Diabetes, Obesity & Metabolism最新文献

{"title":"Association between weight-adjusted-waist index and incident carotid atherosclerosis in the general adult population in Chinese communities: Evidence from the REACTION cohort study.","authors":"Qingzheng Wu, Shuying Li, Wei Jing, Zixin Guo, Jing Yang, Zhiwei Li, Haixia Zhang, Yue Zhang, Binqi Li, Bing Li, Yiming Mu","doi":"10.1111/dom.16456","DOIUrl":"https://doi.org/10.1111/dom.16456","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to examine the relationship between weight-adjusted-waist index (WWI) and the risk of carotid atherosclerosis (CAS) in the general adult population in Chinese communities.</p><p><strong>Materials and methods: </strong>A total of 4671 participants in the prospective REACTION study who attended consecutive health examinations in 2012 and 2018, had no history of CAS. Participants were divided into three groups according to tertiles of WWI: T1 (≤9.88), T2 (9.89 ~ 10.42), T3 (≥10.43). Cox proportional hazard models were used to evaluate the relationship between WWI and CAS by calculating hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis and sensitivity analyses were used to verify the stability of the relationship between WWI and CAS.</p><p><strong>Results: </strong>After a median follow-up of 6.62 years, a total of 2806 new CAS events occurred. Participants in the CAS group were significantly older than those in the non-CAS group (median age 56 vs. 52 years, p < 0.001), and a higher proportion of males (38.1% vs. 17.5%, p < 0.001). After adjustment for potential confounders, Cox regression models showed that participants in the Q2 and Q3 groups had significantly higher risks of CAS than those in the Q1 group. The HRs (95% CIs) for CAS in the Q2 and Q3 groups were 1.171 (1.066, 1.287) and 1.473 (1.333, 1.627), respectively. WWI was significantly associated with increased CAS risk.</p><p><strong>Conclusions: </strong>High WWI is associated with a higher risk of CAS, which implies that WWI might be a reliable indicator to identify high-risk populations of CAS among the general adult population in Chinese communities.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256970","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 efficacy of autologous cell therapy, repeated PTA and conservative treatment in people with diabetes and chronic limb-threatening ischaemia.","authors":"M Dubský, D Sojáková, J Husáková, A Němcová, V Fejfarová, R Jarošíková, V Frelichová, K Sutoris, E B Jude","doi":"10.1111/dom.16510","DOIUrl":"https://doi.org/10.1111/dom.16510","url":null,"abstract":"<p><strong>Aims: </strong>Data about long-term clinical outcomes of revascularization procedures, especially for autologous cell therapy (ACT), in diabetic patients with chronic limb-threatening ischaemia (CLTI) are lacking. The aim of our study was to compare the mortality and amputation rates in patients with diabetic foot ulcers (DFU) and CLTI treated by ACT with patients treated by repeated percutaneous transluminal angioplasty (re-PTA) and those treated conservatively.</p><p><strong>Materials and methods: </strong>One-hundred and thirty patients with DFU and CLTI (defined as transcutaneous oxygen pressure-TcPO₂ <30 mmHg after unsuccessful standard revascularization) treated in our foot clinic over 9 years were enrolled in the study. Forty-five patients were treated by ACT, 43 patients underwent re-PTA, and 42 patients were treated conservatively and formed the control group. Overall survival, amputation-free survival (AFS) and major amputation rate were assessed over a 7-year follow-up period.</p><p><strong>Results: </strong>Baseline demographic characteristics and comorbidities were similar between groups. However, patients in ACT and control groups had significantly worse baseline angiograms in accordance with Graziani and GLASS (infrapopliteal region) classifications than the re-PTA group (both p < 0.001), but there were no differences in baseline values of TcPO₂ between groups. AFS in the ACT and re-PTA groups were significantly longer compared to control (both p < 0.001). The rate of major amputation was significantly lower in both active groups (both p < 0.001). The re-PTA group showed significantly longer overall survival compared to the control group (p < 0.001), but there was no significant difference between ACT and control groups (p = 0.063) and ACT and re-PTA groups (p = 0.081) in this parameter.