Diabetology & Metabolic Syndrome最新文献

{"title":"Associations of TyG index with coronary heart disease risk and coronary artery sclerosis severity in OSA.","authors":"Xuan Qiu, Gulimire Aimaiti, Yulan Chen, Yu Li, Xiaojing Sun","doi":"10.1186/s13098-024-01545-z","DOIUrl":"10.1186/s13098-024-01545-z","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is involved in the pathogenesis and progression of obstructive sleep apnea (OSA) and coronary heart disease (CHD). The triglyceride glucose(TyG) index, an alternative indicator of IR with high reliability, is linked to CHD development and severity. However, the association of TyG index with CHD in OSA cases remains undefined. This study explores the association of TyG index with CHD risk and coronary artery sclerosis severity in the OSA population.</p><p><strong>Methods: </strong>OSA cases with suspected CHD, enrolled at the Department of Hypertension, The First Affiliated Hospital of Xinjiang Medical University between February 2020 and June 2024, were assigned to the OSA and OSA + CHD groups, followed by TyG index assessment. The t-test, Mann-Whitney U-test and one-way analysis of variance were utilized to compare continuous data, while comparisons of categorical data utilized the chi-square test or Fisher's exact test. Logistic regression analysis was conducted to determine factors independently predicting OSA with CHD and Gensini scores. Restrictive cubic spline (RCS) was used to assess potential non-linear associations of TyG index with CHD risk and Gensini score in OSA patients.</p><p><strong>Results: </strong>Totally 1059 OSA patients were included, with 514 diagnosed with CHD (48.54%). Multivariable logistic regression analysis upon adjustment for age, gender, hypertension, diabetes, and smoking history revealed TyG index as a risk factor for CHD in OSA cases. CHD risk in the high-TyG index group was 1.977 fold higher versus the low-TyG index group (OR = 1.977, 95% CI 1.424-2.800, P < 0.001). In addition, TyG index had a linear relationship with CHD (P for nonlinearity = 0.0709). In moderate to severe OSA cases, the high-TyG index group had a significantly higher CHD risk (OR = 2.430, 95% CI 1.601-3.690, P < 0.001). Gensini score and TyG index (P for non-linearity = 0.0033) had a non-linear relationship, while high TyG index was a risk factor for high Gensini score.</p><p><strong>Conclusion: </strong>TyG index is a risk factor for CHD in OSA cases and reflects the severity of coronary atherosclerosis. TyG, a surrogate indicator for IR evaluation, may help predict CHD in OSA cases, especially in moderate to severe OSA.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"301"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853235","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 between thyroid dysfunction and diabetic retinopathy: a two-sample bidirectional Mendelian randomization study.","authors":"Jiali Chen, Jianghao Xiong, Fenfen Zhang, Wanyu Pan, Shaomin Cheng","doi":"10.1186/s13098-024-01552-0","DOIUrl":"10.1186/s13098-024-01552-0","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between thyroid dysfunction and diabetic retinopathy (DR), a two-sample bidirectional Mendelian randomization (MR) study utilizing the Genome-wide Association Study (GWAS) database was conducted to investigate the causal relationship between these two variables.</p><p><strong>Methods: </strong>In this study, GWAS of 48,328,151 single nucleotide polymorphisms(SNP) in the European population from the IEU open GWAS database were utilized as genetic tools for investigating thyroid dysfunction. The total sample size for the study on hyperthyroidism was 460,499 (case group: 3557; control group: 456,942). The total sample size for hypothyroidism was 410,141 (case group: 30,155; control group: 37,986). In addition, the data on DR were extracted from the FinnGen Biobank, comprising a total sample size of 319,046 individuals (10,413 cases and 308,633 controls). For the forward MR analysis, hyperthyroidism and hypothyroidism were considered as exposures with DR as the outcome. Reverse MR analysis was conducted using DR as exposure and hyperthyroidism and hypothyroidism as outcomes.</p><p><strong>Methods: </strong>The main analytical approach employed inverse variance weighting(IVW), supplemented by MR-Egger, Weighted mode method, weighted median, and Simple mode. Cochran's Q test, MR-PRESSO, MR-Egger and leave-one-out analysis were used to evaluate the sensitivity and pleiotropy.