Diabetes research and clinical practice最新文献

{"title":"Predicting factors of sleep quality among adults with type 2 diabetes mellitus: A systematic review.","authors":"Anggraini Dwi Kurnia, Ratsiri Thato, Hsiu Ting Tsai","doi":"10.1016/j.diabres.2025.112388","DOIUrl":"10.1016/j.diabres.2025.112388","url":null,"abstract":"<p><p>The prevalence of poor sleep quality among adults with type 2 diabetes has significantly increased in recent years. This study aimed to review the empirical evidence regarding predicting factors of sleep quality among adults with type 2 diabetes mellitus (T2DM). A comprehensive systematic review search was conducted using Wiley Online Library, PubMed, Scopus, Science Direct, and ProQuest. The publication was completed in August 2024 and the systematic review protocol was registered with PROSPERO (CRD42024564579). The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. A narrative synthesis was performed. Of the 7760 articles identified in the search, 24 articles in cross-sectional studies, case-control, and cohort studies were included in this review. The systematic review classified the factors into socio-demographic factors (gender, marital status, economic status, age, ethnicity), disease characteristics (duration of diabetes, diabetes complication, nocturia, insulin therapy), psychological factors (depressive symptom, anxiety symptoms, diabetes distress), physical factors (poor glycemic control, lower frequency of exercise, bad dietary status, smoking habit, Low HDL cholesterol, high risk of OSA), environmental factor, and social support were found to be predictors of sleep quality among adults with T2DM. Sleep quality can be influenced by socio-demographic factors, disease characteristics, psychological factors, physical factors, environmental factors, and social support. Diabetes programs to enhance sleep quality among adults with T2DM are highly encouraged based on these factors.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112388"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798449","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":"Effects of individual, health system and neighborhood risks on diabetes health outcomes among emerging adults with type 1 diabetes.","authors":"Deborah A Ellis, April Idalski Carcone, Colleen Buggs-Saxton, Arti Bhan, M Bassem Dekelbab","doi":"10.1016/j.diabres.2025.112415","DOIUrl":"10.1016/j.diabres.2025.112415","url":null,"abstract":"<p><strong>Aims: </strong>To test associations between individual, health system and neighborhood-level risk and protective factors, and health outcomes in a diverse sample of emerging adults (EAs) with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>Data were drawn from the baseline data collection of a clinical trial. One hundred and thirteen EAs [47.8 % White/non-Hispanic; mean age = 20.9 years; mean HbA1c = 9.5 % (IFCC = 81 mmol/mol)] completed self-report questionnaires on diabetes-self efficacy, diabetes distress, communication with diabetes health care provider, neighborhood crime and diabetes management. Structural equation modelling estimated the direct and indirect effects of individual, health care provider, and neighborhood factors on diabetes management and glycemic control.</p><p><strong>Results: </strong>In the final model, self-efficacy for diabetes care was the only significant predictor of diabetes management (β = 0.32, p < 0.001). Neighborhood crime (β = 0.17, p < 0.05) and diabetes management (β = -0.28, p < 0.05) had significant direct effects on glycemic control, while diabetes self-efficacy had a significant indirect effect though diabetes management (β = -0.090; p < 0.01).</p><p><strong>Conclusions: </strong>Individual factors such as higher self-efficacy for diabetes management and neighborhood factors such as lower crime rates have protective effects on the diabetes health of EAs with T1D.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112415"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811898","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":"Sex-specific thresholds of peak oxygen consumption for detecting cardiometabolic risk in children and adolescents with type 1 diabetes.","authors":"Antonio García-Hermoso, Nidia Huerta-Uribe, Ignacio Hormazábal-Aguayo, Jacinto Muñoz-Pardeza, Valderi de Abreu de Lima, Neiva Leite, Suzana Nesi-França, Rodrigo Yáñez-Sepúlveda, Juan Hurtado-Almonacid, Yasmin Ezzatvar","doi":"10.1016/j.diabres.2025.112410","DOIUrl":"10.1016/j.diabres.2025.112410","url":null,"abstract":"<p><strong>Aims: </strong>To establish sex-specific peak oxygen consumption (VO_2peak) thresholds that accurately discriminate cardiometabolic risk (CMR) in children and adolescents with type 1 diabetes and to validate these cut-off points using an independent cohort.