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

{"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}

{"title":"Effectiveness of a Structured 2-Year Diabetes Health Education Program of Patients with Type 2 Diabetes Mellitus in Disease-Related Serum Markers.","authors":"Yu-Shan Hsieh, Chin-Lan Lo, Yan-Yu Lin","doi":"10.2147/DMSO.S519747","DOIUrl":"10.2147/DMSO.S519747","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies on the impact of diabetes education on disease management have shown that different educational approaches yield varying degrees of effectiveness across different populations. Adopting face-to-face education with long-term follow-up not only allows for monitoring changes in numerical values but also facilitates the observation of patients' learning status.</p><p><strong>Methods: </strong>This study investigates the impact of a two-year structured Diabetes Health Education (DHE) program on disease-related serum markers in patients with type 2 diabetes mellitus (T2DM). A five-year observational cohort study with retrospective analysis was conducted, involving 1,080 participants who completed the DHE program and 192 non-participants.</p><p><strong>Results: </strong>The DHE program included regular educational sessions every three months, covering topics such as blood glucose management, lipid profiles, and healthy lifestyle practices. Results demonstrated significant improvements among DHE participants: HbA1c levels decreased by 37%, fasting glucose by 4%, total cholesterol by 7%, LDL cholesterol by 13%, and triglycerides by 20%, with HDL cholesterol increasing by 3%. Body weight and diastolic blood pressure (DBP) also showed reductions of 4% and 3%, respectively, while systolic blood pressure (SBP) exhibited no significant changes. The improvements in lipid profiles were evident within six months, whereas glycemic markers required at least 1.5 years to achieve significance.</p><p><strong>Conclusion: </strong>These results suggest that a structured DHE program significantly improves glycemic control, lipid profile, and other metabolic-related markers in patients with T2DM. Notably, HbA1c and fasting glucose levels significantly improved after 1.5 years of consistent DHE participation, highlighting the importance of long-term engagement for glycemic benefits.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1849-1858"},"PeriodicalIF":2.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246927","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":"Correlation Analysis between Serum Uric Acid Levels and Bone Mineral Density in Children with Obesity.","authors":"Naijun Wan, Qian Zhang, Jin Zhang, Tian Zhang, Weijia Shi","doi":"10.2147/DMSO.S521357","DOIUrl":"10.2147/DMSO.S521357","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between serum uric acid (SUA) levels and bone mineral density (BMD) in children with obesity.</p><p><strong>Methods: </strong>229 children with obesity were included in the study, and their blood SUA, fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), calcium (Ca), phosphorus (P), 25-hydroxyvitamin D (25(OH)D) and other indicators were measured. Distal forearm BMD was assessed at the radius and ulna. Differences in these indicators were compared across different genders and age groups.</p><p><strong>Results: </strong>BMD showed significant differences between genders and age groups. The BMD Z-score in the 6-9 years group was higher than that in the 10-12 years group for both boys (-0.13 ± 0.92 vs -1.27 ± 0.62, p = 0.000) and girls (0.68 ± 0.96 vs -0.03 ± 0.73, p = 0.001). Serum SUA levels in the 6-9 years group were lower than those in the 10-12 years group for both boys (345.9 ± 65.7 vs 415.39 ± 74.02, p = 0.000) and girls (338.33 ± 63.33 vs 368.61 ± 75.45, p = 0.047). SUA was negatively correlated with BMD in all age groups of boys and in the 6-9 years group of girls (p<0.05). Multiple linear regression analysis showed that after controlling for other factors affecting BMD, SUA remained significantly negatively correlated with BMD Z-scores (p < 0.001).</p><p><strong>Conclusion: </strong>SUA is negatively correlated with BMD in children with obesity and is an independent factor affecting BMD. It may serve as a potential predictor of BMD in children with obesity.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1837-1847"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246926","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":"Extensive Dynamic Functional Network Connectivity Alterations in Diabetic Retinopathy Among Patients with Type 2 Diabetes.","authors":"Hao Liu, Zheng-Xue Gu, Xiao-Tong Li, Xin Huang","doi":"10.2147/DMSO.S501849","DOIUrl":"10.2147/DMSO.S501849","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a prevalent microvascular complication of diabetes. Prior neuroimaging research has indicated that patients with DR exhibit diverse levels of disrupted brain function alongside a variety of ocular symptoms. Nevertheless, past investigations have predominantly focused on static brain activity changes, leaving uncertainties regarding the modifications in dynamic large-scale brain networks among DR patients.</p><p><strong>Purpose: </strong>The aim of this study was to investigate the alterations in dynamic large-scale functional network connectivity in DR patients and its medical significance.