Diabetes, Obesity & Metabolism最新文献

{"title":"Effectiveness and safety of daily oral semaglutide in people with type 2 diabetes mellitus switching from sulfonylureas: A real-world retrospective study.","authors":"Silvana Costa, Cesare Miranda, Antonia Elefante, Valeria Vallone, Carmela Vinci, Francesca Borroni, Gabriele Brandoni, Antonio M Labate, Feliciano Lo Pomo, Marco Strazzabosco","doi":"10.1111/dom.16314","DOIUrl":"https://doi.org/10.1111/dom.16314","url":null,"abstract":"<p><strong>Background: </strong>Hypoglycaemia is a serious side effect in the treatment of type 2 diabetes mellitus (T2DM), especially when using insulin and insulin secretagogues such as sulfonylureas. Current guidelines recommend reducing or discontinuing these medications in high-risk populations. This study assessed the real-world effectiveness and safety of oral semaglutide in T2DM patients who suspended or reduced sulfonylurea dosages in favour of oral semaglutide.</p><p><strong>Methods: </strong>In this retrospective, multicentre cohort study, the primary endpoint was the change in glycated haemoglobin (HbA1c) from baseline to an average follow-up period of 37 weeks. Secondary endpoints included changes in fasting blood glucose, body weight, the proportion of patients achieving HbA1c ≤7%, and combined reductions in HbA1c (≥1%) and body weight (≥5%). Safety and exploratory endpoints were also evaluated.</p><p><strong>Results: </strong>The study included 104 patients (mean age: 68.9 ± 9.9 years). Treatment discontinuation occurred in 9.6% of patients, and 12.5% reported adverse events, primarily gastrointestinal; no hypoglycaemic events were reported. HbA1c significantly decreased from 7.62% to 7.42% (p = 0.04, mean reduction of 0.22%) and the proportion of patients achieving HbA1c ≤7% increased from 29.8% to 36.3%. Body weight was significantly reduced by 3.03 kg (p < 0.001). Significant reductions (p < 0.05) were observed in fasting blood sugar, waist circumference, diastolic blood pressure, total cholesterol and albumin-to-creatinine ratio, while HDL cholesterol and estimated glomerular filtration rate increased. The 10-year cardiovascular risk score significantly decreased from 17.0% to 12.9% (p < 0.001).</p><p><strong>Conclusion: </strong>Real-world data suggest that oral semaglutide is an effective and safe alternative to sulfonylureas for T2DM patients, with no reported hypoglycaemic episodes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565667","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":"Effect of alirocumab on postprandial hyperlipidaemia in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled, cross-over trial.","authors":"Bertrand Cariou, An Thys, Arsênio Rodrigues Oliveira, Marine P M Letertre, Béatrice Guyomarch, Maxime Carpentier, Claire Cannet, Pierre Morcel, Audrey Ernould, Laurent Flet, Patrick Giraudeau, Samy Hadjadj, Cédric Le May, Mikaël Croyal","doi":"10.1111/dom.16305","DOIUrl":"https://doi.org/10.1111/dom.16305","url":null,"abstract":"<p><strong>Aims: </strong>Postprandial hyperlipidaemia (PPL), characterized by elevated triglyceride (TG) concentrations after a meal, is common in type 2 diabetes (T2D) and is often recognized as an independent cardiovascular risk factor. Here, we aimed to assess the effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition by alirocumab on PPL in patients with T2D.</p><p><strong>Materials and methods: </strong>EUTERPE is a randomized, double-blind, placebo-controlled cross-over trial conducted in male patients with T2D. Participants received sequentially two sequences of 10-week treatment (alirocumab 75 mg Q2W or placebo s/c) with a wash-out period of 10 weeks. The primary end-point was the percentage reduction in plasma TG response after an oral fat load (incremental area under the curve [iAUC]_0-8h TG). Secondary end-points included mass spectrometry-based apolipoprotein measurements and nuclear magnetic resonance (NMR)-based lipoprotein profiling.</p><p><strong>Results: </strong>Fourteen participants were included: age 59 ± 9 years, BMI 32.8 ± 5.5 kg/m², HbA_1C 6.7 ± 0.5%. Compared to placebo, alirocumab did not reduce PPL (iAUC_0-8h TG: -5% [CI 95%: -28, +25], p = 0.68). Alirocumab decreased fasting non-HDL cholesterol (-38.5 ± 5.6%, p = 0.0003), remnant cholesterol (-20.0 ± 13.3%, p = 0.04), apoB100 (-21.2 ± 6.4%, p = 0.004) and apoE (-15.3 ± 6.6%, p = 0.02) concentrations. NMR analyses showed that alirocumab decreased both postprandial VLDL₂ cholesterol (-42% [-55, -25], p < 0.001) and IDL cholesterol (-26% [-38, -12], p = 0.0007), without effect on VLDL₁ cholesterol or TG concentrations.