</p><p><strong>Methods: </strong>This longitudinal study included 83 participants (aged 8-18 years) with type 1 diabetes from the Diactive-1 cohort. VO_2peak was assessed via maximal exercise testing with direct gas analysis, and CMR was calculated using a composite z-score of waist circumference, lipid profile, HbA1c, and blood pressure. VO_2peak thresholds for CMR were identified by sex using logistic regression and receiver operating characteristic analysis, and externally validated in a Brazilian cohort (n = 36). A total of 62 individuals completed the 2-year follow-up assessment.</p><p><strong>Results: </strong>Optimal VO_2peak thresholds were 40.8 ml/kg/min for boys and 33.7 ml/kg/min for girls, with areas under the curve of 0.71 and 0.78, respectively. Participants below these thresholds had significantly higher lipids and overall CMR. These associations persisted at the two-year follow-up and were confirmed in the Brazilian cohort, which also showed elevated HbA1c among high-risk individuals.</p><p><strong>Conclusions: </strong>Our study supports the clinical utility of these thresholds as a non-invasive marker of metabolic health and reinforce the importance of cardiorespiratory fitness promotion in this population.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112410"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816044","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":"Regional and systemic adipose mass and peripheral conduit artery function.","authors":"Denis J Wakeham, Benjamin E Beckman, Mona Mashayekhi, James M Luther, Erica M Garner, Bradley Perkins, Joann Gottlieb, Kevin Niswender, Christopher M Hearon, Nancy J Brown, Joshua A Beckman","doi":"10.1016/j.diabres.2025.112408","DOIUrl":"10.1016/j.diabres.2025.112408","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular function and metabolic function are inherently coupled. While prior studies have linked body mass index (BMI) and visceral adiposity to reduced FMD, the relationship between whole-body and limb-specific adiposity and vascular function in adults with pre-diabetic levels of insulin resistance remains unclear.</p><p><strong>Methods: </strong>We assessed body composition (DEXA), insulin resistance (HOMA-IR and Matsuda Index), and brachial artery FMD in 93 pre-diabetic individuals (69 % Female) aged 18-65 with obesity (BMI ≥ 30 kg/m²). Data were analyzed with Pearson product-moment correlation coefficients.</p><p><strong>Results: </strong>FMD was not associated with BMI (r = 0.12, p = 0.24), total body fat (kg) (r = -0.12, p = 0.31), or arm fat (kg) (r = 0.00, p = 0.99). In contrast, there was an inverse correlation between FMD and Waist:Hip ratio (r = -0.24, p = 0.03), total body lean mass (r = -0.32, p = 0.005) and arm lean mass (r = -0.25, p < 0.03). The correlation between FMD and Waist:Hip ratio persisted after adjusting for HOMA-IR (r =  - 0.31, P = 0.01), the Matsuda Index (r =  - 0.31, P < 0.01) and sex (r = -0.35, p = 0.006).</p><p><strong>Conclusion: </strong>In adults with obesity and insulin resistance, higher visceral adiposity, but not systemic and regional fat mass, is independently associated with impaired vascular function. These findings suggest that visceral fat distribution may have detrimental effects on vascular health, distinct from its impact on insulin sensitivity.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112408"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798450","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":"Relationship between triglyceride-glucose index and stroke risk in middle-aged and older Chinese population: a national longitudinal study based on explainable machine learning.","authors":"Ying Gao, Meihui Zhang, Chen Xu, Birong Wu, Shan Qiao, Yong Cai, Fan Hu","doi":"10.1016/j.diabres.2025.112414","DOIUrl":"10.1016/j.diabres.2025.112414","url":null,"abstract":"<p><strong>Aims: </strong>The triglyceride-glucose (TyG) index is a recognized surrogate marker for insulin resistance. This study explores the relationship between the baseline TyG index and the subsequent risk of stroke in middle-aged and older adults, while also examining the variable importance of various predictors potentially influencing stroke incidence.</p><p><strong>Methods: </strong>We included 6863 participants from the China Health and Retirement Longitudinal Study (CHARLS) who had no history of stroke at the start of the study. To identify important predictors, we employed the Least Absolute Shrinkage and Selection Operator (Lasso) Cox regression model, followed by a multivariate Cox proportional hazards model to analyze the association between the TyG index and future stroke incidence. Subgroup analyses by age and gender were conducted. The significance of different predictors was assessed using explainable survival machine learning models that accounted for temporal changes.