Diabetology & Metabolic Syndrome最新文献

{"title":"Effects of home- and gym-based resistance training on glycemic control in patients with type 2 diabetes mellitus-a systematic review and meta-analysis.","authors":"Magnus Bärg, Veronica Idiart-Borda Polotto, Stefanie Geiger, Steffen Held, Christian Brinkmann","doi":"10.1186/s13098-025-01793-7","DOIUrl":"10.1186/s13098-025-01793-7","url":null,"abstract":"<p><strong>Background: </strong>Targeting skeletal muscle mass and quality through resistance training (RT) may be a particularly promising approach for treating metabolic diseases. While the benefits of RT in managing type 2 diabetes mellitus (T2DM) are well established, most studies supporting these benefits have been conducted in controlled laboratory or gym settings. To date, it remains unclear whether home-based RT can be as effective as gym-based RT in improving the glycemic profile of patients with T2DM. Therefore, the primary aim of this meta-analysis was to compare the effects of home-based versus gym-based RT on glycemic control (HbA1c) in patients with T2DM.</p><p><strong>Methods: </strong>A systematic literature search was conducted using SPORTDiscus, PubMed and BISp SURF databases (updated until 2 August 2024). After screening, 20 controlled trials (involving 1397 participants) met the inclusion criteria.</p><p><strong>Results: </strong>A random-effects model revealed a significant effect of RT on glycemic control, with a pooled mean difference favoring RT versus control (mean difference: -0.33; 95% confidence interval (CI): -0.49 to -0.18). Gym-based RT significantly reduced HbA1c compared to control conditions (-0.39; 95% CI: -0.57 to -0.22), while home-based RT showed no significant effect (+0.12; 95% CI: -0.16 to +0.39). Heterogeneity was substantial, suggesting considerable variability between studies. The methodological quality score of the included studies, assessed using the PEDro (Physiotherapy Evidence Database) scale, ranged from 3 to 8, with an average score of 6 ± 1 (\"good\" quality).</p><p><strong>Conclusions: </strong>This meta-analysis confirms the effectiveness of RT in reducing HbA1c levels in individuals with T2DM. Notably, the present findings highlight that gym-based RT is effective, while home-based RT is not. Possible reasons include increased motivation by coaches or training buddies in the gym, resulting in increased adherence to the training program, as well as the limited availability of equipment or imprecise load dosing during home workouts.</p><p><strong>Review registration: </strong>CRD420250650823.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"228"},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324695","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":"Preclinical evidence of the effect of icariin on diabetic nephropathy: a systematic review and meta-analysis.","authors":"Xueli Man, Peiyao Ren, Juan Jin, Qiang He","doi":"10.1186/s13098-025-01760-2","DOIUrl":"10.1186/s13098-025-01760-2","url":null,"abstract":"<p><strong>Background: </strong>Icariin (ICA), a bioactive flavonoid derived from Epimedium species, has demonstrated anti-inflammatory and anti-fibrotic properties in preclinical studies, suggesting potential therapeutic effects on diabetic nephropathy (DN). However, systematic evaluation of its efficacy remains unclear.</p><p><strong>Objective: </strong>The purpose of this study is to evaluate the efficacy of Icariin on DN by preclinical evidence and meta-analysis. Meanwhile, the main possible action mechanisms of Icariin against DN were also summarized.</p><p><strong>Methods: </strong>As of October 1, 2024, we conducted a systematic search across seven prominent Chinese and English databases (CNKI, Wanfang, CBM, PubMed, Cochrane Library, Embase, and Web of Science) to identify studies investigating the therapeutic effects of icariin on DN. PROSPERO has released a summary protocol (registration number: CRD42024564001).</p><p><strong>Results: </strong>This meta-analysis encompassed nine studies, involving a total of 308 animals, and revealed that icariin significantly reduced blood glucose, SCR, BUN, 24 h UP, 24 h UV, KI, MDA, and IL-1β levels, while augmenting antioxidant enzyme activities (SOD and GPX). Furthermore, ICA lowered TG and TC, indicative of its potential in mitigating risk factors. However, direct comparisons between ICA and angiotensin II receptor blockers (ARB) yielded no statistically significant differences in DN treatment outcomes (p > 0.05). The greatest effects were recorded in high-dose (> 30 mg/kg/day) groups rather than in low-dose (< 30 mg/kg/day) groups. For time-response effects, subgroup analysis indicated that intervention duration of ICA can influence the treatment effect, and more beneficial effects were observed when studies had a drug administration time of < 8 weeks.