Diabetes, Obesity & Metabolism最新文献

{"title":"Impact of healthy lifestyles on the risk of metabolic dysfunction-associated steatotic liver disease among adults with comorbid hypertension and diabetes: Novel insight from a largely middle-aged and elderly cohort in South China","authors":"Jun-Yan Xi PhD,&nbsp;Yi-Jing Wang PhD,&nbsp;Xiao-Heng Li PhD,&nbsp;Nuo-Min Sun MPH,&nbsp;Rui-Qi Ming MPH,&nbsp;Hua-Ling Yan MPH,&nbsp;Huan-Le Cai PhD,&nbsp;Jian-Jun Bai PhD,&nbsp;Yi-Ning Xiang PhD,&nbsp;Jing Gu PhD,&nbsp;Xiao Lin PhD,&nbsp;Gang Liu MPH,&nbsp;Yuan-Tao Hao PhD","doi":"10.1111/dom.16289","DOIUrl":"10.1111/dom.16289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The association between lifestyle and metabolic dysfunction-associated steatotic liver disease (MASLD) has been well documented. However, evidence is still limited from vulnerable populations, especially middle-aged and elderly adults with comorbid hypertension and diabetes, who are at higher risk of developing MASLD than the general population. We aimed to examine the potential causal links of a healthy lifestyle with the risk of MASLD in this vulnerable population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 41,964 middle-aged and elderly participants with comorbid hypertension and diabetes were included in a longitudinal cohort from 2010 to 2023. Weighted scores for lifestyle were evaluated by exercise frequency, alcohol consumption, smoking status and salt intake. Marginal structural models were used to estimate the single lifestyle–MASLD associations, which were further risk stratified by quartile ranges of weighted scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A mean follow-up period of 5.2 years (217 972 person-years) revealed that 21 697 participants developed MASLD. The hazard ratio (HR) of daily exercise, never consuming alcohol, never smoking and low salt intake for the risk of MASLD was 0.617 (95% confidence interval: 0.365 ~ 1.042), 0.237 (0.093 ~ 0.603), 0.153 (0.097 ~ 0.240) and 0.945 (0.919 ~ 0.971), respectively. Compared with weighted scores that were below the 25th percentile, the HR was 0.952 (0.902 ~ 1.005), 0.747 (0.694 ~ 0.803) and 0.097 (0.065 ~ 0.144) for the 25th, 50th and 75th percentiles, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this vulnerable population, daily exercise, abstinence from alcohol and smoking and a low-salt diet may reduce the risk of MASLD, and the most stringent combination of healthy lifestyles could reduce the risk of MASLD by over 90%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2800-2809"},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571805","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":"ISM1 regulates white adipose tissue remodelling by dampening adipocyte differentiation and enhancing inflammation.","authors":"Yajun Hu, Zhiyuan Shen, Liu Yang, Yanling Zhang, Tianfa Wang, Xiaohan Zhang, Sanjian Yu, Min Yu, Bing Zhao","doi":"10.1111/dom.16310","DOIUrl":"https://doi.org/10.1111/dom.16310","url":null,"abstract":"<p><strong>Aims: </strong>Isthmin-1 (ISM1), a secretory protein predominantly derived from brown adipose tissue, enhances glucose tolerance and attenuates hepatic steatosis. However, its potential involvement in white adipose tissue remodelling remains elusive, which profoundly impacts adipocyte insulin sensitivity and consequently alters systemic metabolic homeostasis.</p><p><strong>Materials and methods: </strong>ISM1 expression profiles in human and mouse were systematically characterized using Tabula Sapiens. With the intervention of ISM1 expression, mouse preadipocyte cell lines were employed to observe adipocyte differentiation. Furthermore, inflammatory responses of preadipocytes and macrophages induced by palmitic acid (PA) were also studied in vitro. In vivo, overexpression of ISM1 in white adipose tissue followed by 4 weeks of high-fat diet (HFD) was compared.</p><p><strong>Results: </strong>ISM1 exhibited exclusive expression in adipose stem cells and progenitor cells in white adipose tissue. Stable overexpression of ISM1 in 3T3-F442A could significantly impair the ability to differentiate into adipocytes and promote myofibroblast-like differentiation. Notably, under PA stimuli, ISM1 amplified pro-inflammatory responses elicited by mouse adipocyte progenitors and macrophages with an increase in a couple of inflammatory factors. In mice, ISM1 overexpression could inhibit the differentiation of adipocyte progenitors in inguinal white adipose tissue and enhance macrophage accumulation in epididymal white adipose tissue with a short-term HFD.</p><p><strong>Conclusions: </strong>ISM1 may primarily be derived from stem/progenitor cells in white adipose tissues. ISM1 plays an important role in HFD-induced white adipose tissue remodelling, suggesting its complex potential in improving insulin resistance and treating metabolic disorders.