Diabetes/Metabolism Research and Reviews最新文献

{"title":"Proteomic and Metabolomic Interplay in the Regulation of Energy Metabolism During Obesity and Metabolic Syndrome","authors":"Carlos Vinicius F. da Silva,&nbsp;Carlos José F. da Silva,&nbsp;Thaís R. Cataldi,&nbsp;Carlos A. Labate,&nbsp;Youssef B. Sade,&nbsp;Sandra Mara N. Scapin,&nbsp;Fabiano L. Thompson,&nbsp;Cristiane Thompson,&nbsp;Carina Maciel da Silva-Boghossian,&nbsp;Eidy de Oliveira Santos","doi":"10.1002/dmrr.70090","DOIUrl":"https://doi.org/10.1002/dmrr.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Explore the influence of obesity and Metabolic Syndrome disorders on the plasma proteome and metabolome, through an integrated analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We investigated metabolic and proteomic alterations associated with obesity and MetS, through mass spectrometry, using plasma samples from 49 volunteers, categorized according to BMI, and MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 231 proteins and 77 metabolites. A subset, including DMBT1, Vanin-1, PTPRJ, <i>β</i>-hydroxybutyrate, <i>α</i>-tocopherol, and 5-oxoproline, emerged as potential key players associated with obesity and MetS. By integrating proteomic and metabolomic data, we were able to construct an interactive network involved in metabolic dysfunction, revealing associations between these molecules and clinical parameters, such as BMI, HOMA-IR and HOMA-β.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data suggested an interplay between anti-inflammatory (DMBT1, 3-hydroxybutyrate, 5-oxoproline) and pro-inflammatory pathways (Vanin-1, <i>α</i>-tocopherol, PTPRJ) during disorders of obesity and MetS, demonstrating the potential of an integrated multi-omics approach for a better understanding of the mechanism behind obesity-associated metabolic diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172052","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":"Development of a Chinese-Specific Clinical Model to Predict Maturity-Onset Diabetes of the Young","authors":"Sandra T. F. Tsoi,&nbsp;Cadmon K. P. Lim,&nbsp;Ronald C. W. Ma,&nbsp;Eric S. H. Lau,&nbsp;Baoqi Fan,&nbsp;Chun Kwan O,&nbsp;Yingnan Fan,&nbsp;Elaine Chow,&nbsp;Alice P. S. Kong,&nbsp;Wing-Yee So,&nbsp;Juliana C. N. Chan,&nbsp;Andrea O. Y. Luk","doi":"10.1002/dmrr.70087","DOIUrl":"10.1002/dmrr.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Accurate identification of individuals with maturity-onset diabetes of the young (MODY) can support precision diabetes management. However, diagnosing MODY is challenging due to overlapping clinical features with type 2 diabetes. We aimed to develop a prediction model for identifying Chinese with high likelihood of MODY for further genetic testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a logistic regression model using clinical data from an unselected cohort of 1021 Chinese with young-onset (age at diagnosis ≤ 40) non-type 1 diabetes enrolled in the Hong Kong Diabetes Register, 1.9% (<i>n</i> = 19) of whom had MODY (<i>GCK</i>-, <i>HNF1A</i>-, <i>HNF4A</i>- and <i>HNF1B</i>-MODY) by molecular confirmation. We validated the model in an independent local cohort of 822 Chinese with young-onset non-type 1 diabetes. We compared the performance of the new Chinese-specific MODY prediction model with an existing MODY probability calculator in the validation cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prediction model comprised the following clinical variables: current age, age at diagnosis, sex, body mass index, systolic blood pressure, HDL-cholesterol, LDL-cholesterol, triglyceride and fasting C-peptide. It demonstrated acceptable discrimination of patients with MODY in the validation dataset, with an area under the curve of 0.813 (95% confidence interval 0.647–0.979). At the probability cut-off of 50%, the model achieved a sensitivity of 72.7% and a specificity of 92.4%. It allows identification of one MODY case in every nine genetic tests conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We developed a comprehensive Chinese-specific MODY prediction model. This model can be used in unselected Chinese with young-onset non-type 1 diabetes to identify high-risk individuals for genetic testing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087925","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":"Adherence to Modified American Heart Association Cardiovascular Health Standards Is Associated With Lower Atherosclerotic Burden in Mediterranean Individuals With Type 1 Diabetes","authors":"Camila Milad,&nbsp;Clara Viñals,&nbsp;Verónica Perea,&nbsp;Tonet Serés-Noriega,&nbsp;Antonio-Jesús Blanco-Carrasco,&nbsp;Irene Vinagre,&nbsp;Maria Claro,&nbsp;Clara Solà,&nbsp;Alex Mesa,&nbsp;Dennisse Ayala,&nbsp;Ignacio Conget,&nbsp;Marga Giménez,&nbsp;Antonio J. Amor","doi":"10.1002/dmrr.70088","DOIUrl":"10.1002/dmrr.