Diabetology International最新文献

{"title":"Method comparison and agreement of a fluorescence immunoassay-based HbA1c test with a routine HPLC method.","authors":"Harresh Adikesavalu, Neema Raja Beaulah Budithi, Suja Ramanathan, G Veena, S Nalina Priya, D Sowmya, Arunkumar Chakkaravarthi","doi":"10.1007/s13340-026-00936-z","DOIUrl":"10.1007/s13340-026-00936-z","url":null,"abstract":"<p><strong>Background: </strong>Glycated hemoglobin (HbA1c) is widely used for diabetes diagnosis and long-term monitoring. Although high-performance liquid chromatography (HPLC) is the accepted method, its requirement for specialized instrumentation and infrastructure can limit its accessibility in some settings. Rapid point-of-care platforms based on fluorescence immunoassay (FIA) technology enable more accessible alternative. This study evaluated the analytical agreement between the TRUSTlight HbA1c fluorescence immunoassay and the HPLC comparator method.</p><p><strong>Methods: </strong>A total of 200 anonymized residual samples collected from a diagnostic laboratory in Chennai, India, between January and February 2026 were included. HbA1c levels were measured using the ion-exchange HPLC method and compared with the TRUSTlight Glycosylated Hemoglobin Test Kit. Method agreement was assessed using Bland-Altman analysis and Passing-Bablok regression. Classification agreement at the 6.5% HbA1c threshold was assessed in comparison with the HPLC comparator method.</p><p><strong>Results: </strong>Mean HbA1c values were 6.97 ± 1.90% and 6.98 ± 1.80% for HPLC and TRUSTlight FIA, respectively. Positive and negative classification agreement was 91.84 and 89.22%, with overall agreement of 90.50%. Bland-Altman analysis showed a mean bias of 0.008% and 95% limits of agreement of - 0.987% to 1.003%. At the 6.5% diagnostic cutoff, these limits corresponded to approximately - 15.2% to + 15.4% relative differences and were wider than the ± 5% NGSP manufacturer certification criterion. Passing-Bablok regression showed no significant constant or proportional bias.</p><p><strong>Conclusion: </strong>The TRUSTlight FIA showed a small mean bias relative to the HPLC comparator, although the observed limits of agreement were wider than the ± 5% NGSP manufacturer certification criterion. Further validation is needed to determine its suitability for longitudinal HbA1c monitoring.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s13340-026-00936-z.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"83"},"PeriodicalIF":1.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and muscle dysfunction in young adults with type 1 diabetes mellitus: associations with bone mineral density.","authors":"Lucas Rista, Valeria Ines Rojas, Lucas R Brun, Luis Agustin Ramirez Stieben, Mercedes Lombarte, María Lorena Brance","doi":"10.1007/s13340-026-00938-x","DOIUrl":"10.1007/s13340-026-00938-x","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate bone mineral density (BMD), body composition, muscle strength, physical performance, and the prevalence of sarcopenia in young adults with type 1 diabetes mellitus (T1DM), and to explore clinical, metabolic, and skeletal correlates associated with sarcopenia.</p><p><strong>Methods: </strong>A cross-sectional study that evaluated BMD, body composition, muscle strength, and physical performance in 42 young adults with T1DM compared with 42 age- and sex-matched non-diabetic controls. DXA was used to assess areal and volumetric BMD, as well as whole-body composition, while muscle strength and function were evaluated using handgrip strength, gait speed, sit-to-stand, and timed up-and-go tests. Sarcopenia was defined following EWGSOP2 criteria.</p><p><strong>Results: </strong>Areal and volumetric BMD values did not differ between groups at the lumbar spine, femoral neck, or total hip, suggesting preserved BMD in this young population. Body composition, including appendicular skeletal muscle mass index, was also similar between groups. In contrast, the T1DM group displayed significantly reduced muscle strength and impaired physical performance across multiple functional tests. Sarcopenia was diagnosed in 23.8% of T1DM participants, whereas no cases were identified in controls (OR 23.3). Within the T1DM group, participants with sarcopenia exhibited lower femoral BMD and cortical surface BMD than those without sarcopenia.</p><p><strong>Conclusions: </strong>Young adults with T1DM exhibit a high prevalence of sarcopenia and impaired muscle function despite preserved BMD and muscle mass. Among individuals with T1DM, sarcopenia was associated with lower femoral BMD and cortical surface BMD, supporting the importance of early musculoskeletal assessment in diabetes care.