Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy最新文献

{"title":"The Effects of Exercise Combined with Pharmacotherapy on Body Composition and Metabolic Parameters in Overweight/Obese Adults: A Meta-Analysis and Network Pharmacology Study.","authors":"Tianhang Peng, Wanyuan Liang, Ju Wei, Ni Ding, Xiuqi Tang, Zike Zhang","doi":"10.2147/DMSO.S590529","DOIUrl":"https://doi.org/10.2147/DMSO.S590529","url":null,"abstract":"<p><strong>Objective: </strong>Overweight and obesity are major global health issues. Traditional interventions have limited efficacy, while pharmacological treatments are hindered by side effects and weight rebound. This study evaluates the effects of combined exercise and medication on body composition and metabolic health in overweight/obese adults, using network pharmacology to explore potential synergistic mechanisms.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Scopus, Web of Science, Medline, and Cochrane up to October 2025 identified 18 randomized controlled trials with 5,620 participants. Meta-analysis was performed using RevMan 5.4 and Stata 14. Outcomes included weight, BMI, body fat percentage, and metabolic markers. Network pharmacology was conducted using liraglutide and orlistat to identify shared targets and perform enrichment analysis.</p><p><strong>Results: </strong>Combined exercise and medication significantly reduced weight (MD = -2.49, 95% CI: -3.83, -1.14), BMI (MD = -0.79, 95% CI: -1.25, -0.34), and body fat percentage (MD = -1.97, 95% CI: -3.76, -0.18) compared to exercise alone. The combined intervention also significantly reduced systolic and diastolic blood pressure and triglycerides. However, compared to medication alone, it showed only reductions in weight and BMI, with no significant improvements in lean body mass, HDL, LDL, or fasting glucose. Network pharmacology revealed 109 obesity-related targets, including IL1B, STAT3, and SIRT1, involved in inflammation, lipid metabolism, and energy regulation. GO/KEGG analysis showed enrichment in fatty acid metabolism and AMPK signaling pathways. These pathways were highly consistent with metabolic adaptations induced by exercise, suggesting potential synergistic effects between exercise and medication in metabolic regulation.</p><p><strong>Conclusion: </strong>Combined exercise and medication significantly enhance weight loss in overweight/obese adults. Network pharmacology suggests that the IL1B-STAT3 inflammatory axis and SIRT1/CD36 lipid metabolism network may be central to the mechanisms. Future studies should explore the long-term efficacy and mechanistic specificity of different drug-exercise combinations.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"590529"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Multimorbidity and Risk of All-Cause and Cause-Specific Mortality: A Retrospective Cohort Study of 123,791 Chinese Adults.","authors":"Xianhui Ran, Zhiyuan Fan, Na Wang, Tianyi Zhao, Hui Li, Xiao Liu, Enying Gong, Shuanghua Xie, Beiyao Gao, Lan An, Gang Chen, Xiao Ma, Chen Wang","doi":"10.2147/DMSO.S593341","DOIUrl":"https://doi.org/10.2147/DMSO.S593341","url":null,"abstract":"<p><strong>Aim: </strong>Metabolic diseases are increasingly prevalent worldwide and often coexist. However, the patterns of metabolic multimorbidity and their long-term associations with mortality remain poorly understood. This study aimed to characterize these patterns and evaluate their associations with all-cause and cause-specific mortality.</p><p><strong>Methods: </strong>This retrospective cohort study included 123,791 adults aged 25-74 years who underwent health examinations at a large medical center in northern China between 2015 and 2022. Five metabolic diseases were assessed: diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease, and obesity. Metabolic multimorbidity was defined as the coexistence of two or more of these conditions. Cox proportional hazards models were used to estimate associations with all-cause, cardiovascular, and cancer mortality.