Diabetology & Metabolic Syndrome最新文献

{"title":"Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study.","authors":"Chong Zhang, Cuijun Hao, Weiru Liang, Kun Hu, Tingting Guo, Yi Chen, Meng Ning, Yingwu Liu","doi":"10.1186/s13098-025-01649-0","DOIUrl":"10.1186/s13098-025-01649-0","url":null,"abstract":"<p><strong>Background: </strong>Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a nationwide longitudinal cohort.</p><p><strong>Methods: </strong>Data were derived from the China Health and Retirement Longitudinal Study, including individuals aged ≥ 45 years. Participants were categorized into early and advanced CKM syndrome stages. The BRI was used to measure abdominal obesity, and frailty was assessed using the frailty index.</p><p><strong>Results: </strong>Higher BRI in individuals within early CKM syndrome stages was associated with an increased risk of frailty progression compared to those with advanced stages (adjusted hazard ratio [aHR] 1.30, 95% confidence interval [CI] 1.17-1.45 vs. aHR 1.16, 95% CI 0.96-1.40). High cumulative BRI with advanced CKM stages progression and persistent advanced CKM stages over time also predicted a greater risk of frailty. Furthermore, BRI outperformed body mass index (BMI) in predicting frailty progression after combined with conventional model (area under the curve [AUC] 0.708, 95% CI 0.694-0.722 vs. AUC 0.704, 95% CI 0.690-0.718; P = 0.033).</p><p><strong>Conclusions: </strong>Abdominal obesity, indicated by BRI, is a strong predictor of frailty progression, particularly in early CKM stages. High cumulative BRI, along with advanced CKM progression and persistent advanced CKM stages, further increases frailty risk. Notably, BRI outperforms BMI in enhancing conventional frailty prediction models. These findings underscore the importance of monitoring abdominal obesity in early CKM stages to mitigate future frailty risk.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"75"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540348","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":"Brazilian guideline for screening and diagnosis of type 2 diabetes: a position statement from the Brazilian Diabetes Society.","authors":"Melanie Rodacki, Lenita Zajdenverg, Wellington Santana da Silva Júnior, Luciano Giacaglia, Carlos Antonio Negrato, Roberta Arnoldi Cobas, Bianca de Almeida-Pititto, Marcello Casaccia Bertoluci","doi":"10.1186/s13098-024-01572-w","DOIUrl":"https://doi.org/10.1186/s13098-024-01572-w","url":null,"abstract":"<p><strong>Background: </strong>Patients with type 2 diabetes (T2D) often experience prolonged periods of asymptomatic hyperglycemia, which significantly increases the risk of developing chronic complications related to diabetes. Screening programs for individuals at high risk for T2D provide valuable opportunities not only for early diagnosis but also for detecting intermediate hyperglycemic states, commonly referred to as prediabetes. Interventions aimed at preventing diabetes in this group can successfully delay or even avoid the onset of the disease and its associated burdens. This review is an update of the Brazilian Diabetes Society (Sociedade Brasileira de Diabetes [SBD]) evidence-based guideline for diagnosing diabetes and screening T2D.</p><p><strong>Methods: </strong>The methodology was previously published and defined by the internal institutional steering committee. The working group drafted the manuscript by selecting vital clinical questions for a narrative review, utilizing MEDLINE via PubMed to identify relevant studies. The review assessed the best available evidence, including randomized clinical trials (RCTs), meta-analyses, and high-quality observational studies related to the diagnosis of diabetes.</p><p><strong>Results and conclusions: </strong>Fifteen specific recommendations were formulated. Screening is recommended for adults aged 35 and older or younger individuals with obesity and additional risk factors. For children and adolescents, screening is recommended starting at age ten or the onset of puberty if they are overweight or obese and have additional risk factors. Fasting plasma glucose (FPG) and HbA1c are recommended as initial screening tests. The oral glucose tolerance test (OGTT) is recommended for high-risk individuals with normal HbA1c and FPG or those with prediabetes. The 1-h OGTT is preferred over the 2-h OGTT, as it is both more practical and a superior test. A structured approach to reevaluation intervals is provided.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"78"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556050","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":"Association between lipoprotein(a) and diabetic peripheral neuropathy in patients with type 2 diabetes: a meta-analysis.","authors":"Li Sheng, Yiwen Yang, Yunqing Zhou","doi":"10.1186/s13098-025-01621-y","DOIUrl":"10.1186/s13098-025-01621-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes (T2D). Lipoprotein(a) [Lp(a)], a known cardiovascular risk factor, has been hypothesized to influence the development of DPN. This meta-analysis aimed to investigate the relationship between Lp(a) levels and DPN in patients with T2D.