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cardiovascular risk factor (CVRF) management and healthy lifestyles protect against cardiovascular disease (CVD), although their impact in type 1 diabetes (T1D) is underexplored. This study aimed to examine the relationship between healthy lifestyle parameters and preclinical atherosclerosis in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Cross-sectional study in individuals with T1D without established CVD, meeting one of the following: ≥ 40 years-old, diabetic kidney disease, or ≥ 10 years duration of T1D with another CVRF. We used a modification of the American Heart Association ‘Life's Simple Seven’ (AHA-LSS) scoring system, measuring 7 variables (body mass index, smoking, physical activity, Mediterranean diet, LDL-cholesterol, blood pressure, and HbA1c) scoring ranging 0–13 points (higher score, better CVRF profile). Presence of plaques was assessed using carotid ultrasound. Patients were categorised into low (AHA-LSS ≤ 5), medium (AHA-LSS 6–7) and high (AHA-LSS ≥ 8) tertiles. Associations between AHA score and atherosclerosis were assessed using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included <i>n</i> = 518 individuals (55% women, age 48 ± 11 years, T1D duration 27 ± 11 years, HbA1c 7.49 ± 0.90%, AHA-LLS 6 [5–8]). An inverse relationship was observed between AHA-LSS score and different CVRFs and plaque burden (<i>p</i> &lt; 0.05 for all). This inverse relationship persisted after adjusting for classical and specific-T1D CVRFs not included in the score, both for plaque presence (OR 0.37 [0.20–0.70]) and ≥ 2 plaques (OR 0.30 [0.13–0.68]; <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Holistic control of CVRFs and healthy lifestyles are associated with lower preclinical atherosclerosis prevalence in individuals with T1D. These findings highlight the need to address non-glycaemic factors in this population to improve cardiovascular health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082246","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":"Endothelial Dysfunction and Therapeutic Advances in Chronic Kidney Disease","authors":"Feng Liang,&nbsp;Gui Li,&nbsp;Kehong Chen,&nbsp;Jia Chen,&nbsp;Junling He,&nbsp;Yani He","doi":"10.1002/dmrr.70086","DOIUrl":"https://doi.org/10.1002/dmrr.70086","url":null,"abstract":"<p>Chronic kidney disease (CKD) substantially increases cardiovascular risk, with endothelial dysfunction as its central pathological mechanism. This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial-mesenchymal transition (EndMT). Recent advances have yielded several promising CKD treatment strategies, including dual endothelin-angiotensin receptor antagonists (DEARA), dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), renin-angiotensin-aldosterone system inhibitors (RAASi), sodium-glucose cotransporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA), which have demonstrated favourable protective effects on endothelial cells. Moreover, emerging anti-ageing therapies are novel therapeutic directions for research related to endothelial protection. In future studies, the synergistic effects of nonpharmacological interventions (such as lifestyle modifications and nutritional support) and pharmacological therapies will be a new direction, providing ideas for improving endothelial dysfunction, decelerating the progression of CKD, reducing the risk of cardiovascular events, and ultimately improving patient outcomes.