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

{"title":"Association of Betaine, Choline, and TMAO with Type 2 Diabetes in Rural China: A Nested Case-Control Study from the Handan Eye Study (HES).","authors":"Jun Liang, Jie Hao, Yu Qin, Ou Liu, Kunning Shao, Wei Zhao, Jiangping Wen","doi":"10.2147/DMSO.S522576","DOIUrl":"10.2147/DMSO.S522576","url":null,"abstract":"<p><strong>Background: </strong>Conflicting evidence exists regarding the association of gut microbiota-related metabolites - TMAO and its precursor choline and betaine with type 2 diabetes Mellitus (T2DM), particularly in rural Chinese populations. This study aimed to prospectively examine these relationships in a northern rural Chinese cohort.</p><p><strong>Methods: </strong>A nested case-control study was conducted within the Handan Eye Study. At baseline (2006-2007), 5,512 participants aged ≥30 years were enrolled. After 6.5 years of follow-up, 209 incident T2DM cases and 394 age- and sex-matched controls were included. Plasma choline, betaine, and TMAO levels were measured using ultra-performance liquid chromatography. Logistic regression and linear models assessed associations with T2DM risk, insulin resistance (IR), and metabolic parameters.</p><p><strong>Results: </strong>Baseline betaine level was lower in the T2DM group compared to controls (betaine: 7431.4 ng/mL versus 7821.5 ng/mL). After adjusting for BMI, waist-to-hip ratio, and diabetes history, no significant associations were found between choline, betaine, or TMAO and T2DM risk. However, higher betaine quartiles showed a trend toward reduced T2DM risk (Q4 vs Q1 OR: 0.59, 95% CI: 0.34-1.06). Betaine was inversely correlated with HOMA-IR (β = -0.16), HOMA-β (β = -0.13), and TyG index (β = -0.21) (p < 0.05). Plasma choline levels were positively associated with fruit intake frequency, while TMAO levels decreased with higher exercise intensity.</p><p><strong>Conclusion: </strong>Betaine may play a protective role against dyslipidemia, adiposity, and T2DM risk in rural Chinese populations. Further studies are needed to explore TMAO's complex role in diabetes development.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2537-2545"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752650","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 Insights and Reproductive Health Challenges: High-Protein Hypocaloric Diets in PCOS Management [Letter].","authors":"Weilan Liu, Luyang Su, Shixia Zhao","doi":"10.2147/DMSO.S552390","DOIUrl":"10.2147/DMSO.S552390","url":null,"abstract":"","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2507-2508"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741598","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":"Understanding Mental Health Service Perceptions in Chinese Americans with Type 2 Diabetes and Co-Occurring Mental Health Challenges Living in New York City: A Qualitative Study.","authors":"Jing Liu, Jiepin Cao, Yun Shi, Yulin Jiang, Jiayin Ruan, Bei Wu, William Tsai, Lu Hu","doi":"10.2147/DMSO.S529615","DOIUrl":"10.2147/DMSO.S529615","url":null,"abstract":"<p><strong>Purpose: </strong>Chinese Americans face disproportionately higher rates of Type 2 Diabetes (T2D) and co-occurring mental health challenges. Little is known about how they perceive mental health care during their journey with diabetes. This study aimed to provide an in-depth exploration of mental health care perceptions in this population.</p><p><strong>Patients and methods: </strong>Two focus group discussions involving 12 participants were conducted in Mandarin. Participants were purposively sampled from a previous survey of Chinese immigrants with T2D who reported co-occurring mental health challenges and were recruited through referrals from primary care practices and community-based organizations in New York City. Data were analyzed using inductive content analysis.</p><p><strong>Results: </strong>The participants in this study ranged in age from 45 to 67 years. Most were female, married, and had low educational attainment (less than a college education) and low annual household incomes (less than USD $25,000). All participants were first-generation Chinese immigrants with limited English proficiency and had health insurance. HbA1c levels ranged from 6.5% to 12.6%. Depressive symptoms and elevated stress were the most commonly reported mental health issues in this sample. Data analysis revealed five categories related to participants' perceptions of mental health care: 1) interactions between mental health and T2D, 2) barriers to accessing mental health care, 3) facilitators of accessing mental health care, 4) coping strategies for mental health challenges, and 5) preferences for mental health services.