Canadian Journal of Diabetes最新文献

Predicting the Risk of COVID-19 Among Adult Patients With Diabetes: A Machine Learning Approach 预测成年糖尿病患者感染COVID-19的风险：一种机器学习方法。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.09.001

Dean T. Eurich PhD , Darren Lau MD , Weiting Li MSc , Olivia Weaver MSc , Tanya Joon MSc , Ming Ye PhD , Finlay A. McAlister MD , Padma Kaul PhD , Salim Samanani MD

Objectives

In this study our aim was to develop a machine learning model that could accurately predict the risk of acquiring COVID-19 in community-dwelling adults with type 1 and/or type 2 diabetes in Alberta, Canada.

Methods

This predictive supervised machine learning study included adults (≥18 years old) living in Alberta, Canada, between April 1, 2019, and March 31, 2021, with pre-existing diabetes (n=372,055, excluding 2,541 due to migration; final sample size 369,514). The outcome of interest was a positive severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2) polymerase chain reaction test result between March 1, 2020, and March 1, 2021. Model features were extracted from routinely collected Alberta administrative health data from March 1, 2015, to March 1, 2020. Fifteen algorithms were trained on 67% of the data and the top performer (Light Gradient Boost [LGBoost] model) was validated on the remaining 33%. The model was calibrated and model performance was assessed using area under the receiver-operating characteristic curve (AUROC), area under the precision recall curve (AUPRC), and threshold analyses.

Results

Among the 369,514 individuals with diabetes, 140,511 were tested, of whom 13,082 had a positive SARS-CoV-2 test. The LGBoost model incorporated 367 features with AUROC and AUPRC of 0.69 and 0.08, respectively. The model was well-calibrated for common risk thresholds (<0.2 probability) with high specificity (≥0.98 at all thresholds); however, sensitivity and positive predictive values were low at all thresholds (≤0.08 and ≤0.18, respectively).

Conclusions

The LGBoost model lacked the sensitivity to be clinically useful in predicting SARS-CoV-2 infection in Albertans with diabetes. Alternative data sources may be required to improve future COVID-19 prediction models from the community.

目的：开发一种机器学习模型，准确预测加拿大阿尔伯塔省社区居住的1型和/或2型糖尿病成年人感染COVID-19的风险。方法：这项预测监督机器学习研究纳入了2019年4月1日至2021年3月31日期间居住在加拿大阿尔伯塔省的已有糖尿病的成年人（bb0 =18岁）（n=372,055，不包括因移民而导致的n=2,541；最终样本量=369,514）。感兴趣的结果是2020年3月1日至2021年3月1日期间SARS-CoV-2 PCR检测结果阳性。模型特征提取自2015年3月1日至2020年3月1日定期收集的艾伯塔省行政卫生数据。在67%的数据上训练了15种算法，在其余33%的数据上验证了表现最好的算法（Light Gradient Boost Model, LGBoost）。对模型进行了标定，并采用受试者工作特征曲线下面积（AUROC）、精确召回曲线下面积（AUPRC）和阈值分析对模型性能进行了评估。结果：在369514名糖尿病患者中，有140511人接受了检测，其中13082人的SARS-CoV-2检测呈阳性。LGBoost模型包含367个特征，AUROC和AUPRC分别为0.69和0.08。该模型对常见的风险阈值进行了很好的校准（在所有阈值均为0.98），但是在所有阈值上的敏感性和阳性预测值都很低(结论：LGBoost模型缺乏敏感性，无法在临床上用于预测阿尔伯塔省糖尿病患者的SARS-CoV-2感染。可能需要其他数据源来改进来自社区的未来COVID-19预测模型。

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引用次数: 0

A Diabetes Peer Mentorship Program for First Nations Youth and Young Adults: An Intervention Protocol 第一民族青年和年轻人糖尿病同伴辅导计划：干预方案。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.07.003

Sahar Fazeli PhD, MSc , Jonathan Linton , Paul Linton , Lucy Trapper , Catherine Godin PDt, MSc , Helene Porada DtP, ADA , Deborah Da Costa PhD , Kaberi Dasgupta MD, MSc, FRCPC , Isabelle Malhame MD, MSc , Claudia Mitchell PhD , Elham Rahme PhD , Julia Elisabeth Von Oettingen MD, PhD, MMSc, FRCP , Romina Pace MD

Objectives

The rising incidence of type 2 diabetes (T2D) among Indigenous peoples, exacerbated by historic injustices and health inequities, underscores the need for culturally sensitive health interventions that address both the physiological and psychological burdens of diabetes. This research protocol describes a community-driven initiative aimed at enhancing diabetes management among Indigenous youth and young adults in Canada, leveraging the lived experience and leadership of Indigenous young adults. This project seeks to integrate traditional Indigenous practices with modern health strategies to foster better health outcomes and psychosocial support through peer mentorship.