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007935","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":"The Effect of Metformin on Insulin Requirement, Glycaemic Control and Weight Gain in Type 1 Diabetes During Pregnancy—a Randomised, Placebo-Controlled Multicentre Study","authors":"Elina Juuma,&nbsp;Kati Tihtonen,&nbsp;Saara E. Metso,&nbsp;Päivi M. Hannula,&nbsp;Mika Helminen,&nbsp;Kristiina Tertti,&nbsp;Heidi Immonen,&nbsp;Leena Georgiadis,&nbsp;Kirsi Väyrynen,&nbsp;Petteri Ahtiainen,&nbsp;Hilkka Nikkinen,&nbsp;Minna Koivikko,&nbsp;Hannele Laivuori,&nbsp;Jukka Uotila","doi":"10.1002/dmrr.70085","DOIUrl":"https://doi.org/10.1002/dmrr.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Our aim was to ascertain whether metformin can reduce insulin requirement without compromising glycaemic control during pregnancy in women with type 1 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 126 pregnant women with type 1 diabetes were recruited for a randomised, double-blind, placebo-controlled multicentre study. The primary outcome was total insulin change, defined as the difference between baseline and third trimester maximum insulin dose (IU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty women in the placebo group and 51 women in the metformin group completed the study. A predetermined sample size of 200 participants was not achieved. There was no significant difference in the primary outcome, that is, in the change of total insulin requirement (33 vs. 27 IU, <i>p</i> = 0.193). However, the metformin group showed a significantly lower increase in the prandial insulin change, with 24 versus 14 IU (<i>p</i> = 0.014) and 0.3 versus 0.2 IU/kg (<i>p</i> = 0.048). In the exploratory subgroup analysis, metformin attenuated prandial insulin increase in women with high BMI (&gt; 25 kg/m²) or high baseline insulin requirement (&gt; 40 IU) (25 vs. 15 IU, <i>p</i> = 0.028, 30 vs. 14 IU, <i>p</i> = 0.007). Weight gain remained more often within target in the metformin group (20% vs. 40%, <i>p</i> = 0.029). A similar weight benefit was observed in subgroups (BMI&gt; 25 kg/m² 8% vs. 32%, <i>p</i> = 0.005, insulin requirement&gt; 40 IU 6% vs. 34%, <i>p</i> = 0.004). No differences were seen in glycaemic control or neonatal outcome between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Metformin was not shown to affect total insulin change but reduced the prandial insulin change and improved weight gain control especially in insulin-resistant subgroups. These findings warrant further studies on metformin as an adjunctive medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT03765359.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007947","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":"Incretin-Based Adjunct to Background Insulin Treatment for Managing Body Weight Excess in Type 1 Diabetes: An Expert Opinion Viewpoint From the Italian Association of Clinical Endocrinologists","authors":"Giuseppe Lisco,&nbsp;Anna De Tullio,&nbsp;Olga Eugenia Disoteo,&nbsp;Michela Armigliato,&nbsp;Edoardo Guastamacchia,&nbsp;Simonetta Marucci,&nbsp;Giovanni De Pergola,&nbsp;Enrico Papini,&nbsp;Marco Chianelli,&nbsp;Andrea Frasoldati,&nbsp;Vincenzo De Geronimo,&nbsp;Vincenzo Triggiani,&nbsp;The Italian Association of Clinical Endocrinologists—Medications and Therapeutics Committee; Diabetes Committee; Obesity and Eating Disorders Committee; Technology, Telehealth, and Digital Innovation Committee","doi":"10.1002/dmrr.70073","DOIUrl":"https://doi.org/10.1002/dmrr.70073","url":null,"abstract":"<p>Overweight and obesity represent common chronic metabolic disorders in the general population, and observed trends describe a substantial growth in the prevalence of weight excess also among individuals with type 1 diabetes (T1D), the so-called ‘lean phenotype’ of diabetes. The sharp rise of weight excess and obesity-related cardio-nephron-metabolic burdens observed in T2D is expected to produce similar consequences in T1D, leading to the urgent need to endorse therapeutic protocols as in most parts of the World no adjunctive treatments are approved for T1D, making weight excess management challenging in these individuals. The notable results shown by newer glucagon-like peptide 1 receptor agonists (GLP-1RAs) and emerging dual agonists, especially while managing cardio-metabolic burdens, in T2D have encouraged fervent anecdotal and non-anecdotal research also in T1D, indicating that non-insulin injective agents can be effective and safe. With this expert opinion paper, the members of four of the most representative Committees of the Italian Association of Clinical Endocrinologists provide the scientific community with a state-of-the-art report on the use of GLP-1RAs and other incretin-based injective therapy to treat body weight excess in T1D individuals and new insights on the topic with reliable methodology and clinical expertise.