Frontiers in Endocrinology最新文献

{"title":"Level of knowledge, stress and acceptance of illness in young adults with type 1 diabetes mellitus.","authors":"Anna Stefanowicz-Bielska, Małgorzata Rąpała, Kamila Mazuryk, Ewa Dygaszewicz","doi":"10.3389/fendo.2025.1648260","DOIUrl":"10.3389/fendo.2025.1648260","url":null,"abstract":"<p><strong>Introduction: </strong>The chronic character of Type 1 Diabetes Mellitus (T1DM) causes patients to be fully aware of the essence and consequences of their illness and to suffer from stigmatisation, tiredness, stress, fear, anxiety and poor mental health.</p><p><strong>Purpose of the paper: </strong>The purpose of this paper is to assess the level of knowledge, stress and acceptance of the illness in young adults with T1DM and to present the impact of various sociodemographic and medical factors on the level of knowledge, stress and acceptance of the illness in young adults with T1DM.</p><p><strong>Materials and methods: </strong>This study used an original survey and the psychological PSS-10 and AIS questionnaires among young adults with T1DM who had been ill for more than a year. The survey was conducted from 01.08.2023 to 30.11.2024.</p><p><strong>Results: </strong>The survey involved 274 young adults aged 18 to 35 years, who had T1DM for 13.4 ± 7.1 years on average. The medians of the test and raw scores for the respondents' answers to statements in the AIS psychological questionnaire were 18 (17÷19) and 29 (23÷35), respectively, whereas the medians of the raw score and sten scores in the responses given in the PSS-10 psychological questionnaire were 20 (15÷24) and 7 (5÷8), respectively. A negative relationship was confirmed between the level of knowledge and the HbA1c concentration. The survey indicated that women with primary education, being in a relationship, smoking, having hypertension, hypothyroidism and lipohypertrophy, and being treated with multiple daily injections (MDI; automatic insulin pen) had high stress levels. There was a positive relationship between the level of stress experienced by the respondents and their BMI, as well as between the duration of the illness and the number of hyperglycaemic incidents at night. The survey indicated that people with primary education, being single, nonsmoking, not keeping a \"paper\" self-monitoring journal and having regular nursing and educational appointments at the Diabetes Clinic better accept their illness. The survey confirmed a negative relationship between the level of acceptance of the illness and the HbA1c concentration and hyperglycaemic incidents during the day.</p><p><strong>Conclusions: </strong>The level of stress experienced by young T1DM patients is high. Young T1DM patients do not accept the illness. Understanding treatment principles helps patients achieve metabolic balance in a significant way. The level of stress, the level of acceptance of the illness doesn't have relation to the level of knowledge. Contemporary technologies used in T1DM self-monitoring and treatment reduce the level of stress and help patients accept and adapt to the illness. The use of MDI generates a high level of stress in young T1DM patients, and the fact that they do not need to keep a \"paper\" self-monitoring journal helps them better accept the illness. Educational nurses support young","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1648260"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212163","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":"Bridging east and west: integrative approaches to obesity management through traditional Chinese medicine.","authors":"Qianrong Li, Zhao Liu, Xiaolin Zhang","doi":"10.3389/fendo.2025.1644381","DOIUrl":"10.3389/fendo.2025.1644381","url":null,"abstract":"<p><p>This study provides a comprehensive review of research pertaining to the treatment of obesity using traditional Chinese medicine (TCM). It encompasses fundamental theories, epidemiological data, pathological mechanisms, clinical practices, technological advancements, and directions for future research. In the section on fundamental theories, the etiology, pathogenesis, historical development, and theoretical foundations of obesity within TCM are examined. The current state of obesity has been analyzed through an epidemiological lens, along with the application of TCM and relevant clinical research findings. The pathological mechanism section evaluates the effect of TCM on metabolic regulation, inflammatory responses, and adipocyte functionality in the context of obesity. Clinical practices are illustrated through case studies of commonly utilized TCM prescriptions, acupuncture, moxibustion therapy, and integrative approaches combining traditional Chinese and Western medicine. The Technological Advancements section discusses the emergence of new formulations, modern diagnostic technologies, and personalized treatment strategies. The future outlook addresses potential research trajectories, prospects for integrating TCM with contemporary medical practices, and trends in international collaborations. Evidence suggests that TCM holds promise in various aspects of obesity treatment. However, further investigation is necessary to elucidate its efficacy and underlying mechanisms, enhance international cooperation and standardization efforts, and foster the advancement of TCM in obesity management.