Xiudao Song, Jin Ma, Ting Zou, Rong Xin Lu, Wei Ji, Fei Huang, Meiqi Yin
{"title":"Cathepsin H increases the risk of diabetic retinopathy: evidence from Mendelian randomization and bioinformatic analysis.","authors":"Xiudao Song, Jin Ma, Ting Zou, Rong Xin Lu, Wei Ji, Fei Huang, Meiqi Yin","doi":"10.1186/s13098-025-01829-y","DOIUrl":"10.1186/s13098-025-01829-y","url":null,"abstract":"","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"255"},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564649","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}
{"title":"Impact of DHEA supplementation on testosterone and estradiol levels in postmenopausal women: a meta-analysis of randomized controlled trials assessing dose and duration effects.","authors":"ShuYun He, Kunna Lu, Lianying Zhang, Hanwen Cao, Xinyuan Tang, Xinhuan Zhang","doi":"10.1186/s13098-025-01770-0","DOIUrl":"10.1186/s13098-025-01770-0","url":null,"abstract":"<p><strong>Background and aim: </strong>The effects of dehydroepiandrosterone (DHEA) supplementation on testosterone and estradiol concentrations in postmenopausal women have produced conflicting results. This meta-analysis of randomized controlled trials aimed to evaluate the impact of DHEA supplementation on serum testosterone and estradiol levels and to provide evidence regarding the optimal dosage and duration of supplementation.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed/Medline, Embase, Web of Science, and Scopus to identify relevant studies published before June 11, 2024. Data were analyzed using a random-effects model and presented as weighted mean differences (WMDs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The analysis included 21 studies, comprising 17 trial arms assessing estradiol and 20 assessing testosterone. DHEA supplementation significantly increased estradiol (WMD: 7.86 pg/mL; 95% CI 6.33-9.40; P ≤ 0.001) and testosterone levels (WMD: 24.31 ng/dL; 95% CI 15.22-33.40; P ≤ 0.001). Subgroup analyses showed greater increases in estradiol levels among studies using DHEA dosages ≥ 50 mg/day (WMD: 8.65 pg/mL) and those with participants aged ≥ 60 years (WMD: 8.92 pg/mL), although the differences were modest and 95% CIs overlapped. For testosterone, higher levels were observed with DHEA dosages ≥ 50 mg/day (WMD: 29.65 ng/dL).</p><p><strong>Conclusion: </strong>DHEA supplementation at doses ≥ 50 mg/day significantly increases testosterone levels in postmenopausal women. Moreover, in women aged ≥ 60 years, supplementation at the same dosage significantly elevates estradiol levels.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"258"},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564661","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}
{"title":"Non-linear associations of triglyceride glucose index with all-cause and cardiovascular mortality in patients with heart failure.","authors":"Huanhuan Miao, Zhanyang Zhou, Zheng Yin, Yuhui Zhang, Yuqing Zhang, Jian Zhang","doi":"10.1186/s13098-025-01812-7","DOIUrl":"10.1186/s13098-025-01812-7","url":null,"abstract":"<p><strong>Background: </strong>The relationship between triglyceride glucose (TyG) index and long-term prognosis in individuals with heart failure (HF) remains unclear. This study aimed to explore the relationship between the TyG index and both all-cause and cardiovascular mortality in patients with HF.</p><p><strong>Methods: </strong>A total of 709 participants with HF were included from the National Health and Nutrition Examination Survey (1999-2018). The primary endpoints were all-cause mortality and cardiovascular mortality. Participants were classified into three groups (T1, T2, and T3) based on the tertiles of the TyG index, with T1 representing the group having the lowest values, T2 the middle-value group, and T3 the group with the highest values. Multivariate Cox proportional hazards regression model was used to investigate the associations between the TyG index and both all-cause mortality and cardiovascular mortality. The restricted cubic spline (RCS) analysis was used to examine the non-linear associations between TyG index and the endpoint events, and a two-piecewise Cox hazards model was constructed.