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases was performed up to October 12, 2024. Observational studies assessing blood Lp(a) levels in T2D patients with and without DPN or evaluating the association between Lp(a) and DPN risk were included. Data synthesis utilized a random-effects model to calculate standardized mean differences (SMDs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eleven studies with 18,022 patients were included. Patients with DPN had significantly higher Lp(a) levels than those without DPN (SMD: 0.10, 95% CI: 0.02-0.19, p = 0.01; I² = 43%). High Lp(a) levels were associated with DPN (OR: 1.31, 95% CI: 1.07-1.60, p = 0.009; I² = 62%). Subgroup analyses according to study design, mean age of the patients, methods for measuring Lp(a) concentration, cutoff values of a high Lp(a), and study quality scores showed consistent results (p for subgroup difference all > 0.05). A high Lp(a) was associated with DPN in studies from Asian countries, but not in those from European countries (p for subgroup difference = 0.001).</p><p><strong>Conclusion: </strong>Elevated Lp(a) levels are associated DPN in T2D patients, particularly in studies from Asian countries.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"76"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540427","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":"Association of triglyceride-glucose index with bone mineral density and fracture: a systematic review.","authors":"Maryam Yousefiasl, Arezou Soltanattar, Ali Ezzatollahi Tanha, Pouria Azami, Maryam Alaei, Amir Ali Alamdari, Farhad Esmailsorkh, Amirhossein Habibzadeh, Shaghayegh Khanmohammadi","doi":"10.1186/s13098-025-01642-7","DOIUrl":"https://doi.org/10.1186/s13098-025-01642-7","url":null,"abstract":"<p><strong>Background and aim: </strong>Studies have found inconsistent results regarding triglyceride-glucose (TyG) index and bone health. This systematic review aims to synthesize the existing evidence on the association between the (TyG) index, bone mineral density (BMD), and bone fractures.</p><p><strong>Method: </strong>A comprehensive search of PubMed, Scopus, Web of Science, and Embase databases was performed for studies published up to December 26, 2024. Inclusion criteria encompassed human studies examining the TyG index in relation to BMD or fractures. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Data synthesis included both qualitative and descriptive statistical analyses.</p><p><strong>Results: </strong>From 201 studies identified, 12 met the inclusion criteria comprising 817,242 participants. Most studies reported a significant association between TyG index and bone fractures. The studies reported inconsistent findings regarding the association between the TyG index and BMD. While some studies found no correlation between the TyG index and BMD in individuals aged ≥ 50 years, studies on the general population aged ≥ 18 years demonstrated a significant correlation between the TyG index and BMD. Variations in the age of study populations, the presence of diabetes, BMI, and adjustment factors likely contributed to these discrepancies. Further research is needed to clarify the role of the TyG index in bone health and its potential utility as a surrogate marker.</p><p><strong>Conclusion: </strong>The TyG index is associated with bone fractures and can serve as a surrogate marker for osteoporosis in the general populations rather than exclusively for the elderly.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"77"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556036","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":"Effect of high-dose N-acetyl cysteine on the clinical outcome of patients with diabetic peripheral neuropathy: a randomized controlled study.","authors":"Sherien Mohamed Emara, Sarah Farid Fahmy, Mona Mohamed AbdelSalam, Lamia Mohamed El Wakeel","doi":"10.1186/s13098-025-01624-9","DOIUrl":"https://doi.org/10.1186/s13098-025-01624-9","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a vastly common and bothersome disorder with a clinically challenging course of treatment affecting patients with diabetes. This study aimed to evaluate the efficacy and safety of high dose oral N-acetyl cysteine (NAC) as adjuvant therapy on clinical outcome of DPN.</p><p><strong>Methods: </strong>A prospective, randomized, parallel, open label, controlled clinical trial. Ninety eligible DPN patients were randomly assigned to either control group receiving standard of care or NAC group receiving standard of care treatment and NAC at a dose of 2400 mg/day for 12 weeks. Glutathione peroxidase (GPx), nuclear factor erythoid-2 related factor (NRF-2) and tumor necrosis factor (TNF) were measured at baseline and after 12 weeks to assess anti-oxidant and anti-inflammatory properties. Michigan neuropathy screening instrument (MNSI), Toronto clinical neuropathy score (TCNS), Diabetic neuropathy score (DNS), Diabetes-39 quality of life questionnaire (DQOL) and pain score were assessed at baseline and after 12 weeks.