Pub Date : 2024-08-10DOI: 10.1007/s00592-024-02327-9
Roberto Franceschi, Riccardo Pertile, Marco Marigliano, Enza Mozzillo, Claudio Maffeis, Silvana Zaffani, Carlotta Dusini, Annalisa Antonelli, Francesca Di Candia, Giulio Maltoni, Erika Cantarelli, Nicola Minuto, Marta Bassi, Ivana Rabbone, Silvia Savastio, Stefano Passanisi, Fortunato Lombardo, Valentino Cherubini, Maria Alessandra Saltarelli, Stefano Tumini
Aim: The purpose of this study was to develop a questionnaire to examine the future acceptance of Automatic insulin delivery systems (AIDs), their perceived usefulness, ease of use, and trust in the device in subjects with type 1 diabetes (T1D).
Methods: A questionnaire in Italian, based on the Technology Acceptance Model, was developed to examine intention to use AIDs, considered as a measure of future acceptance, and its determinants to use the system. A total of 43 questions for children and 46 for parents were included, and a 5-point Likert scale was used.
Results: 239 subjects with T1D using multiple daily injections (MDI) or sensor-augmented pump (SAP) and their parents completed the questionnaire. The completion rate was excellent, with almost 100% of items answered. The overall Cronbach's coefficient for children and adolescents was 0.92 and 0.93 for parents, indicating excellent internal consistency in both groups. Parent-youth agreement was 0.699 (95% confidence interval: 0.689-0.709), indicating a good agreement between the two evaluations. Factor analysis identified measurement factors for the "artificial pancreas (AP)-acceptance labeled benefits and hassles of AIDs, and the internal consistency of the total scale was alpha = 0.94 for subjects with T1D and 0.95 for parents. The level of AP acceptance was more than neutral: 3.91 ± 0.47 and 3.99 ± 0.43 (p = 0.07) for youths and parents, respectively (possible score range 1 to 5, neutral score is 3.0). Parents reported higher scores in the benefit items than children-adolescents (p = 0.04).
Conclusions: We developed a new questionnaire based on the items available in the literature, and we demonstrated that the "AP-acceptance" reveals a meaningful factor structure, good internal reliability, and agreement between parent-young people evaluations. This measure could be a valuable resource for clinicians and researchers to assess AP acceptance in pediatric patients with T1D and their parents. This patient profiling approach could help to enroll candidates for AIDs with proper expectations and who most likely will benefit from the system.
{"title":"Future acceptance of automated insulin delivery systems in youths with type 1 diabetes: validation of the Italian artificial pancreas-acceptance measure.","authors":"Roberto Franceschi, Riccardo Pertile, Marco Marigliano, Enza Mozzillo, Claudio Maffeis, Silvana Zaffani, Carlotta Dusini, Annalisa Antonelli, Francesca Di Candia, Giulio Maltoni, Erika Cantarelli, Nicola Minuto, Marta Bassi, Ivana Rabbone, Silvia Savastio, Stefano Passanisi, Fortunato Lombardo, Valentino Cherubini, Maria Alessandra Saltarelli, Stefano Tumini","doi":"10.1007/s00592-024-02327-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02327-9","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to develop a questionnaire to examine the future acceptance of Automatic insulin delivery systems (AIDs), their perceived usefulness, ease of use, and trust in the device in subjects with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A questionnaire in Italian, based on the Technology Acceptance Model, was developed to examine intention to use AIDs, considered as a measure of future acceptance, and its determinants to use the system. A total of 43 questions for children and 46 for parents were included, and a 5-point Likert scale was used.</p><p><strong>Results: </strong>239 subjects with T1D using multiple daily injections (MDI) or sensor-augmented pump (SAP) and their parents completed the questionnaire. The completion rate was excellent, with almost 100% of items answered. The overall Cronbach's coefficient for children and adolescents was 0.92 and 0.93 for parents, indicating excellent internal consistency in both groups. Parent-youth agreement was 0.699 (95% confidence interval: 0.689-0.709), indicating a good agreement between the two evaluations. Factor analysis identified measurement factors for the \"artificial pancreas (AP)-acceptance labeled benefits and hassles of AIDs, and the internal consistency of the total scale was alpha = 0.94 for subjects with T1D and 0.95 for parents. The level of AP acceptance was more than neutral: 3.91 ± 0.47 and 3.99 ± 0.43 (p = 0.07) for youths and parents, respectively (possible score range 1 to 5, neutral score is 3.0). Parents reported higher scores in the benefit items than children-adolescents (p = 0.04).</p><p><strong>Conclusions: </strong>We developed a new questionnaire based on the items available in the literature, and we demonstrated that the \"AP-acceptance\" reveals a meaningful factor structure, good internal reliability, and agreement between parent-young people evaluations. This measure could be a valuable resource for clinicians and researchers to assess AP acceptance in pediatric patients with T1D and their parents. This patient profiling approach could help to enroll candidates for AIDs with proper expectations and who most likely will benefit from the system.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-10DOI: 10.1007/s00592-024-02331-z
Martina Molteni, Sara Lodigiani, Marsida Teliti, Mario Rotondi, Valeria Guazzoni
{"title":"Use of dulaglutide in a pregnant woman with type 2 diabetes until third trimester of pregnancy","authors":"Martina Molteni, Sara Lodigiani, Marsida Teliti, Mario Rotondi, Valeria Guazzoni","doi":"10.1007/s00592-024-02331-z","DOIUrl":"10.1007/s00592-024-02331-z","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 11","pages":"1491 - 1494"},"PeriodicalIF":3.1,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-024-02331-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911320","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}
Aims: This study aimed to explore the correlation between homeostasis model assessment of insulin resistance(HOMA-IR)and cardiometabolic risk index(CMRI) among different metabolic adults to evaluate the value of HOMA-IR in predicting cardiometabolic risk.
