Diabetes & metabolism最新文献

{"title":"Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor agonist and an SGLT2 inhibitor in observational real-life studies","authors":"André J. Scheen","doi":"10.1016/j.diabet.2024.101594","DOIUrl":"10.1016/j.diabet.2024.101594","url":null,"abstract":"<div><h3>Background</h3><div>Combining a glucagon-like peptide-1 receptor agonist (GLP-1RA) and an sodium-glucose cotransporter 2 inhibitor (SGLT2i) improved cardiovascular (and renal) prognosis compared to either monotherapy in several post-hoc exploratory analyses of randomized controlled trials (RCTs) versus placebo carried out in patients with type 2 diabetes (T2DM) and high cardiovascular/renal risk. The aim of the present work is to verify if such a benefit of the combined therapy is also present in real-life clinical practice.</div></div><div><h3>Methods</h3><div>An extended search of the literature was performed to select observational retrospective studies that compared cardiovascular and/or renal outcomes in patients with T2DM treated with a GLP-1RA/SGLT2i combination versus patients treated with either GLP-1RA monotherapy or SGLT2i monotherapy, in addition to standard of care therapy.</div></div><div><h3>Results</h3><div>Nine observational studies showed that a GLP-1RA/SGLT2i combination is associated with a greater reduction in major adverse cardiovascular events (MACEs), hospitalization for heart failure and all-cause-mortality when compared to either GLP-1RA alone or SGLT2i alone, without obvious differences between the two monotherapies, including regarding heart failure. Results were obtained in different populations, including patients with atherosclerotic cardiovascular disease and/or heart failure. Only three observational studies gave information on renal outcomes, with a greater benefit when the GLP-1RA/SGLT2i combination was compared with GLP-1RA alone or SGLT2i alone.</div></div><div><h3>Conclusion</h3><div>In real-life conditions, the GLP-1RA/SGLT2i combination reduced cardiovascular and renal outcomes compared with both GLP-1RA monotherapy and SGLT2i monotherapy. Overall, observational studies confirm the results reported in post-hoc exploratory analyses of RCTs versus placebo.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101594"},"PeriodicalIF":4.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752504","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":"Prevent hypoglycaemia when using automated insulin delivery systems in type 1 diabetes requires near normal glycaemic variability","authors":"Louis Monnier ,&nbsp;Claude Colette ,&nbsp;Eric Renard ,&nbsp;Pierre-Yves Benhamou ,&nbsp;Safa Aouinti ,&nbsp;Nicolas Molinari ,&nbsp;David Owens","doi":"10.1016/j.diabet.2024.101589","DOIUrl":"10.1016/j.diabet.2024.101589","url":null,"abstract":"<div><h3>Aim</h3><div>Although newer technologies of insulin delivery in type 1 diabetes have facilitated an improvement in glycaemic control the risk of hypoglycaemia remains a threat. Therefore, it is important to define the thresholds of glycaemic variability below which the risk of hypoglycaemia can be eliminated or at least minimized.</div></div><div><h3>Methods</h3><div>Randomized controlled trials conducted from 2017 to 2023 comparing Sensor-Augmented-Pumps and Augmented Insulin Delivery Systems (<em>n</em> = 16 and 22 studies, respectively) were selected. A weighted linear model of regression was used to compute the relationship between glycaemic variability and times spent below glucose range. The intercepts of regression lines with the abscissa axis (time below range = 0 %) defined the glycaemic variability thresholds.</div></div><div><h3>Results</h3><div>Positive relationships were observed between the 2 metrics. The scatter plots indicated that the times spent below range never reached the value of 0 % and that the glycaemic variability never fell below 28 %. By extrapolating the regression lines, the glycaemic variability at intercepts with time below range &lt; 70 mg/dL of 0 % was 30.1 % with sensor augmented pumps and 18.9 % with automated insulin delivery. For a time below range &lt; 54 mg/dL of 0 % the respective glycaemic variability values were 32.7 % and 19.9 % (with sensor augmented pumps and automated insulin delivery, respectively).</div></div><div><h3>Conclusions</h3><div>Importantly, glycaemic variability targets and ambient hyperglycaemia are interdependent. Users of automated insulin delivery need to reach a glycaemic variability of 18 % to 20 % to minimize or eradicate the risk of hypoglycaemia. Such values are those observed in healthy non-diabetic people.