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1644381"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212169","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":"Prevalence of diabetes and prediabetes among working-age adults and influencing factors of new-onset diabetes: a five-year cohort study (2018-2023).","authors":"Jing Tan, Mingzhu Chen, Yang Lei, Xiaofen Shi, Cuiping Cao, Naili Du, Yuyou Yao, Xiaojuan Yao","doi":"10.3389/fendo.2025.1626925","DOIUrl":"10.3389/fendo.2025.1626925","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and prediabetes in the young and middle-aged population represent a significant public health challenge in China. In recent years, the prevalence of diabetes has gradually increased within this group. This study aims to evaluate the prevalence of diabetes and prediabetes in a health check-up population of young and middle-aged individuals, and to analyze the key factors influencing the new onset of diabetes. The study provides data support for the early prevention of diabetes.</p><p><strong>Method: </strong>This study used retrospective cohort analyses to examine the data from the physical examination centers of three hospitals in Wuxi, China, for the population aged 18-59 from 2018 to 2023. Analyzing the changes in the prevalence of diabetes and prediabetes in the population. Single-factor analysis was used to examine differences in basic characteristics and laboratory indicators between individuals who developed diabetes and those who did not within five years. A multifactorial logistic regression model (MLR model), Cox proportional hazards model (Cox model), and generalized estimating equation (GEE) model were employed to analyze the factors associated with the development of diabetes. ROC curves were used to evaluate the performance of these three models. Finally, a nomogram was constructed to predict the risk of developing diabetes in the next five years.</p><p><strong>Results: </strong>From 2018 to 2023, the number of diabetes cases increased year by year, with the highest increase of 1.39% observed between 2020 and 2021. New-onset diabetes patients had poorer lifestyle and health profiles compared to those without new-onset diabetes. New-onset diabetes group also had worse metabolic and inflammatory profiles (P < 0.05), with significantly lower eGFR (P = 0.027). The AUC values for all three models were 0.64, with the GEE model performing best in Youden index (0.237), the Cox model in sensitivity (0.577), and the MLR model in specificity (0.776). The most significant factors identified were NLR, FBG, Cr, BMI, and exercise habits. The nomogram built using these five factors showed good predictive performance with AUC values of 0.705 and 0.666 in the training and test sets, respectively.</p><p><strong>Conclusion: </strong>The significant factors influencing the onset of diabetes include NLR, FPG, Cr, BMI, and exercise habits. The nomogram can effectively predict the risk of diabetes in the next five years, providing a powerful tool for early intervention. Future research could explore the interactions among these factors and validate the model's applicability in different populations.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1626925"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212119","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":"Comparison of conventional ICSI and rescue ICSI in patients without severe male factor and poor oocyte yield.","authors":"Mingzhao Li, Wennan Chen, Xia Xue","doi":"10.3389/fendo.2025.1637404","DOIUrl":"10.3389/fendo.2025.1637404","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the effectivity and safety of early rescue intracytoplasmic sperm injection (R-ICSI) in patients with poor oocyte yield and non-severe male factor.</p><p><strong>Methods: </strong>This study was a retrospective cohort analysis which included 604 conventional ICSI cycles and 116 early R-ICSI cycles at the Northwest Women's and Children's Hospital from February 2014 to December 2023. All patients were during their first assisted reproductive technologies (ART) cycle with 3-5 retrieved oocytes. The male partner had normal or mildly impaired sperm parameters. We compared the reproductive outcomes of conventional ICSI and early R-ICSI cycles in such patients.