</p><p><strong>Methods: </strong>Forty-six patients with DR (type 2 diabetes mellitus) and 46 healthy controls, matched for age, gender, and education level, were enrolled in this study. Initial application of Independent Component Analysis (ICA) methods was used to extract the resting state network (RSN) from resting state functional magnetic resonance imaging (fMRI) data. Subsequently, sliding time window and k-means cluster analysis were employed to derive five stable repetitions of the dynamic functional network connectivity (dFNC) states and compare the differences in dFNC between the two cohorts for each state. Finally, the study investigated between-group variances in three dynamic temporal metrics.</p><p><strong>Results: </strong>Significant between-group differences in dFNC were observed in states 1 and 2. Patients with DR, compared to healthy controls, exhibited reduced functional connectivity within the visual network (VN) and between the dorsal attention network (DAN) and VN, coupled with higher functional connectivity between the default mode network (DMN) and VN, cerebellum network (CN) and VN, and DMN-executive control network (ECN). Regarding the three dynamic temporal metrics, the study findings indicated that DR patients experienced a notable decline in the fraction of time and mean dwell time in state 1, while showing an increase in these metrics for state 3.</p><p><strong>Conclusion: </strong>Our study reveals extensive dynamic functional network connectivity alterations among patients with DR, potentially linked to visual impairment and cognitive deficits. These discoveries offer valuable insights into the neural mechanisms that drive changes in dynamic large-scale brain networks in individuals with DR.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1823-1835"},"PeriodicalIF":2.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215134","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":"Targeting AGE-RAGE Signaling Pathway with Hujin Decoction Ameliorates MAFLD in HepG2 Cells.","authors":"Zixuan Zhang, Jiaxi Shi, Fuxuan Liu, Jing Zhou, Qi Shen, Xuguang Shi","doi":"10.2147/DMSO.S506350","DOIUrl":"10.2147/DMSO.S506350","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the mechanism and substance basis of HJD for the treatment of MAFLD based on system pharmacology.</p><p><strong>Patients and methods: </strong>The ingredients of HJD in vitro and in vivo were detected by UPLC-MS/MS, then network pharmacology and molecular docking technology were used to predict the mechanism and substance basis, then the establishment of in vitro MAFLD model was confirmed by oil red O staining and ELISA technology, and finally the mechanism was verified by PCR, WB and flow cell technology.</p><p><strong>Results: </strong>System pharmacology determined that succinic acid, Ginsenoside Rh4, Caffeic acid, 7-Methoxycoumarin, 5-Acetylsalicylic acid and other ingredients were the basis of pharmacodynamic substances, while RAGE[Advanced glycosylation end product-specific receptor (RAGE)], BCL2[Apoptosis regulator Bcl-2 (BCL2)], and CASP3[Caspase-3 (CASP3)] were predicted as the core targets, and AGE-RAGE was the key pathway. In vitro experiments confirmed that HJD can reduce hepatocyte apoptosis by downregulating the AGE-RAGE signaling pathway to alleviate MAFLD.</p><p><strong>Conclusion: </strong>HJD may act on RAGE, BCL2, CASP3, and other key targets to regulate the AGE-RAGE signaling pathway through succinic acid, Ginsenoside Rh4 and Caffeic acid. This study provides a theoretical basis for the clinical application and quality control of HJD.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1783-1799"},"PeriodicalIF":2.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Bone Metabolism Marker PINP in the Risk of Diabetic Retinopathy: A Cross-Sectional Study.","authors":"Guanhua Chen, Yuan Zhang, Weimin Wang, Yali Jing","doi":"10.2147/DMSO.S518629","DOIUrl":"10.2147/DMSO.S518629","url":null,"abstract":"<p><strong>Background: </strong>Given the association between diabetic microvascular disease and bone metabolism, we aimed to investigate the correlation between the concentration of the serum bone turnover marker procollagen type I N-terminal propeptide (PINP) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) in this study.</p><p><strong>Methods: </strong>This was a cross-sectional study. T2DM patients aged ≥18 years were consecutively recruited from the inpatient population of the Department of Endocrinology at Nanjing Drum Tower Hospital, between January 2016 and January 2018, and participants were divided into DR and non-DR groups. We compared clinical and laboratory data of patients in the two groups. Logistic regression analysis was employed to investigate the overall risk of DR at the PINP quartiles. Receiver operating characteristic (ROC) curves were conducted to estimate the predictive power of PINP for DR.</p><p><strong>Results: </strong>A total of 509 patients with T2DM were included in this study (390 males and 194 females), including 148 patients with DR. Age and diabetes duration were independent risk factors for DR, PINP was also an independent protective factor (all P < 0.05). According to the interquartile range of PINP, all participants were divided into four groups. After adjustment for confounders, patients in Q2, Q3 and Q4 all had a decreased risk of DR compared with Q1 group (OR 0.501, 95% CI 0.280~0.894; OR 0.289, 95% CI 0.157~0.533; OR 0.077, 95% CI 0.036~0.165) respectively. Meanwhile, the AUC of DR diagnosed by the combined diagnostic model of PINP with age and duration of diabetes was 0.8271 (95% CI: 0.7911-0.863).</p><p><strong>Conclusion: </strong>The PINP level is associated with diabetic retinopathy in patients with T2DM, and PINP was an independent protective factor for DR and may help to predict its progression.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1801-1808"},"PeriodicalIF":2.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215185","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}