Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

{"title":"Sequential metabolic cascade from normal liver to multimorbidity in lean Asian adults: Multistate progression modelling","authors":"Masashi Hirooka,&nbsp;Teruki Miyake,&nbsp;Ryo Yano,&nbsp;Yoshiko Nakamura,&nbsp;Yuki Okazaki,&nbsp;Toyoki Shimamoto,&nbsp;Atsushi Yukimoto,&nbsp;Yasunori Yamamoto,&nbsp;Takao Watanabe,&nbsp;Osamu Yoshida,&nbsp;Yoshio Tokumoto,&nbsp;Masanori Abe,&nbsp;Takeru Iwata,&nbsp;Yoichi Hiasa","doi":"10.1016/j.dsx.2026.103454","DOIUrl":"10.1016/j.dsx.2026.103454","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic disorders may progress sequentially from fatty liver to hypertension and diabetes, but this cascade has not been well characterised in lean Asian populations. We aimed to quantify this progression and develop practical risk prediction tools in a large longitudinal Japanese cohort.</div></div><div><h3>Methods</h3><div>We analysed 75,781 health examination records from 24,718 Japanese adults between 2009 and 2019. Continuous-time multistate modelling quantified transitions across four states: no fatty liver, hypertension, or diabetes; fatty liver alone; fatty liver with hypertension; and fatty liver with hypertension and diabetes. Individual risk prediction tools were developed and internally validated.</div></div><div><h3>Findings</h3><div>Among 38,858 observed transitions, 2880 were prespecified forward cascade-transition events. Annual transition intensities were 0.699 for state 0 to 1, 0.809 for state 1 to 2, and 0.769 for state 2 to 3, corresponding to a summed mean progression time of 3.97 years. Normal-range body mass index accounted for 1394 cascade events (48.4%), whereas obesity accounted for 238 events (8.3%). The simplified clinical score showed moderate discrimination (C-statistic, 0.63; 95% confidence interval, 0.58–0.68) and good calibration.</div></div><div><h3>Interpretation and funding</h3><div>Metabolic disease progressed rapidly and sequentially in this Asian cohort, frequently among adults without obesity. These findings support earlier body mass index-independent metabolic screening and prospective evaluation of shorter surveillance intervals in Asian populations.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103454"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475702","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":"Association of maternal glucose and body mass index with adverse pregnancy outcomes among women with normal oral glucose tolerance test results","authors":"Chia-Yu Chang,&nbsp;Ting-Yu Kuo,&nbsp;Meng-Hung Lin,&nbsp;Yu-Lun Ku,&nbsp;Yun-Shing Peng,&nbsp;Yung-Hsiang Lin","doi":"10.1016/j.dsx.2026.103439","DOIUrl":"10.1016/j.dsx.2026.103439","url":null,"abstract":"<div><h3>Aims</h3><div>The study aims to investigate whether adverse pregnancy outcomes were associated with different glucose and BMI levels, even among women with normal oral glucose tolerance test (OGTT) results.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data of 15,967 pregnant women who underwent a 75-g OGTT between 24 and 30 gestational weeks. Adverse pregnancy outcomes included cesarean delivery and birth weight &gt;90th percentile. Adjusted odds ratios (aORs) were calculated according to BMI and post-OGTT glucose levels.</div></div><div><h3>Results</h3><div>Among the women with normal OGTT (n = 13,661), higher BMI was associated with increased risks of cesarean delivery (aOR: 2.09 [95% CI: 1.84-2.36]), preeclampsia or eclampsia (aOR: 1.99[1.37-2.89]), birth weight &gt;90th percentile (aOR: 4.86[3.83-6.16]), and hyperbilirubinemia (aOR: 1.51[1.27-1.79]). Elevated glucose levels, even in women with a normal OGTT, increased the risks, particularly in those with a higher BMI. In the women with BMI ≥28.5 kg/m², a 1-h post-OGTT glucose level 133-155 mg/dL was associated with higher risks of cesarean delivery (aOR: 1.64[1.17-2.29]) and birth weight &gt;90th percentile (aOR: 2.33[1.29-4.22]).</div></div><div><h3>Conclusions</h3><div>Higher maternal BMI and increasing maternal glucose levels significantly increased the risk of adverse perinatal outcomes, even in women with normal OGTT results.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103439"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280691","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":"Dose-dependent effect of milk proteins on body composition and lipid profile in overweight and obese individuals; A GRADE-assessed systematic review and meta-analysis of randomized controlled trials","authors":"Parisa Beitsaeed,&nbsp;Amir Abbas Moarefian,&nbsp;Hossein Shahinfar,&nbsp;Seyedeh Tayebeh Rahideh","doi":"10.1016/j.dsx.2026.103451","DOIUrl":"10.1016/j.dsx.2026.103451","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to determine the optimal dosage of milk proteins, including whey and casein, for improving anthropometric parameters and lipid profiles.</div></div><div><h3>Method</h3><div>A comprehensive literature search was conducted across Scopus, Web of Science, and PubMed databases to assess the effects of milk proteins on anthropometric and lipid-related outcomes. The systematic review protocol was registered in PROSPERO (CRD42024615328).