Diabetology & Metabolic Syndrome最新文献

{"title":"Effect of intermittent fasting, portfolio-moderate-carbohydrate, and anti-inflammatory diets on cardio-metabolic status in pre-diabetic patients; an open-label randomized clinical trial.","authors":"Yahya Pasdar, Amir Saber, Nayebali Rezvani, Samaneh Bozorgi, Shima Moradi, Sahar Cheshmeh, Hossein Niazi, Farid Najafi","doi":"10.1186/s13098-025-01901-7","DOIUrl":"10.1186/s13098-025-01901-7","url":null,"abstract":"<p><strong>Background: </strong>Pre-diabetes is a condition characterized by hyperglycemia that does not meet the cutoff for the diagnosis of diabetes and increases the risk of non-communicable diseases. Choosing an appropriate diet is necessary to prevent the progression of pre-diabetes to diabetes. Therefore, the present study aimed to compare the effects of 3 diets, including intermittent fasting (IF) 5:2, portfolio-moderate-carbohydrate (PMC), and anti-inflammatory (AI) diets, compared to a healthy diet with carbohydrate distribution.</p><p><strong>Methods: </strong>This open label randomized clinical trial was performed on 98 patients with pre-diabetes that were randomly divided into four intervention groups, including IF 5:2 (n = 24), PMC (n = 24), AI (n = 25), and control group (n = 25). Adherence to these dietary intervention was assessed by dietary recall. Glycemic indices (fasting blood sugar (FBS) and hemoglobin A1c (HbA1c)), lipid profile, body composition, anthropometric indices (weight, waist circumference (WC), and body mass index (BMI)), and hs-C reactive protein (CRP) were assessed before and after dietary intervention. Mixed model regression was used for statistical analysis.</p><p><strong>Results: </strong>Compared to the control group, the AI diet significantly reduced weight (β: -1.02; 95% CI: -1.96, -0.07; P = 0.017), FBS (β: -6.42; 95% CI: -12.9, -0.06; P = 0.026), and HbA1c (β: -0.27; 95% CI: -0.55, -0.007; P = 0.028). IF 5:2 showed significant reductions in waist circumference, BMI, FBS, and HbA1c, while PMC intervention resulted in significant improvements in FBS and HbA1c compared to the control group.</p><p><strong>Conclusions: </strong>The study demonstrated that AI, IF 5:2, and PMC diets improved glycemic control and anthropometric indices in pre-diabetic patients, with the AI diet showing the greatest beneficial effects. These findings suggest that anti-inflammatory dietary approaches may be an effective strategy for pre-diabetes management.</p><p><strong>Level of evidence: </strong>Level I, randomized clinical trial.</p><p><strong>Trial registration: </strong>Registration number IRCT20200608047697N2, data 2024-05-16, https://irct.behdasht.gov.ir/trial/76653 .</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"319"},"PeriodicalIF":3.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793709","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":"Empagliflozin targeted the immune-related gene PIK3CA in type 2 diabetes mellitus treatment: network pharmacology analysis and experimental evidence.","authors":"Heng Zhong, Guo-Juan Sun, Fu-Man Du, Wei-Min Wang, Bin-Hong Duan, Hong Qiao","doi":"10.1186/s13098-025-01895-2","DOIUrl":"10.1186/s13098-025-01895-2","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is linked to elevated blood glucose due to insulin resistance. Empagliflozin has demonstrated efficacy in T2DM management, with potential immune-modulatory effects. This study aimed to investigate the immune-related mechanisms of empagliflozin in T2DM treatment.</p><p><strong>Methods: </strong>Gene expression profiles were obtained from common databases, and immune-related differentially expressed genes (IRDEGs) were identified using the \"limma\" R package. The STRING database and Cytoscape software were utilized to construct a protein-protein interaction network and identify key IRDEGs. Molecular docking was performed to predict the interaction between empagliflozin and PIK3CA. Pathways related to PIK3CA were explored using GSEA, and relationship of PIK3CA with immune cells was analyzed using single-cell RNA sequencing analysis. The effects of empagliflozin on high glucose-induced RAW264.7 macrophages and PI3K/AKT signaling were assessed using CCK-8, fluorescence detection, qRT-PCR, and Western blotting.</p><p><strong>Results: </strong>We identified 109 IRDEGs in T2DM, with PIK3CA as a key gene. Empagliflozin showed binding affinity to PIK3CA, which was linked to immune cell interactions and inflammatory responses. Single-cell RNA sequencing analysis revealed the interaction of PIK3CA with macrophages. In high glucose-induced RAW264.7 macrophages, PIK3CA expression was elevated. Empagliflozin ameliorated the high glucose-induced cell injury and inhibited the expression of PIK3CA in macrophages. Additionally, empagliflozin treatment reduced the expression of CD44 and ITGAV, IL-6, and TNF-α, and increased the p-PI3K/PI3K ratio.