Diabetes research and clinical practice最新文献

{"title":"Role of epicardial adipose tissue in cardiac remodeling","authors":"Rongjun Zou ,&nbsp;Miao Zhang ,&nbsp;Weihui Lv ,&nbsp;Jun Ren ,&nbsp;Xiaoping Fan","doi":"10.1016/j.diabres.2024.111878","DOIUrl":"10.1016/j.diabres.2024.111878","url":null,"abstract":"<div><div>Epicardial adipose tissue, or epicardial fat, is a type of visceral fat located between the heart and the pericardium. Due to its anatomical proximity to the heart, EAT plays a significant role in both cardiac physiology and pathologies, including cardiac remodeling and cardiovascular diseases (CVD). However, our understanding of how EAT pathology is influenced by risk factors such as obesity and type 2 diabetes mellitus and how altered EAT can drive cardiac remodeling and CVD, remains limited. Herein, we aimed to summarize and discuss the latest findings on EAT and its role in cardiac remodeling, highlighting the outcomes of clinical and observational studies, provide mechanistic insights, and finally introduce emerging therapeutic agents and nutritional guidelines aimed at preventing these conditions.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111878"},"PeriodicalIF":6.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycemic drugs, circulating inflammatory proteins, and gallbladder diseases: A mediation mendelian randomization study","authors":"Zi-Qi Wang ,&nbsp;Jin-Yan Zhang ,&nbsp;Xingyao Tang ,&nbsp;Jian-Bo Zhou","doi":"10.1016/j.diabres.2024.111882","DOIUrl":"10.1016/j.diabres.2024.111882","url":null,"abstract":"<div><h3>Background</h3><div>The relationship of hypoglycemic drugs, inflammatory proteins and gallbladder diseases remain unknown.</div></div><div><h3>Methods</h3><div>Four hypoglycemic drugs were selected as exposure: glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose cotransporter 2 inhibitors (SGLT-2i), and metformin. The outcome were two gallbladder diseases: cholecystitis and cholelithiasis. Mendelian Randomization (MR) was employed to determine the association between hypoglycemic drugs and gallbladder diseases.</div></div><div><h3>Results</h3><div>DPP-4i and SGLT-2i had no effect on cholecystitis and cholelithiasis. However, a causal relationship was found between inhibition of ETFDH gene, a target of metformin expressed in cultured fibroblasts, and cholelithiasis (OR: 0.84, 95 %CI: (0.72,0.97), p = 0.021), as well as between GLP1R expression in the brain caudate basal ganglia and cholecystitis (OR: 1.29, 95 %CI: (1.11,1.49), p = 0.001). The effect of ETFDH inhibition on cholelithiasis through Interleukin-10 receptor subunit beta (IL-10RB) levels and Neurotrophin-3 (NT-3) levels, with a mediated proportion of 8 % and 8 %, respectively.</div></div><div><h3>Conclusion</h3><div>Metformin plays a protective role in cholelithiasis, while GLP-1RA have a harmful effect on the risk of cholecystitis. Metformin may reduce the risk of cholelithiasis by modulating the levels of Neurotrophin-3 (NT-3) and Interleukin-10 receptor subunit beta (IL-10RB). Further clinical and mechanistic studies are required to confirm these findings.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111882"},"PeriodicalIF":6.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic differences in the effects of lifestyle interventions on adverse pregnancy outcomes among women with gestational diabetes mellitus: A systematic review and meta-analysis","authors":"Yingjun Mu ,&nbsp;Junyao Huang ,&nbsp;Jie Yang ,&nbsp;Hui Zuo ,&nbsp;Matteo Monami ,&nbsp;Nayla Cristina do Vale Moreira ,&nbsp;Akhtar Hussain","doi":"10.1016/j.diabres.2024.111875","DOIUrl":"10.1016/j.diabres.2024.111875","url":null,"abstract":"<div><h3>Aims</h3><div>Lifestyle interventions are widely used among women with gestational diabetes mellitus (GDM). This study aimed to assess the ethnic disparities in the effectiveness of lifestyle interventions on reducing adverse pregnancy outcomes, particularly macrosomia and neonatal hypoglycemia among women with GDM.</div></div><div><h3>Methods</h3><div>We systematically searched the PubMed/MEDLINE, Web of Science, and Cochrane Library databases from January 1, 2000, up to March 31, 2024, to identify randomized controlled trials (RCTs) examining the effects of lifestyle interventions in GDM patients. Subgroup analysis was performed to investigate heterogeneity across different ethnic groups (including Asians, Whites/Caucasians, Hispanics/ Latinos, and Unknown ethnicity). The random effects model was used to calculate the relative risk (RR) and 95% confidence interval (CI).