</p><p><strong>Conclusion: </strong>Based on an analysis of existing experimental evidence, icariin displays promise in slowing the progression of diabetic nephropathy. To validate its anti-diabetic nephropathy efficacy with greater precision and ensure its readiness for clinical translation, further confirmatory animal studies are warranted.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"222"},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324699","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 dietary fiber intake with all-cause and cardiovascular mortality in diabetes and prediabetes.","authors":"Xingxing Chen, Luping Tao, Yunchao Wang","doi":"10.1186/s13098-025-01810-9","DOIUrl":"10.1186/s13098-025-01810-9","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between dietary fiber intake and mortality risks (all-cause and cardiovascular) among U.S. adults with diabetes or prediabetes, and to evaluate the dose-response patterns of these associations.</p><p><strong>Materials and methods: </strong>This longitudinal cohort study analyzed data from 3259 adults with diabetes or prediabetes from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Dietary fiber intake was assessed using two 24-hour dietary recall interviews. Mortality data were obtained through December 31, 2019. Multiple Cox proportional hazards models were used to evaluate associations between fiber intake and mortality outcomes, adjusting for demographic and health-related covariates.</p><p><strong>Results: </strong>Higher dietary fiber intake was significantly associated with reduced all-cause mortality risk (HR = 0.98, 95% CI: 0.97-0.99, P = 0.0039). For cardiovascular mortality, a non-linear relationship was identified with a threshold at 26.2 g/day. Below this threshold, each gram increase in fiber intake was associated with a 3% reduction in cardiovascular mortality risk (HR = 0.97, 95% CI: 0.94-0.99, P = 0.0352), while no significant benefit was observed above this threshold.</p><p><strong>Conclusions: </strong>Dietary fiber intake shows a protective effect against all-cause mortality in U.S. adults with diabetes or prediabetes. For cardiovascular mortality, moderate fiber intake up to 26.2 g/day appears beneficial, while higher intake may not provide additional cardiovascular benefits. These findings provide important evidence for developing targeted dietary recommendations in diabetes management.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"231"},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324691","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 DNA methylation epigenetic markers with all-cause mortality and cardiovascular disease-related mortality in diabetic population: a machine learning-based retrospective cohort study.","authors":"Yuxin Nong, Huazhen Huang, Lulu Xu, Xin Tan, Shuai Xu, Xinyu Zhou, Yiyao Zeng, Yufeng Jiang, Hezi Jiang, Xiangyu Wang, Xian Li, Anchen Xu, Qiaoyi Sun, Hongju Wang, Pinfang Kang, Jili Fan, Xiaohong Bo, Huimin Fan, Yafeng Zhou","doi":"10.1186/s13098-025-01774-w","DOIUrl":"10.1186/s13098-025-01774-w","url":null,"abstract":"<p><strong>Background: </strong>Diabetes has a large and diverse population, with individuals exhibiting significant heterogeneity in the disease. The factors influencing survival and prognosis are complex, making early intervention in diabetic populations particularly challenging. Research has demonstrated a close relationship between DNA methylation (DNAm) clocks and aging as well as various diseases, showing superior predictive capabilities. However, the relationship between DNAm clocks and long-term survival in diabetic patients, particularly concerning cardiovascular-related mortality, remains unclear.</p><p><strong>Methods: </strong>We analyzed the data of the diabetes population cohort in the National Health and Nutrition Examination Survey, which was followed for 20 years. We employed eight machine learning (ML) models to analyze 29 potential DNAm derived epigenetic markers and utilized Cox regression models to assess the risks of all-cause mortality and cardiovascular disease-related mortality in the diabetic population. Additionally, we applied restricted cubic spline (RCS) to analyze potential influence trends.