</p><p><strong>Results: </strong>We observed that there were no significant differences in the MII (86.75 versus 85.09%; <i>p</i> = 0.329) and two pronuclei (2PN) (71.82 versus 72.02%; <i>p</i> = 0.934) rates between conventional intracytoplasmic sperm injection (ICSI) and early R-ICSI groups. Following conventional ICSI, a total multi-pronuclei (MPN) rate of 1.02% was achieved, which was significantly lower than that of 6.33% after early R-ICSI (<i>p</i> < 0.001). There were no significant differences in the D3 good quality embryo (51.80 versus 49.67%; p = 0.499), D3 available embryo (82.28 versus 78.38%; <i>p</i> = 0.112) and blastocyst formation (65.15 versus 68.69%; <i>p</i> = 0.494) rates between the two groups. We also observed that there were no significant differences in the pregnancy (55.45 versus 50.50%; <i>p</i> = 0.357), clinical pregnancy (52.00 versus 46.53%; <i>p</i> = 0.312), ongoing pregnancy (44.91 versus 39.60%; p = 0.324) and live birth (42.73 versus 37.62%; <i>p</i> = 0.339) rates between the two groups.</p><p><strong>Conclusions: </strong>Despite the higher MPN rate, comparable outcomes can be achieved following early R-ICSI when compared to conventional ICSI for couples with non-severe male factor and poor oocyte yield.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1637404"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212147","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":"Distinct patterns of association between the hemoglobin glycation index, the stress-hyperglycemia ratio, and the risk of new-onset atrial fibrillation in critically ill patients.","authors":"Qiqiang Jie, Gang Li, Weichun Qian, Mingzhu He, Haibo Jia, Fengfu Zhang, Jianping Wang","doi":"10.3389/fendo.2025.1656783","DOIUrl":"10.3389/fendo.2025.1656783","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the associations between two novel glycemic indices, the hemoglobin glycation index (HGI) and the stress hyperglycemia ratio (SHR), and the risk of new-onset atrial fibrillation (NOAF) in critically ill patients.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 3,882 adults in the MIMIC-IV database, with the primary outcome defined as NOAF within 7 days of intensive care unit (ICU) admission. Multivariate Cox regression and restricted cubic spline analyses were used to evaluate associations.</p><p><strong>Results: </strong>NOAF occurred in 750 patients (19.3%). After adjustment for confounders, HGI exhibited a significant inverted U-shaped association with NOAF risk, with the highest risk in intermediate quartiles. In contrast, the SHR demonstrated a significant linear inverse relationship with NOAF risk, with higher SHR quartiles consistently associated with lower risk. These associations were especially pronounced in nondiabetic patients and remained consistent across key clinical subgroups.</p><p><strong>Conclusion: </strong>Our findings indicate that the HGI and SHR independently predict NOAF in critically ill patients and may provide valuable tools for risk stratification and personalized glycemic management in the ICU.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1656783"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212152","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":"Health coaching for individuals with type 2 diabetes: assessing the impact of health coaching on HbA1c, hospitalizations, and outpatient services.","authors":"Anthony Gittens, Ernie Medina, Jisoo Oh, Anna Nelson, Adam Aréchiga","doi":"10.3389/fendo.2025.1443490","DOIUrl":"10.3389/fendo.2025.1443490","url":null,"abstract":"<p><strong>Introduction: </strong>The global prevalence of type 2 diabetes mellitus (T2DM) presents substantial public health challenges, particularly among Medicaid populations. Health coaching has emerged as a promising intervention to improve glycemic control and healthcare utilization.</p><p><strong>Methods: </strong>We conducted a retrospective pre-post secondary data analysis of 4,583 CalOptima Medicaid recipients with T2DM between March 2015 and August 2023. Patients who received health coaching (n = 3,777) were compared to those who declined (n = 806). Primary outcomes included HbA1c, hospitalizations, and outpatient visits.</p><p><strong>Results: </strong>The coached group experienced a significantly greater reduction in HbA1c (MD = -1.14, SD = 1.98) compared to the non-coached group (MD = -0.80, SD = 1.96; t(4581) = 4.51, p < .001). Ambulatory visits increased significantly among coached participants (p < .001), though hospitalizations showed no significant changes. Logistic regression indicated coached individuals had higher, though not statistically significant, odds of achieving normal HbA1c levels (OR = 1.19, 95% CI: 0.96-1.46).</p><p><strong>Discussion: </strong>Health coaching was associated with improved glycemic control and increased ambulatory care engagement among Medicaid patients with T2DM. These findings highlight the value of patient-centered interventions in chronic disease management within underserved populations.