</p><p><strong>Results: </strong>Among 123,791 participants (mean [SD] age, 41.3 [11.9] years; 50.8% male), 38,945 (31.5%) had metabolic multimorbidity. Prevalence was higher in men than in women (46.1% vs. 16.4%; <i>P</i> < 0.001). Age-related patterns differed by sex (<i>P</i> for interaction <0.001), with men showing a higher burden at younger ages and women showing a marked rise after midlife. During a median follow-up of 6.1 years (IQR, 4.2-7.6), 724 deaths (0.6%) occurred. Increasing numbers of coexisting diseases were associated with progressively higher risks of all-cause mortality (adjusted hazard ratios [aHRs], 1.38 [95% CI, 1.09-1.76] for one disease to 2.92 [1.82-4.68] for five diseases vs none; P for trend <0.001), cardiovascular mortality (aHRs, 1.78 [1.06-2.99] to 5.13 [2.25-11.7]; P for trend <0.001), and cancer mortality (aHRs, 1.36 [0.91-2.03] to 3.84 [1.90-7.78]; P for trend <0.001).</p><p><strong>Conclusion: </strong>Metabolic multimorbidity was highly prevalent and exhibited distinct age- and sex-related patterns, with a graded association with mortality risk. These findings may reflect shared pathophysiological mechanisms and support integrated, sex-specific strategies to mitigate the growing metabolic burden.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"593341"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834787","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":"Cumulative Triglyceride-Glucose Index and Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: Findings from the Kailuan Cohort.","authors":"Chao Zhang, Zixin Zhang, Qi Qi, Lei Li, Jie Deng, Jiao Zheng, Yue Jiang, Quanle Han, Shouling Wu, Kangbo Li","doi":"10.2147/DMSO.S570754","DOIUrl":"https://doi.org/10.2147/DMSO.S570754","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relationship between the cumulative triglyceride-glucose (cum-TyG) index and the risk of new-onset metabolic dysfunction-associated fatty liver disease (MAFLD).</p><p><strong>Patients and methods: </strong>The present study involved 89,831 participants selected from the Kailuan cohort. The cum-TyG index was evaluated by determining the weighted average of TyG index values recorded at each visit. Participants were divided into four groups based on the quartiles of cum-TyG index or the duration of high TyG index exposure. To investigate the association between levels of the cum-TyG index and the risk of new-onset MAFLD, Cox proportional hazards regression analysis was performed.</p><p><strong>Results: </strong>A total of 16,387 cases of new-onset MAFLD were recorded over a median follow-up duration of 10 years. The Cox proportional hazards regression analysis indicated that the hazard ratios (HRs) and 95% confidence intervals (CIs) significantly increased in quartile 2 (HR: 1.306, 95% CI: 1.246-1.367), quartile 3 (HR: 1.423, 95% CI: 1.357-1.492), and quartile 4 (HR: 1.648, 95% CI: 1.571-1.730), when compared to quartile 1. A similar pattern was noted for 2-year high TyG index exposure (HR: 1.267, 95% CI: 1.200-1.338), 4-year high TyG index exposure (HR: 1.642, 95% CI: 1.557-1.731), and 6-year high TyG index exposure (HR: 2.122, 95% CI: 2.010-2.239), when compared to 0-year high TyG index exposure.</p><p><strong>Conclusion: </strong>The cum-TyG index may provide important information for risk assessment of MAFLD.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"570754"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834532","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":"Predictive Value of the second-Trimester Triglyceride-Glucose Index and Its Derived Indices for Macrosomia in Gestational Diabetes Mellitus.","authors":"Yiting Chen, Shuyu Li, Lanlan Xiang, Yitian Zhu, Yu Zeng, Yajun Chen, Tianying Zhong","doi":"10.2147/DMSO.S577687","DOIUrl":"https://doi.org/10.2147/DMSO.S577687","url":null,"abstract":"<p><strong>Background: </strong>Macrosomia is a major adverse outcome associated with gestational diabetes mellitus (GDM), primarily driven by insulin resistance (IR). The triglyceride-glucose (TyG) index is a well-established surrogate marker for insulin resistance; however, its predictive value when combined with obesity indicators remains incompletely defined. This study aimed to compare the predictive performance of the TyG index and its derived indices during the second trimester for the risk of macrosomia in GDM.