Diabetology & Metabolic Syndrome最新文献

{"title":"The association between insulin resistance assessed by estimated glucose disposal rate and stroke prevalence and mortality in non-diabetic people: evidence from two prospective cohorts.","authors":"Dandan Li, Yan Guo, Fanfan Cui, Yajing Cheng, Shufang Yan, Tong Yu, Xuejiao Li, Zhanju Liu, Hongwei Jiang","doi":"10.1186/s13098-025-01956-6","DOIUrl":"10.1186/s13098-025-01956-6","url":null,"abstract":"<p><strong>Background: </strong>The estimated glucose disposal rate (eGDR), serving as a measure of insulin resistance (IR), provides a simpler and more accessible method for assessing insulin sensitivity. However, its association with stroke and mortality in non-diabetic patients remains to be fully clarified.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) Study (2003-2014, n = 11,063, age ≥ 45) were examined. Participants with diabetes, coronary heart disease (CHD), or missing key data were excluded. eGDR was calculated based on waist circumference, hypertension status, and glycated hemoglobin (HbA1c). The primary outcomes were stroke prevalence and all-cause, cardiovascular, and cerebrovascular disease mortality. For stroke outcomes, a cross-sectional analysis was conducted and multivariate logistic regression was employed for assessment; whereas for all mortality outcomes, longitudinal analysis was performed using multivariate Cox proportional hazards models. The association between eGDR and these outcomes was investigated using Kaplan-Meier survival analysis, Cox proportional hazards regression models, restricted cubic splines (RCS), and mediation analysis, adjusted for demographic and clinical variables. An additional cohort of 6,873 participants from the China Longitudinal Health and Aging Study (CHARLS) was applied to evaluate the association further.</p><p><strong>Results: </strong>Between 2003 and 2014, the NHANES study documented 380 stroke cases. A higher eGDR showed a significant linked to lower stroke prevalence (OR 0.44, 95% CI: 0.31-0.62, P < 0.001), as well as reduced all-cause mortality (HR 0.78, 95% CI: 0.68-0.89), CVD mortality (HR 0.70, 95% CI: 0.53-0.94) and cerebrovascular diseases mortality (HR 0.54, 95% CI: 0.31-0.94) over a median 117.6 months. Each one-unit increase in eGDR was associated with a 15% decrease in stroke prevalence (OR 0.85, 95% CI 0.79-0.9). The protective impact of a higher eGDR against stroke was consistently observed across most subgroups, but significantly stronger in individuals < 60 years. CHARLS demonstrated the research findings.</p><p><strong>Conclusions: </strong>Elevated eGDR levels showed an independent correlation with a significantly reduced prevalence of stroke and decreased risks of mortality in non-diabetic adults.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"390"},"PeriodicalIF":3.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274017","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":"Mobile application-based lifestyle intervention for improving glycemic control and body composition in manufacturing company employees in South Korea.","authors":"Dahyeon Koo, Yujin Bang, Dohoung Kim, Irang Im, Pumsoo Kim, Dougho Park","doi":"10.1186/s13098-025-01948-6","DOIUrl":"10.1186/s13098-025-01948-6","url":null,"abstract":"<p><strong>Background: </strong>Workplace environments play a significant role in the development of chronic metabolic disorders. In this study, we evaluated the effectiveness of a mobile application-assisted lifestyle intervention integrated with continuous glucose monitoring (CGM) in improving glycemic control and body composition among employees of manufacturing companies and explored key predictors of intervention responsiveness.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving 344 employees from two manufacturing companies in South Korea. Participants underwent a 12-week intervention that included individualized coaching through a mobile application and structured behavioral support, with the first 2 weeks involving real-time glucose monitoring. The primary outcomes included changes in glycated hemoglobin (HbA1c) and body mass index (BMI). Secondary outcomes were body composition parameters and CGM-derived glycemic variability indices, including spike count, average real variability (ARV), and frequency strength variability (FSV). Logistic regression analysis was conducted to identify key predictors of intervention effectiveness.