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

{"title":"Health Beliefs and Obesity Bias as Determinants of Attitudes Toward the Rising Tides of GLP-1 Medications: Mounjaro and Ozempic.","authors":"Kholoud Al-Mahzoum, Doaa H Abdelaziz, Fajer Alenezi, Jouza Almutairi, Mohammad Khaled Alsubaiei, Abdullah Bader Alharbi, Sarah Al-Rawi, Shahad Al-Rawi, Fatemah Faisal Bousheheri, Ahmad Hameed Alhajri, Saif Nasser Alajmi, Mohammed Sallam, Noha O Mansour, Eman Khamis Alnazly, Malik Sallam","doi":"10.2147/DMSO.S518994","DOIUrl":"https://doi.org/10.2147/DMSO.S518994","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 (GLP-1) receptor agonists including Mounjaro and Ozempic, are increasingly used for weight management. Assessing the attitudes and beliefs of current and future healthcare professionals is important considering their roles in recommending and prescribing these drugs. This study aimed to investigate the attitudes toward Mounjaro and Ozempic and its correlation with obesity/overweight bias among healthcare professionals and students in medicine and pharmacy in Arab countries.</p><p><strong>Methods: </strong>This cross-sectional study was based on a self-administered online questionnaire with participants recruited via a convenient snowball sampling approach. Attitudes towards Mounjaro and Ozempic were evaluated using a newly developed construct termed Mini Health Beliefs and Attitudes toward GLP-1 Drugs Scale (mini-HBAGS), alongside a novel scale to assess obesity/overweight bias (OOB). The new constructs' validity was assessed via content validity, principal component analysis (PCA), and Cronbach's α.</p><p><strong>Results: </strong>The study included 413 participants predominantly from Kuwait (32.8%), Egypt (20.9%), Saudi Arabia (18.8%), and Jordan (15.4%). Familiarity with Mounjaro and Ozempic was high (83.6%), with 17.2% recommending them. Weight management drug use was 14.0%, including 5.9% for Mounjaro and Ozempic. Among participants familiar with Mounjaro and Ozempic, the mean OOB score was 3.83±0.62 (range: 1.00-5.00), indicating agreement, while the mean score for the mini-H-BAGS was 2.70±0.716 (range: 1.00-5.00), indicating a slightly unfavorable attitude. PCA identified perceived benefits and barriers, and subjective norms and attitudes, as key determinants of attitudes toward Mounjaro and Ozempic.</p><p><strong>Conclusion: </strong>This study revealed slightly negative attitudes toward Mounjaro and Ozempic among healthcare professionals and students in Arab countries. The negative attitudes observed likely reflect concerns about side effects, cost, and accessibility of these medications. The findings highlighted the need for targeted education in Arab countries to address obesity bias and encourage a balanced evaluation of the benefits and risks of GLP-1 drugs for weight management.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1389-1409"},"PeriodicalIF":2.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973552","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":"Impact of GLP-1 Receptor Agonists on Perceived Eating Behaviors in Response to Stimuli.","authors":"Carol Cheney, Krystal Hunter, Marlena Klein","doi":"10.2147/DMSO.S488806","DOIUrl":"https://doi.org/10.2147/DMSO.S488806","url":null,"abstract":"<p><strong>Background: </strong>Several Glucagon-like peptide-1 (GLP-1) receptor agonists are FDA-approved for weight loss in patients with obesity primarily through targeting gastrointestinal pathways to reduce caloric intake; however, less is known about the GLP-1 receptor agonist impact on the behavioral aspects of eating. Our study investigated how patients' perceived eating behaviors evolve in response to different stimuli after initiating a GLP-1 receptor agonist. We hypothesized that participants reported eating behaviors are more in tune with their physiological cues (hunger and satiety) and less influenced by emotional, situational, and external sensory cues after starting their GLP-1 receptor agonists.</p><p><strong>Materials and methods: </strong>This was a survey-based cross-sectional study that included 101 participants with BMI >27 who were prescribed a GLP-1 receptor agonist medication. The survey inquired about participants' perspectives on their eating behaviors before and after starting GLP-1 receptor agonists. The survey was created through Google Forms and consisted of 31 questions in a multiple-choice format. A paired <i>T</i>-test was used to compare the participants' numerical scores for a given question before and after starting the GLP1 receptor agonist.</p><p><strong>Results: </strong>Participants reported feeling significantly more cognizant of their hunger cues and a significant reduction in the frequency with which they ate past the point of feeling full. Participants also reported a significant reduction in the frequency with which they desired to eat food in response to external sensory cues and situational cues. In addition, participants reported a significant reduction in the frequency of consuming food in excess in response to emotional cues.