Methods: This cross-sectional study was conducted over 18 months (from August 1, 2020 to February 18, 2022) and included 1550 participants divided into non-metabolic syndrome (non-MetS) group (n = 628) and metabolic syndrome (MetS) group (n = 922) in three centers of China. Logistic regression analysis was employed to investigate the correlation between HOMA-IR, body fat percentage, BMI (body mass index), visceral fat index, waist-to-hip ratio, vitamin D, and CMRI. Further analysis was conducted to evaluate the ability of HOMA-IR in diagnosing high CMRI within different metabolic, gender, and age groups to predict the risk of cardiovascular disease (CVD).
Results: HOMA-IR was significantly higher in the MetS group compared with the non-MetS group (P < 0.05). CMRI was significantly higher in the MetS group compared to the non-MetS group (P < 0.05). According to ROC curve analysis, HOMA-IR can predict cardiovascular risk (CVR) in the general population, non-MetS individuals, and MetS people. Logistic regression analysis revealed that BMI, visceral fat index, waist-to-hip ratio, and HOMA-IR are independent risk indicators of high CVR, whereas vitamin D may exert a protective role.
Conclusions: HOMA-IR was an independent risk factor for increased CVR in MetS patients. Moreover, HOMA-IR elevates the risk of CVD regardless of MetS and thus can be used for screening the general population.
Trial registration: The study was registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2100054654).
{"title":"The correlation between HOMA-IR and cardiometabolic risk index among different metabolic adults: a cross-sectional study.","authors":"Qiyun Lu, Benjian Chen, Anxiang Li, Qingshun Liang, Jia Yao, Yiming Tao, Fangfang Dai, Xiaoling Hu, Jiayan Lu, Yunwei Liu, Yunyi Liu, Yingxi Wang, Jieer Long, RongHua Zhang, Zhenjie Liu","doi":"10.1007/s00592-024-02332-y","DOIUrl":"https://doi.org/10.1007/s00592-024-02332-y","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to explore the correlation between homeostasis model assessment of insulin resistance(HOMA-IR)and cardiometabolic risk index(CMRI) among different metabolic adults to evaluate the value of HOMA-IR in predicting cardiometabolic risk.</p><p><strong>Methods: </strong>This cross-sectional study was conducted over 18 months (from August 1, 2020 to February 18, 2022) and included 1550 participants divided into non-metabolic syndrome (non-MetS) group (n = 628) and metabolic syndrome (MetS) group (n = 922) in three centers of China. Logistic regression analysis was employed to investigate the correlation between HOMA-IR, body fat percentage, BMI (body mass index), visceral fat index, waist-to-hip ratio, vitamin D, and CMRI. Further analysis was conducted to evaluate the ability of HOMA-IR in diagnosing high CMRI within different metabolic, gender, and age groups to predict the risk of cardiovascular disease (CVD).</p><p><strong>Results: </strong>HOMA-IR was significantly higher in the MetS group compared with the non-MetS group (P < 0.05). CMRI was significantly higher in the MetS group compared to the non-MetS group (P < 0.05). According to ROC curve analysis, HOMA-IR can predict cardiovascular risk (CVR) in the general population, non-MetS individuals, and MetS people. Logistic regression analysis revealed that BMI, visceral fat index, waist-to-hip ratio, and HOMA-IR are independent risk indicators of high CVR, whereas vitamin D may exert a protective role.