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

{"title":"Certain Metabolic Syndrome Component Combinations are Linked to Increased Risk of Hypogonadism in Taiwanese Men.","authors":"Yu-Han Hong, Kuang-Chen Hung, Chih-Li Lin, Chia-Lien Hung, Shih-Kai Tu, Deng-Ho Yang, Chun-Cheng Liao","doi":"10.2147/DMSO.S483344","DOIUrl":"10.2147/DMSO.S483344","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the association between specific combinations of metabolic syndrome (MS) components and the risk of hypogonadism in Taiwanese men.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 6,986 men who underwent health screening from 2009 to 2017. MS was defined as meeting at least three of five criteria: waist circumference (W), triglycerides (T), high-density lipoprotein cholesterol (H), fasting glucose (F), and blood pressure (B). Hypogonadism was defined as total testosterone <300 ng/dL. Differences in MS component prevalence between men with and without hypogonadism were compared. Logistic regression adjusted for age and body mass index was used to assess associations.</p><p><strong>Results: </strong>Among all participants, 6,221 (89.0%) had hypogonadism. The prevalence of MS components was significantly higher in this group (p < 0.001). The risk of hypogonadism increased with the number of MS compon ents. Notably, the combinations F-H-W, F-H-B-W, and F-T-H-B-W were associated with significantly higher odds of hypogonadism.</p><p><strong>Conclusion: </strong>Specific MS component combinations are strongly associated with increased hypogonadism risk in Taiwanese men. These findings suggest that MS composition, not just its presence, should be considered in evaluating testosterone deficiency.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1977-1984"},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474219","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":"Relationships Between Insulin Resistance Surrogate Indicators and Chronic Kidney Disease in Non-Diabetic Individuals: A Retrospective Cross-Sectional Study.","authors":"Qing Liu, Xiao-Fan An, Li Li, Han Zhang, Yu-Qiang Zuo","doi":"10.2147/DMSO.S527662","DOIUrl":"10.2147/DMSO.S527662","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the associations between insulin resistance (IR) surrogate indicators and chronic kidney disease (CKD) in non-diabetic individuals.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 29625 participants who underwent annual health examinations from January to December 2024. Based on estimated glomerular filtration rate, participants were divided into non-CKD and CKD groups. Univariate and multivariate logistic regression analyses were performed to evaluate the relationships between insulin resistance surrogate indicators, including metabolic score of insulin resistance (METS-IR), triglyceride glucose index (TyG), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), total cholesterol-high density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (Non-TG/HDL-C), and CKD, adjusting for potential confounders such as age, sex, blood pressure, and metabolic parameters. Receiver operating characteristic (ROC) curves and DeLong tests were used to compare the predictive performances of different indicators.</p><p><strong>Results: </strong>Among the recruited 29,625 participants, 8.01% (2372/29,625) participants were CKD patients. All insulin resistance surrogate indicators were found to be correlated with the prevalence of CKD. After adjusting for confounding variables, the METS-IR exhibited stronger association with CKD than other insulin resistance surrogate indicators; the odd ratio for CKD in the highest quartile of the METS-IR was 2.360 (95% CI:1.594-3.493). The ROC results showed the area under curve (AUC) of METS-IR were the best, with AUC = 0.681 (0.671-0.691), which was higher than TyG, TG/HDL-C, and NonTG/HDL-C. Results of the DeLong test showed that there was a statistically significant difference between METS-IR and other IR indicators.</p><p><strong>Conclusion: </strong>IR indicators (METS-IR, TyG, TG/HDL-C, and NonTG/HDL-C) were positively correlated with the prevalence of CKD in the non-diabetic population. The METS-IR had the best predictive ability for CKD in this population. Detection and early intervention of elevated IR indicators may help prevent CKD in non-diabetic individuals.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1967-1976"},"PeriodicalIF":2.