Chen MD , Lin Wang BS , Xinhua Li MD , Jiao Gong PhD , Bo Hu MD

Background

Primary biliary cholangitis (PBC) is a chronic liver disease leading to irreversible cirrhosis and liver failure. This study aims to evaluate the relationships between genetically predicted nine lifestyle factors and PBC by Mendelian randomization (MR).

Methods

Genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with specific lifestyle factors, employing a stringent significance threshold of P-value< 5 × 10^–8 and linkage disequilibrium [LD] r² <0.01 with a clumping distance cutoff of 5000 kb. Subsequently, univariable and multivariable MR analyses were conducted, where the inverse variance weighted (IVW) method was considered as the primary analytical approach and then followed by sensitivity analysis.

Results

Non-oily fish intake was causally associated with an increased risk of PBC, with an odds ratio (OR) of 578 (95% confidence interval (CI) 24.17–1.39 × 10⁴). Conversely, the intake of oily fish did not demonstrate a significant decrease in the risk of PBC (P > 0.05). There were suggestive associations observed between bread intake and household income (0.0056<P < 0.05). Furthermore, multivariable MR revealed that only non-oily fish intake remained statistically significant (OR=152, 95%CI=1.51–1.55 × 10⁴, P = 0.0327).

Conclusions

Our findings underscore the causal relationship between non-oily fish intake and an elevated risk of PBC, as ascertained through both univariable and multivariable MR analyses. These findings hold potential clinical implications for the prevention of PBC.

背景：原发性胆道胆管炎（PBC）是一种慢性肝病，可导致不可逆的肝硬化和肝功能衰竭。本研究旨在通过孟德尔随机化（MR）评估遗传预测的9种生活方式因素与PBC之间的关系。方法：利用全基因组关联研究（GWAS）数据，确定与特定生活方式因素显著相关的遗传变异，采用严格的显著性阈值p < 5 × 10-8和连锁不平衡[LD] r2。结果：非含油鱼类摄入与PBC风险增加有因果关系，比值比（OR）为578（95%置信区间（CI） 24.17-1.39 × 104）。相反，摄入油性鱼类并没有显著降低PBC的风险（P < 0.05）。面包摄入量与家庭收入之间存在相关性（0.00564，P=0.0327）。结论：我们的研究结果强调了非油性鱼类摄入与PBC风险升高之间的因果关系，这是通过单变量和多变量MR分析确定的。这些发现对PBC的预防具有潜在的临床意义。

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引用次数: 0

The bamboo ceiling: An underrecognized barrier for Asians and Asian Americans in academic medicine 竹天花板：亚洲人和亚裔美国人在学术医学中未被充分认识的障碍。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.09.013

So Hyun Jeon BS, Anson O’Young BS, Ho-Man Yeung MD

引用次数: 0

Etiology-based outcomes of biopsy-proven kidney thrombotic microangiopathy: A retrospective analysis of genetic, secondary, and infectious causes 基于病因学的活检证实的肾血栓性微血管病的结果：遗传、继发和感染性原因的回顾性分析。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.016

Sidrah Abid MD , Aman Pal MD , Aliyah Audil MS4 , Noor Humayun MD , Omar Ali MD , Kelly Beers DO , Paul J Feustel MEng, PhD , Swati Mehta MD

Background

Thrombotic microangiopathy (TMA) is a pathological diagnosis characterized by microvascular thrombosis, hemolytic anemia, thrombocytopenia, and ischemic organ dysfunction. The evolving understanding of TMA’s heterogeneous etiology, particularly in relation to genetic and complement dysregulation, complicates its diagnosis and management.

Methods

This retrospective study at Albany Medical Center (AMC) aimed to explore clinical outcomes and management strategies among 33 patients diagnosed with biopsy-confirmed TMA between 2018 and 2024.

Results

The cohort consisted of primary hereditary TMA (15.2 %), secondary TMA (69.7 %) and mixed etiologies (15.1 %). Gene panels were performed in 11 patients, revealing complement-related mutations in 9 cases. Of these, 5 had hereditary TMA, while 4 had mixed etiologies involving hereditary in addition to secondary or infectious triggers. Notably, 10 patients received complement inhibition, with 60 % showing improvement in kidney function at 6 months.

Discussion

This highlights the potential benefit of complement-targeted therapies, even in cases where secondary or mixed etiologies are suspected. The results raise the possibility that many secondary or infection-associated TMAs may harbor unrecognized complement-related abnormalities, emphasizing the importance of genetic testing and early complement inhibition in these cases.

Conclusions

Future studies with larger cohorts are essential to further investigate these findings and refine diagnostic and therapeutic strategies for TMA, particularly in cases with complex or overlapping etiologies.