</p><p><strong>Conclusions: </strong>HOMA-IR was an independent risk factor for increased CVR in MetS patients. Moreover, HOMA-IR elevates the risk of CVD regardless of MetS and thus can be used for screening the general population.</p><p><strong>Trial registration: </strong>The study was registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2100054654).</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1007/s00592-024-02346-6
Vincenzo Trischitta, Alessandra Antonucci, Jerzy Adamski, Cornelia Prehn, Claudia Menzaghi, Antonella Marucci, Rosa Di Paola
{"title":"Correction: GALNT2 expression is associated with glucose control and serum metabolites in patients with type 2 diabetes","authors":"Vincenzo Trischitta, Alessandra Antonucci, Jerzy Adamski, Cornelia Prehn, Claudia Menzaghi, Antonella Marucci, Rosa Di Paola","doi":"10.1007/s00592-024-02346-6","DOIUrl":"10.1007/s00592-024-02346-6","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 8","pages":"1015 - 1015"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900562","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}
Pub Date : 2024-08-06DOI: 10.1007/s00592-024-02351-9
Ryeon Heo, Minju Park, Seo-Yeong Mun, Wenwen Zhuang, Junsu Jeong, Hongzoo Park, Eun-Taek Han, Jin-Hee Han, Wanjoo Chun, Won-Kyo Jung, Il-Whan Choi, Won Sun Park
Aims: The present study investigated the vasorelaxant mechanisms of an oral antidiabetic drug, anagliptin, using phenylephrine (Phe)-induced pre-contracted rabbit aortic rings.
Methods: Arterial tone measurement was performed in rabbit thoracic aortic rings.
Results: Anagliptin induced vasorelaxation in a dose-dependent manner. Pre-treatment with the classical voltagedependent K+ (Kv) channel inhibitors 4-aminopyridine and tetraethylammonium significantly decreased the vasorelaxant effect of anagliptin, whereas pre-treatment with the inwardly rectifying K+ (Kir) channel inhibitor Ba2+, the ATP-sensitive K+ (KATP) channel inhibitor glibenclamide, and the large-conductance Ca2+-activated K+ (BKCa) channel inhibitor paxilline did not attenuate the vasorelaxant effect. Furthermore, the vasorelaxant response of anagliptin was effectively inhibited by pre-treatment with the sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) pump inhibitors thapsigargin and cyclopiazonic acid. Neither cAMP/protein kinase A (PKA)-related signaling pathway inhibitors (adenylyl cyclase inhibitor SQ 22536 and PKA inhibitor KT 5720) nor cGMP/protein kinase G (PKG)-related signaling pathway inhibitors (guanylyl cyclase inhibitor ODQ and PKG inhibitor KT 5823) reduced the vasorelaxant effect of anagliptin. Similarly, the anagliptin-induced vasorelaxation was independent of the endothelium.
Conclusions: Based on these results, we suggest that anagliptin-induced vasorelaxation in rabbit aortic smooth muscle occurs by activating Kv channels and the SERCA pump, independent of other vascular K+ channels, cAMP/PKA- or cGMP/PKG-related signaling pathways, and the endothelium.