</p><p><strong>Conclusions: </strong>Inhibition of PCSK9 by alirocumab did not reduce PPL in T2D, confirming that PCSK9 controls remnant cholesterol catabolism rather than intestinal chylomicron production.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565664","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":"Insulin resistance in adipose tissue and fatty liver, but not fat mass, are involved in worsening glycaemic status: The Hiroshima study on glucose metabolism and cardiovascular diseases.","authors":"Nobuo Sasaki, Yoshitaka Ueno, Ryoji Ozono, Yukiko Nakano, Yukihito Higashi","doi":"10.1111/dom.16307","DOIUrl":"https://doi.org/10.1111/dom.16307","url":null,"abstract":"<p><strong>Aims: </strong>Insulin resistance in adipose tissue causes dysregulation of various adipokine levels and ectopic fat accumulation in other organs, such as the liver. This study investigated the effects of insulin resistance in adipose tissue and concomitant fatty liver on each stage of impaired glucose metabolism compared with visceral fat mass.</p><p><strong>Materials and methods: </strong>This observational study included 3644 individuals who underwent two 75-g oral glucose tolerance tests at baseline and follow-up. Adipose insulin resistance index (Adipo-IR), lipid accumulation product (LAP) and fatty liver index (FLI) were used as indicators of insulin resistance in the adipose tissue, visceral fat mass and fatty liver, respectively.</p><p><strong>Results: </strong>Over a mean 2.9-year follow-up period, 463 (32.4%) individuals progressed from normoglycaemia to prediabetes, and 198 (10.6%) developed type 2 diabetes from prediabetes. Comparing the highest-to-lowest quartiles, baseline levels and changes in Adipo-IR were associated with an increased odds of progression from normoglycaemia to prediabetes (odds ratio [OR], 2.22; 95% CI, 1.36-3.65, OR, 2.70; 95% CI, 1.83-3.98, respectively) and from prediabetes to the onset of type 2 diabetes (OR, 2.02; 95% CI, 1.04-3.92, OR, 3.09; 95% CI, 1.84-4.19, respectively), after adjusting for possible confounders. Changes in FLI were associated with progression from prediabetes to type 2 diabetes. LAP did not affect the progression of impaired glucose metabolism.</p><p><strong>Conclusions: </strong>Adipose tissue insulin resistance, rather than fat mass, is crucial in all stages of deterioration of glycaemic status. Fatty liver plays a decisive role in the eventual development of type 2 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565705","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":"Workplace-based continuous glucose monitoring with structured education for pre-diabetes and type 2 diabetes: A prospective community cohort study.","authors":"Ji-Hee Ko, Sun-Joon Moon, Ramzi A Ajjan, Mi Yeon Lee, Hae-Jeong Lee, Boram Choi, JiYeon Park, Seung-Eun Lee, Jae-Hyeon Kang, Cheol-Young Park","doi":"10.1111/dom.16304","DOIUrl":"https://doi.org/10.1111/dom.16304","url":null,"abstract":"<p><strong>Aims: </strong>We investigated the effect of continuous glucose monitoring (CGM) with personalised structured education on patients with type 2 diabetes (T2D) and pre-diabetes in a workplace setting.</p><p><strong>Materials and methods: </strong>This 8-week prospective study enrolled adults with T2D or pre-diabetes at Samsung Electronics Device Solutions between March and September 2023. Participants underwent CGM (Freestyle Libre) for 2 weeks and received personalized structured education on diet and physical activity. The primary outcome was the change in HbA1c level at 8 weeks compared with baseline. Secondary outcomes included changes in fasting blood sugar (FBS), lipid profile, weight and patient-related outcome measures (PROMs) at 8 weeks and longer.</p><p><strong>Results: </strong>Among 234 participants (161 T2D and 73 pre-diabetes), significant improvements were observed in the T2D group patients in terms of HbA1c (6.9% ± 1.2%-6.5% ± 0.8%), FBS (128.4 ± 36.9-117.6 ± 22.2 mg/dL), weight (81.9 ± 13.5-80.7 ± 13.6 kg) and low-density lipoprotein (LDL) cholesterol (106.0 ± 41.5 to 95.1 ± 35.9 mg/dL) (all p < 0.001) levels. Meanwhile, patients with pre-diabetes showed significant improvements in weight (79.7 ± 14.0-78.5 ± 13.9 kg) and LDL cholesterol (124.5 ± 32.8-113.8 ± 29.1 mg/dL) (all p < 0.001), with no significant changes in HbA1c or FBS. These improvements were maintained during follow-up check-ups after a mean of 6.4 months. Participants in both groups demonstrated improvements in their PROMs.