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

{"title":"The Shengmai San Exerts Therapeutic Effects on Type 2 Diabetes by Modulating the PI3K/AKT/GSK3B Signaling Pathway.","authors":"Hongchao Shang, Tianyu Wang, Daoran Pang, Yue Qi, Lu Liu, Yifei Wang, Yan Gao","doi":"10.2147/DMSO.S507953","DOIUrl":"10.2147/DMSO.S507953","url":null,"abstract":"<p><strong>Context: </strong>Shengmai San (SMS) is a traditional Classic Recipes made with Panax ginseng, Ophiopogon, and Schisandra. The precise mechanism of action of SMS remains unclear, despite its noteworthy therapeutic advantages for type 2 diabetes mellitus (T2DM).</p><p><strong>Objective: </strong>The objective of this study was to confirm the mechanism of SMS in the treatment of T2DM.</p><p><strong>Materials and methods: </strong>UPLC-MS/MS was employed to identify the active components in SMS. Using network pharmacology, the intervention pathways of SMS in T2DM rats were investigated. A high-sugar, high-fat diet and intrabitoneal injection of streptozotocin were used to create a T2DM rat model. The serum parameters of each group were assessed following the completion of the experiment. The mRNA and protein expression levels of genes related to the PI3K/AKT/GSK3B pathway were analyzed using qRT-PCR and Western blot.</p><p><strong>Results: </strong>There were 39 components found in SMS San by UPLC-Q-Orbitrap/MS. Network pharmacology and molecular docking study indicate that the PI3K/AKT/GSK3B pathway may be a part of SMS's therapeutic mechanism for the treatment of T2DM. Rats' serum levels of TC, TG, LDL-C, MDA, TNF-α, and IL-6 dramatically dropped after taking SMS, whereas SOD and HDL-C levels rose. The improvement of these parameters may be relate<i>d</i> to SMS activation of downstream target proteins, PI3K, and AKT.</p><p><strong>Conclusion: </strong>SMS can help cure T2DM mellitus by regulating the PI3K/AKT/GSK3B pathway, improving islet tissue injury, reducing oxidative stress, and easing lipid metabolism issues. This study not only revealed the unique therapeutic mechanism of SMS by regulating the PI3K/AKT/GSK3β signaling pathway, but also provided new theoretical support for multi-target and personalized treatment of diabetes. Its novelty lies in the first exploration of the mechanism of action of traditional Chinese medicine prescriptions through the lens of modern molecular biology, emphasizing the potential of natural medicines in diabetes treatment.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"985-1004"},"PeriodicalIF":2.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794920","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":"Opaganib Promotes Weight Loss and Suppresses High-Fat Diet-Induced Obesity and Glucose Intolerance.","authors":"Lynn W Maines, Staci N Keller, Ryan A Smith, Charles D Smith","doi":"10.2147/DMSO.S514548","DOIUrl":"10.2147/DMSO.S514548","url":null,"abstract":"<p><strong>Introduction: </strong>Sphingolipid metabolism has been implicated in many diseases including cancer, pathologic inflammation, viral infection, neurologic pathologies and metabolic pathologies, including obesity and diabetes. We have previously shown that opaganib (aka ABC294640) inhibits three key enzymes in the sphingolipid metabolism pathway: sphingosine kinase-2, dihydroceramide desaturase and glucosylceramide synthase. We and others have demonstrated anticancer, anti-inflammatory and antiviral activities of opaganib in multiple experimental models. Furthermore, opaganib has been studied in clinical trials with patients having cancer or severe Covid-19. In the present studies, the effects of opaganib in the well-established model of High-Fat Diet (HFD)-induced obesity have been studied.</p><p><strong>Methods: </strong>Male or female C57BL/6 mice were fed Control Diet (CD) or HFD and treated with vehicle or opaganib by oral gavage once daily, 5 days per week. Body weights were monitored and glucose tolerance was measured periodically for up to 16 weeks. In some experiments, obese HFD-fed mice were treated with vehicle, opaganib alone, semaglutide alone or opaganib plus semaglutide.</p><p><strong>Results: </strong>Treatment with opaganib markedly suppressed weight gain in male mice fed the HFD but not in mice given the CD. Compared with mice given CD, mice on the HFD demonstrated poor glucose tolerance at 8, 12 and 16 weeks, consistent with the progression of obesity. Importantly, opaganib treatment of the HFD-fed mice abolished this developing glucose intolerance at all times of measurement. Opaganib treatment also reduced the elevation of hemoglobin A1c and the deposition of inguinal fat in HFD-fed mice. Similar results were obtained with female mice, indicating equivalent efficacy of opaganib in both sexes. Additionally, opaganib and semaglutide were equally effective in promoting body weight loss and improving glucose tolerance in obese mice. Opaganib administered either concurrently with semaglutide or as a single drug following cessation of semaglutide treatment eliminated weight rebound.