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"84"},"PeriodicalIF":1.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of the C-reactive protein-triglyceride-glucose index in glycemic control and ischemic limb damage in type 2 diabetes with chronic limb-threatening ischemia.","authors":"Hou Jianyu, Ji Donghua, Ma Qun, Zhou Mohan, Wang Longshuang, Zhong Siyi","doi":"10.1007/s13340-026-00937-y","DOIUrl":"10.1007/s13340-026-00937-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical relevance of the C-reactive protein-triglyceride-glucose index (CTI) in patients with type 2 diabetes mellitus (T2DM) complicated by chronic limb-threatening ischemia (CLTI) .</p><p><strong>Methods: </strong>A total of 520 patients with CLTI were collected and divided into two groups based on the history of T2DM: the combined T2DM group and the non-T2DM group. The CTI of the patients was calculated, and its relationship with blood glucose control levels, risk factors, and the degree of ischemia in CLTI patients was analyzed.</p><p><strong>Results: </strong>The CTI in the combined T2DM group was significantly greater than that in the non-T2DM group (<i>P</i> < 0.001). The CTI in the poorly controlled blood glucose group was significantly greater than that in the well controlled blood glucose group (<i>P</i> < 0.001). Regardless of whether CLTI patients had T2DM, the CTI in the overweight group was greater than that in the non-overweight group (<i>P</i> < 0.05). The area under the curve (AUC) for the CTI discriminating the high wound, ischemia, and foot infection (WIfI) classification was 0.813 (<i>P</i> < 0.001). Univariate and multivariate logistic regression analyses showed that an increased CTI was an independently associated factor for the high WIfI classification in CLTI patients (OR = 6.409, <i>P</i> < 0.001). Kaplan-Meier analysis revealed that patients with CLTI and high CTI levels had significantly lower 1-year amputation-free survival compared to those with low CTI levels.</p><p><strong>Conclusions: </strong>The CTI was closely related to the presence of T2DM, blood glucose control level, and overweight status in CLTI patients. The CTI has certain clinical value in discriminating the degree of ischemia in CLTI, and high CTI levels had significantly lower 1-year amputation-free survival compared to those with low CTI levels.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"82"},"PeriodicalIF":1.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsibility sharing among children with Type 1 Diabetes and their caregivers: a cross-sectional survey from North India using the Diabetes Family Responsibility Questionnaire (DFRQ).","authors":"Anupama Choudhary, Latika Rohilla, Rupinder Kaur, Amisha Rani, Bhor Kaushal, Harpreet Kaur Gill, Jaspreet Kaur, Monika, Devi Dayal","doi":"10.1007/s13340-026-00933-2","DOIUrl":"https://doi.org/10.1007/s13340-026-00933-2","url":null,"abstract":"<p><strong>Background: </strong>Type 1 Diabetes (T1D) management is complex due to multifaceted tasks involving both the child and parents. This study assesses responsibility sharing for diabetes care among children and caregivers and its association with glycemic control.</p><p><strong>Methods: </strong>Using descriptive design, 106 dyads of parent-child (aged 8-16 years) attending the tertiary-level diabetes clinic for at least 6 months were recruited. Data was collected using a structured interview schedule. The Diabetes Family Responsibility Questionnaire (DFRQ) was filled by both the child and parent separately. Higher DFRQ scores depict greater responsibility towards parents.</p><p><strong>Results: </strong>Most children (61.3%) were accompanied by their mother. Nearly half (47.2%) of the children belonged to the 11-13 years age group, 52.8% were females, and 74.5% had a healthy body mass index. A majority (59.4%) had HbA1c levels above 7.5%. Sixty-one (50.8%) dyads had none, eight dyads (6.7%) had more than five, and the rest had less than five items of the DFRQ marked as 'no one takes responsibility'. Dyads where the child was given more responsibility than the parent had poorer glycemic control. DFRQ scores showed a significant negative correlation with both the age of the child (<i>r</i>= - 0.388, <i>p</i> < 0.01) and HbA1c (<i>r</i>= - 0.23, <i>p</i> < 0.01) levels.</p><p><strong>Conclusion: </strong>Parents taking more responsibility predicts better glycemic control, followed by responsibility being shared equally, and glycemic control tends to decline where the adolescent was given more responsibility. Thus, it can be suggested that complete task shifting to adolescents should be done with caution until they are ready.