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

{"title":"Psychosocial Factors Associated with Diabetes Distress Among Adults with Type 2 Diabetes Mellitus: The Roles of Perceived Social Support and Diabetes Management Self-Efficacy in an Indonesian Outpatient Sample.","authors":"Muhammad Afiif Aziz, Neti Juniarti, Titis Kurniawan, Reni Afriana","doi":"10.2147/DMSO.S650264","DOIUrl":"10.2147/DMSO.S650264","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes distress represents a diabetes-specific emotional burden associated with the challenges of long-term diabetes management. Psychosocial factors, including perceived social support and diabetes management self-efficacy, may influence how individuals experience and adapt to type 2 diabetes mellitus (T2DM). However, the relationships among these factors remain insufficiently characterized when diabetes distress is considered the primary outcome. This study aimed to examine the associations among perceived social support, diabetes management self-efficacy, and diabetes distress among adults with T2DM receiving outpatient care in Indonesia.</p><p><strong>Patients and methods: </strong>An analytical observational study with a cross-sectional design was conducted among 107 adults with physician-confirmed T2DM attending an internal medicine outpatient clinic in South Sumatra, Indonesia. Participants were recruited using consecutive sampling. Perceived social support, diabetes management self-efficacy, and diabetes distress were assessed using the Indonesian versions of the Multidimensional Scale of Perceived Social Support, Diabetes Mellitus Self-Efficacy Scale, and Diabetes Distress Scale. Associations among variables were examined using correlation analysis and regression-based path analysis with bootstrap estimation.</p><p><strong>Results: </strong>Participants had a mean age of 54.14 ± 10.82 years, and 76.6% were women. Overall, 26.2% of participants experienced moderate-to-high diabetes distress. Perceived social support was not significantly associated with diabetes management self-efficacy or diabetes distress. In contrast, diabetes management self-efficacy was negatively associated with diabetes distress and remained significant after adjustment for perceived social support and age. The indirect association between perceived social support and diabetes distress through diabetes management self-efficacy was not statistically significant.</p><p><strong>Conclusion: </strong>Among adults with T2DM receiving outpatient care, diabetes management self-efficacy was associated with lower diabetes distress, whereas generalized perceived social support was not significantly associated with diabetes distress or diabetes management self-efficacy. These findings highlight the importance of considering diabetes management self-efficacy as a psychosocial component of patient-centered diabetes care. Future studies should examine whether diabetes-specific support interventions may provide greater benefit than generalized social support for improving psychosocial outcomes among individuals with T2DM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"650264"},"PeriodicalIF":3.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223501","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":"Meta-Analysis of the Impact of Low Glycemic Index Dietary Patterns on Blood Glucose Levels and Pregnancy Outcomes in Gestational Diabetes Mellitus.","authors":"Yu Zhang, Zhiyong Gong, Minda Yu, Ying Gao","doi":"10.2147/DMSO.S599251","DOIUrl":"10.2147/DMSO.S599251","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the efficacy of low glycemic index (LGI) dietary patterns in improving glycemic control and pregnancy outcomes among patients with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) were identified through systematic searches of PubMed, The Cochrane Library, Web of Science, CNKI, VIP Medicine, Wanfang, and other relevant databases. Data extraction and quality assessment were conducted following Cochrane guidelines. Meta-analyses were performed using RevMan 5.3 and STATA 12.0 software.</p><p><strong>Results: </strong>Eleven RCTs comprising 1209 participants were included. Compared with conventional diabetic diets, LGI dietary interventions significantly reduced fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin (HbA1c), and insulin resistance levels. Additionally, LGI diets were associated with a lower incidence of excessive gestational weight gain and improved neonatal outcomes.</p><p><strong>Conclusion: </strong>LGI dietary patterns effectively enhance glycemic control, mitigate insulin resistance, and improve perinatal outcomes in GDM patients. However, further high-quality studies with larger sample sizes are warranted to strengthen these conclusions.