Diabetes & metabolism最新文献

{"title":"Reduced risks of colorectal cancer with GLP-1RAs in type 2 diabetes: A nationwide cohort study using a target trial emulation framework","authors":"Chih-Chien Wu ,&nbsp;Chien-Chou Su ,&nbsp;Yu-Ching Chang ,&nbsp;Pei-Ting Lee ,&nbsp;Yi-Chia Su","doi":"10.1016/j.diabet.2025.101695","DOIUrl":"10.1016/j.diabet.2025.101695","url":null,"abstract":"<div><h3>Aim</h3><div><em>-</em> Type 2 diabetes (T2D) is associated with increased risk of colorectal cancer (CRC). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce CRC risk compared to insulin therapy; however, current evidence is controversial. We aimed to evaluate the association between CRC and the use of GLP-1RAs and long-acting insulins (LAIs).</div></div><div><h3>Methods</h3><div><em>-</em> This target trial emulation employed nationwide data from a Taiwanese T2D cohort. We identified new GLP-1RA and LAI users from 2013 to 2021, and applied propensity score (PS) matching to ensure comparable baseline characteristics. The primary outcome was CRC. Follow-up lasted until outcome occurrence, death, or study end in 2022, whichever came first. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated to assess the association between treatment and outcomes. Sensitivity analyses—including stabilized inverse probability weighting, time-dependent survival analysis, E-values, and negative control outcome analyses—were conducted to test the robustness of findings.</div></div><div><h3>Results</h3><div><em>-</em> We included 11,726 PS-matched pairs of GLP-1RA and LAI users and found no significant baseline disparities between cohorts. Compared to LAIs, GLP-1RAs were associated with significantly reduced CRC risk (HR [95 % CI]: 0.66 [0.48–0.92]), with the association limited to the rectum (HR: 0.53 [0.28–0.92]) but not observed in the right- or left-sided colon (right, HR: 0.69 [0.41–1.19]; left, HR: 0.77 [0.44–1.33]). These findings were consistent across sensitivity analyses and among patients with varying baseline characteristics.</div></div><div><h3>Conclusion</h3><div><em>-</em> Among patients with T2D requiring injectable glucose-lowering agents, GLP-1RA use, compared to LAIs, was associated with reduced CRC risk, particularly in the rectum.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101695"},"PeriodicalIF":4.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body weight trends in individuals with type 1 diabetes using automated insulin delivery vs. traditional insulin pumps","authors":"Charles Thivolet ,&nbsp;Zoé Henry ,&nbsp;Nathalie Bendelac ,&nbsp;Sylvie Villar Fimbel","doi":"10.1016/j.diabet.2025.101693","DOIUrl":"10.1016/j.diabet.2025.101693","url":null,"abstract":"<div><h3>Objective</h3><div>This study analyzed the determinants of weight gain among participants initiating an automated insulin delivery (AID) system.</div></div><div><h3>Research design and methods</h3><div>In this observational study, we evaluated 928 persons with type 1 diabetes initiating an insulin pump therapy, including 467 with AID, 98 with pumps with predictive low-glucose suspend (PLGS) algorithm and 363 initiating a sensor-augmented pump (SAP).</div></div><div><h3>Results</h3><div>After 3 months, median (95CI) TIR increased from 50.69 % [49.2–52.3] to 67.9 % [66.7–69.1] in the AID group and HbA1c levels showed a mean reduction of 0.82 %. AID resulted in equivalent body weight gain to SAP and PLGS despite significant improvements in glucose control. Multivariable analysis revealed that weight gain was linked to baseline HbA1C (<em>P</em> &lt; 0.001) and age but not to the type of pump system. During follow-up, percentage increase in body weight at 12 months were similar between groups</div></div><div><h3>Conclusions</h3><div>In persons with T1D, AID did not increase weight gain in comparison to other pump systems.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101693"},"PeriodicalIF":4.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between smoking status and suicide mortality in patients with type 2 diabetes: A nationwide population-based cohort study","authors":"Chaiho Jeong ,&nbsp;Bongseong Kim ,&nbsp;Dae Jong Oh ,&nbsp;Tae-Seo Sohn ,&nbsp;Kyungdo Han ,&nbsp;Hyuk-Sang Kwon","doi":"10.1016/j.diabet.2025.101692","DOIUrl":"10.1016/j.diabet.2025.101692","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 2 diabetes (T2D) are at greater risk of suicide due to stresses associated with disease management. Smoking adds to this burden. However, its association with suicide mortality in this population remains unclear. This study aimed to evaluate the relationship between smoking and suicide mortality in this high-risk group.