Diabetes, Obesity & Metabolism最新文献

{"title":"Letter to the editor to \"Sick days glycaemic outcomes in a cohort of children and adolescents with type 1 diabetes using an AID system\".","authors":"Frontino Giulio, Rigamonti Andrea, Bonfanti Riccardo","doi":"10.1111/dom.16459","DOIUrl":"https://doi.org/10.1111/dom.16459","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953565","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":"Unlocking the potential of the ACE2/Ang-(1-7)/Mas Axis in liver diseases: From molecular mechanisms to translational applications.","authors":"Jun Yang, Yuan Yang, Xiangyun Tan, Hongzhi Du, Zhongshi Zhou, Liang Chen, Xianxiang Tian, Guohua Zheng, Junjie Hu, Cong Zhang, Zhenpeng Qiu","doi":"10.1111/dom.16435","DOIUrl":"https://doi.org/10.1111/dom.16435","url":null,"abstract":"<p><p>Over the past two decades, the identification of new functions within the renin-angiotensin system (RAS) has extended beyond its traditional roles, with the emergence of the angiotensin-converting enzyme 2 (ACE2)/Ang-(1-7)/Mas axis being particularly significant. This axis is hypothesized to balance or modulate the effects of the traditional ACE/Ang II/AT1 axis in various physiological and pathological contexts. ACE2, a membrane-bound carboxypeptidase and an ancient homologue of ACE converts Angiotensin II (Ang II) into Angiotensin 1-7 (Ang-(1-7)). The Mas receptor is a G-protein-coupled receptor that specifically binds Ang-(1-7). Recent research has increasingly focused on the local expression of RAS in different tissues. Ang-(1-7) produces a variety of biological effects by binding to the Mas receptor, including anti-inflammatory, antioxidant, anti-apoptotic and anti-fibrotic actions, thereby influencing a range of mechanisms in the heart, kidneys, brain and other tissues. Preclinical animal model studies indicate that manipulating the protective RAS can significantly alter the progression of multiple liver diseases. Hepatic overexpression of ACE2 or administration of Ang-(1-7) and its analogues has been shown to be therapeutically effective against drug-induced liver injury, metabolic-associated fatty liver disease, liver fibrosis and hepatocellular carcinoma progression. These effects are achieved through various pathways, including the regulation of lipid metabolism, inhibition of epithelial-mesenchymal transition (EMT) and extracellular matrix (ECM) production, as well as suppression of aerobic glycolysis. In current clinical trials, while recombinant human ACE2 (Rh-ACE2) has demonstrated safety and good tolerance in most studies, research on the relevance of activating the ACE2/Ang-(1-7) axis in the mechanisms and evolution of human diseases remains in its early stages. Therefore, further elucidation of the complex interactions between the classical and counter-regulatory RAS axes in clinical settings is crucial. This review will summarize the roles of selective activation of the ACE2/Ang-(1-7)/Mas axis, with a focus on its mechanisms in the treatment of liver diseases. Additionally, we will discuss the safety concerns regarding selective activation of the ACE2/Ang-(1-7)/Mas axis in clinical applications and the challenges of tissue-specific activation of this axis, providing effective therapeutic strategies for targeted activation of the hepatic ACE2/Ang-(1-7)/Mas axis in clinical practice.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956475","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":"Efficacy of diabetes-specific partial meal replacement on glycemic and weight control in type 2 diabetes: A randomized controlled trial.","authors":"Lew Leong Chen, Noorlaili Mohd Tohit, Arimi Fitri Mat Ludin, Zahara Abdul Manaf, Alicia Wong, Kwan Lee Kuan, Han Wan Chien, Suzana Shahar","doi":"10.1111/dom.16446","DOIUrl":"https://doi.org/10.1111/dom.16446","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the efficacy of a diabetes-specific formula (DSF)-based partial meal replacement (PMR) in improving glycemic control, weight, and underlying hormonal changes among participants with type 2 diabetes and overweight or obesity compared to dietary consultation.</p><p><strong>Materials and methods: </strong>This 12-week, parallel randomized controlled trial was conducted at Hospital Canselor Tuanku Muhriz, National University of Malaysia, from February 2022 to March 2024. Adults aged 20-65 years with type 2 diabetes [haemoglobin A1c (HbA1c) ≥7.5%] and overweight or obesity were randomized into two groups: PMR with DSF (Metabolic+ Sauver) plus dietary consultation (treatment group) or dietary consultation alone (control group). The primary endpoint was mean change in HbA1c at week 12.