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

{"title":"The Impact of Sarcopenic Obesity on Weight Loss Outcomes and Recurrent Weight Gain Following Laparoscopic Sleeve Gastrectomy.","authors":"Xiaoqiang Wang, Xufeng Shu, Wenguang Pei, Chendong Yuan, Xujie Su, Jianbo Xiong, Wenzheng Chen, Guoyang Zhang, Zhigang Jie, Yi Liu","doi":"10.2147/DMSO.S511845","DOIUrl":"10.2147/DMSO.S511845","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenic obesity (SO) presents a significant public health challenge. Although the prevalence of SO is on the rise, there is a notable paucity of research examining the impact of SO on weight loss efficacy following laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Purpose: </strong>To investigate the impact of SO on weight loss outcomes and recurrent weight gain following LSG.</p><p><strong>Methods: </strong>We retrospectively gathered clinical data of 104 patients with obesity who underwent LSG in our hospital between January 2020 and September 2023. The ratio of fat mass to lean mass ≥0.8 was calculated for SO. Among them, the SO group (n=34) and the non-sarcopenic obesity (NSO) group (n=70), and the effect of SO on weight loss outcomes and recurrent weight gain were comparatively analyzed.</p><p><strong>Results: </strong>Within one year after LSG, SO patients had an apparently higher average body mass index, excess body mass index, and lower average percentage of excess weight loss than NSO patients (P<0.05). Furthermore, NSO patients had a statistically striking optimal weight loss rate more than SO patients in the first year after surgery (58.6% vs 35.3%, P=0.026). Within two years after LSG, SO patients had a lower occurrence rate of recurrent weight gain than NSO patients. Nonetheless, this difference was not statistically significant (P=0.212). Additionally, diabetes was an independent risk factor for recurrent weight gain postoperatively in patients with obesity when both univariate and multivariate analyses were conducted (P<0.05).</p><p><strong>Conclusion: </strong>SO adversely affects short-term weight loss outcomes after LSG. However, the effect of SO on postoperative recurrent weight gain was not statistically significant, indicating that further research is needed. Furthermore, diabetes is an independent risk factor for postoperative recurrent weight gain in patients with obesity.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2655-2665"},"PeriodicalIF":3.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793738","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":"Waist-to-Height Ratio - Reference Values and Associations with Cardiovascular Risk Factors in a Russian Adult Population.","authors":"Kamila Kholmatova, Alexandra Krettek, Irina V Dvoryashina, Sofia Malyutina, Sarah Cook, Ekaterina Avdeeva, Alexander V Kudryavtsev","doi":"10.2147/DMSO.S491261","DOIUrl":"10.2147/DMSO.S491261","url":null,"abstract":"<p><strong>Purpose: </strong>Waist-to-height ratio (WHtR) is an anthropometric index with limited data on its population distribution. The aim was to establish WHtR reference values and investigate WHtR associations with socio-demographic, lifestyle and clinical characteristics in Russian adults.</p><p><strong>Methods: </strong>We used data from the population-based cross-sectional Know Your Heart study (2015-2018, Arkhangelsk and Novosibirsk, N = 4495, 58.1% of women, 35-69 years, mean age 54.0). Age-adjusted WHtR reference values for the total study population and by sex were modeled as marginal 5th-95th percentiles (P5-P95) through quantile regressions. WHtR associations with cardiovascular biomarkers were assessed using linear regressions.</p><p><strong>Results: </strong>The conventional WHtR threshold of 0.5 for abdominal obesity was the value of P25, while P50 and P75 values were 0.54 and 0.60. In ages 35-49 years, P5-P50 values were higher in men. In the age group 60-69 years, P25-P95 values were higher in women. In both sexes, WHtR was associated with age, city of residence, not having university education and low physical activity; in women - with poor financial situation, in men - with being married, non-smoking and hazardous drinking. Among clinical parameters, C-reactive protein had the strongest positive association with WHtR in both sexes, while HDL cholesterol had the strongest negative association. Each standard deviation (SD) change in ln-transformed C-reactive protein was associated with 0.435 and 0.321 SD increase in WHtR in women and men, respectively. One SD increase in HDL cholesterol was associated with -0.334 SD change in WHtR in women and with corresponding change of -0.297 SD in men. In women, WHtR had stronger associations with age, university education, poor financial situation, blood pressure, HDL cholesterol, and ln-transformed C-reactive protein, in men - with being married, current smoking, LDL and non-HDL cholesterol, and HbA1c.