Journal of Diabetes Investigation最新文献

{"title":"Association of glucagon-like peptide-1 receptor agonist use with clinical outcomes in patients with rheumatoid arthritis and type 2 diabetes.","authors":"Yu-Ting Yu, Ying Chun Lee, Yu-Wei Fang, Wen-Hui Hsieh, Ming-Hsien Tsai","doi":"10.1111/jdi.70281","DOIUrl":"10.1111/jdi.70281","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with improved survival and renal outcomes in patients with rheumatoid arthritis and type 2 diabetes, a population at high cardiometabolic risk.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study using an active-comparator, new-user design within the TriNetX US Collaborative Network. Adults with rheumatoid arthritis and type 2 diabetes initiating GLP-1 RAs or dipeptidyl peptidase-4 inhibitors (DPP-4is) between 2016 and 2023 were included. The primary outcome was all-cause mortality; secondary outcomes were major adverse cardiovascular events (MACE), major adverse kidney events (MAKE), and all-cause hospitalization. Hazard ratios (HRs) were estimated using Cox regression after 1:1 propensity score matching.</p><p><strong>Results: </strong>A total of 4,607 patients per group were followed for up to 4 years. GLP-1 RA use was associated with lower all-cause mortality (HR 0.68; 95% confidence intervals (CI), 0.58-0.80), reduced MAKE (HR 0.89; 95% CI, 0.82-0.97), and fewer hospitalizations (HR 0.92; 95% CI, 0.86-0.98), compared with DPP-4is. No significant difference was observed for MACE (HR 0.96; 95% CI, 0.89-1.04). Results were consistent across prespecified subgroups and sensitivity analyses.</p><p><strong>Conclusions: </strong>In patients with rheumatoid arthritis and type 2 diabetes, GLP-1 RA therapy was associated with 32% lower mortality, 11% fewer kidney events, and 8% fewer hospitalizations vs DPP-4is. These findings support GLP-1 RAs as a promising therapeutic option for this high-risk population.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"766-780"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight from polygenic modifiers in Asian monogenic diabetes.","authors":"Pei-Ying Kao, Wayne Huey Herng Sheu","doi":"10.1111/jdi.70289","DOIUrl":"10.1111/jdi.70289","url":null,"abstract":"<p><p>A Proposed Translation Roadmap for Asia Diabetes Individuals.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"713-715"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor in Response to \"A novel index for diagnosis of type 2 diabetes mellitus: Cholesterol, high density lipoprotein, and glucose (CHG) index\".","authors":"Ying Li, Lei Jin","doi":"10.1111/jdi.70269","DOIUrl":"10.1111/jdi.70269","url":null,"abstract":"","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"897"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of renal function on antidiabetic drug selection in Japan: A real-world analysis using the J-DREAMS database.","authors":"Masashi Kubota, Mitsuru Ohsugi, Kohjiro Ueki","doi":"10.1111/jdi.70280","DOIUrl":"10.1111/jdi.70280","url":null,"abstract":"<p><strong>Aims: </strong>To describe renal function-specific prescribing patterns of antidiabetic drugs in Japanese patients with type 2 diabetes using real-world data and to identify selection trends up to the second therapy.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed data from the J-DREAMS registry (2015-2023) to evaluate the proportions of first and second drug classes stratified by renal function (eGFR ≥60 vs <60 mL/min/1.73 m²) and to examine temporal changes across registration periods. Prescription proportions by renal function were also compared using propensity score matching.</p><p><strong>Results: </strong>Among 24,868 patients, 36.1% had an eGFR <60 mL/min/1.73 m². DPP-4 inhibitors were the most common first agents regardless of renal function, followed commonly by metformin and insulin. The use of SGLT2 inhibitors and GLP-1 receptor agonists increased as second-line therapies; in more recent periods, SGLT2 inhibitors were most frequently selected in the normal renal function group (25.6%), while GLP-1 receptor agonists ranked third in the reduced renal function group (15.9%). After matching, prescription proportions of SGLT2 inhibitors were similar between groups, whereas sulfonylureas (SUs), metformin, and thiazolidinediones were less frequent in the reduced renal function group.</p><p><strong>Conclusions: </strong>Prescribing patterns in Japan have shifted toward earlier use of SGLT2 inhibitors and GLP-1 receptor agonists, with medications appropriately tailored to renal function.