</p><p><strong>Results: </strong>A total of 454 people with diabetes were followed up, with a median follow-up time of 177.6 months. Through machine learning methods, we identified several high-performing DNAm markers, finding that four epigenetic biomarkers, ZhangAge (HR = 2.86, 95% CI: 2.19-3.73, P < 0.001), GrimAge2Mort (HR = 3.06, 95% CI: 2.26-4.14, P < 0.001), TIMP1Mort (HR = 2.95, 95% CI: 2.18-4.01, P < 0.001), and PhenoAge (HR = 2.94, 95% CI: 1.23-3.88, P < 0.001), were significantly associated with all-cause mortality in the diabetic population. Further research indicated that GrimAge2 Mort (HR = 2.86, 95% CI: 1.30-6.29, P = 0.009) and TIMP1Mort (HR = 4.08, 95% CI: 2.17-7.68, P < 0.001) were associated with cardiovascular disease-related mortality. RCS curves demonstrated that the mortality risk for all diabetic patients increased with rising levels of these DNAm epigenetic markers.</p><p><strong>Conclusion: </strong>We found four DNAm-derived epigenetic markers (ZhangAge, GrimAge2 Mort, TIMP1Mort, PhenoAge) that are associated with all-cause mortality risk in the diabetic population. Further research suggested that GrimAge and PhenoAge influence the risk of cardiovascular-related mortality.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"221"},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324692","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":"Exercise training and inflammatory adipokines in patients with type 2 diabetes: a systematic review, meta-analysis, and meta-regression.","authors":"Arezoo Pourkoshki, Amirabbas Monazzami, Fatemeh Heydarpour, Dong Keon Yon, Lee Smith, Masoud Rahmati","doi":"10.1186/s13098-025-01811-8","DOIUrl":"10.1186/s13098-025-01811-8","url":null,"abstract":"<p><strong>Background: </strong>Improvements in adipocytes levels can reduce the risk of diabetes and cardiovascular disease, indicating adipocytes to be a hopeful remedial target in type 2 diabetes mellitus (T2DM) and other related diseases. However, there is no consensus on the role of various exercise training on adipokines in T2DM and the results are contradictory. Therefore, this systematic review, meta-analysis, and meta-regression investigated the effects of different types of exercise training on some inflammatory adipokines concentrations in T2DM.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed/MEDLINE, Web of Science, Embase, Google Scholar, and Cochrane up to September 2024. Studies investigating the effects of exercise training on Resistin, apelin, visfatin, and vaspin were included. Meta-analysis was performed using a random-effect model (DerSimonian-Laird method) to calculate weighted means differences with 95% confidence intervals (CIs). The Cochrane Collaboration's tool was also used to asses risk of bias of studies.</p><p><strong>Results: </strong>Analysis of 36 studies (50 intervention arms, n = 1811) demonstrated that exercise training significantly decreased resistin (mean difference [MD]: -1.02 ng/ml, 95% CI -1.48 to -0.57, p < 0.0001) and visfatin (MD: -0.70 ng/ml, 95% CI -1.07 to -0.32, p = 0.0002) levels but had no significant effect on Apelin (MD: 0.02 ng/ml, 95% CI -0.04 to 0.08, p = 0.55) and vaspin (MD: 0.00 ng/ml, 95% CI -0.0 to 0.0, p = 0.69) levels compared to control in T2DM. Stronger effects were observed in combined training in men and more than 8 weeks of intervention. Meta-regression analysis also showed that there is a significant linear relation between changes in resistin with BMI changes but other variables were not observed to have significant linear relationships with changes of BMI, glucose, Insulin, and HOMA-IR.</p><p><strong>Conclusions: </strong>Overall, aerobic and combined training decreased inflammatory adipokines with a positive supplementary effect for patient with T2DM.</p><p><strong>Registration: </strong>PROSPERO registration no. CRD42024617538.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"224"},"PeriodicalIF":3.