</div></div><div><h3>Results</h3><div>After applying inclusion and exclusion criteria, twenty-one studies comprising 4567 participants were included. Lifestyle interventions significantly reduced the incidence of macrosomia ((RR = 0.54; 95 % CI: 0.42–0.70, <em>P</em> &lt; 0.001), with consistent effects observed across racial groups. Conversely, lifestyle interventions were associated with a significant reduction in the risk of neonatal hypoglycemia only among Asians (RR = 0.56; 95 % CI: 0.38–0.84, <em>P</em> = 0.004), while no significant effects were observed in Whites/Caucasians or Hispanics/Latinos (all <em>P</em> &gt; 0.05). Sensitivity analyses confirmed the robustness of the findings.</div></div><div><h3>Conclusions</h3><div>Regardless of ethnic background, this study emphasizes the significant benefits of lifestyle interventions in reducing the risk of macrosomia among women with GDM. However, lifestyle interventions seem to reduce the risk of neonatal hypoglycemia only among Asians, which warrants further studies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111875"},"PeriodicalIF":6.1,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343569","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":"All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study","authors":"Jae-Seung Yun ,&nbsp;Kyungdo Han ,&nbsp;Bongseong Kim ,&nbsp;Seung-Hyun Ko ,&nbsp;Hyuk-Sang Kwon ,&nbsp;Yu-Bae Ahn ,&nbsp;Yong-Moon Mark Park ,&nbsp;Seung-Hwan Lee","doi":"10.1016/j.diabres.2024.111876","DOIUrl":"10.1016/j.diabres.2024.111876","url":null,"abstract":"<div><h3>Aims</h3><div>The rise in one-person households is a global trend. We aimed to investigate mortality risk in individuals with diabetes living alone (IDLA) using a large-scale population-based database.</div></div><div><h3>Methods</h3><div>A total of 2,447,557 adults with type 2 diabetes were identified from the Korean National Health Information Database. One-person households were defined based on the number of registered family members. The risks of all-cause and cause-specific mortalities were estimated using a multivariable Cox proportional hazards regression model.</div></div><div><h3>Results</h3><div>During a median follow-up period of 6.0 years, 191,084 deaths (7.8 %) occurred. IDLA had a higher risk of mortality compared to those not living alone after adjusting for potential confounders (HR 1.20, 95 % CI: 1.18–1.22). This association was more prominent in younger individuals, men, and those with low income, and it was dependent on the duration of living alone. The risks of cause-specific mortality were all significantly higher in the IDLA group compared with the non-IDLA group. Adherence to favorable lifestyle behaviors was associated with a significant reduction in all-cause mortality, particularly in IDLA.</div></div><div><h3>Conclusions</h3><div>The elevated risk of mortality in IDLA highlights the need for tailored medical interventions and social assistance, particularly for those with unhealthy lifestyles or low income.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111876"},"PeriodicalIF":6.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of how exercise position statement guidelines are being used in the real world in type 1 diabetes: Findings from the type 1 diabetes exercise initiative (T1DEXI)","authors":"Peter G. Jacobs ,&nbsp;Martin Chase Marak ,&nbsp;Peter Calhoun ,&nbsp;Robin L. Gal ,&nbsp;Jessica R. Castle ,&nbsp;Michael C. Riddell","doi":"10.1016/j.diabres.2024.111874","DOIUrl":"10.1016/j.diabres.2024.111874","url":null,"abstract":"<div><h3>Aims</h3><div>Position statement guidelines should help people with type 1 diabetes (T1D) improve glucose outcomes during exercise.</div></div><div><h3>Methods</h3><div>In a 4-week observational study, continuous glucose, insulin, and nutrient data were collected from 561 adults with T1D. Glucose outcomes were calculated during exercise, post-exercise, and overnight, and were compared for sessions when participants used versus did not use exercise guidelines for open-loop (OL) and automated insulin delivery (AID) therapy.</div></div><div><h3>Results</h3><div>Guidelines requiring behaviour modification were rarely used while guidelines not requiring modification were often used. The guideline recommending reduced meal insulin before exercise was associated with lower time &lt;3.9 mmol/L during exercise (−2.2 %, P=0.02) for OL but not significant for AID (−1.4 %, P=0.27). Compared to exercise with low glucose (&lt;3.9 mmol/L) in prior 24-hours, sessions without recent low glucose had lower time &lt;3.9 mmol/L during exercise (−1.2 %, P&lt;0.001). The AID guideline for no carbohydrates before exercise when CGM is flat, or increasing, was not associated with improved glycaemia.</div></div><div><h3>Conclusions</h3><div>Free-living datasets may be used to evaluate usage and benefit of position statement guidelines. Evidence suggests OL participants who reduced meal insulin prior to exercise and did not have low glucose in the prior 24 h had less time below range.