</p><p><strong>Results: </strong>Among 156 participants (mean age 52.2 ± 9.7 years), 141 completed the 12-week intervention. The treatment group had a greater HbA1c reduction compared to controls (-0.83% vs. -0.19%; MD: -0.63%; 95% CI: -1.00, -0.27; p < 0.001). A significantly higher proportion of the treatment group participants (61.4%) achieved clinically significant HbA1c reduction (≥0.5%) compared to controls (42.3%, p = 0.023). Fasting glucose, insulin, and anthropometric measurements also significantly improved in the treatment group compared to controls. Subsample analysis on hormonal changes revealed significant improvements in adiponectin levels among the treatment group.</p><p><strong>Conclusion: </strong>This study demonstrated that PMR with DSF significantly improved glycemic and weight management in participants with type 2 diabetes and overweight or obesity. Adiponectin levels increased in the treatment group, correlating with improved glycemic control. No adverse events were observed on liver and kidney profiles, highlighting its potential as a safe and effective approach for diabetes management.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957151","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":"Prevalence of overweight and obesity in children and adolescents: A large-scale population-based study.","authors":"Elamin Abdelgadir, Fauzia Rashid, Alaaeldin Bashier, Marwan Zidan, Nandu Thalange, Mohamed Hassanein, Fatheya Alawadi","doi":"10.1111/dom.16449","DOIUrl":"https://doi.org/10.1111/dom.16449","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951656","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":"Proteomic associations with fluctuation and long-term changes in BMI: A 40-year follow-up study.","authors":"Alvaro Obeso, Gabin Drouard, Teemu Palviainen, Xiaoling Wang, Miina Ollikainen, Karri Silventoinen, Jaakko Kaprio","doi":"10.1111/dom.16448","DOIUrl":"https://doi.org/10.1111/dom.16448","url":null,"abstract":"<p><strong>Introduction: </strong>While some studies have explored associations between weight change and blood proteins, most have been intervention-based, offering limited insight into proteomic associations with long-term weight gain. It remains unclear whether plasma proteins are related to BMI fluctuation over time. This study investigates associations of long-term BMI changes and fluctuations with over 1000 plasma proteins involved in cardiometabolic and inflammation functions.</p><p><strong>Data and methods: </strong>The study included 304 Finnish adult twins (117 men) born before 1958 from the Older Finnish Twin Cohort, with BMI data spanning five time points (1975, 1981, 1990, 2011 and 2012-2014). Proteomic data were derived from blood samples collected at the last BMI measurement. Linear mixed-effects models analysed individual BMI trajectories, producing intercepts (baseline BMI) and slopes (BMI change rates). BMI fluctuation was calculated as the average squared deviation from expected BMI across time points. Associations between BMI changes/fluctuation and (i) 1231 plasma proteins related to cardiometabolic and inflammatory functions and (ii) polygenic risk scores for BMI (PRS_BMI), as well as interaction effects between PRS_BMI and baseline BMI on protein-BMI relationships were studied. Within-pair analyses using monozygotic twins were conducted to account for shared confounding factors.</p><p><strong>Results: </strong>A total of 135 proteins were associated with changes in BMI over 40 years, while 17 proteins were linked to fluctuation in BMI: 12 associations (10 with BMI changes and 2 with fluctuation) remained significant in within-twin pair analyses. PRS_BMI was associated with BMI changes but not with fluctuation. PRSBMI-protein interactions explaining BMI changes or fluctuation were found, though a single interaction between the antigen CD72 protein and baseline BMI was observed.</p><p><strong>Conclusion: </strong>This study highlights significant associations between plasma proteins and long-term BMI changes and fluctuations, with no evidence of PRS_BMI-protein interactions influencing BMI trends. These findings underscore the substantial role of environmental factors in shaping proteome-BMI associations over adulthood.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956661","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":"Glucagon-like peptide-1 receptor agonists lower risk of cardiovascular and non-cardiovascular mortality: A meta-analysis of eleven cardiovascular outcome trials","authors":"Yu Mi Kang MD,&nbsp;Erin A. Bohula MD,&nbsp;A. Michael Lincoff MD,&nbsp;Donna H. Ryan MD,&nbsp;KyungAh Im PhD,&nbsp;Colleen Thomas MS,&nbsp;Marc S. Sabatine MD,&nbsp;Benjamin M. Scirica MD","doi":"10.1111/dom.16424","DOIUrl":"10.1111/dom.16424","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 7","pages":"4017-4021"},"PeriodicalIF":5.