Diabetes Care最新文献_第9页

Genetic Discovery and Risk Prediction for Type 1 Diabetes in Individuals Without High-Risk HLA-DR3/DR4 Haplotypes 无高危HLA-DR3/DR4单倍型个体1型糖尿病的遗传发现和风险预测

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-03 DOI: 10.2337/dc24-1251

Carolyn McGrail, Joshua Chiou, Ruth Egamal, Amber M. Luckett, Richard A. Oram, Paola Benaglio, Kyle J. Gaulton

{"title":"Genetic Discovery and Risk Prediction for Type 1 Diabetes in Individuals Without High-Risk HLA-DR3/DR4 Haplotypes","authors":"Carolyn McGrail, Joshua Chiou, Ruth Egamal, Amber M. Luckett, Richard A. Oram, Paola Benaglio, Kyle J. Gaulton","doi":"10.2337/dc24-1251","DOIUrl":"https://doi.org/10.2337/dc24-1251","url":null,"abstract":"OBJECTIVE More than 10% of patients with type 1 diabetes (T1D) do not have high-risk HLA-DR3 or -DR4 haplotypes with distinct clinical features, such as later onset and reduced insulin dependence. We aimed to identify genetic drivers of T1D in the absence of DR3/DR4 and improve prediction of T1D risk in these individuals. RESEARCH DESIGN AND METHODS We performed T1D association and fine-mapping analyses in 12,316 non-DR3/DR4 samples. Next, we performed heterogeneity tests to examine differences in T1D risk variants in individuals without versus those with DR3/DR4 haplotypes. We further assessed genome-wide differences in gene regulatory element and biological pathway enrichments between the non-DR3/DR4 and DR3/DR4 cohorts. Finally, we developed a genetic risk score (GRS) to predict T1D in individuals without DR3/DR4 and compared with an existing T1D GRS. RESULTS A total of 18 T1D risk variants in non-DR3/DR4 samples were identified. Risk variants at the MHC and multiple other loci genome wide had heterogeneity in effects on T1D dependent on DR3/DR4 status, and non-DR3/DR4 T1D had evidence for a greater polygenic burden. T1D-assocated variants in non-DR3/DR4 were more enriched for regulatory elements and pathways involved in antigen presentation, innate immunity, and β-cells and depleted in T cells compared with DR3/DR4. A non-DR3/DR4 GRS outperformed an existing risk score GRS2 in discriminating non-DR3/DR4 T1D from no diabetes (area under the curve 0.867; P = 7.48 × 10−32) and type 2 diabetes (0.907; P = 4.94 × 10−44). CONCLUSIONS In total, we identified heterogeneity in T1D genetic risk dependent on high-risk HLA-DR3/DR4 haplotype, which uncovers disease mechanisms and enables more accurate prediction of T1D across the HLA background.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"14 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142763244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Compounded GLP 1 and Dual GIP/GLP 1 Receptor Agonists: A Statement from the American Diabetes Association 复合GLP - 1和双重GIP/GLP - 1受体激动剂：美国糖尿病协会声明

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-02 DOI: 10.2337/dci24-0091

Joshua J. Neumiller, Mandeep Bajaj, Raveendhara R. Bannuru, Rozalina G. McCoy, Elizabeth J. Pekas, Alissa R. Segal, Nuha A. ElSayed

引用次数: 0

Continuous Glucose Monitor Accuracy for Diabetes Management in Hospitalized Children 连续血糖监测在住院儿童糖尿病管理中的准确性

