Endocrinology, Diabetes and Metabolism最新文献

{"title":"Gestational Diabetes and Long-Term Risk of Maternal Kidney Disease: Systematic Review and Meta-Analysis of Population Base Cohort Studies.","authors":"Mansour Bahardoust, Elham Rahimpour, Sheida Shokohyar, Zahra Aghakhani, Ali Delpisheh, Mohammadsadra Shamohammadi, Meisam Haghmoradi, Azin Ghaffari","doi":"10.1002/edm2.70208","DOIUrl":"https://doi.org/10.1002/edm2.70208","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) may increase the risk of maternal chronic kidney disease (CKD). The association of GDM with maternal CKD has been heterogeneous across studies, and this association remains controversial. The aim of this systematic review was to investigate the association of GDM with the risk of maternal CKD.</p><p><strong>Methods: </strong>MEDLINE/PubMed, EMBASE, Scopus and Web of Science were searched, with no time limit, up to 25 August 2025 by two independent investigators to identify studies that had assessed the association of GDM with maternal risk of CKD. Heterogeneity between studies was assessed using Cochrane's Q and I2 tests. Meta-regression was performed to identify factors associated with heterogeneity.</p><p><strong>Results: </strong>Eleven cohort studies involving 21,313,434 participants (1,530,599 (7.2%) GDM) were included. Pooled estimates from eleven studies showed that GDM was significantly associated with an increased risk of maternal CKD (HR: 2.19; 95% CI: 1.7, 2.68; p: 0.001, I²:92.2%). Further analyses restricted to studies adjusting for key confounders (HR: 2.47; 95% CI: 1.87, 3.08; p: 0.001, I2:24.2%) also showed a significant association. While pooled estimates from three studies did not show a significant association between GDM and an increased risk of AKI (HR: 1.1; 95% CI: 0.94, 1.26). Subgroup analyses showed that GDM was significantly associated with an increased risk of maternal CKD in both DM + (HR: 6.24) and DM - (HR: 1.4).</p><p><strong>Conclusion: </strong>Gestational diabetes mellitus (GDM) with and without DM was significantly associated with an increased risk of maternal CKD. GDM with DM had a synergistic effect on maternal CKD risk. Although GDM was not significantly associated with increased AKI, only three studies were included in the AKI analysis, which may have affected these results by random error and therefore lack sufficient power and evidence to draw conclusions.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70208"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preterm Birth Increases Susceptibility to Hyperglycemia-Induced Kidney Injury With Sex-Specific Differences in Structural and Molecular Responses.","authors":"Rachel K Dailey, Aleksandra Cwiek, Logan C Hamil, Sage Timberline, Ayyappa Kumar Sista Kameshwar, Masako Suzuki, Jaya Isaac, Kimberly deRonde, Mark Conaway, Kevin M Bennett, Edwin J Baldelomar, Matthew R Hoch, Kimberly J Reidy, Jennifer R Charlton","doi":"10.1002/edm2.70223","DOIUrl":"10.1002/edm2.70223","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth increases the long-term risk of diabetes and chronic kidney disease (CKD), yet its impact on diabetic kidney disease (DKD) is unclear. We previously showed that male preterm mice with diabetes develop early features of DKD, including reduced podocyte density, decreased renin expression, activation of angiogenesis pathways, and impaired endothelial-podocyte signaling. Here, we examine whether preterm birth similarly accelerates DKD progression in female mice and compare structural and transcriptomic outcomes in the females to the prior male cohort to assess sex-specific differences.</p><p><strong>Methods: </strong>Preterm mice were delivered by Caesarean section at 19 days post conception (dpc) and term mice at 20 dpc. Hyperglycemia was induced at 6 weeks with streptozotocin to generate term-diabetic (T-D) and preterm-diabetic (PT-D) groups; controls were term-nondiabetic (T-ND) and preterm-nondiabetic (PT-ND). Body weight and glucose were monitored, and kidneys were analyzed at 18 weeks using histologic, stereologic, imaging, and transcriptomic methods.</p><p><strong>Results: </strong>Compared with T-ND females, PT-D females showed higher albuminuria, more atubular glomeruli, reduced proximal tubule (PT) fraction, and pro-fibrotic gene activation. Compared to T-D females, PT-D females had higher blood urea nitrogen (BUN) levels and reduced PT fraction. This was associated with activation of pathways associated with the vasculature and suppression of mitochondrial metabolism gene pathways, along with Notch signalling alterations. Sex differences included a lower PT fraction in preterm females than males and fewer atubular glomeruli in PT-D females than PT-D males. Renin expression was lower in PT-D than T-D in males only. When comparing PT-D to T-D across sexes, 582 differentially expressed genes were unique to females. Notch signalling was upregulated in both male and female PT-D mice compared to T-D.