</p><p><strong>Results: </strong>During a median follow-up period of 74 months, a total of 355 deaths were recorded, with 128 of them attributed to cardiovascular causes. Multivariate Cox regression models showed that compared to the T1 group, the T2 group exhibited a significantly lower risk of cardiovascular mortality (model 1 h: 0.51, 95%CI: 0.28-0.94; model 2 h: 0.55, 95%CI: 0.30-1.00). The RCS analysis revealed a nonlinear relationship between TyG index and all-cause mortality (p-non-linear: 0.014) as well as the cardiovascular mortality (p-non-linear: 0.049) among patients with HF. The inflection points were identified as 8.89 for all-cause mortality and 8.86 for cardiovascular mortality. The risk of all-cause mortality and cardiovascular mortality demonstrated a significantly increase when the TyG index exceeded the corresponding inflection points.</p><p><strong>Conclusions: </strong>J-shaped associations were observed between TyG index and both all-cause mortality and cardiovascular mortality in patients with HF. TyG index exhibited significant predictive value in this population.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"256"},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564662","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}
{"title":"Genetic association of vitamin D receptor polymorphisms (ApaI, BsmI, and FokI) with gestational diabetes mellitus in North Indian women: a case-control study.","authors":"Rakesh Kumar Gupta, Sonal Tiwari, Sakshi Agarwal, Amita Diwakar, Pawan K Dubey","doi":"10.1186/s13098-025-01827-0","DOIUrl":"10.1186/s13098-025-01827-0","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) affects nearly 14% of pregnancies and imposes an increased risk of adverse outcomes for both pregnant women and their developing babies. This study examined the genetic association of vitamin D receptor (VDR) variants (ApaI, BsmI, and FokI) with GDM in the North Indian population.</p><p><strong>Methods: </strong>Tetra-ARMS PCR was used for genotyping of VDR variants followed by Sanger sequencing validation. The genotypes of VDR variants, Odds ratio (OR) and confidence interval (CI) were further analyzed in GDM and determined by different genetic models.</p><p><strong>Results: </strong>The C allele of ApaI (rs7975232) genotype significantly associated with increased risk of GDM compared to the TT genotype carrying pregnant women. The A allele of BsmI, and A allele of FokI genotypes was found as a risk factor for GDM. Sanger sequencing confirmed the changes in ApaI (T/C), BsmI (A/G), and FokI (A/G) gene sequence which linked to GDM. The circulatory vitamin D3 levels were significantly lower in GDM patients whereas, homozygous genotypes of ApaΙ (CC, P < 0.0884), BsmI (GG, P < 0.8192) and FokI (GG, P < 0.0303) was associated with vitamin D deficiency. On other hand, mother age, blood glucose and glycated haemoglobin (HbA1c) were significantly higher in the GDM group vs. the control group.</p><p><strong>Conclusion: </strong>VDR ApaI (rs7975232) and FokI (rs2228570) polymorphisms, HbA1c level, and vitamin D are associated with the risk of GDM in the north Indian population. Considering the impact of vitamin D3 level, it is suggested that pregnant Indian women must consider vitamin D supplementation during pregnancy.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"257"},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564651","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}
{"title":"Cardiovascular-kidney-metabolic syndrome, systemic inflammation, and incident dementia: evidence from 400,740 UK Biobank participants.","authors":"Pingan Li, Haiping Zhang, Jianhua Ma, Jinqi Wang, Shiyun Lv, Xiaoyu Zhao, Xinghua Yang, Yanxia Luo, Xiuhua Guo, Lixin Tao, Bo Gao","doi":"10.1186/s13098-025-01805-6","DOIUrl":"10.1186/s13098-025-01805-6","url":null,"abstract":"<p><strong>Background: </strong>Although some studies examined the association of individual risk factors for cardiovascular-kidney-metabolic (CKM) syndrome (diabetes, chronic kidney disease, and stroke) with the risk of incident dementia, little is known about the impact of overall CKM health on dementia risk. This study investigated (1) the association between CKM syndrome and risk of incident dementia in 400,740 UK Biobank participants and (2) whether systemic inflammation mediated this association.</p><p><strong>Methods: </strong>The association between CKM syndrome and the risk of dementia was assessed using Cox proportional hazards models. The mediating role of systemic inflammation markers was evaluated in 389,287 individuals.