</div></div><div><h3>Result</h3><div>The meta-analysis of 21 randomized controlled trials found that each 60 g/day increase in milk proteins intake significantly reduced low-density lipoprotein cholesterol by 5.85 mg/dl (95% CI = −8.87, −2.83, P &lt; 0.001) and increased high-density lipoprotein cholesterol by 3.39 mg/dl (95%CI = 1.46, 5.33, P &lt; 0.001). To achieve optimal benefits, the suggested effective range doses for fat free mass was 30 g, for triglycerides was 50 g, and for high-density lipoprotein cholesterol was 40 g.</div></div><div><h3>Conclusion</h3><div>Our findings indicate, the correlation between the dosage of milk proteins and fat free mass and lipid markers was nonlinear, while a linear association was established with lipoproteins.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103451"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371675","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 Expanding Waistline, the Persistent Hunger: NFHS–6 and India's Fragmented Nutritional Future","authors":"Yashendra Sethi,&nbsp;Priyali Shah,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103448","DOIUrl":"10.1016/j.dsx.2026.103448","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103448"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383538","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":"Association between grip strength and the diabetes complications severity index (DCSI) in patients with type 2 diabetes mellitus","authors":"Hideyuki Iwamoto,&nbsp;Yuichiro Iwamoto,&nbsp;Tomohiko Kimura,&nbsp;Yoshiro Fushimi,&nbsp;Junpei Sanada,&nbsp;Zen Yoshikawa,&nbsp;Masato Kubo,&nbsp;Ryo Inaba,&nbsp;Yui Okamoto,&nbsp;Masashi Shimoda,&nbsp;Shuhei Nakanishi,&nbsp;Kohei Kaku,&nbsp;Hideaki Kaneto","doi":"10.1016/j.dsx.2026.103449","DOIUrl":"10.1016/j.dsx.2026.103449","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to clarify the association between grip strength and the Diabetes Complications Severity Index (DCSI) in patients with type 2 diabetes mellitus (T2DM). While grip strength is widely used as an indicator of sarcopenia, its capacity to reflect the accumulation of diabetic complications has not been sufficiently investigated. In this study, we examined the relationship between grip strength and DCSI.</div></div><div><h3>Methods</h3><div>The study included 501 T2DM patients hospitalized for diabetes education between 2018 and 2024. Grip strength was categorized into sex-specific quartiles. Severity was assessed using the DCSI. Kruskal-Wallis tests with Dunn's post hoc tests were used for interquartile comparisons, with further stratified analyses by age, sex, BMI, and presence of sarcopenia. Additionally, to examine the independent relationship of grip strength, a multiple regression analysis was conducted.</div></div><div><h3>Results</h3><div>Lower grip strength was associated with higher DCSI scores. This trend persisted in stratified analyses by age, sex, BMI, and presence of sarcopenia. In the multiple regression analysis, grip strength was an independent negative predictor of DCSI scores.</div></div><div><h3>Conclusions</h3><div>Reduced grip strength is independently associated with higher DCSI scores and may serve as a simple indicator suggesting an increased risk of complications.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103449"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379439","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":"Highlights of the current issue","authors":"Ningjian Wang,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103469","DOIUrl":"10.1016/j.dsx.2026.103469","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103469"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148731217","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":"Higher maternal 3rd trimester insulin resistance is linked to central fat deposition in 7-year-old girls. An Odense Child Cohort study","authors":"Matias S. Serup ,&nbsp;Camilla V.B. Palm ,&nbsp;Anja F. Dreyer ,&nbsp;Anders Grøntved ,&nbsp;Jan S. Jørgensen ,&nbsp;Henrik T. Christesen ,&nbsp;Tina K. Jensen ,&nbsp;Dorte Glintborg ,&nbsp;Marianne S. Andersen","doi":"10.1016/j.dsx.2026.103450","DOIUrl":"10.1016/j.dsx.2026.103450","url":null,"abstract":"<div><h3>Aims</h3><div>To examine associations between maternal 3rd trimester insulin resistance, glucose status and child body composition at 7 years, including gynoid and android fat deposition in boys and girls.</div></div><div><h3>Methods</h3><div>903 mother-child pairs (girls, n = 449) were included from the Odense Child Cohort. Third trimester insulin resistance, homeostatic model assessment-insulin resistance (HOMA-IR), fasting plasma glucose (FPG), insulin, and HbA1c and 1st trimester HbA1c were measured. Child Dual X-ray Absorptiometry (DXA)-assessed body composition (total, android and gynoid fat mass) were estimated at 7 years. Participants and health professionals were blinded for maternal FPG, insulin and HbA1c results.</div></div><div><h3>Results</h3><div>In girls, a doubling in 3rd trimester HOMA-IR was associated with 7.1% (<em>P</em> = 0.02), 1.1% (<em>P</em> = 0.008) and 4% (<em>P</em> = 0.008) higher android, gynoid and total fat mass percentages, respectively. One mmol/L higher maternal FPG was associated with 6.1% (<em>P</em> = 0.02) higher total fat mass percentage in girls. Associations between 3rd trimester HOMA-IR, FPG, insulin, HbA1c and child fat mass percentage were positive in girls (All <em>P</em> ≤ 0.02) and boys (<em>P</em> = 0.14, 0.07, 0.19 and 0.15, respectively), but were only significant in girls.</div></div><div><h3>Conclusions</h3><div>Insulin resistance in 3rd trimester was linked to more central fat in 7-year-old girls, suggesting higher susceptibility to insulin resistance in girls compared to boys.