</p><p><strong>Conclusion: </strong>Preterm birth increases susceptibility to kidney injury in females after exposure to hyperglycemia. However, preterm females with hyperglycemia are more resistant to kidney damage than males.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70223"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable Home-Use Triglyceride Meter Demonstrates Good Agreement With Plasma Laboratory Measures During Pregnancies Complicated by Metabolic Disease.","authors":"S S Farabi, L A Barbour, E Z Dunn, C Ingram, E Lopez, J Hinojosa, E Phillips, N Hirsch, K Rolloff, S Pierce, J E Friedman, T L Hernandez","doi":"10.1002/edm2.70237","DOIUrl":"https://doi.org/10.1002/edm2.70237","url":null,"abstract":"<p><strong>Background: </strong>Fasting and postprandial triglycerides (PPTG) in obese pregnancies may be stronger predictors of fetal overgrowth than glucose, making them a potential novel treatment target. Measurement of TG currently requires venipuncture in a laboratory, a barrier to collecting repeated measures to understand contributions to fetal growth. Our aim was to evaluate agreement between fingerstick capillary TG using an FDA-approved point-of-care (POC) meter and venipuncture plasma TG (vTG) during fasting and controlled fed conditions within pregnant women.</p><p><strong>Methods: </strong>Pregnant patients (n = 35) with obesity alone (59%) or GDM (41%) (BMI 33 ± 4 kg/m²) had fasting vTG and POC TG collected, within ≤ 5 min apart at 25 ± 9 weeks' gestation. A subset (n = 23) had PPTG collected at 1- and 2-h after a controlled breakfast test meal (35 ± 2 weeks). Two-way mixed effects intraclass correlations (ICC) and Bland-Altman plots determined agreement. Paired t-tests were used to compare vTG and POC TG (mean ± SD).</p><p><strong>Results: </strong>Sixty-eight paired fasting TG and 52 paired 1- and 2-h PPTG were collected. Fasting vTG were slightly lower than POC TG (181 ± 66 vs. 192 ± 81 mg/dL), as were 1-h (225 ± 65 vs. 260 ± 76) and 2-h PPTG (227 ± 70 vs. 249 ± 77; p < 0.05 all). The ICC for fasting TG was 0.86 [95% CI: 0.78, 0.91] and 0.84 [95% CI: 0.32, 0.94] for PPTG. The mean % difference (vTG minus POC TG) was -4.6% ± 17.8% for fasting TG and -12.0% ± 12.0% for PPTG.</p><p><strong>Discussion/conclusion: </strong>These data suggest good agreement between vTG and POC TG in fasting and PPTG during pregnancies complicated by obesity and GDM. Our findings support the novel approach to utilising a POC TG meter, similar to a glucometer, to conveniently discern the contribution of TG and their potential targets in optimising fetal growth in pregnant patients with obesity and GDM.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70237"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Macronutrient Ordering on Postprandial Glycaemic Control in Diabetes: A Systematic Review.","authors":"Rebecca McKenzie, Charlotte Sterling, Hannah O'Hara, Jayne Woodside","doi":"10.1002/edm2.70228","DOIUrl":"https://doi.org/10.1002/edm2.70228","url":null,"abstract":"<p><strong>Aims: </strong>This systematic review aims to investigate if macronutrient ordering is effective at lowering postprandial glucose excursions in individuals with diabetes.</p><p><strong>Methods: </strong>A systematic search of Medline, Embase and Web of Science was conducted up to February 2025. Two independent reviewers screened title and abstract using Covidence software. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second reviewer. Findings were synthesized narratively. PROSPERO registration: CRD42025639742.</p><p><strong>Results: </strong>In total, we included six studies involving 144 participants. Most studies reported that a carbohydrate last meal pattern was effective at lowering postprandial glucose excursions in individuals with diabetes. There was some evidence for the carbohydrate last meal pattern lowering insulin levels and increasing GLP-1 and GIP levels in individuals with diabetes. The risk of bias ranged from low to some concerns, and the GRADE assessment showed a low certainty of evidence.