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474220","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":"Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study.","authors":"Nur Adam Mohamed, Rahma Yusuf Haji Mohamud, Fadumo Hussein Hilowle, Tigad Abdisad Ali, Yusuf Abdirisak Mohamed, Adan Ali Gabow, Hawa Nuradin Mohamed, Nor Osman Sidow, Mohamed Sheikh Hassan, Mohamud Mire Waberi","doi":"10.2147/DMSO.S533810","DOIUrl":"10.2147/DMSO.S533810","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a growing global health crisis, affecting hundreds of millions worldwide. Poor sleep quality-often under-recognized-impairs glycemic control and accelerates diabetes-related complications. Despite its clinical relevance, data on sleep quality among T2DM patients in Somalia are virtually nonexistent. This study aimed to evaluate the prevalence and determinants of poor sleep quality among T2DM patients in Mogadishu, Somalia.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted between November 2024 and January 2025 at Mogadishu Somali-Turkiye Recep Tayyip Erdogan Training and Research Hospital. A total of 311 adults with T2DM were selected using systematic sampling. Data were collected using structured questionnaires and validated instruments including the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), and Oslo Social Support Scale (OSSS-3). Logistic regression analysis was employed to identify variables independently associated with suboptimal sleep quality.</p><p><strong>Results: </strong>Overall, 54.0% of participants reported poor sleep quality (95% CI: 48.3-59.7). Multivariable analysis identified several significant predictors, including female gender, unemployment, low income, substance use, physical inactivity, and depressive symptoms. Clinical factors such as comorbidities, poor glycemic control, and diabetes-related complications were also independently associated with suboptimal sleep quality.</p><p><strong>Conclusion: </strong>Over half of T2DM patients in Mogadishu experience poor sleep quality, influenced by sociodemographic, behavioral, psychological, and clinical factors. The findings highlight the need to incorporate sleep evaluation and targeted interventions-focusing on mental health, lifestyle, and metabolic control-into routine diabetes care.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1949-1965"},"PeriodicalIF":2.8,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332550","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":"Effectiveness of an Individualized Diabetes Health Education Program Using Real-Time Continuous Glucose Monitoring in Improving Blood Glucose: A Pilot Interventional Study on Subjects with Prediabetes.","authors":"Yuqi Ma, Sisi Deng, Wei Xie, Minfang Weng, Yeran Jia","doi":"10.2147/DMSO.S511187","DOIUrl":"10.2147/DMSO.S511187","url":null,"abstract":"<p><strong>Background: </strong>While lifestyle modification remains fundamental for prediabetes management, the potential added value of real-time continuous glucose monitoring (RT-CGM) in diabetes health education programs warrants investigation. This study evaluated whether an individualized diabetes health education program using RT-CGM could improve glycemic control compared to general dietary guidance in prediabetic individuals.</p><p><strong>Methods: </strong>In this randomized controlled trial conducted at Guangdong Provincial People's Hospital (initiated September 2022), we enrolled 41 adults (>18 years) with prediabetes, randomly assigning them to either: (1) RT-CGM group (n=20) receiving meal adjustments based on continuous glucose data and energy balance, or (2) control group (n=21) receiving adjustments based solely on energy balance. The study comprised two intensive 14-day education sessions (baseline and 1-year follow-up) with metabolic assessments (HbA1c, fasting blood glucose, BMI, lipid profile, and uric acid) conducted at baseline, 1-year, and 2-year timepoints.</p><p><strong>Results: </strong>The RT-CGM group demonstrated significantly greater improvements in HbA1c compared to controls at both 1-year (p=0.007) and 2-year (p=0.033) follow-ups.</p><p><strong>Conclusion: </strong>Our findings suggest that incorporating RT-CGM into diabetes health education program can enhance glycemic control in prediabetic individuals compared to general dietary guidance alone. These results support the potential clinical utility of RT-CGM in prediabetes management strategies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1939-1948"},"PeriodicalIF":2.8,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332551","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 Visceral Adiposity with Nephropathy in Patients with Diabetes Mellitus: Data from Chinese and US Cohorts.","authors":"Fan Zhang, Wenjian Li","doi":"10.2147/DMSO.S516687","DOIUrl":"10.2147/DMSO.S516687","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the relationship between the visceral adiposity index (VAI) and diabetic nephropathy (DN) in patients with diabetes mellitus in two cohorts from China and the United States.