</p><p><strong>Conclusion: </strong>This study suggests the complex interactions between T2D and mental health issues among Chinese Americans. The findings indicate that seeking professional mental health services is uncommon among many individuals in this population and highlight several barriers and facilitators to access. The findings also suggest directions for future interventions to support mental health among Chinese Americans with T2D. Addressing mental health needs through effective interventions is essential for providing comprehensive care to this underserved population. Future research should explore the role of stigma in mental health-seeking behaviors, as well as design and assess the effectiveness of mental health interventions for Chinese Americans with T2D.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2525-2536"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741599","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 Nomogram-Based Risk Prediction Model for Diabetic Retinopathy in Elderly Adults with Type 2 Diabetes Mellitus.","authors":"Meitong Chen, Tongtong Niu, Yan Sun, Meisong Chang, Shanshan Liu, Tiantian Xu, Huixia Cui","doi":"10.2147/DMSO.S530424","DOIUrl":"10.2147/DMSO.S530424","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy (DR) is a significant comorbidity with Type 2 Diabetes Mellitus (T2DM), however, risk prediction for DR remains understudied in the elderly population. This study aimed to develop and validate a nomogram for identifying individuals at high risk of DR among elderly T2DM patients to guide early clinical intervention.</p><p><strong>Patients and methods: </strong>A retrospective cohort of 1912 T2DM patients (aged ≥60 years) was enrolled from 2018 to 2024. Sociodemographic, biochemical, and health-related variables were extracted. The cohort was randomly stratified into derivation (70%) and validation (30%) sets. Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to identify key predictors, followed by multivariate logistic regression to construct the nomogram. Model performance was evaluated via Receiver Operating Characteristic-Area Under the Curve (ROC-AUC), calibration plots, Hosmer-Lemeshow (H-L) tests, and decision curve analysis (DCA). External validation was performed using an independent cohort (n = 476).</p><p><strong>Results: </strong>Among 1912 patients, 655 (34.3%) were diagnosed with DR. Independent predictors included T2DM duration, glycosylated hemoglobin (HbA1c), platelet-to-lymphocyte ratio (PLR), estimated glomerular filtration rate (eGFR), and neutrophil percentage to albumin ratio (NPAR) (all <i>p</i> < 0.05). The nomogram demonstrated robust discrimination, with AUCs of 0.823 (95% CI: 0.805-0.851) and 0.808 (95% CI: 0.770-0.846) in the derivation and internal validation sets, respectively. Calibration plots demonstrated strong agreement between predicted and observed risks (H-L test: <i>p</i> = 0.807 [derivation], <i>p</i> = 0.374 [validation]). DCA indicated favorable clinical utility across threshold probabilities, and external validation confirmed generalizability (AUC=0.788) and readiness for clinical deployment.</p><p><strong>Conclusion: </strong>This rigorously validated nomogram, integrating clinical accessible variables, provided a pragmatic tool for early DR risk stratification in elderly T2DM patients. Implementation of this model in clinical practice may enable personalized risk mitigation strategies to reduce DR incidence in this vulnerable population.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2509-2523"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741597","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":"Asprosin Levels in Adults with Type 2 Diabetes Mellitus and Diabetic Kidney Disease: A Systematic Review and Meta-Analysis.","authors":"Jovana Ristic, Sena Kodalak, Gonzalo Alberto Peralta-Jiménez, Maria Fernanda Moura de Lima, Marijana Kovacevic, Srdjan Masic, Tatjana Nikolic","doi":"10.2147/DMSO.S527579","DOIUrl":"10.2147/DMSO.S527579","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic kidney disease (DKD) significantly affects health and healthcare costs due to chronic kidney disease complications. Given asprosin's potential as a biomarker for disease progression, we conducted the first systematic review and meta-analysis on its relationship with DKD in adults with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane, and Web of Science were systematically searched. Standard mean differences (SMD) with 95% confidence intervals (CI) and Fisher's Z transformation were used to examine the relationship between asprosin and DKD. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) and its version for cross-sectional studies. Heterogeneity (I² > 50%) was analyzed with a random-effects model.</p><p><strong>Results: </strong>Six studies (n = 1340) were included. Meta-analysis results indicated that T2DM patients with DKD (micro/macroalbuminuria) had significantly higher circulating asprosin levels than normoalbuminuric T2DM patients (SMD: 1.5, 95% CI: 0.69-2.32, p = 0.0003). Meta-analysis of correlation revealed a positive association of asprosin with urinary albumin excretion ratio (UACR) (Fisher's Z = 0.4; 95% CI: 0.240-0.554, p < 0.001) and body mass index (BMI) (Fisher's Z = 0.17; 95% CI: 0.036-0.301, p = 0.013), and a negative association with estimated glomerular filtration rate (eGFR) (Fisher's Z = -0.35; 95% CI: -0.471 to -0.239, p < 0.001).</p><p><strong>Conclusion: </strong>Asprosin is elevated in T2DM patients with pre-DKD (early stage DKD) and DKD and correlates with key markers of disease severity. Additional research is required to better understand the pathophysiological mechanisms of asprosin and its role in DKD.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2493-2506"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728534","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 Emerging Role of Anti-Hyperglycemic Agents for the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Silvia Pieralice, Rocco Amendolara, Valentina Berna, Giuseppina Manganaro, Annalisa Zurru, Luca D'Onofrio, Renata Risi, Marianna Alfonsi, Ernesto Maddaloni, Raffaella Buzzetti","doi":"10.2147/DMSO.S528569","DOIUrl":"10.2147/DMSO.S528569","url":null,"abstract":"<p><p>The prevalence of type 2 diabetes mellitus (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) is rapidly increasing worldwide. MASLD, previously known as non-alcoholic fatty liver disease (NAFLD), is defined as a condition of steatotic liver disease (SLD) with one or more cardiometabolic risk factor(s) and the absence of harmful alcohol intake. The variety of MASLD includes steatosis, metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH), fibrosis, cirrhosis and MASH-related hepatocellular carcinoma (HCC). Subjects with T2D have a doubled risk of developing MASLD, and vice versa. Furthermore, the presence of T2D is considered a risk factor for cirrhosis, hepatocellular carcinoma and liver-related mortality in patients with MASLD as well as the presence of MASLD is associated with adverse outcomes in T2D population, including cardiovascular and chronic kidney diseases. The relationship between MASLD and T2D is bidirectional. Given the fact that a mutually detrimental relationship between T2D and MASLD exists, the approach to managing MASLD is undergoing a transformative phase, with increasing attention toward the use of anti-hyperglycemic agents. In this review, we explore the emerging role of anti-hyperglycemic agents in the context of MASLD treatment, examining the latest scientific evidence and assessing the effectiveness of these novel approaches. Understanding the interconnection between diabetes and MASLD could open new therapeutic perspectives and guide the formulation of more effective treatment protocols for this growing metabolic epidemic.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2477-2491"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728539","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":"Serum LEAP2 Levels Across the Spectrum of Metabolic Dysfunction-Associated Fatty Liver Disease: A Potential Noninvasive Biomarker for Severity Stratification.","authors":"Xinyang Huang, Zihao Deng, Xiaozhou Li, Songxin Yan, Kunjiang Zhong, Fengning Yuan, Ligang Liu, Chaolin Deng, Tingting Liu, Ruizhao Zhao, Amin Buhe, Tianxiong Li, Hao Zhao","doi":"10.2147/DMSO.S536270","DOIUrl":"10.2147/DMSO.S536270","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate circulating liver-expressed antimicrobial peptide 2 (LEAP2) as a potential noninvasive biomarker for the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) and its progression to metabolic dysfunction-associated steatohepatitis (MASH).