</p><p><strong>Conclusions: </strong>Evidence suggests that the carbohydrate last meal pattern effectively reduces postprandial glucose excursions in individuals with diabetes. However, significant heterogeneity in study design limits overall certainty in the findings. Further research is needed to confirm these effects.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70228"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Shortcomings in a Study of Peripheral Circulatory Complications in Type 2 Diabetes.","authors":"Ahmar Jan Qureshi, Muhammad Riyyan Tariq Tagga, Raghabendra Kumar Mahato","doi":"10.1002/edm2.70230","DOIUrl":"https://doi.org/10.1002/edm2.70230","url":null,"abstract":"<p><strong>Introduction: </strong>This critique examines the methodological quality of a recent study by Shahid et al. on mortality trends related to peripheral circulatory complications in patients with type 2 diabetes mellitus using the CDC WONDER database.</p><p><strong>Methods: </strong>We critically appraised the original study's methodology, including the consistency of reported mortality rates, age group data presentation, classification of urban and rural areas, reporting of race and ethnicity data, place of death analysis and causal inferences drawn from the ecological design.</p><p><strong>Results: </strong>Several methodological shortcomings were identified: inconsistent reporting of mortality rate denominators (per 100,000 vs. per 1,000,000 population); selective reporting of age group data in the main text; use of a non-standard threshold (500,000 population) for classifying urban and rural areas; inconsistent use of the 'Non-Hispanic' qualifier for race and ethnicity categories; percentages summing to over 100% in the place of death analysis; and unsupported causal claims in the discussion.</p><p><strong>Conclusions: </strong>While the original study addresses an important public health concern, the identified methodological issues limit the interpretability of its findings. Addressing these concerns through consistent denominators, complete age-stratified reporting and standard classifications would strengthen future research in this area.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70230"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor Glycemic Control in East Africa: Prevalence, Risk Factors and Public Health Implications in Diabetes Management.","authors":"Fanny Eseohe Onohuean, Mary Onohuean, Haron Olot, Hope Onohuean","doi":"10.1002/edm2.70233","DOIUrl":"https://doi.org/10.1002/edm2.70233","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus remains a major public health concern in East Africa, and poor glycaemic control continues to drive avoidable complications, deaths and pressure on already stretched health systems.</p><p><strong>Objective: </strong>To estimate the prevalence of poor glycemic control and describe the main factors associated with it among people living with diabetes in East Africa.</p><p><strong>Methods: </strong>This review synthesized evidence from observational studies, cross-sectional surveys and regional health databases identified through PubMed, Scopus and Web of Science, following PRISMA guidance. Sociodemographic, clinical and behavioural indicators were examined to identify common patterns and predictors of poor glycaemic control. The review also considered how measurement approaches shaped reported estimates.</p><p><strong>Results: </strong>Fifty records were identified across PubMed (10), Scopus (23) and Web of Science (17). After screening, 37 records were eligible for full-text review, and 15 studies met the inclusion criteria for evidence synthesis. Across the region, poor glycemic control was consistently high, ranging from 60% to 85%. Most studies were facility-based and cross-sectional. Glycemic control was assessed mainly using HbA1c, commonly defined as ≥ 7% or > 7.5%, and less frequently by fasting blood glucose, typically ≥ 7.2 mmol/L or > 130 mg/dL. Type 2 diabetes was the dominant population studied, with fewer mixed cohorts and only one study focused on type 1 diabetes. Factors repeatedly linked to poor control included older age, longer duration of diabetes, poor medication adherence, limited access to care, low health literacy, inadequate diabetes education, insulin use, comorbidities, diabetic complications, unhealthy diet, physical inactivity, sedentary behaviour, substance use and limited self-management support.</p><p><strong>Conclusion: </strong>Poor glycemic control is alarmingly common among people with diabetes in East Africa and reflects intertwined clinical, behavioural and health-system challenges. Region-specific strategies are needed to strengthen primary care, improve diabetes education, expand affordable monitoring and treatment and enhance surveillance to guide policy and resource allocation.