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101589"},"PeriodicalIF":4.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712350","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":"Medial arterial calcification of the lower limbs in diabetes: Time for awareness? A short narrative review","authors":"Jean-Michel Davaine ,&nbsp;Damien Denimal ,&nbsp;Pauline Treca ,&nbsp;Hugo Francon ,&nbsp;Franck Phan ,&nbsp;Agnès Hartemann ,&nbsp;Olivier Bourron","doi":"10.1016/j.diabet.2024.101586","DOIUrl":"10.1016/j.diabet.2024.101586","url":null,"abstract":"<div><div>In patients with diabetes, peripheral arterial disease, particularly below the knee, is associated with medial arterial calcification. This is a frequent and potentially serious complication, affecting all types of diabetes. In recent years, our understanding of the pathophysiology and clinical significance of medial arterial calcification has improved considerably. Here, we offer a short narrative review of the epidemiology, clinical consequences, and pathophysiology of this complication. Now that medial arterial calcification of the lower limbs is better understood, we also focus on the prospect of treatments targeting arterial calcification.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101586"},"PeriodicalIF":4.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635418","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":"Non-dioxin-like polychlorinated biphenyls (NDL-PCBs) dietary exposure is associated with an increased risk of type 2 diabetes in the European prospective investigation into cancer and nutrition (EPIC) cohort","authors":"Xuan Ren ,&nbsp;Geneviève Nicolas ,&nbsp;Pauline Frenoy ,&nbsp;Keren Papier ,&nbsp;Conchi Moreno-Iribas ,&nbsp;Giovanna Masala ,&nbsp;Christina C. Dahm ,&nbsp;Jie Zhang ,&nbsp;Franziska Jannasch ,&nbsp;Matthias B. Schulze ,&nbsp;Elisabete Weiderpass ,&nbsp;Paolo Chiodini ,&nbsp;Claudia Vener ,&nbsp;Paolo Vineis ,&nbsp;Alicia K. Heath ,&nbsp;Fulvio Ricceri ,&nbsp;Sandra M. Colorado-Yohar ,&nbsp;Chloé Marques ,&nbsp;Thibault Fiolet ,&nbsp;Gianluca Severi ,&nbsp;Francesca Romana Mancini","doi":"10.1016/j.diabet.2024.101587","DOIUrl":"10.1016/j.diabet.2024.101587","url":null,"abstract":"<div><h3>Aims/hypothesis</h3><div>The aim of the present study was to investigate the association between dietary exposures to dioxins, dioxin-like polychlorinated biphenyls (DL-PCBs) and non-dioxin-like polychlorinated biphenyls (NDL-PCBs) and the incidence of type 2 diabetes mellitus (T2DM) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.</div></div><div><h3>Methods</h3><div>This prospective cohort study with a median 11.7 years of follow-up, included 318,416 individuals recruited in 21 centers in eight countries. Dietary intake of dioxins and PCBs was calculated by combining EPIC food consumption data with food contamination data from the European Food Safety Authority (EFSA). To identify incident cases of T2DM, a thorough review of various sources including self-reported information, linkage to primary and secondary care registers, drug registers, hospital admissions, and mortality data was conducted. Associations between dietary intake of dioxins and PCBs and T2DM were evaluated using multivariable Cox regressions.</div></div><div><h3>Results</h3><div>Higher T2DM risk was observed for higher estimated dietary intake of non-dioxin-like PCBs (NDL-PCBs; HR _{per 1 SD increment} = 1.03 [95 %CI 1.01;1.04], and HR _(Q4 _{vs Q1)} = 1.15 [1.08;1.22], <em>P</em>-trend &lt; 0.001). The results were consistent in analyses stratified by gender, body mass index, country, median follow-up, or self-reported hypertension and hyperlipidemia, as well as when adjusting for fat intake. No consistent association was observed between dioxins+DL-PCBs intake and T2DM risk.</div></div><div><h3>Conclusion / interpretation</h3><div>Results obtained in this large European prospective study indicate a positive and linear association between dietary intake of NDL-PCBs and risk of T2DM. This association remained consistent across various stratified and sensitivity analyses. Further studies are warranted to better understand the biological mechanisms underlying this association.