</p><p><strong>Patients and methods: </strong>After screening, 1,949 Chinese participants and 7,158 US participants were included in the analysis. Logistic regression models examined the relationship between VAI and DN. Concurrently, the restricted cubic spline (RCS) model was utilized to investigate the potential nonlinear relationship between VAI and DN. Additionally, segmented logistic regression analysis and subgroup analysis were conducted.</p><p><strong>Results: </strong>In both cohorts, each unit increase in VAI was associated with a higher prevalence of DN, with a 4% increase (OR=1.04, P<0.001) observed in the Chinese cohort compared to a 3% rise (OR=1.03, P<0.001) in the US cohort. The RCS analysis revealed a nonlinear relationship between VAI and DN, with an inflection point identified at 5. The results of the subgroup analyses demonstrated that the positive correlation between VAI and DN was observed across diverse subgroups. However, the interaction between some subgroups indicated the presence of potential heterogeneity.</p><p><strong>Conclusion: </strong>A significant positive association was observed between visceral adiposity and DN. Further research is required to elucidate the precise mechanisms by which visceral adiposity and DN are associated and to validate these findings in more diverse populations.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1925-1937"},"PeriodicalIF":2.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Renal Dysfunction Subtypes and Vertebral Fracture in Patients with Type 2 Diabetes: A Longitudinal Study.","authors":"Nandong Hu, Yiping Zhang, Zicheng Wei, Rui Yu, Yingying Zhang, Xiao Chen","doi":"10.2147/DMSO.S522430","DOIUrl":"10.2147/DMSO.S522430","url":null,"abstract":"<p><strong>Purpose: </strong>Renal dysfunction and vertebral fracture are both common in patients with type 2 diabetes mellitus (T2DM). However, the association between renal dysfunction and vertebral fracture has rarely been evaluated longitudinally. In this longitudinal study, we evaluated the associations between different subtypes of renal dysfunction and vertebral fracture (VF) in patients with type 2 diabetes.</p><p><strong>Methods: </strong>This study recruited T2DM patients aged 50 years or older whose computed tomography (CT) imaging screening revealed no VFs from January 2019-December 2021. The participants were followed up annually until January 2024. The Genant score was used to define new-onset VFs. The renal dysfunction phenotypes were as follows: no renal dysfunction, estimated glomerular filtration rate (eGFR) decline or proteinuria, and eGFR decline + proteinuria. Cox proportional hazards models were used to assess the association between renal dysfunction and VF.</p><p><strong>Results: </strong>A total of 135 patients developed new VFs over a median follow-up period of two years. A total of 270 patients without fractures were matched according to follow-up time and body mass index. Bone CT attenuation (HU) (adjusted hazard ratio (HR) = 0.97, 95% confidence interval (CI) 0.99-0.99) was independently associated with VF. eGFR decline or proteinuria and eGFR decline + proteinuria were associated with VF (adjusted HR = 1.98, 95% CI 1.35-2.92; adjusted HR = 2.53, 95% CI 1.30-4.92). Subgroup analyses revealed associations in women, patients without accompanying neuropathy, patients without vascular lesions, and patients who did not receive insulin therapy. The addition of renal dysfunction improved the area under the curve of the clinical model from 0.817 (95% CI: 0.78-0.85) to 0.839 (95% CI: 0.80-0.87) (p < 0.05).</p><p><strong>Conclusion: </strong>Renal dysfunction was associated with VF in patients with T2DM. The addition of renal dysfunction improved the ability of bone mass to predict VF.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1915-1924"},"PeriodicalIF":2.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309693","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 Effects of Specific Gut Microbiota on Hyperuricemia - A Mendelian Randomization Analysis and Clinical Validation.","authors":"Dilinuer Αikepa, Yi He, Wujin Chen, Meiting Liang, Yongkun Du, Xiaoyu Chen, Manxi Du, Yuqiu Zhu, Jianping Wang, Yuping Sun","doi":"10.2147/DMSO.S510384","DOIUrl":"10.2147/DMSO.S510384","url":null,"abstract":"<p><strong>Background: </strong>Hyperuricemia (HUA) is a metabolic disorder caused by an imbalance between uric acid (UA) production and excretion. It is closely associated with various diseases, including gout and kidney disease. The intestines play a significant role in UA excretion, and emerging evidence suggests that gut microbiota modulate UA excretion and degradation. However, the specific functional microbial biomarkers and their roles in HUA remain underexplored.