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"79"},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between stigma and treatment satisfaction in patients with type 2 diabetes: a cross-sectional study.","authors":"Erika Watanabe, Hiroyuki Ito, Midori Kobayashi, Mari Tanaka","doi":"10.1007/s13340-026-00935-0","DOIUrl":"https://doi.org/10.1007/s13340-026-00935-0","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the comprehensive association between diabetes stigma, treatment satisfaction, and clinical parameters in patients with type 2 diabetes.</p><p><strong>Methods: </strong>This cross-sectional study included 307 Japanese outpatients. Diabetes stigma was assessed using the Kanden Institute Stigma Scale (KISS). Treatment satisfaction and perceived hyperglycemia were evaluated via the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Data regarding patient demographics, comorbidities, and antidiabetic treatments were also collected. We investigated independent factors associated with the continuous KISS score using multivariable linear regression models to prevent information loss.</p><p><strong>Results: </strong>The median age of the participants was 69 years, median body mass index (BMI) was 24.9 kg/m2, and median HbA1c was 7.1%. The median continuous KISS score was 11. In the multivariable linear regression model, after adjusting for prespecified confounders, including age, sex, duration of diabetes, and the number of antidiabetic agents, higher body mass index (BMI), the use of injection therapy, lower treatment satisfaction, and a higher perceived frequency of hyperglycemia were independently associated with higher continuous KISS scores (all <i>P</i> < 0.05). Conversely, objective HbA1c lacked a significant independent association with diabetes stigma.</p><p><strong>Conclusions: </strong>In patients with type 2 diabetes, a higher burden of diabetes stigma is independently associated with comorbid obesity, the use of injection therapy, lower treatment satisfaction, and the subjective perception of hyperglycemia, but not independently with objective HbA1c. This highlights the necessity of addressing patient experiences and psychosocial burden beyond objective glycemic targets.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s13340-026-00935-0.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"78"},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of imeglimin on liver enzymes and body composition in patients with MASLD and type 2 diabetes: a pilot study.","authors":"Kaede Fujita, Takanobu Iwadare, Takefumi Kimura, Yuma Kamijo, Taiki Okumura, Shun-Ichi Wakabayashi, Hiroyuki Kobayashi, Tomoo Yamazaki, Naoki Tanaka, Hideo Kunimoto","doi":"10.1007/s13340-026-00931-4","DOIUrl":"https://doi.org/10.1007/s13340-026-00931-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM), yet effective pharmacological options remain limited. Imeglimin, a novel antidiabetic agent targeting mitochondrial bioenergetics, has shown potential hepatoprotective effects in preclinical studies; however, its impact on liver function and body composition in MASLD remains unclear.</p><p><strong>Methods: </strong>This retrospective, single-center pilot study analyzed prospectively collected data from 28 patients with MASLD and T2DM who were treated with imeglimin for 6 months. Clinical and biochemical parameters were assessed at baseline and at 3 and 6 months. Body composition was evaluated using bioelectrical impedance analysis.</p><p><strong>Results: </strong>Over 6 months, fasting blood glucose decreased from 148.5 to 131.0 mg/dL (<i>p</i> = 0.015), accompanied by reductions in liver enzymes (aspartate aminotransferase: 33-26 U/L, <i>p</i> < 0.001; alanine aminotransferase: 28.5-23.5 U/L, <i>p</i> = 0.001). Body weight and body fat percentage also decreased (<i>p</i> < 0.001 and <i>p</i> = 0.018, respectively), whereas no statistically significant changes were observed in skeletal muscle mass. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Imeglimin therapy was associated with favorable changes in glycemic parameters, liver enzymes, and body composition in this pilot cohort, without a statistically significant reduction in skeletal muscle mass. These findings suggest a potential metabolic and hepatic effect of imeglimin and may be particularly relevant for patients with MASLD at risk of sarcopenia. Larger prospective studies with histological or validated non-invasive endpoints are warranted.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s13340-026-00931-4.