Endocrinology, Diabetes and Metabolism最新文献

{"title":"Placebo-Referenced Class-Level Treatment Effects on Chronic Kidney Disease Progression in Patients With Diabetes: A Network Meta-Analysis.","authors":"Ravi Kumar Pandey, Maryam Imran, Ishba Manal, Muhammad Ahmad, Aliya Noor, Ali Rohan","doi":"10.1002/edm2.70285","DOIUrl":"10.1002/edm2.70285","url":null,"abstract":"<p><strong>Background and aim: </strong>Multiple pharmacologic therapies reduce chronic kidney disease (CKD) progression in patients with diabetes; however, the absence of head-to-head trials and heterogeneity across studies limits the interpretation of indirect comparisons. We evaluated class-level treatment effects within a predominantly placebo-centred evidence network.</p><p><strong>Methods: </strong>We conducted a systematic review and class-level frequentist random-effects network meta-analysis of randomised controlled trials evaluating major pharmacologic therapy classes for CKD progression in patients with diabetes. The primary outcome was CKD progression, defined according to the principal composite kidney endpoint reported in each trial. Exploratory analyses evaluated albuminuria reduction and trial-level surrogate associations between albuminuria and clinical kidney outcomes.</p><p><strong>Results: </strong>Nine trials involving 37,749 participants were included. The evidence network was star-shaped with placebo as the central comparator. All therapeutic classes were associated with reduced CKD progression compared with placebo. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) demonstrated the most precise estimate (HR 0.66, 95% CI 0.60-0.74) and were supported by high-confidence evidence. Confidence in placebo-referenced estimates for other therapeutic classes ranged from moderate to low because of indirectness, limited trial numbers and differences in study design and patient populations. Findings were generally consistent across sensitivity analyses. No significant association was observed between treatment-induced albuminuria reduction and clinical kidney outcomes (R² = 0.007), although interpretation was limited by ecological bias and the small number of included studies.</p><p><strong>Conclusions: </strong>Multiple pharmacologic classes were associated with reduced CKD progression compared with placebo in patients with diabetes. Among placebo-referenced comparisons, the most consistent and highest-confidence estimates were observed for SGLT2i. However, the predominantly placebo-centred network, absence of direct active-comparator trials and important transitivity concerns limit inference regarding comparative efficacy among therapies. Findings should therefore be interpreted as placebo-referenced class-level treatment effects rather than evidence of comparative superiority. Direct comparative effectiveness and combination-therapy trials are needed to define optimal treatment strategies.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70285"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473332","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":"Efficacy of Empagliflozin on Liver Enzymes, Lipid Profile and BMI in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review and Meta-Analysis.","authors":"Mehdi Karimi, Ali Tahmasebi, Sepehr Ramezanipour, Fatemeh Naseri Rad, Fereshteh Valizadeh, Pegah Abedi, Meisam Gholami, Narges Sobhan Ardekani, Manijeh Ebrahimzadeh Pirshahid","doi":"10.1002/edm2.70294","DOIUrl":"10.1002/edm2.70294","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent and associated with obesity and dyslipidemia, yet effective pharmacological interventions remain limited. Empagliflozin has shown potential benefits in MASLD, although evidence remains limited. This systematic review and meta-analysis assesses the efficacy of empagliflozin in patients with MASLD, both diabetic and non-diabetic.</p><p><strong>Methods: </strong>An advanced database search was conducted up to June 1st, 2026, to identify eligible randomized controlled trials (RCTs). The relevant data were extracted from selected studies. Pooled effect sizes were calculated as weighted mean differences (WMDs) with 95% confidence intervals (CIs) using a random-effects model.</p><p><strong>Results: </strong>Seven RCTs comprising 591 participants were included. Empagliflozin significantly improved liver enzyme profiles. Specifically, it reduced alanine aminotransferase (ALT) (WMD: -12.24 IU/L; p = 0.037), aspartate aminotransferase (AST) (WMD: -9.51 IU/L; p = 0.048), and gamma-glutamyl transferase (GGT) (WMD: -14.92 IU/L; p = 0.023). Reductions in alkaline phosphatase (ALP) were observed but did not reach statistical significance (WMD: -26.28 IU/L; p = 0.292). Although substantial heterogeneity was observed for several liver enzyme outcomes. Empagliflozin had no significant effect on lipid parameters, including triglycerides (TG), total cholesterol (TC), low-density and high-density lipoprotein cholesterols (LDL-C, HDL-C). Empagliflozin also produced a statistically significant but modest reduction in body mass index (BMI) (WMD: -0.71 kg/m²; p < 0.001). Empagliflozin also produced a statistically significant but clinically modest reduction in BMI (WMD: -0.71 kg/m²; 95% CI: -1.00 to -0.43; p < 0.001).