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

{"title":"Comparison of MR Spectroscopy, 2-Point Dixon, and Multi-Echo T2* Sequences in Assessing Hepatic Fat Fraction Across a Diverse Range of Body Mass Index (BMI) and Waist Circumference Ratio (WCR) Values.","authors":"Beata Brzeska, Agnieszka Sabisz, Oliwia Kozak, Edyta Szurowska, Joanna Pieńkowska","doi":"10.2147/DMSO.S481062","DOIUrl":"10.2147/DMSO.S481062","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to compare and evaluate the accuracy of three magnetic resonance imaging (MRI) sequences-MR liver spectroscopy, 2-point Dixon, and multi-echo T2*-in assessing hepatic fat fraction in patients with various body mass indexes (BMIs).</p><p><strong>Methods: </strong>167 participants were recruited, including 110 healthy subjects with diverse BMIs and 57 bariatric surgery candidates. The MRI protocol involved three sequences: multi-echo single voxel STEAM 1H spectroscopy, 2-point mDixon, and multi-echo T2* sequence. Hepatic fat fraction was measured using these sequences and analyzed statistically to determine correlations and agreement between the methods.</p><p><strong>Results: </strong>A strong positive correlation was observed between BMI and waist circumference ratio (WCR) (r_s(165) = 0.910, p<0.001). MRS obtained hepatic fat fraction numerical values in 13.33% of the normal BMI group, 48.48% of the overweight group, and 72.97% of the obese group. Strong correlations were found between all methods, with significant agreement, particularly between MRS and multi-echo T2*.</p><p><strong>Conclusion: </strong>Robust correlations were observed between MR spectroscopy, 2-point Dixon, and multi-echo T2* methods for liver fat fraction measurement, especially in patients with higher BMI and WCR. These findings highlight the importance of BMI and WCR in interpreting fat fraction measurements, as method performance can vary across body composition profiles.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"601-614"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540351","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":"Proteomic Analysis of the Effects of Shenzhu Tiaopi Granules on Model Rats with Type 2 Diabetes Mellitus.","authors":"Jin-Dong Zhao, Zhao-Hui Fang","doi":"10.2147/DMSO.S493036","DOIUrl":"https://doi.org/10.2147/DMSO.S493036","url":null,"abstract":"<p><strong>Background: </strong>Shenzhu Tiaopi granule (STG) has antidiabetic functions. Data-independent acquisition proteomic technology is an integral part of systems biology. Herein, proteomics was used to analyse the effects of STG on type 2 diabetes mellitus (T2DM) and the mechanism by which STG normalizes glucose metabolism.</p><p><strong>Methods: </strong>Goto-Kakizaki (GK) T2DM model (Mod) rats, aged 15-16 weeks and with a fasting blood glucose (FBG) level of ≥11.1 mmol/L, were treated with metformin or STG for 12 weeks. Wistar rats aged 15-16 weeks were included in the control (Con) group. Body weight, FBG, total cholesterol (TC), total triglyceride (TG) levels and low-density lipoprotein (LDL-C) levels were measured, and pathological observation, Western blot analysis and data-independent acquisition proteomics of the liver were performed.</p><p><strong>Results: </strong>Significant differences in FBG, TC, TG, LDL-C (p < 0.01) and pathological liver morphology were observed between the Mod group and Con group, whereas both metformin and STG normalized the glucose and lipid metabolism indicators (p < 0.05 or p < 0.01). In total, 5856 proteins were identified via proteomic analysis, 97 of which were significantly differentially expressed in the liver and affected fatty acid metabolism, unsaturated fatty acid biosynthesis, the peroxisome proliferator-activated receptor (PPAR) signalling pathway, pyruvate metabolism, and terpenoid backbone biosynthesis. Screening identified 10 target proteins, including perilipin-2 (Plin2), pyruvate dehydrogenase kinase 4, farnesyl diphosphate synthase (Fdps) and farnesyl-diphosphate farnesyltransferase 1. Among these proteins, the key proteins were Plin2 and Fdps, which were found to be associated with the PPAR signalling pathway and terpenoid backbone biosynthesis via relationship networks. Plin2 and Fdps are closely related to hyperglycaemia. STG can downregulate Plin2 and upregulate Fdps (p < 0.01).</p><p><strong>Conclusion: </strong>STG ameliorated hyperglycaemia by significantly altering the expression of different proteins, especially Fdps and Plin2, in the livers of GK rats. These findings may reveal the potential of traditional Chinese medicine for treating T2DM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"583-599"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540513","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 Gestational Diabetes Mellitus in Mainland China: A Systematic Review and Meta-Analysis.","authors":"Linjuan Xia, Zehua Yang, Qincai Mu, Yulin Ji, Juncheng Lyu","doi":"10.2147/DMSO.S502043","DOIUrl":"10.2147/DMSO.S502043","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify and evaluate risk factors associated with gestational diabetes mellitus (GDM) in mainland China.