Journal of Diabetes最新文献

{"title":"Association of Glycaemia Risk Index With Indices of Atherosclerosis: A Cross-Sectional Study","authors":"Keiichi Torimoto,&nbsp;Yosuke Okada,&nbsp;Tomoya Mita,&nbsp;Kenichi Tanaka,&nbsp;Fumiya Sato,&nbsp;Naoto Katakami,&nbsp;Hidenori Yoshii,&nbsp;Keiko Nishida,&nbsp;Yoshiya Tanaka,&nbsp;Ryota Ishii,&nbsp;Masahiko Gosho,&nbsp;Iichiro Shimomura,&nbsp;Hirotaka Watada","doi":"10.1111/1753-0407.70065","DOIUrl":"https://doi.org/10.1111/1753-0407.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study determined the association of the glycaemia risk index (GRI), a novel comprehensive metric derived from continuous glucose monitoring (CGM), and atherosclerosis in patients with type 2 diabetes (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated the relationship between GRI and intima-media thickness (IMT), gray-scale median (GSM), tissue characteristics of the carotid artery wall, and brachial-ankle pulse wave velocity (baPWV), using baseline data from a multicenter prospective cohort study of 1000 Japanese patients with T2DM free of cardiovascular disease (CVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study subjects were 999 patients (age: 64.6 ± 9.6 years, mean ± SD, 60.9% males, body mass index: 24.6 ± 3.9 kg/m², HbA1c 7.1% ± 0.8%, TIR 78.9% ± 18.6%) with T2DM (duration of 12.9 ± 8.5 years). A higher GRI was associated with a longer duration of diabetes, a higher HbA1c level, a mean glucose level, and baPWV, and lower mean GSM. No association was noted between GRI and mean IMT. GRI was significantly associated with mean GSM (regression coefficient, <i>β</i> = −0.1277; 95% confidence interval: CI: −0.2165 to −0.0390, <i>p</i> = 0.005) and baPWV (regression coefficient, <i>β</i> = −3.1568; 95% CI: 1.5058 to 4.8079, <i>p</i> &lt; 0.001) after adjustment for various cardiovascular risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GRI is a potentially useful predictor of atherosclerosis in patients with T2DM. Our findings suggest that GRI, a marker of the risk of hypoglycaemia and hyperglycaemia, may serve as a clinically useful tool for the assessment of the risk of CVD in patients with T2DM, independent of the classical cardiovascular risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565102","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":"Sex Differences in the Efficacy of Glucagon-Like Peptide-1 Receptor Agonists for Weight Reduction: A Systematic Review and Meta-Analysis","authors":"Yucheng Yang,&nbsp;Liyun He,&nbsp;Shumeng Han,&nbsp;Na Yang,&nbsp;Yiwen Liu,&nbsp;Xuechen Wang,&nbsp;Ziyi Li,&nbsp;Fan Ping,&nbsp;Lingling Xu,&nbsp;Wei Li,&nbsp;Huabing Zhang,&nbsp;Yuxiu Li","doi":"10.1111/1753-0407.70063","DOIUrl":"https://doi.org/10.1111/1753-0407.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To verify sex differences of GLP-1RAs for weight reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched RCTs reporting weight change by sex from PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials registries. Meta-regression was performed to evaluate the association between weight reduction and sex differences. Subgroup analyses were stratified by individual GLP-1RA medications, dose, treatment duration, indication, type of control, background treatment, and baseline weight. The study protocol was registered (CRD42023480167).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies covering dulaglutide, exenatide, liraglutide, semaglutide, and retatrutide were included in this study. The meta-analysis showed that females lost more weight than males (MD 1.04 kg [95% CIs 0.70–1.38]; MD 1.69% [95% CI 0.78–2.61]). The pooled results of GLP-1RAs indicated similar results (MD 0.88 kg [95% CIs 0.67–1.09]). Meta-regression illustrated that substantial weight reduction was significantly relevant to greater gender differences (<i>β</i> = −0.19 [95% CIs −0.29 to −0.09]). Subgroup analysis demonstrated that indications for weight reduction increased the gender difference in weight reduction (MD 4.21 kg [95% CIs 1.75–6.67]). Background treatment, dose, duration of treatment, baseline weight, and type of control had no subgroup differences in the sex difference in weight reduction of GLP-1RAs. Dulaglutide (MD 0.88 kg [95% CIs 0.63–1.12]) and semaglutide (MD 1.04 kg [95% CIs 0.45–1.63]) showed statistically significant differences in weight reduction between males and females. No gender difference was observed in the exenatide subgroup analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Females lost more weight than males when treated with GLP-1RAs for weight reduction. The sex difference in weight reduction became more pronounced as the degree of weight reduction increased. Indications for obesity could magnify this sex difference.