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324696","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":"Hypomagnesemia: exploring its multifaceted health impacts and associations with blood pressure regulation and metabolic syndrome.","authors":"Wenlong Wu, Ming Gong, Pan Liu, Huiying Yu, Xue Gao, Xin Zhao","doi":"10.1186/s13098-025-01772-y","DOIUrl":"10.1186/s13098-025-01772-y","url":null,"abstract":"<p><p>This article provides a comprehensive and in-depth exploration of the multifaceted effects of Hypomagnesemia on human health, with a specific focus on its intricate associations with mechanisms regulating blood pressure and metabolic syndrome. Firstly, the fundamental concept of hypomagnesemia is elucidated, followed by a detailed analysis of its prevalence, risk factors, and Magnesium Deficiency Score. Furthermore, this article delves into the intricate relationship between hypomagnesemia and blood pressure regulation, encompassing its impact on endothelial function, vascular calcification, oxidative stress and inflammatory response, sympathetic nervous system activity as well as the renin-angiotensin-aldosterone system (RAAS). Additionally, it explores the correlation between hypomagnesemia and insulin resistance, metabolic syndrome along with other health issues. Notably noteworthy is that this paper also places special emphasis on exploring the potential role of hypomagnesemia in specific diseases such as renal hypertension and preeclampsia while providing novel insights for their prevention and treatment. Finally, this article summarizes the diverse effects of hypomagnesemia on health while anticipating future research directions. Future studies should further investigate the pathogenesis underlying hypomagnesemia while optimizing assessment methods for magnesium deficiency to develop targeted intervention strategies aimed at offering improved treatment options alongside preventive measures for patients.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"217"},"PeriodicalIF":3.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309691","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":"The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study.","authors":"Guanchao Sun, Wenjuan Wu, Binbin Su, Ru Zhang, Xiaoyu Dong, Lihui Wang, Shiping Xu, Hui Shi","doi":"10.1186/s13098-025-01756-y","DOIUrl":"10.1186/s13098-025-01756-y","url":null,"abstract":"<p><strong>Background: </strong>As the immune response product to food antigens, food-specific serum immunoglobulin G reactivity (FSsIgGR) has been reported the clinical relevance to metabolic disorders, but its connections to metabolic dysfunction-associated fatty liver disease (MAFLD) remain underexplored, particularly within Chinese populations. Understanding this association could facilitate personal diet modification for MAFLD treatment. We investigated the association between FSsIgGR and MAFLD and the mediating roles of plasma glucose markers, specifically fasting blood glucose (FPG) and hemoglobin A1c (HbA1c).</p><p><strong>Methods: </strong>This study utilized data from the Second Medical Center of the Chinese PLA General Hospital from 2017 to 2021, to analyze the relationships between FSsIgGR and MAFLD in 25,928 participants. Using a robust sampling method and adjusting for various covariates, we explored both linear and nonlinear associations using linear regression models, restricted cubic splines (RCS), subgroup analysis, and sensitivity analysis. Furthermore, mediation analyses were conducted to evaluate the role of plasma glucose markers, such as FPG and HbA1c, in these relationships.</p><p><strong>Results: </strong>The overall prevalence of FSsIgGR-positive and MAFLD was 60.8% and 53.5%, respectively, with a mean age of 49.6 ± 9.7 years (68.8% male). Both the quantity and level of FSsIgGR exhibited negatively linear associations with MAFLD (OR 0.98, 95% CI 0.96-0.99, P = 0.041; OR 0.99, 95% CI 0.97-0.99, P = 0.044), even after adjusting for multiple covariates. Sensitivity analyses supported the robustness of these findings. Of note, subgroup analysis showed that FSsIgGR still was negatively associated with MAFLD patients without Type 2 diabetes (OR 0.98, 95% CI 0.95-0.99) or insulin resistance (OR 0.97, 95% CI 0.94-0.99), while that statistical significance of associations disappears in MAFLD patients with Type 2 diabetes or insulin resistance. Furthermore, plasma glucose markers, particularly FPG, significantly mediated the relationship between FSsIgGR and MAFLD, with indirect effects estimated at 15.5% (P = 0.0002).</p><p><strong>Conclusions: </strong>These findings indicated FSsIgGR was linked to a reduced risk of MAFLD, particularly MAFLD without Type 2 diabetes or insulin resistance, and plasma glucose mediated that process. Further research is needed to elucidate the mechanism underlying that association, expecting to provide reference for personalized diet of MAFLD patients.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"219"},"PeriodicalIF":3.