</p><p><strong>Conclusion: </strong>Three-quarters of the study population had WHtR values exceeding the conventional threshold for abdominal obesity. Men and women differed in the WHtR associations with socio-demographic and lifestyle risk factors, biomarkers of inflammation, hypertension, dyslipidemia, and diabetes. WHtR is a useful cardiovascular risk indicator in a Russian adult population.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2641-2653"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793739","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":"Advances in the Epigenetic Mechanisms of Diabetic Nephropathy Pathogenesis.","authors":"Changlong Zhang, Song Xue, Peijun Ren, Shuaijie Han, Yu Zhou, Yingkui Si, Xue Han, Xiaoqian Zhang, Yanan Zhang, Na Chen, Hua He, Ran Feng, Lili Shang","doi":"10.2147/DMSO.S507171","DOIUrl":"10.2147/DMSO.S507171","url":null,"abstract":"<p><p>Diabetic nephropathy (DN) is one of the most severe microvascular complications of diabetes and a leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD). While traditional research has linked the onset of DN to factors such as metabolic dysregulation, inflammation, and oxidative stress, these mechanisms alone fail to fully explain the complex pathological features and individual variability of DN. In recent years, epigenetic research has provided new insights, revealing the critical roles of DNA methylation, histone modifications, and non-coding RNAs in the development of DN. DNA methylation regulates gene expression by altering methylation levels in promoter regions, affecting genes involved in inflammation and fibrosis. Histone modifications, including acetylation and methylation, influence gene transcription by altering chromatin structure. Additionally, non-coding RNAs, such as microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), play essential roles in gene expression networks. This review summarizes the latest advances in understanding these epigenetic mechanisms in DN pathogenesis, explores their roles in regulating inflammation, fibrosis, and cell damage, and discusses their potential applications in the diagnosis and treatment of DN. Further investigation into epigenetic modifications holds promise for identifying novel diagnostic markers and personalized therapeutic strategies for DN.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2629-2639"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774876","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 Neutrophil/High-Density Lipoprotein Cholesterol Ratio with Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study and Predictive Model Construction.","authors":"Wenxian Li, Hongxia Tang, Xiaowei Tong, Yifan Zhao, Shien Li","doi":"10.2147/DMSO.S528506","DOIUrl":"10.2147/DMSO.S528506","url":null,"abstract":"<p><strong>Objective: </strong>The neutrophil/high-density lipoprotein cholesterol ratio (NHR) has been identified as a combined indicator of inflammatory cells and lipid metabolism. The objective of this study was to investigate the relationship between the NHR and metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>This cross-sectional study selected patients with T2DM who were admitted to the Department of Endocrinology at the First Hospital of Zhangjiakou City. Liver ultrasound was performed on all patients to determine the presence or absence of MASLD, and NHR values were calculated. The patients were grouped according to the median NHR, and a difference analysis was performed to compare the differences in clinical information between groups.Logistic regression was used to assess independent influences of MASLD, and subgroup analyses were performed. The final stage of this project involved construction of a novel predictive model for MASLD, derived from the screened influential factors, alongside an evaluation of its predictive value using the receiver operating characteristic.</p><p><strong>Results: </strong>A total of 621 patients with T2DM were included in this study according to the inclusion and exclusion criteria. Logistic regression analyses showed a significant negative correlation between NHR and MASLD, and this correlation was particularly significant in men and in patients not using GLP-1A. In addition, restricted cubic spline curve (RCS) plots showed a nonlinear correlation between NHR and MASLD. The area under the curve (AUC) of the novel prediction model constructed on the basis of NHR reached 0.78 (95% CI 0.75-0.82), which can be used to predict the onset of MASLD, and is effective in clinical applications.