Nature Medicine最新文献_第4页

Rethinking brain body maps and phantom limbs 重新思考大脑身体图和幻肢

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-15 DOI: 10.1038/d41591-025-00057-1

引用次数: 0

Primary care detection of Alzheimer’s disease using a self-administered digital cognitive test and blood biomarkers 使用自我管理的数字认知测试和血液生物标志物对阿尔茨海默病的初级保健检测

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-15 DOI: 10.1038/s41591-025-03965-4

Pontus Tideman, Linda Karlsson, Olof Strandberg, Susanna Calling, Ruben Smith, Patrik Midlöv, Philip B. Verghese, Joel B. Braunstein, Niklas Mattsson-Carlgren, Erik Stomrud, Sebastian Palmqvist, Oskar Hansson

{"title":"Primary care detection of Alzheimer’s disease using a self-administered digital cognitive test and blood biomarkers","authors":"Pontus Tideman, Linda Karlsson, Olof Strandberg, Susanna Calling, Ruben Smith, Patrik Midlöv, Philip B. Verghese, Joel B. Braunstein, Niklas Mattsson-Carlgren, Erik Stomrud, Sebastian Palmqvist, Oskar Hansson","doi":"10.1038/s41591-025-03965-4","DOIUrl":"https://doi.org/10.1038/s41591-025-03965-4","url":null,"abstract":"After the clinical implementation of amyloid-β-targeting therapies for people with cognitive impairment due to Alzheimer’s disease (AD), there is an urgent need to efficiently identify this patient population in primary care. Therefore, we created a brief and self-administered digital cognitive test battery (BioCog). Based on its sub-scores, a logistic regression model was developed in a secondary care cohort (n = 223) and then evaluated in an independent primary care cohort comprising 19 primary care centers (n = 403). In primary care, BioCog had an accuracy of 85% when using a single cutoff to define cognitive impairment, which was significantly better than the assessment of primary care physicians (accuracy 73%). The accuracy increased to 90% when using a two-cutoff approach. BioCog had significantly higher accuracy than standard paper-and-pencil tests (that is, Mini-Mental State Examination, Montreal Cognitive Assessment, Mini-Cog) and another digital cognitive test. Furthermore, BioCog combined with a blood test could detect clinical, biomarker-verified AD with an accuracy of 90% (one cutoff), significantly better than standard-of-care (accuracy 70%) or when using the blood test alone (accuracy 80%). In conclusion, this proof-of-concept study shows that a brief, self-administered digital cognitive test battery can detect cognitive impairment and, when combined with a blood test, accurately identify clinical AD in primary care.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"35 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lessons from a long cohort study of diabetes in South Asia 南亚糖尿病长期队列研究的经验教训

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-12 DOI: 10.1038/s41591-025-03947-6

Shivani A. Patel, Dimple Kondal, Mohan Deepa, Howard H. Chang, Venkatesan Radha, Sailesh Mohan, Yan V. Sun, Arshed A. Quyyumi, Mohammed K. Ali, Nikhil Tandon, Viswanathan Mohan, Dorairaj Prabhakaran, K. M. Venkat Narayan

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Genetic subtyping of obesity reveals biological insights into the uncoupling of adiposity from its cardiometabolic comorbidities 肥胖的遗传分型揭示了肥胖从其心脏代谢合并症解耦的生物学见解

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-12 DOI: 10.1038/s41591-025-03931-0

Nathalie Chami, Zhe Wang, Victor Svenstrup, Virginia Diez Obrero, Daiane Hemerich, Yi Huang, Hesam Dashti, Eleonora Manitta, Michael H. Preuss, Kari E. North, Louise Aas Holm, Cilius E. Fonvig, Jens-Christian Holm, Torben Hansen, Camilla Scheele, Alexander Rauch, Roelof A. J. Smit, Melina Claussnitzer, Ruth J. F. Loos

{"title":"Genetic subtyping of obesity reveals biological insights into the uncoupling of adiposity from its cardiometabolic comorbidities","authors":"Nathalie Chami, Zhe Wang, Victor Svenstrup, Virginia Diez Obrero, Daiane Hemerich, Yi Huang, Hesam Dashti, Eleonora Manitta, Michael H. Preuss, Kari E. North, Louise Aas Holm, Cilius E. Fonvig, Jens-Christian Holm, Torben Hansen, Camilla Scheele, Alexander Rauch, Roelof A. J. Smit, Melina Claussnitzer, Ruth J. F. Loos","doi":"10.1038/s41591-025-03931-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03931-0","url":null,"abstract":"Obesity is a heterogeneous condition not adequately captured by a single adiposity trait. We conducted a multi-trait genome-wide association analysis using individual-level data from 452,768 UK Biobank participants to study obesity in relation to cardiometabolic health. We defined continuous ‘uncoupling phenotypes’, ranging from high adiposity with healthy cardiometabolic profiles to low adiposity with unhealthy ones. We identified 266 variants across 205 genomic loci where adiposity-increasing alleles were simultaneously associated with lower cardiometabolic risk. A genetic risk score (GRSuncoupling) aggregating these variants was associated with a lower risk of cardiometabolic disorders, including dyslipidemia and ischemic heart disease, despite higher obesity risk; unlike an adiposity score based on body fat percentage-associated variants (GRSBFP). The 266 variants formed eight genetic subtypes of obesity, each with distinct risk profiles and pathway signatures. Proteomic analyses revealed signatures separating adiposity- and health-driven effects. Our findings reveal new mechanisms that uncouple obesity from cardiometabolic comorbidities and lay a foundation for genetically informed subtyping of obesity to support precision medicine.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"15 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reinventing the eye exam with artificial intelligence 用人工智能重塑眼科检查

