Diabetes, Obesity & Metabolism最新文献

{"title":"External validation of a prediction model for estimating fat mass in Arab children and adolescents","authors":"Tareq Al-Ati PhD,&nbsp;Khalid El Kari PhD,&nbsp;Lara Nasreddine PhD,&nbsp;Hessa Al-Kandari MRCPCH,&nbsp;Richard D. Riley PhD,&nbsp;Peter H. Whincup FRCP,&nbsp;Christopher G. Owen PhD,&nbsp;Mohammed T. Hudda PhD","doi":"10.1111/dom.16281","DOIUrl":"10.1111/dom.16281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Current childhood fat mass (FM) assessment techniques are not suitable for clinical and population-level adiposity assessment. A prediction model, which accurately estimates childhood FM using predictor variables of weight, height, age, sex and ethnicity, requires validation in Arab populations. We evaluate the model's performance in Kuwaiti, Lebanese and Moroccan children/adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from three cross-sectional studies on 471 individuals, aged 6–15 years, were obtained with complete information on predictors and the outcome of log transformed fat-free mass assessed by reference standard deuterium dilution (lnFFM). Country-specific predictive performance statistics of <i>R</i>², calibration slope and calibration-in-the-large (measures the calibration/agreement between observed and predicted lnFFM with ideal values of 1 and 0, respectively) and root mean square error (RMSE) were quantified and pooled across countries via random-effects meta-analysis. FM estimates from bioimpedance were also available for Lebanese children and were compared to the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The model showed strong predictive ability in all populations. Pooled <i>R</i>² calibration slope and calibration-in-the-large values on the original lnFFM scale were 87.73% (95% CI: 77.20, 98.26%), 0.95 (95% CI: 0.83, 1.08) and −0.03 (95% CI: −0.16, 0.11), respectively. Model intercepts were recalibrated in each country to improve accuracy; updated country-specific equations are provided. After recalibration, RMSEs on the FM scale were 1.3, 1.6 and 2.8 kg in Kuwait, Lebanon and Morocco, respectively. The RMSE from the model was lower than bioimpedance (2.4 kg) amongst Lebanese children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>The model explained a large proportion of the variance in FM, produced well-calibrated predictions and relatively low RMSEs in Arab settings. It predicted FM more accurately than bioimpedance, indicating its potential for implementation in clinical- and population-level settings, particularly in low- and middle-income countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2740-2749"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497655","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":"Time in range—A new gold standard in type 2 diabetes research?","authors":"Ashni Goshrani MD,&nbsp;Rose Lin MD,&nbsp;David O'Neal MD,&nbsp;Elif I. Ekinci MBBS","doi":"10.1111/dom.16279","DOIUrl":"10.1111/dom.16279","url":null,"abstract":"<p>Glycated haemoglobin (HbA1c) is currently the gold standard outcome measure for type 2 diabetes trials. Time in range is a continuous glucose monitoring (CGM) metric defined as the proportion of time in euglycemia (3.9–10.0 mmol/L) and may be valuable not only in type 1 diabetes clinical trials but also as an endpoint in type 2 diabetes trials. This narrative review aimed to assess the relative merits of time in range versus HbA1c as outcome measures for type 2 diabetes studies. It reviews the strengths and limitations of time in range as an outcome measure and evaluates studies in type 2 diabetes that have used time in range as a primary or secondary outcome measure. A literature search was conducted on PubMed and MEDLINE databases using key terms “time in range” AND “diabetes” OR “type 2 diabetes mellitus”. Further evidence was obtained from relevant references of retrieved articles. Literature search identified 247 papers, of which 110 were included in this review. These included a broad range of articles, including 45 randomized trials using time in range as an outcome measure in patients with type 2 diabetes, as well as papers validating time in range. Time in range provides valuable and clinically relevant information and should be used as an important endpoint in type 2 diabetes in clinical trial settings, in conjunction with HbA1c.