Methods

The program, developed and led by an Eeyou Istchee Cree community member, involves various health-promoting activities, including dietary guidance, physical exercise, and traditional land-based practices. These activities are designed to improve self-management of diabetes and to address diabetes distress, a significant factor in diabetes care.

Results

Anticipated outcomes include improved psychosocial factors (reduced distress and enhanced resilience) and clinical measures of diabetes management (glycemia, body mass index, and blood pressure). The project's methodology combines quantitative assessments of psychological and health outcomes with qualitative feedback from participants, captured through innovative methods like Photovoice to ensure participants’ voices and experiences directly inform the intervention’s efficacy and adaptability.

Conclusions

Overall, this protocol outlines a framework for a scalable, sustainable model of health intervention that respects and revitalizes Indigenous cultural practices and community autonomy. The expected results aim to demonstrate the effectiveness of peer-led and culturally informed interventions in improving psychological and health outcomes, with the potential to guide similar initiatives in other Indigenous and marginalized communities worldwide.

由于历史上的不公正和卫生方面的不公平，土著人民中2型糖尿病发病率不断上升，这突出表明需要采取对文化敏感的卫生干预措施，解决糖尿病的生理和心理负担。本研究方案描述了一项社区驱动的倡议，旨在加强加拿大土著青年和年轻人的糖尿病管理，利用土著年轻人的生活经验和领导能力。该项目力求将传统的土著做法与现代保健战略结合起来，通过同侪指导促进更好的保健成果和社会心理支持。该方案由一名伊尤伊什奇族（EI）社区成员制定和领导，涉及各种促进健康的活动，包括饮食指导、体育锻炼和传统的陆上实践。这些活动旨在改善糖尿病的自我管理，并解决糖尿病困扰（DD），这是糖尿病护理中的一个重要因素。预期的结果包括改善心理社会因素（减少痛苦和增强恢复力）和糖尿病管理的临床措施（血糖、体重指数、血压）。该项目的方法将心理和健康结果的定量评估与参与者的定性反馈相结合，通过Photovoice等创新方法捕获，以确保参与者的声音和经验直接告知干预的有效性和适应性。总的来说，该议定书概述了一个可扩展的、可持续的卫生干预模式框架，该模式尊重和振兴土著文化习俗和社区自治。预期结果旨在证明同伴主导和了解文化的干预措施在改善心理和健康结果方面的有效性，并有可能指导全世界其他土著和边缘化社区采取类似举措。

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引用次数: 0

Assessment of Clinical Factors Influencing Glucose Management Indicator and Glycated Hemoglobin Discordance in Children With Type 1 Diabetes: A 1-Year, Real-world Data Observation 影响1型糖尿病儿童血糖管理指标及糖化血红蛋白不一致的临床因素评估-一年真实数据观察

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.08.002

Grażyna Deja PhD , Aleksandra Brudzińska , Łukasz Wybrańczyk , Rafał Deja PhD , Przemysława Jarosz-Chobot PhD

Objectives

Published data still highlight discordances between glucose management indicator (GMI; the parameter estimating glycated hemoglobin [A1C] from continuous glucose monitoring [CGM] reporting) and laboratory A1C, for reasons yet to be explored. In our study we aimed to identify potential clinical factors contributing to these discordances.

Methods

A retrospective study of 99 children (mean 12.92±4.03 years) was conducted using CGM devices (Dexcom G6-31, FreeStyle Libre 2-30, and Guardian 3-38). Inclusion criteria for patients were type 1 diabetes (T1D), continuous use of one type of CGM (with >70% sensor activity) over the previous year, and quarterly visits. At each visit, we collected data for age, sex, body mass index, diabetes duration, daily insulin dose, CGM report (14 of 90 days), and laboratory A1C.