{"title":"Vasorelaxant mechanisms of the antidiabetic anagliptin in rabbit aorta: roles of Kv channels and SERCA pump.","authors":"Ryeon Heo, Minju Park, Seo-Yeong Mun, Wenwen Zhuang, Junsu Jeong, Hongzoo Park, Eun-Taek Han, Jin-Hee Han, Wanjoo Chun, Won-Kyo Jung, Il-Whan Choi, Won Sun Park","doi":"10.1007/s00592-024-02351-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02351-9","url":null,"abstract":"<p><strong>Aims: </strong>The present study investigated the vasorelaxant mechanisms of an oral antidiabetic drug, anagliptin, using phenylephrine (Phe)-induced pre-contracted rabbit aortic rings.</p><p><strong>Methods: </strong>Arterial tone measurement was performed in rabbit thoracic aortic rings.</p><p><strong>Results: </strong>Anagliptin induced vasorelaxation in a dose-dependent manner. Pre-treatment with the classical voltagedependent K<sup>+</sup> (Kv) channel inhibitors 4-aminopyridine and tetraethylammonium significantly decreased the vasorelaxant effect of anagliptin, whereas pre-treatment with the inwardly rectifying K<sup>+</sup> (Kir) channel inhibitor Ba<sup>2+</sup>, the ATP-sensitive K<sup>+</sup> (K<sub>ATP</sub>) channel inhibitor glibenclamide, and the large-conductance Ca<sup>2+</sup>-activated K<sup>+</sup> (BKCa) channel inhibitor paxilline did not attenuate the vasorelaxant effect. Furthermore, the vasorelaxant response of anagliptin was effectively inhibited by pre-treatment with the sarco/endoplasmic reticulum Ca<sup>2+</sup>-ATPase (SERCA) pump inhibitors thapsigargin and cyclopiazonic acid. Neither cAMP/protein kinase A (PKA)-related signaling pathway inhibitors (adenylyl cyclase inhibitor SQ 22536 and PKA inhibitor KT 5720) nor cGMP/protein kinase G (PKG)-related signaling pathway inhibitors (guanylyl cyclase inhibitor ODQ and PKG inhibitor KT 5823) reduced the vasorelaxant effect of anagliptin. Similarly, the anagliptin-induced vasorelaxation was independent of the endothelium.</p><p><strong>Conclusions: </strong>Based on these results, we suggest that anagliptin-induced vasorelaxation in rabbit aortic smooth muscle occurs by activating Kv channels and the SERCA pump, independent of other vascular K<sup>+</sup> channels, cAMP/PKA- or cGMP/PKG-related signaling pathways, and the endothelium.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1007/s00592-024-02347-5
Fernando Sebastian-Valles, Julia Martínez-Alfonso, Jose Alfonso Arranz Martin, Jessica Jiménez-Díaz, Iñigo Hernando Alday, Victor Navas-Moreno, Teresa Armenta-Joya, Maria Del Mar Fandiño García, Gisela Liz Román Gómez, Jon Garai Hierro, Luis Eduardo Lander Lobariñas, Carmen González-Ávila, Purificación Martinez de Icaya, Vicente Martínez-Vizcaíno, Mónica Marazuela, Miguel Antonio Sampedro-Nuñez
Aims: This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range.
Methods: We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards.
Results: Patients' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040).
Conclusion: TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.
{"title":"Time above range and no coefficient of variation is associated with diabetic retinopathy in individuals with type 1 diabetes and glycated hemoglobin within target.","authors":"Fernando Sebastian-Valles, Julia Martínez-Alfonso, Jose Alfonso Arranz Martin, Jessica Jiménez-Díaz, Iñigo Hernando Alday, Victor Navas-Moreno, Teresa Armenta-Joya, Maria Del Mar Fandiño García, Gisela Liz Román Gómez, Jon Garai Hierro, Luis Eduardo Lander Lobariñas, Carmen González-Ávila, Purificación Martinez de Icaya, Vicente Martínez-Vizcaíno, Mónica Marazuela, Miguel Antonio Sampedro-Nuñez","doi":"10.1007/s00592-024-02347-5","DOIUrl":"https://doi.org/10.1007/s00592-024-02347-5","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards.</p><p><strong>Results: </strong>Patients' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040).</p><p><strong>Conclusion: </strong>TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1007/s00592-024-02343-9
Baiju Wang, Han Li, Na Wang, Yuan Li, Zihua Song, Yajuan Chen, Xiaobing Li, Lei Liu, Hanwen Chen
Background/aims: Homocysteine (Hcy) has been associated with an increased risk of diabetic nephropathy (DN) in patients, but there is still controversy. This study aims to investigate the causal relationship between plasma Hcy and DN.
Methods: A Mendelian randomization (MR) study using data from 2 samples was employed to infer causal relationships. The aggregated genetic data associated with Hcy was derived from the largest genome-wide association study (GWAS) to date, involving 44,147 individuals of European ancestry.Data on SNP-diabetic nephropathy, creatinine, and urea nitrogen were obtained from the IEU GWAS database. The analysis method employed a fixed-effect or random-effect inverse variance-weighted approach to estimate effects.Additional analysis methods were used to assess stability and sensitivity. The potential for pleiotropy was evaluated using the MR-Egger intercept test.
Results: Using 12 SNPs as instrumental variables, two-sample MR analysis revealed no evidence of a causal relationship between genetically predicted plasma Hcy levels and diabetic nephropathy, as well as creatinine and blood urea nitrogen levels. This finding is consistent with the results obtained from other testing methods.
Conclusions: Two-sample Mendelian Randomization analysis found no evidence of a causal relationship between plasma homocysteine levels and diabetic nephropathy, creatinine, or urea.