</p><p><strong>Methods: </strong>The TyG index, TyG body mass index (TyG-BMI), TyG waist circumference (TyG-WC), and TyG waist-to-height ratio (TyG-WHtR) were assessed at 24-28 weeks of gestation. Their associations with macrosomia were analyzed using binary logistic regression and restricted cubic spline (RCS) analysis. The predictive performance of these indices was compared using receiver operating characteristic (ROC) curves, integrated discrimination improvement (IDI), and net reclassification improvement (NRI). The associations between TyG and its derived indices and the risk of delivering a macrosomic infant were further explored across different subgroups.</p><p><strong>Results: </strong>Logistic regression revealed that GDM women in the highest tertile had a 3.458- and 3.718-fold higher risks of delivering macrosomia compared to the lowest tertile for TyG-BMI and TyG-WC, respectively. RCS analysis showed a dose-response relationship (all <i>P</i> for overall < 0.001). Compared with the conventional TyG index, which had an area under the curve (AUC) of 0.596, both TyG-BMI (AUC = 0.682) and TyG-WC (AUC = 0.681) demonstrated significantly better performance (<i>P</i> < 0.01); furthermore, their superiority was confirmed by significant IDI and NRI values (<i>P</i> < 0.01). The association was more pronounced in primiparous women aged < 35 years (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Elevated second-trimester TyG index and its derived indices are associated with an increased risk of macrosomia in GDM women. TyG-BMI and TyG-WC outperformed the conventional TyG index and may serve as valuable supplementary markers for early risk stratification in GDM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"577687"},"PeriodicalIF":3.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765323","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":"Development and Validation of a Nursing-Integrated Nomogram to Predict 1-Year Ulcer Recurrence in Patients with Diabetic Foot Ulcers After Endovascular Therapy.","authors":"Li Fu, Wei Zeng, Huiyan Ding, Zhimin Chen, Xiaoyue Chen","doi":"10.2147/DMSO.S591186","DOIUrl":"https://doi.org/10.2147/DMSO.S591186","url":null,"abstract":"<p><strong>Background: </strong>Endovascular therapy (EVT) has become the first-line treatment for ischemic diabetic foot ulcers (DFU). However, the rate of ulcer recurrence within one year remains high, leading to repeat hospitalizations and amputations. Current prognostic models primarily focus on vascular patency and biological markers, largely overlooking the critical influence of nursing assessments, patient self-care behaviors, and social support systems.</p><p><strong>Objective: </strong>To construct and validate a novel nomogram that integrates clinical indicators with nursing assessment variables to predict the risk of 1-year ulcer recurrence in DFU patients following successful EVT.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 568 DFU patients who underwent successful EVT at a tertiary center between January 2020 and December 2024. Patients were randomized into a training cohort (n=398) and a validation cohort (n=170). Predictors included demographics, clinical markers, and nursing assessments (Exercise of Self-Care Agency [ESCA] scale, Off-loading Adherence, Social Support Rating Scale [SSRS]). Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariable logistic regression were used for model construction. The model was visualized as a nomogram and evaluated using the C-index, calibration plots, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>The 1-year recurrence rate was 34.2% (194/568). Five independent predictors were identified: HbA1c (OR 1.32), WIfI stage (OR 2.05), ESCA score (OR 0.93), Poor Off-loading Adherence (OR 3.12), and Social Support Score (OR 0.89). The nursing-integrated nomogram showed excellent discrimination with a C-index of 0.842 (95% CI: 0.805-0.879) in the training cohort and 0.815 (95% CI: 0.762-0.868) in the validation cohort. Calibration plots demonstrated good agreement. DCA indicated significant net clinical benefit across threshold probabilities of 10% to 75%.</p><p><strong>Conclusion: </strong>Integrating nursing assessment indicators with clinical data significantly improves the prediction of DFU recurrence. This nomogram provides a practical tool for nurses to identify high-risk patients at discharge, facilitating targeted behavioral interventions to improve long-term limb salvage outcomes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"591186"},"PeriodicalIF":3.