</p><p><strong>Results: </strong>NAC group showed a significant increase (p < 0.05) in NRF-2 by 25.3% and GPx by 100% and a decline of 21.45% in TNF-alpha levels versus controls that reported a decline in NRF-2 and GPx and an increase in TNF-alpha. HgbA1C and AST levels significantly decreased in NAC versus controls (7.2 ± 1 vs 8 ± 1.1, p = 0.028 and 29.1 vs 55.4, p = 0.012) respectively. NAC administration resulted in a significant decline in MNSA, TCNS, DNS and pain scores versus controls that showed increase in all scores. The QOL total score and the anxiety and energy and mobility domain scores significantly decreased in the NAC group versus controls, p < 0.001.</p><p><strong>Conclusion: </strong>High dose NAC administered for 12 weeks modulated inflammation by reducing TNF-alpha and increasing GPx and NRF2 versus controls. NAC improved clinical outcomes of DPN reflected by a decline in neuropathy and pain scores and an improvement in QOL.</p><p><strong>Clinical trial registration number: </strong>NCT04766450.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"79"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556086","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":"Association between the triglyceride-glucose index and acute kidney injury in patients undergoing percutaneous coronary: a retrospective analysis of the MIMIC-IV database.","authors":"Fan Zhang, Shen Zhan, Lihong Zhang, Xin Zheng, Xiangru Li, Yuzhu Wang","doi":"10.1186/s13098-025-01647-2","DOIUrl":"https://doi.org/10.1186/s13098-025-01647-2","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication that affects the outcomes of patients undergoing percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, a metric computed from fasting blood triglyceride and glucose levels, is closely associated with poor PCI outcomes. This study examined the association between the TyG index and incidence of AKI in patients undergoing PCI.</p><p><strong>Methods: </strong>Clinical information was obtained from the Medical Information Mart for Intensive Care IV database, which contains clinical data on 70,000 patients admitted to the intensive care unit at Beth Israel Deaconess Medical Center from 2008 to 2019. In total, 435 patients who underwent PCI were enrolled in this retrospective study, and they were categorized according to their AKI status, TyG quartiles, and diabetes mellitus (DM) history to analyze their baseline characteristics. The association of the TyG index with the risk of AKI was assessed using restricted cubic spline regression and logistic regression models. Subgroup analyses were also performed in patients with and without DM.</p><p><strong>Results: </strong>Compared with the non-AKI population, patients with AKI who underwent PCI had a higher mean TyG index (p = 0.004). The restricted cubic spline regression model revealed a linear correlation between the TyG index and AKI risk (p for nonlinear = 0.123) in patients undergoing PCI. A high TyG index was a risk factor for AKI in non-DM subgroup, as well as in patients with BMI < 28 (odds ratio [OR] = 1.77; p = 0.050) and those with no history of diabetes (OR = 1.83; p = 0.047) or COPD (OR = 1.56; p = 0.030).</p><p><strong>Conclusions: </strong>This study highlighted the role of the TyG index as a predictive biomarker for AKI in patients without DM undergoing PCI, providing clinicians with a tool for identifying high-risk individuals for early intervention.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"74"},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540430","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":"Association between estimated glucose disposal rate with the all-cause and cause-specific mortality among the population with cardiometabolic syndrome.","authors":"Chao Fu, Yuxin Li, Xiangyang Gao, Yan Gong, Hantong Wang, Guanyun Wang, Xiaoxue Ma, Bingqing Han, Shanshan Liu, Hao Zhang, Fei Wang, Qiang Zeng","doi":"10.1186/s13098-025-01636-5","DOIUrl":"10.1186/s13098-025-01636-5","url":null,"abstract":"<p><strong>Background: </strong>Estimated glucose disposal rate (eGDR) is considered as a reliable alternative indicator of insulin resistance. However, the relationship between eGDR levels and mortality among individuals with cardiometabolic syndrome (CMS), as well as within different glucose metabolic states in this population, remains unclear.</p><p><strong>Methods: </strong>We conducted a cohort study on 9928 CMS participants from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2018. The relationship between eGDR levels and mortality in the CMS population was evaluated using multivariable Cox proportional hazards regression models and restricted cubic splines (RCS). Finally, stratified analysis was performed to determine the relationship between eGDR levels and mortality in different subgroups.