</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554460","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":"Response to Commentary on “Pedal Medial Arterial Calcification in Diabetic Foot Ulcers: A Significant Risk Factor of Amputation and Mortality”","authors":"Lihong Chen,&nbsp;Dawei Chen,&nbsp;Hongping Gong,&nbsp;Chun Wang,&nbsp;Yun Gao,&nbsp;Yan Li,&nbsp;Weiwei Tang,&nbsp;Panpan Zha,&nbsp;Xingwu Ran","doi":"10.1111/1753-0407.70070","DOIUrl":"https://doi.org/10.1111/1753-0407.70070","url":null,"abstract":"&lt;p&gt;We appreciate the authors for their insightful commentary and for recognizing our manuscript [&lt;span&gt;1&lt;/span&gt;] as a valuable contribution that provides crucial insights into the relationship between pedal MAC, the risk of amputation, and mortality in patients with diabetic foot ulcers (DFUs).&lt;/p&gt;&lt;p&gt;We concur that a more sophisticated classification system, such as SINBAD or WIfI systems, could enhance the comprehension of the severity and risk associated with DFUs and improve communication among healthcare professionals. However, considering its simplicity and practicality, the Wagner wound classification system remains internationally recognized and widely utilized.&lt;/p&gt;&lt;p&gt;Regarding laboratory markers, inflammatory biomarkers including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI) exhibit significant variability. Specifically, in patients with diabetic foot infections, these inflammatory markers are markedly elevated. Consequently, they serve as indicators of acute infection but are not suitable for assessing long-term prognosis, such as amputation risk or mortality. Additionally, laboratory markers such as magnesium, zinc, and vitamin B12 are not routinely evaluated in clinical practice. Further research could explore the potential associations between these markers and the prognosis of DFUs.&lt;/p&gt;&lt;p&gt;Because of the longitudinal nature of the study design, participants were followed up over an extended period. The hypoglycemic medications prescribed may have varied over time, making it challenging to incorporate both the medications and their dosages into the analysis. Regarding infections and antibiotics, diabetic foot infection is indeed a recognized risk factor for amputation and short-term mortality. However, based on our previous meta-analysis, the primary long-term causes of mortality include cardiovascular diseases, infections (such as sepsis, respiratory infections, and foot infections), and cancers [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We acknowledge that patients with DFUs may concurrently suffer from autoimmune disorders, psychiatric conditions, and malignancies. These comorbidities elevate the risk of amputation and adverse outcomes [&lt;span&gt;3&lt;/span&gt;]. However, in this study, we excluded individuals with these comorbidities prior to analysis.&lt;/p&gt;&lt;p&gt;With respect to socioeconomic status and educational attainment, it is well-established that a lower socioeconomic status constitutes a substantial risk factor for amputation among patients with diabetes and peripheral artery disease [&lt;span&gt;4&lt;/span&gt;]. Socioeconomic status, social capital, and medical challenges significantly impede the effective management and prevention of DFUs [&lt;span&gt;5&lt;/span&gt;]. Enhanced government intervention is imperative to ensure equitable access to health resources. Additionally, a history of ulceration and prior amputations is a critical risk f","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554589","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":"Commentary on “Pedal Medial Arterial Calcification in Diabetic Foot Ulcers: A Significant Risk Factor of Amputation and Mortality”","authors":"Mostafa Javanian,&nbsp;Mohammad Barary,&nbsp;Ali Alizadeh Khatir,&nbsp;Majid Khalilizad,&nbsp;Soheil Ebrahimpour","doi":"10.1111/1753-0407.70071","DOIUrl":"https://doi.org/10.1111/1753-0407.70071","url":null,"abstract":"&lt;p&gt;We were glad to read the article entitled “Pedal Medial Arterial Calcification in Diabetic Foot Ulcers: A Significant Risk Factor of Amputation and Mortality,” published in your prestigious journal [&lt;span&gt;1&lt;/span&gt;]. This sheds light on the yet less known association, made clear by the authors, between pedal, medial arterial calcification (MAC) and its strong relationship with amputation and mortality in diabetic foot ulcer (DFU) patients. Not only is pedal MAC a new significant predictor of amputation, but it is also a predictor of amputation independent of peripheral artery disease (PAD). However, we believe that filling in some methodological missing parts could attune the study hypothesis and strengthen the conclusions of the study.