</p><p><strong>Conclusion: </strong>Together, these results suggest that GLP-1 receptor agonists may promote substantial weight loss through improved perceived regulation of eating behavior, supporting a state in which physiological cues have a greater influence on food intake than emotional, external, sensory, and situational cues.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1411-1418"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962823","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":"Protective Role of H₂S in High Glucose-Induced Cardiomyocyte and Endothelial Cell Dysfunction: A Mechanistic Review.","authors":"Xiaoya Zhai, Yefei Gao, Haifei Lou, Liping Meng, Jiedong Zhou, Hui Lin, Fukang Xu","doi":"10.2147/DMSO.S505138","DOIUrl":"https://doi.org/10.2147/DMSO.S505138","url":null,"abstract":"<p><p>Hydrogen sulfide (H₂S), recognized as a significant gasotransmitter, has been shown to effectively reduce damage to cardiomyocytes and endothelial cells caused by diabetes. Its protective effects primarily stem from several mechanisms, including S-sulfhydration of proteins, reduction of cell death, alleviation of mitochondrial damage, improvement of ion channel dysfunction, interaction with nitric oxide, and modulation of angiogenesis. H₂S is synthesized by cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), and 3-mercaptopyruvate sulfurtransferase (3-MST), whose expression is significantly reduced under diabetic conditions, including experimental high-glucose treatment in cells and diabetes mellitus animal models. This review summarizes the protective role of H₂S and its donors in these pathological processes, highlights existing research gaps-including challenges in the targeted delivery of H₂S donors, limited clinical translation, and incomplete mechanistic understanding-and discusses future directions for developing targeted H₂S-based therapeutic strategies.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1373-1388"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984035","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":"Factors Associated with Poor Therapeutic Compliance Among Diabetic Patients in Health Facilities of Kinshasa.","authors":"Magloire Atantama, Danny Mafuta Munganga, Remy Kapongo Yobo, Joseph Bidingija Mabika, Jeje-Paul Mikobi Minga, Christian Kisoka Lusunsi, Jean-Bosco Kasiam Lasi On'Kin, Noël Otshudi Onembo, Pascal Bayauli Mwasa","doi":"10.2147/DMSO.S508883","DOIUrl":"https://doi.org/10.2147/DMSO.S508883","url":null,"abstract":"<p><strong>Background: </strong>Poor therapeutic compliance among diabetic patients is one of the public health issues contributing to inadequate diabetes mellitus control and an increased risk of chronic complications. This study aimed to determine the frequency and factors associated with poor therapeutic compliance among diabetic patients in Kinshasa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between November 2021 and November 2022 on diabetic patients aged at least 18 years who visited four health facilities in Kinshasa. The Morisky questionnaire was used to assess therapeutic compliance. Data analysis was carried out using SPSS 26 software. Descriptive analyses, Pearson's chi-square test, Mann-Whitney <i>U</i>-test, and logistic regression were applied. A <i>p</i>-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 131 participants were enrolled, of which 88 (67.1%) had poor compliance. The mean age was 53.8 ± 16.5 years, with male participants representing 67.9%. Median values of blood glucose, glycated hemoglobin (HbA1c), triglycerides (TG), and LDL-cholesterol were high in the non-compliant group with respectively 147.5 mg/dL, 8.5%, 146.9 mg/dL, and 116.5 mg/dL. Inadequate self-monitoring (AOR: 10.144, 95% CI 3.543-29.040, <i>p</i><0.001), treatment mode combining oral antidiabetic drugs (OADs) and insulin (AOR: 3.098 95% CI 1.078-8.904, <i>p</i>=0.036) were significantly associated with poor compliance with treatment.</p><p><strong>Conclusion: </strong>The present study revealed a suboptimal level of therapeutic compliance among participants while highlighting associated factors such as treatment type and inadequate self-monitoring. Thus, setting up a team focusing on therapeutic education is required for better disease management.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1365-1371"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986091","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":"Comparative Predictive Value of the TyG Index and UHR for Lower Extremity Artery Disease in Type 2 Diabetes: A Retrospective Analysis.","authors":"Chen Shao, Chengzhi Fei, Mingxue Gu, Xiujing Zha, Juan Li, Delu Zheng, Diwen Wang, Yanqiu Wang, Xiaolei Hu","doi":"10.2147/DMSO.S496727","DOIUrl":"https://doi.org/10.2147/DMSO.S496727","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive value of triglyceride glucose index (TyG) and the ratio of serum uric acid (SUA) to high-density lipoprotein cholesterol (HDL-C) (UHR) for lower extremity atherosclerotic disease (LEAD) in type 2 diabetes (T2DM) patients.