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70233"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycaemia Risk Prediction Models for Type 2 Diabetes: A Systematic Review and Meta-Analysis.","authors":"Yiwen Wei, Yu Liu, Jingwen Bo, Xiaoyan Bai","doi":"10.1002/edm2.70227","DOIUrl":"10.1002/edm2.70227","url":null,"abstract":"<p><strong>Background: </strong>The growing number of hypoglycaemia risk prediction models for Type 2 diabetes mellitus (T2DM) underscores the need for systematic evaluation of their risk of bias and applicability. This study summarises and critically assesses their characteristics and predictive performance using established guidelines for prediction model development.</p><p><strong>Methods: </strong>The review protocol was registered on PROSPERO (CRD420251031980). We searched nine main English and Chinese databases from inception to May 2025. The CHARMS checklist and PROBAST tool were used to assess the risk of bias and applicability. A meta-analysis of AUC values from models was conducted using MedCalc software.</p><p><strong>Results: </strong>We included 25 studies (45 models), with reported AUCs ranging from 0.630 to 0.996. The pooled AUC value of 16 models was 0.815 (95% CI 0.765-0.861), indicating excellent discrimination. 24 (96%) studies were overall at high risk of bias and 22 (88%) studies had low-risk applicability, primarily due to small sample size, improper handling of missing data, failure to report calibration, screening of predictors by univariate analysis and lack of external validation.</p><p><strong>Conclusions: </strong>Current hypoglycaemia prediction models for T2DM show substantial methodological limitations and high bias risk. While machine learning models have advanced rapidly in recent years, their methodology remains opaque and validation is limited. Future research should focus on optimising existing models, enhancing methodological rigour and conducting external validation.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70227"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tirzepatide as Adjunct to Insulin in Adults With Type 1 Diabetes and Overweight or Obesity: A Systematic Review of Randomized and Real-World Evidence.","authors":"Giuseppina Alessia Acucella, Danilo Caponio","doi":"10.1002/edm2.70225","DOIUrl":"10.1002/edm2.70225","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity are increasingly common in adults with type 1 diabetes (T1D), contributing to insulin resistance, higher insulin requirements, and greater cardiometabolic burden. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has shown major metabolic benefits in type 2 diabetes and obesity, but its role in T1D remains unclear. This systematic review evaluated tirzepatide as adjunctive therapy to insulin in adults with T1D and overweight or obesity.</p><p><strong>Methods: </strong>This review followed PRISMA 2020 and was registered in PROSPERO (CRD420261335230). PubMed/MEDLINE, Embase, Scopus, Web of Science Core Collection, and ClinicalTrials.gov were searched from inception to March 1, 2026. Eligible studies included randomized and observational studies reporting efficacy or safety outcomes of tirzepatide added to insulin in adults with T1D. Because of marked clinical and methodological heterogeneity, findings were synthesized qualitatively without meta-analysis, and certainty of evidence was assessed using a GRADE-based framework.</p><p><strong>Results: </strong>Eight studies were included: one small 12-week phase 2 randomized placebo-controlled trial and seven observational studies, most at serious risk of bias. The most consistent finding was body weight reduction. In the randomized trial, tirzepatide reduced mean body weight by 10.3 kg, with an estimated treatment difference of 8.7 kg versus placebo, corresponding to an 8.8% reduction from baseline. A placebo-adjusted 35.1% reduction in total daily insulin dose and a between-group HbA1c difference of -0.4 percentage points were also reported, although glycaemic findings were short-term and imprecise. Gastrointestinal adverse events were the most frequent safety findings. Evidence certainty was low or very low.</p><p><strong>Conclusions: </strong>Tirzepatide may be a promising investigational adjunct in selected adults with T1D and overweight or obesity, particularly for weight reduction. However, current evidence remains insufficient to establish durable glycaemic benefit or long-term safety. Larger randomized trials are needed.