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007937","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":"Increased Risk of Type 1 Diabetes in Boys Under the Age of 5 Years During COVID-19 Lockdowns in Finland, Sweden and Stanford, CA, USA—An Observational Multicenter Study","authors":"Susanna Tall,&nbsp;Priya Prahalad,&nbsp;Martin Adiels,&nbsp;Annika Rosengren,&nbsp;Suvi M. Virtanen,&nbsp;David M. Maahs,&nbsp;Mikael Knip","doi":"10.1002/dmrr.70084","DOIUrl":"https://doi.org/10.1002/dmrr.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The COVID-19 pandemic has been associated with an increased incidence of type 1 diabetes. Changes in the type 1 diabetes incidences in countries like Sweden where very mild COVID-19 pandemic related measures were applied have not been established so far. We analysed the incidence of type 1 diabetes during the COVID-19 lockdown and before the lockdown in Sweden, Finland and Stanford, CA, USA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Type 1 diabetes incidence rates during the first 18 months of the SARS-CoV-2 pandemic (3/2020–8/2021) were compared to a period before the pandemic (three corresponding 18-month terms 2014–2019) in Sweden, Finland and Stanford.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Sweden, type 1 diabetes incidence increased by 5% (IRR 1.05; 95% CI = 0.98–1.12; <i>p</i> = 0.18, <i>N</i> = 4458), in Finland by 17% (IRR 1.17; 95% CI = 1.07–1.27; <i>p</i> &lt; 0.001, <i>N</i> = 2881) and in Stanford by 10% (IRR = 1.10; 95% CI = 0.91–1.34; <i>p</i> = 0.34, <i>N</i> = 531) during the lockdown compared to the time before lockdown. In boys under 5 years of age, the incidence increased significantly in all regions: Sweden (IRR 1.21; 95% CI = 1.00–1.46; <i>p</i> = 0.05, <i>N</i> = 521), Finland (IRR = 1.33; 95% Cl = 1.06–1.67, <i>p</i> = 0.02, <i>N</i> = 363) and Stanford CA, USA (IRR = 2.07\"; 95% Cl = 1.06–4.02, <i>p</i> = 0.03, <i>N</i> = 37).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lockdowns during the COVID-19 pandemic may have untoward consequences such as an increased risk of type 1 diabetes in young children, boys in particular. The hygiene hypothesis may explain this finding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923591","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":"Metabolic Cardiovascular Renal Disease (Met-CVRD): A New Nomenclature","authors":"Paolo Pozzilli,&nbsp;Maria Vittoria Messina,&nbsp;Michael Roden","doi":"10.1002/dmrr.70083","DOIUrl":"https://doi.org/10.1002/dmrr.70083","url":null,"abstract":"<p>Cardiovascular Renal Disease (CVRD) has been introduced as a syndrome describing the coexistence of certain common diseases. However, this terminology misses the role of metabolic abnormalities not only as relevant comorbidities, but even more as key causal factors. Thus, the word ‘metabolic’ should come first to define this syndrome as its joint underlying pathogenesis. Although, CVRD and type 2 diabetes (T2D) have historically been treated as coexisting but separate conditions, growing evidence underscores a bidirectional and metabolically driven relationship between the heart and kidneys, mediated by upstream processes. These comprise insulin resistance, ectopic lipid deposition, mitochondrial abnormalities, dyslipidaemia and chronic low-grade inflammation, typical of T2D and the metabolic syndrome. These metabolic disturbances begin silently in early adulthood, well before traditional clinical markers can signal CVRD onset. Here, we introduce the new terminology of Metabolic Cardiovascular Renal Disease (Met-CVRD), to indicate that the word ‘Metabolic’ represents its major pathogenic factor. We then discuss then the necessity of prioritising early at-risk individual identification and prompt intervention with cardiorenal-protective therapies like glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT2) inhibitors. Met-CVRD provides a cohesive and proactive strategy to halt the advancement of cardiorenal disease across several systems by transcending organ-specific frameworks.