背景/目的:同型半胱氨酸(Hcy)与患者糖尿病肾病(DN)风险增加有关,但仍存在争议。本研究旨在探讨血浆 Hcy 与 DN 之间的因果关系:方法:使用两个样本的数据进行孟德尔随机化(MR)研究,以推断因果关系。与 Hcy 相关的综合遗传数据来自迄今为止最大的全基因组关联研究(GWAS),涉及 44,147 名欧洲血统的个体。SNP-糖尿病肾病、肌酐和尿素氮的数据来自 IEU GWAS 数据库。分析方法采用固定效应或随机效应反方差加权法来估计效应。使用MR-Egger截距检验评估了多向性的可能性:使用 12 个 SNP 作为工具变量,双样本 MR 分析显示,没有证据表明基因预测的血浆 Hcy 水平与糖尿病肾病以及肌酐和血尿素氮水平之间存在因果关系。这一结果与其他测试方法得出的结果一致:结论:双样本孟德尔随机分析没有发现血浆同型半胱氨酸水平与糖尿病肾病、肌酐或尿素之间存在因果关系的证据。
{"title":"The impact of homocysteine on patients with diabetic nephropathy: a mendelian randomization study.","authors":"Baiju Wang, Han Li, Na Wang, Yuan Li, Zihua Song, Yajuan Chen, Xiaobing Li, Lei Liu, Hanwen Chen","doi":"10.1007/s00592-024-02343-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02343-9","url":null,"abstract":"<p><strong>Background/aims: </strong>Homocysteine (Hcy) has been associated with an increased risk of diabetic nephropathy (DN) in patients, but there is still controversy. This study aims to investigate the causal relationship between plasma Hcy and DN.</p><p><strong>Methods: </strong>A Mendelian randomization (MR) study using data from 2 samples was employed to infer causal relationships. The aggregated genetic data associated with Hcy was derived from the largest genome-wide association study (GWAS) to date, involving 44,147 individuals of European ancestry.Data on SNP-diabetic nephropathy, creatinine, and urea nitrogen were obtained from the IEU GWAS database. The analysis method employed a fixed-effect or random-effect inverse variance-weighted approach to estimate effects.Additional analysis methods were used to assess stability and sensitivity. The potential for pleiotropy was evaluated using the MR-Egger intercept test.</p><p><strong>Results: </strong>Using 12 SNPs as instrumental variables, two-sample MR analysis revealed no evidence of a causal relationship between genetically predicted plasma Hcy levels and diabetic nephropathy, as well as creatinine and blood urea nitrogen levels. This finding is consistent with the results obtained from other testing methods.</p><p><strong>Conclusions: </strong>Two-sample Mendelian Randomization analysis found no evidence of a causal relationship between plasma homocysteine levels and diabetic nephropathy, creatinine, or urea.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Controlled metabolic factors and socioeconomic status (SES) was crucial for prevention of diabetic retinopathy (DR). The study aims to assess the metabolic factors control and SES among working-age adults (18-64 years) with diabetes compared to older adults (65 years and older).
Methods: Totals of 6738 participants with self-reported diagnosed diabetes from National Health and Nutrition Examination Survey were included, of whom 3482 were working-age and 3256 were elderly. The prevalence of DR, metabolic factors control, and the impact of SES and diabetic duration on DR was estimated. Subgroup analysis among working-age adults was employed across different diabetic duration and SES level.
Results: The prevalence of DR was 20.8% among working-age adults and 20.6% in elderly adults. Further, working-age adults possessed suboptimal control on glycemia (median HbA1c: 7.0% vs. 6.8%, p < 0.001) and lipids (Low-density lipoprotein < 100 mg/dL: 46.4% vs. 63.5%, p < 0.001), but better blood pressure control (< 130/80 mmHg: 53.5% vs. 37.5%, p < 0.001) compared to the elderly, judging based on age-specific control targets. Prolonged diabetic duration didn't improve glycemic and composite factors control. SES like education and income impacted metabolic factors control and adults with higher SES were more likely to control well. Diabetic duration was a significant risk factor (OR = 4.006, 95%CI= (2.752,5.832), p < 0.001) while higher income (OR = 0.590, 95%CI= (0.421,0.826), p = 0.002) and educational level (OR = 0.637, 95%CI= (0.457,0.889), p = 0.008) were protective against DR.
Conclusions: Working-age adults with diabetes demonstrate suboptimal metabolic profile control, especially glycemia and lipids. Additional efforts are needed to improve metabolic factor control and reduce DR risk, particularly for those with longer diabetes duration, less education, and lower incomes.
