Endocrinology, Diabetes and Metabolism最新文献

{"title":"The Role of Serum Free Fatty Acids in Endothelium-Dependent Microvascular Function","authors":"Alexander E. Sullivan,&nbsp;Meaghan C. S. Courvan,&nbsp;Aaron W. Aday,&nbsp;David H. Wasserman,&nbsp;Kevin D. Niswender,&nbsp;Emily M. Shardelow,&nbsp;Emily K. Wells,&nbsp;Quinn S. Wells,&nbsp;Matthew S. Freiberg,&nbsp;Joshua A. Beckman","doi":"10.1002/edm2.70031","DOIUrl":"10.1002/edm2.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elevated serum free fatty acid (FFA) concentration is associated with insulin resistance and is a hallmark of metabolic syndrome. A pathological feature of insulin resistance is impaired endothelial function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the effect of FFA reduction with either acipimox, a nicotinic acid derivative that impairs lipolysis, or salsalate, a salicylate that reduces basal and inflammation-induced lipolysis, on insulin-mediated endothelium-dependent vasodilation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a post hoc, combined analysis of two randomised, double-blind, placebo-controlled crossover trials. Sixteen subjects were recruited (6 with metabolic syndrome and 10 controls) and randomised to acipimox 250 mg orally every 6 h for 7 days or placebo. Nineteen subjects were recruited (13 with metabolic syndrome and 6 controls) and randomised to receive salsalate 4.5 g/day for 4 weeks or placebo. The primary outcome was the association between FFA concentration and insulin-mediated vasodilation, measured by venous-occlusion strain-gauge plethysmography at baseline and following FFA modulation with the study drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, FFA concentration (<i>R</i> = −0.35, <i>p</i> = 0.043) and insulin sensitivity (HOMA-IR: <i>R</i> = −0.42, <i>p</i> = 0.016, Adipo-IR: <i>R</i> = −0.39, <i>p</i> = 0.025) predicted insulin-mediated vasodilation. FFA levels were significantly reduced after drug pretreatment (0.604 vs. 0.491 mmol/L, <i>p</i> = 0.036) while insulin levels, insulin sensitivity and inflammatory markers were unchanged. Despite a reduction in circulating FFA with drug therapy, neither insulin-stimulated vasodilation nor insulin sensitivity improved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Short-term reduction of FFA concentration does not improve insulin-stimulated vasodilation in patients with metabolic syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT00759291 and NCT00760019 (formerly NCT00762827)</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071194","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":"Association of Albumin-To-Creatinine Ratio With Diabetic Retinopathy Among US Adults (NHANES 2009–2016)","authors":"Han Dai,&nbsp;Ling Liu,&nbsp;Weiwei Xu","doi":"10.1002/edm2.70029","DOIUrl":"10.1002/edm2.70029","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study investigates the relationship between the albumin-to-creatinine ratio and diabetic retinopathy (DR) in US adults using NHANES data from 2009 to 2016. This study assesses the predictive efficacy of the urinary serum albumin-to-creatinine ratio (UACR/SACR Ratio) against traditional biomarkers such as the serum albumin-to-creatinine ratio (SACR) and urinary albumin-to-creatinine ratio (UACR) for evaluating DR risk. Additionally, the study explores the potential of these biomarkers, both individually and in combination with HbA1c, for early detection and risk stratification of DR.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This cross-sectional study analysed data from 2594 diabetic adults in the National Health and Nutrition Examination Survey (NHANES 2009–2016). Multivariate logistic regression models, adjusted for demographic (sex, age, race and education) and clinical factors (WBC, PLT, RDW, HbA1c, HBP and CHD), examined the associations between biomarkers and DR. Biomarkers were analysed both continuously and in quartiles to assess dose–response relationships. Receiver operating characteristic (ROC) curve analysis evaluated the predictive accuracy of individual biomarkers and combined models.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Elevated SACR levels were inversely related to DR risk, while UACR showed a positive correlation. The UACR/SACR ratio demonstrated superior predictive capability for DR compared to SACR and UACR alone. The most accurate predictive model combined SACR, UACR, UACR/SACR ratio and HbA1c (AUC = 0.614), highlighting DR development complexity. Subgroup analyses revealed stronger associations in participants aged &lt; 60 years and those with hypertension (both &lt;i&gt;p&lt;/i&gt; &lt; 0.05), with more pronounced effects observed in males and Mexican Americans, while lifestyle factors showed no significant modifying effect.