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765331","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 Association of the Timing of Physical Activity with Cardiometabolic Health in Diabetes: An IMI2 SOPHIA Study.","authors":"Ebaa Al Ozairi, Mohammad Irshad, Jumana AlKandari, Abdullah Al-Ozairi, Dherar Alroudhan, Dalal Alsaeed, Nele Steenackers, Bart Van der Schueren, Stuart R Gray","doi":"10.2147/DMSO.S570107","DOIUrl":"https://doi.org/10.2147/DMSO.S570107","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association of timing of the most active five hours (M5 time) with markers of cardiometabolic health in people with type 1 diabetes (T1D) and type 2 diabetes (T2D).</p><p><strong>Patients and methods: </strong>People with T1D or T2D were invited to participate in the study. Physical activity was measured over a 7-day period with a wrist worn accelerometer. The M5time (as a linear and circular (sin-cos) variable) and the amount of activity in these five hours (M5value) were calculated, and associations with glycaemic control, blood lipids and body composition were examined using multiple linear regression, with multiple testing controlled using false discovery rate (FDR) correction.</p><p><strong>Results: </strong>A total of 891 people with T1D and 1381 people with T2D were included. In people with T1D, M5time (linear) was associated with waist circumference after full adjustment (model 3) (B = -0.32, SE = 0.15, FRD p = 0.047). Similarly, in people with T1D M5 time (circular) was also significantly associated with BMI (p = 0.004) and waist circumference (p = 0.001), with amplitudes of BMI: 1.32 kg/m2 and Waist: 4.28 cm, and phases of BMI: 12:51h and Waist: 13:06h. In people with T2D, M5 time was not associated with any cardiometabolic markers after FDR correction in any adjusted models.</p><p><strong>Conclusion: </strong>In people with T1D, the time of day at which people were most active was associated with some cardiometabolic markers. However, in people with T2D, there was no association with any cardiometabolic markers. Overall, our data indicates little effect of time of and physical activity at any time of day should be promoted.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"570107"},"PeriodicalIF":3.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765288","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 Body Composition and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Xinrui Cao, Guoli Shen, Ting Sun","doi":"10.2147/DMSO.S598731","DOIUrl":"https://doi.org/10.2147/DMSO.S598731","url":null,"abstract":"<p><strong>Background: </strong>Although being overweight or obese is a significant risk factor for type 2 diabetes mellitus (T2DM), conventional measures like body weight and body mass index have limitations in distinguishing between muscle and fat. Body composition metrics have superior value in explaining metabolic heterogeneity.</p><p><strong>Objective: </strong>This study conducted the systematic review and meta-analysis to investigate the relationship between body composition (fat/muscle-related indicators) and T2DM.</p><p><strong>Methods: </strong>We conducted a systematic search of eight databases to identify observational studies reporting the relationship between body composition and T2DM up to July 31, 2025. To pool effect sizes, random/fixed-effects models were employed. Subgroup and sensitivity analyses explored heterogeneity sources. Study quality was assessed via the Agency for Healthcare Research and Quality and Newcastle-Ottawa Scale tools.</p><p><strong>Results: </strong>A total of 36 studies with 2,614,625 participants were included. Fat-related analyses demonstrated that leg fat mass reduces T2DM risk (OR = 0.54 [0.46, 0.63], <i>P</i> < 0.0001), while body fat mass (OR = 2.36 [1.39, 4.02], <i>P</i> < 0.0001), trunk fat mass (OR = 1.35 [1.12, 1.62], <i>P</i> < 0.0001), visceral fat area (OR = 3.18 [1.28, 7.89], <i>P</i> < 0.0001), body fat percentage (OR = 1.67 [1.31, 2.14], <i>P</i> < 0.0001), and fat mass index (OR = 1.17 [1.08, 1.27], <i>P</i> < 0.0001) increase the risk. Muscle-related analyses indicated that lower skeletal muscle mass index is a risk element for T2DM (OR = 1.46 [1.17, 1.82], <i>P</i> = 0.0007), while lean mass changes showed no significant association.