背景：血栓性微血管病（TMA）是一种以微血管血栓形成、溶血性贫血、血小板减少和缺血性器官功能障碍为特征的病理诊断。对TMA的异质性病因，特别是与遗传和补体失调有关的不断发展的理解，使其诊断和管理复杂化。方法：本回顾性研究在奥尔巴尼医学中心（AMC）进行，旨在探讨2018年至2024年间活检证实的33例TMA患者的临床结果和管理策略。结果：原发性遗传性TMA占15.2%，继发性TMA占69.7%，混合病因占15.1%。对11例患者进行基因检测，发现9例补体相关突变。其中，5例为遗传性TMA， 4例为混合病因，除继发性或感染性诱因外，还包括遗传性。值得注意的是，10名患者接受了补体抑制，其中60%的患者在6个月时肾功能有所改善。讨论：这突出了补充靶向治疗的潜在益处，即使在怀疑继发性或混合病因的病例中也是如此。结果提出了许多继发性或感染相关的tma可能包含未被识别的补体相关异常的可能性，强调了基因检测和早期补体抑制在这些病例中的重要性。结论：对于进一步研究这些发现和完善TMA的诊断和治疗策略，特别是在病因复杂或重叠的病例中，未来更大队列的研究是必不可少的。

{"title":"Etiology-based outcomes of biopsy-proven kidney thrombotic microangiopathy: A retrospective analysis of genetic, secondary, and infectious causes","authors":"Sidrah Abid MD , Aman Pal MD , Aliyah Audil MS4 , Noor Humayun MD , Omar Ali MD , Kelly Beers DO , Paul J Feustel MEng, PhD , Swati Mehta MD","doi":"10.1016/j.amjms.2025.10.016","DOIUrl":"10.1016/j.amjms.2025.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Thrombotic microangiopathy (TMA) is a pathological diagnosis characterized by microvascular thrombosis, hemolytic anemia, thrombocytopenia, and ischemic organ dysfunction. The evolving understanding of TMA’s heterogeneous etiology, particularly in relation to genetic and complement dysregulation, complicates its diagnosis and management.</div></div><div><h3>Methods</h3><div>This retrospective study at Albany Medical Center (AMC) aimed to explore clinical outcomes and management strategies among 33 patients diagnosed with biopsy-confirmed TMA between 2018 and 2024.</div></div><div><h3>Results</h3><div>The cohort consisted of primary hereditary TMA (15.2 %), secondary TMA (69.7 %) and mixed etiologies (15.1 %). Gene panels were performed in 11 patients, revealing complement-related mutations in 9 cases. Of these, 5 had hereditary TMA, while 4 had mixed etiologies involving hereditary in addition to secondary or infectious triggers. Notably, 10 patients received complement inhibition, with 60 % showing improvement in kidney function at 6 months.</div></div><div><h3>Discussion</h3><div>This highlights the potential benefit of complement-targeted therapies, even in cases where secondary or mixed etiologies are suspected. The results raise the possibility that many secondary or infection-associated TMAs may harbor unrecognized complement-related abnormalities, emphasizing the importance of genetic testing and early complement inhibition in these cases.</div></div><div><h3>Conclusions</h3><div>Future studies with larger cohorts are essential to further investigate these findings and refine diagnostic and therapeutic strategies for TMA, particularly in cases with complex or overlapping etiologies.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 1","pages":"Pages 76-81"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In memoriam: Richard W McCallum 纪念理查德·W·麦卡勒姆。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.005

C. Mel Wilcox MD

引用次数: 0

Rural-urban disparities in mortality from alcoholic liver disease in the United States, 1999 to 2020 1999年至2020年美国酒精性肝病死亡率的城乡差异

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.11.001

Yousaf Zafar MD , Melanie Baker MD , Aun Muhammad MD , Donaldo Martinez Vicente MD , Roger Victor Mishoe MD , Niall Mehaffey MD , Jan Petrasek MD, PhD , Zehra Naseem MD , Hafsa Azam MBBS , Areesha Hafeez MBBS , Syed Sarmad Javaid MBBS

Background

Between 2010 and 2016, alcohol-related liver disease (ALD) became the leading cause of nearly 1 in 3 liver transplants in the United States, surpassing hepatitis C. This condition is associated with high morbidity and mortality across the country. We aim to study the trends and regional disparities in ALD-related mortality among adults in the United States.

Methods

Death certificates from the CDC WONDER database were examined from 1999 to 2020 for ALD-related mortality in adults ≥25 years. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, urbanization, and geographic region.

Results

Between 1999 and 2020, 447,109 ALD-related deaths occurred among adults ≥25 years. The AAMR increased from 6.2 in 1999 to 15.7 in 2020. Men had consistently higher AAMR than women (AAMR; men: 14.1 vs women: 5.1). Non-Hispanic (NH) American Indian/Alaska Natives had the highest overall AAMR (43.7), followed by Hispanic (13.5), NH White (9.2), NH Black (7.2), and NH Asian/Pacific Islander (2.5) population. AAMR also varied substantially by region, with highest reported AAMR in West and lowest in Northeast, nonmetropolitan areas had higher ALD-related AAMR than metropolitan. States in the top 90th percentile of ALD-related AAMR were Washington, Alaska, and Oregon.