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The UACR/SACR Ratio emerged as a potentially superior DR predictor, particularly in younger patients and those with hypertension, suggesting its utility in enhancing early detection and risk stratification. Comprehensive evaluation of renal function and glycaemic control biomarkers, considering age- and comorbidity-specific patterns, could improve DR risk prediction and management. Future longitudinal studies should validate these findings, particularly in identified high-risk subgroups, and investigate underlying mechanisms, potentially advancing personalised DR prediction and management strategies.&lt;/p&gt;\u0000 ","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013310","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":"Exploring the Predictive Role of 11-Oxyandrogens in Diagnosing Polycystic Ovary Syndrome","authors":"Armaiti Parvez Mody,&nbsp;Maya Beth Lodish,&nbsp;Richard Joseph Auchus,&nbsp;Adina F. Turcu,&nbsp;Fei Jiang,&nbsp;Heather Gibson Huddleston","doi":"10.1002/edm2.70022","DOIUrl":"10.1002/edm2.70022","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Context&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS), yet the androgen(s) responsible remain ambiguous. Recent studies have suggested that 11-oxygenated C&lt;sub&gt;19&lt;/sub&gt; steroids (11-oxyandrogens), specifically 11-ketotestosterone, may be a good marker for hyperandrogenism in PCOS.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate the utility of 11-oxyandrogens to differentiate women with and without PCOS relative to classical androgens.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Case–control study performed at a PCOS clinic and research center in an academic setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patients&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;114 women with PCOS and 78 healthy controls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Interventions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Using the PCOS Tissue Bank, serum samples and data from 114 women registered from 2013 to 2017 between the ages of 18–40 years, were obtained and classified using Rotterdam PCOS criteria. Data were compared to 78 healthy women of similar age, with serum samples obtained between 2017 and 2020. 11-oxyandrogens and sex steroids were measured using mass spectrometry, and their associations to Rotterdam PCOS, age, and BMI were assessed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;11-oxyandrogens and sex steroids.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Total testosterone, androstenedione, and four 11-oxyandrogens were significantly elevated in women with PCOS compared to age matched controls, controlling for age and BMI (&lt;i&gt;p&lt;/i&gt; &lt; 0.01 for all). When considered together, the four 11-oxyandrogens were more predictive of PCOS compared to testosterone and androstenedione. When all androgens were considered individually, 11-ketoandrostenedione was the most predictive of PCOS. Of the six androgens studied, 11-ketotestosterone was the only androgen that demonstrated a weak association with hirsutism score (&lt;i&gt;r&lt;/i&gt; = 0.17; &lt;i&gt;p&lt;/i&gt; = 0.07) within the PCOS group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;11-oxyandrogens were statistically higher in women with PCOS and may serve as better predictors of PCOS than testosterone and androstenedione.&lt;/p&gt;\u0000 ","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013364","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":"Interventions for Type 2 Diabetes Prevention and Management Among Indigenous Children and Youth: A Systematic Review","authors":"Edmund Wedam Kanmiki,&nbsp;Yaqoot Fatima,&nbsp;Thuy Linh Duong,&nbsp;Roslyn Von Senden,&nbsp;Tolassa W. Ushula,&nbsp;Abdullah A. Mamun","doi":"10.1002/edm2.70026","DOIUrl":"10.1002/edm2.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Indigenous populations experience a disproportionately higher burden of early onset of type 2 diabetes mellitus (T2DM). To contribute towards addressing this health disparity, evidence-based culturally appropriate interventions are urgently needed. This systematic review examines interventions designed to improve the prevention and management of T2DM among Indigenous children and youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of five electronic databases was carried out in February 2023 to identify relevant studies published in English. We included studies of all designs involving Indigenous children and youth under 25 years of age. An adapted version of the National Institute of Health (NIH) quality assessment tool for pre-post intervention studies was used for quality assessment. Due to the heterogeneity of methods used by reviewed publications, the convergent integrated approach developed by Joanna Briggs Institute (JBI) for mixed-method systematic reviews was employed in the analysis. Prospero registration ID: CRD42023423671.