</div></div><div><h3>Methods</h3><div>This cohort study utilized the Korean National Health Insurance Service (NHIS) database. A total of 2,524,769 participants aged ≥ 20 years with T2D who underwent national health examinations in 2015–2016 were included. Participants were followed until suicide death or the end of the study period.</div></div><div><h3>Results</h3><div>Over 5.8 years mean follow-up, 5,578 individuals died by suicide. Risk of suicide mortality was significantly higher—adjusted hazard ratio [95 % confidence interval]—in current smokers compared to never-smokers: 1.55 [1.44;1.67]. A dose–response pattern was observed among current smokers: 1.41 [1.22;1.63] for light smokers (&lt;10 cigarettes/day) and 1.66 [1.52;1.81] for heavy smokers (≥20/day). In ex-smokers, only those with a smoking history of ≥ 30 years exhibited an elevated risk: 1.12 [1.02;1.24]. The association was particularly strong in women: 2.97 [2.39;3.69]; and individuals aged &lt;65 years: 1.76 [1.61;1.92].</div></div><div><h3>Conclusions</h3><div>Current smoking was significantly associated with increased suicide mortality in patients with T2D, particularly among heavy smokers, women and those younger than 65 years. Long-term smoking history was also associated with elevated risk among ex-smokers.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101692"},"PeriodicalIF":4.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conduction disturbances in Type 1 and Type 2 Diabetes in two large independent nationwide and international databases","authors":"Lucile Accoceberry ,&nbsp;Uazman Alam ,&nbsp;Grégoire Fauchier ,&nbsp;Lisa Lochon ,&nbsp;Arnaud Bisson ,&nbsp;Pierre Henri Ducluzeau ,&nbsp;Gregory Y.H. Lip ,&nbsp;Laurent Fauchier","doi":"10.1016/j.diabet.2025.101690","DOIUrl":"10.1016/j.diabet.2025.101690","url":null,"abstract":"<div><h3>Aim</h3><div>Type 1 (T1D) and type 2 diabetes (T2D) are associated with increased cardiovascular risk, but limited data exist on their independent association with conduction disturbances. We evaluated the association between diabetes and conduction disorders, comparing T1D and T2D populations with non-diabetic controls in two independent databases.</div></div><div><h3>Methods</h3><div>Observational study using two large databases with matched cohorts: the French PMSI and the international TriNetX network. PMSI captures nationwide hospital admissions in France, while TriNetX includes patients from over 120 healthcare organizations worldwide. We identified &gt; 440,000 patients with T2D from PMSI and &gt; 900,000 patients with T2D and &gt; 20,000 patients with T1D from TriNetX. Using 1:1 propensity score matching, these patients were matched to non-diabetic controls based on demographics and comorbidities</div></div><div><h3>Results</h3><div>Compared to no DM, T2D was associated with a higher risk of conduction disturbances, including atrioventricular block (HR 1.22 [1.19–1.25], PMSI; HR 1.50 [1.45–1.55], TriNetX), left bundle branch block (BBB), (HR 1.12 [1.08–1.17], PMSI; HR 1.50 [1.47–1.54], TriNetX), and right BBB (HR 1.14 [1.09–1.18], PMSI; HR 1.38 [1.34–1.43], TriNetX). Patients with T2D also had a higher risk of myocardial infarction (HR 1.29 [1.25–1.32], PMSI; HR 2.14 [2.08–2.19], TriNetX). Conversely, T1D was not associated with an increased risk of conduction disorders in the TriNetX cohort.</div></div><div><h3>Conclusion</h3><div>T2D is independently associated with conduction disturbances and a higher incidence of coronary events compared to no DM, whereas T1D does not appear to confer the same risk. This suggests distinct pathophysiological mechanisms and the possible need for enhanced monitoring in T2D patients.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101690"},"PeriodicalIF":4.