&lt;/p&gt;&lt;p&gt;First and foremost, one of the strengths of the study is the use of a widely recognized classification system for grading DFUs, the Wagner classification system. However, I think the study could have benefited from the inclusion of a more comprehensive ulcer scoring system, which takes into account several factors such as ulcer location, size, depth, ischemia, and neuropathy, such as the SINBAD ulcer classification [&lt;span&gt;2&lt;/span&gt;]. This would offer a more comprehensive understanding of severity and risk, particularly for those patients with more complex presentations.&lt;/p&gt;&lt;p&gt;Another point of consideration is to investigate further the role of additional laboratory markers in supplementing our understanding of the clinical outcomes of the patient population. For instance, biomarkers including magnesium, zinc, vitamin B12, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the systemic inflammatory response index (SIRI) could provide a higher level of precision into the underlying mechanisms and may better orient the clinical risk assessment [&lt;span&gt;3, 4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The study also fails to thoroughly examine the drugs given to the patients, especially antidiabetic medicines and antibiotics. These treatments can greatly affect how well we heal and whether we have complications like amputation. A detailed breakdown of these medications and their dosages would further shed light on their potential impact on the study's findings.&lt;/p&gt;&lt;p&gt;Further research may also be strengthened by including additional potential comorbid conditions, including autoimmune disorders, psychiatric disorders, and cancers. It is well established that these factors have significant effects on the course of DFUs and the risk of amputation and mortality. This would give a better representation of the patient population and could potentially increase the predictive power of the model.&lt;/p&gt;&lt;p&gt;A deeper dive into demographic information like socioeconomic status, education level, alcohol use, and the patient's history of ulcers or amputation would also improve the study. Previous research has shown how much these variables affect health outcomes, how the","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554590","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":"Response to “Comment on Prevalence and Influencing Factors of Malnutrition in Diabetic Patients: A Systematic Review and Meta-Analysis”","authors":"Tong Zhang,&nbsp;Yuxia Ma,&nbsp;Lin Han","doi":"10.1111/1753-0407.70066","DOIUrl":"https://doi.org/10.1111/1753-0407.70066","url":null,"abstract":"&lt;p&gt;We thank the authors for their insightful comments and for recognizing that our manuscript provides valuable contributions to the field of clinical nutrition [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Firstly, we acknowledge that meta-regression can provide additional insights into heterogeneity, but its feasibility and reliability in our study were constrained by the inconsistent and limited reporting of key covariates, such as sample characteristics, across the included studies, and current meta-analysis studies on single-group rates are all highly heterogeneous [&lt;span&gt;2, 3&lt;/span&gt;]. Additionally, even meta-regression analysis cannot completely resolve heterogeneity, which is inherent to meta-analysis investigating prevalence rates. Heterogeneity is now widely recognized and accepted as a standard challenge in such studies and is one of the issues to be addressed by future methodologists [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Secondly, using Egger's test and funnel plots to assess publication bias are widely adopted methods, and while tools such as Doi plots and the LFK index may provide alternative methods for detecting publication bias, these methods have not been universally used in meta-analyses. We acknowledge that prediction intervals (PIs) can convey the range of effects expected in future studies, but calculating and interpreting PIs relies on normality assumptions, which may be difficult to guarantee. Importantly, retaining our original analysis methods does not alter the conclusions of this paper, which is why we opted to maintain them.&lt;/p&gt;&lt;p&gt;Thirdly, regarding malnutrition assessment tools, we note that a meta-analysis of 83 studies identified more than 30 nutritional assessment tools, none of which are universally applicable or specifically developed for diabetic patients [&lt;span&gt;5&lt;/span&gt;]. We recognize that pooling results from diverse tools introduces significant heterogeneity, but limiting analysis to stratified results would constrain the exploration of factors influencing malnutrition in diabetic patients. To address this, we performed subgroup analysis based on assessment tools. Furthermore, we also advocate for the development of a standardized malnutrition assessment tool tailored for diabetic patients to enhance consistency and comparability across studies.