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101587"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 SGLT2 inhibitors with incident cancer","authors":"Yuta Suzuki ,&nbsp;Hidehiro Kaneko ,&nbsp;Akira Okada ,&nbsp;Toshiyuki Ko ,&nbsp;Takahiro Jimba ,&nbsp;Katsuhito Fujiu ,&nbsp;Norifumi Takeda ,&nbsp;Hiroyuki Morita ,&nbsp;Jin Komuro ,&nbsp;Masaki Ieda ,&nbsp;Koichi Node ,&nbsp;Issei Komuro ,&nbsp;Hideo Yasunaga ,&nbsp;Norihiko Takeda","doi":"10.1016/j.diabet.2024.101585","DOIUrl":"10.1016/j.diabet.2024.101585","url":null,"abstract":"<div><h3>Aim</h3><div>It remains unknown whether sodium-glucose cotransporter 2 inhibitors (SGLT2i) could be associated with incident cancer.</div></div><div><h3>Methods</h3><div>We analyzed individuals having diabetes and newly prescribed SGLT2i or dipeptidyl peptidase 4 inhibitors (DPP4i) in a large-scale epidemiological database. The primary outcome was the incidence of cancer. A propensity score matching algorithm was employed to compare the subsequent development of cancer between the SGLT2i and DPP4i groups.</div></div><div><h3>Results</h3><div>After 1:2 propensity score matching, 26,823 individuals (8,941 SGLT2i, 17,882 DPP4i) were analyzed. During the mean follow-up duration of 2.0 ± 1.6 years, 1,076 individuals developed cancer. SGLT2i administration was associated with a reduced risk of cancer (HR 0.80, 95 % CI 0.70–0.91). Particularly, SGLT2i administration was related to a lower risk of colorectal cancer (HR 0.71, 95 % CI 0.50–0.998). Our primary findings remained consistent across various sensitivity analyses, including overlap weighting analysis (HR 0.79, 95 % CI 0.66–0.94), inverse probability of treatment weighting 0.75 (95 % CI 0.65–0.86), and induction period settings 0.78 (95 % CI 0.65–0.93). The risk of developing cancer was comparable among individual SGLT2is (<em>P</em>-value of 0.1738).</div></div><div><h3>Conclusion</h3><div>Our investigation using nationwide real-world data demonstrated the potential advantage of SGLT2i over DPP4i in reducing the development of cancer in individuals with diabetes.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101585"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515790","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":"Periodontitis adversely affects lipoprotein subfractions – results from the cohort study SHIP-TREND","authors":"Pascal Basdorf ,&nbsp;Thomas Kocher ,&nbsp;Sebastian-Edgar Baumeister ,&nbsp;Christiane Pink ,&nbsp;Kathrin Budde ,&nbsp;Astrid Petersmann ,&nbsp;Nele Friedrich ,&nbsp;Henry Völzke ,&nbsp;Matthias Nauck ,&nbsp;Birte Holtfreter","doi":"10.1016/j.diabet.2024.101584","DOIUrl":"10.1016/j.diabet.2024.101584","url":null,"abstract":"<div><h3>Aim</h3><div>We aimed to investigate the medium-term associations of periodontitis and the number of missing teeth with serum lipoproteins and their plasma subfractions using follow-up data from the population-based Study of Health in Pomerania (SHIP-TREND).</div></div><div><h3>Methods</h3><div>A total of 2,058 participants with 7-year follow-up data underwent periodontal examinations, serum lipid panel tests, and proton nuclear magnetic resonance (¹H-NMR) spectroscopy of plasma lipoproteins and their subfractions. Generalized models with gamma distribution and loglink were used to analyze associations between periodontal variables and lipoproteins and their subfractions, adjusting for confounders using propensity score weighting.</div></div><div><h3>Results</h3><div>Periodontal variables were consistently associated with elevated follow-up serum levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels. When plasma lipoprotein subfractions were evaluated, periodontal variables were associated with elevated levels of triglycerides and cholesterol-enriched apolipoprotein B-containing lipoprotein particles, particularly small dense low-density lipoprotein, very-low-density lipoprotein and intermediate density lipoprotein. In addition, altered high-density lipoprotein particle composition was observed, suggesting potential functional changes.</div></div><div><h3>Conclusion</h3><div>This study provides evidence for causal effects of periodontitis on conventional serum lipids and plasma lipoprotein subfractions. As the underlying biological mechanisms are not fully understood, further research is needed.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101584"},"PeriodicalIF":4.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perirenal fat and chronic kidney disease in type 2 diabetes: The mediation role of afferent arteriolar resistance","authors":"Xiangjun Chen ,&nbsp;Yao Qin ,&nbsp;Jinbo Hu ,&nbsp;Yan Shen ,&nbsp;Yun Mao ,&nbsp;Lianghua Xie ,&nbsp;Jia Li ,&nbsp;Jie Wang ,&nbsp;Shumin Yang ,&nbsp;Qifu Li ,&nbsp;John Cijiang He ,&nbsp;Zhihong Wang","doi":"10.1016/j.diabet.2024.101583","DOIUrl":"10.1016/j.diabet.2024.101583","url":null,"abstract":"<div><h3>Aim</h3><div>Perirenal fat (PRF) is an independent predictor for chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM) patients. Previous studies speculated that PRF may promote renal dysfunction through affecting renal hemodynamics. To verify this hypothesis, we studied the relationship between PRF and renal hemodynamics in T2DM.