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring perceived barriers to physical activity among individuals with type 1 diabetes in the era of new technologies: An analysis from the BETTER registry","authors":"C. Guédet ,&nbsp;L. Alexandre-Heymann ,&nbsp;J.E. Yardley ,&nbsp;V. Messier ,&nbsp;V. Boudreau ,&nbsp;T. Chahal ,&nbsp;M. Dostie ,&nbsp;M-E. Mathieu ,&nbsp;A-S. Brazeau ,&nbsp;S. Tagougui ,&nbsp;R. Rabasa-Lhoret","doi":"10.1016/j.diabet.2025.101677","DOIUrl":"10.1016/j.diabet.2025.101677","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to identify barriers to physical activity for people living with type 1 diabetes (PwT1D) and their relationship with sociodemographic and disease-specific factors.</div></div><div><h3>Methods</h3><div><em>-</em> Cross-sectional study with BETTER registry participants (&gt;14 years) who completed the BAPAD1 (Barriers to Physical Activity in T1D) questionnaire. An item with a score of 5 or more was defined as a barrier. Participants were categorized into 4 subgroups based on their insulin therapy and blood glucose monitoring modality: 1) multiple daily injections (MDI) without continuous glucose monitoring (CGM), 2) MDI with CGM, 3) continuous subcutaneous insulin infusion (CSII) with CGM, and 4) automated insulin delivery system (AID).</div></div><div><h3>Results</h3><div>Among 1117 participants, the main perceived barrier was fear of hypoglycemia. BAPAD1 scores were similar across all subgroups, but more individuals in the AID group perceived \"fear of hypoglycemia\" and \"loss of control over diabetes\" as barriers. Being female, having a low income or education level, being overweight or obese, taking medication for depression, younger diabetes, higher HbA1c, presence of microvascular complications, and lack of confidence in managing hypoglycemia were associated with higher BAPAD1 score.</div></div><div><h3>Conclusion</h3><div>Fear of hypoglycemia remains the main barrier to physical activity for PwT1D. Technological advances alone are not sufficient to reduce perceived barriers to physical activity, highlighting the need for complementary educational and behavioral interventions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101677"},"PeriodicalIF":4.6,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between continuous glucose monitoring metrics and metabolic dysfunction-associated steatotic liver disease in adults with type 1 diabetes undergoing vibration-controlled transient elastography: a multicenter cross-sectional study","authors":"Alessandro Mantovani ,&nbsp;Stefano Ciardullo ,&nbsp;Elena Sani ,&nbsp;Alessandro Csermely ,&nbsp;Emigela Shtembari ,&nbsp;Ilaria Milani ,&nbsp;Paolo Sbraccia ,&nbsp;Gianluca Perseghin ,&nbsp;Frida Leonetti ,&nbsp;Giovanni Targher ,&nbsp;Valeria Guglielmi ,&nbsp;Danila Capoccia","doi":"10.1016/j.diabet.2025.101684","DOIUrl":"10.1016/j.diabet.2025.101684","url":null,"abstract":"<div><h3>Background</h3><div>There is uncertainty regarding the association between continuous glucose monitoring (CGM), derived glycemic metrics, and metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>We consecutively enrolled 262 adult individuals with established T1D undergoing vibration-controlled transient elastography (VCTE) with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). All participants underwent CGM. MASLD was defined as CAP ≥248 dB/m and the presence of at least one cardiometabolic risk factor. Significant liver fibrosis was defined as LSM ≥8 kPa.</div></div><div><h3>Results</h3><div>Participants had a mean age of 54±13 years, a mean body mass index (BMI) of 25.8 ± 5.6 kg/m² and a mean HbA1c of 7.7 ± 1.4 %. The prevalence of MASLD and significant liver fibrosis was 35.1 % (<em>n</em> = 92) and 4.6 % (<em>n</em> = 12), respectively. Using quantile regression analysis, time above range 180–250 mg/dl (TAR1) was significantly associated with increased CAP values (coefficient: 1.037; 95 % confidence interval [0.216;1.858]; <em>P</em> = 0.013). This association remained significant even after adjusting for age, sex, BMI, HbA1c, and total daily insulin dose. Other variables independently associated with CAP were older age, male sex, BMI, and total daily insulin dose. Using a random forest regression model, BMI was found to be the most important factor, followed by age, total daily insulin dose, and TAR1.</div></div><div><h3>Conclusions</h3><div>TAR1 was independently associated with increased CAP values, even after adjustment for age, BMI, sex, HbA1c, and total daily insulin dose, suggesting a potential role for glycemic variability in hepatic fat accumulation in adults with T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101684"},"PeriodicalIF":4.