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111874"},"PeriodicalIF":6.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343568","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":"Relevance of gastric emptying to the timing of prandial insulin administration in hospitalised patients with diabetes","authors":"Yixuan Sun ,&nbsp;Yong Luo ,&nbsp;Cong Xie ,&nbsp;Karen L Jones ,&nbsp;Michael Horowitz ,&nbsp;Christopher K Rayner ,&nbsp;Tongzhi Wu","doi":"10.1016/j.diabres.2024.111877","DOIUrl":"10.1016/j.diabres.2024.111877","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111877"},"PeriodicalIF":6.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A post-hoc pooled analysis to evaluate efficacy and safety of insulin glargine 300 U/mL in insulin-naïve people with type 2 diabetes with/without prior use of glucagon-like peptide-1 receptor agonist therapy","authors":"Alice Y.Y. Cheng ,&nbsp;Didac Mauricio ,&nbsp;Robert Ritzel ,&nbsp;Mohammed E. Al-Sofiani ,&nbsp;Timothy Bailey ,&nbsp;Maria Aileen Mabunay ,&nbsp;Mireille Bonnemaire ,&nbsp;Lydie Melas-Melt ,&nbsp;Safia Mimouni ,&nbsp;Melanie Davies","doi":"10.1016/j.diabres.2024.111871","DOIUrl":"10.1016/j.diabres.2024.111871","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate treatment advancement with insulin glargine 300 U/mL (Gla-300), with or without prior glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>Efficacy and safety outcomes of insulin-naïve patients intensifying with Gla-300, with/without prior GLP-1 RA therapy, were evaluated in three analyses (N = 3562): a pooled analysis of seven interventional studies, a subanalysis comparing participants who stopped GLP-1 RA therapy and initiated Gla-300 with those who received add-on Gla-300, and an expanded analysis including two observational studies.</div></div><div><h3>Results</h3><div>Glycaemic outcomes, including HbA1c improvement and fasting plasma glucose, were similar between groups with/without prior GLP-1 RA use. HbA1c least squares mean change from baseline was − 1.7 % and − 1.6 % with and without prior GLP-1 RA, respectively. Glycaemic outcomes were similar between participants who stopped GLP-1 RA therapy when initiating Gla-300 and those who received add-on Gla-300, although more participants receiving add-on Gla-300 achieved HbA1c targets. The expanded analysis yielded similar results. Incidence of hypoglycaemia was low with no clinically relevant weight changes in all analyses.</div></div><div><h3>Conclusions</h3><div>Treatment advancement with Gla-300 in patients with T2D, with/without prior GLP-1 RA therapy, improved glycaemic outcomes with no relevant impact on weight, while maintaining a low hypoglycaemia risk.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111871"},"PeriodicalIF":6.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343566","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":"Ambulatory blood pressure monitoring and vascular complications in patients with type 1 diabetes mellitus – Systematic review and meta-analysis of observational studies","authors":"Mariana Costa Hoffmeister ,&nbsp;Vinicius Hammel Lovison ,&nbsp;Eduardo Priesnitz Friedrich ,&nbsp;Ticiana da Costa Rodrigues","doi":"10.1016/j.diabres.2024.111873","DOIUrl":"10.1016/j.diabres.2024.111873","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to evaluate the role of the 24-Hour Ambulatory Blood Pressure Monitoring (ABPM) as a possible predictor of vascular outcomes in office normotensive people with type 1 diabetes mellitus (T1DM).</div></div><div><h3>Methods</h3><div>This is a systematic review including cohort studies from the Embase, PubMed/Medline, and Web of Science databases on people with T1DM undergoing ABPM and subsequent evaluation of vascular complications. Measurements of difference (MD) were obtained using random effect model <em>meta</em>-analysis.</div></div><div><h3>Results</h3><div>We found 364 articles and 49 duplicates. Seven studies were included, comprising 635 participants aged 25.8 ± 6.2 years. Most (57.5 %) were men, mean duration of diabetes was 11.8 ± 5.3 years, mean glycated hemoglobin level among participants was 8.5 % ± 1.6 %, and mean follow-up time was 4.2 years. Lower night systolic blood pressure MD − 4.37 mmHg (p = 0.0009) and night diastolic blood pressure MD − 3.97 mmHg (p &lt; 0.0001) were associated with lower incidence of albuminuria. People with<!--> <!-->T1DM who presented no beginning or progression of retinopathy were those with lower night diastolic blood pressure MD − 3.62 mmHg (p = 0.042), diurnal diastolic blood pressure MD − 2.69 mmHg (p = 0.0138), and 24-hour diastolic blood pressure MD − 3.65 mmHg (p = 0.037).