</div></div><div><h3>Methods</h3><div>91 T2DM patients were included. PRF thickness (PRFT) was measured by magnetic resonance imaging. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined by renal dynamic imaging. Renal vascular resistance (RVR), glomerular hydrostatic pressure (P_GLO), afferent (R_A) and efferent (R_E) arteriolar resistance were calculated by Gomez equations. Multiple linear regression was used to determine the relationship between PRFT and renal hemodynamics. Mediation analysis was conducted to estimate the mediation effects of renal hemodynamics on the relationship between PRF and CKD.</div></div><div><h3>Results</h3><div>All patients were divided into three groups according to the tertiles of PRFT. Compared with patients in tertile 1, GFR and ERPF were significantly decreased in patients in tertile 3, while RVR and R_A were significantly increased. PRFT was negatively correlated with GFR, ERPF and P_GLO, and positively correlated with RVR and R_A after adjustment for sex, age, visceral adipose tissue and treatments with ACE inhibitors/angiotensin receptor blockers and sodium-glucose cotransporter protein-2 inhibitors. Moreover, RVR and R_A mediated the effect of PRF on GFR, with a mediated proportion of 29.1 % and 41.4 % respectively.</div></div><div><h3>Conclusion</h3><div>In T2DM patients, PRF was negatively correlated with GFR, and positively correlated with R_A. R_A mediated the relationship between PRF and CKD.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101583"},"PeriodicalIF":4.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402585","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":"Diuretics and risk of major adverse limb events in patients with type-2 diabetes: An observational retrospective study","authors":"Khadija Ba ,&nbsp;Laurence Salle ,&nbsp;Laudy Serhal ,&nbsp;Mamadou Adama Sow ,&nbsp;Julien Magne ,&nbsp;Philippe Lacroix ,&nbsp;Lucie Chastaingt ,&nbsp;Victor Aboyans","doi":"10.1016/j.diabet.2024.101582","DOIUrl":"10.1016/j.diabet.2024.101582","url":null,"abstract":"<div><h3>Aim</h3><div>In patients with type-2 diabetes mellitus (T2DM), sodium-glucose co-transporter 2 inhibitors are suspected to increase the risk of amputation. “Traditional” diuretics may increase major adverse limb events (MALEs), but the evidence is weak. We studied the association between common diuretics (i.e. thiazides, loop- and potassium-sparing diuretics) and MALEs/amputations in patients with T2DM.</div></div><div><h3>Methods</h3><div>Consecutive T2DM patients without cardiovascular history referred to our center for cardiovascular check-ups were retrospectively studied. Follow-up data on MALEs were collected. We used Cox models to assess the association between diuretics and MALEs, or amputation alone. A propensity score with inverse probability of diuretic treatment weighting (IPTW) analysis was performed.</div></div><div><h3>Results</h3><div>We studied 1309 patients, (59.5 ± 10.7 years, 51 % females) with diabetes duration of 9.1 ± 8.5 years, among whom 402 (30 %) were taking diuretics. During a follow-up of 3.8 ± 1.64 years, 121 (9.1 %) had MALEs, including 19 (1.4 %) amputations. Death occurred in 111 patients and the proportion of death was significantly different between groups: patients with diuretics <em>n</em> = 49, 44.1% vs patients without diuretics <em>n</em> = 62, 55.9 %, <em>P</em> = 0.001. Diuretics, in multivariable analysis, were associated with MALEs (aHR[95 %CI] 1.96[1.32;2.91] <em>P</em> = 0.001), even after adjustment on propensity score (aHR 1.66[1.08;2.56] <em>P</em> = 0.02) and IPTW analysis (aHR 1.76[1.67;1.84] <em>P</em> &lt; 0.0001). This risk was particularly increased in case of an abnormal ankle-brachial index (aHR 2.29[1.32;3.96], <em>P</em> = 0.003) at baseline. Looking at diuretic classes separately, the adjusted risk was increased with loop diuretics (aHR 2.56[1.16;5.64] <em>P</em> = 0.020), thiazides (aHR 2.21[1.37;3.57] <em>P</em> = 0.001) or potassium sparing diuretics (aHR 2.56[1.16;5.64] <em>P</em> = 0.020).</div></div><div><h3>Conclusion</h3><div>Diuretic treatment weighting may be associated with increased risk of MALEs. We identified several markers of increased risk of limb events where the use of diuretics should be considered with caution.