&lt;/p&gt;&lt;p&gt;Finally, we agree that the analysis of some influencing factors, such as smoking, education level, and diabetic foot infection, was limited by small sample sizes. Future studies should focus more on the impact of these factors on the nutritional status of diabetic patients. Additionally, future analysis should aim to incorporate confounding variables, including socioeconomic status, dietary patterns, and psychological factors, to provide a more comprehensive understanding of malnutrition risk.&lt;/p&gt;&lt;p&gt;In conclusion, we thank the authors for their comments on the manuscript and for providing valuable insights. We hope these clarifications address the issues raised and further illuminate our analytica","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530089","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":"Comment on: “Prevalence and Influencing Factors of Malnutrition in Diabetic Patients: A Systematic Review and Meta-Analysis”","authors":"Shubham Kumar,&nbsp;Nosaibah Razaqi,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1111/1753-0407.70067","DOIUrl":"https://doi.org/10.1111/1753-0407.70067","url":null,"abstract":"&lt;p&gt;We read with great interest the recent article by Zhang et al., titled “Prevalence and influencing factors of malnutrition in diabetic patients: A systematic review and meta-analysis” [&lt;span&gt;1&lt;/span&gt;]. The study provides valuable insights into an important area of clinical nutrition. The authors should be commended for their effort in consolidating data on malnutrition in diabetic patients and highlighting its associated risk factors. However, upon a detailed review of the article, several methodological issues and potential areas for improvement were identified, which could enhance the reliability and clinical applicability of their findings.&lt;/p&gt;&lt;p&gt;One significant limitation lies in the presence of substantial heterogeneity across the included studies, as evidenced by high &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; values (&gt; 90%). The heterogeneity raises concerns regarding the comparability of pooled prevalence estimates for malnutrition and at-risk malnutrition, which the authors reported as 33% and 44%, respectively. Although the authors performed subgroup analyses by measurement tools, region, and diabetes complications, these analyses did not fully address the underlying causes of variability. The authors could have considered using meta-regression analysis to explore potential sources of heterogeneity, such as differences in study design, sample characteristics, and diagnostic criteria [&lt;span&gt;2&lt;/span&gt;]. This statistical approach would have provided a deeper understanding of the heterogeneity and potentially improved the robustness of their conclusions.&lt;/p&gt;&lt;p&gt;Additionally, the authors relied on confidence intervals (CIs) to present pooled estimates but did not include prediction intervals (PIs). While CIs describe the precision of the pooled effect size, PIs would have conveyed the range of effects expected in future studies. The use of PIs is especially critical in the presence of high heterogeneity, as it offers a clearer picture of the variability across different settings and populations [&lt;span&gt;3&lt;/span&gt;]. The inclusion of PIs alongside CIs would have strengthened the interpretation of the meta-analysis results, particularly for clinical decision-making.&lt;/p&gt;&lt;p&gt;Another important methodological concern involves the assessment of publication bias. The authors used Egger's test and visual inspection of funnel plots to evaluate publication bias. While these methods are widely used, they may not be optimal for meta-analyses involving proportions, where asymmetry in funnel plots can arise from true heterogeneity rather than bias. The authors might have instead employed more appropriate approaches, such as the Doi plot and LFK index, which are specifically designed to assess publication bias in proportion meta-analyses [&lt;span&gt;4&lt;/span&gt;]. These methods offer greater reliability in detecting bias in prevalence studies and could have provided additional assurance regarding the integrity of the findings.&lt;/p&gt;&lt;p&gt;The use of diverse diagnostic tools, such as the Mini Nu","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530367","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":"Genetically Predicted Frailty Index Is Associated With Increased Risk of Multiple Metabolic Diseases: 175 226 European Participants in a Mendelian Randomization Study","authors":"Hexing Wang,&nbsp;Haifeng Zhang,&nbsp;Dongliang Tang,&nbsp;Yinshuang Yao,&nbsp;Junlan Qiu,&nbsp;Xiaochen Shu","doi":"10.1111/1753-0407.70062","DOIUrl":"https://doi.org/10.1111/1753-0407.