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1443490"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212095","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 triglyceride-glucose index is associated with coronary plaque features and clinical outcomes in patients with ST-segment elevation myocardial infarction.","authors":"Yibo Guo, Lina Cui, Jiaqing Guo, Chengmei Jin, Lili Xiu, Yubo Gao, Chen Zhao, Xueming Xu, Jinfeng Tan, Jincheng Han, Lulu Li, Tao Chen, Jiannan Dai, Bo Yu, Chao Fang","doi":"10.3389/fendo.2025.1665292","DOIUrl":"10.3389/fendo.2025.1665292","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index is a reliable surrogate marker for insulin resistance, and is associated with cardiovascular diseases. However, the specific impact of TyG index on coronary plaque vulnerability and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. This study aimed to investigate the association of the TyG index with coronary plaque characteristics and clinical outcomes.</p><p><strong>Methods: </strong>Between January 2017 to December 2019, 1,831 STEMI patients who underwent optical coherence tomography imaging were retrospectively enrolled. Patients were divided into three groups based on TyG index tertiles (Group T1: <8.82, Group T2: 8.82-9.41, Group T3: ≥9.41). Major adverse cardiovascular and cerebrovascular events (MACCE) included cardiac death, non-fatal stroke, non-fatal myocardial infarction, ischemia-driven revascularization, and rehospitalization.</p><p><strong>Results: </strong>The average age was 58.7 years, and 72.1% were male. The incidence of plaque rupture, thin-cap fibroatheromas, macrophages, and the size of lipid core, increased with increasing TyG index tertiles (all <i>P</i><0.05). Multivariate logistic regression analysis showed that TyG index independently predicted culprit plaque rupture (T2: OR 1.39, 95%CI 1.06-1.82; T3: OR 1.51, 95%CI 1.05-2.16; T1 as reference). During a median follow-up of 4.2 years, 541 (29.9%) patients developed MACCE. Patients in the highest TyG index tertile had a significantly higher cumulative incidence of MACCE (43.5% vs. 37.3% vs. 31.1%, <i>P</i> = 0.007) than the other two groups. After adjusting for clinical risk factors and coronary plaque features, the increased TyG index independently predicted MACCE (HR 1.18, 95%CI 1.00-1.38, per unit increased). This association was notable in patients without diabetes but was not demonstrable in diabetes (interaction <i>P</i>-value <0.05).</p><p><strong>Conclusions: </strong>In patients with STEMI, elevated TyG index increased atherosclerotic plaque vulnerability, and independently predicted plaque rupture. A higher TyG index was an independent predictor of MACCE, especially for patients without diabetes.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1665292"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212108","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":"Epigenetic modification of hypothalamic neuropeptides and metabolic hormone receptors in metabolic health.","authors":"Busayo Oladun, Smita Mall, Min-Hyun Kim","doi":"10.3389/fendo.2025.1645474","DOIUrl":"10.3389/fendo.2025.1645474","url":null,"abstract":"<p><p>The hypothalamus plays a central role in regulating metabolism by integrating neuropeptide signaling with environmental cues to maintain energy homeostasis. Adverse environmental factors, such as obesogenic diet, undernutrition, stress, and sedentary lifestyles, can disrupt the normal regulation of key hypothalamic neuropeptides and metabolic hormone receptors through epigenetic mechanisms, including DNA methylation, histone modifications, and microRNA regulation. These epigenetic alterations are not merely transient; they can be heritable and may influence metabolic health across generations, highlighting the critical need to understand the underlying epigenetic mechanisms. In this review, we provide a comprehensive overview of how environmental factors shape the epigenetic landscape of hypothalamic neuropeptides (pre-opiomelanocortin, neuropeptide Y, and agouti-related peptide) and metabolic hormone receptors (leptin receptor and insulin receptor), thereby modulating their expression and contributing to long-term metabolic outcomes. A better understanding of environment-epigenome interactions holds promise for the development of innovative therapeutic strategies to combat obesity and metabolic disorders.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1645474"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212100","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":"Machine learning-based prediction of hypoglycemia severity in hospitalized diabetic patients.","authors":"Hongjian Jia, Jietao Zhang","doi":"10.3389/fendo.2025.1634358","DOIUrl":"10.3389/fendo.2025.1634358","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for hypoglycemia in hospitalized patients with type 2 diabetes mellitus (T2DM) and develop predictive models for hypoglycemia severity based on machine learning algorithms.