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2342-2362"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497662","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":"Most hospitalised patients with type 2 diabetes benefit from continuous glucose monitoring compared to point-of-care glucose testing in a non-intensive care unit setting: A heterogeneity of treatment effect analysis","authors":"Mikkel Thor Olsen PhD,&nbsp;Signe Hjejle Jensen MD,&nbsp;Louise Mathorne Rasmussen RN,&nbsp;Carina Kirstine Klarskov PhD,&nbsp;Birgitte Lindegaard PhD,&nbsp;Jonas Askø Andersen PhD,&nbsp;Hans Gottlieb PhD,&nbsp;Suzanne Lunding PhD,&nbsp;Katrine Bagge Hansen PhD,&nbsp;Ulrik Pedersen-Bjergaard DMSc,&nbsp;Peter Lommer Kristensen PhD","doi":"10.1111/dom.16297","DOIUrl":"10.1111/dom.16297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Understanding whether improved glycaemic outcomes from continuous glucose monitoring (CGM) compared to point-of-care (POC) glucose testing apply uniformly to all hospitalised non-intensive care unit (non-ICU) patients with type 2 diabetes or vary among subgroups is crucial for allocating healthcare resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This two-site randomised controlled trial DIAbetes TEam and Cgm (DIATEC) enrolled 166 non-ICU patients with type 2 diabetes. Diabetes management was based on either POC glucose testing or CGM. Diabetes management was carried out by general hospital staff, under the guidance of specialised diabetes teams, using insulin titration protocols in both groups. We conducted heterogeneity of treatment effect regression analyses to assess whether certain patient characteristics (e.g., age, gender, haemoglobin A1c, etc.) modified the effects of CGM, compared to POC glucose testing, on the glycaemic outcomes time in/above/below range, mean glucose level, standard deviation (SD), coefficient of variation (CV) and hypoglycaemic events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No heterogeneity of treatment effect was observed, suggesting that all patients benefited equally from CGM compared to POC glucose testing regarding glycaemic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>From a glycaemic perspective, CGM could be widely recommended for most non-ICU patients with type 2 diabetes, as its glycaemic benefits over POC glucose testing appear consistent regardless of individual characteristics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2857-2863"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497658","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":"A comparison of ultra-rapid and rapid insulin in automated insulin delivery for type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials","authors":"Puguh Oktavian MD,&nbsp;Citrawati Dyah Kencono Wungu PhD,&nbsp;Sony Wibisono Mudjanarko PhD,&nbsp;Indah Mohd Amin PhD","doi":"10.1111/dom.16268","DOIUrl":"10.1111/dom.16268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to summarize and compare the evidence on the efficacy and safety of automated insulin delivery (AID) systems using ultra-rapid-acting insulin analogues (URAIs), such as fast-acting insulin aspart (FIASP) and ultra-rapid lispro (URLi) (referred to as AID–URAIs), versus those using rapid-acting insulin analogues (RAIs) (referred to as AID–RAIs) in patients with type 1 diabetes (T1D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of AID–URAI versus AID–RAI. We systematically searched PubMed, Scopus, ProQuest, Web of Science, Cochrane Library, Clinicaltrial.gov, and medRxiv for articles up to 30 October 2024. Percent time-in-range (TIR; 3.9–10 mmol/L), time-below-range (TBR; 3.9- and 3.0-mmol/L), and time-above-range (TAR; &gt;10.0- and 13.9-mmol/L) were extracted. This study was registered in the PROSPERO (CRD42024602279).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen randomized controlled trials (664 participants) were included in this study. AID–URAI were associated with an increased percentage of TIR, but not clinically significant (pooled mean difference {MD} = 1.07% [95% confidence interval {CI}: 0.11 to 2.02]; <i>I</i>² = 0%; <i>p</i> = 0.029; high certainty). The favourable effect was consistent in AID systems incorporating automated bolus correction, adults, study duration &gt;4 weeks, and FIASP subgroups. AID–URAI has a 0.35% lower percentage of TBR (&lt;3.9 mmol/L) compared with AID–RAI. There were no significant differences in the risk of diabetic ketoacidosis and severe hypoglycemia between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AID–URAI slightly improves the percentage of TIR and has a good safety profile without increasing the risk of diabetic ketoacidosis and severe hypoglycemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2658-2669"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490292","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":"Tirzepatide reduces body weight by increasing fat utilization via the central nervous system-adipose tissue axis in male mice","authors":"Ailin Zhang MS,&nbsp;Qinhui Liu MS,&nbsp;Yimin Xiong MS,&nbsp;Jiahui Li MD,&nbsp;Ying Xu MD,&nbsp;Haiying Song MD,&nbsp;Xiandan Jing BS,&nbsp;Haixia Xu PhD,&nbsp;Na Yang MS,&nbsp;Yanping