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

{"title":"A systematic review on the impact of type 2 diabetes on Leydig and Sertoli cells: Molecular mechanisms and functional consequences","authors":"Ali Akbar Oroojan ,&nbsp;Hooman Etedali ,&nbsp;Homa Shirani Lapari","doi":"10.1016/j.dsx.2026.103423","DOIUrl":"10.1016/j.dsx.2026.103423","url":null,"abstract":"<div><h3>Background and aims</h3><div>Type 2 diabetes (T2D) disrupts male reproductive function by impairing Leydig and Sertoli cell activity, leading to hormonal imbalances and defective spermatogenesis. This systematic review explores the molecular mechanisms underlying T2D-induced dysfunction in these testicular cells, emphasizing alterations in steroidogenesis, cell signaling, and metabolic regulation.</div></div><div><h3>Methods</h3><div>A systematic review of peer-reviewed studies was conducted using databases such as PubMed. to identify relevant studies published between January 1, 2010, and December 30, 2024. Studies investigating the effects of type 2 diabetes mellitus on Leydig and Sertoli cells. Key molecular markers, androgen receptors, insulin-like growth factor-binding proteins (Igfbp5), and cell junction proteins (Cx43, TJP1, GJA1), were analyzed. Additionally, pathways such as PI3K/Akt, MEK5-ERK5-MEF2C, and inflammatory markers (PERK, IKKβ) were reviewed to understand their roles in diabetic testicular dysfunction. The risk of bias was assessed using the SYRCLE tool.</div></div><div><h3>Results</h3><div>T2D reduces Leydig cell function by downregulating insulin receptors (IR-β, IR-α) and disrupting steroidogenic pathways, leading to lower testosterone levels. Increased miR-504 and miR-935 expression suppresses the MEK5-ERK5-MEF2C survival pathway, promoting apoptosis in Leydig cells. Sertoli cell dysfunction is characterized by decreased VEGF expression, impaired BTB integrity, and metabolic shifts favoring glycogen accumulation instead of lactate production. Insulin resistance further exacerbates these effects, leading to defective spermatogenesis.</div></div><div><h3>Conclusions</h3><div>Diabetes-induced dysfunction in Leydig and Sertoli cells is a key contributor to male infertility. Targeting VEGF restoration, insulin signaling pathways, and miRNA regulation may offer potential therapeutic strategies. Further studies are needed to develop interventions that preserve testicular function in diabetic individuals.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103423"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849051","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":"Could fructosamine be used in the glycemic monitoring of individuals with a history of gestational diabetes mellitus?","authors":"Christos Chatzakis,&nbsp;Tanvi Mansukhani,&nbsp;Rea Mitsigiorgi,&nbsp;Elodie May,&nbsp;Kypros H. Nicolaides","doi":"10.1016/j.dsx.2026.103440","DOIUrl":"10.1016/j.dsx.2026.103440","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the association of fructosamine with multiple glycemic control indices in individuals with previous gestational diabetes mellitus(GDM), with or without prediabetes or type 2 diabetes(T2D).</div></div><div><h3>Materials</h3><div>Individuals with prior GDM were studied 5–9 months postpartum. Data included demographics, medical history, clinical measures, HbA1c, oral glucose tolerance test(OGTT), fructosamine, and blinded continuous glucose monitoring(CGM). Associations between fructosamine and glycemic indices were assessed using regression models with interaction terms for dysglycemia; standardized models and partial R² enabled head-to-head comparison with HbA1c.</div></div><div><h3>Results</h3><div>Among 844 participants, 407(48.2%) had prediabetes and 47(5.5%) T2D. Mean fructosamine was higher in T2D(255.6 ± 4.0 μmol/L) than in normoglycemic (235.7 ± 22.0 μmol/L) and prediabetes groups(238.3 ± 21.4; p &lt; 0.001). Fructosamine correlated with 2-h post-load glucose(β = 0.018,p &lt; 0.001) and HbA1c(β = 0.054,p &lt; 0.001), but not fasting glucose; it was inversely related to CGM time-in-range and positively to time-above-range, time-below-range, glucose management indicator, glycemic variability, and coefficient of variation. Associations were strongest in T2D. Compared directly, HbA1c related more to time-in-range, whereas fructosamine more strongly reflected glycemic variability. Combined models improved fit.</div></div><div><h3>Conclusions</h3><div>In individuals with prior GDM, fructosamine captured adverse glycemic patterns, especially variability and provided information complementary to HbA1c, supporting its use as a practical adjunct where CGM is unavailable.