</p><p><strong>Results: </strong>After 12 weeks, HbA1c, BMI, body weight, and body fat mass significantly reduced. In addition, the muscle-to-fat ratio significantly increased. Participants with baseline HbA1c ≥ 6.5% showed greater improvements in HbA1c (7.2→6.8%, p < 0.001) than those with HbA1c < 6.5%. Similarly, the high BMI subgroup (≥ 25 kg/m²) exhibited significant improvements in BMI (27.6 to 27.0 kg/m², p < 0.001). Early CGM data indicated significant reductions in spike count (p = 0.046), ARV (p = 0.001), and FSV (p = 0.031). Lower baseline FSV indicated greater HbA1c improvement (adjusted odds ratio, 0.67; 95% confidence interval, 0.50-0.90, p = 0.008).</p><p><strong>Conclusion: </strong>This study demonstrated that a 12-week mobile application-based lifestyle intervention is associated with improved glycemic control and body composition, particularly among manufacturing company employees with elevated baseline HbA1c and BMI. Early reductions in glycemic variability indicated the intervention's potential for rapid and sustained metabolic benefits.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"389"},"PeriodicalIF":3.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274079","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":"Calf skinfold measurements as a diagnostic tool for lipodystrophy syndromes: a cross-sectional study.","authors":"Grayce Ellen da Cruz Paiva Lima, Fabia Karine de Moura Lopes, Jessica Silveira Araújo, Natália Prado Boris, Virginia Oliveira Fernandes, Victor Rezende Veras, Mayara Teixeira Alexandrino Sales, Lorena Taúsz Tavares Ramos, Amanda Caboclo Flor, Ana Paula Dias Rangel Montenegro, Maria Helane Gurgel Castelo, Clarisse Mourao Melo Ponte, Júlia Lemos Lima Verde, Maria C Foss-Freitas, Renan Magalhães Montenegro Junior","doi":"10.1186/s13098-025-01934-y","DOIUrl":"10.1186/s13098-025-01934-y","url":null,"abstract":"<p><strong>Background: </strong>Lipodystrophy syndromes (LS) are characterized by reduced body fat and associated metabolic complications, such as insulin resistance and diabetes. The diagnosis of LS can be challenging in clinical settings. Skinfold measurement and body composition assessment using DEXA are commonly used for screening and diagnosis. This study aimed to identify alternative easy-to-use body composition parameters for diagnosing LS in clinical settings.</p><p><strong>Methods: </strong>This cross-sectional study included patients with genetically confirmed congenital generalized lipodystrophy (CGL) and familial partial lipodystrophy (FPL), with 62 matched healthy controls. Comprehensive data, including medical history, body composition, laboratory measurements, and imaging parameters, were collected. The receiver operating characteristic (ROC) curve was constructed using genetic test results, the gold standard for diagnosing genetic lipodystrophy, as the reference, and the sensitivity and specificity of calf skinfold measurements were measured with those of the genetic tests.</p><p><strong>Results: </strong>We included 62 patients with a mean age of 32 ± 18 (2-68) years, of whom 69.3% were women. The prevalence of diabetes mellitus (70%) and hypertriglyceridemia (83%) were also high. All body composition parameters significantly differed, except for calf skinfold measurements, which were similar between the CGL and FPL patients (p = 0.270). The ROC curve analysis identified a new cutoff point for calf skinfold measurement of <8 mm, with high diagnostic accuracy.</p><p><strong>Conclusions: </strong>This study identified calf skinfold measurements <8 mm as an accurate diagnostic tool for CGL and FPL. Notably, clinical accessibility to calf skinfold will favor its widespread use, standardization, and inclusion in physical examination protocols, improving lipodystrophy detection and diagnosis.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"388"},"PeriodicalIF":3.