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search identified 1127 publications, and 25 studies with a total of 4594 participants from four countries were eligible after screening. Notably, most (80%) originated from North America. Most interventions involved &lt; 100 participants and lasted 6 months or less (58%). While knowledge and behaviours improved for most interventions, longer and culturally responsive interventions, often combining both community and school-based elements, demonstrated a greater effect on key anthropometrics and biomarkers associated with the risk of T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review highlights the urgent need for more research to address T2DM among Indigenous youth. Future research should prioritise culturally appropriate, long-term interventions that engage communities and empower Indigenous youth to make healthy choices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972450","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":"Diagnosis Osteoporosis Risk: Using Machine Learning Algorithms Among Fasa Adults Cohort Study (FACS)","authors":"Saghar Tabib,&nbsp;Seyed Danial Alizadeh,&nbsp;Aref Andishgar,&nbsp;Babak Pezeshki,&nbsp;Omid Keshavarzian,&nbsp;Reza Tabrizi","doi":"10.1002/edm2.70023","DOIUrl":"10.1002/edm2.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In Iran, the assessment of osteoporosis through tools like dual-energy X-ray absorptiometry poses significant challenges due to their high costs and limited availability, particularly in small cities and rural areas. Our objective was to employ a variety of machine learning (ML) techniques to evaluate the accuracy and precision of each method, with the aim of identifying the most accurate pattern for diagnosing the osteoporosis risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed the data related to osteoporosis risk factors obtained from the Fasa Adults Cohort Study in eight ML methods, including logistic regression (LR), baseline LR, decision tree classifiers (DT), support vector classifiers (SVC), random forest classifiers (RF), linear discriminant analysis (LDA), K nearest neighbour classifiers (KNN) and extreme gradient boosting (XGB). For each algorithm, we calculated accuracy, precision, sensitivity, specificity, F1 score and area under the curve (AUC) and compared them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The XGB model with an AUC of 0.78 (95% confidence interval [CI]: 0.74–0.82) and an accuracy of 0.79 (0.75–0.83) demonstrated the best performance, while AUC and accuracy values of RF were achieved (0.78 and 0.77), LR (0.78 and 0.77), LDA (0.78 and 0.76), DT (0.76 and 0.79), SVC (0.71 and 0.64), KNN (0.63 and 0.59) and baseline LR (0.72 and 0.82), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The XGB model had the best performance in assessing the risk of osteoporosis in the Iranian population. Given the disadvantages and challenges associated with traditional osteoporosis diagnostic tools, the implementation of ML algorithms for the early identification of individuals with osteoporosis can lead to a significant reduction in morbidity and mortality related to this condition. This advancement not only alleviates the substantial financial burden placed on the healthcare systems of various countries due to the treatment of complications arising from osteoporosis but also encourages health policies to shift toward more preventive approaches for managing this disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932904","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":"Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis","authors":"Vida Ghasemi,&nbsp;Mojdeh Banaei,&nbsp;Zahra Kiani,&nbsp;Fahimeh Ramezani Tehrani,&nbsp;Marzieh Saei Ghare Naz","doi":"10.1002/edm2.70024","DOIUrl":"10.1002/edm2.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134–0.553] <i>p</i> = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343–0.315] <i>p</i> = 0.01), red blood cell (0.387 [95% CI 0.224–0.550] <i>p</i> &lt; 0.001), mean platelet volume (0.498 [95% CI 0.165–0.831] <i>p</i> = 0.003), white blood cell count (0.351 [95% CI 0.0882–0.615] <i>p</i> = 0.009) and neutrophil–lymphocyte ratio (0.534 [95% CI 0.127–0.941] <i>p</i> = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (−0.249 [95% CI −0.386–−0.112] <i>p</i> &lt; 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8–1.86] <i>I</i>² = 57.