Li PhD,&nbsp;Li Mo PhD,&nbsp;Qin Tang PhD,&nbsp;Jinhan He PhD","doi":"10.1111/dom.16294","DOIUrl":"10.1111/dom.16294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Tirzepatide, a dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, demonstrates promise as a potent medication for obesity. However, the extent to which its weight-reducing effects go beyond suppressing appetite remains unclear. This study aimed to elucidate this by establishing a pair-fed control group, effectively eliminating the influence of reduced caloric intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Mice fed on a chow diet or a high-fat diet received single or long-term intracerebroventricular (i.c.v.) injections of tirzepatide or vehicle. The vehicle-treated mice were pair-fed to the tirzepatide-treated group to avoid the impact induced by different caloric intakes. Body weight and food intake were monitored daily. Respiratory exchange ratio (RER) was determined in metabolic cages. Fat utilization was calculated based on RER. Parameters of lipid metabolism were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mice receiving i.c.v. administration of tirzepatide exhibited significant reductions in body weight and fat content compared with pair-fed controls. These effects were mediated by increased lipolytic capacity in white adipose tissue and enhanced thermogenesis in brown and beige adipose tissues, leading to decreased RER and increased lipid utilization. Mechanistic investigations revealed that these effects were primarily mediated by sympathetic nervous system innervation of adipose tissues. This innervation, in turn, might be associated with the neuronal activity changes in the dorsomedial hypothalamus and the nucleus of the solitary tract within the hindbrain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings establish a critical role for tirzepatide in shifting the substrate preference to fat utilization through the central nervous system–adipose tissue axis, promoting weight loss independent of food intake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2844-2856"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497670","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":"Quantitative proteomics identifies plasma protein alterations that associate with metabolic and thrombotic profile changes after bariatric surgery","authors":"Hasnain Ahmed MSc,&nbsp;Marco F. Fernandes PhD,&nbsp;Kazim Abbas MD,&nbsp;Silvia A. Synowsky PhD,&nbsp;Sally L. Shirran PhD,&nbsp;Ramzi A. Ajjan MD,&nbsp;Alan J. Stewart PhD","doi":"10.1111/dom.16267","DOIUrl":"10.1111/dom.16267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Roux-en-Y gastric bypass (RYGB) surgery has been shown to lead to favourable health outcomes in obese patients. However, the molecular changes that occur and how they relate to clinical measures are poorly understood. Here, we characterise the proteomic alterations that occur in plasma of RYGB patients before and 9 months after surgery using quantitative proteomics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma proteomics was performed by sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS) to identify and quantify differentially abundant proteins. Relationships between significantly altered proteins and clinical markers were examined. A gene set enrichment analysis was also conducted to identify altered pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From the proteomic analysis, 27 proteins increased, and 43 proteins decreased in abundance 9 months after surgery, providing insights into the physiological changes that accompany weight loss. Proteins including sex hormone binding globulin (SHBG), inter-alpha-trypsin inhibitor heavy chain 3 (ITIH3) and apolipoprotein D (APOD), which increased in abundance post-surgery, highlight improvements in lipid regulation, insulin sensitivity and inflammation. Proteins involved in coagulation, including α2-macroglobulin, kallikrein-B1, prothrombin, and factor (FX, FXI and FXII), exhibited reduced levels, aligning with a decrease in thrombotic potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide a mechanistic understanding of how bariatric surgery leads to systemic changes in metabolic and haemostatic pathways, thus favourably modulating the risk of developing cardiovascular disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2647-2657"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497660","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":"Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight","authors":"Michelle Look MD,&nbsp;Julia P. Dunn MD,&nbsp;Robert F. Kushner MD,&nbsp;Dachuang Cao PhD,&nbsp;Charles Harris MD,&nbsp;Theresa Hunter Gibble PhD,&nbsp;Adam Stefanski MD,&nbsp;Ryan Griffin