</p><p><strong>Conclusion: </strong>NHR is significantly correlated with MASLD, and NHR has the potential to be an early detection and intervention indicator for screening T2DM patients for MASLD.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2597-2609"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774877","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 Effectivity MultiModality Treatment on Rehabilitation Management of Diabetic Foot Disease Patients for Improvement of Clinical Efficacy & Hemorheological Status.","authors":"Shuo Li, Yan Liu, Yu Chen","doi":"10.2147/DMSO.S526919","DOIUrl":"10.2147/DMSO.S526919","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a multimodal intervention-comprising rehabilitation management and foot preventive measures-on clinical outcomes, hemorheological parameters, and vascular endothelial function in patients with diabetic foot (DF).</p><p><strong>Methods: </strong>This retrospective study included 126 <i>DF</i> patients admitted to our hospital from February 2023 to April 2024. Patients were divided into a control group (n = 63, receiving routine nursing care) and an intervention group (n = 63, receiving routine care plus rehabilitation management combined with foot preventive measures). Key outcome measures included: (1) clinical efficacy; (2) hemorheological indicators-whole blood low-shear viscosity (WBLSV), high-shear viscosity (WBHSV), fibrinogen (FIB), and erythrocyte deformability index (EDI); (3) vascular endothelial function indicators-endothelin (ET), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and calcitonin gene-related peptide (CGRP); (4) self-management ability-Adult Health Self-Management Scale (AHSMSRS), General Self-Efficacy Scale (GSES); and (5) nursing satisfaction-Newcastle Nursing Service Satisfaction Scale (NSNS).</p><p><strong>Results: </strong>The intervention group had a significantly higher total treatment efficacy rate (92.06% vs 77.78%, P < 0.05). Post-intervention hemorheological parameters (WBLSV, WBHSV, FIB, EDI) and endothelial markers (ET, bFGF, VEGF, CGRP) showed greater improvement in the intervention group (P < 0.05). Similarly, AHSMSRS scores declined and GSES scores improved more markedly in the intervention group (P < 0.05). Nursing satisfaction was also higher (96.83% vs 71.43%, P < 0.05).</p><p><strong>Conclusion: </strong>Compared with routine nursing care alone, the multimodal intervention strategy may improve clinical efficacy, hemorheology, endothelial function, self-management capabilities, and patient satisfaction in diabetic foot care. However, these findings should be interpreted with caution given the retrospective design.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2561-2571"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774879","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 Prospective Study of the Correlation Between Time in Range and Incidence of Diabetic Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus.","authors":"Xiangxiang Shan, Shenhang Yao, Ben Hu, Chi Xu, Yonghong Cao, Wu Dai","doi":"10.2147/DMSO.S526784","DOIUrl":"10.2147/DMSO.S526784","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the correlation between time in range (TIR) and the risk of cardiovascular autonomic neuropathy (CAN) development in patients with Type 2 diabetes mellitus (T2DM).</p><p><strong>Patients and methods: </strong>This prospective cohort study enrolled patients with type 2 diabetes mellitus (T2DM) hospitalized and followed at the Department of Endocrinology, Hefei Hospital of Anhui Medical University, between September 2020 and July 2024. All participants underwent standardized cardiovascular autonomic neuropathy (CAN) assessment via the Ewing test, and time in range (TIR) was derived from baseline continuous glucose monitoring (CGM) data. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CAN incidence, adjusted for relevant covariates.