</p><p><strong>Methods: </strong>303 patients with T2DM were divided into LEAD group (n=192) and non-LEAD group (n=111) based on the results of lower extremity vascular color Doppler ultrasound. All patients were divided into a training set and a validation set at a 7:3 ratio. In the training set, Least absolute shrinkage and selection operator (LASSO) regression was applied to screen for predictive factors of LEAD, and a multivariate logistic regression model was constructed to analyze the predictive factors, with a nomogram being plotted. The discriminative ability and calibration of the model were evaluated using the receiver operating characteristic (ROC) curve area under the curve (AUC) and calibration curves in both the training and validation sets. Decision curve analysis (DCA) was used to evaluate the clinical net benefit.</p><p><strong>Results: </strong>The variables selected by the LASSO regression included age, pulse pressure difference (PP), TyG, and UHR. The multivariate logistic regression model indicated that age, PP, TyG, and UHR were predictive factors for LEAD in T2DM patients (P<0.05). ROC curve analysis suggested that the discriminatory ability was in the following order: the nomogram model (AUC=0.872), TyG (AUC=0.751), and UHR (AUC=0.709), which were greater than that of age and PP. TyG and UHR cut-off values were 9.836 and 216.248, respectively. The specificities of TyG and UHR were 0.760 and 0.547, and the sensitivities were 0.629 and 0.807, respectively. The calibration curve showed the model's predictions matched actual conditions. DCA verified the model's clinical benefit.</p><p><strong>Conclusion: </strong>Both TyG and UHR have good predictive value and are suitable for screening LEAD in T2DM patients.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1341-1351"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985110","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":"Profile of Serum Bile Acids in Elderly Type 2 Diabetic Patients with Various Obesity Types: A Cross-Sectional Study.","authors":"Mengxiao Guo, Yuejian Mao, Feng Xie, Ruirui Wang, Lei Zhang","doi":"10.2147/DMSO.S495623","DOIUrl":"https://doi.org/10.2147/DMSO.S495623","url":null,"abstract":"<p><strong>Objective: </strong>The distribution of body fat plays a critical role in the pathogenesis of type 2 diabetes mellitus (T2DM). However, the specific metabolic profiles and biomarkers that distinguish the different obesity phenotypes in T2DM remain to be fully elucidated. Bile acids (BAs), which are recognized as pivotal signaling molecules in the regulation of glucose and lipid metabolism, warrant further investigation to characterize their profiles across different obesity phenotypes. Understanding the clinical significance of these BAs in the management of T2DM is essential and merits thorough exploration.</p><p><strong>Design: </strong>In this cross-sectional study conducted at the Zhangjiang Community Health Service Center in Shanghai, ninety-nine elderly participants were recruited and categorized into four groups: non-diabetic controls (NC), T2DM with lean phenotype (TN), T2DM with overweight phenotype (TO), and T2DM with abdominal obesity phenotype (TA). Biochemical indices, visceral adiposity indices, and bile acid (BA) profiles were analyzed and compared across the groups.</p><p><strong>Results: </strong>Healthy individuals exhibited lower triglyceride levels, waist-to-hip ratio (WHR), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI), as well as higher HDL-c level and total BA levels compared to T2DM patients. T2DM patients with different obesity phenotypes displayed distinct BA profiles. Specifically, the TN group showed higher levels of conjugated DCA BA species, GDCA, and TDCA, compared to the TO group. These BA species are essential for regulating lipid and glucose metabolism. In contrast, the TA group exhibited higher ratios of 12α-hydroxylated BAs to non 12α-hydroxylated BAs, taurine-conjugated BAs to glycine-conjugated BAs, and higher levels of LCA compared to the TO group. Additionally, CVAI was positively associated with unconjugated SBAs, CA-7S, and DLCA.