</p><p><strong>Conclusion: </strong>The results concluded that T2DM is associated with both abnormal fat/muscle mass and imbalanced fat distribution. Our findings highlighted that based on the results of body composition assessment, we can identify high-risk populations and develop personalized interventions to optimize T2DM prevention strategies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"598731"},"PeriodicalIF":3.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765335","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 Hormone Sensitivity Indicators and Controlled Attenuation Parameter (CAP) Values in Euthyroid Adults with Overweight/Obesity.","authors":"Yifang Zhang, Cuiping Bao, Lingling Liu, Renjiao Liu, Xincheng Wang, Xiaoxuan Guo, Chunjun Li","doi":"10.2147/DMSO.S564396","DOIUrl":"https://doi.org/10.2147/DMSO.S564396","url":null,"abstract":"<p><strong>Background: </strong>Obesity is an established contributor to hepatic steatosis. Despite weight control efforts, the incidence of steatosis and its associated hepatic complications continues to increase, highlighting the critical need to identify obesity-related pathogenic mechanisms for developing effective therapeutic strategies.</p><p><strong>Aim: </strong>This study aims to explore the association between thyroid hormone sensitivity indicators and hepatic steatosis assessed by controlled attenuation parameter (CAP) values in euthyroid individuals with overweight/obesity.</p><p><strong>Methods: </strong>Sensitivity to THs, was evaluated using TFQI_FT3, TFQI_FT4, TSHI, TT4RI, TT3RI, and FT3/FT4 ratio. Hepatic steatosis was diagnosed via Vibration-controlled Transient Elastography (VCTE). Linear regression, binary logistic regression, and restricted cubic spline regression (RCS) were used to analyze the associations between these composite indices and CAP levels. Bayesian mediation analysis was performed to assess the mediation effect of liver enzymes and lipids on the relationship between sensitivity parameters to THs and CAP.</p><p><strong>Results: </strong>Compared to the non-severe hepatic steatosis group, the severe hepatic steatosis group exhibited significantly higher levels of TFQI_FT3, and FT3/FT4 ratio (all P < 0.05). After adjustment for multiple risk factors, TFQI_FT3 (β = 25.38, 95% CI 10.21-40.55) and the FT3/FT4 ratio (β = 210.92, 95% CI 116.37-305.47) increased with CAP (P<0.001), but not in TFQIFT4 (p = 0.071). These associations remained significant in binary logistic regression analysis and RCS. Further mediation analysis and subgroup analysis showed that the correlation was not mediated by blood lipid and liver enzyme impairment, and remained stable across all subgroups.</p><p><strong>Conclusion: </strong>The correlation between TH sensitivity and hepatic steatosis was significantly stronger in TFQI_FT3 than in TFQI_FT4. TFQI_FT3 and the FT3/FT4 ratio can be used as new indicators for predicting hepatic steatosis in individuals with overweight/obesity.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"564396"},"PeriodicalIF":3.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765257","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":"Vitamin D Metabolite Ratios and Association with Type 2 Diabetes Mellitus in a Youth Saudi Population.","authors":"Sobhy M Yakout, Syed D Hussain, Abdullah M Alnaami, Nasser M Al-Daghri","doi":"10.2147/DMSO.S597635","DOIUrl":"https://doi.org/10.2147/DMSO.S597635","url":null,"abstract":"<p><strong>Purpose: </strong>Vitamin D deficiency is highly prevalent in Saudi Arabia and has been associated with type 2 diabetes mellitus (T2DM). The vitamin D metabolite ratio (VMR), defined as the ratio of 24,25-dihydroxyvitamin D₃ [24,25(OH)₂D₃] to 25-hydroxyvitamin D₃ [25(OH)D₃], may provide a more functional assessment of vitamin D status than total 25(OH)D alone. This study aimed to investigate the associations between vitamin D metabolite ratio and T2DM status in a Saudi youth cohort.