</p><p><strong>Results: </strong>Two-sample bidirectional MR analysis revealed a significant association between the presence of hyperthyroidism and hypothyroidism and an increased risk of DR in the forward MR analysis (IVW: OR = 1.29, 95% [CI] = 1.12-1.49, P < 0.001; OR = 1.17, 95% CI = 1.10-1.25, P < 0.001). In the reverse MR analysis, DR was found to be associated with an elevated risk of developing hyperthyroidism and hypothyroidism (IVW: OR = 1.56, 95% CI 1.38-1.76, P < 0.001; OR = 1.41, 95% CI 1.25-1.59, P < 0.001). Furthermore, most supplementary MR methods also demonstrated statistically significant differences and exhibited effect sizes consistent with those obtained from IVW. The sensitivity analysis confirmed the relative reliability of our causal findings.</p><p><strong>Conclusions: </strong>Our findings provide genetic evidence supporting a bidirectional causal relationship between thyroid function and DR.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"297"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853228","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":"Astragaloside IV attenuates podocyte apoptosis via regulating TXNIP/NLRP3/GSDMD signaling pathway in diabetic nephropathy.","authors":"Zhibo Hu, Yu Zhou, Cailing Gao, Junfen Liu, Congqing Pan, Jun Guo","doi":"10.1186/s13098-024-01546-y","DOIUrl":"10.1186/s13098-024-01546-y","url":null,"abstract":"<p><strong>Objectives: </strong>Among all the diabetes complications brought on by persistent inflammation is diabetic kidney disease (DKD). One essential method of the inflammatory response's programmed cell death is anthrax. One of the main causes of diabetic renal disease progression in a high-glycemic environment is the lysis of renal resident cells.</p><p><strong>Method: </strong>This investigation sought to determine whether Astragaloside IV (AS-IV)'s anti-pyroptosis action provides a protective function for the kidneys. For 12 weeks, db/db mice received 40 mg/kg of AS-IV by transgastric gavage. To validate the possible in vitro mechanism, mouse podocytes were cultivated for additional experiments.</p><p><strong>Results: </strong>In vitro, AS-IV led to a significant reduction in blood urea nitrogen (BUN), urine albumen-to-creatinine ratio (UACR), serum creatinine (CREA), and hyperglycemia in db/db mice and lessen the pathological alterations in the kidney. Moreover, pyrin structural domain of the NLR family pyrin domain containing 3 (NLRP3), cleaved-caspase-1, gasdermin D (GSDMD), IL-18, and IL-1β were down-expressed and podocyte markers podocin and nphs1 were up-regulated following AS-IV intervention. By silencing GSDMD, we demonstrated in vitro that HG-stimulated podocytes undergo pyroptosis. We also discovered that AS-IV can mitigate this pyroptosis. To confirm that AS-IV prevented the NLRP3 inflammasome from activating, the NLRP3 inhibitor CY-09 was employed. It was also discovered that AS-IV prevents the expression of TXNIP and NLRP3 as well as their interaction. GSDMD expression was significantly downregulated following TXNIP-siRNA treatment, whereas GSDMD expression was upregulated in TXNIP overexpression cells; this upregulation could be undone with AS-IV.</p><p><strong>Conclusions: </strong>The anti-pyroptosis effect of AS-IV via the TXNIP-NLRP3-GSDMD axis improves the renal function and podocyte damage of db/db mice and delays the onset of DKD, according to in vivo and in vitro experimental data.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"296"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853354","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":"Interaction between sex and one-hour post-load glucose on metabolic syndrome and its components among Chinese people at high risk of diabetes.","authors":"Xin Chai, Juan Zhang, Yachen Wang, Di Li, Dongli Zhu, Kaipeng Liang, Chunyu Yang, Jinping Wang, Qiuhong Gong, Zhiwei Yang, Ruitai Shao","doi":"10.1186/s13098-024-01544-0","DOIUrl":"10.1186/s13098-024-01544-0","url":null,"abstract":"<p><strong>Background: </strong>Recently, International Diabetes Federation position statement has adopted one-hour post-load glucose (1hPG) ≥ 8.6 mmol/L for diagnosing intermediate hyperglycemia. We aimed to assess the association of 1hPG ≥ 8.6 mmol/L with metabolic syndrome (MetS) and its components, as well as interaction between sex and 1hPG ≥ 8.6 mmol/L on MetS and its components in Chinese people at high risk of diabetes.