</p><p><strong>Conclusions: </strong>Among adults with T2D and pre-diabetes, the use of CGM with structured education in a workplace-based setting helped with weight loss and improved LDL cholesterol levels in both groups, while also improving glycaemia in patients with T2D.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555466","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":"Effects of insulin-induced hypoglycaemia on cardiac function in people with type 1 and type 2 diabetes and people without diabetes.","authors":"Therese Wilbek Fabricius, Clementine Verhulst, Cecilie Hornborg Svensson, Malene Wienberg, Anthonie L Duijnhouwer, Cees J Tack, Peter L Kristensen, Bastiaan E de Galan, Ulrik Pedersen-Bjergaard","doi":"10.1111/dom.16283","DOIUrl":"https://doi.org/10.1111/dom.16283","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular disease is the most common complication and cause of death in people with diabetes. Hypoglycaemia is independently associated with the development of cardiovascular complications, including death. The aim of this study was to assess changes in cardiac function and workload during acute hypoglycaemia in people with and without diabetes and to explore the role of diabetes type, magnitude of the adrenaline response, and other phenotypic traits.</p><p><strong>Materials and method: </strong>We enrolled people with type 1 diabetes (n = 24), people with insulin-treated type 2 diabetes (n = 15) and controls without diabetes (n = 24). All participants underwent a hyperinsulinaemic-normoglycaemic-(5.3 ± 0.3 mmol/L)-hypoglycaemic (2.8 ± 0.1 mmol/L)-glucose clamp. Cardiac function was assessed by echocardiography, with left ventricular ejection fraction (LVEF) as the primary endpoint.</p><p><strong>Results: </strong>During hypoglycaemia, LVEF increased significantly in all groups compared to baseline (6.2 ± 5.2%, p < 0.05), but the increase was significantly lower in type 1 diabetes compared to controls without diabetes (5.8 ± 3.4% vs. 9.4 ± 5.0%, p = 0.03, 95% CI difference: -5.0, -0.3). In people with type 1 diabetes, ΔLVEF was inversely associated with diabetes duration (β: -0.16, 95% CI: -0.24, -0.53, p = 0.001) and recent exposure to hypoglycaemia (β: -0.30, 95% CI: -0.53, -0.07, p = 0.015). Hypoglycaemia also increased global longitudinal strain (GLS) in controls without diabetes (p < 0.05), but this did not occur in the two diabetes subgroups (p > 0.10).</p><p><strong>Conclusions: </strong>Hypoglycaemia increased LVEF in all groups, but the increase diminished with longer disease duration and prior exposure to hypoglycaemia in type 1 diabetes, suggesting adaptation to recurrent hypoglycaemia. The increment in GLS observed in controls was blunted in people with diabetes. More research is needed to determine the clinical relevance of these findings.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565704","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 coordinated changes in insulin sensitivity and insulin secretion associated with the remission of type 2 diabetes following short-term insulin therapy.","authors":"Ravi Retnakaran, Jiajie Pu, Alexandra Emery, Caroline K Kramer, Bernard Zinman","doi":"10.1111/dom.16315","DOIUrl":"https://doi.org/10.1111/dom.16315","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565706","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":"An overview of insulin therapy for the non-specialist.","authors":"Philip D Home","doi":"10.1111/dom.16280","DOIUrl":"https://doi.org/10.1111/dom.16280","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Nearly all health professionals, whatever their practice or speciality, now have contact with a significant number of insulin-using people with diabetes. People with type 1 diabetes are nearly universally managed on more complex insulin regimens, increasingly with complex support technology, and with some understanding of the concepts underlying these needed by anyone with responsibility for other aspects of their health care. People with type 2 diabetes usually come to insulin therapy in time, now with a prevalence for insulin administration of ≈50%, thanks to improved management of associated health risks giving longer life expectancy. But while some understandings have simplified the usual approach (basal insulin, self-adjustment dose algorithms), the advent of other medical products offering cardio-renal protection, the use of insulin in combination with these, and the marketing of novel insulin analogues and biosimilars, have all added complexity to clinical decision making. However for the insulin user in the mainstream of care (ambulatory diabetes