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted involving 971 Saudi adolescents (age 14.9 ± 1.7 years), including 864 normoglycemic individuals, 74 with prediabetes, and 33 with T2DM. Serum vitamin D metabolites [25(OH)D₃, 24,25(OH)₂D₃, and 25(OH)D₂] were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The vitamin D metabolite ratio was calculated, and its association with T2DM was assessed using logistic regression analysis adjusted for age and body mass index (BMI). VMR was analyzed both as a continuous variable and dichotomized at <4% versus ≥4%. The 4% threshold was selected based on preliminary data from adult populations and exploratory analysis of our data distribution, recognizing that this threshold requires validation in adolescent cohorts.</p><p><strong>Results: </strong>Lower VMR (<4%) was associated with higher odds of T2DM (OR: 4.7, 95% CI: 1.1-20.0, p = 0.036), though the wide confidence interval reflects the small T2DM sample size (n=33). Preliminary analysis indicated that VMR may be associated with T2DM in Saudi adolescents, but findings should be interpreted cautiously given the small T2DM sample and cross-sectional design. Larger prospective studies are needed to confirm these preliminary observations.</p><p><strong>Conclusion: </strong>A lower vitamin D metabolite ratio is associated with T2DM among Saudi adolescents. VMR may provide complementary information beyond total 25(OH)D; however, formal comparative predictive analyses were not performed, underscoring the importance of proper vitamin D metabolism in glucose homeostasis. However, given the cross-sectional design and small T2DM sample size, these findings are preliminary and require validation in larger prospective studies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"597635"},"PeriodicalIF":3.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765351","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":"Skin Organoids in Diabetic Chronic Wounds: Current Status and Future Perspectives.","authors":"Zhiyao Wang, Minjie Hou, Jie Pei, Fei Gao, Zhi Li","doi":"10.2147/DMSO.S598026","DOIUrl":"https://doi.org/10.2147/DMSO.S598026","url":null,"abstract":"<p><p>Diabetes is one of the most prevalent chronic metabolic diseases worldwide, and its incidence continues to rise. Diabetes-related complications have become a major public health concern, with diabetic chronic wounds-particularly diabetic foot ulcers-representing one of the most challenging and clinically significant manifestations. These non-healing wounds often require prolonged recovery, severely impair patients' quality of life, and impose substantial economic and psychological burdens on healthcare systems and families. Conventional therapeutic approaches are limited by insufficient reparative capacity, scarcity of functional tissue sources, and the inability to achieve durable structural and functional restoration, frequently resulting in suboptimal outcomes. Recent advances in stem cell engineering and three-dimensional tissue technologies have enabled the development of organoids-emerging biomimetic regenerative constructs-allowing their increasing application in tissue repair, including diabetic ulcers. This review provides an integrated summary of the major barriers to diabetic wound healing, the regenerative mechanisms of skin organoids, and recent progress in this field. Unlike previous reviews that address organoids or wound healing separately, this work specifically focuses on diabetic chronic wounds while emphasizing engineering strategies, regenerative potential, and translational considerations. We further analyze the key challenges that hinder clinical translation, including model consistency, vascularization capacity, long-term functional stability, immune compatibility, potential tumorigenicity, and interactions with the local microenvironment. Collectively, this work aims to provide a structured framework and future research directions for the application of skin organoids in diabetic chronic wound repair, supporting their responsible transition from experimental research toward clinical practice.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"598026"},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765321","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}