Diabetes, Obesity & Metabolism最新文献

{"title":"Investigating multimorbidity trajectories in people living with MASLD diagnosis: A trajectory analysis using the UK Biobank.","authors":"Fang Lu, Hailin Yang, Bingyang She, Qianhui Lu, Yining Bao, Wai-Kay Seto, William C W Wong, Man-Fung Yuen, Yingli He, Xinyuan He, Fanpu Ji, Lei Zhang","doi":"10.1111/dom.70095","DOIUrl":"https://doi.org/10.1111/dom.70095","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health concern, and its presence increases the risk of multi-system diseases. This study aimed to investigate the multimorbidity trajectories of chronic diseases in people living with MASLD.</p><p><strong>Methods: </strong>We identified 137 859 MASLD patients in UK Biobank and used 'propensity score matching' to match an equal number of non-MASLD controls. Diseases were reclassified into 472 categories based on the International Classification of Diseases, Tenth Revision (ICD-10) chapters. Multimorbidity trajectories post-MASLD diagnosis were mapped using validated trajectory analysis. We introduced the 'Multimorbidity Trajectory Position Index (MTPI)' to denote a disease's position across trajectories, highlighting its temporal pattern.</p><p><strong>Results: </strong>Participants had a median age of 59 (52-64) years, with 65.6% being male. Over 13 years of follow-up, Phenome-wide association analysis (PheWAS) identified 128 diseases with elevated risks post-MASLD diagnosis, with obesity (HR: 8.77, 95% CI: 8.37-9.18), diabetes (HR: 4.34, 95% CI: 4.15-4.53), and sleep disorders (HR: 3.21, 95% CI: 3.01-3.42) showing the strongest associations. Trajectory analysis revealed 6637 common trajectories involving 69 diseases, grouped into metabolic, inflammatory, and cardiovascular clusters. These clusters are linked to downstream conditions, with intermediary diseases such as hypertension, diabetes, and inflammatory arthritis, ultimately leading to electrolyte imbalances and sepsis. MTPI demonstrated a gradient in disease progression, with early-stage conditions showing low values, mid-stage conditions moderate values, and late-stage conditions high values.</p><p><strong>Conclusion: </strong>People living with MASLD demonstrated multimorbidity trajectories involving co-occurrence of metabolic diseases, chronic inflammation, and cardiovascular diseases. If replicated, these pathways may serve as promising targets to improve late-life health in individuals with MASLD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013628","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":"Comparative efficacy of sleeve gastrectomy with fundoplication versus standard sleeve gastrectomy in obesity and gastroesophageal reflux disease: A randomised trial.","authors":"Pierdiwasi Maimaitiyusupu, Aikebaier Aili, Maimaiti Yisireyili, Yiliang Li, Kelimu Abudureyimu, Xin Li","doi":"10.1111/dom.70094","DOIUrl":"https://doi.org/10.1111/dom.70094","url":null,"abstract":"<p><strong>Aims: </strong>This randomised controlled trial compared the efficacy of modified laparoscopic sleeve gastrectomy with fundoplication (LSGFD) versus standard laparoscopic sleeve gastrectomy (LSG) in achieving weight loss and alleviating gastroesophageal reflux disease (GERD) in patients with obesity.</p><p><strong>Materials and methods: </strong>Eighty patients with obesity (body mass index [BMI] ≥27.5 kg/m² with comorbidities or ≥32.5 kg/m²) with mild-to-moderate GERD were randomised to LSGFD (n = 27) or LSG (n = 53). Assessments included weight, BMI, waist-hip ratio, percentage of excess weight loss (%EWL), GERD Questionnaire scores, endoscopy, lower oesophageal sphincter (LES) pressure and DeMeester scores preoperatively and at 6-12 months postoperatively. Fundoplication type (180° Dor, 270° Toupet or 360° Nissen) was intraoperatively adjusted based on LES pressure. Statistical analyses used t-tests, analysis of variance and chi-square tests (SPSS v19.0).</p><p><strong>Results: </strong>No significant differences were observed between the two groups in preoperative parameters. However, at 6 and 12 months postoperatively, both groups showed significant reductions in body weight, BMI, waist circumference, hip circumference and waist-hip ratio, along with a significant increase in the %EWL. The LSGFD group demonstrated superior outcomes in treating GERD and other obesity-related comorbidities, particularly notable improvements in reflux esophagitis.