</p><p><strong>Conclusions: </strong>Our study showed significantly longer AFS and lower major amputation rates in patients treated by ACT and re-PTA in contrast to patients treated conservatively. Overall survival was significantly longer only in the re-PTA group. ACT was shown to be effective in long-term limb salvage in people with no-option CLTI.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256974","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.15670","DOIUrl":"https://doi.org/10.1111/dom.15670","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 7","pages":"3553-3554"},"PeriodicalIF":5.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.15670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244426","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":"Genetic risk and polygenic risk score assessment of prediabetes and progression to type 2 diabetes.","authors":"Usama Aliyu, Umm-Kulthum Ismail Umlai, Nayra M Al-Thani, Salman M Toor, Abdul Badi Abou-Samra, Omar M E Albagha","doi":"10.1111/dom.16490","DOIUrl":"https://doi.org/10.1111/dom.16490","url":null,"abstract":"<p><strong>Aims: </strong>To identify susceptibility loci to prediabetes and evaluate the performance of existing polygenic risk scores (PGS) for type 2 diabetes (T2D) in predicting prevalent prediabetes and progression to diabetes.</p><p><strong>Materials and methods: </strong>We conducted a case-control Genome-Wide Association Study (GWAS) on Qatar Biobank (QBB) participants with prediabetes (n = 2267) and normoglycaemia (n = 8665). We further evaluated the performance of 140 existing PGS for T2D in predicting prediabetes using logistic regression in the baseline QBB cohort (n = 10 932) and progression to T2D using Cox regression in the follow-up cohort (n = 2143).</p><p><strong>Results: </strong>GWAS identified two loci associated with prediabetes (p < 5 × 10^-8), mapped near GCK and HK1 genes. Among 140 PGS, PGS004838 showed the strongest association with prediabetes (OR/SD: 1.37, 95% CI: 1.29-1.45, p-value: 4.45 × 10^-27). Among 2143 individuals without diabetes at baseline, 9.3% progressed to T2D over 6.0 years of median follow-up. PGS004838 outperformed the other 139 PGS in predicting progression to T2D (HR/SD: 1.79, 95% CI: 1.53-2.10, p-value: 2.08 × 10^-13). Individuals in the very high genetic risk quintile were younger and had a 2.4-fold increased risk of progressing to T2D compared to the intermediate genetic risk quintile.</p><p><strong>Conclusions: </strong>This study identified two genetic loci associated with prediabetes. PGS004838 showed the highest performance in predicting prediabetes and progression to T2D, with the strongest effect reported to date. Our findings have clinical translation potential in risk stratification and early intervention.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223853","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":"Safety, pharmacokinetics and pharmacodynamics of Efsubaglutide Alfa in healthy participants: A randomised, dose-escalation phase 1 study.","authors":"Qinghua Wang, Qiaoli Cui, Yulong Xu, Gerald J Prud'homme, Yuanxun Yang, Dalong Zhu, Yiming Li, Yehong Yang, Juan Li","doi":"10.1111/dom.16452","DOIUrl":"https://doi.org/10.1111/dom.16452","url":null,"abstract":"<p><strong>Aims: </strong>This Phase 1 study aimed to evaluate the safety, pharmacokinetics (PK) and pharmacodynamics (PD) of single-dose subcutaneous Efsubaglutide Alfa, a novel glucagon-like peptide-1 receptor agonist (GLP-1RA), in healthy participants.</p><p><strong>Materials and methods: </strong>This randomised, double-blind, placebo-controlled, single-dose escalation study was conducted at a single centre. A total of 48 healthy adults were randomised (6:2) across six dose cohorts (0.375, 0.75, 1.5, 3, 6 and 9 mg) to receive Efsubaglutide Alfa or placebo. Safety, PK and PD parameters were assessed.</p><p><strong>Results: </strong>Efsubaglutide Alfa exhibited dose-proportional PK, with a median T_max of 47.5-71.7 h and a mean half-life (T_1/2) of 121.4 h. Exposure increased linearly across doses (C_max: 37.1-832.4 ng/mL, AUC_0-∞: 8699.6-193446.6 ng/mL·h). No serious AEs occurred; mild-to-moderate gastrointestinal AEs (nausea, vomiting, decreased appetite) were the most common in Efsubaglutide Alfa-treated subjects. Post-dose, fasting plasma glucose transiently declined on Day 1, returned to baseline by Day 2, and remained within -0.8 to +1.9 mmol/L relative to baseline (within expected physiological variability) through Day 28. Fasting insulin and C-peptide levels slightly increased on Day 1, normalised by Day 2, and remained stable. At Day 2, OGTT revealed reduced glucose excursions in Efsubaglutide Alfa recipients (p = 0.0150 vs. placebo; AUC ~0.7 mmol/L·2 h lower), while insulin and C-peptide levels remained unchanged. Dose-dependent weight loss peaked at Day 4-7, with up to a 4.0% reduction (p < 0.0001) at the higher dose, followed by a gradual return towards baseline by Day 28.