</p><p><strong>Conclusion: </strong>Empagliflozin's therapeutic effects in T2DM may be mediated through the modulation of immune pathways, particularly by targeting PIK3CA within the PI3K/AKT signaling pathway.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"320"},"PeriodicalIF":3.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793734","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":"Evaluating body composition, the eating behavior scale, and the healthy lifestyle index in female Jordanian adults with metabolic syndrome: a cross-sectional study.","authors":"Buthaina Alkhatib, Islam Al-Shami, Lana M Agraib, Amjad Al Shdaifat","doi":"10.1186/s13098-025-01757-x","DOIUrl":"10.1186/s13098-025-01757-x","url":null,"abstract":"","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"318"},"PeriodicalIF":3.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793735","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":"Uncovering the link between cardiometabolic index and depression in diabetes: a large-scale population study.","authors":"Nuo Ma, Jiasuer Alifu, Guilin Meng, Jiangping Ma, Haichao Wang, Xiulin Meng, Xueyuan Liu","doi":"10.1186/s13098-025-01881-8","DOIUrl":"10.1186/s13098-025-01881-8","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that individuals with diabetes are more likely to suffer from depression, and metabolic dysregulation may be the pathophysiological mechanism underlying this comorbidity. The Cardiometabolic Index (CMI) is an innovative metric that integrates abdominal obesity and lipid levels, providing a comprehensive assessment of cardiometabolic health. Currently, the relationship between CMI and depression in diabetes has not been clarified. This study aims to explore the association between CMI and depression among American adults with diabetes.</p><p><strong>Methods: </strong>This study enrolled 3,182 patients with diabetes from the National Health and Nutrition Examination Survey (2005-2018). A multivariable logistic regression model, restricted cubic spline (RCS) regression analysis, subgroup analysis, and interaction tests were employed to explore the association between CMI and depression. Mediation analysis was also performed to investigate the role of inflammatory factors-including neutrophils, lymphocytes, White Blood Cells, neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII)-in the association between CMI and depression in patients with diabetes.</p><p><strong>Results: </strong>We found that CMI is positively associated with depression in diabetes patients, and RCS regression analysis further confirmed a non-linear (L-shaped) relationship between CMI and depression, with an inflection point at CMI = 1.694. Depression risk increased significantly below this threshold but plateaued beyond it, suggesting a threshold effect primarily within the moderate to high CMI range. Subgroup analysis and interaction tests indicated that the association between CMI and depression was consistently present across all subgroups, with no significant differences observed among them (all interaction p-values > 0.05). Female, lower educational, lower household income, unmarried, smokers, and those with hypertension were more likely to develop depression among diabetes patients. Mediation analysis suggested that neutrophils and NLR significantly mediated the CMI-depression relationship, explaining 5.04% and 4.74% of the total effect, respectively.</p><p><strong>Conclusions: </strong>In patients with diabetes, a non-linear (L-shaped) relationship exists between CMI and depression, and inflammatory factors significantly mediate this relationship.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"317"},"PeriodicalIF":3.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793737","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":"Dionysus or apollo, skeletal muscle mass changes in type 2 diabetes with sarcopenia receiving GLP-1 receptor agonist: systematic review and meta-analysis.","authors":"Yanying Wang, Boya Lan, Shuo Zhang, Yue Mu, Jia Mi, Jing Yu, Qun Zhan, Baoling Luo, Fuyang Lin, Jia Teng, Xiuge Wang, Guanchi Yan","doi":"10.1186/s13098-025-01877-4","DOIUrl":"10.1186/s13098-025-01877-4","url":null,"abstract":"<p><strong>Objective: </strong>Type 2 diabetes mellitus (T2DM) increases the risk of sarcopenia, but evidence on the effects of glucagon-like peptide 1 receptor agonist (GLP-1 RA) in skeletal muscle is limited and inconsistent. The study aimed to evaluate the skeletal muscle mass of GLP-1 RA in patients with type 2 diabetes.