</p><p><strong>Conclusion: </strong>Overall, the data indicate that opaganib effectively suppresses the loss of metabolic control in mice on HFD, suggesting that opaganib may be useful alone or in combination with existing therapies for weight management and improve conditions associated with obesity and diabetes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"969-983"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794918","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":"A Machine Learning Model for Predicting Diabetic Nephropathy Based on TG/Cys-C Ratio and Five Clinical Indicators.","authors":"Dongmei Zhou, Lingyu Shao, Libo Yang, Yongkang Chen, Yue Zhang, Feng Yue, Weipeng Gu, Shuyi Li, Shuyan Li, Jing Wei","doi":"10.2147/DMSO.S502649","DOIUrl":"10.2147/DMSO.S502649","url":null,"abstract":"<p><strong>Objective: </strong>Distinguishing diabetic nephropathy (DN) from non-diabetic renal disease (NDRD) remains challenging. This study developed and validated a machine learning model for differential diagnosis of DN and NDRD.</p><p><strong>Methods: </strong>We included 100 type 2 diabetes mellitus (T2DM) patients with proteinuria from four Xuzhou hospitals (2013-2021), divided into DN (n=50) and NDRD (n=50) groups based on renal biopsy. Clinical data were used to build a predictive model. External validation was performed on 55 patients from The Affiliated Taian City Central Hospital of Qingdao University (2019-2023). Models were constructed using Python's scikit-learn library (v1.4.2), with feature selection via Recursive Feature Elimination (RFE).</p><p><strong>Results: </strong>Compared to NDRD, DN patients had lower TG/Cys-c ratio [1.45 (0.75, 1.99) vs 2.78 (1.81, 4.48)], higher systolic blood pressure (156.80 ± 20.14 vs 137.66 ± 17.67), longer diabetes duration [78 (24, 120) vs 18 (6, 48) months], higher diabetic retinopathy prevalence (60% vs 40%), higher HbA1c [7.98 (6.50, 10.40) vs 7.10 (6.70, 7.90)], and lower hemoglobin (115.66 ± 22.20 vs 135.64 ± 18.59). The logistic regression (LR) model, incorporating TG/Cys-c ratio, SBP, diabetes duration, DR, HbA1c, and Hb, achieved an AUC of 0.9305, accuracy of 0.8333, sensitivity of 0.8283, and specificity of 0.8701. External validation showed an AUC of 0.9642, accuracy of 0.9455, sensitivity of 0.9615, and specificity of 0.9310. We named this method PDN (Prediction of Diabetic Nephropathy) and developed an online platform: http://cppdd.cn/service/PDN.</p><p><strong>Conclusion: </strong>This machine learning-based method effectively differentiates DN from NDRD, aiding clinicians in diagnosis and treatment planning.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"955-967"},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794917","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 Distinct Ultrasound Characteristics and Prognostic Features of Insulin-Induced Lipohypertrophy: A Systematic Review.","authors":"Haiyan Yang, Linlin Zhang, Qingmei Dong, Yuqin She, Yu Zhang, Min Cao, Mingming Xu, Shufang Chu","doi":"10.2147/DMSO.S413623","DOIUrl":"10.2147/DMSO.S413623","url":null,"abstract":"<p><strong>Background: </strong>Insulin-induced lipohypertrophy (LH) is a common complication of insulin therapy. However, its ultrasound characteristics, classification, and progression patterns remain poorly understood. This review aimed to systematically analyze the ultrasound characteristics and progression patterns of LH, and explore the relationship between different LH types and clinical outcomes.</p><p><strong>Methods: </strong>A systematic literature search was conducted from January 2000 to October 2024 in PubMed, Web of Science, Embase, and Cochrane Library following PRISMA guidelines. Studies that examined LH using ultrasound in diabetic patients receiving insulin therapy were included. Two independent reviewers performed study selection and quality assessment using standardized tools.</p><p><strong>Results: </strong>Twenty studies involving 5067 patients were included. Ultrasound showed significantly higher detection rates (57.6-100%) than physical examination (27.9-79.7%), with subclinical LH reported in 13.0-55% of cases. Twelve studies provided detailed ultrasound characteristics, with most describing well-defined borders, echo patterns predominantly showed hyper-echogenicity, and noted reduced or absent blood flow. Two ultrasound patterns were identified based on nodule size and echo patterns. Follow-up studies demonstrated distinct progression patterns and varying metabolic improvements among different LH types.