services in primary and secondary care) the broad principles of choice and management of insulin therapy are fairly easily applied. In the current article, the complexity is dissected and addressed, some of the stigma around insulin therapy is neutralised, and the fundamental approach in regular care drawn into focus. PLAIN LANGUAGE SUMMARY: Insulin therapy is used in their diabetes lifetime by nearly all people with type 2 diabetes (T2DM), as well as in all people with type 1 diabetes (T1DM). In T2DM this is in the context of the usual progression of islet B-cell secretory failure, but also very often in the context of other conditions, from cancer or steroid therapy to acute arterial events or major surgery. Its prescription in these circumstances means that, in pharmaco-epidemiological studies, insulin use is invariably associated with poor health outcomes, but in a series of major RCTs of 5-15 years duration no excess of vascular or oncological adverse health outcomes was found. Physiologically insulin secretion occurs in two scenarios, namely basal insulin at night and between meals (≈50%), and in short (≈4 h) bursts with meals (≈50%). The former suppresses liver glucose production, which in its absence causes plasma glucose to rise threefold to around 12 mmol/l (but much higher if metabolic stress or with sugar-containing drinks). Meal-time insulin secretion in addition promotes glucose storage in skeletal muscle. People with T1DM, having no endogenous insulin secretion, thus require a multiple injection regimen (basal + meal-time), or pumped insulin, often now moderated by continuous glucose monitoring (CGM). Basal and meal-time preparations of pharmaceutical insulin analogues are also used for T2DM, with GLP-1RA and metformin usually continued. The starting regimen is normally basal only, usually with insulin glargine (100 U/ml), originator or biosimilar, while insulin degludec or g","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539606","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":"Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment.","authors":"Rotana M Radwan, Yao An Lee, Pareeta Kotecha, Davene R Wright, Inmaculada Hernandez, Ronald Ramon, William T Donahoo, Yong Chen, John M Allen, Jiang Bian, Jingchuan Guo","doi":"10.1111/dom.16318","DOIUrl":"10.1111/dom.16318","url":null,"abstract":"<p><strong>Aims: </strong>To characterize trends in the initiation of newer anti-obesity medications (AOMs) and determine factors associated with their use among obese/overweight populations.</p><p><strong>Materials and methods: </strong>This study utilized electronic health record data from OneFlorida+ (2015-2024). Adults eligible for AOMs were included, defined as having a body mass index (BMI) ≥30 kg/m² or a BMI of 27-29.9 kg/m² with at least one obesity-related comorbidity. The primary outcome was the initiation of newer AOMs, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs) including liraglutide, semaglutide and tirzepatide. Trends across years were examined, and a multivariable logistic regression identified sociodemographic, clinical and healthcare utilization factors associated with AOM initiation.</p><p><strong>Results: </strong>Of 319,949 adults, 1.8% initiated newer AOMs. Semaglutide accounted for 77.9% of initiations, tirzepatide 19.7% and liraglutide 17.8%. Initiation trends showed liraglutide uptake peaked at 5% in 2018 but declined afterward, while semaglutide and tirzepatide uptake increased exponentially since 2022. Odds of initiation were lower for Black (aOR [95% CI]: 0.87 [0.80-0.94]) and Hispanic (0.84 [0.78-0.91]) groups versus Whites, and for Medicaid (0.69 [0.63-0.76]) and uninsured (0.81 [0.74-0.87]) patients versus privately insured. Higher odds were associated with being female, middle-aged, having more outpatient visits and visiting endocrinologists.</p><p><strong>Conclusions: </strong>The initiation of newer AOMs among overweight and obese populations remains low, but uptake has increased exponentially since 2022. Our findings reveal significant disparities in obesity care, highlighting the importance of addressing inequities in AOM access to improve obesity outcomes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539714","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":"Genetic evidence for the effects of glucokinase activation on frailty-related outcomes: A Mendelian randomisation study.","authors":"Rong Hua, Mai Shi, Elaine Chow, Aimin Yang, Yin Ting Cheung","doi":"10.1111/dom.16312","DOIUrl":"https://doi.org/10.1111/dom.16312","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to use the Mendelian randomisation (MR) design to investigate the potential causal effects of glucokinase (GK) activation on frailty-related outcomes and to explore the potential mediating effects of metabolic and inflammatory biomarkers.