</p><p><strong>Patients and methods: </strong>This prospective observational study enrolled obese patients with MAFLD, categorized into simple steatosis (SS) or MASH based on liver histopathology, along with healthy controls (HC). Serum levels LEAP2 were quantified using enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared among groups, followed by univariable and multivariate ordinary logistic regression to identify MAFLD predictors. The diagnostic performance of LEAP2 was evaluated through receiver operating characteristic (ROC) curve analysis. Additionally, Hepatic LEAP2 transcriptomic data from public Gene Expression Omnibus (GEO) datasets (GSE126848, GSE135251) were analyzed for validation.</p><p><strong>Results: </strong>Seventy-four participants (24 HC, 24 SS, 26 MASH) were analyzed. Serum LEAP2 levels significantly and progressively increased with MAFLD severity (median ng/mL: HC 11.54, SS 13.62, MASH 18.34; P<0.001), correlating positively with disease stage (Spearman's <i>ρ</i>=0.526, P<0.001). This pattern was validated using hepatic LEAP2 transcript data from GEO datasets (P<0.001; Spearman's <i>ρ</i>=0.317, P<0.001). Multivariate logistic regression identified serum LEAP2 as an independent factor associated with MAFLD presence (OR=1.14, 95% CI 1.03-1.26; P=0.014), alongside BMI and ALT, while HDL was protective. ROC analysis demonstrated good diagnostic performance for distinguishing MASH from HC (AUC=0.86) and moderate performance for adjacent stages (HC vs SS, AUC=0.70; SS vs MASH, AUC=0.70).</p><p><strong>Conclusion: </strong>Serum LEAP2 levels progressively increase with MAFLD severity and are independently associated with the disease. LEAP2 demonstrates potential as a noninvasive biomarker for assessing MAFLD severity, particularly in distinguishing MASH from healthy individuals. These findings warrant further investigation into LEAP2's pathophysiological role and therapeutic potential.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2439-2450"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728538","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":"Characterization of Vitreous Microbiota Dysbiosis Associated with Proliferative Diabetic Retinopathy.","authors":"Fangying Song, Yan Qi, Wenhui Ma, Jun Li, Yan Gao, Xiubin Ma","doi":"10.2147/DMSO.S527069","DOIUrl":"10.2147/DMSO.S527069","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging evidence suggests an association between ocular microbiota dysbiosis and ophthalmic diseases; however, the role of the posterior segment microbiome in diabetic retinopathy (DR) remains poorly characterized. In this study, we characterized the vitreous microbiome of patients with proliferative diabetic retinopathy (PDR) and systematically compared its microbial community structure with that of healthy controls.</p><p><strong>Methods: </strong>A cohort of 19 PDR patients with type 2 diabetes mellitus and 19 non-DR controls were enrolled, with vitreous samples obtained through vitrectomy. Vitreous microbial composition was characterized using 2bRAD-M sequencing technology, enabling species-level taxonomic resolution. The comparison of dominant taxa, biomarker analysis and metabolic pathway differences between the two groups were further explored.</p><p><strong>Results: </strong>The results of microbiome profiling revealed significant compositional differences in the vitreous core microbiome of PDR patients compared to controls, potentially associated with enhanced activity in membrane transport, nucleotide metabolism and carbohydrate metabolism pathways. LEfSe analysis identified 536 distinctive biomarkers of the two groups. At species level, the PDR group had significantly lower relative abundances of CAG-485_sp009775375, Akkermansia_muciniphila and Bacteroides_acidifaciens, compared with control group.</p><p><strong>Conclusion: </strong>This is the first study confirming the microbiota in human vitreous fluid samples by 2bRAD-M sequencing. These findings suggest a potential link between vitreous microbial dysbiosis and PDR, offering novel insights for future mechanistic investigations into DR.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2451-2462"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728535","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":"Urinary Ferritin as an Early Indicator of Tubular Injury in Diabetic Kidney Disease: Insights from NHANES and Clinical Cohorts.","authors":"Bin Huang, Xiangyu Ding, Wenjie Wen, Shandong Ye","doi":"10.2147/DMSO.S523961","DOIUrl":"10.2147/DMSO.S523961","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between iron metabolism disorders and diabetic kidney disease (DKD) and to evaluate the potential of urinary ferritin as an early marker of tubular injury in diabetic patients.