</p><p><strong>Conclusion: </strong>Empagliflozin appears to improve liver enzymes and modestly reduce BMI in patients with MASLD, while having a neutral effect on lipid parameters. These findings may confer a statistically significant but clinically modest benefit, particularly in patients with coexisting metabolic risk factors. However, the evidence is limited by small sample sizes, short follow-up periods, and potential publication bias; therefore, the conclusions should be considered preliminary and hypothesis-generating.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70294"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593772","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 Selected Anthropometric Indices With Diabetic Kidney Disease Among Iranian Adults With Diabetes.","authors":"Mehrsadat Miri, Maryam Karimi Ghahfarokhi, Shahrzad Mohseni, Ali Golestani, Samaneh Akbarpour, Mahnaz Pejman Sani, Ozra Tabatabaei-Malazy","doi":"10.1002/edm2.70282","DOIUrl":"10.1002/edm2.70282","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated the association and discriminative ability of several lipid- and adiposity-related indices-triglyceride-glucose (TyG), TyG-body mass index (TyG-BMI), waist-triglyceride index (WTI), visceral adiposity index (VAI) and lipid accumulation product (LAP)-with diabetic kidney disease (DKD) among Iranian adults with diabetes.</p><p><strong>Methods: </strong>In this nationwide cross-sectional study, data were obtained from 3272 diabetic individuals aged ≥ 25 years who participated in the 2021 world health organization (WHO) STEPwise approach to Noncommunicable Disease Risk Factor Surveillance (STEPS) survey. Survey-weighted multivariable logistic regression models were applied for each index, adjusting for demographic, lifestyle, clinical and medication-related factors. Discriminative performance was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Overall, 27.9% of participants had DKD. Individuals with DKD exhibited significantly higher mean values across all studied indices (p < 0.001). In adjusted analyses, each one-standard deviation (SD) increase in TyG, TyG-BMI, WTI, VAI and LAP was associated with 36%, 20%, 27%, 24% and 27% higher odds of DKD, respectively (all p < 0.001). All indices demonstrated moderate discriminative performance, with area under the curve (AUC) values ranging from 0.696 to 0.704; however, no significant differences were observed in their discriminatory ability.</p><p><strong>Conclusion: </strong>In this large sample of Iranian adults with diabetes, low-cost indices were associated with DKD and may help identify high-risk individuals, particularly in resource-limited settings. However, their moderate discriminative performance suggests limited standalone diagnostic utility, and longitudinal studies are needed to establish their predictive value.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70282"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431187","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":"The Impact of Diabetes on Breast Cancer Development in Women: An Integrative Review.","authors":"Israt Jahan, Mohammad Harun-Ur-Rashid, Imran Hossain, Fatema-Tuz- Zohora","doi":"10.1002/edm2.70276","DOIUrl":"10.1002/edm2.70276","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing epidemiological evidence suggests that diabetes is associated with a modest but significant elevation in breast cancer risk, as well as poorer clinical outcomes following diagnosis. This integrative review critically synthesizes current epidemiological, biological and clinical evidence to elucidate the role of diabetes in breast cancer development and progression among women.</p><p><strong>Methods: </strong>We conducted a structured literature search (2010-2025) to identify original studies examining the relationship between diabetes and breast cancer risk and outcomes. English-language human studies were included. Titles, abstracts and full texts were screened against predefined criteria, and relevant data were extracted and synthesized narratively.