</p><p><strong>Conclusions: </strong>LSGFD provides equivalent weight loss to LSG but significantly superior control of GERD symptoms and resolution of reflux esophagitis. It offers enhanced management of obesity-related comorbidities without increasing surgical risk, supporting its use in obese patients with GERD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013631","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":"Insights from predicting results of the GRADE trial using real-world data.","authors":"Sushama Kattinakere Sreedhara, Sebastian Schneeweiss, Elyse DiCesare, Elisabetta Patorno, Theodore N Tsacogianis, Marie C Bradley, Shirley V Wang","doi":"10.1111/dom.70068","DOIUrl":"https://doi.org/10.1111/dom.70068","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013560","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":"Olfactory training improves cognition and modifies brain networks in type 2 diabetes patients with mild cognitive impairment: A 16-week randomised controlled trial.","authors":"Yining Chao, Xuewei Tong, Bing Zhang, Huijie Yang, Lu Zhang, Kexin Wu, Yi Zhang, Qian Li, Zhou Zhang, Yan Bi","doi":"10.1111/dom.70103","DOIUrl":"https://doi.org/10.1111/dom.70103","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes (T2D) related cognitive impairment links to comorbid and modifiable olfactory dysfunction; however, the efficacy of olfactory training (OT) to mitigate cognitive decline specifically in these patients with mild cognitive impairment (MCI) remains unestablished. This study aimed to determine whether OT alleviates cognitive decline in this population.</p><p><strong>Materials and methods: </strong>In this 16-week, open-label trial, 60 T2D participants with MCI were randomly assigned (1:1) to OT or routine care (control). The OT group performed twice-daily 6-minute exposure to six odorants (rose, eucalyptus, lemon, clove, coffee, and cinnamon), with adherence monitored remotely. The primary outcome was the change in Montreal Cognitive Assessment (MoCA) score. Secondary outcomes included: (1) other neuropsychological assessments, (2) olfactory tests, (3) structural and odour-induced functional magnetic resonance imaging, and (4) metabolic parameters.</p><p><strong>Results: </strong>OT significantly improved global cognition, as demonstrated by greater score increases in MoCA (OT: Δ + 1.9 vs. control: Δ + 0.4, p = 0.001, η²_p = 0.190, 95% CI [0.04, 0.35]) compared to controls. Domain-specific enhancements were observed in visuospatial constructional, language, and executive function. Concurrently, OT elevated overall olfactory performance. Neuroimaging revealed parallel neural alterations, with volume increases in hippocampal subfields and prefrontal hypoactivation during tasks. Critically, mediation analysis showed olfactory enhancement (Δolfactory total score) mediated global cognitive improvement (ΔMoCA). No significant metabolic differences emerged between groups.</p><p><strong>Conclusions: </strong>A 16-week OT regimen improves global and domain-specific cognition for MCI in T2D, alongside olfactory and neuroimaging enhancements. These findings support OT as a low-cost, home-based strategy for cognitive preservation in this high-risk population.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999367","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":"The protective role of TIGIT+ B cells in attenuating type 1 diabetes progression.","authors":"Yiman Peng, Jingyue Li, Ying Deng, Zhiguang Zhou, Mengyao Shu","doi":"10.1111/dom.70092","DOIUrl":"https://doi.org/10.1111/dom.70092","url":null,"abstract":"<p><strong>Aims: </strong>Type 1 diabetes (T1D) is an autoimmune disease caused by the destruction of insulin-producing pancreatic β-cells. While T cells are well-known critical, growing evidence shows that B cells also play a key role in T1D development. T cell immunoreceptor with immunoglobulin and ITIM domain (TIGIT), as an inhibitory immune checkpoint, is important in maintaining immune homeostasis and has become a therapeutic target for several autoimmune diseases. Our recent study identified a protective role of TIGIT+ regulatory T cells (Tregs) in T1D. However, the involvement of TIGIT+ B cells in T1D progression remains unclear.