</p><p><strong>Methods: </strong>Eight electronic databases were searched for literature published from January 2010 until December 2023. Heterogeneity was quantified using I². Data were pooled by fixed or random effects models and expressed as odds ratio and 95% confidence intervals.</p><p><strong>Results: </strong>A total of 69 observational studies with an overall sample size of 2,138,032 Chinese women and 219,303 patients with GDM were included in the analysis. After adjusting confounders, older maternal age (OR = 1.12, 95% CI: 1.09-1.15), maternal age ≥35 years (OR = 1.96, 95% CI: 1.74-2.21), higher pre-pregnancy body mass index (OR = 1.24, 95% CI: 1.17-1.32), pre-pregnancy overweight (OR = 1.78, 95% CI: 1.64-1.92) or obesity (OR 2.52, 95% CI: 2.06-3.08), family history of diabetes (OR = 1.85, 95% CI: 1.58-2.17), history of GDM (OR = 4.09, 95% CI: 2.13-7.82), and elevated levels of fasting plasma glucose (OR = 2.54, 95% CI: 2.13-3.01), hemoglobin (OR = 1.47, 95% CI: 1.14-1.89) and serum triglycerides (OR = 1.69, 95% CI: 1.31-2.16) in early pregnancy were associated with an increased risk of GDM in mainland China. But gravidity ≥2 (OR = 1.06, 95% CI: 0.89-1.27), conception by assisted reproductive technology analyses (OR = 1.54, 95% CI: 0.95-2.51) were not associated with GDM, and parity ≥1 (OR = 0.88, 95% CI: 0.82-0.94) was related to lower risk of GDM. In available unadjusted studies, history of abortion (OR = 1.34, 95% CI: 1.31-1.37) increased risk of GDM, non-Han ethnicity (OR = 0.78, 95% CI: 0.59-1.03) and high school or lower education level (OR1.09, 95% CI: 0.94-1.26) showed no correlation with GDM.</p><p><strong>Conclusion: </strong>The key risk factors for GDM in mainland China included older maternal age, maternal age ≥35 years, pre-pregnancy overweight or obesity, family history of diabetes, history of GDM, elevated levels of FPG, Hb, and serum TG in early pregnancy. Early identification and intervention for women at high risk should be performed to prevent the development of GDM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"565-581"},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515032","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 Body Mass Index and Glycemic Control in Type 2 Diabetes Mellitus: A Cross-Sectional Study.","authors":"Li Deng, Long Jia, Xiao-Li Wu, Ming Cheng","doi":"10.2147/DMSO.S508365","DOIUrl":"10.2147/DMSO.S508365","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI) is a known risk factor for poor glycemic control in patients with Type 2 diabetes mellitus (T2DM). However, the extent to which BMI correlates with glycated hemoglobin (HbA1c) levels and its clinical implications require further investigation.</p><p><strong>Objective: </strong>This study aimed to assess the relationship between BMI and HbA1c levels in T2DM patients and to explore the clinical significance of BMI management in optimizing glycemic control.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 200 T2DM patients from Jinniu District Hospital between 2024/04/01 and 2024/10/03. BMI and HbA1c levels were recorded, and patients were categorized into normal weight (BMI < 25 kg/m²), overweight (25 ≤ BMI < 30 kg/m²), and obese (BMI ≥ 30 kg/m²). Pearson correlation analysis was used to assess the relationship between BMI and HbA1c. One-way ANOVA was employed to compare HbA1c levels across BMI categories.</p><p><strong>Results: </strong>A significant positive correlation between BMI and HbA1c was observed (r = 0.45, P < 0.001). Obese patients had significantly higher HbA1c levels (8.5 [7.8-9.0]%) compared to overweight (7.7 [7.2-8.1]%, P < 0.01) and normal-weight patients (6.9 [6.4-7.5]%, P < 0.001). The graded relationship indicated worsening glycemic control with increasing BMI.</p><p><strong>Conclusion: </strong>Higher BMI is associated with poorer glycemic control in T2DM patients. Obese patients, in particular, may benefit from more intensive weight management strategies to reduce HbA1c levels and prevent diabetes-related complications. These findings underscore the importance of integrating BMI reduction into diabetes management plans to improve clinical outcomes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"555-563"},"PeriodicalIF":2.