目的:控制代谢因素和社会经济地位(SES)对预防糖尿病视网膜病变(DR)至关重要。本研究旨在评估与老年人(65 岁及以上)相比,工作年龄成年人(18-64 岁)糖尿病患者的代谢因素控制和社会经济地位:方法:共纳入了 6738 名在全国健康与营养调查中自我报告确诊为糖尿病的参与者,其中 3482 人为工作年龄段,3256 人为老年人。对DR患病率、代谢因素控制以及社会经济状况和糖尿病病程对DR的影响进行了估计。对不同糖尿病病程和社会经济地位的工作年龄成人进行了分组分析:结果:劳动适龄成年人的 DR 患病率为 20.8%,老年人为 20.6%。此外,工作年龄段的成年人血糖控制不佳(HbA1c 中位数:7.0% vs. 6.8%,p 结论:工作年龄段的成年人糖尿病患者的血糖控制不佳(HbA1c 中位数:7.0% vs. 6.8%,p):工作年龄段的成人糖尿病患者的代谢情况控制不佳,尤其是血糖和血脂。需要采取更多措施来改善代谢因素控制和降低 DR 风险,尤其是对于糖尿病病程较长、受教育程度较低和收入较低的人群。
{"title":"The differences of metabolic profiles, socioeconomic status and diabetic retinopathy in U.S. working-age and elderly adults with diabetes: results from NHANES 1999-2018.","authors":"Bo Li, Xiaoyun Cheng, Yikeng Huang, Chuandi Zhou, Chufeng Gu, Xinyu Zhu, Chenxin Li, Mingming Ma, Ying Fan, Xun Xu, Zhi Zheng, Haibing Chen, Shuzhi Zhao","doi":"10.1007/s00592-024-02328-8","DOIUrl":"https://doi.org/10.1007/s00592-024-02328-8","url":null,"abstract":"<p><strong>Aims: </strong>Controlled metabolic factors and socioeconomic status (SES) was crucial for prevention of diabetic retinopathy (DR). The study aims to assess the metabolic factors control and SES among working-age adults (18-64 years) with diabetes compared to older adults (65 years and older).</p><p><strong>Methods: </strong>Totals of 6738 participants with self-reported diagnosed diabetes from National Health and Nutrition Examination Survey were included, of whom 3482 were working-age and 3256 were elderly. The prevalence of DR, metabolic factors control, and the impact of SES and diabetic duration on DR was estimated. Subgroup analysis among working-age adults was employed across different diabetic duration and SES level.</p><p><strong>Results: </strong>The prevalence of DR was 20.8% among working-age adults and 20.6% in elderly adults. Further, working-age adults possessed suboptimal control on glycemia (median HbA1c: 7.0% vs. 6.8%, p < 0.001) and lipids (Low-density lipoprotein < 100 mg/dL: 46.4% vs. 63.5%, p < 0.001), but better blood pressure control (< 130/80 mmHg: 53.5% vs. 37.5%, p < 0.001) compared to the elderly, judging based on age-specific control targets. Prolonged diabetic duration didn't improve glycemic and composite factors control. SES like education and income impacted metabolic factors control and adults with higher SES were more likely to control well. Diabetic duration was a significant risk factor (OR = 4.006, 95%CI= (2.752,5.832), p < 0.001) while higher income (OR = 0.590, 95%CI= (0.421,0.826), p = 0.002) and educational level (OR = 0.637, 95%CI= (0.457,0.889), p = 0.008) were protective against DR.</p><p><strong>Conclusions: </strong>Working-age adults with diabetes demonstrate suboptimal metabolic profile control, especially glycemia and lipids. Additional efforts are needed to improve metabolic factor control and reduce DR risk, particularly for those with longer diabetes duration, less education, and lower incomes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1007/s00592-024-02350-w
Agnieszka Zmysłowska, Julia Grzybowska-Adamowicz, Arkadiusz Michalak, Julia Wykrota, Agnieszka Szadkowska, Wojciech Młynarski, Wojciech Fendler
Aims
In this study we evaluated the use of Continuous Glucose Monitoring system in adults with insulin-dependent diabetes in the course of Wolfram syndrome (WFS) in comparison to patients with type 1 diabetes (T1D).
Methods
Individuals with WFS (N = 10) used continuous glucose monitoring for 14 days and were compared with 30 patients with T1D matched using propensity score for age and diabetes duration. Glycemic variability was calculated with Glyculator 3.0.