</p><p><strong>Methods: </strong>Based on this, we hypothesize that the Mendelian randomization (MR) analysis method can be used to identify and define microbial biomarkers associated with HUA. Accordingly, we conducted an MR study using gut microbiota data from 18,340 participants across 24 distinct cohorts, including 129 HUA patients and 352,232 controls, to investigate the causal relationship.</p><p><strong>Results: </strong>We found that the genus <i>Ruminococcus</i> was linked to a lower risk of HUA, while the family <i>Clostridiaceae</i> was associated with a higher risk of HUA. Clinical validation showed that high <i>Clostridiaceae</i> and low <i>Ruminococcus</i> abundance could distinguish HUA patients from healthy individuals, and the predictive diagnostic efficacy of <i>Clostridiaceae</i> was better. The combined model further enhanced diagnostic accuracy.</p><p><strong>Conclusion: </strong>Our findings provide important information on the micro-biome features of HUA and novel insights into the further determination of the roles of the involved microorganisms, providing a reference for disease diagnosis and the development of microbial therapies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1891-1902"},"PeriodicalIF":2.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309704","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":"Inhibition of Caspase-3/GSDME Pathway-Mediated Pyroptosis of Renal Tubular Epithelial Cells by Dagliflozin in the Pathogenesis of Diabetic Kidney Disease and Study of Its Mechanism.","authors":"Hong Jiang, Mengya Gao, Jiaqi Liu, Lijuan Yang, Lei Liu","doi":"10.2147/DMSO.S515034","DOIUrl":"10.2147/DMSO.S515034","url":null,"abstract":"<p><strong>Objective: </strong>Investigating the effects and mechanisms of dapagliflozin on pyroptosis of renal tubular epithelial cells under high-glucose conditions through the regulation of the Caspase-3/GSDME signaling pathway, providing experimental evidence for the clinical treatment of diabetic kidney disease.</p><p><strong>Methods: </strong>Human renal tubular epithelial cells (HK-2) were cultured in vitro and divided into control group (5mmol/L D-glucose), high-glucose group (30mmol/L D-glucose), dagliflozin group (2.5μmol/L dagliflozin), and monoinhibitor group (20μmol/L caspase-1 inhibitor), dual inhibitor group (20μmol/L caspase-1 inhibitor + 50μmol/L caspase-3 inhibitor), and SiRNA transfection group. All groups were intervened for 48h. The cell viability was detected by cell counting kit-8 and the glucose and dagliflozin concentrations of the intervention were determined. Caspase-1, caspase-3, GSDMD, GSDME, GSDME-N, caspase-8, NF-κB were detected by Western blot. Detection of cellular pyroptosis in each group by flow cytometry.</p><p><strong>Results: </strong>Compared with the control group, the D-glucose group showed decreased cell viability, increased cell pyroptosis, and increased levels of caspase-1, caspase-3, GSDMD, GSDME, GSDME-N, caspase-8, NF-κB, and other related proteins (P<0.05). Compared with the D-glucose group, the rate of cellular pyroptosis and the levels of caspase-1, caspase-3, GSDMD, GSDME, GSDME-N and other related proteins were decreased in the dagliflozin group and the dual inhibitor group (<i>P</i><0.05). Compared with the transfected control group, the cellular pyroptosis rate and the levels of caspase-1, caspase-3, GSDMD, GSDME, GSDME-N, and other related proteins were then further reduced in the transfected group targeting SGLT2 knockdown (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>In the proximal tubular cells of diabetic kidney disease, dagliflozin inhibited high glucose-induced pyroptosis of human HK-2, and its mechanism of action may be related to the inhibition of caspase 3/GSDME pathway signaling.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1903-1914"},"PeriodicalIF":2.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309703","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 Model for In-Hospital Death in Older Patients with Type 2 Diabetes Mellitus: A Multicenter Retrospective Study in Southwest China.","authors":"Yang Tang, Zhengyu Zhang, Yue Yu, Yuxin He, Yuan Yuan, Xin Wu, Qian Xu, Jianhua Niu, Xiaoxin Wu, Juntao Tan","doi":"10.2147/DMSO.S527018","DOIUrl":"10.2147/DMSO.S527018","url":null,"abstract":"<p><strong>Objective: </strong>Older patients with type 2 diabetes mellitus (T2DM) often face severe health challenges. This study aims to develop and validate a predictive model for estimating in-hospital death risk in this population.