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A relationship between frailty index (FI) and metabolic diseases (MDs) has been reported in previous observational studies. However, the causality between them remains unclear. This study aimed to examine the causal effect of FI on MDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a bidirectional two-sample Mendelian randomization (MR) study. A recent large-scale genome-wide association study (GWAS) provided available data associated with FI, and summary statistics on eight MDs were collected from the IEU OpenGWAS database. Inverse variance weighted (IVW) was used as the main analysis to estimate causal effects, together with MR pleiotropy residual sum and outlier (MR-PRESSO), MR-Egger, Cochran's Q test, pleiotropy test, leave-one-out method, and MR Steiger analysis were used in the sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our MR study demonstrated for the first time that elevated FI was causally associated with an increased risk of MDs including obesity (odds ratio [OR] = 1.78; 95% confidence interval [CI]: 1.17–2.70; <i>p</i> = 0.0075), T2DM (OR = 1.67; 95% CI: 1.24–2.24; <i>p</i> = 6.95 × 10⁻⁴), gout (OR = 2.45; 95% CI: 1.29–4.64; <i>p</i> = 0.006), hypothyroidism (OR = 1.96; 95% CI: 1.47–2.60; <i>p</i> = 3.47 × 10⁻⁶), and HTN (OR = 2.17; 95% CI: 1.72–2.74; <i>p</i> = 5.25 × 10⁻¹¹). However, no causal association was found between FI and osteoporosis, vitamin D deficiency, and hyperthyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings support a causal relationship between FI and multiple MDs. This is crucial for the prevention of associated MDs in patients with frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530132","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":"Association Between Skin Autofluorescence and Coronary Heart Disease in Chinese General Population: A Cross-Sectional Study","authors":"Qingzheng Wu,&nbsp;Yu Cheng,&nbsp;Hongyan Liu,&nbsp;Yuepeng Wang,&nbsp;Bing Li,&nbsp;Yiming Mu","doi":"10.1111/1753-0407.70061","DOIUrl":"https://doi.org/10.1111/1753-0407.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to investigate the relationship between SAF and CHD in the general population of China and to assess the feasibility of SAF used as a predictor of CHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was nested within the prospective study REACTION (Cancer Risk Assessment in Chinese Diabetic Population) which included a total of 5806 eligible participants from two communities located in urban Beijing in 2018. SAF were measured using a fluorescence detector (DM Scan). CHD was the study endpoint and was determined by a face-to-face clinical survey. Pearson's correlation analysis, linear regression analysis, and binary logistic regression analysis were used to examine the association between SAF and CHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall prevalence of CHD in the general population was 12.1%. Logistic analysis showed that after full adjustment for confounding factors, the risk of CHD increased significantly with increasing lnSAF quartiles (<i>p</i>-trend &lt; 0.05). Compared to Q1 group, the multivariate adjusted ORs of Q2 and Q3 groups were 1.071 (0.817, 1.404), 1.025 (0.781, 1.344), respectively, and the OR was markedly increased at Q4 (OR = 1.377 [1.043, 1.817]). When lnSAF was a continuous variable, the risk of CHD increased with the elevation of lnSAF level. Stratified analysis showed that in subgroups with overweight (24–28 kg/m²), eGFR &lt; 60 mL/min/1.73 m², and diabetes mellitus (DM), lnSAF was still significantly correlated with CHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Chinese general population, higher lnSAF is independently associated with increased risk of CHD, and noninvasive SAF holds the potential to be a biomarker for CHD risk evaluation and stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530133","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":"Prevalence, Awareness, Treatment, and Control of Diabetes Among 0.98 Million Patients With Stroke/TIA in China: Insights From a Nationwide Cohort Study","authors":"Siqi Chen,&nbsp;Gulbahram Yalkun,&nbsp;Hongqiu Gu,&nbsp;Xin Yang,&nbsp;Chunjuan Wang,&nbsp;Xingquan Zhao,&nbsp;Yilong Wang,&nbsp;Liping Liu,&nbsp;Xia Meng,&nbsp;Yong Jiang,&nbsp;Hao Li,&nbsp;Yongjun Wang,&nbsp;Zixiao Li,&nbsp;Jue Liu,&nbsp;Donghua Mi","doi":"10.1111/1753-0407.70059","DOIUrl":"https://doi.org/10.1111/1753-0407.