</p><p><strong>Conclusion: </strong>These results revealed that T2DM patients with different obesity phenotypes exhibit distinct BA profiles. Specific BAs, particularly GDCA, TDCA, and LCA, are closely associated with adiposity indices and may serve as crucial signaling molecules in modulating visceral adiposity, serum lipid profiles, and glucose homeostasis in obese T2DM patients. These BA species play a pivotal role in the pathogenetic process underlying diabetes and various forms of obesity. Furthermore, their significance highlights their potential contributors to drug development and as therapeutic targets for T2DM patients with specific obesity subtypes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1353-1364"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971085","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":"Combining Network Pharmacological Analysis and Animal Experiments to Explore the Pharmacological Mechanism of Zhangyanming Tablets in Diabetic Retinopathy.","authors":"Mengmeng Yang, Hualin Liu, Jiewen Zhou, Kewei Wang, Yujing Sun, Na Ning, Qiuling Huang, Jiajia Hu, Jidong Liu, Fei Yan, Xinguo Hou, Li Chen, Lingshu Wang, Fuqiang Liu","doi":"10.2147/DMSO.S495286","DOIUrl":"https://doi.org/10.2147/DMSO.S495286","url":null,"abstract":"<p><strong>Background: </strong>Zhangyanming Tablets (ZYMT) is a proprietary Chinese medicine containing a variety of traditional Chinese medicines, which can be used to treat a wide range of eye diseases, but its exact effect on diabetic retinopathy (DR) and the specific mechanism are still unclear. This study aims to investigate the ameliorative effects and specific mechanisms of ZYMT on DR.</p><p><strong>Methods: </strong>Key regulatory genes and potential therapeutic targets of ZYMT for DR were evaluated using network pharmacological analysis. Diabetic db/db mice were given low-dose ZYMT (330 mg/kg) and high-dose ZYMT (660 mg/kg), and relevant metabolic indices were tested. Histochemical staining and optical coherence tomography angiography (OCTA) were used to evaluate the histopathological structure of mice retina, RT-qPCR, TUNEL staining and immunofluorescence staining were used to evaluate the anti-apoptosis and anti-angiogenesis effect of ZYMT on DR.</p><p><strong>Results: </strong>The results of network topology analysis showed that the top 10 Traditional Chinese Medicine (TCM) ingredients of ZYMT were quercetin, luteolin, kaempferol, wogonin, naringenin, β-sitosterol, baicalein, isorhamnetin, acacetin, and stigmasterol. ZYMT treats DR through key nodes such as AKT1, TNF, MAPK8, RELA, VEGFA, HIF1A, IL6, CASP3, BCL2, STAT3, and ICAM1. ZYMT has a direct effect on DR rather than secondary improvement of metabolic indices. Tissue staining demonstrated that ZYMT improved retinal vascular morphology and delayed retinal thinning in db/db mice. The OCTA imaging also showed that ZYMT increased blood flow density in db/db mice. TUNEL staining and RT-qPCR results showed that ZYMT could reduce the apoptosis of retinal cells in db/db mice, and RT-qPCR and immunofluorescence staining showed that ZYMT could inhibit retinal neovascularization.</p><p><strong>Conclusion: </strong>This study found the potential target of ZYMT to ameliorate DR through network pharmacological analysis, and verified that ZYMT can improve DR by exerting anti-apoptosis and anti-neovascularization.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1323-1339"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972451","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":"EfficientNetB0-Based End-to-End Diagnostic System for Diabetic Retinopathy Grading and Macular Edema Detection.","authors":"Xin Long, Fan Gan, Huimin Fan, WeiGuo Qin, Xiaonan Li, Rui Ma, Leran Wang, Rui Hu, Yilin Xie, Lei Chen, Jian Cao, Yinan Shao, Kangcheng Liu, Zhipeng You","doi":"10.2147/DMSO.S506494","DOIUrl":"https://doi.org/10.2147/DMSO.S506494","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop and validate a deep learning-based automated diagnostic system that utilizes fluorescein angiography (FFA) images for the rapid and accurate diagnosis of diabetic retinopathy (DR) and its complications.</p><p><strong>Methods: </strong>We collected 19,031 FFA images from 2753 patients between June 2017 and March 2024 to construct and evaluate our analytical framework. The images were preprocessed and annotated for training and validating the deep learning model. The study employed a two-stage deep learning system: the first stage used EfficientNetB0 for a five-class classification task to differentiate between normal retinal conditions, various stages of DR, and post-laser treatment status; the second stage focused on images classified as abnormal in the first stage, further detecting the presence of diabetic macular edema (DME). Model performance was evaluated using multiple classification metrics, including accuracy, AUC, precision, recall, F1-score, and Cohen's kappa coefficient.</p><p><strong>Results: </strong>In the first stage, the model achieved an accuracy of 0.7036 and an AUC of 0.9062 on the test set, demonstrating high accuracy and discriminative ability. In the second stage, the model achieved an accuracy of 0.7258 and an AUC of 0.7530, performing well. Additionally, through Grad-CAM (gradient-weighted class activation mapping), we visualized the most influential image regions in the model's decision-making process, enhancing the model's interpretability.