</p><p><strong>Methods: </strong>The cross-sectional study was conducted in DaQing city of HeiLongJiang Province, China between August, 2023 and January, 2024. Eligible individuals with fasting glucose of 5.6-6.9 mmol/L and age of 25-55 years in health checkup data in the year of 2023 or with at least one risk factor of diabetes were invited to receive the oral glucose tolerance test and biochemical examinations. Individuals with self-reported presence of diabetes or usage of glucose-lowering medication were excluded. MetS was defined as presence of at least three of the five components according to the Chinese Diabetes Society criteria. Logistic regression was performed to evaluate the association of 1hPG ≥ 8.6 mmol/L with MetS and its components. Additive interaction was estimated using the relative excess risk due to interaction, attributable proportion due to interaction (AP), and synergy index.</p><p><strong>Results: </strong>A total of 2419 subjects comprising 1465 men (60.6%) with a mean age of 45.77 ± 6.20 years were included, and the prevalence of MetS was 46.8%, with 59.7% in men and 27.1% in women. 1hPG ≥ 8.6 mmol/L was associated with MetS (aOR = 4.40, 95% CI 3.26-6.01), elevated blood pressure (aOR = 1.46, 95% CI 1.13-1.89), hyperglycemia (aOR = 15.46, 95% CI 11.56-20.98), and reduced HDL-C (aOR = 1.51, 95% CI 1.07-2.15) in the overall population, whereas no significant association between 1hPG ≥ 8.6 mmol/L and elevated blood pressure in men (aOR = 1.36, 95% CI 0.97-1.91) or dyslipidemia in women (elevated TG: aOR = 0.81, 95% CI 0.47-1.39; reduced HDL-C: aOR = 1.08, 95% CI 0.49-2.37). Additive interaction effect between sex and 1hPG ≥ 8.6 mmol/L on MetS was observed, with 31% attributed to the interaction effect between men and 1hPG ≥ 8.6 mmol/L (AP = 0.31, 95% CI 0.06-0.49).</p><p><strong>Conclusions: </strong>There was an additive interaction effect between sex and 1hPG on MetS among Chinese people at high risk of diabetes. 1hPG test and sex-specific strategies should be taken into consideration in cardiometabolic disorder identification and management.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"295"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853370","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":"Gestational diabetes mellitus and risk of neonatal respiratory distress syndrome: a systematic review and meta-analysis.","authors":"Fang Yang, Hua Liu, Cuixia Ding","doi":"10.1186/s13098-024-01539-x","DOIUrl":"10.1186/s13098-024-01539-x","url":null,"abstract":"<p><strong>Aim: </strong>Gestational Diabetes Mellitus (GDM), a common pregnancy complication characterized by glucose intolerance, is increasingly recognized as a risk factor for Neonatal Respiratory Distress Syndrome (NRDS). This study aimed to systematically review and quantify the association between GDM and NRDS.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Scopus, Embase, and Web of Science from their inception through July 30, 2024, to identify relevant studies. A total of 44 studies, including 50 datasets and over 6.2 million participants, were included in the analysis. Meta-analyses were performed using random-effects models to estimate pooled odds ratios (ORs) and assess heterogeneity among studies. Subgroup analyses were conducted based on study design, gestational age, diagnostic methods, and geographical regions.</p><p><strong>Results: </strong>Our meta-analysis demonstrated a statistically significant association between GDM and an increased risk of NRDS in newborns (OR 1.9; 95%CI 1.5-2.3). A sub-group analysis based on studies participants showed significant association in both GDM-based (OR, 2.0; 95%CI, 1.5-2.7) and NRSD-based studies (OR, 1.7; 95%CI, 1.3-2.3). This association was consistent across other various subgroups, including both term and preterm pregnancies and across different continents. Sensitivity analysis confirmed the robustness of these findings, and cumulative meta-analysis showed a steady increase in the strength of the association over time.