</p><p><strong>Materials and methods: </strong>This study investigated the expression, functional and metabolic characteristics of TIGIT+ B cells in T1D patients and non-obese diabetic (NOD) mice using flow cytometry. The regulatory mechanisms were further elucidated through T cell-B cell co-culture experiments. Additionally, in vivo intervention studies were conducted to explore potential therapeutic targets for T1D.</p><p><strong>Results: </strong>We found that the frequency of TIGIT+ B cells was decreased and negatively correlated with disease progression in T1D. TIGIT+ B cells showed decreased co-stimulation, activation, proliferation, pro-inflammatory cytokine production, glucose metabolism and increased anti-inflammatory cytokine production compared to TIGIT- B cells. Furthermore, in vitro co-culture experiments revealed that TIGIT+ B cells suppressed the pro-inflammatory differentiation and pathogenic functions of T cells. Importantly, the use of TIGIT-immunoglobulin or adoptive transfer of TIGIT+ B cells both effectively prevented the disease onset and hyperglycaemia in cyclophosphamide-accelerated NOD mice.</p><p><strong>Conclusions: </strong>Our study provides a theoretical basis for targeting TIGIT+ B cells as a novel immunotherapy strategy for T1D.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999346","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":"Post-exercise glycaemic control for 24 h: Fasted morning exercise with and without glucagon in adults with type 1 diabetes using automated insulin delivery.","authors":"Clara Solà, Sissel Banner Lundemose, Olivia M McCarthy, Kirsten Nørgaard","doi":"10.1111/dom.70085","DOIUrl":"https://doi.org/10.1111/dom.70085","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990923","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":"Identification of subtypes of type 2 diabetes in the Chinese population and their distinct complication risk profiles.","authors":"Qiu Xiao, Chengjun Zhang, Yanfeng Jiang, Chen Suo, Genming Zhao, Xingdong Chen, Min Chen, Kelin Xu","doi":"10.1111/dom.70056","DOIUrl":"10.1111/dom.70056","url":null,"abstract":"<p><strong>Aims: </strong>To identify and validate subgroups of type 2 diabetes in Chinese populations using clustering analysis and assess their complication risks.</p><p><strong>Materials and methods: </strong>Data from 5653 type 2 diabetes patients in the Shanghai Suburban Adult Cohort and Biobank (SSACB) and 6384 in the Southwest China Diabetic Chronic Complications Study were integrated. Using body mass index, fasting blood glucose, age at diabetes diagnosis, and triglycerides to high-density lipoprotein cholesterol ratio, k-means clustering was performed by sex in SSACB and validated in Southwest China Diabetic Chronic Complications Study. Cox and logistic regression models compared complication risks.</p><p><strong>Results: </strong>Five type 2 diabetes subgroups were identified: Hyperglycaemic Diabetes (HGD), Obesity-Related Diabetes (ORD), Young-Onset Diabetes (YOD), Insulin Resistance Diabetes (IRD), and Elderly-Onset Diabetes (EOD). Verification in an external validation cohort confirmed the robustness and reproducibility of the identified subgroups. In SSACB, distinct subgroup-specific complication risks were observed. Specifically, the HGD subgroup showed the highest risks for stroke (HR = 1.37, 95% CI: 1.10-1.70), peripheral vascular disease (HR = 1.66, 95% CI: 1.36-2.03), retinopathy (HR = 3.53, 95% CI: 2.53-4.90), peripheral neuropathy (HR = 1.89, 95% CI: 1.56-2.30), and nephropathy (HR = 1.81, 95% CI: 1.41-2.34). The IRD subgroup had the highest risk for coronary heart disease (HR = 1.20, 95% CI: 1.01-1.43). Similar risk patterns were observed in the validation cohort.</p><p><strong>Conclusions: </strong>We identified five clinically distinct type 2 diabetes subgroups with differential complication risks in the Chinese population, providing a basis for precision diabetes management.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144937375","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":"Early insulin degludec with continuous intravenous insulin infusion in the management of diabetic ketoacidosis: A randomized controlled trial.","authors":"Kitti Thammakosol, Methus Jantarapootirat, Sirinapa Traiwanatham, Chutintorn Sriphrapradang","doi":"10.1111/dom.70101","DOIUrl":"https://doi.org/10.1111/dom.70101","url":null,"abstract":"<p><strong>Aims: </strong>To determine the effectiveness and safety of early combination therapy with insulin degludec and intravenous insulin infusion (IVII) compared with IVII alone in diabetic ketoacidosis (DKA) management.