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A comprehensive epidemiological investigation of the coexistence between diabetes and stroke/TIA in China is urged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Chinese Stroke Center Alliance program, a nationwide multi-center registry study, were used to detect the prevalence, awareness, treatment, and control of diabetes among stroke/TIA. The distribution of diagnosed and undiagnosed diabetes and prediabetes among stroke/TIA patients was investigated, the medical care around diabetes and their respective risk predictors were analyzed, and the association of all above diabetes characteristics with in-hospital death was evaluated using multi-variable Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 980 625 patients included, 308 426 (31.5%) had prediabetes, while 365 052 (37.2%) had diabetes, with nearly a third of them undiagnosed (112 969, 30.9%). Of residual aware diabetic patients, 59.0% were treated, with 27.3% controlled. Compared to Han ethnicity, Zhuang ethnicity had a lower prevalence of diabetes (37.3% vs. 35.1%) but were less aware (69.4% vs. 56.5%), treated (59.4% vs. 47.8%), and controlled (27.4% vs. 26.0%). Patients with prediabetes, diagnosed, and undiagnosed diabetes had increasingly higher risks of in-hospital death (adjusted HR [95% CI]: 1.47 [1.35–1.60]; 2.15 [1.97–2.34]; 4.20 [3.87–4.56], all <i>p</i> &lt; 0.001). Unaware and untreated diabetes were independently associated with in-hospital death (adjusted HR [95% CI]: 1.99 [1.85–2.14]; 2.84 [2.63–3.07, both <i>p</i> &lt; 0.001]). Compared with controlled diabetes, those with uncontrolled diabetes had a lower risk of in-hospital death (adjusted HR [95% CI]: 0.77[0.68–0.88], <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings indicate that over two-thirds of stroke/TIA patients are exposed to diabetes in China, causing higher in-hospital mortality, which should be screened and intervened early.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530134","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":"Insulin Resistance and Cancer","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.70064","DOIUrl":"https://doi.org/10.1111/1753-0407.70064","url":null,"abstract":"&lt;p&gt;It has long been clear that Type 2 diabetes is associated with an increased likelihood of the development of a variety of malignancies. The Shanghai Standardized Diabetes Management System data set of more than 400 000 persons from 2011 to 2018 showed a 10% increase in overall malignancy rates over those in the nondiabetic population, with a particularly high risk of cancers of the pancreas [&lt;span&gt;1&lt;/span&gt;], thyroid [&lt;span&gt;2&lt;/span&gt;], bladder, kidney, breast, colorectum, and liver compared with the general population, and with a greater relative increase in younger persons [&lt;span&gt;3&lt;/span&gt;]. Several mechanisms have been proposed for this association [&lt;span&gt;4&lt;/span&gt;]. Hyperglycemia itself might predispose individuals to cancer [&lt;span&gt;5, 6&lt;/span&gt;]. Obesity underlies the majority of instances of Type 2 diabetes and is associated with malignancy, with adipose tissue secretion of inflammatory cytokines and leptin, decreased production of adiponectin, and, particularly in postmenopausal women, adipose tissue estrogen production playing roles in specific tissues. An attractive hypothesis of the underlying mechanism for all of these is that insulin resistance itself gives rise to malignancy [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Certainly, it is plausible that insulin resistance may be a major underlying cause of cancer development. Insulin has mitogenic effects, which may particularly manifest in insulin resistance with hyperinsulinemia, and insulin may be pro-angiogenic, leading to an anti-apoptotic effect in DNA-damaged cells, furthering carcinogenesis; features of these mechanisms have been shown in breast cancer models, with the insulin receptor substrate receptor (IRS)-1 showing high expression, and with adipose tissue secretory proteins such as leptin stimulated by insulin and having mitogenic, angiogenic, and anti-apoptotic effects, while adiponectin levels are suppressed by insulin and lowered in obesity, leading to opposing effects [&lt;span&gt;8&lt;/span&gt;]. In breast cancer development, factors related to insulin resistance produced in systemic adipose tissue may have endocrine effects, adipocytes in the tumor capsule would have paracrine effects, and factors directly produced by tumor cells could have autocrine effects in cancer promotion [&lt;span&gt;9&lt;/span&gt;]. In the development of pancreatic cancer, insulin might act on pancreatic acinar cells to increase digestive enzyme production, leading to inflammation in pancreatic exocrine tissue, while insulin might also directly increase pancreatic cell mitosis and potentiate metaplasia [&lt;span&gt;9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Proxy measures of insulin resistance have been used to support this concept. In a study based on nearly 400 000 persons in the UK Biobank, the triglyceride-glucose-BMI product, an insulin resistance measure based on the metabolic syndrome, and the ratio of triglyceride to HDL cholesterol were analyzed to determine the relationship between insulin resistance and esophageal cancer risk [&lt;span&gt;10&lt;/span&gt;], showing adenocarc","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489822","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}