</p><p><strong>Conclusions: </strong>Efsubaglutide Alfa was well tolerated in healthy participants, with a favourable PK and PD profiles that support further clinical development in type 2 diabetes and metabolic disorders.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223855","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":"A1c versus oral glucose tolerance test for chronic glycemic surveillance in women with previous gestational diabetes.","authors":"Ravi Retnakaran, Jiajie Pu, Anthony J Hanley, Bernard Zinman","doi":"10.1111/dom.16513","DOIUrl":"https://doi.org/10.1111/dom.16513","url":null,"abstract":"<p><strong>Aims: </strong>Women with gestational diabetes (GDM) are advised to undergo an oral glucose tolerance test (OGTT) within 6 months postpartum, owing to their elevated risk of developing pre-diabetes/diabetes. However, the optimal approach to glycemic surveillance in the years thereafter is unclear. We thus sought to compare OGTT, fasting glucose and A1c for chronic monitoring of women with previous GDM.</p><p><strong>Materials and methods: </strong>At both 3-years and 5-years postpartum, 111 women with previous GDM had glucose tolerance assessed with A1c, fasting glucose and OGTT, with concomitant evaluation of insulin sensitivity/resistance (Matsuda index, HOMA-IR) and beta-cell function (Insulin Secretion-Sensitivity Index-2 (ISSI-2), insulinogenic index/HOMA-IR (IGI/HOMA-IR)).</p><p><strong>Results: </strong>At 3-years postpartum, no women were identified with dysglycemia (pre-diabetes/diabetes) by fasting glucose alone. Instead, dysglycemia was diagnosed in 10 women by A1c alone, 24 women by OGTT alone and 16 women by both A1c and OGTT. Beta-cell function progressively worsened from those diagnosed by A1c alone to OGTT alone to those meeting both criteria (ISSI-2: p < 0.001; IGI/HOMA-IR: p = 0.01). At 5-years, dysglycemia was diagnosed in 13 women by A1c alone, 27 by OGTT alone and 21 by both measures. Beta-cell function again progressively decreased from A1c alone to OGTT alone to both (ISSI-2: p < 0.001; IGI/HOMA-IR: p < 0.001) but was now accompanied by worsening insulin sensitivity/resistance (Matsuda index: p < 0.001; HOMA-IR: p = 0.002) and rising fasting glucose (p = 0.008) across these groups.</p><p><strong>Conclusions: </strong>In women with previous GDM, dysglycemia on OGTT identifies a higher risk metabolic phenotype than when diagnosed by A1c, suggestive of more informative and robust glycemic surveillance by OGTT.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223852","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":"Risk of thyroid cancer related to glucagon-like peptide-1 receptor agonists: A systematic review with meta-analysis of harms of randomized controlled trials.","authors":"Lucas Duchemin, Arthur Morice, Pierre-Marie Morice, Claire Bernardeau, Joachim Alexandre, Sophie Fedrizzi, Angélique Da Silva, Louis Boismoreau, Jean-Luc Faillie, Charles Dolladille","doi":"10.1111/dom.16504","DOIUrl":"https://doi.org/10.1111/dom.16504","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223854","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":"CHIP mediates glucagon action on hepatic glucose production via regulating Smad3 ubiquitination.","authors":"Quan Pan, Weiqi Ai, Yunmei Chen, Zheng Shen, Wanbao Yang, Wen Jiang, Shaodong Guo","doi":"10.1111/dom.16493","DOIUrl":"https://doi.org/10.1111/dom.16493","url":null,"abstract":"<p><strong>Aims: </strong>Excessive hepatic glucose production (HGP) driven by glucagon contributes to hyperglycaemia in obesity and type 2 diabetes (T2D), yet the molecular mechanisms underlying this dysregulation remain incompletely defined. This study investigates the role of Smad3 signaling and its regulation by CHIP (Carboxy-terminus of Hsc70-interacting protein) in modulating glucagon action on HGP.</p><p><strong>Materials and methods: </strong>We examined glucagon signaling and HGP in primary hepatocytes and in high-fat diet (HFD)-induced obese (DIO) mice. Mechanistic studies included hepatic knockdown of CHIP and Smad3, assessment of Smad3 protein stability, ubiquitination assays, and quantification of gluconeogenic gene expression.