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273952","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":"Drug-induced insulin autoimmune syndrome: a clinico-epidemiological analysis integrating pharmacovigilance data and case series.","authors":"Xiuheng Yu, Min Li, Yi Liao, Yuqing Xie, Jing Xu, Youqi Long, Shixin Xiang","doi":"10.1186/s13098-025-01952-w","DOIUrl":"10.1186/s13098-025-01952-w","url":null,"abstract":"<p><strong>Background: </strong>Insulin autoimmune syndrome (IAS) is a rare immune-mediated hypoglycemic disorder predominantly triggered by pharmacological agents. Despite the established links to thiol-containing drugs, emerging non-thiol triggers and significant geographical reporting biases limit comprehensive risk profiling. This study integrated pharmacovigilance data and published evidence to establish the first systematic epidemiological and pharmacological profile of drug-induced IAS.</p><p><strong>Methods: </strong>We analysed 228 IAS cases from the FDA AE Reporting System (FAERS; 2004-Q2 2024) and a systematic review of 263 published cases (1980-2024). Multimodal disproportionality analysis-including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Multi-item Gamma Poisson Shrinker (MGPS), and Bayesian Confidence Propagation Neural Network (BCPNN)-identified drug-induced adverse event signals. Associations were stratified into a three-tier evidence framework (Levels 1-3) based on methodological concordance, case counts, and strength of the supporting literature.</p><p><strong>Results: </strong>Fifty-eight agents showed potential IAS associations, including 12 novel pharmacovigilance signals (e.g., bevacizumab, sitagliptin, amlodipine, and olmesartan). Thiol-containing drugs exhibit the strongest signals (PRR > 200; e.g., captopril, methimazole, and clopidogrel). Level 1 evidence (highest confidence) implicated the use of clopidogrel, captopril, omeprazole, and methimazole. IAS was predominantly affected in older patients (median age, 66 years; IQR, 58-77 years), with a male predominance (59.21%), reflecting sex-specific prescription patterns. Geographical disparities persisted, with 85.17% of the cases reported in the literature in Asia. Reports of hypoglycemia exceeded IAS cases for most agents, suggesting an underdiagnosis.</p><p><strong>Conclusions: </strong>This study established the first evidence-based hierarchy for drug-induced IAS, identifying 58 agents warranting clinical vigilance. Thiol-containing drugs dominate the high-risk profile; however, novel associations (e.g., proton pump inhibitors (PPIs), dipeptidyl peptidase-4 (DPP-4) inhibitors) reveal broader immunological mechanisms. Clinicians should prioritize IAS in older patients with unexplained hypoglycemia exposed to antiplatelet agents or PPIs. Standardized diagnostic criteria and pharmacogenetic profiling (e.g., human leukocyte antigen DRB1 (HLA-DRB1) *04:06) are urgently required to improve detection.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"387"},"PeriodicalIF":3.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257585","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":"A correlation study on triglyceride-glucose index and extensive neovascularization within carotid artery plaques.","authors":"Sen Wang, Yiqun Lin, Shuai Zheng, Yuyang Gan, Ying Liu, Yukang Zhang, Wen He, Wei Zhang","doi":"10.1186/s13098-025-01942-y","DOIUrl":"10.1186/s13098-025-01942-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the correlation between the triglyceride-glucose (TyG) index and intraplaque neovascularization (IPN), evaluate the predictive efficacy of the TyG index for massive IPN, and provide novel serological markers for the early clinical identification of vulnerable plaques.</p><p><strong>Methods: </strong>A total of 308 patients enrolled between May 2019 and December 2024 were included. IPN (0-3) was graded by Contrast-enhanced ultrasound (CEUS) and dichotomized (Grade I: none/minimal neovascularization, Grade II: extensive neovascularization). The association between the TyG and Grade II and its predictive performance were evaluated.</p><p><strong>Results: </strong>The proportion of IPN Grade II significantly increased with ascending TyG quartiles (Q1: 37.66% vs. Q4: 85.71%, P < 0.001). After adjusting for confounders, the risk of Grade II in the Q4 group was 7.32 times higher than in the Q1 group (95% CI: 2.81-19.05). Restricted cubic spline analysis revealed an exponential increase in risk when TyG > 8.28. Subgroup analysis demonstrated a stronger association between TyG and IPN Grade II in hypertensive populations. Furthermore, the TyG index yielded an area under the curve of 0.72, with a sensitivity of 81% and specificity of 60% at the optimal cutoff value of 8.645.