</p><p><strong>Results: </strong>Cox regression analysis showed a significant correlation between eGDR levels and both all-cause and cause-specific mortality in the entire CMS population (all p < 0.05). RCS analysis revealed a non-linear relationship between eGDR levels and both all-cause (p for overall < 0.001, p for non-linear < 0.001) and diabetes specific mortality (p for overall < 0.001, p for non-linear = 0.004) in CMS population, while a linear relationship with cardiovascular specific mortality (p for overall < 0.001, p for non-linear = 0.091). In participants with baseline diabetes mellitus (DM), eGDR levels were significantly correlated with all-cause mortality, cardiovascular specific mortality, and diabetes specific mortality (all p < 0.05). In CMS participants with baseline pre-diabetes mellitus (Pre-DM), eGDR levels were significantly correlated with cardiovascular-specific and diabetes-specific mortality (all p < 0.05). In CMS participants with baseline normal glucose regulation (NGR), eGDR levels were only significantly related to diabetes specific mortality (p < 0.05).</p><p><strong>Conclusion: </strong>There is a significant correlation between eGDR levels and both all-cause and cause-specific mortality in the entire CMS population. Furthermore, the protective effect of high eGDR levels on mortality persists across various glucose metabolic states.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"73"},"PeriodicalIF":3.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515014","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":"Association of pericoronary inflammation with atherosclerotic plaque progression in diabetic patients with improved modifiable cardiovascular risk factors: a longitudinal CCTA cohort study.","authors":"Tianhao Zhang, Hongkai Zhang, Xuelian Gao, Pingan Peng, Tianlong Chen, Xiaoming Zhang, Jingyao Yang, Yang Zheng, Yulu Peng, Xiaonan Ma, Dongmei Shi, Zhijian Wang, Lei Xu, Yujie Zhou, Yu Du","doi":"10.1186/s13098-025-01645-4","DOIUrl":"10.1186/s13098-025-01645-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pericoronary adipose tissue (PCAT) attenuation, as assessed by coronary computed tomography angiography (CCTA), has been identified as a marker of pericoronary inflammation and a predictor of future adverse atherosclerotic events. However, the impact of changes in PCAT attenuation, as evaluated by consecutive CCTAs, on plaque progression in high-risk atherosclerotic patients with improved modifiable cardiovascular risk factors (mCRFs) remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive patients with type 2 diabetes mellitus (T2DM) who had improved mCRFs and underwent serial, clinically indicated CCTA examinations (time interval ≥ 12 months) at our center between July 2019 and July 2022 were screened. Eligible participants had at least one study plaque, defined as a plaque without significant anatomic stenosis, located in one of the major coronary arteries, which had not been intervened upon or caused adverse events between serial CCTA scans. Percent atheroma volume (PAV) and PCAT attenuation were measured for each study plaque at baseline and follow-up using CCTA plaque analysis software. Changes in PAV (δPAV = follow-up PAV - baseline PAV) were compared based on changes in PCAT attenuation [δPCAT attenuation] (&gt; 0 or ≤ 0). Multivariate linear regression models were used to evaluate the relationship between δPCAT attenuation and δPAV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 98 T2DM patients (mean age: 59.9 years; 75.3% men; 152 plaques) had mCRFs that reached therapeutic targets at follow-up CCTA. However, overall PAV progressed from baseline in all patients [(41.68 ± 12.47)% vs. (43.71 ± 12.24)%, p = 0.035], accompanied by an increase in coronary inflammation (i.e., PCAT attenuation) during a median follow-up of 13.5 months (interquartile range [IQR]: 12.2, 17.5 months).Compared to patients with δPCAT attenuation ≤ 0, those with δPCAT attenuation &gt; 0 had a significantly greater increase in overall PAV from baseline [(4.09 ± 12.09)% vs. (-0.82 ± 10.74)%, p = 0.011], calcified PAV [1.57% (IQR: 0.13%, 3.84%) vs. 0.38% (IQR: -0.26%, 2.58%), p = 0.008], and a numerical but non-significant increase in non-calcified PAV [(1.29 ± 11.75)% vs. (-1.87 ± 10.47)%, p = 0.089]. Multivariate linear regression models demonstrated that increased PCAT attenuation was significantly associated with the progression of overall PAV (β = 0.339, 95% CI: 0.129-0.549), non-calcified PAV (β = 0.237, 95% CI: 0.019-0.455), and calcified PAV (β = 0.109, 95% CI: 0.019-0.200), independent of age, sex, cardiovascular risk factors, medications, and baseline PCAT attenuation and PAV (all p &lt; 0.05). The effect of elevated PCAT attenuation on overall plaque progression was consistent across subgroups (all p for interaction &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this longitudinal CCTA cohort of T2DM patients with improved mCRFs, increased pericoronary inflammation was associated with the progression of atherosclerotic