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923521","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":"Differential Impact of Early Versus Mid-Pregnancy Physical Activity on Gestational Diabetes Mellitus: The Mediation Effect of Blood Lipid Profiles","authors":"Jing Peng,&nbsp;Bo Jiao,&nbsp;Zhen Huang,&nbsp;Feixue Shao,&nbsp;Yuan Liu,&nbsp;Cunjie Lin,&nbsp;Xiaolin Hua","doi":"10.1002/dmrr.70082","DOIUrl":"https://doi.org/10.1002/dmrr.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Emerging evidence links low physical activity (PA) and dysregulated lipid metabolism to gestational diabetes mellitus (GDM) risk. This study aimed to determine which gestational stage is more vulnerable to low PA and whether changes in blood lipids mediate this risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted among 3997 pregnant women (614 with GDM) during the COVID-19 lockdown in Shanghai, a unique natural experiment provided by the uniform imposition of PA restrictions. Multivariable logistic regression estimated the association between low PA at different gestational stages and GDM risk, while mediation analyses explored the role of blood lipids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women with GDM were older and had higher rates of overweight/obesity compared with non-GDM participants. Notably, the GDM group exhibited a higher prevalence of low PA during early pregnancy and elevated lipid levels. Logistic regression demonstrated that low PA during early pregnancy was significantly associated with increased GDM risk (OR = 2.041, 95% CI: 1.577–2.644). Moreover, low PA was significantly linked to dysregulated lipid profiles in both early and mid-pregnancy. Mediation analysis further indicated that elevated total cholesterol (TC) levels partially mediated this relationship. In contrast, low PA in mid-pregnancy was not directly linked to GDM (OR = 1.244, 95% CI: 0.966–1.6), although increased triglyceride (TG) levels during this stage mediated an effect on GDM risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early pregnancy is a critical window for GDM prevention. Additionally, these findings advocate for stage-specific exercise and lipid management strategies to reduce GDM risk and improve maternal and neonatal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897468","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":"Advancements in Pharmacotherapy for Diabetic Kidney Disease: A Systematic Review","authors":"Hongli Zhang,&nbsp;Jiewen Chen,&nbsp;Niansong Wang,&nbsp;Wei Chen,&nbsp;Youhua Xu,&nbsp;Dingkun Gui","doi":"10.1002/dmrr.70077","DOIUrl":"https://doi.org/10.1002/dmrr.70077","url":null,"abstract":"<p>Diabetic kidney disease (DKD), affecting 20–40% of individuals with diabetes, is the leading cause of end-stage renal disease and represents a considerable global public health challenge owing to its high morbidity and mortality rates. Although traditional DKD management has focused on renin-angiotensin system blockade, the residual risk of renal failure persists despite optimised therapy. New therapeutic drugs, including glucagon-like peptide-1 receptor agonists, have triggered a paradigm shift in DKD treatment. Sodium-glucose cotransporter-2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and selective endothelin receptor antagonists have shown notable efficacy in improving renal outcomes in patients with type 2 diabetes mellitus. Furthermore, traditional Chinese medicine (TCM), with its holistic approach and evidence-based refinements, has shown considerable promise in DKD treatment, particularly as its theoretical framework continues to evolve. This study highlighted the transformative potential of multitargeted strategies in mitigating DKD progression, improving cardiovascular outcomes, and alleviating healthcare burdens. Future research should prioritise standardised trials, long-term safety assessments of TCM and personalised therapeutic regimens to optimise clinical management and patient quality of life.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891614","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}