Results
We revealed significant differences in glycemic indices between adults with Wolfram syndrome-related diabetes and matched comparison group. Patients with Wolfram syndrome presented lower mean glucose in 24-h and nighttime records [24h: 141.1 ± 30.4mg/dl (N = 10) vs 164.9 ± 31.3mg/dl (N = 30), p = 0.0427; nighttime: 136.7 ± 39.6mg/dl vs 166.2 ± 32.1mg/dl (N = 30), p = 0.0442]. Moreover, they showed lower standard deviation of sensor glucose over all periods [24h: 50.3 ± 9.2mg/dl (N = 10) vs 67.7 ± 18.7 mg/dl (N = 30), p = 0.0075; daytime: 50.8 ± 8.7mg/dl (N = 10) vs 67.4 ± 18.0mg/dl (N = 30), p = 0.0082; nighttime: 45.1 ± 14.9mg/dl (N = 10) vs 65.8 ± 23.2mg/dl (n = 30), p = 0.0119] and coefficient of variation at night [33.3 ± 5.8% (N = 10) vs 40.5 ± 8.8% (N = 30), p = 0.0210]. Additionally, WFS patients displayed lower time in high-range hyperglycemia (> 250mg/dl) across all parts of day [24h: 4.6 ± 3.8% (N = 10) vs 13.4 ± 10.5% (N = 30), p = 0.0004; daytime: 4.7 ± 3.9% (N = 10) vs 13.8 ± 11.2% (N = 30), p = 0.0005; nighttime: 4.2 ± 5.5% (N = 10) vs 12.1 ± 10.3% (N = 30), p = 0.0272].
Conclusions
Adult patients with Wolfram syndrome show lower mean blood glucose, less extreme hyperglycemia, and lower glycemic variability in comparison to patients with type 1 diabetes.
{"title":"Continuous glycemic monitoring in managing diabetes in adult patients with wolfram syndrome","authors":"Agnieszka Zmysłowska, Julia Grzybowska-Adamowicz, Arkadiusz Michalak, Julia Wykrota, Agnieszka Szadkowska, Wojciech Młynarski, Wojciech Fendler","doi":"10.1007/s00592-024-02350-w","DOIUrl":"10.1007/s00592-024-02350-w","url":null,"abstract":"<div><h3>Aims</h3><p>In this study we evaluated the use of Continuous Glucose Monitoring system in adults with insulin-dependent diabetes in the course of Wolfram syndrome (WFS) in comparison to patients with type 1 diabetes (T1D).</p><h3>Methods</h3><p>Individuals with WFS (N = 10) used continuous glucose monitoring for 14 days and were compared with 30 patients with T1D matched using propensity score for age and diabetes duration. Glycemic variability was calculated with Glyculator 3.0.</p><h3>Results</h3><p>We revealed significant differences in glycemic indices between adults with Wolfram syndrome-related diabetes and matched comparison group. Patients with Wolfram syndrome presented lower mean glucose in 24-h and nighttime records [24h: 141.1 ± 30.4mg/dl (N = 10) vs 164.9 ± 31.3mg/dl (N = 30), p = 0.0427; nighttime: 136.7 ± 39.6mg/dl vs 166.2 ± 32.1mg/dl (N = 30), p = 0.0442]. Moreover, they showed lower standard deviation of sensor glucose over all periods [24h: 50.3 ± 9.2mg/dl (N = 10) vs 67.7 ± 18.7 mg/dl (N = 30), p = 0.0075; daytime: 50.8 ± 8.7mg/dl (N = 10) vs 67.4 ± 18.0mg/dl (N = 30), p = 0.0082; nighttime: 45.1 ± 14.9mg/dl (N = 10) vs 65.8 ± 23.2mg/dl (n = 30), p = 0.0119] and coefficient of variation at night [33.3 ± 5.8% (N = 10) vs 40.5 ± 8.8% (N = 30), p = 0.0210]. Additionally, WFS patients displayed lower time in high-range hyperglycemia (> 250mg/dl) across all parts of day [24h: 4.6 ± 3.8% (N = 10) vs 13.4 ± 10.5% (N = 30), p = 0.0004; daytime: 4.7 ± 3.9% (N = 10) vs 13.8 ± 11.2% (N = 30), p = 0.0005; nighttime: 4.2 ± 5.5% (N = 10) vs 12.1 ± 10.3% (N = 30), p = 0.0272].</p><h3>Conclusions</h3><p>Adult patients with Wolfram syndrome show lower mean blood glucose, less extreme hyperglycemia, and lower glycemic variability in comparison to patients with type 1 diabetes.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 10","pages":"1333 - 1338"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-024-02350-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884872","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}
Aims: Diabetic retinopathy (DR) results from complex genetic and metabolic interactions. Unraveling the links between blood metabolites and DR can advance risk prediction and therapy.