</p><p><strong>Conclusion: </strong>Ultrasound reveals three distinct patterns (nodular, diffuse, and hypoechoic), each with unique prognostic features, providing a basis for individualized management.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"941-954"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771164","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":"Evaluation of Effects of a High-Protein Hypocaloric Diet on Body Composition and Cardio-Metabolic Factors in Women with Polycystic Ovary Syndrome and Overweight or Obesity.","authors":"Fang Wang, Wei Wei, Peng Ju Liu","doi":"10.2147/DMSO.S501972","DOIUrl":"10.2147/DMSO.S501972","url":null,"abstract":"<p><strong>Background: </strong>The optimal composition of a hypocaloric diet for women with polycystic ovary syndrome (PCOS) remains uncertain. The aim of this study was to evaluate and compare the impacts of a hypocaloric high-protein diet (HPD) versus an isocaloric conventional calorie-restricted diet (CRD) with normal protein intake on the body composition and biochemical profiles of women diagnosed with PCOS combined with overweight or obesity.</p><p><strong>Methods: </strong>This was a dietary intervention study evaluating the effects of two types of diets on women with PCOS who initiated weight loss independently at the Clinical Nutrition Clinic of Peking Union Medical College Hospital from March 2023 to March 2024 was carried out. Specifically, the records of 72 women with PCOS who were overweight or obese and underwent a 3-month weight management program were examined in a retrospective manner. The hypocaloric dietary intervention was adopted to achieve weight reduction, with either HPD or CRD. Body composition, serum lipids, glucose, insulin, and total testosterone (TT) were evaluated at baseline and post-intervention, and the differences were compared between and within groups.</p><p><strong>Results: </strong>Both groups achieved significant weight loss, with the HPD group losing an average of -8.9 ± 4.6 kg and the CRD group losing -10.0 ± 9.4 kg, without a significant difference between them (<i>P</i> > 0.05). However, the HPD was superior in preserving fat-free mass (FFM) and fat-free mass index (FFMI), with losses of -1.5 ± 1.6 kg and -0.7 ± 1.1 kg/m², respectively, compared to the CRD group's losses of -4.4 ± 4.2 kg and -2.1 ± 1.9 kg/m² (<i>P</i> < 0.01). Additionally, the HPD group showed a more significant reduction in body fat percentage (-5.3 ± 3.3% vs -3.2 ± 4.5%, <i>P</i> < 0.05). Biochemical indicators were comparable in both groups.</p><p><strong>Conclusion: </strong>Compared to an isocaloric standard-protein CRD, the dietary intervention with a HPD appears to be more helpful in preserving FFM in women with PCOS during a short-term weight loss program. Further well-designed trials are needed to verify our findings.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"931-939"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762732","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":"Effects of SGLT2 Inhibitors on Cardiovascular and Lower Limb Events in Patients with Type 2 Diabetes: A Nationwide Population-Based Study.","authors":"Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Yang Ho Kang, Joo Yeon Kim, Su Hyun Kim, Soo Yong Lee, Seung Hun Woo, Minae Park, Sojeong Park, Dong Hee Kim, Dasol Kang, Sujin Park, Dongwon Yi","doi":"10.2147/DMSO.S515384","DOIUrl":"10.2147/DMSO.S515384","url":null,"abstract":"<p><strong>Purpose: </strong>The cardiovascular (CV) benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) are well established, but their effects on lower limb events (LLEs) remain inconclusive, with conflicting findings from clinical trials and real-world studies. This study aimed to assess the risks of CV and LLEs associated with SGLT2i compared to dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with type 2 diabetes.</p><p><strong>Patients and methods: </strong>The study included patients with type 2 diabetes who were newly prescribed SGLT2i or DPP-4i using data from the National Health Insurance Service in South Korea. A 1:1 propensity score matching method was used to assign 97,584 patients to the SGLT2i and DPP-4i groups. The study endpoints included all-cause mortality, CV events, and LLEs-a composite outcome encompassing diabetic foot or ulcer, amputation, debridement, graft transplantation or flap operation, and revascularization.</p><p><strong>Results: </strong>Over a median follow-up of 2.74 years, the SGLT2i group had a lower incidence of all-cause mortality (hazard ratio [HR] 0.63, 95% CI 0.51-0.78), heart failure (HR 0.85, 95% CI 0.78-0.93), ischemic stroke (HR 0.77, 95% CI 0.67-0.88), and peripheral artery disease (HR 0.66, 95% CI 0.63-0.69) than the DPP-4i group. However, no significant difference was observed in the incidence of myocardial infarction (HR 1.06, 95% CI 0.87-1.28) or LLEs (HR 1.05, 95% CI 0.80-1.38) between the two groups.