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103440"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221544","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":"Prevalence of nephropathy in type 2 diabetes patients in the Eastern Mediterranean Region: A systematic review and meta-analysis","authors":"Shahryar Zeighami ,&nbsp;Sonia Shaabani ,&nbsp;Mohammad Moheb ,&nbsp;Maryam Pakfetrat ,&nbsp;Seyede Pegah Azarchehry ,&nbsp;Saeid Dehghankhalili ,&nbsp;Alireza Mirahmadizadeh ,&nbsp;Roya Sahebi ,&nbsp;Omid Keshavarzian ,&nbsp;Alireza Heiran","doi":"10.1016/j.dsx.2026.103438","DOIUrl":"10.1016/j.dsx.2026.103438","url":null,"abstract":"<div><h3>Objectives</h3><div>The high prevalence of T2D leads to increased complications like diabetic nephropathy, a leading cause of end-stage renal disease and renal replacement therapies. As studies from the Eastern Mediterranean Region report various prevalence rates for this complication, we conducted a meta-analysis to estimate the prevalence of nephropathy in T2D patients in the Eastern Mediterranean Region.</div></div><div><h3>Method</h3><div>We searched for the relevant keywords in the titles and abstracts of articles indexed in Medline/PubMed, Scopus, EMBASE, Web of Science, and Google Scholar from January 1st, 2000, to December 13th, 2019. Two independent researchers carried out two-stage screening and then extracted the relevant data. We conducted summary proportions estimation, subgroup analysis, meta-regression analysis, and publication bias assessment.</div></div><div><h3>Results</h3><div>Out of 3225 identified citations, 38 articles were entered into the meta-analysis, involving 112,235 patients. The prevalence of nephropathy in T2D patients was 26% (95% confidence interval (CI) = 22, 31%), and it was 30% (95% CI = 24, 37%) in males and 22% (95% CI = 17, 28%) in females. Meta-regression analysis showed that the hypertension and anti-hypertensive medications use were significant moderators (P = 0.040 and 0.005, respectively); however, the Human Development Index (HDI), publication year, mean T2D duration, mean age, and diagnostic test were not significant moderators (P = 0.283, 0.725, 0.280, 0.220, and 0.241, respectively).</div></div><div><h3>Conclusions</h3><div>Diabetic nephropathy's high prevalence in the Eastern Mediterranean Region highlights the importance of diabetes screening, periodic examinations, diabetes care, and risk factor control. Large-scale longitudinal studies should be conducted in the region to fill critical gaps in understanding the long-term effects of diabetes on kidney health, identify modifiable risk factors, and establish effective intervention strategies tailored to the specific populations of the region.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103438"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221584","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":"Co-design of an animated resource to understand inequities in access to diabetes technologies among children and young people with type 1 diabetes from ethnic minority groups and/or low socioeconomic areas","authors":"Eda Tonga ,&nbsp;Mark Evans ,&nbsp;Nick Oliver ,&nbsp;Sze May Ng ,&nbsp;Natalie Darko","doi":"10.1016/j.dsx.2026.103432","DOIUrl":"10.1016/j.dsx.2026.103432","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to explore barriers to diabetes technology access and co-create an educational animation to address them.</div></div><div><h3>Methods</h3><div>Guided by a community-based participatory research (CBPR) approach and the Generative Co-Design Framework for Healthcare Innovation, the study followed three stages: Pre-Design, Co-Design, and Post-Design. It built on prior qualitative research and was shaped by input from an advisory panel. Co-design workshops informed the animation's content and style. A total of 16 participants were involved: 6 (2 parents, 4 young people) contributed to advisory sessions, and 10 (5 parents, 5 children and young people) participated in co-design workshops. Data were analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>Key barriers included misconceptions about cost, limited awareness of NHS-funded technologies, and emotional and financial burdens. Participants emphasised the importance of diverse representation, accessible language, and engaging visuals to ensure the animation resonated with a wide audience, including healthcare professionals, families, educators, and policymakers. Post-design evaluation confirmed its usability.