</p><p><strong>Conclusion: </strong>This study demonstrates that the TyG index is significantly and independently associated with extensive IPN in carotid plaques. This finding suggests the TyG index has potential as a supplementary serological marker in the assessment of plaque vulnerability.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"385"},"PeriodicalIF":3.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250369","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":"Sex-specific associations between type 2 diabetes and muscle health in middle-aged adults.","authors":"Yijia Wang, Songting Gao, Qiang Xu, Zhongxin Zhu","doi":"10.1186/s13098-025-01963-7","DOIUrl":"10.1186/s13098-025-01963-7","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) and sarcopenia have emerged as significant public health challenges that disproportionately affect middle-aged adults. However, the relationship between T2DM and muscle parameters in this critical age remains inadequately elucidated.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis of cross-sectional data derived from 2,446 middle-aged participants (aged 40-59 years; 1,230 men and 1,216 women) enrolled in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. T2DM was defined by physician-confirmed diagnosis and/or glycohemoglobin (HbA1c) ≥ 6.5%. We systematically evaluated appendicular lean mass index (ALMI) and grip strength in relation to T2DM status, employing multiple linear regression models with hierarchical adjustment for demographic, anthropometric, and clinical covariates.</p><p><strong>Results: </strong>Following comprehensive covariate adjustment, T2DM exhibited a significant inverse association with combined grip strength (β=-3.14; 95% CI: -4.55, -1.73) but showed no significant association with ALMI (β=-0.05; 95% CI: -0.13, 0.02). Sex-stratified analyses revealed significant reductions in both muscle mass and strength exclusively among men with T2DM, whereas no significant associations were observed in women. The adverse impact of T2DM on grip strength was particularly pronounced among individuals with BMI < 25 kg/m² (β=-6.72; 95% CI: -10.38, -3.06). Furthermore, glycohemoglobin demonstrated positive associations with ALMI in non-diabetic individuals, while serum glucose levels exhibited inverse associations with ALMI across the total study population.</p><p><strong>Conclusions: </strong>Our findings demonstrated negative associations between T2DM and muscle mass and strength in middle-aged men, but not in women. These observations underscore the critical importance of early muscle health surveillance and targeted therapeutic interventions in T2DM patients, particularly among men and those with BMI < 25 kg/m².</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"384"},"PeriodicalIF":3.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250365","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":"U-shaped association of the stress hyperglycemia ratio with all-cause mortality and premature death in patients with cardiovascular disease: a cohort study.","authors":"Na Wang, Ya Shao, Yan Zhan, Meiling Shao, Bin Liu, Longti Li, Huiqin Zhong","doi":"10.1186/s13098-025-01959-3","DOIUrl":"10.1186/s13098-025-01959-3","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) is recognized as a significant indicator of relative hyperglycemia that has demonstrated to correlate with poor outcomes, including elevated mortality rates in individuals facing severe acute conditions. However, the connection between SHR and all-cause mortality and premature death in individuals with cardiovascular disease (CVD) remains insufficiently investigated. This research intended to investigate the relationship between SHR and all-cause mortality and premature death among individuals with CVD.</p><p><strong>Methods: </strong>This cohort study involved data extracted from 2,714 follow-up cohorts sourced from the National Health and Nutrition Examination Survey (NHANES). Participants were categorized based on SHR quartiles. The relationship between SHR and all-cause mortality and premature death in CVD patients was analyzed using Kaplan-Meier survival curves, restricted cubic splines (RCS), Cox proportional hazards models, threshold effect analysis, and subgroup analyses.