</p><p><strong>Conclusion: </strong>In this nationwide, real-world study, SGLT2i use demonstrated a neutral effect on LLEs compared to DPP-4i in patients with type 2 diabetes. However, SGLT2i was associated with a lower risk of all-cause mortality, heart failure, ischemic stroke, and peripheral artery disease. These findings contribute to the ongoing debate on the safety of SGLT2i regarding LLEs and highlight their broader CV benefits, warranting further investigation into their long-term effects on lower limb complications.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"917-929"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762729","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":"Metabolomics Analysis of the Mechanism of Yuquan Capsules in the Treatment of T2DM Rats Using UPLC/MS.","authors":"Mengli Zhang, Zhien Tan, Min Ou, Taiping Li, Xiaonan Yang, Lu Chen, Rui Xiao, Na Lu, Xijun Wang, Fangfang Wu","doi":"10.2147/DMSO.S512089","DOIUrl":"10.2147/DMSO.S512089","url":null,"abstract":"<p><strong>Purpose: </strong>Yuquan capsule (YQC) is a well-known proprietary Chinese medicine used for the treatment of type 2 diabetes mellitus. The aim of this study was to investigate the potential mechanism and efficacy of YQC in the treatment of T2DM by means of metabolomics.</p><p><strong>Methods: </strong>Thirty-two male SD rats were randomly divided into four groups of control, type 2 diabetic mellitus (T2DM), metformin (Met), and YQC. Establishment of the T2DM model by high-fat diet (HFD) and streptozotocin (STZ). Fasting blood glucose (FBG) and weight were measured weekly, urine output was collected and recorded. The blood, kidney, pancreas, and liver tissue samples were collected at the end of the experiment. Blood samples were analyzed with methods of ELISA, pancreas, and liver tissues were analyzed by pathological sections, and serum was analyzed by metabolomics using ultra-performance liquid chromatography quadrupole time-of-flight coupled with mass spectrometry (UPLC-Q/TOF-MS).</p><p><strong>Results: </strong>It was observed that YQC could reduce blood glucose levels by modulating blood lipid and transaminase indices, and by diminishing the concentration of inflammatory factors within hepatic and pancreatic tissues. Furthermore, YQC restores homeostasis by regulating lipid and amino acid metabolism, engaging 21 biomarkers and 10 metabolic pathways.</p><p><strong>Conclusion: </strong>YQC has the capacity to enhance blood lipid and transaminase levels, suppress the expression of inflammatory factors, and foster the homeostatic progression of metabolic circulation in rats with T2DM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"905-916"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751641","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":"Metformin for the Treatment of Type 2 Diabetes in Asian Adults: A Systematic Review.","authors":"Noel Somasundaram, Sanjay Kalra, Dina Shrestha, S Abbas Raza, Saptarshi Bhattacharya, Rakesh Sahay, Faria Afsana, Mohammad Wali Naseri, Guru Prasad Dhakal, Ketut Suastika, Jeyakantha Ratnasingam, Ali Abdulla Latheef","doi":"10.2147/DMSO.S479889","DOIUrl":"10.2147/DMSO.S479889","url":null,"abstract":"<p><p>Metformin is a cheap, orally administered, guideline recommended glucose-lowering drug (GLD), initiated as monotherapy in treatment naïve newly diagnosed type 2 diabetes (T2D), and in combination with other GLDs in T2D not controlled on metformin. The unique Asian T2D phenotype that is markedly different than Western population, and warrants T2D treatment approaches unique to the Asian population. However, the bulk of metformin literature is from Western population and may not be generalizable for Asians. The systematic review evaluated the efficacy and safety of metformin monotherapy and combination therapy in Asians. Literature on other GLDs recommended by the 2023 American Diabetes Association guidelines as add-on therapy to metformin were included from Asia. The systematic review concluded that metformin is effective and safe for long-term T2D control of T2D in Asians. Metformin monotherapy may be initiated and continued in treatment naïve Asian patients with T2D and/or obesity if the monotherapy is adequate for achieving glycemic control. Other GLDs may be added for better glycemic control for those who fail on monotherapy. Patients inadequately controlled on another first-line GLD can achieve glycemic control and target HbA1c of <7% by adding metformin in a once daily dose. The use of metformin reduces the risk of hypoglycemia, and its gastrointestinal side effects are mild and manageable in Asians.