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-02 DOI: 10.2337/dc24-1562

Neha Garg, Kamryn Lewis, Perrin C. White, Soumya Adhikari

{"title":"Continuous Glucose Monitor Accuracy for Diabetes Management in Hospitalized Children","authors":"Neha Garg, Kamryn Lewis, Perrin C. White, Soumya Adhikari","doi":"10.2337/dc24-1562","DOIUrl":"https://doi.org/10.2337/dc24-1562","url":null,"abstract":"OBJECTIVE The adoption of continuous glucose monitors (CGMs) in inpatient settings in the pediatric population has been slow because of a scarcity of data on their reliability in hospitalized children. RESEARCH DESIGN AND METHODS We retrospectively reviewed the accuracy of the Dexcom G6 CGM system in pediatric patients with diabetes admitted to our academic children’s hospital from March 2018 to September 2023. We cross-referenced the Dexcom Clarity database against an internal database of inpatient admissions to identify all children with CGM data admitted to the hospital. We recorded sensor glucose readings from Clarity and values for point-of-care (POC) glucose, blood urea nitrogen (BUN), and pH from the electronic medical record. CGM accuracy and clinical reliability were measured by mean absolute relative difference (MARD) and Clarke error grid (CEG) analyses. RESULTS There were 3,200 admissions of children with diabetes in this period, of which 277 (from 202 patients age 2–18 years) had associated CGM data. Paired CGM and POC measurements (n = 2,904) were compared, resulting in an MARD of 15.9%, with 96.6% of the values in zones A and B of the CEG analysis. Approximately 62% of paired values fell within a 15% or 15 mg/dL difference, whichever was larger (15%/15 mg/dL range), 74% within 20%/20, and 88% within 30%/30. Serum pH, sodium, and BUN had no impact on CGM values or absolute relative difference in linear regression analysis. CONCLUSIONS CGMs demonstrated acceptable accuracy in hospitalized children with diabetes. CGM data should be integrated into hospital electronic records to optimize management.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"204 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cutaneous Carbonyl Stress Is Associated With Nerve Dysfunction in Recent-Onset Type 2 Diabetes 皮肤羰基应激与新发 2 型糖尿病患者的神经功能障碍有关

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-25 DOI: 10.2337/dc24-1799

Gidon J. Bönhof, Alexander Strom, Tobias Jung, Kálmán B. Bódis, Julia Szendroedi, Robert Wagner, Tilman Grune, Michael Roden, Dan Ziegler

{"title":"Cutaneous Carbonyl Stress Is Associated With Nerve Dysfunction in Recent-Onset Type 2 Diabetes","authors":"Gidon J. Bönhof, Alexander Strom, Tobias Jung, Kálmán B. Bódis, Julia Szendroedi, Robert Wagner, Tilman Grune, Michael Roden, Dan Ziegler","doi":"10.2337/dc24-1799","DOIUrl":"https://doi.org/10.2337/dc24-1799","url":null,"abstract":"OBJECTIVE Endogenous carbonyl stress leads to the formation of advanced glycation end products (AGEs). AGEs represent a potential target to prevent or treat diabetic sensorimotor polyneuropathy (DSPN). The current study aimed to characterize cutaneous carbonyl stress, oxidative stress, immune cells, and endothelial cell damage in early type 2 diabetes compared with normal glucose tolerance (NGT) using novel cutaneous biomarkers. RESEARCH DESIGN AND METHODS Included were 160 individuals recently (≤12 months) diagnosed with type 2 diabetes and 144 with NGT from the German Diabetes Study baseline cohort. Nerve function was assessed using electrophysiological, quantitative sensory, and clinical testing. Skin biopsies were obtained to analyze intraepidermal nerve fiber density, AGEs autofluorescence, argpyrimidine area, and endothelial cell area. In addition, skin autofluorescence was measured noninvasively using the AGE reader. A subgroup with type 2 diabetes (n = 80) was reassessed 5 years later. RESULTS After adjustment for sex, age, HbA1c, LDL cholesterol, and BMI, argpyrimidine area (17.5 ± 18.8 vs. 11.7 ± 12.7%) was higher in recent-onset type 2 diabetes than in NGT (P &lt; 0.05). AGEs autofluorescence was inversely correlated with nerve conduction (e.g., peroneal motor nerve conduction velocity: r = −0.346) and positively with AGE reader measurements in type 2 diabetes (r = 0.358, all P &lt; 0.05), but not in NGT. Higher baseline AGEs autofluorescence and lower endothelial cell area predicted the deterioration of clinical and neurophysiological measures after 5 years. CONCLUSIONS Cutaneous AGEs markers were associated with neurophysiological deficits in recent-onset type 2 diabetes and predicted their progression after 5 years, substantiating the role of carbonyl stress in the development of early DSPN.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"33 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osteoprotegerin, Osteopontin, and Osteocalcin Are Associated With Cardiovascular Events in Type 2 Diabetes: Insights From EXSCEL 骨保护蛋白、骨生成素和骨钙素与 2 型糖尿病患者的心血管事件有关：来自 EXSCEL 的启示