</p><p><strong>Results: </strong>Studies indicate that women with diabetes experience an increased incidence of breast cancer, with stronger associations observed in postmenopausal populations, and partial attenuation of risk following adjustment for obesity, highlighting both shared and independent metabolic contributions. Mechanistically, chronic hyperinsulinemia, altered insulin-like growth factor signalling, low-grade systemic inflammation, oxidative stress and oestrogen-metabolic crosstalk are frequently proposed as biologically plausible pathways through which diabetes may influence breast carcinogenesis, particularly in hormone-receptor-positive tumours. Clinically, diabetes has been linked to delayed diagnosis, increased treatment-related complications, and higher breast cancer-specific mortality, underscoring the need for integrated metabolic and oncologic care.</p><p><strong>Conclusion: </strong>Diabetes mellitus, particularly type 2 diabetes, is consistently associated in observational studies with a small increment in breast cancer risk and a more clearly adverse impact on survival. Mechanistic and translational evidence supports biologically plausible pathways linking metabolic dysregulation to tumour initiation, progression and treatment tolerance, but definitive causal effects remain uncertain. Medication and biomarker-based research and practice should be incorporated in metabolic-oncologic care and research to enhance prevention and outcomes.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70276"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406228","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":"Continuous Glucose Monitoring in Glycogen Storage Diseases: A Systematic Review of Clinical Utility, Accuracy and Patient Outcomes.","authors":"Reihaneh Mohsenipour, Farzaneh Abbasi, Maryam Sadat Ghaderian, Asal Khalili Dehkordi, Saeideh Abdolahpour, Kasra Akbari","doi":"10.1002/edm2.70274","DOIUrl":"10.1002/edm2.70274","url":null,"abstract":"<p><strong>Background: </strong>Achieving euglycemia in Glycogen Storage Diseases (GSD) depends on strict dietary adherence; however, intermittent monitoring frequently fails to detect rapid hypoglycemic excursions. This systematic review evaluates the clinical utility, accuracy and psychosocial impact of Continuous Glucose Monitoring (CGM) across hepatic GSD subtypes.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, Web of Science and Cochrane Library (inception to December 2025) following PRISMA 2020 guidelines. Eligible studies included randomized trials, cohorts and case series reporting CGM outcomes in hepatic GSD.</p><p><strong>Results: </strong>Thirty-one studies (N = 323) met inclusion criteria, predominantly GSD Ia, Ib and III. CGM consistently identified asymptomatic hypoglycemia, with adult cohorts spending up to 12% of time below range (< 70 mg/dL) despite normal spot checks. In interventional settings, CGM-guided dietary titration improved Time in Range (e.g., 72%-86% in gene therapy trials) and reduced serum triglycerides and liver size. However, sensor performance showed a positive bias in the hypoglycemic range, potentially masking severe neuroglycopenia. Psychosocially, while CGM improved sleep quality scores, it introduced 'alarm fatigue' from false-positive alerts.</p><p><strong>Conclusion: </strong>Emerging evidence suggests that CGM may shift GSD management from reactive treatment to proactive stabilization. It offers superior sensitivity for detecting occult hypoglycemia and guiding therapy, though its utility is tempered by sensor inaccuracy at lower limits and the burden of constant surveillance. Future implementation requires subtype-specific interpretation and sensors optimized for the hypoglycemic range.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70274"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377423","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":"Comment on 'A Prospective Evaluation of Glucagon Stimulation Test Safety in Adults With Chronic Moderate-to-Severe Traumatic Brain Injury'.","authors":"Aisha Zahir, Muhammad Faizan Khan, Gulalai Tariq","doi":"10.1002/edm2.70288","DOIUrl":"10.1002/edm2.70288","url":null,"abstract":"","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70288"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473306","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 Between Serum Follicle-Stimulating Hormone Levels and Risk of Diabetes in Middle-Aged Men: A Long-Term Population-Based Longitudinal Study.","authors":"Maryam Mousavi, Faeghe Firouzi, Fahimeh Ramezani Tehrani, Fereidoun Azizi, Samira Behboudi-Gandevani","doi":"10.1002/edm2.70262","DOIUrl":"10.1002/edm2.70262","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the association between serum FSH levels and both the prevalence and incidence of T2DM among middle-aged and older men.