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928400","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 Time in Range Without Hypoglycaemia Using a Risk Calculator for Intermittently Scanned CGM in Type 1 Diabetes","authors":"Fernando Sebastian-Valles,&nbsp;Jose Alfonso Arranz Martin,&nbsp;Julia Martínez-Alfonso,&nbsp;Jessica Jiménez-Díaz,&nbsp;Iñigo Hernando Alday,&nbsp;Victor Navas-Moreno,&nbsp;Teresa Armenta Joya,&nbsp;Maria del Mar del Fandiño García,&nbsp;Gisela Liz Román Gómez,&nbsp;Jon Garai Hierro,&nbsp;Luis Eduardo Lander Lobariñas,&nbsp;Carmen González-Ávila,&nbsp;Purificación de Martinez de Icaya,&nbsp;Vicente Martínez-Vizcaíno,&nbsp;Miguel Antonio Sampedro-Nuñez,&nbsp;Mónica Marazuela","doi":"10.1002/edm2.70020","DOIUrl":"10.1002/edm2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the impact of clinical and socio-economic factors on glycaemic control and construct statistical models to predict optimal glycaemic control (OGC) after implementing intermittently scanned continuous glucose monitoring (isCGM) systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 1072 type 1 diabetes patients (49.0% female) from three centres using isCGM systems. Clinical data and net income from the census tract were collected for each individual. OGC was defined as time in range &gt; 70%, with time below 70 mg/dL &lt; 4%. The sample was randomly split in two equal parts. Logistic regression models to predict OGC were developed in one of the samples, and the best model was selected using the Akaike information criterion and adjusted for Pearson's and Hosmer–Lemeshow's statistics. Model reliability was assessed via external validation in the second sample and internal validation using bootstrap resampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 2314 models explored, the most effective predictor model included annual net income per person, sex, age, diabetes duration, pre-isCGM HbA1c, insulin dose/kg, and the interaction between sex and HbA1c. When applied to the validation cohort, this model demonstrated 72.6% specificity, 67.3% sensitivity, and an area under the curve (AUC) of 0.736. The AUC through bootstrap resampling was 0.756. Overall, the model's validity in the external cohort was 80.4%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical and socio-economic factors significantly influence OGC in type 1 diabetes. The application of statistical models offers a reliable means of predicting the likelihood of achieving OGC following isCGM system implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883120","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":"Reduction of Hepatic Fat Content by Dulaglutide for the Treatment of Diabetes Mellitus: A Two-Centre Open, Single-Arm Trial","authors":"Chuanfeng Liu,&nbsp;Yu Xin,&nbsp;Yajing Huang,&nbsp;Lili Xu,&nbsp;Ruizhi Zhou,&nbsp;Yangang Wang,&nbsp;Wei Wang","doi":"10.1002/edm2.70021","DOIUrl":"10.1002/edm2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the elevated level of NAFLD prevalence, the incidence of diabetes, hypertension, metabolic syndrome and other diseases is also significantly elevated. GLP-1RA can exert weight loss, glucose-lowering effects and various nonglycaemic effects. However, the relationship between quantitative reduction in hepatic fat content and improvement of pancreatic islet function by GLP-1RA is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This trial was a single-arm open cohort study. A total of 38 patients with T2DM and NAFLD were enrolled in the GLP-1RA treatment group. The included patients were tested for biochemical and blood glucose levels, adiponectin and FGF21 levels, and liver fat content was measured using MRI. Measure the above indicators again after at least 3 months of GLP-1RA treatment. Divided into Q1 (average decrease of 0.37%) and Q2 (average decrease of 8.6%) groups based on the degree of reduction in liver fat content.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Q2 group showed an average reduction in liver fat content of 8.6%, a decrease in glycated haemoglobin of 18.17%, a weight loss of 7.29% and an increase in fasting c-peptide release by 1.03%, 1-h and 2-h postprandial c-peptide release by 28.86% and 18.28% respectively. In contrast, Q1 group had an average reduction in liver fat content of 0.37%, a decrease in glycated haemoglobin of only 6.53%, a weight loss of 3.41%, a decrease in fasting c-peptide release by 1.91% and an increase in 1-h and 2-h postprandial c-peptide release by 19.18% and 11.66% respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reduction in liver fat content effectively improves pancreatic islet function secretion, particularly postprandial c-peptide secretion, especially in the first hour after a meal. This improvement leads to a decrease in glycated haemoglobin levels and promotes better compliance with blood glucose control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883124","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":"Retinal Microperimetry as a Novel Tool for Early Detection of Subclinical Cognitive Dysfunction and Brain Damage in Type 1 Diabetes: A Pilot Study","authors":"Manel Mateu-Salat,&nbsp;Nicole Stanton-Yonge,&nbsp;Frederic Sampedro Santaló,&nbsp;José Ignacio Vela,&nbsp;Jesús Díaz Cascajosa,&nbsp;Eva Safont Pérez,&nbsp;Daniela Rego-Lorca,&nbsp;Ana Chico","doi":"10.1002/edm2.70018","DOIUrl":"https://doi.org/10.1002/edm2.