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571806","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 high hourly overnight variability of insulin requirements as an explanation for the superiority of automated insulin delivery systems.","authors":"Giona Castagna, Giuseppe Lepore, Nicolò Diego Borella, Roberto Trevisan","doi":"10.1111/dom.16319","DOIUrl":"https://doi.org/10.1111/dom.16319","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571807","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.15667","DOIUrl":"https://doi.org/10.1111/dom.15667","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 4","pages":"1633-1634"},"PeriodicalIF":5.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.15667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565104","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":"Data-driven discovery of midlife cardiometabolic profile associated with incident early-onset and late-onset dementia","authors":"Jiang Li MPH,&nbsp;Jie Li MD,&nbsp;Yuefeng Yu MD,&nbsp;Ying Sun MD,&nbsp;Yanqi Fu MD,&nbsp;Lingli Cai MD,&nbsp;Wenqi Shen MD,&nbsp;Xiao Tan PhD,&nbsp;Ningjian Wang MD,&nbsp;Yingli Lu MD,&nbsp;Bin Wang PhD","doi":"10.1111/dom.16292","DOIUrl":"10.1111/dom.16292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiometabolic risk factors have been associated with the risk of late-onset dementia. However, evidence regarding early-onset dementia was inconsistent, and the impact of clustered cardiometabolic risk factors was unclear. We aimed to investigate the associations of cardiometabolic profiles with incident early-onset and late-onset dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 289 494 UK Biobank participants, cluster analysis was built on 12 common cardiometabolic markers. Analyses were performed on those aged &lt;65 years at baseline (<i>n</i> = 249 870) for early-onset dementia and those ≥65 at the end of follow-up (<i>n</i> = 191 213) for late-onset dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 14.1 years, 279 early-onset dementia cases and 3167 late-onset dementia cases were documented. Among the five clusters of cardiometabolic profiles identified (cluster 1 [obesity-dyslipidemia pattern], cluster 2 [high blood pressure pattern], cluster 3 [high liver enzymes pattern], cluster 4 [inflammation pattern] and cluster 5 [relatively healthy pattern]), cluster 3 was significantly associated with higher risks of both early-onset and late-onset dementia; however, the risk estimate for early-onset dementia (hazard ratio 2.58, 95% CI 1.61–4.14) was larger than that for late-onset dementia (1.36, 1.09–1.71). Cluster 4 was associated with a higher risk of late-onset dementia (hazard ratio 1.39, 95% CI 1.13–1.72). No significant interactions were observed between cardiometabolic clusters and apolipoprotein E ε4 genotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cardiometabolic patterns characterised by relatively high liver enzyme levels or systemic inflammation were associated with increased risks of early-onset and late-onset dementia. Identification of high-risk subgroups according to distinct cardiometabolic patterns might help develop more precise strategies for dementia prevention regardless of apolipoprotein E (APOE) ε4 status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2822-2832"},"PeriodicalIF":5.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565661","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":"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 PhD,&nbsp;Clementine Verhulst PhD,&nbsp;Cecilie Hornborg Svensson MD,&nbsp;Malene Wienberg PhD,&nbsp;Anthonie L. Duijnhouwer PhD,&nbsp;Cees J. Tack MD,&nbsp;Peter L. Kristensen MD,&nbsp;Bastiaan E. de Galan MD,&nbsp;Ulrik Pedersen-Bjergaard MD,&nbsp;the Hypo-RESOLVE consortium","doi":"10.1111/dom.16283","DOIUrl":"10.1111/dom.16283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Method</h3>\u0000 \u0000 <p>We enrolled people with type 1 diabetes (<i>n</i> = 24), people with insulin-treated type 2 diabetes (<i>n</i> = 15) and controls without diabetes (<i>n</i> = 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During hypoglycaemia, LVEF increased significantly in all groups compared to baseline (6.2 ± 5.2%, <i>p</i> &lt; 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%, <i>p</i> = 0.03, 95% CI difference: −5.0, −0.3). In people with type 1 diabetes, ΔLVEF was inversely associated with diabetes duration (<i>β</i>: −0.16, 95% CI: −0.24, −0.53, <i>p</i> = 0.001) and recent exposure to hypoglycaemia (<i>β</i>: −0.30, 95% CI: −0.53, −0.07, <i>p</i> = 0.015). Hypoglycaemia also increased global longitudinal strain (GLS) in controls without diabetes (<i>p</i> &lt; 0.05), but this did not occur in the two diabetes subgroups (<i>p</i> &gt; 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2768-2776"},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16283","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}