Conclusions

Our study suggests an increasing trend in ALD-related mortality, especially among men, NH American Indian/ Alaska natives, and nonmetropolitan regions. Targeted strategies are needed to prevent and treat ALD among patients that are at risk to curb increasing levels of ALD-related mortality.

背景：在2010年至2016年期间，酒精相关性肝病（ALD）成为美国近三分之一肝脏移植的主要原因，超过丙型肝炎。这种疾病在全国范围内具有高发病率和死亡率。我们的目的是研究美国成人老年痴呆症相关死亡率的趋势和地区差异。方法：研究1999年至2020年CDC WONDER数据库中25岁以上成人ald相关死亡率的死亡证明。计算每10万人的年龄调整死亡率（AAMRs）和年变化百分比（APC），并按年份、性别、种族/民族、城市化和地理区域进行分层。结果：1999年至2020年间，年龄≥25岁的成年人中发生了447,109例ald相关死亡。AAMR由1999年的6.2上升至2020年的15.7。男性的AAMR始终高于女性（AAMR：男性：14.1，女性：5.1）。非西班牙裔（NH）美国印第安人/阿拉斯加原住民的总体AAMR最高（43.7），其次是西班牙裔（13.5），NH白人（9.2），NH黑人（7.2）和NH亚洲/太平洋岛民（2.5）人口。AAMR也因地区而异，西部最高，东北部最低，非大都市地区的AAMR高于大都市地区。与阿尔茨海默病相关的AAMR排名前90%的州是华盛顿州、阿拉斯加州和俄勒冈州。结论：我们的研究表明，与老年痴呆症相关的死亡率呈上升趋势，尤其是在男性、NH美洲印第安人/阿拉斯加原住民和非大都市地区。需要有针对性的策略来预防和治疗有风险的ALD患者，以抑制ALD相关死亡率的上升。

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引用次数: 0

Reply to “Questions regarding comparison of 24 vs 72-hr octreotide infusion in acute esophageal variceal hemorrhage: A multi-center RCT” 主题：回复“关于24小时与72小时奥曲肽输注治疗急性食管静脉曲张出血的问题：一项多中心RCT”。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.08.015

Jad Allam M.D. , Don C. Rockey M.D.

引用次数: 0

Can health literacy reduce the risk of chronic complications in diabetic patients? 健康素养能否降低糖尿病患者慢性并发症的风险？

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences

Pub Date : 2026-01-01 DOI: 10.1016/j.amjms.2025.10.002

Betul Erismis MD , Nesibe Simsekoglu RN, PhD , Merve Feyza Demir Gurdal MD , Neziha Erken MD , Ozge Pasin PhD , Enes Seyda Sahiner MD

Objectives

Health literacy (HL) is a key determinant of health outcomes, particularly in managing chronic conditions like diabetes mellitus (DM). This study investigates Hl levels in diabetic patients and examines its association with chronic complications.

Methods

A cross-sectional study was conducted with 207 diabetic patients between April and July 2024. HL was assessed using the Turkey Health Literacy Scale, categorizing patients into four levels: inadequate, problematic, adequate, and excellent. Demographic data, laboratory results, and microvascular/macrovascular complications were analyzed using non-parametric statistical tests.

Results

The mean HL score was 29.83, and 32.8 % of participants experiencing chronic microvascular complications. HL levels were significantly associated with education, gender, and occupation but showed no direct correlation with chronic complications or HbA1c levels. However, patients with lower HL had higher rates of microalbuminuria and poor glycemic control.

Conclusions

Although HL was not directly linked to chronic DM complications, inadequate HL may contribute to a higher risk of specific complications, such as diabetic nephropathy. Addressing HL through targeted interventions can enhance diabetes self-management and reduce complication risks.

Practice Implications

Routine HL assessments and personalized education strategies—incorporating digital tools and community support—could enhance patient outcomes and alleviate healthcare burdens. Policymakers and researchers should prioritize HL in chronic disease management strategies.

目标：健康素养（HL）是健康结果的关键决定因素，特别是在管理糖尿病等慢性病方面。本研究探讨了糖尿病患者的Hl水平及其与慢性并发症的关系。方法：对2024年4月至7月期间207例糖尿病患者进行横断面研究。HL采用土耳其健康素养量表进行评估，将患者分为四个级别：不充分、有问题、足够和优秀。采用非参数统计检验对人口统计数据、实验室结果和微血管/大血管并发症进行分析。结果：HL平均评分为29.83,32.8%的参与者出现慢性微血管并发症。HL水平与教育程度、性别和职业显著相关，但与慢性并发症或HbA1c水平无直接关系。然而，低HL患者有较高的微量白蛋白尿率和较差的血糖控制。结论：虽然HL与慢性糖尿病并发症没有直接关系，但HL不足可能会导致特定并发症的高风险，如糖尿病肾病。通过有针对性的干预措施解决HL可加强糖尿病自我管理并降低并发症风险。实践意义：常规HL评估和个性化教育策略（结合数字工具和社区支持）可以提高患者的治疗效果并减轻医疗负担。决策者和研究人员应在慢性病管理策略中优先考虑HL。

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引用次数: 0