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-translational modifications of apolipoproteins as promising biomarkers for diabetes-related cardiovascular diseases: A comprehensive review","authors":"Chloé Chevalier ,&nbsp;Arsênio Rodrigues Oliveira ,&nbsp;Valentin Blanchard ,&nbsp;Cédric Le May ,&nbsp;Bertrand Cariou ,&nbsp;Samy Hadjadj ,&nbsp;Mikaël Croyal","doi":"10.1016/j.diabet.2025.101683","DOIUrl":"10.1016/j.diabet.2025.101683","url":null,"abstract":"<div><div>Lipoproteins are biochemical complexes of apolipoproteins and lipids that primarily mediate the transport of lipids through the circulation, from sites of absorption or synthesis to those of use, storage, or excretion. In type 2 diabetes (T2D), disruptions in lipoprotein metabolism are key drivers of complications and strongly contribute to atherosclerotic cardiovascular disease (ASCVD). As a result, ASCVD remains the leading cause of death in T2D, with significantly higher prevalence than in non-diabetic individuals. Protein post-translational modifications (PTMs) have emerged as key contributors to organ failure mechanisms, with specific PTMs closely linked to the pathogenesis of T2D. Several reports also emphasized the value of plasma apolipoproteins for the early prediction of ASCVD in cardiometabolic diseases. Thus, apolipoproteins, and especially their structurally post-translational modified forms, offer new insights into the molecular mechanisms of lipoprotein dysfunction and may enhance the specificity of ASCVD risk stratification in T2D. This review outlines major apolipoprotein PTMs identified in T2D, many of which can now be quantified in biological samples, particularly via mass spectrometry. We also discuss their role in lipoprotein metabolism dysfunction and their potential value in assessing ASCVD risk in T2D, highlighting their growing potential as clinical biomarkers in population-based cohort studies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101683"},"PeriodicalIF":4.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists, body composition, skeletal muscle and risk of sarcopaenia: from promising findings in animal models to debated concern in human studies","authors":"André J. Scheen","doi":"10.1016/j.diabet.2025.101681","DOIUrl":"10.1016/j.diabet.2025.101681","url":null,"abstract":"<div><div>Background. - Glucagon-like peptide-1 (GLP-1)-based therapies induce a clinically relevant weight loss, which is associated with overall better prognosis in people with type 2 diabetes and/or clinical obesity. However, a risk of excessive reduction in fat-free mass (FFM) and skeletal muscle mass (SSM), potentially leading to sarcopaenia in at-risk patients, is currently a matter of debate as this negative effect could minimize their benefit/risk balance. <em>Methods.</em> - An extensive literature search to detect animal and human studies that investigated the effects of GLP-1-based therapies on changes in body composition (FFM and SMM), muscle strength, structure, and function. <em>Results.</em> - Favourable effects on SMM, intramuscular lipid deposition, inflammation and mitochondrial health were consistently reported in different rodent models with GLP-based therapies. However, mixed results were reported in human studies, some reported an excessive FFM/SMM loss while others arguing for a protective effect against sarcopaenia (including less myosteatosis). This controversy may result from misinterpretation of SMM derived from FFM changes and a lack of studies that properly investigate SMM, muscle function and structure in humans. <em>Conclusion</em>. - Maximizing fat loss while preserving lean (muscle) tissue mass and function is a central goal of modern obesity pharmacological treatments. Currently, available data preclude to have a definite conclusion about positive/negative effects of GLP-1-based therapies on muscle. Further investigations using accurate methodologies to assess not only SMM but also muscle structure, function (strength) and performance are needed to better analyse the effects of GLP-1-based therapies, especially among individuals at higher risk of sarcopaenia, older patients and frail people.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101681"},"PeriodicalIF":4.