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499687","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 Role of Placental MFF-Mediated Mitochondrial Fission in Gestational Diabetes Mellitus.","authors":"Lijie Wei, Chenyun Fang, Yi Jiang, Huiting Zhang, Peng Gao, Xuan Zhou, Shenglan Zhu, Yuanyuan Du, Rui Su, Lili Guo, Mengzhou He, Shaoshuai Wang, Ling Feng, Jun Yu","doi":"10.2147/DMSO.S484002","DOIUrl":"10.2147/DMSO.S484002","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetes mellitus (GDM) refers to hyperglycemia first recognized during pregnancy, characterized by decreased insulin sensitivity and impaired glucose metabolism. Dynamic fusion and fission processes within mitochondria play critical roles in maintaining glucose metabolism homeostasis. Given the fundamental role of mitochondrial fission factor (MFF) in mitochondrial fission, the intention of this study was to investigate mitochondrial dynamics in the placentae of GDM patients and explore the role of MFF in the etiopathogenesis and progression of GDM through the modulation of glucose metabolism and insulin resistance.</p><p><strong>Methods: </strong>40 Placental tissues were obtained from pregnant women undergoing cesarean section with GDM (n=20) and those with normoglycemia (n=20). To mimic the intrauterine high glucose environment, immortalized human-derived first-trimester extravillous trophoblast cells HTR8/SVneo were used and treated in a high glucose environment. Immunofluorescence was utilized to analyze MFF expression in placental tissues and mitochondrial length in HTR8/SVneo cells. The expression levels of glucose transporters (GLUTs) and other pivotal proteins involved in mitochondrial dynamics and the insulin signaling pathway, were assessed by Western blotting. Additionally, cellular glucose uptake capacity was determined using a glucose assay kit.</p><p><strong>Results: </strong>MFF expression was greater in the GDM group than in the normoglycemic group. In a high-glucose environment, the expression of fusion-related proteins OPA1, MFN1 and MFN2 decreased while the expression of DRP1 and MFF increased, indicating that the mitochondrial dynamics of trophoblast cells shift toward fission. Elevated mitochondrial fission hinders the insulin signaling pathway, resulting in a reduction in glucose uptake by HTR8/SVneo cells and a concurrent decrease in GLUT4 expression.</p><p><strong>Discussion: </strong>Our study demonstrates that MFF-mediated mitochondrial fission inhibits insulin sensitivity and upregulates glucose transport in GDM, which is related to offspring exposure to a hyperglycemic intrauterine environment. These results provide a novel therapeutic target for addressing GDM that may mitigate unfavorable pregnancy outcomes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"541-554"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491060","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":"Serum Lipidomic Analysis of T2DM Patients: A Potential Biomarker Study.","authors":"Wenwen Qi, Chunjing Yang, Jingfeng Li, Li Bao","doi":"10.2147/DMSO.S505863","DOIUrl":"10.2147/DMSO.S505863","url":null,"abstract":"<p><strong>Purpose: </strong>Comprehensive analysis of serum lipidomics is important for the treatment and prevention of type 2 diabetes (T2DM). The purpose of this study was to provide a profile of lipid changes in the serum of T2DM patients and identify potential lipid biomarkers.</p><p><strong>Patients and methods: </strong>In this study, we collected clinical physiological parameters and determined the serum lipid profiles of 30 T2DM patients and 30 matched healthy volunteers using the UPLC-MS method. <i>T</i> test and multivariate statistical analyses were used to identify candidate lipid predictors using the GraphPad Prism 9.5 software and MetaboAnalyst 5.0 online platform.</p><p><strong>Results: </strong>Based on the above test, 1162 lipid metabolites were detected, of which 267 were significantly altered in the T2DM group (FDR < 0.05), which belonged to the five main lipid classes. Eleven lipids were identified as potential lipid biomarkers with the specific screening criteria (variable importance in the projection (VIP) >1.0; P < 0.05; log₂(Fold Change) > 1) in the MetaboAnalyst 5.0 online platform. The Pearson rank correlation test showed that ten differential lipids were significantly correlated with T2DM-related physiological parameters (2h-loaded blood glucose and HbAc1 (glycated haemoglobin)). ROC curve analyses revealed that the combined 11 lipids or LPI classes can be as candidate features for the development of an integrated diagnostic biosignature for T2DM.</p><p><strong>Conclusion: </strong>The results of this study revealed important changes in lipids in T2DM patients, expanded the knowledge of lipid levels and T2DM progression, and provided important metabolic information for the therapy and diagnosis of T2DM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"529-539"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481775","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":"Insights Into Non-Alcoholic Fatty Liver Disease and Diabetes Mellitus in Somalia: Prevalence and Risk Factors.","authors":"Mohamed Osman Omar Jeele, Hawa Nuradin Mohamed, Rukia Omar Barei Addow, Mohamed Omar Hassan, Bakar Ali Adam","doi":"10.2147/DMSO.S486956","DOIUrl":"10.2147/DMSO.S486956","url":null,"abstract":"<p><strong>Introduction: </strong>NAFLD is a rapidly expanding global health issue that is distinguished by the accumulation of hepatic fat that is not associated with alcohol consumption. Parallel to the increase in obesity and type 2 diabetes mellitus (T2DM), its prevalence is also increasing. Amidst a backdrop of limited epidemiological data, Somalia, which is undergoing urbanization and dietary adjustments, is contending with escalating rates of NAFLD. Our study aims to addresses critical voids in local epidemiological data regarding this subject in Somalia.