</p><p><strong>Methods: </strong>Randomized controlled trials of GLP-1 RA for sarcopenia with type 2 diabetes were identified by searching databases (up to July 6, 2025). Electronic databases (CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane library, Web of Science, and Google Scholar), grey literature (Open Grey and Proquest) and reference lists of included articles were searched. The I² and τ² statistic was used to assess the heterogeneity. The random effects model was applied regardless of the heterogeneity. Funnel plots were used to assess publication bias. The results were evaluated by calculating the risk ratio (RR), mean difference (MD), and confidence interval (CI).</p><p><strong>Results: </strong>The study included nine randomized controlled trials with a total of 1089 participants. GLP-1 RA significantly reduced weight-related changes and fat-related changes, including body weight (BW) (MD= -2.25, 95%CI: -6.99 to 1.89 P = 0.20), body mass index (BMI) (MD= -1.83, 95%CI: -3.88 to 0.23, P < 0.01), fat mass (FM) (MD= -8.00, 95%CI: -11.93 to -4.08, P < 0.01), body fat ratio (BFR) (MD= -2.76, 95%CI: -3.65 to -1.87, P < 0.01), visceral fat area (VFA) (MD = 0.74, 95%CI: -54.93 to 56.40, P < 0.05). In muscle-related changes, lean body mass (LBM) (MD = 4.61, 95%CI: -4.19 to 13.42, P = 0.31), and skeletal muscle index (SMI) (MD = 0.59, 95% CI: -0.69 to 1.86, P = 0.19) were not significantly different.</p><p><strong>Conclusion: </strong>GLP-1 receptor agonists, regardless of structure, have beneficial effects on body weight and fat content in type 2 diabetes with sarcopenia, but have no effect on reducing muscle mass.</p><p><strong>Registration: </strong>PROSPERO (CRD42023473528).</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"315"},"PeriodicalIF":3.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793708","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":"SRPK1 is a significant factor in driving the progression of diabetic kidney fibrosis.","authors":"Shichao Han, Shuaijun Ma, Kepu Liu, Ruochen Qi, Guohui Wang, Weijun Qin, Xutao Zhang","doi":"10.1186/s13098-025-01889-0","DOIUrl":"10.1186/s13098-025-01889-0","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy leads to renal fibrosis via excessive ECM accumulation. Current therapies lack specificity, highlighting the need to identify targets like SRPK1, whose role in diabetic kidney fibrosis remains unclear.</p><p><strong>Methods: </strong>We investigated SRPK1's function using a streptozotocin-induced diabetic nephropathy mice model and administered the selective SRPK1 inhibitor SRPIN340. Histological, biochemical, and molecular analyses were performed to assess ECM deposition, renal function, and fibrotic marker expression. Additionally, Western blotting and immunohistochemistry were utilized to explore the involvement of the NF-κB/NLRP3 signaling pathway.</p><p><strong>Results: </strong>SRPK1 expression was significantly elevated in fibrotic kidneys, correlating with increased ECM components (collagen I/III, fibronectin) and reduced renal function. SRPIN340 treatment markedly alleviated ECM accumulation, improved glomerular filtration rate, and suppressed fibrotic markers (α-SMA, TGF-β). Mechanistically, SRPK1 activation promoted NF-κB/NLRP3 pathway activation, leading to inflammatory cytokine release (IL-1β, TNF-α) and fibrosis. Inhibition of SRPK1 via SRPIN340 abrogated these effects, suggesting a causal role for SRPK1 in fibrotic progression.</p><p><strong>Conclusion: </strong>SRPK1 activates NF-κB/NLRP3 pathway, promoting ECM synthesis and inflammation in diabetic nephropathy; SRPIN340 reduces fibrosis, highlighting SRPK1 as a therapeutic target.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"316"},"PeriodicalIF":3.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793736","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":"Curcumin as a promising therapeutic agent for diabetic neuropathy: from molecular mechanisms to functional recovery.","authors":"Shirin Barati, Abdullah Yadegari, Maedeh Shahmohammadi, Fatemeh Azami, Fatemeh Tahmasebi, Mohammad Reza Rouhani, Sahar Kazemi, Elmira Roshani Asl","doi":"10.1186/s13098-025-01884-5","DOIUrl":"10.1186/s13098-025-01884-5","url":null,"abstract":"<p><p>Diabetes mellitus is an endocrine disorder characterized by prolonged hyperglycemia. It results from either insulin deficiency (type 1 diabetes mellitus, T1DM) or insulin resistance (type 2 diabetes mellitus, T2DM). This condition has emerged as a significant health concern in recent years. Hyperglycemia induces the overproduction of reactive oxygen species (ROS), which can modulate multiple pathways, including