</p><p><strong>Methods: </strong>This study utilised data from 1097 men aged ≥ 40 years, who participated in the population-based Tehran Lipid and Glucose Study. Participants were followed over six phases between 2002 and 2021. FSH levels were measured at baseline, and participants were followed for incident T2DM over 3774.78 person-years. Multivariable logistic and Cox regression models were used to examine associations between FSH levels and prevalent and incident T2DM, adjusting for demographic and metabolic confounders. Subgroup analyses were performed by age group (< 50 vs. ≥ 50 years).</p><p><strong>Results: </strong>At baseline, the prevalence of T2DM was 18.41%, and no significant association was observed between FSH levels and T2DM prevalence after full adjustment (OR: 1.0; 95% CI: 0.98-1.03). During follow-up, 302 new T2DM cases were identified. In the fully adjusted Cox model, higher FSH levels were independently associated with a lower risk of developing T2DM (HR: 0.96; 95% CI: 0.93-0.99). The inverse association was especially evident in men aged ≥ 50 years (HR: 0.96; 95% CI: 0.93-0.99), whereas no significant association was found in younger men.</p><p><strong>Conclusion: </strong>Higher serum FSH levels were independently associated with a reduced risk of incident T2DM in men, particularly among those aged ≥ 50. These findings suggest a potential protective metabolic role of FSH in older men. Further research is warranted to elucidate the non-reproductive roles of FSH in men.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70262"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391912","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":"Knowledge, Attitudes and Practices on the Use of Antidiabetic Medications for Weight Loss: A Cross-Sectional Study in the Lebanese Population.","authors":"Rim Masri, Hekmat Kaakour, Hasnaa Hamdan, Pascale Salameh","doi":"10.1002/edm2.70286","DOIUrl":"10.1002/edm2.70286","url":null,"abstract":"<p><strong>Background: </strong>The growing use of antidiabetic medications for weight loss has raised concerns about public awareness, safety and appropriate use. This study assessed knowledge, attitudes and practices (KAP) regarding antidiabetic medications use for weight loss among Lebanese adults and identified associated factors.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among Lebanese adults between June and July 2025 using convenience sampling through social media. The questionnaire was adapted from published instruments, expert-reviewed and pilot-tested. Data on sociodemographic characteristics, KAP and medication use were collected. Knowledge and attitude scores were calculated, and factors associated with medication use were evaluated by multivariable regression.</p><p><strong>Results: </strong>A total of 405 participants were included. Mean knowledge and attitude scores were 69.39 ± 8.71 and 69.11 ± 5.54 (out of 100), indicating moderate knowledge and cautious attitudes. Higher education and healthcare-related employment were independently associated with higher knowledge and more appropriate attitudes toward safe use of antidiabetic medications, whereas previous weight-control complications were associated only with more appropriate attitudes. Overall, 12.3% reported using antidiabetic medications for weight loss, primarily semaglutide. Among users, 62.0% experienced side effects, 46.0% reported weight regain after discontinuation, and 32.0% used these medications without medical consultation. Medication use was associated with smoking (aOR 3.13, 95% CI 1.53-6.38), prior weight-control complications (aOR 8.50, 95% CI 3.27-22.12), higher knowledge scores (aOR 1.05, 95% CI 1.00-1.09), and adherence to a weight-loss diet (aOR 2.21, 95% CI 1.35-3.60), while higher occupational physical activity was inversely associated (aOR 0.58, 95% CI 0.41-0.84).</p><p><strong>Conclusion: </strong>Lebanese adults demonstrated moderate knowledge and generally appropriate attitudes toward the safe use of antidiabetic medications for weight loss. Reported side effects, weight regain and unsupervised use underscore the need for public education, physician-guided counselling and stronger oversight. Findings should be interpreted considering the cross-sectional design and convenience sampling, limiting causal inference and generalizability.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70286"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449726","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":"Frequency of Insulin Resistance in Overweight Patients With Metabolic-Associated Fatty Liver Disease (MAFLD) at a Tertiary Healthcare Centre in Bangladesh","authors":"Md. Mohiuddin Rozaik,&nbsp;Md. Kawsar Uddin,&nbsp;Syed Azmal Mahmood,&nbsp;Sadia Islam Sukonna,&nbsp;Tasnim Nafian,&nbsp;Kazi Ali Aftab,&nbsp;Khaled Mahbub Murshed,&nbsp;Md Abul Kalam Azad","doi":"10.1002/edm2.70271","DOIUrl":"10.1002/edm2.