</p><p><strong>Methods: </strong>Adult non-pregnant hospitalized patients diagnosed with T2DM were retrospectively enrolled from the electronic medical record system of the Affiliated Hospital of Qingdao University. Patients were categorized into hypoglycemia groups (mild, moderate-to-severe) or a non-hypoglycemia group based on inpatient venous plasma glucose levels. After data preprocessing, univariate and multivariate analyses were conducted to identify significant predictors. Three predictive models (XGBoost, Random Forest [RF], and Logistic Regression) were subsequently constructed and validated to evaluate their predictive performances.</p><p><strong>Results: </strong>From an initial cohort of 8,947 patients, 1,798 patients were included after data screening. Among the evaluated models, the RF model demonstrated the highest predictive accuracy (93.3%) and Kappa coefficient (0.873), followed by XGBoost (accuracy: 92.6%, Kappa: 0.860). Logistic regression exhibited comparatively lower performance (accuracy: 83.8%, Kappa: 0.685). The macro-average area under the ROC curve (AUC) values for RF, XGBoost, and logistic regression were 0.960, 0.955, and 0.788, respectively, highlighting the superior discriminative capability of the RF model. While both XGBoost and RF models identified glycemic control metrics and glucose variability as core predictors for hypoglycemia, the RF model additionally emphasized medication usage, whereas XGBoost prioritized basal metabolic parameters.</p><p><strong>Conclusions: </strong>The RF model outperformed XGBoost and conventional logistic regression in predicting hypoglycemia severity among hospitalized T2DM patients. The results emphasize the importance of closely monitoring glucose levels and glucose variability during diabetes management to prevent hypoglycemia. The developed model provides a foundation for implementing preventive strategies to reduce hypoglycemia occurrence in hospitalized patients with T2DM.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1634358"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212110","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 inflammation and nutrition-based indicators and diabetic foot ulcers: a cross-sectional study and a retrospective study.","authors":"Hua Chen, Yu Zhou, Jiezhi Dai","doi":"10.3389/fendo.2025.1654831","DOIUrl":"10.3389/fendo.2025.1654831","url":null,"abstract":"<p><strong>Background: </strong>Inflammation and nutrition status have emerged as important factors in impaired wound healing in diabetes. However, the association between inflammation and nutrition-based indicators and diabetic foot ulcer (DFU) has not been reported.</p><p><strong>Methods: </strong>This study used a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) database and a clinical retrospective study to investigate the association between the inflammation and nutrition-based indicators and DFU. We analyzed data from 31,126 individuals in the NHANES data between 1999 and 2004. Inflammation and nutrition-based indicators included neutrophil-albumin ratio (NAR), monocyte-albumin ratio (MAR), red cell distribution width-albumin ratio (RAR), the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, and prognostic nutritional index (PNI). Binary logistic regression on single and multiple variables and restricted cubic spline were conducted to assess the association and nonlinear relationship between these biomarkers and the prevalence of DFU. Subgroup analyses were performed to evaluate the stability of the associations. Additionally, a retrospective study was conducted to further assess the associations between NAR, MAR, RAR, HALP, PNI, and the prevalence of DFU using binary logistic regression analysis.</p><p><strong>Results: </strong>A total of 129 participants with DFUs and 1,515 without DFUs were included in this cross-sectional study. NAR, MAR, RAR, HALP, PNI, and DFU are significantly associated with the prevalence of DFU. After adjusting for all covariates (model 3), the third tertile of NAR (OR = 1.73 [1.09-2.74]), MAR (OR = 1.71 [1.05-2.79]), and RAR (OR = 4.47 [2.57-7.77]) were positively linked with DFU, compared with the first tertile. The third tertile of HALP (OR = 0.50 [0.31-0.80]) and PNI (OR = 0.42 [0.26-0.67]), respectively, were negatively linked with DFU compared with the first tertile. The RCS curves showed a nonlinear relationship between RAR and the prevalence of DFU, with an inflection point at 3.83. In the retrospective study, NAR, MAR, and RAR were positively associated with the prevalence of DFU as follows: NAR: OR = 4.71 (1.99-11.18), MAR: OR = 2.56 (1.23-5.31), and RAR: OR = 6.15 (2.31-16.41). On the other hand, HALP and PNI were negatively linked with the risk of DFU (HALP: OR = 0.93 [0.90-0.97] and PNI: OR = 0.85 [0.78-0.93]).</p><p><strong>Conclusion: </strong>High NAR, MAR, and RAR were positively associated with the prevalence of DFU, whereas low HALP and PNI were linked with an increased prevalence of DFU. In addition, RAR performed better in terms of predictive ability.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1654831"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205835","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}