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-22 DOI: 10.2337/dc24-1455

Ernesto Maddaloni, Maggie Nguyen, Svati H. Shah, Rury R. Holman

{"title":"Osteoprotegerin, Osteopontin, and Osteocalcin Are Associated With Cardiovascular Events in Type 2 Diabetes: Insights From EXSCEL","authors":"Ernesto Maddaloni, Maggie Nguyen, Svati H. Shah, Rury R. Holman","doi":"10.2337/dc24-1455","DOIUrl":"https://doi.org/10.2337/dc24-1455","url":null,"abstract":"OBJECTIVE To evaluate the association of four bone metabolism biomarkers (osteoprotegerin, osteopontin, sclerostin, and osteocalcin) with cardiovascular events in people with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) was a randomized clinical trial evaluating the cardiovascular (CV) safety and efficacy of once-weekly exenatide for patients with T2D. Candidate biomarker data were selected from proteomic profiling performed at baseline and 12 months after randomization samples by SomaScan assay in 5,473 trial participants. The primary composite outcome was the first occurrence of CV death, nonfatal myocardial infarction, or nonfatal stroke (major cardiovascular events [MACE]). Cox proportional hazards models controlling for confounders were used for time-to-event analyses to calculate hazard ratios (HRs) with 95% CI for a 1 SD increase in the biomarker concentrations. RESULTS The primary outcome occurred in 813 participants (14.9%). Higher levels of osteoprotegerin (HR 1.11; 95% CI 1.03–1.20; P = 0.0047) and osteopontin (HR 1.10; 95% CI 1.02–1.18; P = 0.0095) were associated with an increased risk of MACE. The addition of osteoprotegerin and osteopontin to a clinical predictive model containing traditional CV risk factors provided minimal incremental value for MACE prediction (C-index 0.629 vs. 0.638; likelihood ratio test P &lt; 0.001). Osteocalcin and sclerostin were not associated with MACE. Osteocalcin had a nonlinear association with all-cause death and with CV death. CONCLUSIONS Higher levels of osteoprotegerin and osteopontin are associated with an increased risk of CV events in people with T2D, supporting the hypothesis that pathways involved in bone metabolism play a role in CV disease.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"66 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study 胰岛素抵抗与肺部影像学异常和肺部疾病的关系：弗雷明汉后代研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-21 DOI: 10.2337/dc24-1754

Sarath Raju, Paula Sierra, Vickram Tejwani, Kristen A. Staggers, Meredith McCormack, Dennis T. Villareal, Ivan O. Rosas, Nicola A. Hanania, Tianshi David Wu