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309692","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":"The impact of three months of adjuvant yoga intervention on glycemic control among adolescents with type 1 diabetes: a randomized control trial.","authors":"Sonu Maurya, Suchitra Patil, Amit Singh, Indu Rani, Navneet Kaur, Sriloy Mohanty, Akshay Anand, Raghuram Nagarathna","doi":"10.1186/s13098-025-01632-9","DOIUrl":"10.1186/s13098-025-01632-9","url":null,"abstract":"<p><strong>Background: </strong>There is growing evidence that shows the benefits of yoga on people with diabetes. The benefit of yoga for people with Type 2 Diabetes has been proven. Incorporating yoga in daily life helps to attain glycaemic control and reduces the risk of complications in people with diabetes especially in the Type 2 Diabetes Mellitus (T2DM) field. However, limited work is done for yoga on Type 1 Diabetes Mellitus (T1DM). The current trial aimed to investigate the effect of yoga intervention on glycemic control and Quality of Life (QoL) among adolescents with T1DM.</p><p><strong>Methods: </strong>In this trial, 92 T1DM subjects with mean age of 13.35 ± 2.41 years were recruited and randomly allocated to either yoga or control arm with an allocation ratio of 1:1. The control arm received standard care whereas; the yoga arm received additional tailored yoga sessions for three months. Venous blood samples were collected for HbA1c and average blood glucose (ABG) along with daily insulin requirements, PedsQL-3.0, PedsQL-4.0, Kutcher Adolescent Depression Scale, Fear of hypoglycaemia questionnaire at baseline and post-intervention. Both per-protocol and Intention-to-treat (ITT) analysis were done.</p><p><strong>Results: </strong>Out of 92 participants recruited, only 46 could complete the trial (yoga arm: n = 25). The per-protocol analysis showed a significant reduction in the HbA1c levels (14.68% vs. -12.90%;p < 0.001) as well as in the ABG levels (17.72% vs. -15.65%;p < 0.001) in the intervention arm when compared to the control arm. An ITT analysis of the primary objectives also yielded similar results. Further, Insulin requirements (p = 0.04) and hyperglycaemia frequency (p = 0.02) were significantly reduced in the yoga arm however, it lacked significance in between-group analysis. Fear of hypoglycaemia was reduced by 23.9% in the intervention group while it was 3% in the control group which was significant. Significant improvement in QoL, depression, and level of physical activity were observed following yoga intervention compared to the control group.</p><p><strong>Conclusion: </strong>The three-month adjuvant yoga intervention was associated with an improved glycaemic control and QoL among adolescents with T1DM.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"216"},"PeriodicalIF":3.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301317","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":"Associations between metal exposure and metabolic syndrome: exploring the mediating role of biological ageing among US adults.","authors":"Liuyan Zheng, Xinyue Lu, Suping Luo, Jianhui Guo, Xingyan Xu, Le Yang, Mingjun Chen, Shaowei Lin, Xiaoxu Xie, Huangyuan Li, Siying Wu","doi":"10.1186/s13098-025-01784-8","DOIUrl":"10.1186/s13098-025-01784-8","url":null,"abstract":"<p><strong>Background: </strong>The relationship between mixed metal exposure and metabolic syndrome (MetS) remains controversial, and the underlying mechanisms of this relationship are not yet fully understood.</p><p><strong>Objective: </strong>We evaluated the association between urinary metals and MetS and investigated the potential mediating effect of ageing.</p><p><strong>Methods: </strong>This study utilized National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018 and included 11,541 adults aged 20 years and above. We explored the association between urinary concentrations of nine metals and MetS using weighted quantile sum (WQS) regression, grouped weighted quantile sum (GWQS) regression, and Bayesian kernel machine regression (BKMR). In addition, various methodologies have been used to assess biological ageing, encompassing the examination of cellular senescence through the evaluation of telomere length, as well as a comprehensive evaluation of overall body ageing through the determination of biological age. The contribution of biological ageing to the association between urinary metals and MetS was investigated in a mediation analysis.