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"599251"},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215258","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":"Genetic and Body Composition Factors Associated with Metabolic-Associated Steatotic Liver Disease: A Cross-Sectional Analysis of a Health Screening Cohort.","authors":"Yi-Hsuan Shen, Yi-Chen Lee, Tzu-Jung Chou, Hao-Hsiang Chang, Chia-Wen Lu, Kuo-Chin Huang","doi":"10.2147/DMSO.S630425","DOIUrl":"10.2147/DMSO.S630425","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic-associated steatotic liver disease (MASLD), newly defined in 2023, is characterized by excessive hepatic triglyceride accumulation in the presence of cardiometabolic risk factors. The body roundness index (BRI), an indicator of body fat distribution and visceral adiposity, has been proposed as a potential predictor of MASLD. Variants in the FTO (fat mass and obesity-associated) gene are well established as genetic determinants of adiposity and metabolic dysfunction. This cross-sectional study aimed to evaluate the predictive value of FTO variants and BRI for MASLD.</p><p><strong>Material and methods: </strong>This cross-sectional study included 5042 adult men and women aged ≥20 years who underwent self-funded health check-ups and single-nucleotide polymorphism genotyping at the HAVO Health Exam Clinic between January 2020 and December 2021. Participants were classified into the MASLD (n = 2644) and non-MASLD (n = 2398) groups. Hepatic steatosis was diagnosed by abdominal ultrasonography, and MASLD was defined as evidence of hepatic steatosis alongside at least one cardiometabolic risk factor in the absence of other causes of hepatic steatosis. Genotyping was performed using the Global Screening Array-24 v1.0 BeadChip (Infinium, California, USA). Multiple logistic regression models and receiver operating characteristic (ROC) curve analyses were applied to evaluate the predictive performance of the BRI and FTO variants for MASLD.</p><p><strong>Results: </strong>Among 2644 MASLD and 2398 non-MASLD individuals, the MASLD group had a significantly higher mean BRI (4.08 ± 1.01 vs 2.72 ± 0.69, p < 0.001). Higher BRI quartiles were associated with increased MASLD risk (Q4 OR = 20.50, 95% CI: 13.78-30.51). FTO variants were associated with an elevated BRI (TT: 3.40, AT: 3.54, AA: 3.69, p < 0.001). The AUC for the combined model incorporating both FTO variants and BRI, along with age and sex, in detecting MASLD was 0.907.</p><p><strong>Conclusions: </strong>The BRI is a strong predictor of MASLD, with FTO risk allele further amplifying susceptibility to MASLD. Integrating genetic and anthropometric markers may enhance MASLD risk assessment.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"630425"},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215293","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":"Adherence and Persistence to Injectable versus Oral GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus: A Comparative Systematic Review and Analysis.","authors":"Ahmed M Ashour","doi":"10.2147/DMSO.S614243","DOIUrl":"10.2147/DMSO.S614243","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) requires sustained glycemic control to prevent long-term complications. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective therapies, traditionally administered via injection. The introduction of oral formulations, such as oral semaglutide, may improve patient adherence and persistence.</p><p><strong>Methods: </strong>A systematic review with descriptive pooled synthesis was conducted using studies identified from PubMed, ClinicalTrials.gov, and relevant real-world observational data sources. Adherence and persistence outcomes were summarized and compared descriptively between injectable and oral GLP-1 RAs.</p><p><strong>Results: </strong>Across the included total of 13 studies and medical records, data from 1348 patients were summarized. Oral GLP-1 RAs were associated with higher reported adherence (70.8% vs 62.4%) and persistence (62.1% vs 47.8%) compared with injectable formulations. A chi-square test of independence showed that the difference in adherence between oral and injectable GLP-1 was significant; (<i>χ</i> ² = 10.8, p < 0.01). Similarly, chi-square test showed that the observed variation in persistence between Oral-GLP vs injectable GLP-1 was also significant (<i>χ</i> ² = 37.9, p < 0.001). Injectable therapies were associated with higher rates of adverse events, particularly injection-site reactions.</p><p><strong>Conclusion: </strong>Oral GLP-1 RAs may be associated with improved adherence and persistence in patients with T2DM. These findings suggest that formulation choice may influence long-term diabetes treatment continuation, although further study-level meta-analytic research is needed.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"614243"},"PeriodicalIF":3.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215269","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":"Diabetes Mellitus in Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Prevalence of Types and Risk Factors.","authors":"Kimia Kake, Milad Jalilian","doi":"10.2147/DMSO.S650265","DOIUrl":"https://doi.org/10.2147/DMSO.S650265","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is associated with an increased risk of diabetes mellitus (DM) and type 2 diabetes mellitus (T2DM), yet the overall burden and related risk factors remain incompletely characterized.</p><p><strong>Aim: </strong>This study aimed to estimate the prevalence of DM in overall and T2DM in patients with schizophrenia and to summarize associated risk factors.