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101582"},"PeriodicalIF":4.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378774","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":"Sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase IV inhibitors and risk of dementia among patients with type 2 diabetes and comorbid mental disorders: A population-based cohort study","authors":"Bin Hong ,&nbsp;Hyesung Lee ,&nbsp;Ahhyung Choi ,&nbsp;Woo Jung Kim ,&nbsp;Young Min Cho ,&nbsp;Dong Keon Yon ,&nbsp;Ju-Young Shin","doi":"10.1016/j.diabet.2024.101581","DOIUrl":"10.1016/j.diabet.2024.101581","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate whether the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors which have shown potential neuroprotective effects, is associated with lower risk of dementia in patients with type 2 diabetes (T2D) and comorbid mental disorders, who are considerably more susceptible to dementia.</div></div><div><h3>Methods</h3><div>Using the nationwide healthcare data of South Korea between 2010 and 2022, we conducted a retrospective cohort study among patients with T2D and comorbid mental disorders initiating SGLT2 inhibitors versus active comparator (Dipeptidyl Peptidase IV (DPP4) inhibitors). Hazard ratios (HRs) and rate differences (RDs) per 1000 person-years of incident dementia were estimated after weighting by propensity score fine stratification method.</div></div><div><h3>Results</h3><div>Over a 4.8-year median follow-up, SGLT2 inhibitors were associated with a 12 % lower risk of dementia compared with DPP4 inhibitors (11.31 vs. 12.86 events per 1000 person years; HR 0.88, 95 % CI 0.84 to 0.92; RD -1.55, -2.13 to -0.97). The results were consistent when stratified by age, sex, individual component, severe mental disorders, presence of insulin, history of cardiovascular disease, or history of hypertension.</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors versus DPP4 inhibitors were associated with a lower risk of incident dementia in patients with T2D and comorbid mental disorders. Further randomized controlled trials are required to confirm our findings.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101581"},"PeriodicalIF":4.6,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335940","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":"Low hemoglobin, even within the normal range, is associated with diabetic kidney disease","authors":"Wenjun Wang ,&nbsp;Yetong Wang ,&nbsp;Fangli Tang ,&nbsp;Huanhuan Liu ,&nbsp;Yaujiunn Lee ,&nbsp;Sofianos Andrikopoulos ,&nbsp;Qingqing Lou","doi":"10.1016/j.diabet.2024.101580","DOIUrl":"10.1016/j.diabet.2024.101580","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the association between hemoglobin (Hb) levels and incident diabetic kidney disease (DKD) in patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 1,657 patients with diabetes, without DKD at baseline, recruited from six clinics affiliated with Lee's United Clinic in Taiwan. Demographic data and laboratory results were collected and analyzed. Participants were stratified into quartiles based on their baseline Hb levels. A subgroup analysis was conducted specifically for patients with normal Hb levels (men: Hb ≥ 120 g/l, women: Hb ≥ 110 g/l). Cox regression analysis assessed the relation between Hb levels and incident DKD, adjusting for relevant covariates.</div></div><div><h3>Results</h3><div>Among the initial cohort, 93 (5.6 %) had anemia at baseline. Over an average follow-up period of 5.7 ± 2.6 years, 594 patients (35.8 %) developed DKD. Cox regression analysis revealed that, after adjusting for multiple variables, compared with patients in the highest quartile of baseline Hb levels (Q4: Hb ≥ 154 g/l), the hazard of DKD was 1.6 times higher in the lowest quartile (Q1: Hb ≤ 130 g/l) HR [95 % CI] 1.58 [1.19;2.21] <em>P</em> &lt; 0.001. In patients with normal Hb levels, Cox regression analysis also revealed that compared to the highest quartile (Q’4, Hb ≥ 154 g/l) the hazard of developing DKD was 1.3 times higher in the lowest quartile (Q’1, Hb ≤ 132 g/l) HR [95 % CI ] 1.29 [1.08;1.72] <em>P</em> = 0.042.</div></div><div><h3>Conclusions</h3><div>Lower Hb is associated with incident DKD, even in patients with normal Hb levels, independent of other risk factors.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 6","pages":"Article 101580"},"PeriodicalIF":4.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305509","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}