</p><p><strong>Results: </strong>After adjusting for confounders, the WQS and GWQS analyses found positive and negative correlations between metal exposure and MetS, and the main metals affecting MetS risk were cadmium (Cd) and lead (Pb), respectively. A positive relationship was found between exposure to mixed metals and the risk of MetS in the BKMR results. Mediation analysis showed that ageing biomarkers, including biological age and telomere length, mediated 68.43% and 12.05% of the association between metal exposure and MetS, respectively. Biological ageing may play a major role in the association between mixed metal exposure and MetS. Cd contributed the most to the positive association, indicating that priority control measures may be necessary to reduce the risk of MetS related to Cd exposure.</p><p><strong>Significance: </strong>The findings of this study could contribute to the advancement of targeted measures for metal precautions, ultimately mitigating the incidence of metabolic syndrome.</p><p><strong>Impact statement: </strong>This research employed multipollutant models including WQS regression, GWQS and BKMR to evaluate the combined effects of various metal exposures on the risk of developing MetS based on a nationally representative large cross-sectional study. In addition, this research investigated biological aging by conducting a comprehensive assessment of biological age and telomere length. Our goal is to understand its potential mediating effect on metal exposure and the occurrence of metabolic syndrome. The insights gained from this study could provide valuable hints for future mechanistic research in this field.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"215"},"PeriodicalIF":3.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301316","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":"CARDIAL-MS (CArdio-Renal-DIAbetes-Liver-Metabolic Syndrome): a new proposition for an integrated multisystem metabolic disease.","authors":"Amélio F Godoy-Matos, Cynthia Melissa Valério, Wellington S Silva Júnior, João Marcello de Araujo-Neto, Andrei C Sposito, José Hermógenes Rocco Suassuna","doi":"10.1186/s13098-025-01796-4","DOIUrl":"10.1186/s13098-025-01796-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Syndrome-a constellation of insulin resistance, cardiovascular risk factors as hyperglycemia, hypertension, and dyslipidemia, and systemic metabolic dysfunction-may be driven by dysregulation of adipose tissue, which manifests as adiposopathy (pathogenic adipose tissue expansion or maldistribution), ectopic fat deposition (in the liver, muscle, pancreas, and cardiorenal systems), and altered secretion of adipokines/hepatokines. Weight gain, obesity, and/or unfavorable fat distribution create a scenario wherein the type, size, location, secretions, or even scarcity of adipocytes drive pathophysiological mechanisms leading to hepatic steatosis and steatohepatitis, type 2 diabetes, and heart and kidney disease. While recent frameworks, such as cardiovascular-kidney-metabolic syndrome, emphasize holistic staging, the central role of metabolic dysfunction-associated steatotic liver disease (MASLD) in multisystem morbidity remains underrecognized.</p><p><strong>Main text: </strong>This narrative review synthesizes evidence linking MASLD and diabetes to cardiovascular and kidney diseases through shared pathways of adiposopathy, ectopic lipid accumulation, and dysregulated adipokine/hepatokine signaling. We propose CARDIAL-MS (CArdio-Renal-DIAbetes-Liver-Metabolic Syndrome), an expanded pathophysiological model that unifies these interactions into four progressive stages: (1) weight gain and dysfunctional adipose tissue; (2) metabolic risk factors and markers of risk; (3) cardiometabolic diseases and chronic kidney disease; and (4) advanced cardio-renal-liver-metabolic disease. By integrating MASLD as a pivotal component, CARDIAL-MS reframes metabolic syndrome as a continuum of interconnected organ injuries rather than isolated risk factors.</p><p><strong>Conclusion: </strong>CARDIAL-MS provides a staging model to identify patients at critical transition points-from reversible metabolic disturbances to irreversible organ damage. This model emphasizes early interventions targeting adipose tissue health and ectopic fat deposition to mitigate the progression of metabolic cardiorenal diseases. By recognizing the syndromic nature of these conditions, CARDIAL-MS offers clinicians an actionable paradigm for risk stratification, timely diagnosis, and personalized prevention strategies.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"218"},"PeriodicalIF":3.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309690","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}