plaque, particu","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"71"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499692","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":"Metabolic syndrome including both elevated blood pressure and elevated fasting plasma glucose is associated with higher mortality risk: a prospective study.","authors":"Shu Li, Chi Pang Wen, Huakang Tu, Sicong Wang, Xue Li, Andi Xu, Wenyuan Li, Xifeng Wu","doi":"10.1186/s13098-025-01628-5","DOIUrl":"10.1186/s13098-025-01628-5","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) encompasses a collection of metabolic abnormalities. This study aims to determine which combination of MetS components has the highest mortality risk, and to investigate the causal relationships between MetS components and longevity.</p><p><strong>Methods: </strong>Prospective analyses were conducted on 340,196 participants from the MJ cohort at baseline, and 121,936 participants had follow-up MetS information. We defined MetS according to the NCEP ATP III criteria. The study's outcomes included mortality from cardiovascular disease (CVD), cancer, and all causes combined. We employed Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals. Multivariable Mendelian randomization (MVMR) was employed to infer causality using the genetic data of MetS components and longevity.</p><p><strong>Results: </strong>Elevated blood pressure (BP) was the initial split for all-cause mortality, cancer mortality, and CVD mortality. Participants with MetS, especially those with elevated BP and elevated fasting plasma glucose (FPG), had higher mortality risks than those with other types of MetS. In the MJ cohort, participants with elevated BP and FPG (BG-type MetS) had a 44% (HR = 1.44, 95% CI = 1.37-1.51), 73% (HR = 1.73, 95% CI = 1.62-1.84), and 34% (HR = 1.34, 95% CI = 1.27-1.42) increased risk of all-cause mortality, cancer mortality, and CVD mortality, respectively, compared with non-BG-type MetS (12%, 24%, 5%). The highest mortality rate and mortality risk were observed in participants with BG-type MetS at baseline and follow-up (mortality rate/1000 person years = 9.73, 95% CI = 8.81-10.74; HR = 1.52, 95% CI = 1.35-1.72). SBP and FPG increases that were genetically proxied to a 1-standard deviation higher level decreased the probabilities of living to the 90th percentile age by 41% (OR = 0.59, 95% CI = 0.40-0.86) and 32% (OR = 0.68, 95% CI = 0.48-0.98) in MVMR, respectively.</p><p><strong>Conclusions: </strong>Individuals with BG-type MetS are at a higher risk of death than those with other types of MetS. Therefore, these individuals should be targeted to improve MetS outcomes.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"72"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499715","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":"Stress hyperglycemia ratio: a novel prognostic marker in chronic kidney disease.","authors":"Tianquan Chen, Yijiao Zhu, Yushuang Liu, Hongxia Li, Zhe Han, Min Liu, Xia Xu, Rong Wang","doi":"10.1186/s13098-025-01639-2","DOIUrl":"10.1186/s13098-025-01639-2","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) has recently been suggested to characterize acute glycemic rise better than the admission blood glucose and to be associated with unfavorable outcomes in patients with various cardiovascular diseases. This study aimed to explore the associations between SHR and all-cause or cardiovascular disease (CVD) mortality in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>Adults with CKD participating in the 1999-2018 US National Health and Nutrition Examination Survey with complete SHR and follow-up data were included. SHR was calculated from fasting blood glucose and glycated hemoglobin levels. Associations between SHR and mortality were investigated by weighted multivariable Cox regression analysis.</p><p><strong>Results: </strong>Among the 3284 participants (mean age 61 years, men prevalence 44.09%) included, 1324 (487 CVD-related) deaths occurred during a median follow-up of 87 months. The restricted cubic spline curve adjusted for all covariates showed a U-shaped and J-shaped association between SHR and all-cause or CVD mortality, respectively, with discernible inflection points at 0.86 and 0.88, respectively. The hazard ratio (95% confidence interval) was 0.117 (0.034-0.404) for SHR < 0.86 and 2.065 (1.328-3.209) for SHR ≥ 0.86 for all-cause mortality, and 0.063 (0.008-0.531) for SHR < 0.88 and 1.551 (0.770-3.124) for SHR ≥ 0.88 for CVD mortality.</p><p><strong>Conclusion: </strong>We identified U-shaped and J-shaped association between SHR and all-cause or CVD mortality, respectively, in patients with CKD. This result highlights that SHR may be potentially informative for the risk stratification of CKD patients. Given the potential limitations of residual confounding, prospective studies are needed to confirm our findings.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"69"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499720","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}