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"873-904"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751645","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":"Risk Factors for MAFLD and Advanced Liver Fibrosis in Adult-Onset Craniopharyngioma Patients: A Cross-Sectional Study.","authors":"Lijiao Chen, Wei Wu, Hongying Ye","doi":"10.2147/DMSO.S504968","DOIUrl":"10.2147/DMSO.S504968","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence of and risk factors for metabolic dysfunction-associated fatty liver disease (MAFLD) and advanced liver fibrosis (ALF) in postoperative adult-onset craniopharyngioma (AOCP) patients.</p><p><strong>Patients and methods: </strong>This cross-sectional study included 242 postoperative AOCP patients at Huashan Hospital (Shanghai, China). Clinical characteristics were compared between patients with and without MAFLD and ALF. Independent risk factors for MAFLD and ALF were identified using binary logistic regression analysis.</p><p><strong>Results: </strong>The prevalence of MAFLD in postoperative AOCP patients was 67.4% (95% CI 61.2-73.0%), and 32.5% (95% CI 25.8-40.0%) of patients with MAFLD were diagnosed with ALF. Body mass index (BMI) was independently associated with MAFLD (OR = 1.51, 95% CI 1.33-1.72, P < 0.001). In patients with MAFLD, hypertension (OR = 2.33, 95% CI 1.04-5.20, P = 0.040), glycated hemoglobin (HbA1c) (OR = 1.34, 95% CI 1.01-1.78, P = 0.044), daily hydrocortisone dose (OR = 1.08, 95% CI 1.01-1.15, P = 0.026), and insulin-like growth factor-1 (IGF-1)(OR = 0.99, 95% CI 0.97-0.99, P = 0.011) were independently associated with the presence of ALF.</p><p><strong>Conclusion: </strong>MAFLD is a common comorbidity in postoperative AOCP patients and is associated with a high risk of ALF. MAFLD is closely related to BMI, while ALF is significantly associated with hypertension, HbA1c levels, IGF-1 levels, and daily hydrocortisone dose. Strategies such as controlling weight gain, maintaining optimal blood glucose and blood pressure levels, appropriate hormone replacement, and avoiding excessive glucocorticoid use should be implemented to prevent and delay the onset and progression of MAFLD and ALF.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"859-871"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751707","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":"An Exploration of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) Platelet Ratio Index (APRI) Scores with Dysglycemia and Diabetic Retinopathy: The Beichen Eye Study.","authors":"Limei Chen, Xiaoxia Miao, Manqiao Wang, Fei Gao, Emmanuel Eric Pazo, Liying Hu, Chen Chen, Yu Shi, Xiuqing Zhu, Xiaorong Li, Juping Liu","doi":"10.2147/DMSO.S502129","DOIUrl":"10.2147/DMSO.S502129","url":null,"abstract":"<p><strong>Background and purpose: </strong>Liver metabolism is closely linked to glucose levels. Studies have shown that the aspartate aminotransferase to platelet ratio index (APRI), as a marker of liver fibrosis, is associated with type 2 diabetes mellitus (T2DM). However, the existing evidence remains insufficient to establish this association definitively. Furthermore, no prior studies have investigated the potential relationship between APRI and diabetic retinopathy (DR). This study aimed to investigate the association of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to platelet ratio index (APRI) scores with dysglycemia and DR.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 5828 participants aged 50 and older. All participants underwent laboratory blood tests, ophthalmological examinations, and interviews using questionnaires. Multiple linear regression models and receiver operating characteristic (ROC) curves explored the association between ALT and AST APRI scores and dysglycemia. Binary logistic regression was used to analyze the association between ALT and AST APRI scores and DR. Analyses were conducted for males and females separately to examine sex-specific effects.</p><p><strong>Results: </strong>In the multiple linear regression models, ALT and AST APRI scores were associated with fasting blood glucose after adjusting various potential confounders in the whole population or subgroup analysis (all P <0.05). ALT APRI score was superior to AST APRI score in the discrimination of hyperglycemic participants. In the univariate analysis, the ALT and AST APRI scores were associated with DR in the female participants with diabetes (P = 0.043, P=0.022). However, binary logistic regression models found no evident significant association between the ALT and AST APRI scores and DR in the female participants with diabetes (all P>0.05).</p><p><strong>Conclusion: </strong>ALT and AST APRI scores are potential markers for the diagnosis of hyperglycemia, and ALT APRI score is superior to AST APRI score. ALT and AST APRI scores are not independent risk factors for DR.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"847-858"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751636","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}