</p><p><strong>Results: </strong>Compared with stage 0 CKM syndrome, stages 3 and 4 were significantly associated with an increased risk of dementia (hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.14-1.59; HR, 1.80; 95% CI 1.57-2.07). A significant linear trend was observed between CKM syndrome stages and dementia risk. Stage 2 CKM syndrome with more than two risk factors for CKM significantly increased dementia risk (HR, 1.25; 95% CI 1.07-1.46). Advanced CKM syndrome was associated with an increased risk of dementia (HR, 1.62; 95% CI 1.53-1.71). Four systemic inflammation markers significantly mediated the association between CKM syndrome and the risk of dementia.</p><p><strong>Conclusions: </strong>Higher stages of CKM syndrome are associated with an increased risk of dementia, and systemic inflammation mediates this association. These results highlight the importance of early and comprehensive management of poor CKM health to reduce the risk of dementia.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"253"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559453","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}
{"title":"Dietary inflammatory index and mortality in middle-aged and elderly patients with metabolic syndrome.","authors":"Xiangmei Li, Lei Liu, Xing Li, Long Yang, Li Men","doi":"10.1186/s13098-025-01818-1","DOIUrl":"10.1186/s13098-025-01818-1","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Syndrome (MetS) significantly increases the risk of cardiovascular diseases and mortality, particularly in middle-aged and elderly populations. The Dietary Inflammation Index (DII) is a validated tool for assessing the inflammatory potential of an individual's diet, with higher scores indicating a dietary pattern that is more favorable to inflammation. The MetS population is inherently characterized by chronic low-grade inflammation, and previous studies have demonstrated an association between the DII and a wide range of chronic diseases in the general population, but little is known about the relationship between dietary inflammation and risk of death in the MetS population. This study aimed to investigate the association between DII and all-cause and cardiovascular mortality among middle-aged and elderly MetS patients.</p><p><strong>Methods: </strong>This retrospective cohort study was based on publicly available data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. A total of 7,143 participants aged 40 years and older who were diagnosed with MetS were included. The MetS is based on the Joint Interim Statement criteria developed by the International Diabetes Federation (IDF) in 2009, which defines the MetS as the presence of any three or more of the following five items: central obesity, elevated triglycerides, lowered high-density lipoprotein (HDL) cholesterol, elevated blood pressure, and impaired glucose metabolism. Nutrient intake data were obtained from 24-hour dietary recalls. DII calculations were based on 28 food nutrient parameters, including energy, macronutrients, vitamins, minerals, and selected bioactive ingredients. Kaplan-Meier (KM) survival curves were used to analyze survival outcomes. Cox proportional hazards regression models were employed to assess the relationship between DII and mortality, with adjustments made for potential confounding factors. Restricted cubic spline (RCS) plots were used to explore the dose-response relationship.</p><p><strong>Results: </strong>During a median follow-up period of 98 months, 1,026 participants (14.36%) died, including 284 (4.43%) from cardiovascular diseases. KM survival curves showed that higher DII quartiles were associated with lower survival rates (Log-rank P < 0.05). Cox regression results indicated that each unit increase in DII was associated with a higher risk of all-cause mortality (HR = 1.052, 95% CI: 1.006-1.100, P = 0.026) and cardiovascular mortality (HR = 1.157, 95% CI: 1.076-1.244, P < 0.001). Compared to the lowest quartile, participants in the highest DII quartile had significantly higher risks of all-cause mortality (HR = 1.289, 95% CI: 1.020-1.628, P = 0.033) and cardiovascular mortality (HR = 1.817, 95% CI: 1.194-2.764, P = 0.005). RCS analysis revealed a linear relationship between DII and both all-cause mortality (nonlinearity, P = 0.705) and cardiovascular mortality (nonlinearity, P = 0","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"245"},"PeriodicalIF":3.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552583","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}