Pharm. D.","doi":"10.1111/dom.16275","DOIUrl":"10.1111/dom.16275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We assessed changes in body composition following tirzepatide treatment in a substudy of participants with obesity or overweight from the SURMOUNT-1 trial, overall and post hoc in clinically relevant subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Substudy participants (<i>n</i> = 160 of the 2539 in SURMOUNT-1) underwent dual-energy X-ray absorptiometry (DXA) at baseline and Week 72. Body composition parameters were evaluated by analysis of covariance, logistic regression or Fisher's exact test. Post hoc subgroup analyses were conducted by sex (female or male), age (&lt;50, 50 to &lt;65, or ≥65 years) and total body weight reduction tertiles (≤15.3 kg, &gt;15.3 to ≤25.9 kg, or &gt;25.9 kg).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 160 participants (pooled tirzepatide doses <i>n</i> = 124, placebo <i>n</i> = 36) with baseline and end of study DXA data were 73% female and had a mean weight of 102.5 kg and body mass index of 38.0 kg/m². The change in body weight, fat mass and lean mass from baseline to Week 72 was −21.3%, −33.9% and −10.9% with tirzepatide and −5.3%, −8.2% and −2.6% with placebo, respectively (<i>p</i> &lt; 0.001 for all comparisons). Of the body weight lost, approximately 75% was fat mass and 25% was lean mass for both tirzepatide and placebo. These proportions remained consistent across most subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In participants with obesity or overweight from the SURMOUNT-1 trial, tirzepatide treatment significantly reduced body weight, fat mass and lean mass compared with placebo, while in post hoc analyses, the proportion of body weight lost as fat or lean mass was relatively consistent including in clinically relevant subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2720-2729"},"PeriodicalIF":5.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490272","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":"An update and overview of the various health-related benefits of probiotics: A focus on clinical trials demonstrating efficacy, tolerability and use in patients with impaired glucose tolerance and type 2 diabetes","authors":"Takayuki Toshimitsu PhD,&nbsp;Junichiro Irie MD","doi":"10.1111/dom.16273","DOIUrl":"10.1111/dom.16273","url":null,"abstract":"<p>Recently, probiotics have been investigated as potential therapeutic agents for various diseases. Clinical studies using probiotics have been conducted in humans with impaired glucose tolerance and type 2 diabetes mellitus. Chronic inflammation plays a pivotal role in initiating insulin resistance in the pathogenesis of type 2 diabetes, leading to cardiovascular diseases. Intestinal dysfunction and inflammation have been postulated to trigger systemic chronic inflammation, and it is assumed that the suppression of inflammation in the intestine is the point of activity of probiotics. Therefore, in this review, among the randomised controlled trials that evaluated the effects of probiotics in patients with impaired glucose tolerance and type 2 diabetes, we selected trials that evaluated the indices of glycaemic control and inflammation-related markers. Some trials have shown that the probiotics administration improved glycaemic indices, such as HbA1c levels, and reduced C-reactive protein levels and proinflammatory cytokines, such as IL-6, in the blood, suggesting the suppression of inflammation. Two trials showed improvements in glycaemic indices, implying that they were mediated by IL-10, an anti-inflammatory cytokine. Although a correlation between the suppression of inflammation by probiotics and improvement in glycaemic control has not been documented, one trial revealed that glycaemic control worsened, accompanied by a decrease in anti-inflammatory cytokine levels, after probiotics were discontinued. Other studies have shown that probiotics can reduce blood endotoxin levels and increase intestinal mucin production. These findings suggest that probiotic administration has enormous potential to suppress chronic inflammation in metabolic disorders, leading to improved glycaemic control. Suppression of chronic inflammation has been speculated to prevent vascular diseases in type 2 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 S1","pages":"15-22"},"PeriodicalIF":5.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481970","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":"Anti-VEGF monotherapy versus anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy for diabetic macular edema: A Bayesian network meta-analysis","authors":"Xiaofei Yang BSMed,&nbsp;Yang Cao MD,&nbsp;Xiaoming Cao MD,&nbsp;Lijuan Wang BD,&nbsp;Xiaoxia Zhang MD,&nbsp;Zengyu Zhang BSMed,&nbsp;Xinyu Zai BSMed,&nbsp;Zheyi Yan MD","doi":"10.1111/dom.16270","DOIUrl":"10.1111/dom.16270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To conduct a network meta-analysis (NMA) comparing the efficacy of anti-vascular endothelial growth factor (VEGF) monotherapy versus anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy for diabetic macular edema (DME).