</div></div><div><h3>Conclusion</h3><div>Small mean differences in blood pressure parameters, as measured by ABPM, between people with T1DM are associated with a lower incidence or risk of progression of nephropathy and retinopathy.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111873"},"PeriodicalIF":6.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying subtypes of type 2 diabetes mellitus based on real-world electronic medical record data in China","authors":"Jiayu Wang ,&nbsp;Bixia Gao ,&nbsp;Jinwei Wang ,&nbsp;Wenwen Liu ,&nbsp;Weijia Yuan ,&nbsp;Yangfan Chai ,&nbsp;Jun Ma ,&nbsp;Yangyang Ma ,&nbsp;Guilan Kong ,&nbsp;Minchao Liu","doi":"10.1016/j.diabres.2024.111872","DOIUrl":"10.1016/j.diabres.2024.111872","url":null,"abstract":"<div><h3>Aims</h3><div>To replicate the European subtypes of type 2 diabetes mellitus (T2DM) in the Chinese diabetes population and investigate the risk of complications in different subtypes.</div></div><div><h3>Methods</h3><div>A diabetes cohort using real-world patient data was constructed, and clustering was employed to subgroup the T2DM patients. Kaplan–Meier analysis and the Cox models were used to analyze the association between diabetes subtypes and the risk of complications.</div></div><div><h3>Results</h3><div>A total of 2,652 T2DM patients with complete clustering data were extracted. Among them, 466 (17.57 %) were classified as severe insulin-deficient diabetes (SIDD), 502 (18.93 %) as severe insulin-resistant diabetes (SIRD), 672 (25.34 %) as mild obesity-related diabetes (MOD), and 1,012 (38.16 %) as mild age-related diabetes (MARD). The risk of chronic kidney disease (CKD) and diabetic retinopathy (DR) were different in the four subtypes. Compared with MARD, SIRD had a higher risk of CKD (HR 2.40 [1.16, 4.96]), and SIDD had a higher risk of DR (HR 2.16 [1.11, 4.20]). The risk of stroke and coronary events had no difference.</div></div><div><h3>Conclusions</h3><div>The European T2DM subtypes can be replicated in the Chinese diabetes population. The risk of CKD and DR varied among different subtypes, indicating that proper interventions can be taken to prevent specific complications in different subtypes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111872"},"PeriodicalIF":6.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343570","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 glycemic variability and prognosis in patients with traumatic brain injury: A retrospective study from the MIMIC-IV database","authors":"Linrui Qi ,&nbsp;Xin Geng ,&nbsp;Rongliang Feng ,&nbsp;Shuaishuai Wu ,&nbsp;Tengyue Fu ,&nbsp;Ning Li ,&nbsp;Hongming Ji ,&nbsp;Rui Cheng ,&nbsp;Hao Wu ,&nbsp;Dan Wu ,&nbsp;Lian Huang ,&nbsp;Qingshan Long ,&nbsp;Xiangyu Wang","doi":"10.1016/j.diabres.2024.111869","DOIUrl":"10.1016/j.diabres.2024.111869","url":null,"abstract":"<div><h3>Background</h3><div>Elevated glycemic variability (GV) often occurs in intensive care unit (ICU) patients and is associated with patient prognosis. However, the association between GV and prognosis in ICU patients with traumatic brain injury (TBI) remains unclear.</div></div><div><h3>Method</h3><div>Clinical data of ICU patients with TBI were obtained from the Medical Information Mart for Intensive Care (MIMIC) -IV database. The coefficient of variation (CV) was utilized to quantify GV, while the Glasgow Coma Scale (GCS) was employed to evaluate the consciousness status of TBI patients. Pearson linear correlation analysis, linear regression, COX regression and restricted cubic spline (RCS) were used to investigate the relationship between CV and consciousness impairment, as well as the risk of in-hospital mortality.</div></div><div><h3>Result</h3><div>A total of 1641 ICU patients with TBI were included in the study from the MIMIC-IV database. Pearson linear correlation and restricted cubic spline (RCS) analysis results showed a negative linear relationship between CV and the last GCS (<em>P</em> = 0.002) with no evidence of nonlinearity (P for nonlinear = 0.733). Multivariable linear regression suggested a higher CV was associated with a lower discharge GCS [β (95 %CI) = −1.86 (−3.08 ∼ −0.65), <em>P</em> = 0.003]. Furthermore, multivariable COX regression indicated that CV ≥ 0.3 was a risk factor for in-hospital death in TBI patients [HR (95 %CI) = 1.74 (1.15–2.62), <em>P</em> = 0.003], and this result was also consistent across sensitivity and subgroup analyses.</div></div><div><h3>Conclusion</h3><div>Higher GV is related to poorer consciousness outcomes and increased risk of in-hospital death in ICU patients with TBI. Additional research is needed to understand the logical relationship between GV and TBI progression.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111869"},"PeriodicalIF":6.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}