</p><p><strong>Results: </strong>Over an average follow-up duration of 88.38 months, 1,201 deaths were documented, of which 351 were classified as premature. The Kaplan-Meier curves illustrated that individuals in quartile 2 of SHR exhibited highest survival probability compared to other quartiles. Cox proportional hazards regression revealed a positive association between SHR (for continuous) and all-cause mortality (HR 1.57, 95% CI 1.12-2.19) as well as premature death (HR 1.96, 95% CI 1.10-3.49). Compared with the second quartile, both lower and higher SHR values were significantly correlated with elevated risk of all-cause mortality and premature death (HR > 1, P-value < 0.05). The RCS analysis elucidated a U-shaped association of SHR with risk of all-cause mortality and premature death. Furthermore, the threshold effect analysis pinpointed the inflection points for SHR relative to all-cause mortality and premature death at 0.86 and 0.87, respectively. E-value indicated that the model demonstrated robust stability concerning potential unknown confounding variables.</p><p><strong>Conclusion: </strong>An independent association of SHR with all-cause mortality and premature death was observed among individuals with CVD. Maintaining SHR within a moderate range might improve their prognosis.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"386"},"PeriodicalIF":3.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250391","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":"Low-grade inflammation score (INFLA- score) associated with metabolic syndrome and its components in shift workers.","authors":"Suxin Jiang, Jueqi Wang, Xue Guan, Hengqing An, Ning Tao","doi":"10.1186/s13098-025-01850-1","DOIUrl":"10.1186/s13098-025-01850-1","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between the low-grade inflammation score (INFLA-score) and metabolic syndrome (MetS) in shift workers working in the oilfield operations in Karamay City, Xinjiang, and to provide data support for the effective prevention of MetS through the reduction of systemic inflammatory responses.</p><p><strong>Methods: </strong>INFLA-score was calculated based on C-reactive protein, leukocyte count, platelet count, and neutrophil-to-lymphocyte ratio (NLR) in 1,758 shift workers working at the oilfield base in Karamay City, Xinjiang, China, in the year 2023, as the study population. A logistic regression analysis model combined with restricted cubic spline was used to analyze the relationship between INFLA-score and MetS and its components in shift workers.</p><p><strong>Results: </strong>A total of 1758 shift workers were included, of whom 785 were diagnosed with MetS. Multifactorial logistic regression analysis showed that those with higher INFLA score had a higher likelihood of developing MetS (OR = 1.08, 95% CI: 1.07-1.10). In the Q1-Q4 INFLA quartile group, the risk of developing MetS was 3.58 times higher in the Q4 group than in the Q1 group. After adjusting for all confounders, INFLA-score was found to be positively associated with elevated blood glucose, blood pressure, waist circumference, triglyceride levels, and lower HDL (p < 0.001). Restricted cubic spline results showed a dose-response relationship between INFLA-score and MetS and its components. In subgroup analyses and interaction tests, women had a higher risk of MetS than men (men: OR = 1.07, 95% CI: 1.05-1.09, p < 0.001; women: OR = 1.13, 95% CI: 1.09-1.16, p < 0.001), and the interaction showed that there was an effect of the association between sex and INFLA score on the occurrence of MetS (interaction p < 0.05).</p><p><strong>Conclusions: </strong>Elevated INFLA-score was associated with MetS among shift workers, and the INFLA-score was a simple, cost-effective test for MetS. Therefore, MetS can be combated by controlling the levels of inflammatory factors in shift workers.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"381"},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225123","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":"Immune checkpoint inhibitor therapy and risk of type 1 diabetes mellitus in metastatic cancer patients.","authors":"Ming-Hsun Lin, Ren-Hua Ye, Hong-Jie Jhou, Hsin-Yu Chen, Li-Ting Kao, Tina Yi-Jin Hsieh, Yu-Han Chen, Andrea Yue-En Sun, Xiaoyi Zhang, Ming-Shen Dai, Ching-Liang Ho, Po-Huang Chen, Cho-Hao Lee","doi":"10.1186/s13098-025-01940-0","DOIUrl":"10.1186/s13098-025-01940-0","url":null,"abstract":"<p><strong>Aims: </strong>To assess the risk of new-onset type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA) in metastatic cancer patients treated with immune checkpoint inhibitors (ICIs) compared to those receiving non-ICI therapies.