</p><p><strong>Methods: </strong>This PRISMA-guided systematic review and meta-analysis included observational studies reporting DM or T2DM in patients with schizophrenia. Databases were systematically searched. Pooled prevalence estimates were calculated using a random-effects model in CMA software. Heterogeneity was assessed using Cochran's Q test and I², while publication bias was evaluated using Egger's regression test and trim-and-fill analysis.</p><p><strong>Results: </strong>Thirty-five studies involving 139,304 individuals were included, and 34 studies contributed to the meta-analysis. The pooled prevalence of DM was 10.4% (95% CI: 8.3-12.9%), and the pooled prevalence of T2DM was 13.2% (95% CI: 9.1-18.9%). Between-study heterogeneity was substantial for both outcomes (I² = 99.49% and 99.38%, respectively). Egger's test suggested possible publication bias; however, trim-and-fill analysis identified no missing studies and did not alter the pooled estimates. Commonly reported risk factors included older age, female sex, obesity or higher body mass index, family history of diabetes, sedentary lifestyle, lower socioeconomic status, longer illness duration, and antipsychotic exposure, particularly clozapine and olanzapine.</p><p><strong>Conclusion: </strong>Overall diabetes, particularly type 2 diabetes, is prevalent among patients with schizophrenia and associated with demographic, clinical, treatment-related, and medication-related risk factors. These findings support routine metabolic screening and early preventive interventions to reduce diabetes risk and improve health outcomes in this high-risk population.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"650265"},"PeriodicalIF":3.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179763","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":"FTO-Mediated m6A Demethylation in Insulin Resistance and Type 2 Diabetes: Tissue-Specific Mechanisms - a Narrative Review.","authors":"Hadil Shams Aldeen Alsagher, Shaden Haddad","doi":"10.2147/DMSO.S638334","DOIUrl":"https://doi.org/10.2147/DMSO.S638334","url":null,"abstract":"<p><p>This narrative review aims to clarify the tissue-specific effects of the fat mass and obesity-associated (FTO) gene, which encodes a demethylase enzyme, on lipid and glucose metabolism and appetite regulation. Some FTO single-nucleotide polymorphisms (SNPs) regulate neighboring genes, while the FTO protein demethylates single-stranded nucleic acids. The FTO enzyme modulates RNA lifecycle processes, including splicing, export, decay, and translation. However, recent studies suggest that FTO expression and activity may influence metabolic signals across multiple tissues. Evidence from genetic-association studies, experimental cellular and animal models, and human metabolic studies suggests tissue-specific effects of FTO, although findings are not always consistent across evidence types. In the liver, FTO has been reported to promote lipogenesis through effects on SREBP-1c maturation and the expression of lipogenic genes. In adipocytes, FTO has been implicated in adipogenesis through effects on Mitotic Clonal Expansion (MCE), including regulation of RUNX1T1 splicing, during terminal differentiation through effects on C/EBP-β transcription. In addition to effects attributed to FTO protein, the FTO locus-mediated mechanisms can influence neighboring genes such as IRX3, which has been implicated in adipocyte thermogenic programs. FTO has also been implicated in the regulation of gluconeogenic gene expression in the liver. In skeletal muscle, FTO has been associated with altered AMPK signaling and lipid accumulation. In pancreatic β-cells, FTO has been reported to affect insulin secretion, although findings are inconsistent across experimental models. In the hypothalamus, FTO-related mechanisms have been linked to RPGRIP1L and leptin signaling, suggesting a potential role in appetite regulation. FTO inhibitors have also been investigated for their potential to modulate FTO-related effects. In summary, FTO dysregulation may be involved in insulin resistance and metabolic risk factors associated with T2D. However, the underlying mechanisms and causal relationships remain incompletely established, particularly given differences among genetic-association studies, experimental models, and human metabolic studies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"638334"},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179753","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":"Knowledge Gaps, Primary Care Provider Counselling, and Barriers to Diabetic Retinopathy Screening Among Adults with Diabetes in Syria: A Multicenter Cross-Sectional Study.","authors":"Ahmad Al Malla, Ahmad Bishr Nasra, Shahd Almansour, Mohammad Alaa Aldakak, Mohammad Al Saleh, Joudi Alkhateeb, Lama Bashar Salman, Youssef Latifeh","doi":"10.2147/DMSO.S624626","DOIUrl":"https://doi.org/10.2147/DMSO.S624626","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a leading cause of preventable vision loss, yet retinal screening remains suboptimal in low-resource settings. This study assessed DR-related knowledge, risk perception, screening practices, and barriers among adults with diabetes attending selected healthcare facilities across multiple Syrian regions.