{"title":"Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study","authors":"Sarath Raju, Paula Sierra, Vickram Tejwani, Kristen A. Staggers, Meredith McCormack, Dennis T. Villareal, Ivan O. Rosas, Nicola A. Hanania, Tianshi David Wu","doi":"10.2337/dc24-1754","DOIUrl":"https://doi.org/10.2337/dc24-1754","url":null,"abstract":"OBJECTIVE Insulin resistance (IR) may be a risk factor for lung disease, but objective evidence is limited. We sought to define the relationship of longitudinal IR with radiographic imaging outcomes and examiner-identified incident lung disease in the Framingham Offspring Study. RESEARCH DESIGN AND METHODS Participants without baseline lung disease underwent repeated measurements of fasting insulin and glucose levels over an average period of 13.6 years, from which time-weighted average HOMA-IR was calculated. Each participant then underwent a cardiac gated whole-lung computed tomography scan, which was analyzed for the presence of emphysema, interstitial lung abnormalities (ILAs), and quantitative airway features. Incident lung disease was determined by a study examiner. The relationship of HOMA-IR to these outcomes was estimated in models adjusted for demographics, BMI, and lifetime smoking. RESULTS A total of 875 participants with longitudinal IR data and outcomes were identified. Their mean age was 51.5 years, and BMI was 26.7 kg/m2. HOMA-IR was temporally unstable, with a within-person SD approximately two-thirds of the between-person SD. In adjusted models, a 1 SD increase in log(HOMA-IR) z score was associated with higher odds of qualitative emphysema (odds ratio [OR] 1.33; 95% CI 1.04–1.70), ILAs (OR 1.35; 95% CI 1.05–1.74), and modest increases in airway wall thickness and wall area percentage. These radiographic findings were corroborated by a positive association of HOMA-IR with incident lung disease. CONCLUSIONS IR is associated with radiographic lung abnormalities and incident lung disease. Deeper phenotyping is necessary to define mechanisms of IR-associated lung injury.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"198 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-Effectiveness of the National Diabetes Prevention Program: A Real-World, 2-Year Prospective Study 全国糖尿病预防计划的成本效益：一项为期两年的前瞻性真实世界研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-20 DOI: 10.2337/dc24-1110

Shihchen Kuo, Wen Ye, Di Wang, Laura N. McEwen, Claudia Villatoro Santos, William H. Herman

{"title":"Cost-Effectiveness of the National Diabetes Prevention Program: A Real-World, 2-Year Prospective Study","authors":"Shihchen Kuo, Wen Ye, Di Wang, Laura N. McEwen, Claudia Villatoro Santos, William H. Herman","doi":"10.2337/dc24-1110","DOIUrl":"https://doi.org/10.2337/dc24-1110","url":null,"abstract":"OBJECTIVE We evaluated the real-world cost-effectiveness of the National Diabetes Prevention Program (NDPP) for people with prediabetes in a large workforce with employer-sponsored health insurance. RESEARCH DESIGN AND METHODS We performed difference-in-differences analyses using individual-level health insurance claims and survey data for 5,948 adults with prediabetes who enrolled (n = 575) or did not enroll (n = 5,373) in the NDPP to assess NDPP’s effects on health economic outcomes. We assessed direct medical costs for the year before the NDPP enrollment/index date and for 2 years thereafter; EuroQol 5-Dimension 5-level questionnaire (EQ-5D-5L) utility scores at baseline, 1 year, and 2 years; and quality-adjusted life-years (QALYs) over 2 years. We used propensity score weighting to adjust for potential bias due to self-selection for enrollment, multiple imputation to handle missing data, and bootstrapping to produce CIs. We adopted a health care sector perspective and discounted costs and QALYs at 3% annually. Costs were expressed in 2020 U.S. dollars. RESULTS Compared with nonenrollees, each NDPP enrollee had an average reduction of $4,552 (95% CI −13,231, 2,014) in 2-year total direct medical costs. Cost savings were primarily related to hospitalizations, outpatient visits, and emergency room visits. Compared with nonenrollees, each enrollee had no difference in EQ-5D-5L utility scores at 2 years or QALYs gained over 2 years. The uncertainty analyses found that enrollment in the NDPP had an 88% probability of saving money and 84% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY-gained over 2 years. CONCLUSIONS In this real-world population with prediabetes, enrollment in the NDPP was likely to provide cost savings.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"4 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142679178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burden and Excess Risk of Adverse Outcomes in Patients With Type 1 Diabetes Using KDIGO Classification: A National Cohort Study 采用 KDIGO 分类的 1 型糖尿病患者不良后果的负担和过高风险：一项全国队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-20 DOI: 10.2337/dc24-0908