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"801-809"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of renal histological diagnosis in patients with type 2 diabetes and proteinuria atypical for diabetic nephropathy.","authors":"Shogo Kuwagata, Masami Chin-Kanasaki, Aki Yamada, Tomonori Sakae, Nahomi Ishimoto, Yoshimi Imamura-Uehara, Kosuke Yamahara, Mako Yasuda-Yamahara, Sho Sugahara, Yuki Tanaka-Sasaki, Natsumi Kuwata, Kimihiro Nishimura, Koichiro Murata, Itsuko Miyazawa, Shogo Ida, Natsuko Ohashi, Shinji Kume","doi":"10.1111/jdi.70277","DOIUrl":"10.1111/jdi.70277","url":null,"abstract":"<p><strong>Background/aim: </strong>Most patients with proteinuria are considered to have typical diabetic nephropathy (DN). However, when proteinuria occurs without diabetic retinopathy, with hematuria, or persists despite strict glycemic and blood pressure control, it is considered atypical for DN and warrants further evaluation for non-DN via kidney biopsy. Nevertheless, comprehensive information on renal histopathology and prognosis following kidney biopsy remains limited. This study aimed to clarify these issues through a retrospective analysis.</p><p><strong>Methods: </strong>Among 490 patients who underwent kidney biopsy at Shiga University of Medical Science Hospital between 2013 and 2024, 51 Japanese patients with type 2 diabetes who met at least one criterion for proteinuria atypical for DN were included. Pre- and post-biopsy changes in proteinuria levels and eGFR decline rate, as well as renal histology, were analyzed.</p><p><strong>Results: </strong>Among the 51 patients, 17 (33.3%) were histologically diagnosed with typical DN, whereas 34 (66.7%) were diagnosed with non-DN, including membranous nephropathy, immunoglobulin A (IgA) nephropathy, renal sclerosis, interstitial nephritis, vasculitis, and others. Compared with the DN group, patients with non-DN were significantly older and had a lower prevalence of diabetic retinopathy. Additionally, the non-DN group showed significant improvements in both proteinuria levels and in the eGFR decline following biopsy and appropriate disease-specific therapy.</p><p><strong>Conclusion: </strong>A kidney biopsy identified a wide range of kidney diseases as the underlying causes of atypical proteinuria in DN, particularly in elderly patients, thereby improving renal outcomes. These findings underscore the clinical importance of heightened awareness of atypical proteinuria in diabetes management, particularly in aging populations.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"781-790"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LIN28A blocks the EndMT process of high glucose-induced HRMECs by stabilizing SIRT6 mRNA.","authors":"Xueying Wang, Zixu Huang, Xiaohui Kuang, Yali Nan, Zhiwen Zhang, Zongming Song","doi":"10.1111/jdi.70284","DOIUrl":"10.1111/jdi.70284","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a microvascular condition resulting from microangiopathy, causing gradual retinal damage and potential blindness. Endothelial-mesenchymal transition (EndMT) serves an important function in DR development. Exploring the molecular mechanism of EndMT in DR is needed.</p><p><strong>Methods: </strong>Human retinal microvascular endothelial cells (HRMECs) were incubated with high glucose (HG) to induce an in vitro DR model. Lentivirus and small-interfering RNAs were used to construct SIRT6 and LIN28A overexpression or knockdown in HRMECs, respectively. AMPK inhibitor, compound C, was used to block AMPK signaling in HRMECs. α-SMA and PECAM1 levels were identified using immunofluorescence. CCK8 and transwell were used to detect cell viability and migration, respectively. The mRNA stability of SIRT6 was analyzed after HRMECs were exposed to actinomycin D. RNA immunoprecipitation was applied to verify the binding relationship between LIN28A and SIRT6 mRNA in HRMECs.</p><p><strong>Results: </strong>In HG-induced HRMECs, the cells undergo the EndMT process, and SIRT6 levels are downregulated. HG treatment reduced the level of p-AMPK in HRMECs, and compound C reversed the inhibition of SIRT6 overexpression on EndMT in HG-induced HRMECs. By binding to SIRT6 mRNA, LIN28A could enhance SIRT6 mRNA stability. Additionally, LIN28A overexpression inhibited EndMT in HG-induced HRMECs, which was reversed by SIRT6 knockdown.</p><p><strong>Conclusion: </strong>The stabilization of SIRT6 mRNA by LIN28A activated AMPK signaling, inhibiting the EndMT process in HRMECs caused by HG.