Results

We confirmed linear dependency between A1C and GMI—that is, higher A1C led to more A1C–GMI differences. The A1C–GMI 90-day discordance was categorized into 4 thresholds: 48.7% at <0.25, 20.1% between 0.25 and 0.5, 22.4% between 0.5 and 0.75, and 8.7% at >0.75. Children with A1C–GMI 90 discordance <0.5% had significantly lower A1C (6.80% vs 7.59%), shorter T1D duration (<5 years), and more stable A1C (differences <0.4 between results). The analysis of participants’ stability based on comparing A1C–GMI 90 discordances at subsequent follow-up visits confirmed an individual variability of <0.25 in two-thirds of participants. Other factors were not associated with the A1C–GMI discordance.

Conclusions

One-year, real-world data show that clinically significant discordances (A1C–GMI 90 >0.5%) occurred in <30% of the children. A greater difference is more likely in individuals with higher A1C, longer diabetes duration, and less stable glycemic management. Individual A1C–GMI 90 discordance was mostly stable, although with varying degrees of difference.

目的：已发表的数据仍然强调GMI（从CGM报告中估计HbA1c的参数）与实验室HbA1c之间的不一致，原因尚待探讨。本研究旨在找出导致这些不一致的潜在临床因素。方法：对99例12.92岁（SD 4.03）使用CGM装置（Dexcom G6-31、Libre 2-30、Guardian 3-38）的儿童进行回顾性研究。纳入标准为：1型糖尿病，过去一年持续使用一种CGM（>70%传感器活动），每季度访问一次。每次就诊时，我们收集数据：年龄、性别、BMI、糖尿病病程、每日胰岛素剂量、CGM报告（14/90天）和实验室HbA1c。结果：我们证实了HbA1c和GMI之间的线性依赖关系——HbA1c越高，HbA1c-GMI的差异越大。HbA1c-GMI 90天不一致性分为4个阈值：48.7% 0.75。结论：一年真实数据显示，临床显著不一致（HbA1c-GMI 90 >0.5%）发生在不到30%的儿童中。在HbA1c值较高、糖尿病病程较长、血糖控制不稳定的个体中，差异更大。HbA1c-GMI 90虽然存在不同程度的差异，但比较稳定。

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引用次数: 0

Identifying Potential Sustainable and Scalable Interventions to Recognize Signs of Diabetes in Children Across Canada 确定潜在的可持续和可扩展的干预措施，以识别加拿大儿童糖尿病的迹象。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.09.002

Zeenat Ladak BSc, MD , Priscilla Medeiros PhD , Geneviève Rouleau PhD , Jennifer Shuldiner PhD , Shazhan Amed MSc, MD , Elizabeth Cummings MD , Manpreet Doulla MD , Josephine Ho MD , Mark Inman MD, FRCPC , Sarah E. Lawrence MD , Patricia Li MD, MSc, FRCPC , Elizabeth Moreau BA , Meranda Nakhla MD, MSc , Julia Von Oettingen MD, PhD, MMSc, FRCP , Elizabeth Sellers MD, MSc , Diane K. Wherrett MD , Rayzel Shulman MD, PhD, FRCPC , Celia Laur PhD

Objectives

Delayed diagnosis of diabetes in children can lead to diabetic ketoacidosis, a life-threatening condition occurring in 10% to 80% of children at diabetes diagnosis. Ketoacidosis is preventable with prompt recognition of signs, urgent attendance to care, and rapid diagnosis and management. Our aim in this study was to plan for the development of an intervention to recognize signs of diabetes in children and prevent ketoacidosis that is evidence and theory informed and has potential for widespread implementation and long-term impact across Canada.

Methods

This qualitative exploratory study included researchers, educators, parents, caregivers, and representatives from relevant health-care organizations (n=41). Through targeted recruitment and snowball sampling, participants took part in a focus group or interview on opportunities to adapt, sustain, scale, and evaluate various diabetes awareness interventions. Transcripts were analyzed using content analysis to examine barriers and facilitators of potential interventions.

Results

Participants proposed several interventions, including using posters, magnets, educational take-home cards, and mass media, to increase awareness about the signs of diabetes in children and the need to rapidly seek care to prevent delayed diagnosis. Each strategy was noted to have advantages, such as refrigerator magnets being visible for a long time, and disadvantages, such as high-cost resources required for mass media. Participants also identified challenges in evaluating interventions and about how to tailor strategies for specific populations while remaining relevant across Canada.

Conclusions

This work informs the development, implementation, and evaluation of a Canadian strategy to recognize signs of diabetes in children and prevent a delay in diagnosis.