Kianoush Makvandi, Björn Eliasson, Hanne Krage Carlsen, Seema Baid-Agrawal

{"title":"Burden and Excess Risk of Adverse Outcomes in Patients With Type 1 Diabetes Using KDIGO Classification: A National Cohort Study","authors":"Kianoush Makvandi, Björn Eliasson, Hanne Krage Carlsen, Seema Baid-Agrawal","doi":"10.2337/dc24-0908","DOIUrl":"https://doi.org/10.2337/dc24-0908","url":null,"abstract":"OBJECTIVE The widely adopted Kidney Disease: Improving Global Outcomes (KDIGO) classification system has been underused in assessing the burden and risk of adverse outcomes in type 1 diabetes. This observational study aimed to clarify how each KDIGO category correlates with outcomes, including mortality, in this patient group. RESEARCH DESIGN AND METHODS In 40,199 individuals with type 1 diabetes from the Swedish National Diabetes Register, we examined the 1) prevalence of different KDIGO categories at baseline; 2) incidence of adverse kidney and cardiovascular (CV) outcomes, including mortality, within each category; and 3) association of baseline category with excess risk of five outcomes: 40% decline in estimated glomerular filtration rate (eGFR), kidney failure, major adverse kidney/CV events, and all-cause mortality. Cox regression analyses were conducted using three different reference categories: 1) the conventional low-risk “combined G1A1 + G2A1”; 2) “G1A1” alone to assess whether G2A1 had excess risk; and 3) “G1bA1” alone to evaluate whether eGFR ≥105 mL/min/1.73 m2 had increased risk. RESULTS Among 39,067 included patients, with a mean follow-up of 9.1 years, 18.5% presented with chronic kidney disease (CKD), defined as eGFR &lt;60 mL/min/1.73 m2 and/or albuminuria. A progressive increase in the incidence and adjusted hazard ratio for all studied outcomes was found with advancing eGFR and albuminuria categories, including in G2A1 (non-CKD). A eGFR ≥105 mL/min/1.73 m2 without albuminuria was not associated with increased risk. CONCLUSIONS A progressively increasing burden of all studied adverse outcomes was observed with advancing KDIGO categories. Even individuals with preserved eGFR and normoalbuminuria (G2A1) conventionally perceived as non-CKD, had an excess risk for all outcomes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"3 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142679176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reduced Aqueous Retinol-Binding Protein 3 Concentration Is Associated With Diabetic Macular Edema and Progression of Diabetic Retinopathy 水视黄醇结合蛋白 3 浓度降低与糖尿病黄斑水肿和糖尿病视网膜病变进展有关

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-20 DOI: 10.2337/dc24-1260

Tanvi Chokshi, Ward Fickweiler, Surya Jangolla, Kyoungmin Park, I-Hsien Wu, Hetal Shah, Jennifer K. Sun, Lloyd Paul Aiello, George L. King