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"739-750"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between the neutrophil-to-lymphocyte ratio and enlarged perivascular spaces in type 2 diabetes mellitus.","authors":"Wei Zhang, Zhen Wang, Yaping Sun, Shaofeng Xu, Lei Zhu, Xiaolei Li","doi":"10.1111/jdi.70278","DOIUrl":"10.1111/jdi.70278","url":null,"abstract":"<p><strong>Aims: </strong>To determine the relationship between the neutrophil-to-lymphocyte ratio and enlarged perivascular spaces in patients with type 2 diabetes mellitus.</p><p><strong>Materials and methods: </strong>Cranial magnetic resonance imaging data from 200 patients with type 2 diabetes mellitus were analyzed to categorize enlarged perivascular spaces in the basal ganglia and centrum semiovale (CSO) by severity. Mild and moderate-to-severe enlarged perivascular spaces groups were compared.</p><p><strong>Results: </strong>The neutrophil-to-lymphocyte ratio (NLR) was notably elevated in the moderate-to-severe group compared with the mild group, for both basal ganglia (BG) (P < 0.01) and CSO (P < 0.01) enlarged perivascular spaces. Spearman analyses demonstrated strong positive correlations between the NLR and the severity of both BG (r = 0.545, P < 0.001) and CSO (r = 0.440, P < 0.001) enlarged perivascular spaces. Binary logistic regression analysis identified the NLR as an independent risk factor for BG (P < 0.01) and CSO (P < 0.01) enlarged perivascular spaces in patients with type 2 diabetes mellitus. Receiver operating characteristic curve analysis demonstrated that the NLR had an area under the curve of 0.824 for predicting moderate-to-severe BG enlarged perivascular spaces and 0.768 for predicting moderate-to-severe CSO enlarged perivascular spaces.</p><p><strong>Conclusions: </strong>The NLR independently predicts moderate-to-severe BG and CSO enlarged perivascular spaces in patients with type 2 diabetes mellitus and exhibits diagnostic accuracy for cerebral small vessel disease.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"844-850"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of CXCL10 in high-fat diet-induced skeletal muscle inflammation and atrophy.","authors":"An Liyuan, Yu Hirata, Tomoya Inoue, Kenji Sugawara, Wataru Ogawa","doi":"10.1111/jdi.70270","DOIUrl":"10.1111/jdi.70270","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Obesity is often accompanied by skeletal muscle atrophy, which aggravates insulin resistance and metabolic dysfunction. Chronic inflammation is implicated in this process, but the molecular mediators linking obesity-induced inflammation to muscle wasting have remained unclear. We investigated the role of the chemokine CXCL10 in skeletal muscle inflammation and atrophy induced by a high-fat diet (HFD).</p><p><strong>Materials and methods: </strong>Male C57BL/6J mice were fed an HFD or normal diet for 2 weeks and received either neutralizing antibodies to CXCL10 or control immunoglobulin G. Muscle morphology, macrophage infiltration, and gene expression were examined by histology, immunohistochemistry, reverse transcription-quantitative polymerase chain reaction analysis, and RNA sequencing. Cultured C2C12 myotubes were also treated with recombinant CXCL10 or lipopolysaccharide (LPS), with or without antibodies to CXCL10, for assessment of direct effects on myotube atrophy.</p><p><strong>Results: </strong>HFD feeding upregulated Cxcl10 expression in skeletal muscle. It also induced fiber atrophy, macrophage infiltration, and increased expression of individual inflammation- or proteolysis-related genes in muscle, with these effects being attenuated by CXCL10 neutralization. Transcriptomic analysis further revealed a broad reversal of HFD-induced changes in gene expression related to protein catabolism and myofiber structure by anti-CXCL10 administration. Both CXCL10 and LPS reduced myotube diameter and increased expression of catabolism- or inflammation-related genes in cultured C2C12 myotubes, whereas CXCL10 blockade prevented these effects of LPS.</p><p><strong>Conclusions: </strong>CXCL10 mediates HFD-induced skeletal muscle atrophy by promoting inflammation and proteolysis. CXCL10 neutralization mitigates such muscle loss and may represent a novel therapeutic strategy to preserve skeletal muscle mass under metabolic stress.