AGEs-RAGE, PKC stimulation, NF-κB and PI3K/AKT. These pathways contribute to diabetes-related complications such as inflammation, oxidative stress, insulin resistance, and reduced glucose uptake. The interplay of these metabolic disturbances can lead to demyelination and peripheral nerve damage, resulting in diabetic neuropathy. This is a challenging complication of diabetes for which there are limited effective treatments. Despite its low bioavailability, curcumin, a natural component extracted from turmeric, despite its low bioavailability, affects and modulates several intracellular pathways underlying neuropathic damage. Curcumin is considered a potential treatment for diabetic neuropathy (DN) because it measurably reduces markers of oxidative stress and inflammatory cytokines, while significantly alleviating neuropathic pain and improving nerve function. MicroRNAs (miRNAs or miR), which are small non-coding RNAs consisting of 19-25 nucleotides, are stable in circulation and can regulate multiple target genes. This makes them promising biomarkers for both diagnostic and therapeutic applications. Curcumin has been shown to regulate the dysregulation of relevant miRNAs associated with neuropathy by suppressing the inflammatory miR-21 while enhancing the expression of the anti-inflammatory miR-146a. Current formulations of curcumin face bioavailability challenges; however, advancements in delivery systems and structural modifications, such as nanoformulations, have significantly improved its bioavailability. These improvements overcome previous pharmacokinetic limitations and enhance the therapeutic effects of curcumin. With continued research, curcumin could ultimately become a cornerstone in managing diabetic complications and improving the quality of life for affected patients.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"314"},"PeriodicalIF":3.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788528","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 the estimated glucose disposal rate and the occurrence of major cardiovascular events and stroke.","authors":"Yue-Yang Zhang, Qin Wan","doi":"10.1186/s13098-025-01872-9","DOIUrl":"10.1186/s13098-025-01872-9","url":null,"abstract":"<p><strong>Background: </strong>The Estimated Glucose Disposal Rate (eGDR) recognised as a reliable biomarker for assessing insulin resistance. Accordingly, this study aims to investigate the potential association between eGDR and the occurrence of major adverse cardiovascular events (MACE) and stroke within a cohort of the Chinese population.</p><p><strong>Methods: </strong>The China Cardiometabolic Disease and Cancer Cohort Study is a large-scale, nationwide, multicenter prospective cohort study initiated in 2010. The study collected baseline data from 10,008 participants, with a subsequent 10-year follow-up period. Following the relevant inclusion and exclusion criteria, a total of 8,723 participants were included in the final analysis. Participants were stratified into four groups based on the quartiles of their eGDR levels. To better evaluate the association between eGDR and the risks of MACE and stroke, the study employed Cox proportional hazards models, restricted cubic splines (RCS), receiver operating characteristic curve(ROC), and subgroup analyses to ensure the robustness of the findings.</p><p><strong>Results: </strong>A total of 438 MACE events and 445 stroke events were documented. Cox regression and RCS analyses demonstrated a negative association between eGDR and the risk of both MACE and stroke in fully adjusted models. Specifically, each one standard deviation increase in eGDR was associated with a 2% reduction in the risk of MACE and stroke. Moreover, compared with participants in the Q1 group, those in the Q4 group exhibited a significantly lower risk of primary outcomes. The RCS analysis identifies an optimal eGDR threshold of 9.92. Additionally, the ROC demonstrates that incorporating eGDR significantly enhances the diagnostic efficacy compared to the basic model and other positive controls.</p><p><strong>Conclusions: </strong>Elevated eGDR levels are associated with a lower risk of MACE and stroke among non-diabetic individuals in China.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"312"},"PeriodicalIF":3.