儿童糖尿病的延迟诊断可导致糖尿病酮症酸中毒，这是一种危及生命的疾病，发生在10-80%诊断为糖尿病的儿童中。酮症酸中毒是可以预防的迹象，及时识别，紧急护理，快速诊断和管理。本研究的目的是制定一项干预措施的发展计划，以识别儿童糖尿病的迹象并预防酮症酸中毒，这是有证据和理论依据的，具有在加拿大广泛实施和长期影响的潜力。方法：本定性探索性研究包括研究人员、教育工作者、家长、照顾者和相关医疗机构代表（n=41）。通过有针对性的招募和滚雪球抽样，参与者参加焦点小组或面谈，了解适应、维持、扩大和评估各种糖尿病意识干预措施的机会。使用内容分析来分析转录本，以检查潜在干预措施的障碍和促进因素。结果：参与者提出了几种干预措施，包括使用海报、磁铁、教育带回家卡和大众媒体，以提高对儿童糖尿病症状的认识，以及迅速寻求护理以防止延误诊断的必要性。每一种战略都有其优点，例如冰箱磁铁可以长时间可见；也有缺点，例如大众传播媒介所需的资源成本高。与会者还确定了评估干预措施方面的挑战，以及如何为特定人群量身定制战略，同时在加拿大各地保持相关性。结论：这项工作为加拿大识别儿童糖尿病症状和防止诊断延误的策略的制定、实施和评估提供了信息。

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引用次数: 0

Physician-reported Pediatric Diabetes Virtual Visit Quality and Outcome Not Associated With Social Determinants of Health 医生报告的儿童糖尿病虚拟访问质量和结果与健康的社会决定因素无关。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.08.001

Laurence Bastien MD , Ellen B. Goldboom MD , Ewa Sucha PhD , Richard J. Webster PhD , Ivan Terekhov PhD , Caroline Zuijdwijk MD

Objectives

Social determinants of health (SDH) impact diabetes outcomes. In response to the COVID-19 pandemic, virtual care ensured health-care access. However, socially disadvantaged groups have less technology access and skills, leading to potential disparities. We assessed the association between SDH and virtual visit success in children living with diabetes.

Methods

We conducted a secondary study of prospectively collected data for children attending a virtual diabetes physician visit from December 1, 2020, to March 31, 2021. Simultaneously, a quality improvement study required physicians to rate visit success indicators, including comparability to in-person visit (same/better/worse) and outcome (successfully/unsuccessfully replaced in-person visit). These data and patient characteristics were extracted from the electronic health record. Postal code–based deprivation indices were used to determine SDH. Statistical analysis tested for the association between deprivation quintiles and virtual visit success.

Results

Data were obtained for 447 children (age 12.7±3.8 years, 52.3% boys, 93.1% with type 1 diabetes, glucose management indicator 8.0±1.41%). Physicians reported 17.7% worse visits and 13.3% unsuccessful visits. Overall, 20.7% visits were worse or unsuccessful. The odds of having a worse or unsuccessful visit were not different in those with highest vs lowest degree of material deprivation (odds ratio [OR] 1.12, 95% confidence interval [CI] 0.39 to 3.20), social deprivation (OR 0.92, 95% CI 0.32 to 2.66), or ethnic concentration (OR 0.71, 95% CI 0.29 to 1.72).

Conclusions

In our pediatric diabetes population, virtual visit success was not associated with SDH measures, suggesting equitable delivery of virtual care regardless of socioeconomic status. Further studies are required to assess this association in other populations.

目的：健康的社会决定因素（SDH）影响糖尿病结局。为应对COVID-19，虚拟医疗确保了医疗服务的可及性。然而，社会弱势群体获得技术和技能的机会较少，从而导致潜在的差距。我们评估了SDH与糖尿病儿童虚拟就诊成功之间的关系。方法：我们对2020年12月1日至2021年3月31日参加虚拟糖尿病医生就诊的儿童进行了一项前瞻性研究。同时，一项质量改进研究要求医生对访问成功指标进行评分，包括与面对面访问的可比性（相同/更好/更差）和结果（成功/不成功地取代面对面访问）。这些数据和患者特征是从电子健康记录中提取的。采用邮政编码剥夺指数测定SDH。统计分析测试了剥夺五分位数与虚拟访问成功之间的关系。结果：447例儿童(年龄12.7±3.8岁；男性52.3%;93.1%为1型糖尿病；血糖管理指标（8.0±1.41%）。医生报告了17.7%的糟糕就诊和13.3%的不成功就诊。总体而言，20.7%的患者就诊情况较差或不成功。在物质剥夺程度最高和最低的患者中，就诊更糟糕或不成功的几率没有差异（比值比[or] 1.12, 95%可信区间[CI] 0.39, 3.20），社会剥夺（or 0.92, 95%CI 0.32, 2.66），或种族集中（or 0.71, 95%CI 0.29, 1.72）。结论：在我们的儿童糖尿病人群中，虚拟就诊成功与SDH测量无关，这表明无论社会经济地位如何，都可以公平地提供虚拟护理。需要进一步的研究来评估其他人群的这种关联。