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"719-728"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregabalin efficacy in painful diabetic peripheral neuropathy: A focused analysis of optimal dosing and the relationship of baseline glycemic control.","authors":"Ashish Bajaj, Gordon Sloan, Chris Walker, Egbert Biesheuvel, Sagar Suresh Kumbhar, Gavin Lyndon, Solomon Tesfaye","doi":"10.1111/jdi.70288","DOIUrl":"10.1111/jdi.70288","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic neuropathy, the most common long-term complication of diabetes, frequently presents as painful diabetic peripheral neuropathy (pDPN), significantly impairing patients' quality of life. Pregabalin is an established treatment for pDPN, but optimal dosing and the influence of glycemic control on efficacy remain uncertain.</p><p><strong>Aims: </strong>To evaluate (1) the efficacy of different pregabalin doses for pDPN, and (2) the impact of baseline glycemic control, measured by glycosylated hemoglobin levels (HbA1c), on pregabalin's efficacy in reducing pain score.</p><p><strong>Methods: </strong>Data from three randomized, double-blind, placebo-controlled trials involving 729 pDPN patients were pooled. Of these, 477 received pregabalin (75, 150, 300, or 600 mg/day) and 252 received placebo over 5-8 weeks. Pain scores were recorded at baseline, weekly, and at the endpoint. Patients were stratified by HbA1c: ≤8% (n = 377) and >8% (n = 346). Analysis of covariance (ancova) assessed changes in endpoint pain scores; MMRM evaluated changes over time.</p><p><strong>Results: </strong>Pregabalin 300 mg/day and 600 mg/day significantly reduced mean pain scores versus placebo (P < 0.0001), while 75 mg/day and 150 mg/day did not. In HbA1c subgroups, pregabalin maintained efficacy at 300 mg/day and 600 mg/day regardless of baseline glycemic control. Among patients with HbA1c ≤8%, pain reductions versus placebo were -1.69 and -1.71 for the 300 mg/day and 600 mg/day groups, respectively (P < 0.0001). In patients with HbA1c >8%, reductions were -1.04 and -1.09 (P ≤ 0.001), demonstrating efficacy independent of glycemic control.</p><p><strong>Conclusions: </strong>Pregabalin at 300 and 600 mg/day provides significant pain relief in pDPN, regardless of HbA1c levels, supporting dose optimization to achieve maximal benefit.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"827-834"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of low-grade albuminuria and triple-line pattern as markers of early peripheral vascular remodeling in adolescents with type 1 diabetes.","authors":"Jung-Chi Hsu, Fu-Sung Lo, Jiann-Shing Jeng, Wen-Yu Tsai, Sandy Huey-Jen Hsu, Hsiang Yang, Tien-Jyun Chang, Ta-Chen Su","doi":"10.1111/jdi.70283","DOIUrl":"10.1111/jdi.70283","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with type 1 diabetes (T1D) face premature atherosclerosis, but standard carotid intima-media thickness (IMT) may lack sensitivity for the earliest vascular injuries. Since urinary albumin-to-creatinine ratio (UACR) reflects systemic endothelial dysfunction, we investigated the triple-line pattern (TLP) as a marker of peripheral remodeling and its dose-response relationship with low-grade albuminuria.</p><p><strong>Methods: </strong>The Subclinical Cardiovascular Disease in Type 1 Diabetes Mellitus (SCVD T1DM) cohort study prospectively recruited 283 adolescents with T1D and 106 age- and sex-matched controls. IMT was measured at the common carotid artery and common femoral artery (CFA) using high-resolution ultrasound. Logistic regression tested categorical UACR thresholds, and restricted cubic spline models evaluated the continuous dose-response association between UACR and TLP.</p><p><strong>Results: </strong>TLP prevalence was higher in type 1 diabetes than in controls (63.9% vs 49.1%, P = 0.008). While type 1 diabetes was associated with carotid thickening, TLP was linked to structural changes in the lower extremities. TLP-positive participants had greater mean CFA IMT (0.56 ± 0.06 vs 0.44 ± 0.06 mm, P < 0.001). UACR ≥15 mg/g independently predicted TLP (odds ratio 2.83, 95% confidence interval 1.01-7.92, P = 0.048), whereas UACR ≥30 mg/g was not significant. Spline analysis showed no significant nonlinearity (P for nonlinearity = 0.424), with risk increasing above approximately 15 mg/g.</p><p><strong>Conclusions: </strong>TLP is a prevalent marker of incipient peripheral vascular remodeling in adolescents with type 1 diabetes without macroalbuminuria. A UACR ≥15 mg/g identifies subclinical vascular risk below conventional thresholds, supporting TLP as a potential tool for refined early risk stratification in this population.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":"835-843"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}