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and the Cochrane Library were systematically searched for randomized controlled trials comparing anti-VEGF monotherapy with anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy for DME. The primary outcomes included the mean best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes from the baseline. A NMA for continuous outcomes was conducted using a fixed-effects model, with mean difference (MD) and corresponding 95% credible interval (CI) reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The NMA included 21 randomized controlled trials involving 1798 eyes. Anti-VEGF monotherapy and anti-VEGF combined with laser or intravitreal glucocorticoid therapy did not significantly change the mean CMT and BCVA at 6 and 12 months from the baseline. Simulation-based ranking results for mean BCVA changes suggested that anti-VEGF therapy combined with laser therapy was likely the most effective at 6 (70.7515%) and 12 (70.9315%) months. Similar results were observed in the simulation-based ranking of mean CMT changes, suggesting that anti-VEGF therapy combined with laser therapy was likely the most effective at 6 (83.6350%) and 12 (74.7730%) months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Anti-VEGF monotherapy and anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy exerted comparable effects. However, the ranking chart recommends anti-VEGF therapy combined with laser therapy. Meanwhile, anti-VEGF therapy combined with intravitreal glucocorticoid therapy did not demonstrate significant benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2679-2689"},"PeriodicalIF":5.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456373","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":"Novel metabolic and inflammatory stratification of overweight/obesity to characterize risks of adverse outcomes: A large population-based cohort study","authors":"Hang Dong MD,&nbsp;Yingzhou Shi PhD,&nbsp;Yicheng Ma MD,&nbsp;Yiping Cheng PhD,&nbsp;Luna Liu PhD,&nbsp;Shengyang Xiao PhD,&nbsp;Zinuo Yuan MD,&nbsp;Zhen Wang PhD,&nbsp;Tuo Li PhD,&nbsp;Jiajun Zhao PhD,&nbsp;Xiude Fan PhD","doi":"10.1111/dom.16262","DOIUrl":"10.1111/dom.16262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The growing epidemic of overweight and obesity elevates disease risks, with metabolic disorders and inflammation critically involved in the pathogenic mechanisms. This study refines the subtyping of overweight and obesity using metabolic and inflammatory markers to enhance risk assessment and personalized prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Based on the UK Biobank, this retrospective study included participants classified as overweight or obese (BMI ≥25 kg/m²). K-means clustering was performed using metabolic and inflammatory biomarkers. Multivariate Cox regression analysis assessed the risk of complications and mortality over a follow-up period of 13.5 years. Genome-Wide Association Studies (GWAS) and Phenome-Wide Association Studies (PheWAS) explored cluster-specific genetic traits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 126 145 participants (mean [IQR] age: 55.0 [14.0] years; 61 983 males [49.1%]), five clusters were identified: (1) Low Metabolic Risk-related, (2) Hypertension-Related, (3) Mixed Hyperlipidemia-Related, (4) Elevated Lipoprotein(a)-Related and (5) High BMI and Inflammation-Related. Cluster 1 exhibited a lower risk of complications than other clusters. Cluster 2 had the highest incidence of stroke, linked to variants affecting blood circulation. Cluster 3 showed the highest risks for ischaemic heart disease, characterized by variants enriched in cholesterol metabolism pathways. Cluster 4 was associated with high cardiovascular risks. Cluster 5 had the highest risks for diabetes, asthma, chronic obstructive pulmonary disease, osteoarthritis and mortality, linked to obesity-related genetic variants. We also proposed a method for applying this classification in clinical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This classification provides insights into the heterogeneity of individuals with overweight and obesity, aiding in the identification of high-risk patients who may benefit from targeted interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2613-2625"},"PeriodicalIF":5.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456327","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}