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引用次数: 0

Patterns in the Incidence (1994–2018) and Prevalence (2004–2018) of Type 1 and Type 2 Diabetes Among Nova Scotian Youth Under 20 Years of Age 新斯科舍省20岁以下青年1型和2型糖尿病发病率（1994-2018）和患病率（2004-2018）的模式

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.09.003

Elizabeth A. Cummings MD , Teresa Pinto MD , O. Maya Rao BSc , Pamela Talbot MSc

Objectives

Rates of type 1 and type 2 diabetes (T1D and T2D, respectively) in youth may be increasing globally, but findings vary across populations. We aimed to determine changes in incidence and prevalence of T1D and T2D over a 25-year period (1994–2018) in youth <20 years of age in Nova Scotia (NS).

Methods

This population-based descriptive epidemiologic study used the Diabetes Care Program of the NS Registry that prospectively collects population-based records for all cases of diabetes in youth. Incidence (1994–2018) and prevalence (2004–2018) of T1D and T2D were calculated per 100,000 for 5-year periods using national census population estimates (0–19 years) and analyzed by sex, age group, and rural vs urban residence.

Results

Incidence (95% confidence interval [CI]) of T1D rose from 26.4 (23.0–29.7) in 1994–1998 to 37.9 (33.3–42.6) in 2014–2018 in 0–14-year-olds. The average annual increase was 0.7 (0.43–0.97) per 100,000. Incidence appeared to plateau after 2008, except in 10–14-year-olds, where it continued to rise. Prevalence (95% CI) of T1D for youth 0–19 years of age increased from 288.4 (278.2–298.6) per 100,000 in 2004–2008 to 333.4 (321.7–345.1) in 2014–2018. Incidence of T2D in 10–19-year-olds rose from 2.9 per 100,000 in 1994–1998 to 13.0 per 100,000 in 2014–2018 and was higher in females and youth living in rural areas.

Conclusions

Incidence of both types of diabetes in NS is high and continuing to rise. Patterns in T1D incidence align with those reported in other high-incidence populations. Incidence and prevalence of T2D in NS youth were similar to or higher than most previous reports despite the lower ethnic diversity in NS compared with other high-incidence populations.

目的：全球青少年1型（T1D）和2型（T2D）糖尿病的发病率可能正在上升；然而，调查结果因人群而异。我们旨在确定新斯科舍省（NS） 20岁以下青年在25年（1994-2018年）期间T1D和T2D发病率和患病率的变化。方法：这项基于人群的描述性流行病学研究使用了NS登记处的糖尿病护理计划，前瞻性地收集了所有青少年糖尿病病例的基于人群的记录。利用国家人口普查估计值（0-19岁）计算了每10万人5年期间T1D和T2D的发病率（1994-2018年）和患病率（2004-2018年），并按性别、年龄组和农村与城市居住地进行了分析。结果：0-14岁儿童T1D的发病率（95% CI）从1994-1998年的26.4（23.0-29.7）上升至2014-2018年的37.9（33.3-42.6）。年平均增长率为0.7(0.43,0.97)/ 10万。2008年之后，除了10-14岁的儿童发病率继续上升外，发病率似乎趋于平稳。0-19岁T1D患病率（95% CI）从2004-2008年的288.4(278.2-298.6)/ 10万增加到2014-18年的333.4（321.7-345.1）。10-19岁青少年的T2D发病率从1994-1998年的2.9 / 10万上升到2014-2018年的13.0 / 10万，女性和农村青年的发病率更高。结论：NS患者两种糖尿病的发病率均较高，且呈持续上升趋势。T1D的发病率模式与其他高发病率人群的报告一致。尽管与其他高发人群相比，NS的种族多样性较低，但NS青年中T2D的发病率和流行率与大多数先前的报告相似或更高。

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引用次数: 0

Tenfold Insulin Icodec Overdose 胰岛素过量10倍：1例报告。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.07.005