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103450"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371748","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":"Comparative effects of SGLT2 inhibitors on Erythropoiesis: A systematic review and network meta-analysis","authors":"Kannan Sridharan,&nbsp;Gowri Sivaramakrishnan","doi":"10.1016/j.dsx.2026.103452","DOIUrl":"10.1016/j.dsx.2026.103452","url":null,"abstract":"<div><h3>Background and aims</h3><div>Sodium glucose cotransporter-2 inhibitors (SGLT2is) may influence erythropoiesis, but intra-class differences and evidence certainty remain unclear. We evaluated the comparative effects of individual drugs on hematological parameters.</div></div><div><h3>Methods</h3><div>We searched electronic databases for randomized controlled trials comparing any SGLT2i with placebo, standard of care, or another SGLT2i. Outcomes included hemoglobin, hematocrit, red blood cell (RBC) count, erythropoietin, and anemia risk. Pooled estimates were calculated using standardized mean difference (SMD) or odds ratio (OR) with 95% confidence intervals (CI). Certainty of evidence was assessed.</div></div><div><h3>Results</h3><div>One hundred thirty-six studies (102,882 participants) were included. As a class, SGLT2is significantly increased post-intervention hemoglobin (SMD 0.42 [95% CI 0.33, 0.51]), change-from-baseline hemoglobin (SMD 0.87 [0.65, 1.10]), post-intervention hematocrit (SMD 0.53 [0.44, 0.62]), change-from-baseline hematocrit (SMD 0.91 [0.72, 1.10]), post-intervention RBC count (SMD 0.56 [0.37, 0.75]), change-from-baseline RBC count (SMD 0.94 [0.48, 1.39]), and post-intervention erythropoietin (SMD 0.26 [0.01, 0.52]), but did not reduce anemia risk (OR 0.93 [0.76, 1.14]). Among individual drugs, ertugliflozin showed the largest post-intervention hemoglobin increase, and canagliflozin showed the largest change-from-baseline hemoglobin increase. Evidence certainty was low to very low.</div></div><div><h3>Conclusions</h3><div>SGLT2is consistently increase hemoglobin, hematocrit, RBC count, and erythropoietin, with intra-class differences observed for specific outcomes. However, low to very low certainty evidence precludes definitive comparative recommendations.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 6","pages":"Article 103452"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400404","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":"MASLD as a crucial component in the pathogenesis, evaluation and management of type 2 diabetes in Asian Indians","authors":"Mohammad Shafi Kuchay ,&nbsp;Anurag Bajpai ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103436","DOIUrl":"10.1016/j.dsx.2026.103436","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103436"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146116","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":"Development of a therapeutic patient education curriculum for healthcare professionals to improve diabetes care in the Eastern Mediterranean region","authors":"Jorge César Correia ,&nbsp;Cosette Fakih El Khoury ,&nbsp;Hicham El Berri ,&nbsp;Lamia Mahmoud ,&nbsp;Amal Fakha ,&nbsp;Matilda Byström ,&nbsp;Dayana El Chaar ,&nbsp;Bianca Hemmingsen ,&nbsp;Zoltan Pataky","doi":"10.1016/j.dsx.2026.103431","DOIUrl":"10.1016/j.dsx.2026.103431","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetes prevalence in the Eastern Mediterranean Region (EMR) is among the highest globally, yet structured therapeutic patient education (TPE) is inconsistently implemented. This study aimed to describe the multi-phase development, structure, and implementation planning of a WHO-led, diabetes-specific TPE curriculum tailored to the EMR.</div></div><div><h3>Methods</h3><div>A multi-phase, formative approach was used to inform curriculum development. This included a synthesis of existing evidence, a regional situation analysis combining desk review, stakeholder surveys, and semi-structured interviews, and stakeholder consultations. Qualitative data were analysed using a thematic approach, and findings were integrated through an expert-driven, iterative consensus process. Reporting was guided by relevant principles for complex intervention description.</div></div><div><h3>Results</h3><div>The different phases identified key gaps in the organization, content, and delivery of diabetes education across the region, as well as priorities for culturally adapted and competency-based training. These findings directly informed the development of a structured curriculum composed of eight modules, covering core aspects of diabetes management, self-care, and context-specific considerations. The curriculum incorporates defined learning objectives, core content areas, and participatory teaching methods, and is supported by an implementation guide informed by implementation science frameworks.</div></div><div><h3>Conclusions</h3><div>This work provides a transparent description of the development of an evidence-informed, theory-driven TPE curriculum adapted to the EMR. The curriculum offers a structured framework to support the delivery of diabetes education and may be adaptable to other contexts, subject to local contextualization and future evaluation.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103431"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978437","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}