</p><p><strong>Results: </strong>Over a 9-year follow-up, 787 participants (11.5 %) experienced a first stroke. The baseline TyG index had an inverted U-shaped relationship with stroke risk. After adjustment for confounders, participants in the second, third, and highest quartiles of the baseline TyG index showed a higher stroke risk compared to those in the lowest quartile (P < 0.01), with adjusted hazard ratios (HR) [95 % confidence intervals (CI)] of 1.45 (1.16-1.82), 1.64 (1.31-2.04), and 1.36 (1.08-1.72), respectively. These associations were consistent across all subgroups except for individuals younger than 60 years. Notably, age emerged as the most significant predictor of stroke risk in the explainable machine learning analysis, with the TyG index also identified as a relatively important factor.</p><p><strong>Conclusions: </strong>This research employs explainable machine learning to delineate factors that contribute to stroke risk, highlighting how the TyG index's impact on stroke risk varies by age and gender. As an established surrogate marker for insulin resistance, the TyG index monitoring may play a crucial role in stroke prevention and management strategies.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112414"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811899","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":"Associations between HbA1c and complications in children diagnosed with type 1 diabetes before age 6: A 30-year follow-up study","authors":"Chris Moran ,&nbsp;Taya A. Collyer ,&nbsp;Amy Brown ,&nbsp;Stacey A. Sakowski ,&nbsp;Velandai Srikanth ,&nbsp;Elisabeth A. Northam ,&nbsp;Richard Beare ,&nbsp;Eva L. Feldman ,&nbsp;Fergus J. Cameron","doi":"10.1016/j.diabres.2025.112447","DOIUrl":"10.1016/j.diabres.2025.112447","url":null,"abstract":"<div><h3>Aims</h3><div>To examine 30-year glycemic trajectory in children with early-onset type 1 diabetes (T1D) and ascertain which stages of childhood and adolescence were most contributory to subsequent microvascular disease.</div></div><div><h3>Methods</h3><div>We recruited children diagnosed with T1D between 1990–1992 into the Cognition and Longitudinal Assessment of Risk Factors over 30 Years cohort study in Australia. HbA_1c was collected from medical records and microvascular complications assessed through self-reports, clinical screenings, retinal photographs, and urinary albumin-creatinine testing.</div></div><div><h3>Results</h3><div>We recruited 30 of the 43 eligible children from the original cohort (Female = 56 %; mean diagnosis age = 2.9 years). After an average of 29.7 years (SD = 3.9 years), 13 participants (33 %) developed neuropathy, 19 (63 %) diabetes-related eye disease, and 3 (10 %) nephropathy. Mean HbA_1c estimates during adolescence (9.0 % [74.9 mmol/mol], 95 %CI 8.6–9.3[70.5–78.1]) were higher than childhood (8.2 % [66.1 mmol/mol], 95 %CI 7.8–8.5[61.7–69.4], p &lt; 0.001) and adulthood (8.2 % [66.1 mmol/mol], 95 %CI 7.8–8.5[61.7–69.4]). There was a statistically significant association between greater deviation from mean childhood HbA_1c and increased neuropathy risk (RRR = 7.8, 95 %CI 1.1–57.4, p = 0.009) but not retinopathy or nephropathy (p ≥ 0.06).</div></div><div><h3>Conclusions</h3><div>Regardless of pre-existing childhood control, adolescent hyperglycemia leads to higher neuropathy risk in adulthood. Adolescent glycemic management is crucial, and individuals with adolescent hyperglycemia may require more support transitioning to adult care.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112447"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991771","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":"Synergistic association of estimated glucose disposal rate and neutrophil-to-albumin ratio with accelerated biological aging","authors":"Binbin Wang ,&nbsp;Shuke Liu ,&nbsp;Quan Li ,&nbsp;Na Meng ,&nbsp;Yan Chen ,&nbsp;Gangzhen Qian","doi":"10.1016/j.diabres.2025.112449","DOIUrl":"10.1016/j.diabres.2025.112449","url":null,"abstract":"<div><h3>Background</h3><div>Biological age (BA) is a more accurate indicator of aging-related functional decline and disease risk than chronological age (CA). Insulin resistance and chronic inflammation are established hallmarks linked to the aging process; however, their synergistic relationship with biological age acceleration is not yet well understood.