</p><p><strong>Conclusion: </strong>Our findings highlight GDM as a significant risk factor for NRDS, underscoring the need for early detection and effective management of GDM to reduce adverse neonatal outcomes. However, limitations such as residual confounding, high heterogeneity among studies, and evidence of publication bias should be considered when interpreting these results. Future research should address these issues by including diverse populations and accounting for key confounders to better understand the GDM-NRDS relationship and explore targeted interventions to mitigate the risk in infants born to mothers with GDM.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"294"},"PeriodicalIF":3.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784468","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 relative risk of clinically relevant cholelithiasis among glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus, real-world study.","authors":"Mohammed Ali Gameil, Elshahat Ali Ahmed Mohamed Yousef, Rehab Elsayed Marzouk, Mohamed H Emara, Abeer H Abdelkader, Rasha Ibrahim Salama","doi":"10.1186/s13098-024-01526-2","DOIUrl":"10.1186/s13098-024-01526-2","url":null,"abstract":"<p><strong>Background and aim: </strong>The association between biliary disorders with weight reduction enhanced by GLP-1RAs was observed frequently, nevertheless, the relative risk of the clinically relevant cholelithiasis was not specified clearly among different GLP-1RAs.</p><p><strong>Methods: </strong>308 patients with type 2 diabetes mellitus (T2D) were recruited and divided into 4 groups; liraglutide, dulaglutide, semaglutide, versus control group; comprised of 69, 76, 71, and 92, respectively. Clinical history, examination, laboratory, and radiology tests were implemented.</p><p><strong>Results: </strong>Cholelithiasis significantly associates GLP1-RAs (p = 0.033). Overall cholelithiasis was evident in 31.2% of our participants. Symptomatic cholelithiasis prevails in 60.4% of patients with cholelithiasis. Symptomatic complicated cholelithiasis prevailed in 33.3%; distributed in 28.1%, 28.1%, 21.9%, and 21.9% in liraglutide, semaglutide, dulaglutide, and control groups, respectively. Meanwhile, symptomatic uncomplicated cholelithiasis was observed in 27.1%; distributed in 34.6%, 30.8%, 15.4%, and 19.2% in Liraglutide, semaglutide, dulaglutide, and control groups, respectively. Asymptomatic cholelithiasis was noted in 36.8%, 21.1%, 10.5%, and 31.6% of patients with dulaglutide, semaglutide, liraglutide, and control groups, respectively. Specifically, 81.1%, 68%, and 44% of patients with liraglutide, semaglutide, and dulaglutide experienced symptomatic cholelithiasis. The relative risk of cholelithiasis was 1.2, 1.3, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 17.25, 14.69, and 10.96, respectively. The relative risk of symptomatic cholelithiasis was 1.6, 0.9, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 3.14, 16.67, and 5.56, respectively.</p><p><strong>Conclusion: </strong>Liraglutide was associated with the highest risk of clinically relevant cholelithiasis than semaglutide, and dulaglutide in patients with T2D.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"293"},"PeriodicalIF":3.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779692","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":"Impact of the obesity paradox on 28-day mortality in elderly patients critically ill with cardiogenic shock: a retrospective cohort study.","authors":"Jing Tian, Ke Jin, Haohao Qian, Hongyang Xu","doi":"10.1186/s13098-024-01538-y","DOIUrl":"10.1186/s13098-024-01538-y","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that the obesity paradox exists in cardiovascular disease (CVD), giving patients a survival advantage, but controversy remains as to whether it applies to patients with cardiogenic shock (CS), especially in the elderly. We therefore aimed to determine whether obesity affects 28-day prognosis in elderly patients with CS.</p><p><strong>Methods: </strong>We used clinical data from the Medical Information Market in Critical Care IV (MIMIC-IV) database. Critical patients with CS were categorized into two groups based on age; age < 65 years and ≥ 65 years were classified as young adult patients and elderly patients, respectively. Patients were then categorized into two subgroups based on their body mass index (BMI), one with a BMI ≥ 30 kg/m² and the other with a BMI < 30 kg/m². The primary outcome was a 28-day prognosis. Secondary outcomes were mechanical ventilation status, length of hospitalization, and length of ICU stay.