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"80"},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT-2 inhibitor add-on to DPP-4 inhibitor therapy significantly reduces HbA1c and body weight without increasing hypoglycaemia risk in type 2 diabetes inadequately controlled on metformin: a systematic review and meta-analysis.","authors":"Arif Saleem, Haris Shinwari, Muhammad Usman, Kamran Adil, Asfandyar Khan, Humam Shah, Iftikhar Ahmad","doi":"10.1007/s13340-026-00934-1","DOIUrl":"https://doi.org/10.1007/s13340-026-00934-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the efficacy of combination therapy with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) versus DPP-4i monotherapy in patients with type 2 diabetes mellitus (T2DM) who remained inadequately controlled on metformin.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) investigating adults with T2DM inadequately controlled on metformin, comparing the combination of SGLT-2i plus DPP-4i versus DPP-4i add-on therapy alone were systematically reviewed. PubMed/Medline, Google Scholar, Embase, and CENTRAL were searched without language restriction. The primary outcomes were change in HbA1c and in fasting plasma glucose (FPG) from baseline, proportion of patients attainting HbA1c < 7.0%, and body weight reduction. Secondary outcomes included hypoglycemia risk, genital infection, urinary tract infection (UTI), and overall and serious adverse events (AEs). Pooled analyses were carried out using the random-effects model.</p><p><strong>Results: </strong>Eleven RCTs (3662 patients) were pooled. Compared with DPP-4i alone, adding a combination of SGLT-2i plus DPP-4i after metformin significantly reduced HbA1c (MD: - 0.47%; 95% CI (- 0.54, - 0.41); GRADE: high), increased the proportion of patients attaining HbA1c < 7.0% (RR: 1.71; 95% CI (1.52, 1.93); GRADE: moderate), reduced FPG (MD: - 15.75 mg/dL; 95% CI (- 21.56, - 9.93); GRADE: moderate), increased genital infection (RR: 2.83 (95% CI 1.02, 7.87; GRADE = moderate), and produced greater body weight reduction (MD: - 1.46 kg; 95% CI (- 1.93, - 0.99); GRADE: moderate). The risk of UTI and overall and serious AEs were insignificantly different between arms.</p><p><strong>Conclusion: </strong>The combinatorial therapy using SGLT-2i and DPP-4i produces a significantly better glycemic control and body weight compared with DPP-4i therapy alone, without increasing the overall safety burden.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s13340-026-00934-1.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 4","pages":"81"},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding thyroid: liver cross talk in type 2 diabetes mellitus-an MASLD perspective.","authors":"Sowmiya Subramani, S Gayathri, Karpagavel Lakshmanan","doi":"10.1007/s13340-026-00916-3","DOIUrl":"10.1007/s13340-026-00916-3","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) has emerging major global health problem and is closely linked to metabolic abnormalities. Given, central role of thyroid hormones in lipid metabolism and overall energy balance, and by focusing on thyroid hormone sensitivity rather than hormone levels alone, this study seeks to provide new insights into the role of thyroid hormone resistance in the development of MASLD.</p><p><strong>Aim: </strong>To evaluate the relationship between thyroid hormone sensitivity indices and the presence of MASLD in euthyroid adults with Type 2 Diabetes Mellitus.</p><p><strong>Methods: </strong>A total of 534 euthyroid participants with T2DM were enrolled at Chettinad Hospital and Research Institute. Participants were divided into two groups based on the presence or absence of MASLD and further categorized into quartiles according to each Indices. Thyroid hormone sensitivity was assessed using multiple indices, including the FT3/ FT4 ratio, TT3RI, TT4RI, TSHI, and TFQI_FT3 and TFQI_FT4. The associations between indices and MASLD were evaluated using regression analyses.</p><p><strong>Results: </strong>MASLD prevalence increased with higher levels of FT3/ FT4 ratio, TT3RI, and TFQI_FT3. After adjusting for potential confounders, elevated FT3/FT4 and TFQI_FT3 remained independent risk factors for MASLD. The association between FT3/FT4, TFQI_FT3 and MASLD was particularly more pronounced in participants aged ≤ 40 years. Mediation analysis suggested that the TyG index partially mediated the relationships between FT3/FT4, TFQI_FT3, and MASLD.</p><p><strong>Conclusion: </strong>Higher FT3/FT4 and TFQI_FT3 levels were strongly associated with the prevalence of MASLD in euthyroid individuals. This relationship was partially mediated by the TyG index, suggesting a role for insulin resistance in linking thyroid hormone sensitivity to MASLD.