</div></div><div><h3>Methods</h3><div>To evaluate the independent and synergistic associations of estimated glucose disposal rate (eGDR), a marker of insulin sensitivity, and neutrophil-to-albumin ratio (NPAR), a reliable marker of systemic inflammation that also captures its impact on metabolic processes, with biological age acceleration estimated by Klemera-Doubal method biological age (KDM-BA) and PhenoAge. We analyzed cross-sectional data from 35,169 U.S. adults aged ≥20 years in National Health and Nutrition Examination Survey (NHANES) 1999–2010 and 2015–2018. Biological age acceleration was defined as BA exceeding chronological age. Multivariable regression and restricted cubic spline models were used to assess linear and nonlinear associations. We examined the combined association of eGDR and NPAR with aging markers, adjusting for a comprehensive set of demographic, lifestyle, and comorbidity covariates.</div></div><div><h3>Results</h3><div>In fully adjusted models, eGDR was robustly and inversely associated with KDM-BA acceleration (OR per 1-unit increase: 0.69, 95 % CI: 0.67–0.72). Compared to the lowest tertile, participants in the highest eGDR tertile had a 83 % lower odds of KDM-BA acceleration (OR = 0.17, 95 % CI: 0.14–0.20). No significant association was observed between eGDR and PhenoAge acceleration. Conversely, higher NPAR was positively associated with acceleration of both KDM-BA (OR per unit increase 1.12, 95 % CI: 1.10–1.14) and PhenoAge (OR per unit increase 1.27, 95 % CI: 1.24–1.30). Participants in the highest NPAR tertile exhibited significantly increased odds of accelerated aging compared to the lowest tertile (KDM-BA acceleration OR = 1.90, 95 % CI: 1.53–2.36; PhenoAge acceleration OR = 3.39, 95 % CI: 2.91–3.95). Both biomarkers showed significant nonlinear dose–response relationships with aging outcomes. Notably, combined exposure to low eGDR and high NPAR conferred the greatest risk of accelerated aging, with OR of 5.46 (95 % CI: 4.60–6.48) for KDM-BA and 2.98 (95 % CI: 2.46–3.62) for PhenoAge. Subgroup analyses revealed significant heterogeneity, with associations varying by BMI and chronic kidney disease status.</div></div><div><h3>Conclusion</h3><div>Reduced insulin sensitivity and heightened inflammation-nutrition imbalance are independently and synergistically associated with accelerated biological aging. The interplay between eGDR and NPAR, particularly their joint effect, highlights the pivotal role of the metabolic-inflammatory axis in the aging process. These findings suggest that combined monitoring of eGDR and NPAR could be a valuable strategy for early r","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112449"},"PeriodicalIF":7.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922788","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":"Analysis of foot thermography images of diabetic patients using artificial intelligence: a scoping review","authors":"Riki Wartakusumah ,&nbsp;Amika Yamada ,&nbsp;Hiroshi Noguchi ,&nbsp;Makoto Oe","doi":"10.1016/j.diabres.2025.112446","DOIUrl":"10.1016/j.diabres.2025.112446","url":null,"abstract":"<div><div>Artificial intelligence (AI) enhances thermal image analysis by providing advanced pattern recognition and improving the accuracy of diabetic foot condition detection. AI-driven thermography systems support clinicians, but research on AI for diabetic foot thermography is fragmented, with diverse algorithms and existing reviews focusing mainly on statistical performance. This review aimed to provide a comprehensive review of AI-based diabetic foot thermography, with a focus on condition detection, performance metrics, clinical implications, and existing research gaps. A scoping review was conducted using PubMed, MEDLINE, CINAHL, ScienceDirect, Scopus, and Google Scholar, with keywords “diabetic foot temperature,” “thermal imaging,” and “artificial intelligence,” including related MeSH terms. Eligible studies included original research and conference proceedings on AI-based foot thermography for diagnosing or monitoring diabetic adults. Literature reviews and <em>meta</em>-analyses were excluded. Sixty articles were reviewed. Most studies addressed increased temperature, followed by decreased temperature, and DFU severity classification pattern. AI performance ranged from 61% to 100%. Study environments were 46.67% controlled, 6.67% uncontrolled, and 46.67% unreported. AI applications included clinical decision support, remote monitoring, and reducing clinician workload. AI has advanced diabetic foot detection; however, additional studies in uncontrolled environments are needed to improve accuracy and enhance generalizability under real-world conditions.