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of cardiovascular events by skin auto-fluorescence: the DIABAGE follow-up study","authors":"Jorys Bueno ,&nbsp;Alpha M. Diallo ,&nbsp;Stéphane Jaisson ,&nbsp;Jenny Fontaine ,&nbsp;Céline Lukas ,&nbsp;Romain Barriquand ,&nbsp;Géraldine Vitellius ,&nbsp;Philippe Gillery ,&nbsp;Brigitte Delemer ,&nbsp;Sara Barraud","doi":"10.1016/j.diabet.2025.101682","DOIUrl":"10.1016/j.diabet.2025.101682","url":null,"abstract":"<div><h3>Aim</h3><div>Advanced glycation end-products (AGEs) are known to play a role in the pathophysiology of type 1 diabetes (T1D) complications. The aim of this study was to assess the predictive value of AGEs indirectly evaluated by skin auto-fluorescence (SAF) on the occurrence of cardiovascular events (CVEs) in T1D.</div></div><div><h3>Methods</h3><div>We measured baseline SAF in T1D patients with at least 10 years history of diabetes and assessed incident CVEs. An optimum threshold of SAF was determined using ROC curve, and its predictive value was assessed by Cox proportional regression.</div></div><div><h3>Results</h3><div>The study included 179 patients, 53 % of whom were women. At baseline, the mean age was 47.7 ± 15.9 years, the mean duration of diabetes was 26.4 ± 12.2 years. Median HbA_1c was 7.7 % (7.3–8.7) and median LDL cholesterol was 2.58 mmol/l (2.14–3.07). Median follow-up was 7.4 years (6.85 - 7.7) with 34 CVEs in 24 patients.</div><div>The median SAF level was 2.7 (2.3–3.1) in patients with incident CVEs and 2.1 (1.8–2.6) in patients without CVEs. The optimum threshold of SAF to differentiate patients with or without incident CVEs was 2.2. The occurrence of CVE was predicted by the optimum SAF threshold in the unadjusted model (HR 6.46), but also after adjustment with different models (HR 3.15–5.05).</div></div><div><h3>Conclusion</h3><div>SAF level is higher in people living with T1D who will present CVEs. Furthermore, SAF threshold of 2.2 predicted the occurrence of CVE. If these results are confirmed, SAF could be a useful marker in cardiovascular risk stratification in T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101682"},"PeriodicalIF":4.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of chiglitazar, a pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes: a real-world study","authors":"Yijiong Tan ,&nbsp;Wenjun Qu ,&nbsp;Jiehua Zhao ,&nbsp;Yunqin Ma ,&nbsp;Qidi Zhang ,&nbsp;Hong Gao ,&nbsp;Qin Zhen ,&nbsp;Yufan Wang ,&nbsp;Yongde Peng ,&nbsp;Fang Liu ,&nbsp;Nengguang Fan","doi":"10.1016/j.diabet.2025.101680","DOIUrl":"10.1016/j.diabet.2025.101680","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the efficacy of chiglitazar, a novel pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes (T2D) in a real-world clinical setting.</div></div><div><h3>Materials and methods</h3><div>This prospective cohort study included T2D patients with MASLD who received either chiglitazar or other glucose-lowering medications over a 24-week period. To minimize selection bias, 1:1 propensity score matching (PSM) was implemented. The primary outcomes were changes in controlled attenuation parameter (CAP, measuring hepatic steatosis) and liver stiffness measurement (LSM, assessing fibrosis). Secondary outcomes included glycemic parameters and liver enzymes.</div></div><div><h3>Results</h3><div>A total of 235 T2D patients were enrolled (40 chiglitazar users, 195 non-chiglitazar users), and 31 matched pairs were derived after 1:1 PSM. The adjusted mean reduction in CAP from baseline to 24 weeks was significantly greater in the chiglitazar group (-28.38 dB/m [95 % CI:36.11;-20.65]) compared to the non-chiglitazar group (-16.74 dB/m [-24.47;-9.01]), with a between-group difference of -11.64 dB/m (-22.38;-0.90, <em>P</em> = 0.038). LSM changes were similar between groups (difference in LS mean:0.11 [-1.04;0.82], <em>P</em> = 0.813). Subgroup analyses indicated that the beneficial effect of chiglitazar was consistent across variables such as sex, age, body mass index, and concomitant use of SGLT-2 inhibitors or GLP-1 receptor agonists (all <em>P</em> for interaction &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Chiglitazar administration is associated with a significant reduction in CAP values in T2D patients with MASLD, suggesting its potential as a dual therapeutic approach for both conditions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101680"},"PeriodicalIF":4.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}