</p><p><strong>Materials and methods: </strong>This prospective, open-label, randomised controlled trial included 80 adults (≥18 years) with DKA. Participants were randomised to either the intervention group, which received early subcutaneous (SC) insulin degludec (0.3 units/kg SC within 3 h of diagnosis) plus standard IVII, or the control group, which received standard IVII alone. The primary outcome was time to DKA resolution. Secondary outcomes included rebound hyperglycaemia, rebound DKA, hypoglycaemia, hypokalaemia, length of hospital stay (LOS), and in-hospital mortality.</p><p><strong>Results: </strong>Eighty patients were enrolled; 67.5% of participants had type 2 diabetes. Baseline characteristics were comparable between groups. DKA resolution was significantly faster in the early degludec group by 3.25 h (7.75 h, IQR 6.00-9.00 h vs. 11.00 h, IQR 6.25-15.00; p = 0.039). At 72 h after transition to SC insulin, mean capillary blood glucose (CBG) was significantly lower with early degludec (213.9 ± 25.8 mg/dL vs. 240.1 ± 42.0 mg/dL; p = 0.012). Rates of rebound hyperglycaemia at 12 h after bridging, mean CBG levels at 12, 24, and 48 h among those with rebound hyperglycaemia, as well as rates of rebound DKA, hypoglycaemia, hypokalaemia, LOS, and in-hospital mortality, were not significantly different between groups.</p><p><strong>Conclusions: </strong>Early administration of SC insulin degludec in combination with IVII accelerated DKA resolution and improved blood glucose levels at 72 h in patients with rebound hyperglycaemia after discontinuation of IVII, without increasing the risk of hypoglycaemia or hypokalaemia.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990901","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":"Diabetes, Obesity and Metabolism","authors":"","doi":"10.1111/dom.15673","DOIUrl":"10.1111/dom.15673","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 10","pages":"5381-5382"},"PeriodicalIF":5.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://dom-pubs.onlinelibrary.wiley.com/doi/epdf/10.1111/dom.15673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935211","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":"Treat to target in weight management with semaglutide: Real-world evidence from an eHealth clinic.","authors":"Søren Seier, Kine Stamp-Larsen, Simon Birk Kjær Jensen, Signe Sørensen Torekov, Henrik Gudbergsen","doi":"10.1111/dom.70096","DOIUrl":"https://doi.org/10.1111/dom.70096","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the effectiveness of an online multidisciplinary weight loss service combining individualised semaglutide dosing with intensive behavioural therapy (IBT) in adults living with overweight or obesity.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included data from Danish participants enrolled in a digital weight loss programme via the Embla app between January 2022 and September 2024. The programme offered semaglutide with personalised dosing alongside evidence-based recommendations on nutrition, exercise and habits, delivered through IBT. All data collection and monitoring was conducted via the Embla app. The primary outcome was percentage change in body weight at week 64. Secondary outcomes included semaglutide dose, proportions achieving ≥5%, ≥10%, ≥15%, or ≥20% weight loss, and weight change by baseline BMI and dose.</p><p><strong>Results: </strong>The study included 2694 participants (78% women, mean age 46.8 ± 10.8 years, mean BMI 34.3 ± 4.8). At weeks 26, 52, and 64, the number of participants that remained in the study was: 1580, 712, and 465. Mean weight loss at week 64 was 16.7% (95% CI: -17.4 to -16.0) with a mean semaglutide dose of 1.08 mg/week (SD 0.54). A total of 98% achieved ≥5% and 82% achieved ≥10% weight loss. Weight change was consistent across BMI classes and medication doses.</p><p><strong>Conclusions: </strong>Participants achieved clinically meaningful weight loss comparable to that seen in randomised trials, despite using lower semaglutide doses. These findings support the effectiveness of a personalised, treat-to-target approach integrating medical and behavioural obesity management in a digital setting.</p><p><strong>Trial registration: </strong>https://osf.io/86kmc/.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990936","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}