</p><p><strong>Results: </strong>We identified Smad3 as a key mediator of glucagon-induced HGP, synergizing with TGF-β1 signaling to enhance gluconeogenic gene G6pc expression in a Foxo1-dependent manner. Glucagon elevated Smad3 protein levels by inhibiting CHIP-mediated ubiquitination, thereby increasing Smad3 stability. CHIP expression was downregulated in the livers of DIO mice. Hepatic CHIP knockdown augmented glucagon-stimulated HGP and increased Smad3 levels, whereas simultaneous knockdown of Smad3 reversed these effects.</p><p><strong>Conclusions: </strong>Our findings reveal a novel CHIP-Smad3 regulatory axis that enhances glucagon action on HGP in obesity. Targeting this pathway may offer a new therapeutic strategy for improving glycaemic control in T2D.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214490","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 health economics of insulin therapy: How do we address the rising demands, costs, inequalities and barriers to achieving optimal outcomes","authors":"Phil McEwan PhD,&nbsp;Marc Evans MD","doi":"10.1111/dom.16488","DOIUrl":"10.1111/dom.16488","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;The health economic value of insulin is usually expressed within a cost-effectiveness framework providing an estimated incremental cost per quality-adjusted life year (QALY) gained. Insulin clinical trials adopt a treat-to-target design in which both intervention and control arms aim to achieve similar levels of glycaemic control thereby allowing a comparison of secondary safety outcomes such as hypoglycaemia and weight gain. While of use to inform clinicians about the new insulin's tolerability, it is of limited use for an economic evaluation. An insulin's true potential value requires an assessment of the relationship between the benefits of attaining individualised glycaemic goals versus the factors known to act as barriers to the initiation/intensification of insulin and that also contribute to poor adherence in clinical practice. Addressing the rising demands that diabetes will impose upon the healthcare system will require the simultaneous execution of multiple strategies that acknowledge population dynamics, healthcare delivery constraints, the role of innovation and funding requirements. Accounting for patient-specific characteristics to develop individualised plans and utilising technologies that address relevant barriers to care will require a whole-system perspective on healthcare value and an appreciation of the interconnectivity of stakeholder needs. Importantly, convenience and treatment satisfaction are often not considered valuable features of insulin therapy; not only do they have value, but they are essential to addressing rising demands.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain Language Summary&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;More people around the world are living with diabetes. This is because people are living longer, populations are getting older, and more people are developing the disease. Clinicians will have to prescribe insulin for more people. To make well-informed decisions about how to spend money on diabetes care, we need to understand how much therapies costs and how well they work. In healthcare, people often talk about “value for money.” This means getting better results without spending more money, or saving money without making things worse.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;However, it's not always easy to figure out the value of new types of insulin. The way insulin is studied in clinical trials doesn’t always relate well to how it works, and is used, in real-life clinical practice. Many studies don’t look at all the things that matter, like how easy it is for people to use the insulin or how it affects their daily lives.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;When two types of insulin have comparable efficacy in terms of lowering blood sugar, other things — like side effects, how easy it is to use, and how well people stick to their treatment — be","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 S5","pages":"24-35"},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214491","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":"SGLT2 inhibitors are associated with a reduced incidence of atrial fibrillation in type 2 diabetes mellitus.","authors":"Mark Luedde, Jamschid Sedighi, Hans-Joerg Hippe, Samuel Sossalla, Karel Kostev","doi":"10.1111/dom.16494","DOIUrl":"https://doi.org/10.1111/dom.16494","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207279","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}