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70225"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olezarsen in Hypertriglyceridemia With High Cardiac Risk: A GRADE-Assessed Meta-Analysis of Randomized Trials With Trial Sequential Evidence.","authors":"Ahmed Emara, Ameer Awashra, Heba Aboeldahab, Ahmed Farid Gadelmawla, Hamza A Abdul-Hafez, Abdullah M Alharran, Amal A Alsubaiei, Muneera Jasim AlRumaihi, Sara Ahmed Albuhmaid, Abdalhakim Shubietah","doi":"10.1002/edm2.70220","DOIUrl":"10.1002/edm2.70220","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia is a widely prevalent disorder of lipid metabolism that increases the risk of cardiovascular disease and pancreatitis, and it often remains difficult to control even with standard treatments. Olezarsen, an antisense oligonucleotide that targets apolipoprotein C-III (ApoC-III), offers a new and promising option for lowering triglyceride levels.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and Cochrane was conducted through September 2025 to identify randomized controlled trials (RCTs) comparing olezarsen with placebo in adults with hypertriglyceridemia at high cardiovascular risk. Dichotomous outcomes were analysed as risk ratios (RRs) and continuous outcomes as percentage mean differences (MDs), both with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Four RCTs (n = 1615 patients) were included. Olezarsen significantly reduced triglycerides (MD -47.71%, 95% CI -56.78 to -38.64, p < 0.0001), non-HDL-C (MD -22.11%, 95% CI -28.48 to -15.75, p < 0.0001), ApoC-III (MD -68.93%, 95% CI -77.54 to -60.31, p < 0.0001), VLDL-C (MD -48.52%, 95% CI -57.16 to -39.87, p < 0.0001), and ApoB (MD -10.67%, 95% CI -16.83 to -4.51, p = 0.0007), while increasing HDL-C (MD 35.13%, 95% CI -27.30 to -42.96, p < 0.0001). LDL-C showed no significant change. The risks of any or serious adverse events were comparable to placebo. Olezarsen was associated with fewer acute pancreatitis events (p = 0.035) but higher rates of liver enzyme elevations ≥ 3× ULN (p = 0.046).</p><p><strong>Conclusions: </strong>Olezarsen demonstrated consistent improvements in triglycerides and other atherogenic lipid parameters with an overall acceptable safety profile. These findings suggest that olezarsen may be a useful adjunct option for patients with persistent hypertriglyceridemia despite standard therapy. Further large-scale and long-term studies are needed to confirm its cardiovascular and safety outcomes.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70220"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Diabetic Foot Ulcer Outcomes: Machine Learning-Based Refinement of IWGDF-Approved Classifications for Outpatient Services.","authors":"Farideh Mostafavi, Mohammad Reza Amini, Yadollah Mehrabi, Melina Rezvani, Mehrangiz Toutounchi, Seyed Saeed Hashemi Nazari","doi":"10.1002/edm2.70193","DOIUrl":"10.1002/edm2.70193","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to validate and compare six IWGDF-approved classification systems for predicting poor prognostic outcomes in diabetic foot ulcers (DFUs), using the same sample in Iran. We also proposed modifications to enhance the performance and feasibility of these tools, in outpatient setting.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving 616 DFUs from 400 patients over a six-month period. We assessed the performance of six wound classification systems: Wagner, UTWCS, PEDIS/IDSA, SINBAD, WIFI, and DiaFORA. We adjusted for the key variables associated with poor outcomes that could affect the performance of these systems, employing ten machine learning techniques along with the Least Absolute Shrinkage and Selection Operator (LASSO) and random forest methods for feature selection methods.</p><p><strong>Results: </strong>Our findings indicated that both the SINBAD and UTWCS systems exhibited comparable effectiveness in predicting outcomes, significantly surpassing other systems. Notably, modifications to the WIFI system-specifically, redefining the wound depth classification to a clearer category-yielded improved predictive capabilities, outperforming the existing systems like SINBAD and UTWCS in predicting poor prognostic outcomes in outpatient setting.</p><p><strong>Conclusion: </strong>SINBAD and UTWCS systems yield the best performance in our samples. Our proposed modification on the WIFI system can enhance its applicability for outpatient services according to reported performances.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":"e70193"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}