{"title":"Reduced Aqueous Retinol-Binding Protein 3 Concentration Is Associated With Diabetic Macular Edema and Progression of Diabetic Retinopathy","authors":"Tanvi Chokshi, Ward Fickweiler, Surya Jangolla, Kyoungmin Park, I-Hsien Wu, Hetal Shah, Jennifer K. Sun, Lloyd Paul Aiello, George L. King","doi":"10.2337/dc24-1260","DOIUrl":"https://doi.org/10.2337/dc24-1260","url":null,"abstract":"OBJECTIVE To evaluate the association of aqueous retinol-binding protein 3 (RBP3) with history of diabetic macular edema (DME) and diabetic retinopathy (DR) progression. RESEARCH DESIGN AND METHODS RBP3 concentration was measured by ELISA in aqueous from patients undergoing cataract surgery at Joslin Diabetes Center. DR progression was defined as two-step or more worsening on the Early Treatment Diabetic Retinopathy Study severity scale, and DME history was determined by clinical diagnosis. RESULTS In 153 eyes (31 with type 1 and 122 with type 2 diabetes; n = 149 patients), 37% had no signs of DR, 40% had mild nonproliferative DR (NPDR), and 23% had moderate NPDR. Aqueous RBP3 decreased from a median of 2.1 nmol/L (interquartile range 0.8–3.4) in eyes with no DR to 1.5 nmol/L (0.8–3.8) in eyes with mild-to-moderate NPDR (P = 0.047). The difference between aqueous RBP3 levels in those with type 1 or type 2 diabetes was not significant. Elevated RBP3 (β = −0.701, 95% CI −1.151 to 0.250, P = 0.002) was associated with no DME history. With a mean follow-up of 5.5 ± 3.6 years, elevated RBP3 at baseline was associated with less subsequent DR progression (odds ratio 0.51, 95% CI 0.28–0.93, P = 0.03). In multivariable analyses, RBP3 remained significantly associated with a DR progression and history of DME. A 5% improvement was seen in the area under the curve when RBP3 was added to clinical models for predicting DR progression (P &lt; 0.05). CONCLUSIONS This study suggests that aqueous RBP3 may be an important protective factor, the first neuroretinal-specific biomarker of DME or DR progression, and a possible therapeutic target.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"52 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142679173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Life Course Associations Between Ambient Fine Particulate Matter and the Prevalence of Prediabetes and Diabetes: A Longitudinal Cohort Study in Taiwan and Hong Kong 环境细颗粒物与糖尿病前期和糖尿病患病率之间的生命历程关联：台湾和香港的纵向队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-12 DOI: 10.2337/dc24-1041

Yuanyuan Yi, Cui Guo, Yiling Zheng, Siyi Chen, Changqing Lin, Alexis K. H. Lau, Martin C. S. Wong, David M. Bishai

{"title":"Life Course Associations Between Ambient Fine Particulate Matter and the Prevalence of Prediabetes and Diabetes: A Longitudinal Cohort Study in Taiwan and Hong Kong","authors":"Yuanyuan Yi, Cui Guo, Yiling Zheng, Siyi Chen, Changqing Lin, Alexis K. H. Lau, Martin C. S. Wong, David M. Bishai","doi":"10.2337/dc24-1041","DOIUrl":"https://doi.org/10.2337/dc24-1041","url":null,"abstract":"OBJECTIVE Both air pollution and diabetes are key urban challenges. The association between particulate matter with a diameter of &lt;2.5 μm (PM2.5) exposure and prediabetes/diabetes in adults is well documented, but the health effects of life course exposure remain unclear. This study evaluated the impact of PM2.5 exposure throughout various life stages on the prevalence of prediabetes/diabetes in adulthood. RESEARCH DESIGN AND METHODS We included 4,551 individuals with 19,593 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. Ambient PM2.5 exposure was assessed using a satellite-based model, delivering a 2-year average exposure at a resolution of 1 km2. Logistic mixed-effects models were used to investigate longitudinal associations between PM2.5 exposure and the prevalence of prediabetes/diabetes. Life course models were used to examine the impact of PM2.5 exposure at different life stages on prediabetes/diabetes in adulthood. RESULTS Over an average follow-up period of 9.93 years, 1,660 individuals with prediabetes/diabetes were observed. For the longitudinal association, every 10 μg/m3 increase in PM2.5 was associated with an increased odds of having prediabetes/diabetes (odds ratio 1.32, 95% CI 1.13, 1.54). The odds of adulthood prediabetes/diabetes increased by 15%, 18%, and 29% for each 10 μg/m3 increase in PM2.5 exposure during school age, adolescence, and adulthood, respectively. CONCLUSIONS Our findings suggest a link between PM2.5 exposure during each life stage and the prevalence of prediabetes/diabetes in adulthood, with the health impacts of exposure during adulthood being slightly greater. This study underscores the need for life course air pollution control strategies to mitigate the substantial disease burden of diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"72 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0