</p><p><strong>Results: </strong>Over a median follow-up of 25.0 months, 123 of 196 participants (62.8%) were diagnosed with CAN. The CAN group exhibited longer diabetes duration, lower time in range (TIR) and body mass index (BMI), higher time above range (TAR), mean glucose (MG), urinary albumin-to-creatinine ratio (UACR), and higher insulin use rates. Participants with low TIR were older, had longer diabetes duration, and displayed: 1. Higher fasting plasma glucose (FPG), HbA1c, and LDL-C levels; 2. Elevated glycemic variability (MAGE, CV, LAGE, SD, MG, TAR) via continuous glucose monitoring (CGM); 3. Greater likelihood of insulin therapy. All differences were statistically significant (P < 0.05). Multivariable Cox regression analyses, adjusted for key covariates (eg, age, HbA1c, insulin use), demonstrated an inverse association between TIR and CAN incidence.</p><p><strong>Conclusion: </strong>Lower TIR is an independent risk factor for CAN in T2DM patients, with higher TIR levels associated with reduced CAN risk (P < 0.05).</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2585-2596"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783721","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":"Integrating Ketone and Glucose Monitoring for Optimized Diabetes Management: Key Ketone Monitoring Updates and Highlights from the ADA 2025 Conference [Podcast].","authors":"David Kerr","doi":"10.2147/DMSO.S555697","DOIUrl":"10.2147/DMSO.S555697","url":null,"abstract":"<p><p>This article discusses innovations and advancements in diabetic ketoacidosis (DKA) and ketone monitoring technology from the 2025 American Diabetes Association (ADA) conference held from June 20-23, 2025, in Chicago, Illinois. The session, \"Continuous Ketone Monitoring-Innovations and Clinical Applications\" featured four expert presentations from Drs. Ketan Dhatariya, Lori Lafell, Jennifer Sherr, and Richard Bergenstal, each addressing the clinical implications of physiology and the impact of ketosis and DKA on people with diabetes; methods to detect ketones and current approaches to prevent DKA; ketone sensor performance criteria and current study data; and the potential clinical impact of continuous ketone monitoring. The discussion concludes by discussing a poster presented at the ADA which discussed ketone profiles in free-living people with type 1 diabetes using continuous ketone monitoring. The article closes by underscoring the desire by both clinicians and patients for continuous ketone monitoring to become mainstream sooner rather than later.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2623-2628"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783724","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":"Establishment and Evaluation of HepG2 Cell Insulin Resistance Model.","authors":"Zixuan Meng, Yuehua Han, Linda Ruan, Chenming Xu, Mengxiao Zhang, Hao Liu","doi":"10.2147/DMSO.S523821","DOIUrl":"10.2147/DMSO.S523821","url":null,"abstract":"<p><strong>Objective: </strong>Establishing HepG2 cell insulin resistance models using glucosamine, high glucose with high insulin and palmitic acid and briefly evaluating them to provide reliable models for insulin resistance research.</p><p><strong>Methods: </strong>Three methods were used to induce insulin resistance in HepG2 cells, and glucose uptake and consumption, glucose metabolism-related mRNA and p-AKT/AKT protein levels and RNA-seq were detected to compare the three induction methods.</p><p><strong>Results: </strong>Glucose consumption capacity was reduced after glucosamine and palmitic acid induction and did not change significantly after high glucose with high insulin induction. Glucose uptake capacity was not significantly changed after glucosamine and high glucose with high insulin induction and was reduced after palmitic acid induction. After high insulin stimulation, p-AKT/AKT levels were elevated in glucosamine and high glucose with high insulin induction and did not change significantly in palmitic acid induction. <i>G6pase</i>, <i>PC</i>, and <i>PCK1</i> were elevated after glucosamine and palmitic acid stimulation, and only PCK1 was elevated after high glucose with high insulin stimulation. The transcriptomes of cells induced by the three methods differed widely.</p><p><strong>Conclusion: </strong>Treatment with 0.2 mM palmitic acid for 24 h is a simple and stable method to induce insulin resistance in HepG2 cells.