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Bangladesh, the prevalence of MAFLD patients is about 33.86%. Most of the patients with MAFLD are also strongly associated with hepatic and adipose tissue insulin resistance (IR). Homeostasis model assessment of insulin resistance (HOMA-IR) is a simple and useful method for evaluating insulin resistance and β cell function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational cross-sectional study was carried out in the outpatient department of Hepatology, Bangladesh Medical University. The subjects were non-alcoholic overweight patients with sonographic evidence of fatty liver disease aged 18 years or above. Participants were subjected to a pre-designed questionnaire including personal data. Assessment of medical history, physical examinations and investigations to measure IR were performed. Statistical analyses were carried out by using the SPSS version PC 26.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Majority of the participants, precisely 60% (95% confidence interval [CI]: 45.2, 73.6) had insulin resistance (IR) and median HOMA-IR index was 2.85. Patients with acanthosis nigricans had significantly higher IR biochemically (Mean HOMA-IR index; 5.79 vs. 2.89), which was significant statistically. No significant correlation was observed between HOMA-IR and alternative metabolic markers, including METS-IR, TG/HDL-c ratio and BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high frequency (60%) of insulin resistance was found among overweight, non-diabetic patients with MAFLD. This finding underscores the immense value of regular screening for hyperglycemia in this population. With the increasing burden of metabolic syndrome, early identification of IR would enable timely preventive interventions—potentially slowing the progression to type 2 diabetes and consequently reducing subsequent risk of developing diabetes-related complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369996","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":"Comparative Efficacy and Safety of Tirzepatide in Asian and Non-Asian Adults With Obesity Without Diabetes: A Systematic Review and Meta-Analysis.","authors":"A B M Kamrul-Hasan, Ibrahim Khalil, Deep Dutta, Kunal Mahajan, Lakshmi Nagendra, Joseph M Pappachan","doi":"10.1002/edm2.70291","DOIUrl":"10.1002/edm2.70291","url":null,"abstract":"<p><strong>Introduction: </strong>Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces substantial weight loss in adults with obesity. Given ethnic differences in obesity phenotype and cardiometabolic risk, this systematic review and meta-analysis compared tirzepatide's efficacy and safety between Asian and non-Asian adults without diabetes.</p><p><strong>Methods: </strong>This PROSPERO-registered review (CRD420261361351) searched PubMed, Scopus, Web of Science and ClinicalTrials.gov through 15 March 2026. Phase 3 SURMOUNT randomised, placebo-controlled trials were classified as Asian (100% Asian participants) or predominantly non-Asian (< 25% Asian participants). The primary outcome was the percentage change in body weight. Secondary outcomes included absolute weight change, body mass index (BMI), waist circumference, weight loss thresholds (≥ 5%, ≥ 10%, ≥ 15%) and adverse events. Random-effects meta-analyses and meta-regression were performed.</p><p><strong>Results: </strong>Five trials (six comparisons; N = 4022) were included: two Asian (SURMOUNT-CN, SURMOUNT-J; n = 148 tirzepatide-treated) and four predominantly non-Asian. Tirzepatide 15 mg/maximum tolerated dose produced an 18.04% greater reduction in body weight versus placebo (95% CI -19.86 to -16.22; p < 0.00001, I² = 77%). Percentage weight loss appeared comparable between Asian (-18.16%) and non-Asian (-17.92%) trials (p = 0.94), but this underpowered comparison cannot confirm equivalence. Absolute weight loss was greater in non-Asians (-23.46 vs. -16.72 kg; p = 0.03), largely reflecting higher baseline weight. Safety profiles were similar, with no statistically significant interactions by ethnic subgroup.</p><p><strong>Conclusions: </strong>Tirzepatide provides clinically meaningful weight reduction, with broadly similar relative percentage efficacy across Asian and non-Asian trial populations. These exploratory, indirect findings do not establish ethnic equivalence and require confirmation in adequately powered, ethnicity-stratified trials.</p><p><strong>Registration: </strong>The meta-analysis was registered in PROSPERO under the registration number CRD420261361351. The review protocol summary is available on the PROSPERO website.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 4","pages":"e70291"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563094","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}