</p><p><strong>Methods: </strong>Clinical data of 17,421 patients with T2DM aged ≥ 65 years admitted to six hospitals in southwest China were collected retrospectively. Model performance was assessed through area under the receiver operating characteristic curve (AUROC) analysis and calibration plots. Clinical utility was evaluated using decision curve analysis (DCA) and clinical impact curve (CIC).</p><p><strong>Results: </strong>The overall in-hospital death rate was 3.19% (556 cases). Eleven independent predictors were identified: age, gender, history of surgery, Charlson Comorbidity Index score, coronary heart disease, chronic obstructive pulmonary disease, serum levels of creatinine, albumin, glycated hemoglobin, nutritional support drug use, and antibiotic drug use. The multivariable model demonstrated robust predictive accuracy with AUROC values of 0.873 (95% CI: 0.857-0.889) in training set, 0.830 (0.797-0.864) in internal validation set, and 0.834 (0.757-0.911) in external validation set. Bootstrap validation (n=1,000 resamples) confirmed adequate calibration. DCA and CIC analyses revealed substantial clinical net benefit across threshold probabilities. An interactive web-based calculator was implemented for clinical application (https://cqykdxtjt.shinyapps.io/in_hospital_death/).</p><p><strong>Conclusion: </strong>The prediction model developed in this study demonstrated robust discrimination, calibration, and clinical utility. It can assist healthcare professionals in identifying high-risk older patients with T2DM, facilitating early prevention, detection, and intervention, thereby reducing the risk of in-hospital death in this vulnerable population.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1873-1889"},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301318","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 Hemoglobin Glycation Index (HGI) and Risk of Diabetic Nephropathy: A Retrospective Cohort Study.","authors":"Weiyi Zhou, Lingyu Zhang, Tongqiang Liu","doi":"10.2147/DMSO.S523442","DOIUrl":"10.2147/DMSO.S523442","url":null,"abstract":"<p><strong>Background: </strong>The Hemoglobin Glycation Index (HGI) quantifies the difference between observed and predicted glycated hemoglobin (HbA1c) values, and has connections to multiple adverse outcomes. However, the relationship between HGI and the risk of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) remains underexplored. The objective of this study was to examine the relationship between baseline HGI and the risk of DN development among patients with T2DM through a retrospective cohort study.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on 1050 newly diagnosed T2DM patients with normal renal function at baseline. Participants were categorized into quartiles based on HGI values. The primary outcome was DN development, defined as persistent proteinuria or reduced estimated glomerular filtration rate (eGFR). Multivariable logistic regression, restricted cubic spline (RCS) analysis, and threshold effect models were employed to assess the association between HGI and DN risk. Subgroup and sensitivity analyses were conducted to validate the robustness of our findings, while mediation analysis was employed to explore potential underlying mechanisms.</p><p><strong>Results: </strong>The study revealed a U-shaped relationship between HGI and DN risk. Both excessively low and high HGI levels were associated with an increased risk of DN, with the lowest risk observed at an HGI threshold of -0.648. In fully adjusted models, the highest HGI quartile (Q4) demonstrated a significantly increased risk of DN (OR = 1.54, 95% CI: 1.03-2.30, <i>P</i> = 0.036), while the lowest HGI quartile (Q1) also showed a trend toward higher risk (OR = 1.40, 95% CI: 0.92-2.14, <i>P</i> = 0.115). However, fasting plasma glucose (FPG) (<i>P</i> for overall = 0.217) and glycated hemoglobin (HbA1c) (<i>P</i> for overall = 0.529) did not show an association with the risk of DN. Subgroup and sensitive analyses confirmed the consistency of this U-shaped association across different patient demographics. Mediation analysis indicated that C-reactive protein (CRP) mediated 11.1% of the effect of |HGI| on DN.</p><p><strong>Conclusion: </strong>In T2DM patients, baseline HGI exhibits a U-shaped association with DN risk, serving as a potential indicator for assessing DN risk.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1859-1872"},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257568","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}