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted from December 2025 to February 2026 in public hospitals in Damascus, Latakia, Homs, and Aleppo. Adults aged ≥18 years with self-reported diabetes were recruited predominantly from diabetes/endocrinology clinics using non-probability sampling. An adapted Arabic questionnaire assessed knowledge (10-item score; adequate ≥6/10), screening, barriers, and provider communication. Bivariate analyses and hierarchical binary logistic regression identified factors associated with adequate knowledge and never screening.</p><p><strong>Results: </strong>Among 375 participants, the mean knowledge score was 5.97 ± 2.40 and 60.0% had adequate knowledge. Only 57.6% recognized the need for screening despite controlled blood glucose. Although 62.9% reported ophthalmology advice, only 40.0% reported formal referral. Overall, 36.3% had never undergone diabetes-related eye screening; leading barriers were lack of clinician recommendation (47.1%) and absence of visual symptoms (39.0%). PCP counselling/advice was associated with higher odds of adequate knowledge (aOR 1.914, 95% CI 1.113-3.292) and lower odds of never screening (aOR 0.267, 95% CI 0.145-0.492). Adequate knowledge was also associated with lower odds of never screening (aOR 0.432, 95% CI 0.259-0.721), with substantial regional differences after adjustment.</p><p><strong>Conclusions: </strong>Among adults with diabetes attending selected public hospital clinics in Syria, moderate overall knowledge coexisted with actionable misconceptions and screening gaps. The findings support evaluating interventions to strengthen patient education, clinician counselling, referral pathways, and equitable access to retinal assessment. Hospital-based non-probability sampling limits generalizability.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"624626"},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179789","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 Multidimensional Obesity Indices and Diabetic Peripheral Neuropathy and Comparison of Their Discriminative Performance.","authors":"Liqing Xie, Haoyang Yu, Wenjian Lin","doi":"10.2147/DMSO.S634272","DOIUrl":"https://doi.org/10.2147/DMSO.S634272","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is an important risk factor for diabetic peripheral neuropathy (DPN), but body mass index (BMI) may not fully reflect variations in fat distribution and overall obesity. This study evaluated the associations between multiple obesity-related indices and DPN risk and compared their discriminative performance and potential clinical value.</p><p><strong>Patients and methods: </strong>A total of 950 participants were enrolled. Fourteen obesity-related indices were assessed: BMI, waist circumference (WC), hip circumference (HC), weight-adjusted waist index (WWI), waist divided by height^0.5 (WHT.5R), waist-to-hip ratio (WHR), conicity index, a body shape index (ABSI), abdominal volume index (AVI), body surface area (BSA), body roundness index (BRI), relative fat mass (RFM), metabolic score for visceral fat (METS-VF), and Chinese visceral adiposity index (CVAI). Binary logistic regression evaluated associations with DPN using continuous and categorical variables. Sensitivity and subgroup analyses assessed robustness and potential effect modification. Receiver operating characteristic (ROC) curves and decision curve analysis evaluated discriminative performance and potential clinical net benefit.</p><p><strong>Results: </strong>After adjustment for potential confounders, all fourteen obesity-related indices were positively associated with DPN risk per standard deviation increase. RFM showed the strongest association (OR = 3.631, 95% CI: 2.576-5.118), followed by conicity index (OR = 2.792, 95% CI: 2.282-3.416). Sensitivity analyses showed that these associations remained generally stable. Among all indices, conicity index had the highest area under the curve (AUC = 0.727), with an optimal cutoff of 1.279. Decision curve analysis indicated that conicity index provided relatively better potential clinical net benefit.</p><p><strong>Conclusion: </strong>Multiple obesity-related indices were associated with increased DPN risk. RFM showed the strongest association, whereas conicity index demonstrated better discriminative performance and potential clinical net benefit. Incorporating conicity index into early DPN screening strategies may facilitate the earlier detection of individuals at high risk. However, its clinical applicability requires further validation in prospective studies and external populations.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"634272"},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179726","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":"Diagnostic Performance of Six Insulin Resistance Indices for MAFLD Across BMI Categories in Type 2 Diabetes.","authors":"Jie Tao, Yun Zhong, Hong Li, Weimin Wang, Juan Tan","doi":"10.2147/DMSO.S557710","DOIUrl":"https://doi.org/10.2147/DMSO.S557710","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic utility of six insulin resistance surrogate indices for metabolic dysfunction-associated fatty liver disease (MAFLD) across different body mass index (BMI) categories in patients with type 2 diabetes (T2DM).