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951769","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":"Macrovascular and microvascular complications in US Medicare enrollees with type 2 diabetes with and without atherosclerotic cardiovascular disease.","authors":"Tyler J Dunn, Xi Tan, Joanna Harton, Sonia Kim, Lin Xie, Cory Gamble, Daniel Rotroff","doi":"10.1111/dom.16441","DOIUrl":"https://doi.org/10.1111/dom.16441","url":null,"abstract":"<p><strong>Aims: </strong>To assess the incidence of macrovascular and microvascular complications in US Medicare enrollees diagnosed with T2D with and without established ASCVD.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study using Medicare fee-for-service claims data from 1 January 2006, through 31 December 2021. Baseline demographic and clinical characteristics were assessed in the 1-year prior to indexing. Cumulative incidences of various diabetes complications were assessed until the first microvascular or macrovascular complication of interest, the end of the study period or death.</p><p><strong>Results: </strong>A total of 2 326 726 patients and 640 666 patients met study inclusion/exclusion criteria for the T2D cohort and T2D + ASCVD sub-cohort, respectively. The incidence rate of any macrovascular event was 483.34 per 10 000 person-years in the T2D cohort. Overall, the 1-year cumulative incidence rate of any macrovascular event was 3.90%. Coronary heart disease (T2D, 3.24%; T2D + ASCVD, 8.10%) and peripheral artery disease (T2D, 1.97%; T2D + ASCVD, 7.33%) were the macrovascular events with the greatest 1-year cumulative incidence. Patients developed microvascular complications at a rate of 1569.28 per 10 000 person-years in the T2D cohort and 1859.80 per 10 000 person-years in the T2D + ASCVD sub-cohort. The 1-year cumulative incidence of any microvascular event was 16.88% in the T2D cohort and 21.16% in the T2D + ASCVD sub-cohort. Neuropathy and nephropathy were the microvascular events with the greatest 1-year cumulative incidence in both cohorts: T2D, 8.34% and 7.02%; T2D + ASCVD, 10.65% and 9.12%, respectively.</p><p><strong>Conclusions: </strong>The frequencies of macrovascular and microvascular complications highlight the importance of annual cardiovascular risk assessment in patients with T2D, especially those with established ASCVD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957997","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":"Long-term delirium and survival outcomes in patients treated with GLP-1 receptor agonists versus metformin in type 2 diabetes: A population-based cohort study","authors":"Mingyang Sun MD,&nbsp;Xiaoling Wang PhD,&nbsp;Zhongyuan Lu PhD,&nbsp;Yitian Yang MD,&nbsp;Shuang Lv MD,&nbsp;Mengrong Miao MD,&nbsp;Wan-Ming Chen PhD,&nbsp;Szu-Yuan Wu MD,&nbsp;Jiaqiang Zhang MD","doi":"10.1111/dom.16434","DOIUrl":"10.1111/dom.16434","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) is associated with an increased risk of delirium and mortality. While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) provide metabolic and neuroprotective benefits, their long-term impact on delirium risk remains uncertain. This study compares GLP-1 RAs and metformin in relation to delirium and mortality in T2DM patients using real-world data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted using the TriNetX global federated research network, which primarily comprises U.S.-based healthcare organisations (approximately 85%), with additional sites in Europe, Asia-Pacific and the Middle East. Adults (≥18 years) with T2DM who initiated GLP-1 RAs or metformin were included. Propensity score matching (PSM) balances baseline characteristics. The primary outcome was incident delirium; the secondary outcome was all-cause mortality. Kaplan–Meier survival curves and time-dependent Cox models assessed associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 1:1 PSM (<i>N</i> = 63 096 per group), GLP-1 RAs showed no overall reduction in delirium risk (AHR: 0.98, 95% CI: 0.94–1.02, <i>p</i> = 0.3628). However, they were protective in the first 5 years (AHR: 0.89, 95% CI: 0.86–0.92, <i>p</i> &lt; 0.0001) but increased delirium risk between 5 and 10 years (AHR: 1.15, 95% CI: 1.04–1.26, <i>p</i> = 0.0046). Subgroup analysis revealed lower delirium risk with GLP-1 RAs in middle-aged patients (40–79 years) and those with HbA1c &lt;7.5%. Higher risk was observed in Asian and Native Hawaiian/Pacific Islander populations. However, these findings should be interpreted with caution due to the relatively small subgroup sizes and the limited representativeness of these groups within the predominantly U.S.