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2573-2584"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774878","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":"Differential Effects of SGLT-2 Inhibitors on Liver Function and Nocturia in Patients with Type 2 Diabetes: A Randomized Controlled Trial.","authors":"Tetsuya Kawahara, Mikio Toda, Maiko Kanagawa, Nagahiro Toyama, Gen Suzuki, Chie Kawahara, Tetsuya Inazu","doi":"10.2147/DMSO.S547088","DOIUrl":"10.2147/DMSO.S547088","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated whether sodium-glucose cotransporter-2 inhibitors (SGLT-2is) improve liver function as a class effect and evaluated their effect on nocturia in patients with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>A total of 135 patients with type 2 diabetes and MASLD were randomly assigned to receive tofogliflozin (20 mg/day), dapagliflozin (5 mg/day), or empagliflozin (10 mg/day). Primary outcomes included changes in liver function and fibrosis markers-various transferases, fibrosis-4 index, mac-2 binding protein glycan isomer, and shear wave speed-along with nocturia frequency. Secondary outcomes were glycemic control, body weight, and lipid profiles. Patients were followed for seven months.</p><p><strong>Results: </strong>The participants had a mean age of 61 years; 43% were female, HbA1c level was 8.7%, and the frequency of nocturia was 0.6 times. All three SGLT-2is significantly improved liver function markers, with no differences between groups. However, nocturia frequency significantly increased with empagliflozin (1.7 times) and dapagliflozin (1.9 times; both <i>p</i> < 0.001) but not with tofogliflozin (0.8 times; <i>p</i> = 0.503). Tofogliflozin resulted in a significantly smaller nocturia increase than the other two drugs (<i>p</i> < 0.001). However, this significant difference persisted up to 1 month; from 3 months onward, urinary frequency improved in all groups, and the difference was not observed. Glycemic control, body weight, and lipid profiles improved similarly across all groups.</p><p><strong>Conclusion: </strong>SGLT-2is improve liver function as a class effect, but their impact on nocturia frequency differs. Tofogliflozin, likely due to its shorter half-life, has the most favorable nocturia profile and may be preferable for patients at risk. The UMIN Clinical Trial Registry number for this study is UMIN000054278; Clinical Trials Registry date 28/04/2024.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2611-2622"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783722","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 Pathological Grades of Metabolic Dysfunction-Associated Steatotic Liver Disease on Weight Loss Following Laparoscopic Sleeve Gastrectomy.","authors":"Yun-Fei Qu, Kang Wang, Yue Li, Yu-Gang Cheng, San-Yuan Hu, Ming-Wei Zhong","doi":"10.2147/DMSO.S523771","DOIUrl":"10.2147/DMSO.S523771","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of hepatic steatosis severity on postoperative weight loss outcomes remains unclear. This study aimed to evaluate the effect of fatty liver severity on percentage of excess weight loss (%EWL) in patients undergoing laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>This retrospective cohort study included 226 patients with obesity who underwent LSG. Baseline data included liver biopsy grade (mild, moderate, or severe), body mass index (BMI), liver function, and metabolic parameters. Postoperative outcomes were assessed at 1, 3, 6, and 12 months. Statistical methods included the Pearson and Spearman correlations, chi-square test, Kruskal-Wallis test, general linear models, Kaplan-Meier analysis, and multivariate regression to identify the predictors of weight loss and cumulative rates of achieving 50% EWL and to plot the cumulative incidence curve.</p><p><strong>Results: </strong>Baseline BMI, homeostasis model assessment for insulin resistance, free fatty acids, and A1C levels were significantly associated with steatosis severity (P < 0.05). Severe metabolic dysfunction-associated steatotic liver disease (MASLD) was associated with a lower %EWL at 1, 3, 6, and 12 months (1 month %EWL: 32.34% vs 38.59% in the mild group; P < 0.05). The Kaplan-Meier analysis showed delayed achievement of 50% EWL in the severe group (P < 0.05). Multivariate regression analysis identified MASLD severity and preoperative BMI as independent predictors of %EWL. General linear models confirmed the significant dynamic effects of MASLD severity on weight loss over time (P < 0.05).</p><p><strong>Conclusion: </strong>MASLD severity significantly affects postoperative weight loss and delays the achievement of optimal outcomes, especially in the early postoperative period. Preoperative evaluation of liver pathology is essential for optimizing surgical outcomes in patients with obese having MASLD.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"2547-2560"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783723","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}