Methods: Leveraging Mendelian Randomization (MR) and Linkage Disequilibrium Score Regression (LDSC), we analyzed 10,413 DR cases and 308,633 controls. Data was sourced from the Metabolomics GWAS server and the FinnGen project.
Results: Our research conducted a comprehensive MR analysis across 486 serum metabolites to investigate their causal role in DR. After stringent selection and validation of instrumental variables, we focused on 480 metabolites for analysis. Our findings revealed 38 metabolites potentially causally associated with DR. Specifically, 4-androsten-3beta,17beta-diol disulfate 2 was identified as significantly associated with a reduced risk of DR (OR = 0.471, 95% CI = 0.324-0.684, p = 7.87 × 10- 5), even after rigorous adjustments for multiple testing. Sensitivity analyses further validated the robustness of this association, and linkage disequilibrium score regression analyses showed no significant genetic correlation between this metabolite and DR, suggesting a specific protective effect against DR.
Conclusions: Our study identifies 4-androsten-3beta,17beta-diol disulfate 2, a metabolite of androgens, as a significant protective factor against diabetic retinopathy, suggesting androgens as potential therapeutic targets.
目的:糖尿病视网膜病变(DR)是复杂的遗传和代谢相互作用的结果。揭示血液代谢物与糖尿病视网膜病变之间的联系可以促进风险预测和治疗:利用孟德尔随机化(Mendelian Randomization,MR)和连锁不平衡评分回归(Linkage Disequilibrium Score Regression,LDSC),我们分析了 10,413 例 DR 病例和 308,633 例对照。数据来源于代谢组学 GWAS 服务器和 FinnGen 项目:我们的研究对 486 种血清代谢物进行了全面的 MR 分析,以研究它们在 DR 中的因果作用。经过对工具变量的严格筛选和验证,我们重点分析了 480 种代谢物。我们的研究结果显示,38种代谢物可能与DR存在因果关系。特别是 4-雄烯-3beta,17beta-二醇二硫酸盐 2 被确定与降低 DR 风险显著相关(OR = 0.471,95% CI = 0.324-0.684,p = 7.87 × 10-5),即使经过严格的多重测试调整也是如此。敏感性分析进一步验证了这种关联的稳健性,连锁不平衡得分回归分析表明,这种代谢物与DR之间没有显著的遗传相关性,这表明对DR有特殊的保护作用:我们的研究发现雄激素的代谢产物 4-雄烯-3beta,17beta-二醇二硫酸盐 2 是糖尿病视网膜病变的重要保护因素,这表明雄激素是潜在的治疗靶点。
{"title":"Elucidating the role of genetically determined metabolites in Diabetic Retinopathy: insights from a mendelian randomization analysis.","authors":"Yao Tan, Zuyun Yan, Jiayang Yin, Jiamin Cao, Bingyu Xie, Feng Zhang, Wenhua Zhang, Wei Xiong","doi":"10.1007/s00592-024-02345-7","DOIUrl":"https://doi.org/10.1007/s00592-024-02345-7","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic retinopathy (DR) results from complex genetic and metabolic interactions. Unraveling the links between blood metabolites and DR can advance risk prediction and therapy.</p><p><strong>Methods: </strong>Leveraging Mendelian Randomization (MR) and Linkage Disequilibrium Score Regression (LDSC), we analyzed 10,413 DR cases and 308,633 controls. Data was sourced from the Metabolomics GWAS server and the FinnGen project.</p><p><strong>Results: </strong>Our research conducted a comprehensive MR analysis across 486 serum metabolites to investigate their causal role in DR. After stringent selection and validation of instrumental variables, we focused on 480 metabolites for analysis. Our findings revealed 38 metabolites potentially causally associated with DR. Specifically, 4-androsten-3beta,17beta-diol disulfate 2 was identified as significantly associated with a reduced risk of DR (OR = 0.471, 95% CI = 0.324-0.684, p = 7.87 × 10<sup>- 5</sup>), even after rigorous adjustments for multiple testing. Sensitivity analyses further validated the robustness of this association, and linkage disequilibrium score regression analyses showed no significant genetic correlation between this metabolite and DR, suggesting a specific protective effect against DR.</p><p><strong>Conclusions: </strong>Our study identifies 4-androsten-3beta,17beta-diol disulfate 2, a metabolite of androgens, as a significant protective factor against diabetic retinopathy, suggesting androgens as potential therapeutic targets.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}