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783719","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":"Glycaemic control, low levels of high-density lipoprotein, and high cardiovascular risk are associated with cardiovascular autonomic neuropathy.","authors":"Tina Okdahl, Anne-Marie Wegeberg, Marie Møller Jensen, Jonas Salling Quist, Christina Brock","doi":"10.1186/s13098-025-01834-1","DOIUrl":"10.1186/s13098-025-01834-1","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular autonomic neuropathy (CAN) is a life-threatening complication associated with diabetes but may also be present without diabetes. A glycaemic threshold for autonomic impairment is not yet established. The purpose of this study was to compare CAN status in people with and without diabetes and to investigate which factors contributed the most to the presence and severity of CAN.</p><p><strong>Methods: </strong>We included 240 participants from three different cohorts: non-diabetic people (n = 40), people with overweight or obesity with or without prediabetes (n = 100), and people with type 2 diabetes (n = 100). All participants underwent cardiovascular autonomic reflex tests using the Vagus™ device, and clinical variables, including age, sex, body mass index, blood pressure, HbA1c, blood lipid profile, and cardiovascular risk score, were recorded.</p><p><strong>Results: </strong>In total, 14% without and 42% with diabetes had CAN. HbA1c had the most significant influence on CAN scores, with a cutpoint of 45.5 mmol/l corresponding to established prediabetes (sensitivity: 0.66; specificity: 0.71). In people with HbA1c levels below the cutpoint, those with CAN had lower levels of high-density lipoprotein (HDL) (1.1 vs. 1.4 mmol/mol, p = 0.003) and higher cardiovascular risk scores (p < 0.001) compared to people without CAN. No differences in any of the investigated clinical factors were seen between people with HbA1c levels above the cutpoint with or without CAN.</p><p><strong>Conclusions: </strong>In individuals with HbA1c levels below 45.5 mmol/l, both HDL levels and cardiovascular risk score were associated with CAN status. Therefore, it may be beneficial to screen for CAN in individuals susceptible to prediabetes, who also exhibit low HDL levels and a high cardiovascular risk.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"313"},"PeriodicalIF":3.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783720","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":"Joint associations of pre-diabetes, pre-hypertension, and pre-dyslipidemia with cardiovascular and metabolic disease progression.","authors":"Cui Ma, Lu Zhai, Rong-Rui Huo, Yu-Hua Liu","doi":"10.1186/s13098-025-01896-1","DOIUrl":"10.1186/s13098-025-01896-1","url":null,"abstract":"<p><strong>Background: </strong>Pre-diabetes, pre-hypertension, and pre-dyslipidemia are early metabolic abnormalities associated with cardiovascular disease (CVD), but their joint effects on CVD and metabolic disease progression remain unclear. This study examines their joint associations and interactions on CVD and progression to diabetes, hypertension, and dyslipidemia in Chinese adults aged ≥ 45 years.</p><p><strong>Methods: </strong>A prospective cohort of 3405 adults (mean age 57.07 years, 49.9% women) from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. Pre-diabetes, pre-hypertension, and pre-dyslipidemia were defined as elevated but subclinical thresholds for blood pressure, glucose, and lipids. Cox model was used to assess associations between the number of pre-disease risk factors (0-3) and incident CVD or progression to diabetes, hypertension, and dyslipidemia. Additive/multiplicative interactions were conducted.</p><p><strong>Results: </strong>At baseline, 24.8%, 38.7%, 28.3%, and 8.2% had 0, 1, 2, and 3 pre-disease factors, respectively. Over 7.1 years, 527 CVD cases occurred. Cumulative pre-disease factors were associated with higher CVD risk: HRs for 1, 2, and 3 factors were 1.33 (95% CI 1.04-1.69), 1.37 (1.14-1.89), and 1.55 (1.11-2.16), respectively. Each additional factor was associated with a 16% higher CVD risk (HR = 1.16, 95% CI 1.06-1.27). Significant additive and multiplicative interactions were observed between pairs of pre-disease factors, with combined risks for CVD exceeding those expected from individual effects (all P < 0.05). Each additional factor was also associated with 44%, 48%, and 18% higher risks of diabetes (HR = 1.44, 95% CI, 1.29-1.62), hypertension (HR = 1.48, 95% CI 1.38-1.58), and dyslipidemia (HR = 1.18, 95% CI 1.11-1.27).</p><p><strong>Conclusions: </strong>Coexisting pre-diabetes, pre-hypertension, and pre-dyslipidemia jointly increase CVD risk and accelerate metabolic disease progression among Chinese adults aged ≥ 45 years. These findings support early, integrated interventions to mitigate CVD risk in individuals with subclinical metabolic abnormalities.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"310"},"PeriodicalIF":3.9,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768531","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}