</p><p><strong>Conclusion: </strong>This study successfully developed an end-to-end DR diagnostic system based on the EfficientNetB0 model. The system not only automates the grading of FFA images but also detects DME, significantly reducing the time required for image interpretation by clinicians and providing an effective tool to improve the efficiency and accuracy of DR diagnosis.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1311-1321"},"PeriodicalIF":2.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987782","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":"Effect of Insulin Resistance on Prognosis of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with or Without Type 2 Diabetes Mellitus.","authors":"Yanli Sun, Wei Deng, Li Luo, Mingwei Chen","doi":"10.2147/DMSO.S513652","DOIUrl":"https://doi.org/10.2147/DMSO.S513652","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to investigate the significance of insulin resistance (IR) markers in predicting 48-hour hemorrhagic transformation and 3-month poor prognosis in acute ischemic stroke (AIS) patients of intravenous thrombolysis (IVT), with or without type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 1352 patients with AIS treated with IVT between January 2019 and December 2023 were retrospectively reviewed. We analyzed the prognostic value of IR markers, including the triglyceride-glucose (TyG) index, triglyceride and body mass index (TYG-BMI), and the insulin resistance metabolic score (METS-IR), in AIS patients who received IVT with or without T2DM. The primary outcome was 48-hour hemorrhagic transformation and 3-month poor prognosis (modified Rankin Scale [mRS] ≥ 3).</p><p><strong>Results: </strong>Among 1181 enrolled patients, 328 were diagnosed with T2DM, representing 27.8% of the cohort. T2DM group showed a higher proportion of poor prognosis (23% vs.11%, p < 0.001), but no significant difference in hemorrhagic transformation between the two groups. TyG index, TyG-BMI, and METS-IR all demonstrated predictive value for 3-month poor prognosis, with the TyG index showing the highest predictive accuracy [area under the curve (AUC): 0.848]. The optimal cutoff point for predicting poor prognosis was 7.409, with sensitivity of 0.762 and specificity of 0.855 (p < 0.001). However, all three indexes were limited in their ability to predict hemorrhagic transformation.</p><p><strong>Conclusion: </strong>Elevated TyG index is an independent risk factor for 3-month poor prognosis in AIS patients of IVT with or without type T2DM, with the TyG index showing the highest predictive value. These findings provide a new understanding that IR can be used as a therapeutic target for AIS patients of IVT.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1299-1309"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978604","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":"Lipotoxicity: A New Perspective in Type 2 Diabetes Mellitus.","authors":"Biaohua Chen, Tiangang Li, Yingli Wu, Liyun Song, Yinying Wang, Yao Bian, Yong Qiu, Zhongshan Yang","doi":"10.2147/DMSO.S511436","DOIUrl":"https://doi.org/10.2147/DMSO.S511436","url":null,"abstract":"<p><p>Type 2 diabetes mellitus is a non-communicable metabolic disorder characterized by insulin resistance (IR) associated with defects in insulin production and secretion. Recent studies have shown that lipotoxicity, which is characterized by the abnormal accumulation of lipids in non-adipose tissues, leads to bodily dysfunction and metabolic disorders, thereby promoting the progression of T2DM. This process is mediated by the induction of endoplasmic reticulum (ER) stress, oxidative stress (OS), mitochondrial dysfunction, and inflammatory responses in pancreatic β-cells, ultimately leading to the activation of apoptosis pathways, which results in β-cell dysfunction and cell death. Furthermore, lipotoxicity interferes with insulin signaling pathways, which worsens IR. Current clinical approaches aimed at mitigating lipotoxicity-induced IR and β-cell dysfunction include the use of metformin, glucagon-like peptide-1 analogs, thiazolidinediones, and molecular chaperones, in addition to interventions such as caloric restriction and physical activity, which reduce fat accumulation in the pancreas and enhance β-cell function. Investigating the interplay between lipotoxicity and T2DM is essential for understanding the underlying disease mechanisms and providing new insights into prevention and therapeutic strategies. This review offers a comprehensive analysis of the mechanisms underlying lipotoxicity in T2DM, highlighting how these insights may drive future research and inform the development of novel treatment approaches.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1223-1237"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989178","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}