</p><p><strong>Results: </strong>1827 patients from the MIMIC-IV ICU database were analyzed, of which 571 patients were < 65 years old and 1256 patients were ≥ 65 years old. According to multifactorial logistic analysis, BMI > 30 kg/m² was not a 28-day risk factor for death in elderly patients critically ill with CS (Overweight OR 1.28, P = 0.221; Obesity OR 1.15, P = 0.709; Severe obesity OR 1.46, P = 0.521; using normal weight as a reference). In contrast, underweight was a risk factor (OR 2.42, P = 0.039). Kaplan-Meier curves showed that in the older age group, 28-day survival was significantly higher in patients with BMI ≥ 30 kg/m² compared to those with BMI < 30 kg/m² [261 (66.75%) vs. 522 (60.35%), P = 0.024].</p><p><strong>Conclusion: </strong>Underweight affects the 28-day prognosis of critically ill elderly patients with CS. In contrast, overweight and or obesity do not appear to have a significant impact on the prognosis of these patients.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"292"},"PeriodicalIF":3.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767528","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":"Onset of Type 2 diabetes in adults aged 50 and older in Europe: an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy.","authors":"Julie Lorraine O'Sullivan, Enrique Alonso-Perez, Francesca Färber, Georg Fuellen, Henrik Rudolf, Jan Paul Heisig, Michaela Kreyenfeld, Paul Gellert","doi":"10.1186/s13098-024-01533-3","DOIUrl":"10.1186/s13098-024-01533-3","url":null,"abstract":"<p><strong>Background: </strong>Disparities in the development of Type 2 Diabetes (T2D) are associated with various social determinants, including sex/gender, migration background, living arrangement, education, and household income. This study applied an intersectional perspective to map social disparities and investigate intersectional effects regarding the onset of T2D among older adults across Europe.</p><p><strong>Methods: </strong>We used data from the Survey of Health and Retirement in Europe (SHARE) to conduct an Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (I-MAIHDA) of T2D onset. Individuals aged 50 years or older without known T2D at Wave 4 (2011, baseline) were included and followed through Waves 5 (2013), 6 (2015), 7 (2016), and 8 (2019-2020). Intersectional models were used to estimate additive main effects of sex/gender, migration background, living arrangement, education level, and household income and intersectional interactions.</p><p><strong>Results: </strong>A total of 39,108 individuals were included (age at baseline M = 65.18 years (SD = 9.62), 57.4% women). T2D onset was reported for 9.2% of the sample over the 9-year observation period. In the fully adjusted model, all social determinants showed significant additive associations with T2D onset, while the discriminatory accuracy of the social strata was found to be low (Variance Partition Coefficient = 0.3%).</p><p><strong>Conclusions: </strong>This study provides a comprehensive mapping of intersectional disparities in onset of T2D among older adults in Europe. The results highlight the risk heterogeneity within the population and show social disadvantages faced by certain groups. However, while the T2D risks were higher in some strata than in others, the intersectional effects were small overall and mostly attributable to the additive main effects. The results suggest that public health strategies to prevent T2D should be universal but tailored to meet the specific situation of the different intersectional strata.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"291"},"PeriodicalIF":3.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750217","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 childhood-adulthood body size trajectories with risk of micro- and macrovascular complications among individuals with type 2 diabetes: a prospective study.","authors":"Xiaomin Zeng, Xingji Lian, Yaxin Wang, Xianwen Shang, Honghua Yu","doi":"10.1186/s13098-024-01499-2","DOIUrl":"10.1186/s13098-024-01499-2","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the association between childhood-adulthood body size trajectories and the risk of micro- and macrovascular complications in individuals with type 2 diabetes (T2D) using data from the UK Biobank.