</p><p><strong>Methods: </strong>This study utilized data from 1,306 diabetic patients and 1,306 propensity score-matched non-diabetic controls from the NHANES (2017-March 2020) dataset. Diabetic participants were classified into Non-DKD (n = 923) and DKD (n = 383) groups based on the urinary albumin-to-creatinine ratio (UACR). Binary logistic regression and restricted cubic spline models were used to evaluate the association between iron metabolism indicators and DKD risk. Additionally, renal tissue samples from 12 patients (6 with T2DM and 6 non-diabetic controls) undergoing nephrectomy were analyzed for iron accumulation and tubular injury markers. Clinical data from 35 T2DM patients (with and without DKD) and 20 matched healthy controls were included to assess urinary ferritin and tubular injury markers. Finally, 120 T1DM patients were stratified by disease duration to assess correlations between urinary ferritin and renal injury biomarkers.</p><p><strong>Results: </strong>Decreased serum iron (OR = 0.962, P = 0.037) and increased serum ferritin (OR = 1.001, P = 0.024) were identified as independent risk factors for DKD. Diabetic patients exhibited higher renal iron, urinary ferritin, and tubular injury markers, with significant correlations between renal iron and urinary ferritin levels. Urinary ferritin levels also increased with T1DM duration, significantly correlating with tubular injury markers.</p><p><strong>Conclusion: </strong>Impaired iron metabolism, characterized by low serum iron and high serum ferritin, is an independent risk factor for DKD. Urinary ferritin may serve as a biomarker of early tubular injury in diabetic patients, even in the absence of albuminuria.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2429-2438"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728540","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":"Chronic Obstructive Pulmonary Disease and Metabolic Syndrome: A Maltese Study on Biomarkers and Clinical Implications.","authors":"Jonathan Gauci, Stephanie Gauci Pullicino, Emma Caruana, Vanessa Petroni Magri, Melissa Marie Formosa, Anthony G Fenech, Stephen Fava, Stephen Montefort, Peter Fsadni","doi":"10.2147/DMSO.S515061","DOIUrl":"10.2147/DMSO.S515061","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic Obstructive Pulmonary Disease (COPD) and Metabolic Syndrome (MetS) are both characterized by inflammation and appear to be linked. The study aims to characterize COPD in Maltese individuals with diabetes and MetS for the first time. The research project also aims to identify biomarkers that are significantly associated with COPD endpoints in the study population having both COPD and MetS.</p><p><strong>Patients and methods: </strong>The study was carried out at Mater Dei Hospital, which is Malta's main general hospital and is government managed. Research subjects were recruited from the Diabetes Clinic. A respiratory questionnaire was administered, followed by the Six-Minute Walk Test (6MWT), Fractional Exhaled Nitric Oxide (FeNO) testing, spirometry and phlebotomy. The American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI) criteria were used to diagnose MetS. A post-bronchodilator FEV₁/FVC ratio of less than 0.7 was necessary to diagnose COPD, as recommended by Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines.</p><p><strong>Results: </strong>The study group consisted of 24 subjects diagnosed with both MetS and COPD. The group showed heterogenous results with a mean St George's Respiratory Questionnaire for COPD total score of 41.7, mean distance on 6MWT of 359m, mean FeNO of 12.2ppb, and mean Forced Expiratory Volume in 1 second of 64.6%. While 62.5% had a modified Medical Research Council score of ≥2, 95.8% had a COPD Assessment Test score of ≥10. One-fourth of the group were at risk for clinical depression, and 20.8% showed severe fatigue. Blood lymphocyte count, ferritin, triglycerides and glucose were significantly associated with multiple respiratory parameters in diabetic MetS subjects with COPD.</p><p><strong>Conclusion: </strong>The local diabetic MetS study population with COPD is heterogenous, with high levels of depression and fatigue. The emergence of biomarkers in this population has clinical and therapeutic implications.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2463-2476"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728536","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}