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112446"},"PeriodicalIF":7.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933287","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":"Possible correlation between Triglyceride/HDL ratio and subclinical myocardial damage in patients with cardiovascular risk factors","authors":"Velia Cassano ,&nbsp;Graziella D’Arrigo ,&nbsp;Mercedes Gori ,&nbsp;Giovanni Tripepi ,&nbsp;Giuseppe Armentaro ,&nbsp;Carlo A. Pastura ,&nbsp;Giandomenico Severini ,&nbsp;Mariarosangela Scarcelli ,&nbsp;Daniele Dallimonti Perini ,&nbsp;Sofia Miceli ,&nbsp;Raffaele Maio ,&nbsp;Vanessa T. Fiorentino ,&nbsp;Elena Succurro ,&nbsp;Marta L. Hribal ,&nbsp;Giorgio Sesti ,&nbsp;Francesco Andreozzi ,&nbsp;Angela Sciacqua","doi":"10.1016/j.diabres.2025.112448","DOIUrl":"10.1016/j.diabres.2025.112448","url":null,"abstract":"<div><h3>Aims</h3><div>The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio is considered a predictor of cardiovascular (CV) disease. The aim of the study was to evaluate the TG/HDL-C ratio as CV risk factor and its possible correlation with subclinical myocardial damage.</div></div><div><h3>Methods</h3><div>We enrolled 545 patients, all of whom underwent oral glucose tolerance test (OGTT). The TG/HDL-C ratio was calculated as the arithmetic ratio between triglyceride and HDL cholesterol concentrations.</div></div><div><h3>Results</h3><div>Patients were stratified into four quartiles based on TG/HDL-C values. From the first to the fourth quartile, there was a progressive deterioration in glucose metabolism, as evidenced by significant increases in fasting plasma glucose (FPG), 2-hour glucose, fasting plasma insulin (FPI), 2-hour insulin (all p &lt; 0.001), along with a reduction in insulin sensitivity. Left ventricular global systolic function, assessed via global longitudinal strain (GLS), showed progressive deterioration across quartiles (p &lt; 0.001). Logistic regression analysis revealed that each one-unit increase in the TG/HDL-C ratio was associated with a 61 % higher likelihood of having a pathological GLS (crude odds ratio: 1.61).</div></div><div><h3>Conclusion</h3><div>In conclusion, patients with elevated TG/HDL-C ratios exhibit subclinical myocardial dysfunction even in the absence of clinical symptoms. The TG/HDL-C ratio may represent a simple marker for early identification of CV risk.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112448"},"PeriodicalIF":7.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919775","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":"Periodontitis, accelerated biological aging, and advanced stages in cardiovascular-kidney-metabolic syndrome in U.S. Adults: A mediation analysis","authors":"Xiang Qi ,&nbsp;Junyu Sui ,&nbsp;Zhongfang Yang ,&nbsp;Alex Dahlen ,&nbsp;Kai Zhang ,&nbsp;Bei Wu","doi":"10.1016/j.diabres.2025.112437","DOIUrl":"10.1016/j.diabres.2025.112437","url":null,"abstract":"<div><h3>Aims</h3><div>Cardiovascular–Kidney–Metabolic (CKM) syndrome is a five‐stage framework integrating cardiovascular, renal, and metabolic health. Periodontitis may contribute to multi-system conditions like CKM syndrome, but its overall impact and mechanisms remain unclear.</div></div><div><h3>Methods</h3><div>We analyzed 3,102 U.S. adults (30–79 years) from NHANES 2009–2014. Periodontal status was classified as none, mild, moderate, or severe; CKM stage (0–4) was determined by clinical criteria. Biological age was estimated via the Klemera–Doubal Method (KDMAge) and Phenotypic Age (PhenoAge) algorithms. Ordinal and binary logistic regression assessed periodontitis–CKM associations, adjusting for sociodemographic and lifestyle factors. Mediation analysis quantified the proportion of this association explained by biological age acceleration (BAA).</div></div><div><h3>Results</h3><div>Advanced CKM (stage 3–4) affected 17.8 % of participants. Severe periodontitis versus none/mild was associated with 1.50‐fold higher odds of a more advanced CKM stage (95 % CI: 1.15–1.96) and 2.05‐fold higher odds of advanced CKM in binary models (95 % CI: 1.50–2.80). Severe periodontitis corresponded to + 1.1 years of KDMAge acceleration and + 1.2 years of PhenoAge acceleration (p &lt; 0.001). BAA mediated 20.1 % of the effect via KDMAge and 13.9 % via PhenoAge (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These findings underscore the importance of integrating oral health into cardiometabolic care, suggesting that addressing periodontal inflammation and BAA could improve CKM outcomes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112437"},"PeriodicalIF":7.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906871","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}