</p><p><strong>Methods: </strong>Childhood body size (average, thinner, and plumper) was self-reported for age 10, and adulthood body size (normal weight, overweight, obesity) was measured using body mass index at baseline. We defined nine body size trajectories by combining childhood and adulthood body size categories. Cox regression models were used to assess the association between these trajectories and the risk of diabetic complications.</p><p><strong>Results: </strong>Among 22,123 participants with T2D, 4,693 developed microvascular complications, and 3,640 developed macrovascular complications. Compared to individuals who maintained a normal body size from childhood to adulthood (the Average-Normal weight group), those with a high body size trajectory from childhood to adulthood (the Plumper-Obesity group) showed the highest risk for microvascular complications (HR 1.55; 95% CI: 1.31, 1.83), diabetic neuropathy (HR 2.18; 95% CI: 1.49, 3.21), diabetic nephropathy (HR 1.79; 95% CI: 1.45, 2.21), macrovascular complications (HR 1.30; 95% CI: 1.09, 1.55), and ischemic heart disease (HR 1.51; 95% CI: 1.23, 1.86). In contrast, individuals who were plumper in childhood but maintained a normal weight in adulthood did not show an increased risk of these complications.</p><p><strong>Conclusions: </strong>A persistent high body size trajectory from childhood to adulthood is associated with the greatest risk of both micro- and macrovascular complications in individuals with T2D, whereas those who were plumper in childhood but achieved a normal weight in adulthood did not show an increased risk of these complications. These findings underscore the importance of weight management from childhood and maintaining a healthy weight throughout adulthood to reduce the risk of diabetic vascular complications in those with T2D.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"289"},"PeriodicalIF":3.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750210","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":"Stronger association between morning serum cortisol level and diurnal time in range in type 2 diabetes?","authors":"Yue Liang, Jingjing Liang, Wenwen Jiang, Wei Wang, Xinyi Yang, Yanyu Liu, Xuguang Jin, Qingyu Guo, Yixin Xu, Bin Lu, Ping Gu, Jiaqing Shao","doi":"10.1186/s13098-024-01515-5","DOIUrl":"10.1186/s13098-024-01515-5","url":null,"abstract":"<p><strong>Background: </strong>The hypothalamic-pituitary-adrenal axis is thought to play a vital role in glucose homeostasis and diabetes. This study investigated the association between morning serum cortisol and time in range (TIR), including daytime TIR, in type 2 diabetes (T2DM).</p><p><strong>Methods: </strong>310 patients with T2DM had serum cortisol measured at 8 a.m. All participants underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR and glycemic variability (GV) parameters were evaluated. Using 100 g standard steamed bread meal test, blood glucose, C peptide and insulin at different points were collected to assess insulin sensitivity and islet function.</p><p><strong>Results: </strong>Patients with higher serum cortisol exhibited lower TIR and TITR (P < 0.001). Spearman correlation analysis showed that the negative correlation between cortisol and daytime TIR (r=-0.231, P < 0.001) was stronger than that of overnight TIR (r=-0.134, P = 0.028). Similarly, there existed a negative correlation between cortisol and pancreatic function indicators such as HOMA-β, insulinogenic index (IGI), area under the curve of C-peptide within half an hour (AUCCp0.5 h) and three hours (AUCCp3h) (r=-0.248, -0.176, -0.140, -0.185, respectively, P < 0.05). In contrast, cortisol was positively associated with TAR (r = 0.217, P < 0.001) and GV parameters including MBG, MAGE, LAGE, HBGI, MODD, ADDR (P of MAGE and MODD > 0.05). Multiple stepwise regression revealed that cortisol was an independent contributor of TIR, TITR and diurnal TIR, with diurnal TIR of stronger relevance.</p><p><strong>Conclusions: </strong>Morning serum cortisol is negatively correlated with TIR, especially diurnal TIR and positively associated with GV parameters. Inappropriate cortisol secretion may have an adverse influence on glucose homeostasis in T2DM.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"16 1","pages":"290"},"PeriodicalIF":3.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750219","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}