Kara Hawker MD , Justin Morein MD , Gurleen Gill MD , Irena Druce MD, MSc

引用次数: 0

The Role of Group Exercise Classes as a Source of Motivation and Support for Those With Diabetes---a Silver Bullet? 团体运动课程作为糖尿病患者动力和支持的来源——灵丹妙药？

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.08.005

Lindsay S. Nagamatsu PhD , Joyla A. Furlano PhD , Samantha Marshall MSc , Olivia Ghosh-Swaby PhD , Gillian Rutherford , Jane Yardley PhD

引用次数: 0

Can a Combined Epigenetic-Biomarker Score Supplant Chronologic Age as an Independent Determinant of Incident Death in Adults With Dysglycemia 表观遗传-生物标志物联合评分能否取代年代学年龄作为成人血糖异常死亡事件的独立决定因素？

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjd.2025.07.006

Hertzel C. Gerstein MD, MSc , Guillaume Pare MD, MSc , Keyun Zhou MSc , Serena Yang MSc , Michael Chong PhD , Gregory R. Steinberg PhD , Shun Fu Lee PhD

Objectives

Diabetes and prediabetes are associated with premature death and are recognized as conditions of accelerated biologic aging. To date, the best measurement of biologic age is chronologic age. Measures of biologic age that can replace chronologic age as a predictor of death can better approximate risk in affected individuals.

Methods

The relationship between 238 biomarkers, epigenetic age scores, and incident death was analyzed in 2,755 participants (mean age 63.7±8 years) in the Outcomes Reduction with an Initial Glargine Intervention (ORIGIN) trial. Independent biomarkers for death identified using Cox models with forward selection were used to derive a biomarker risk score, which, after validation, was combined with epigenetic scores. Hazards for death per standard deviation higher epigenetic-biomarker score, chronologic age, or the age after adjustment for the score were estimated, and the respective β coefficients were compared.

Results

Four hundred eighty-one participants died during a median follow-up of 6.2 years. Each standard deviation higher age increased the hazard of death 1.69-fold (95% confidence interval [CI] 1.58 to 1.81, β=0.53). When 11 independent death biomarkers were combined with 3 epigenetic risk scores to yield an epigenetic-biomarker score, each standard deviation higher score increased the hazard of death 3.27-fold (95% CI 2.90 to 3.68). Adding standardized age to this model yielded a β coefficient for age of 0.00 (p=0.93). C statistics for the epigenetic-biomarker score alone and age alone were 0.77 (95% CI 0.74 to 0.78) and 0.66 (95% CI 0.63 to 0.68), respectively (p<0.001 for the difference).

Conclusion

An epigenetic-biomarker risk score is a better predictor of death than chronologic age.

背景：糖尿病和前驱糖尿病与过早死亡有关，被认为是加速生物衰老的条件。迄今为止，测定生物年龄的最佳方法是计时年龄。生物年龄的测量可以取代年代学年龄作为死亡预测因子，可以更好地估计受影响个体的风险。方法：对2755名参与者（平均年龄63.7±8岁）的238项生物标志物、表观遗传年龄评分与事件死亡之间的关系进行分析。使用前向选择的Cox模型确定的独立死亡生物标志物用于得出生物标志物风险评分，验证后将其与表观遗传评分相结合。估计每标准差较高的表观遗传-生物标志物评分、实际年龄或调整评分后的年龄的死亡风险，并比较各自的β系数。结果：481名参与者在6.2年的中位随访期间死亡。年龄每增加一个标准差，死亡风险增加1.69倍(95%CI 1.58-1.81；β = 0.53)。当11个独立的死亡生物标志物与3个表观遗传风险评分相结合产生表观遗传-生物标志物评分时，每增加一个标准差，死亡风险增加3.27倍（95%CI 2.90, 3.68）。在此模型中加入标准化年龄，得到年龄的贝塔系数为0.00（P=0.93）。单独使用表观遗传-生物标志物评分和单独使用年龄的C统计值分别为0.77 （95%CI 0.74, 0.78）和0.66 (95%CI 0.63, 0.68) （P为差异）。结论：表观遗传-生物标志物风险评分比实际年龄更能预测死亡。

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引用次数: 0

An Interpretive Description of Participant Experiences Doing Resistance Exercise for Post-Menopausal Females With Type 1 Diabetes 绝经后女性1型糖尿病患者抗阻运动的解释性描述

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes

Pub Date : 2025-11-01 DOI: 10.1016/j.jcjd.2025.10.090

JESSICA LOGAN , NORMAND BOULÉ , JANE YARDLEY

引用次数: 0