</p><p><strong>Materials and methods: </strong>Seventeen independent single-nucleotide polymorphisms (SNPs) located within the GCK gene and significantly correlated with the glycated haemoglobin (HbA_1c) level were used as genetic proxies for the effect of GK activation. We employed two-sample MR analysis to assess the relationship between genetically proxied GK activation and multifactorial frailty-related outcomes (frailty index, grip strength, walking pace, appendicular lean mass [ALM] and telomere length) We also explored the potential mediating effects using two-step MR.</p><p><strong>Results: </strong>Genetically proxied GK activation was significantly associated with a lower frailty index (beta: -0.161 per 1% decrease in HbA_1c level due to GK activation, 95% confidence interval: -0.282 to -0.040, false discovery rate-adjusted p = 0.011). Additionally, GK activation showed significant associations with increased grip strength, higher ALM, faster walking pace and longer telomere length. GK activation also demonstrated a significant indirect effect on total grip strength and telomere length by reducing C-reactive protein levels (proportion of mediation: 6.79% to 8.21%).</p><p><strong>Conclusion: </strong>Our study provides genetic evidence supporting the causal effects of GK activation on lowering the risk of frailty. These findings suggest that GK activators (GKAs) may aid in the management of frailty and sarcopaenia in people with diabetes; however, future randomized controlled trials are necessary to validate these results and establish their clinical applicability.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539712","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":"Joint association of remnant cholesterol and lipoprotein-associated phospholipase A2 with composite adverse events: A 12-year follow-up study from Asymptomatic Polyvascular Abnormalities Community study.","authors":"Yuhe Liu, Liang Zhang, Yuehao Xu, Tianyun Zhou, Wenqian Wu, Kangnan Zhang, Rongdi Xu, Wangyang Chen, Weifang Xu, Yong Zhou, Xingdong Zheng, Baofu Chen","doi":"10.1111/dom.16286","DOIUrl":"https://doi.org/10.1111/dom.16286","url":null,"abstract":"<p><strong>Aims: </strong>To explore the association of remnant cholesterol (RC) and lipoprotein-associated phospholipase A2 (Lp-PLA2) with composite adverse events in a large-scale prospective study.</p><p><strong>Methods: </strong>All data were collected from the Asymptomatic Polyvascular Abnormalities Community study between 2010 and 2022. Serum cholesterol levels and Lp-PLA2 were determined by enzyme-linked immunosorbent assay. The participants were categorized into four groups based on their RC and Lp-PLA2 levels: low-RC/Lp-PLA2-, high-RC/Lp-PLA2-, low-RC/Lp-PLA2+ and high-RC/Lp-PLA2+. The composite endpoint was a combination of first-ever stroke, myocardial infarction or all-cause mortality. Cox regression analyses were performed to evaluate associations of RC and Lp-PLA2 with composite adverse events.</p><p><strong>Results: </strong>Of the 1864 eligible participants, the average age was 60.6 years, and 74.3% were male. Over a follow-up of 12 years, we identified 500 composite adverse events, including 210 major adverse cardiovascular events and 342 all-cause deaths. When compared with the group of low-RC/Lp-PLA2-, the hazard ratios with 95% confidence intervals in the group of high-RC/Lp-PLA2+ for stroke, myocardial infarction, major adverse cardiovascular event, all-cause death and composite endpoints were 1.37 (0.87-2.16), 0.72 (0.28-1.82), 1.29 (0.85-1.95), 1.61 (1.10-2.38) and 1.43 (1.07-1.91), respectively. A significant interaction between RC and Lp-PLA2 status has been found for all-cause death and composite endpoint (p for interaction <0.05). In addition, joint association of RC and Lp-PLA2 with all-cause death was modified by sex and age of <60 versus ≥60 years (p for interaction: 0.035 and 0.01, respectively).</p><p><strong>Conclusions: </strong>Elevated RC and Lp-PLA2 levels were associated with an increased risk of composite adverse events, with these associations significantly influenced by sex and age. Our study highlights the synergistic effect of RC and Lp-PLA2 on the composite adverse events.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539713","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}