</p><p><strong>Methods and materials: </strong>The objective of this retrospective study was to evaluate the prevalence of NAFLD and concomitant risk factors among T2DM patients at the Mogadishu Somalia Turkish Training and Research Hospital. A total of 832 patients diagnosed with T2DM between May 2023 and March 2024 were used to analyze the data. Various variables, such as age, sex, diabetic medications, hypertension, insulin resistance, hyperlipidemia, and NAFLD grade, were obtained from electronic medical records. Statistical analyses were conducted to investigate the associations and predictors of NAFLD using descriptive analysis, logistic regression, and multiple regression.</p><p><strong>Results: </strong>The study cohort was predominately female (57%), with a mean age of 53.48 years. The most prevalent grades of NAFLD were grade 1 and grade 2, with NAFLD being identified in 53.8% of patients. NAFLD displayed a robust correlation with insulin resistance (OR: 52.04), with hypertension (OR: 20.091) and hyperlipidemia (OR: 2.528) following shortly thereafter. These factors collectively account for 57% of the variance in NAFLD, as indicated by multiple regression analysis (R² = 0.57, F (6,823) = 184.302, p < 0.001).</p><p><strong>Conclusion: </strong>This investigation emphasizes the presence of a high prevalence of NAFLD among T2DM patients in Mogadishu, Somalia, 53.8% which is substantially influenced by hypertension, insulin resistance, and hyperlipidemia. In this region, the necessity of targeted healthcare strategies to mitigate metabolic liver diseases is underscored by the results.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"507-514"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482498","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":"Murine Model Insights: Identifying Dusp15 as a Novel Biomarker for Diabetic Cardiomyopathy Uncovered Through Integrated Omics Analysis and Experimental Validation.","authors":"Lingling Zhu, Ya Dong, Hang Guo, Jie Qiu, Jun Guo, Yonghui Hu, Congqing Pan","doi":"10.2147/DMSO.S501563","DOIUrl":"10.2147/DMSO.S501563","url":null,"abstract":"<p><strong>Background: </strong>Diabetic Cardiomyopathy (DCM) is a heart condition that arises specifically from diabetes mellitus, characterized by cardiac dysfunction in the absence of coronary artery disease or hypertension. The prevalence of DCM is rising in tandem with the global increase in diabetes, necessitating the development of early diagnostic markers and therapeutic targets. This study integrates bioinformatics analysis with experimental validation to identify potential biomarkers for DCM.</p><p><strong>Methods: </strong>We performed gene expression data mining from the Gene Expression Omnibus (GEO) database. We employed Weighted Gene Co-expression Network Analysis (WGCNA) coupled with machine learning techniques to sift through hub differentially expressed genes (DEGs). Functional enrichment and protein-protein interaction (PPI) network analysis were also conducted to pinpoint key genes functions. Subsequent in vitro and in vivo experiments were performed to validate the findings.</p><p><strong>Results: </strong>Our analysis revealed six core genes significantly associated with DCM. The expression of Dusp15 was notably downregulated and validated in both high-glucose cultured cardiomyocytes and DCM animal models, suggesting its potential role in DCM pathogenesis.</p><p><strong>Conclusion: </strong>The integration of bioinformatics with experimental approaches has identified Dusp15 as a promising candidate for a DCM biomarker, offering valuable insights for early diagnosis and potential therapeutic development.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"515-527"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481838","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 Nomogram Incorporating Intracranial Atherosclerosis Score for Predicting Early Neurological Deterioration in Minor Stroke Patients With Type 2 Diabetes Mellitus.","authors":"Jia Shang, Zehao Zhang, Shifang Ma, Hailong Peng, Lan Hou, Fan Yang, Pei Wang","doi":"10.2147/DMSO.S494980","DOIUrl":"10.2147/DMSO.S494980","url":null,"abstract":"<p><strong>Purpose: </strong>Early neurological deterioration (END) frequently complicates acute ischemic stroke (AIS), worsening prognosis, particularly in patients with type 2 diabetes mellitus (T2DM), where hyperglycemia accelerates atherosclerosis, increasing both stroke risk and subsequent END. This study aimed to identify predictors of END in minor stroke patients with T2DM and develop a nomogram integrating these factors with intracranial atherosclerosis (ICAS) scores, evaluating its performance against various machine learning (ML) models.