Usman H Malabu, Venkat N Vangaveti, Julie Goodall, Jacqueline Bulbrook, Erik Biros, Harshal Deshmukh, Kunwarjit S Sangla
{"title":"Telemedical treatment of diabetic foot ulcer in rural and remote areas: a prospective single centre randomised controlled clinical trial.","authors":"Usman H Malabu, Venkat N Vangaveti, Julie Goodall, Jacqueline Bulbrook, Erik Biros, Harshal Deshmukh, Kunwarjit S Sangla","doi":"10.1186/s13098-025-01817-2","DOIUrl":"10.1186/s13098-025-01817-2","url":null,"abstract":"<p><strong>Objectives: </strong>The role of telemedical treatment for patients with diabetic foot ulcers residing in rural areas remains uncertain. Therefore, our objective was to conduct a randomized controlled trial comparing the effectiveness of telemedical treatment in rural settings with the standard tertiary healthcare approach for managing diabetic foot ulcers.</p><p><strong>Methods: </strong>The study was conducted between 2016 and 2022. Participants were randomly assigned 2:1 to either face-to-face usual care (UC) group or telemedical treatment group. The protocol for the telemedical treatment group involved fortnightly consultations conducted by a locally trained nurse in the patients' rural hospital over 12 weeks compared to similar protocol for face-to-face podiatrist-treated UC group. The primary endpoints were complete healing of the ulcer or limb amputation while secondary outcomes included circulating markers of inflammation as a marker of wound healing.</p><p><strong>Results: </strong>One hundred and fifty-one participants out of 232 met the inclusion criteria and 50 were randomised to telemedical treatment group and 101 to the UC group. The clinical and demographic characteristics of the participants were similar in both groups. Following 12 weeks of treatment, we observed that complete ulcer healing was achieved in 16 out of 50 individuals (32%) in the telemedical treatment group, while 28 out of 101 individuals (28%) in the UC group achieved the same outcome (p = 0.58). Amputation rates were 23% (11/50) in the telemedicine and 25% (23/101) in the UC group (p = 0.080).</p><p><strong>Conclusions: </strong>Our study found no statistically significant differences in wound healing (32% vs. 28%, p = 0.58) or amputation rates (23% vs. 25%, p = 0.80) between nurse-led telemedicine in rural settings and usual care for diabetic foot ulcers over 12 weeks. This promising result suggests that telemedicine could be a viable option for rural patients; however, further research exploring other clinically relevant endpoints and vulnerable subgroups is needed to solidify its role.</p><p><strong>The known: </strong>Diabetic foot ulcers pose a significant burden on rural and remote communities with limited access to specialists' care and high limb amputation rates.</p><p><strong>The new: </strong>Our randomised controlled trial demonstrated that nurse-led telemedicine in rural hospitals is equally effective as podiatrist care in tertiary hospitals for healing diabetic foot ulcers within 12 weeks. Key ulcer measurements and wound healing biomarkers further support this finding.</p><p><strong>The implications: </strong>Telemedicine offers a viable solution for management of diabetic foot ulcer in rural and remote areas. It has the potential to enhance patient outcomes and significantly reduce healthcare disparities.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"246"},"PeriodicalIF":3.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552563","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}
Kaiser Wani, Osama Emam, Balvir Kumar, Nasser M Al-Daghri, Shaun Sabico
{"title":"Exploring inflammation and adipose tissue dysfunction in metabolically healthy versus unhealthy obesity among Arab adults.","authors":"Kaiser Wani, Osama Emam, Balvir Kumar, Nasser M Al-Daghri, Shaun Sabico","doi":"10.1186/s13098-025-01836-z","DOIUrl":"10.1186/s13098-025-01836-z","url":null,"abstract":"","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"244"},"PeriodicalIF":3.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552585","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}