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Retinal microperimetry (MPR) is a non-invasive method that measures retinal light sensitivity (RS) and gaze fixation stability (GFS). MPR has been described as a marker of cognitive impairment in people with Type 2 diabetes, but it has never been assessed in people with Type 1 diabetes (T1D). Our group described subclinical cognitive alterations, structural brain differences, and increased levels of light chain neurofilament (NfL) in people with T1D and impaired awareness of hypoglycaemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure RS and GFS using MPR in individuals with T1D and evaluate its correlation with neuropsychological assessment, plasma NfL levels and CGM-derived glucometric parameters. Secondary objectives: to evaluate the possible differences of RS and GFS in people with T1D depending on hypoglycaemia awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Setting and Participants</h3>\u0000 \u0000 <p>Pilot observational study, people with T1D without clinical cognitive impairment, moderate–severe retinopathy or glaucoma. MPR was performed with MAIA3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 30 subjects were studied: 40% women, age 58 ± 11 years; T1D duration 31 ± 9 years, mild retinopathy 33%. RS was 27.5 dB (26.1–28.3) and GFS(%) 97.6% (93.5%–99.5%). We found a correlation between RS and memory alteration tests (<i>p</i> = 0.016) and between GFS(%) and a composite of attention and executive neuropsychological tests (<i>p</i> = 0.025). An inverse correlation between GFS and time below range was found. No correlation was found with NfL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This first exploratory study in people with T1D supports the potential utility of MPR as a screening tool for subclinical neurocognitive alterations in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861885","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":"Obesity, Metabolic Health, and Diabetic Complications in People With Type 1 Diabetes","authors":"Yuanjie Mao,&nbsp;Jen-Tzer Gau,&nbsp;Ning Jiang","doi":"10.1002/edm2.70017","DOIUrl":"10.1002/edm2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The concept of metabolically healthy obesity (MHO) has not been studied in type 1 diabetes (T1D). By analysing datasets from the DCCT/EDIC study, we compared the development of diabetic complications by obesity and metabolic health over 30 years of follow up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Insulin resistance was calculated by estimated glucose disposal rate (eGDR). The participants (<i>n</i> = 1127) were then divided into four groups based on time-weighted mean body mass index and mean eGDR: metabolically healthy non-obesity (MHN, <i>n</i> = 874), metabolically unhealthy non-obesity (MUN, <i>n</i> = 66), MHO (<i>n</i> = 146) and metabolically unhealthy obesity (MUO, <i>n</i> = 41). Diabetic complications and cardiovascular events were compared across the four groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MUO and MUN groups had significantly higher risk for peripheral neuropathy (<i>p</i> = 0.001 in MUO and <i>p</i> &lt; 0.001 in MUN vs. MHN), cardiac autonomic neuropathy (<i>p</i> &lt; 0.001 in both MUO and MUN vs. MHN), retinopathy (<i>p</i> = 0.001 in MUO and <i>p</i> &lt; 0.001 in MUN vs. MHN) and microalbuminuria (<i>p</i> &lt; 0.001 in both MUO and MUN vs. MHN) than MHN group. Moreover, MUO and MUN groups had significantly higher risks (HR [95%CI]) in any cardiovascular events (2.78 [1.51–5.11] and 1.88 [1.05–3.36]) and major atherosclerotic cardiovascular events (2.72 [1.16–6.37] and 2.31 [1.05–5.10]) compared to MHN group. However, the risk of these complications and cardiovascular events (except peripheral neuropathy and cardiac autonomic neuropathy) in MHO group was not different from that in MHN group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the importance of metabolic health represented by insulin resistance in the development of diabetic complications and cardiovascular events in T1D beyond their weight status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830122","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}