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from 473 minor stroke patients with T2DM treated at our hospital between January 2021 and December 2023. Utilizing LASSO and multivariate logistic regression, we identified characteristic predictors. The cohort was randomly allocated into training (n = 331) and validation (n = 142) groups. Six ML algorithms-SVM, LR, RF, CART, KNN, and Naive Bayes-were assessed, and nomograms were used to visualize the predictive model's performance, evaluated via Area Under the Curve (AUC), calibration plot, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>The ICAS score has been recognized as a pivotal determinant of END, alongside four other significant factors: NIHSS score, low-density lipoprotein cholesterol (LDL-C) levels, presence of branch atheromatous disease (BAD), and stenosis of the responsible vessel ≥50%. The model demonstrated robust predictive capabilities, achieving strong performance in training (AUC = 0.795) and validation (AUC = 0.799) sets. This advanced ML model, which integrates biochemical and imaging indicators, enables accurate risk assessment for END in minor stroke patients with T2DM.</p><p><strong>Conclusion: </strong>By integrating the ICAS score with the NIHSS score, LDL-C levels, presence of BAD, and stenosis of responsible vessels ≥50%, we developed a clinical model for predicting END in patients with minor stroke and T2DM. This model provides critical decision support for clinicians, facilitating early identification of high-risk patients, personalized treatment, and improved outcomes.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"491-506"},"PeriodicalIF":2.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Sensitivity to Thyroid Hormones and Non-Alcoholic Fatty Liver Disease and the Severity of Liver Fibrosis in Euthyroid Adults: A Retrospective Study.","authors":"Liyuan Zhou, Lanxuan Jiang, Yu An, Jia Liu, Guang Wang, Ying Wang, Ning Yang","doi":"10.2147/DMSO.S499517","DOIUrl":"10.2147/DMSO.S499517","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between non-alcoholic fatty liver disease (NAFLD) and thyroid function is controversial. A mild acquired thyroid hormone resistance may exist and explain these contradictions. This study aims to investigate the associations of thyroid hormone sensitivity with NAFLD and the severity of liver fibrosis in euthyroid populations.</p><p><strong>Patients and methods: </strong>Twenty-nine thousand three hundred and eighty-six adult subjects were recruited from the medical examination center of the Beijing Chao-Yang Hospital. Free triiodothyronine (FT3)/free thyroxine (FT4), thyroid feedback quartile-based index for FT4 (TFQI_FT4) and for FT3 (TFQI_FT3), thyroid stimulating hormone index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and thyrotropin triiodothyronine resistance index (TT3RI) were calculated. Logistic regression analysis was used to analyze the associations of thyroid hormone sensitivity indices with the risks of NAFLD and related metabolic disorders. The correlation between thyroid hormone sensitivity and the severity of liver fibrosis evaluated by noninvasive fibrosis indices was analyzed through ordinal logistic regression.</p><p><strong>Results: </strong>Euthyroid adults with NAFLD had elevated levels of serum FT3 and FT4, reduced TSH, and impaired sensitivity to thyroid hormones. Compared with participants in the first quartile group, the risk of NAFLD was higher in the fourth quartile of TFQI_FT3 (OR 1.25, 95% CI 1.13-1.39, P < 0.001) and FT3/FT4 (OR 1.45, 95% CI 1.32-1.60, P < 0.001) after adjusting for metabolic confounders. Among NAFLD patients, higher FT3/FT4 positively correlated with increased severity of liver fibrosis, with ORs per SD of 10.80 (95% CI 4.12-28.53, P < 0.001) for aminotransferase-to-platelet ratio index, 4.74 (95% CI 1.56-14.38, P = 0.006) for NAFLD fibrosis score and 3.21 (95% CI 1.02-10.08, P = 0.046) for fibrosis-4 index.</p><p><strong>Conclusion: </strong>Impaired central sensitivity to FT3 and higher FT3/FT4 were associated with increased risks of NAFLD and related metabolic disorders. In patients with NAFLD, higher FT3/FT4 correlated with its progression to liver fibrosis. These findings might provide novel insight into the monitoring and evaluation of the risk of NAFLD and the severity of liver fibrosis.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"479-490"},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482496","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}