</p><p><strong>Methods: </strong>This single-center, cross-sectional study utilized a consecutive sampling method and was conducted at the Department of Endocrinology and Geriatrics, Huaian First People's Hospital (January 2018 to December 2022). Inclusion criteria were age ≥18 years and confirmed T2DM. A total of 2079 hospitalized adult patients meeting these criteria were initially screened. After applying exclusion criteria (including other diabetes types, secondary liver diseases, excessive alcohol consumption, low BMI, and incomplete data), 1205 patients with T2DM were enrolled and stratified by body mass index (BMI) into normal weight (n=429) and overweight/obese groups (n=776). MAFLD was diagnosed based on abdominal ultrasound, yielding 636 cases of MAFLD and 569 non-MAFLD controls. Six insulin resistance surrogate indices-homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C), and Chinese visceral adiposity index (CVAI)-were assessed for their diagnostic performance using receiver operating characteristic (ROC) analysis, DeLong's test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The overall prevalence of MAFLD was 52.78%, with rates of 34.03% in the normal weight group and 63.14% in the overweight/obese group. In the overweight/obese cohort, TyG-BMI demonstrated superior diagnostic accuracy (AUROC 0.769; optimal cut-off 240.503; sensitivity 76.37%, specificity 66.91%), significantly outperforming all other indices except for METS-IR, which showed comparable efficacy and could serve as an alternative. Among normal-weight individuals, TG/HDL-C exhibited the highest diagnostic performance (AUROC 0.763; optimal cut-off 2.908; sensitivity 70.00%, specificity 73.58%), which was significantly better than HOMA-IR and CVAI, but showed no significant difference compared with TyG, TyG-BMI, or METS-IR. DCA indicated that TyG-BMI consistently provided the greatest net clinical benefit, particularly within the high-risk threshold range (0.4-0.6), regardless of BMI category.</p><p><strong>Conclusion: </strong>TyG-BMI should be prioritized as the primary screening indicator for MAFLD in overweight and obese T2DM patients, with METS-IR as a valid alternative. In normal weight patients, TG/HDL-C demonstrates excellent clinical utility, with TyG-BMI serving as effective alternatives.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"557710"},"PeriodicalIF":3.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166995","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":"Circulating FTO Protein Levels and β-Cell Function in Individuals with Different Metabolic Profiles: A Cross- Sectional Study.","authors":"Hadil Shams Aldeen Alsagher, Shaden Haddad","doi":"10.2147/DMSO.S643391","DOIUrl":"https://doi.org/10.2147/DMSO.S643391","url":null,"abstract":"<p><strong>Background: </strong>Obesity and type 2 diabetes mellitus are characterized by insulin resistance and progressive impairment of β-cell function. Fat mass and obesity-associated (FTO) protein, an m6A demethylase involved in metabolic regulation, has been linked to obesity. However, the relationship between circulating FTO protein levels and β-cell function among individuals with different metabolic profiles remains unclear. This study aimed to investigate circulating FTO levels and their relationship with β-cell function, assessed by (HOMA-β), in individuals with newly diagnosed T2D, obese individuals without diabetes, and normal-weight individuals without diabetes.</p><p><strong>Patients and methods: </strong>This cross-sectional observational study included 82 participants: 39 individuals newly diagnosed with T2D, 23 obese individuals without diabetes, and 20 normal-weight individuals without diabetes. Anthropometric and biochemical parameters, including fasting blood glucose, glycated hemoglobin, fasting insulin, HOMA-IR, and HOMA-β, were assessed. Serum FTO levels were measured using ELISA. Correlation and multiple linear regression analyses were performed to examine the relationship between circulating FTO levels and (HOMA-β).</p><p><strong>Results: </strong>Serum FTO protein levels differed significantly among the three groups (P = 0.002), with the highest levels observed in obese individuals without diabetes. In this group, FTO protein levels were positively correlated with body mass index, fasting insulin, and HOMA-β (P = 0.018, P = 0.040, and P = 0.033, respectively). HOMA-β was also positively correlated with FTO, fasting insulin, and HOMA-IR. However, the positive association between FTO levels and HOMA-β was not statistically significant after adjustment for age, sex, and metabolic status.</p><p><strong>Conclusions: </strong>Circulating FTO levels were highest in obese individuals without diabetes and were positively correlated with HOMA-β in this group. However, this relationship was not independently significant after adjustment for potential confounders. These findings provide preliminary evidence of a relationship between circulating FTO and β-cell function in the context of obesity, while the cross-sectional design precludes causal or temporal inferences.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"19 ","pages":"643391"},"PeriodicalIF":3.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164559","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}