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-12 DOI: 10.1038/s41591-025-03968-1

引用次数: 0

Mending a mother’s mitochondrial DNA 修复母亲的线粒体DNA

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-12 DOI: 10.1038/d41591-025-00056-2

引用次数: 0

Health impacts of microplastic and nanoplastic exposure 接触微塑料和纳米塑料对健康的影响

IF 5 1区医学

Nature Medicine Pub Date : 2025-09-11 DOI: 10.1038/s41591-025-03902-5

Marja H. Lamoree, Jeske van Boxel, Federica Nardella, Kas J. Houthuijs, Sicco H. Brandsma, Frederic Béen, Majorie B. M. van Duursen

{"title":"Health impacts of microplastic and nanoplastic exposure","authors":"Marja H. Lamoree, Jeske van Boxel, Federica Nardella, Kas J. Houthuijs, Sicco H. Brandsma, Frederic Béen, Majorie B. M. van Duursen","doi":"10.1038/s41591-025-03902-5","DOIUrl":"10.1038/s41591-025-03902-5","url":null,"abstract":"As evidence demonstrating the presence of micro- and nanoplastics (MNPs) in the human body accumulates, so do concerns about their potential health impacts. Multiple factors determine the properties and behavior of MNPs—including polymer type, size, shape and the presence of a biocorona, among others—which place high demands on analytical methodology and tools for assessment of potential adverse health effects. Experimental models have shown that MNPs can cross cell barriers in the human lung and intestine and reach systemic circulation and subsequently tissues such as reproductive organs, placenta and brain. Early clinical findings indicate that MNPs may be associated with adverse health outcomes, including immune modulation, reproductive effects and cardiovascular effects. However, these studies typically suffer from low patient numbers and inadequate MNP exposure assessment, which precludes adequate risk assessment. Still, outcomes from animal and cell-based analyses generally support the preliminary clinical findings. To conduct more robust human studies, maturation of methods for exposure and effect assessment are crucial. Addressing these challenges will improve scientific research on the health impact of MNPs, which is urgently needed. There are strong indications that MNP exposure negatively impacts human health, but a robust evidence base is lacking. This Review focuses on the current state of the science, offering a critical review of the data, analytical challenges and research priorities.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"31 9","pages":"2873-2887"},"PeriodicalIF":50.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functions of the global health system in a new era 全球卫生系统在新时代的功能

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-11 DOI: 10.1038/s41591-025-03936-9

Kumanan Rasanathan, Keith Cloete, Githinji Gitahi, Octavio Gómez-Dantés, Diah Saminarsih, Soumya Swaminathan, Amirhossein Takian, John-Arne Røttingen

引用次数: 0

Reply to: Critical evaluation of the ProfiLER-02 study design and outcomes 回复：对ProfiLER-02研究设计和结果的关键评价

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-10 DOI: 10.1038/s41591-025-03960-9

Olivier Trédan, Marie-Sarah Cabrillac, Sylvie Chabaud, Gwenaelle Garin, David Pérol, Jean-Yves Blay

引用次数: 0

Association between the English National Health Service Diabetes Prevention Programme and incident multiple long-term conditions 英国国民健康服务糖尿病预防计划与事件多重长期条件之间的关系

IF 82.9 1区医学

Nature Medicine Pub Date : 2025-09-10 DOI: 10.1038/s41591-025-03922-1

Emma Barron, Paul Chappell, Izzy Hatfield, David C. D. Hope, Xiaochen Ge, Chirag Bakhai, Dominique Bradley, Ellie Bragan Turner, Rupert Dunbar-Rees, Nasrin Hafezparast, Desmond G. Johnston, Gary Wainman, Adrian Pratt, Eirion T. Slade, Edward W. Gregg, Kamlesh Khunti, Jonathan Valabhji

{"title":"Association between the English National Health Service Diabetes Prevention Programme and incident multiple long-term conditions","authors":"Emma Barron, Paul Chappell, Izzy Hatfield, David C. D. Hope, Xiaochen Ge, Chirag Bakhai, Dominique Bradley, Ellie Bragan Turner, Rupert Dunbar-Rees, Nasrin Hafezparast, Desmond G. Johnston, Gary Wainman, Adrian Pratt, Eirion T. Slade, Edward W. Gregg, Kamlesh Khunti, Jonathan Valabhji","doi":"10.1038/s41591-025-03922-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03922-1","url":null,"abstract":"Existing evaluations of the National Health Service Diabetes Prevention Programme (NHS DPP) in England have demonstrated associated reductions in body weight, hemoglobin A1c and incident type 2 diabetes (T2D). In this study, we examined associations between completion of the NHS DPP and incidence of T2D and 30 other long-term conditions (LTCs), including LTCs considered linked to the programʼs interventional goals of body weight reduction, increased physical activity and improved diet quality (LTC-L) and LTCs considered to be possibly linked to those goals (LTC-PL). We found that completers of the NHS DPP had lower incidences of T2D, LTC-L and LTC-PL compared to non-attenders. Although these associations attenuated over time, they remained significant for all outcomes at 24 months with an odds ratio of 0.53 (95% confidence interval: 0.48–0.59) for T2D and rate ratios of 0.79 (0.74–0.84) and 0.80 (0.74–0.88) for LTC-L and LTC-PL, respectively. However, we were not able to directly conclude whether lower incidence rates were a direct result of completing the NHS DPP or due to residual bias stemming from unmeasured confounding and imprecision in the estimation of diagnosis.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"44 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0