-based database, in which Asian and Native Hawaiian/Pacific Islander patients together accounted for less than 5% of the overall cohort. Mortality risk was lower in absolute terms for GLP-1 RAs (6.28% vs. 9.95%) but higher in long-term hazard (AHR: 1.16, 95% CI: 1.12–1.21, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GLP-1 RA use was initially associated with a lower risk of delirium, but this association reversed over time. Subgroup variations suggest individualised treatment considerations. Metformin remains a preferred option given its stable cognitive and survival benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 7","pages":"3984-3996"},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953840","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":"Recurrent hypoglycemia exposure increases the risk of platelet activation and thrombosis in insulin-treated diabetic rats.","authors":"Ashish K Rehni, Sunjoo Cho, Allen Liu, Jonathan Lo, Stephanie S Kim, Nathalie Khoury, Miguel A Perez-Pinzon, Wenche Jy, Kunjan R Dave","doi":"10.1111/dom.16440","DOIUrl":"https://doi.org/10.1111/dom.16440","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes is a widespread disease associated with long-term complications. Treatment of diabetes alleviates these complications but cause an increased risk of recurrent hypoglycemia (RH). Hypoglycemia exposure increases the risk of cardiovascular events by an unknown mechanism. Since the effect of mild/moderate hypoglycemia on thrombosis is unknown, we studied the effect of RH exposure on platelet function and thrombosis in insulin-treated diabetic (ITD) rats.</p><p><strong>Materials and methods: </strong>ITD rats were randomized to either control or hypoglycemia groups. First, we determined the minimum duration and frequency of RH exposure that increases the risk of thrombosis and the time window after a single hypoglycemic episode (SH)/RH exposure with increased risk of thrombosis in male ITD rats. Next, we confirmed whether RH exposure increases the risk of thrombosis in female ITD rats. Subsequently, we evaluated the impact of RH exposure on platelet susceptibility to aggregation and platelet gene expression.</p><p><strong>Results: </strong>One hour hypoglycemia increased the clot weight and the effect of SH and RH on thrombosis lasted for at least 1 and 7 days post-exposure, respectively. A minimum frequency of twice-a-week hypoglycemia exposure for 6 weeks increased the risk of thrombosis in male ITD rats. Increased susceptibility of platelet activation was observed in RH-exposed male ITD rats. Lastly, we identified RH-induced alterations in the platelet transcriptome in male ITD rats. We also confirmed that RH exposure increases the risk of thrombosis in female rats.</p><p><strong>Conclusions: </strong>Understanding the mechanism of RH-induced platelet activation and thrombosis may help limit thrombotic complications in diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955854","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":"Clinical observation and experimental study on the role of choroid-to-retina volume ratio in diabetic retinopathy.","authors":"Jian Zhao, Junbiao Zhang, Yaling Xuan, Chunxi Huang, Yanli Liu, Meixia An","doi":"10.1111/dom.16444","DOIUrl":"https://doi.org/10.1111/dom.16444","url":null,"abstract":"<p><strong>Aims: </strong>The retinal blood supply system reserve (RBSSR) reflects the vascular system's capacity to meet increased retinal metabolic demands and may be critical in the pathogenesis of diabetic retinopathy (DR). This study aimed to clinically measure and experimentally validate the choroid-to-retina volume ratio (CRVR) as an indicator of the RBSSR in DR.</p><p><strong>Materials and methods: </strong>Diabetic patients were divided into NDR group (no apparent retinopathy, 134 eyes) and DR group (nonproliferative DR, 125 eyes) in the cross-sectional survey. Optical coherence tomography angiography (OCTA) 12 × 12 mm² fovea-centred scans were performed on subjects. Retinal and choroidal parameters were automatically measured, and the CRVR was analysed. Atropine eye drops were used for C57BL/6J mice modelling, and CRVR was examined by OCTA. Early DR mouse models were subsequently induced by streptozotocin, and fundus structural changes as well as retinal apoptosis were examined.</p><p><strong>Results: </strong>The DR group exhibited significantly lower CRVR than the NDR group (all p < 0.05). Logistic regression analysis and area under the ROC curve (AUC) analysis indicate that low CRVR is a risk factor for DR, with all AUC values exceeding 0.70. Compared with controls, atropine increased the CRVR in mice. Additionally, eyes treated with atropine exhibited fewer punctate hyperfluorescent lesions, a tighter arrangement of the outer nuclear layer (ONL), and reduced apoptosis in the ONL and retinal pigment epithelium in early DR models.</p><p><strong>Conclusions: </strong>The study supports the existence of the RBSSR and suggests that CRVR can serve as a potential indicator of RBSSR, highlighting its role in DR pathogenesis.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959642","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}