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"63"},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and validation of tolerogenic dendritic cells-related biomarkers in diabetic retinopathy.","authors":"Chun-Yi Wei, Song-Man Li, Ling-Juan Liu, Jun-Peng Huang, Xiao-Hui Lai, Li-Juan Yang, Wen-Wang Liang","doi":"10.1007/s13340-026-00914-5","DOIUrl":"10.1007/s13340-026-00914-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a primary microvascular complication of diabetes. Its pathogenesis is associated with chronic inflammation and immune responses. While tolerogenic dendritic cells (tolDCs) are critical for suppressing excessive inflammation and maintaining immune homeostasis, their function in DR is not well characterized.</p><p><strong>Objective: </strong>To identify biomarkers associated with tolDCs in DR and to explore their mechanisms.</p><p><strong>Methods: </strong>Biomarkers were identified from public databases using differential analysis, machine learning (LASSO regression analysis and Random Forest analysis), and expression validation. Their mechanisms were then explored through enrichment analysis and immune infiltration, and ultimately validated by reverse transcription-quantitative PCR (RT-qPCR) on clinical blood samples.</p><p><strong>Results: </strong>A total of 2096 differentially expressed genes (DEGs)1 were identified between DR and control groups. By intersecting with 6267 tolDCs-related genes, 51 key candidates were selected. Machine learning and expression validation further pinpointed two biomarkers: transcription factor EC (TFEC) and chromatin modifying protein 2 A (CHMP2A). Gene Set Enrichment Analysis (GSEA) showed significant enrichment of TFEC in 994 pathways and CHMP2A in 748, with co-enriched pathways including apoptosis, VEGFA-VEGFR2 signaling, and VEGF signaling. Analysis identified eight altered immune cell types; TFEC correlated strongest with activated NK cells (cor = - 0.49, <i>p</i> < 0.001), while CHMP2A correlated with resting mast cells (cor = 0.49, <i>p</i> < 0.001). RT-qPCR confirmed TFEC upregulation and CHMP2A downregulation in DR, validating the bioinformatic results.</p><p><strong>Conclusion: </strong>TFEC and CHMP2A are potential biomarkers involved in DR pathogenesis via tolDCs.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"61"},"PeriodicalIF":1.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of distinct metabolic subtypes among Japanese men with prediabetes: a data-driven cluster analysis from the J-DOIT1 study.","authors":"Naoki Sakane, Kaoru Takahashi, Masayuki Domichi, Akiko Suganuma, Hideshi Kuzuya","doi":"10.1007/s13340-026-00917-2","DOIUrl":"10.1007/s13340-026-00917-2","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>To identify distinct metabolic subtypes among Japanese men with prediabetes and evaluate their association with the future risk of type 2 diabetes.</p><p><strong>Methods: </strong>A data-driven cluster k-means cluster analysis was conducted in 2,172 men with prediabetes, defined as a fasting plasma glucose (FPG) concentration of 100-125 mg/dL (5.6-6.9 mmol/L) from the JDOIT-1 cohort. Four biochemical indicators-body mass index (BMI), fasting plasma glucose (FPG), alanine aminotransferase (ALT), and non-HDL cholesterol-were standardized and used for clustering. The optimal number of clusters (k = 3) was determined using the elbow method. The association between cluster membership and 5-year diabetes-free survival was examined.</p><p><strong>Results: </strong>Three metabolic phenotypes were identified: Cluster 1 (MRP, <i>n</i> = 1,149), metabolically resilient; Cluster 2 (OFIP, <i>n</i> = 581), obesity- and insulin-resistant; and Cluster 3 (NOHP, <i>n</i> = 442), non-obese hyperglycemic. Annual diabetes incidence rates were 0.70%, 2.73%, and 6.73% in the MRP, OFIP, and NOHP groups, respectively (<i>p</i> < 0.001). Compared with MRP, adjusted hazard ratios were 3.95 (95% CI 2.64-5.92) for OFIP and 9.81 (95% CI 6.75-14.26) for NOHP. Lifestyle interventions significantly reduced diabetes risk only in the OFIP group (HR 0.59, 95% CI 0.36-0.97, <i>p</i> = 0.037).</p><p><strong>Conclusions/interpretation: </strong>Unsupervised clustering identified distinct metabolic subtypes predictive of diabetes onset. Diabetes risk increased progressively from metabolically resilient to insulin-resistant and hyperglycemic phenotypes. Targeted lifestyle interventions may be particularly effective in individuals with obesity- and dyslipidemia-related insulin resistance.</p><p><strong>Trial registration: </strong>University hospital Medical Information Network (UMIN) Center UMIN000000662)、Approval date 11 December 2006.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-026-00917-2.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"62"},"PeriodicalIF":1.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}