</p><p><strong>Method: </strong>A retrospective cohort study using TriNetX global electronic health records (2014-2025) from multiple healthcare systems. Adult metastatic cancer patients initiating ICI or non-ICI therapy were included. Patients with preexisting diabetes within 6 months were excluded. After 1:1 propensity score matching, 25,463 patients remained in each group. Outcomes were identified by ICD-10 codes.</p><p><strong>Results: </strong>Median follow-up was 764 days (ICI) vs. 692 days (non-ICI). ICI use was associated with a higher risk of T1DM (HR, 2.35; 95% CI, 1.81-3.04) and DKA (HR, 10.58; 95% CI, 4.21-26.59). Cumulative incidence analyses supported these findings, with ICIs showing higher risks of T1DM (0.75% vs. 0.32%; RR, 2.32 [95% CI, 1.79-3.00]) and DKA (0.20% vs. 0.04%; RR, 5.00 [95% CI, 2.54-9.86]). Subgroup analyses identified elevated baseline HbA1c (> 6.0%), male sex, white race, and dual checkpoint blockade as high-risk factors.</p><p><strong>Conclusion: </strong>ICIs significantly increase the risk of T1DM and DKA. These findings highlight the need for vigilant glycemic monitoring in cancer patients treated with ICIs, especially within identified high-risk subgroups.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"377"},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225086","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":"Sarcopenia index as a predictor of ventricular arrhythmia risk in patients with type 2 diabetes mellitus: a longitudinal study.","authors":"Xiaoyao Li, Linmei Yang, Yuan Gao, Keping Chen, Min Tang, Hongxia Niu, Qi Sun, Shu Zhang","doi":"10.1186/s13098-025-01937-9","DOIUrl":"10.1186/s13098-025-01937-9","url":null,"abstract":"<p><strong>Objective: </strong>The correlation between sarcopenia and diabetes mellitus (DM) holds considerable importance. The prognosis of ventricular arrhythmias in individuals with type 2 diabetes mellitus complicated by sarcopenia remains uncertain.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with DM who underwent implantable cardioverter defibrillator (ICD) implantation at Fuwai Hospital. Sarcopenia status was assessed using the biomarker sarcopenia index(SI). Patients were divided into low SI (less than 81.33, n = 74) and high SI (greater than 81.33, n = 158) groups according to the best cut-off value. The primary endpoint was the occurrence of ventricular arrhythmias. Secondary endpoint was appropriate shock therapy.</p><p><strong>Results: </strong>A total of 232 patients who met the inclusion criteria were included. The average follow-up period was 25.85 ± 16.13 months. During the follow-up, a total of 69 cases (29.7%) of ventricular arrhythmias and 31 cases (13.4%) of appropriate shock therapy were recorded. ROC analysis showed that SI had a good predictive value for ventricular arrhythmias (AUC 0.807, cut point value 81.33, sensitivity 66.7%, specificity 82.8%). The lower SI groups had an increased proportion of ventricular arrhythmias (62.2% vs. 14.6%, P < 0.001) and appropriate shock therapy (28.4% vs. 6.3%, P < 0.001) during follow-up. The KM curve showed significantly increased risk of ventricular arrhythmias (log-rank P < 0.001) and appropriate shock (log-rank P < 0.001) in the lower SI group. Multivariate analysis showed that low SI was an independent risk factor for ventricular arrhythmias (hazard ratio (HR) 5.318, 95% confidence interval (CI): 3.198-8.841, P < 0.001), and appropriate shock (hazard ratio (HR) 5.765, 95% confidence interval (CI): 2.689-12.361, P < 0.001).</p><p><strong>Conclusions: </strong>In diabetic patients, SI has a high prediction value for the occurrence of ventricular arrhythmia, and is anticipated to serve as a prognostic indicator for the likelihood of sudden cardiac death in this patient population.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"376"},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225160","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}