</div></div><div><h3>Conclusions</h3><div>Guided by collaborative principles, the co-designed animation is a valuable tool for raising awareness and promoting equitable access to diabetes technology. Future research should explore broader implementation and standardisation of such educational tools across NHS services.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103432"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877166","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":"Endoplasmic reticulum stress in diabetes mellitus: A comprehensive review of emerging insights and recent progress","authors":"Harsh Kumar ,&nbsp;Reena Kumari ,&nbsp;Vineet Kumar Maurya ,&nbsp;Saroj Kumar Amar ,&nbsp;Prawej Ansari ,&nbsp;Veronique Seidel ,&nbsp;James Harper ,&nbsp;Ashish Kothari ,&nbsp;Anoop Misra ,&nbsp;Sandeep Kumar","doi":"10.1016/j.dsx.2026.103420","DOIUrl":"10.1016/j.dsx.2026.103420","url":null,"abstract":"<div><h3>Background/ aim</h3><div>Endoplasmic reticulum stress (ERS), caused by excessive buildup of misfolded proteins in the ER lumen, has emerged as a major contributor to diabetes mellitus (type-1 and type-2; T1DM and T2DM), leading to β-cell dysfunction, insulin resistance, and related comorbidities. In this review, we aim to characterize the signal transduction pathways in normal versus diseased conditions and their impact on the development of insulin-dependent and insulin-independent diabetes.</div></div><div><h3>Methods</h3><div>Evidence on ERS and diabetes were searched in MEDLINE and Google scholar databases using search strings that incorporated synonyms of ERS, diabetes, β-cell dysfunction and insulin resistance and their impact in disease progression. Our search was guided by the pertinent keywords as mentioned in the “keywords” section, that encompassed past twenty-five years of body of literature in this field as evident from <em>Urano</em> et al. <em>2000</em> till <em>Sue</em> et al. <em>2025</em>.</div></div><div><h3>Results/ conclusion</h3><div>Our results and conclusion are the distillation of past two and half decades of scientific research dedicated towards understanding the biology of ERS dependent diabetes. The ERS-induced Unfolded Protein Response (UPR), comprising of three signaling cascades, is pivotal in either protecting against or contributing to the pathophysiology of T1DM and T2DM. Clinically, ERS manifests as insulin resistance, heightened inflammation, and β-cell destruction. Consequently, ERS effectors and proteins involved in the UPR pathways have become attractive targets for pharmacological investigation. We also review some of the protein biomarkers of ERS dependent diabetes and relevant <em>in vivo/ex vivo</em> models used in clinical versus preclinical settings, as well as the latest state-of-the-art targeted molecular and cellular therapies that are currently being tried for the diabetic patients.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103420"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807517","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":"Predictive factors of MASLD in young adults: A systematic review and narrative synthesis","authors":"Moirangthem Jeena Devi ,&nbsp;Anita Malhotra ,&nbsp;Piyush Ranjan ,&nbsp;Manisha Sabharwal ,&nbsp;Aditi Verma ,&nbsp;Nikita Madan ,&nbsp;Archana Kumari ,&nbsp;Maroof A. Khan ,&nbsp;Upendra Baitha ,&nbsp;Bindu Prakash","doi":"10.1016/j.dsx.2026.103435","DOIUrl":"10.1016/j.dsx.2026.103435","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) in young adults is an emerging public health concern influenced by a multitude of demographic, lifestyle, metabolic, genetic, and environmental factors.</div></div><div><h3>Methods</h3><div>A systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted using PubMed, Wiley Online Library, and Cochrane Library. Studies investigating the predictors of metabolic dysfunction-associated steatotic liver disease in young adults aged 18–45 years were included. Methodological quality was assessed using the JBI checklist, and the adapted GRADE system was employed to evaluate the quality of evidence.</div></div><div><h3>Results</h3><div>The review identified 43 factors positively associated with MASLD, and 9 factors negatively associated with MASLD among young adults. The most consistent risk factors were metabolic abnormalities, such as obesity, insulin resistance, and dyslipidemia. Lifestyle behaviors, particularly poor dietary habits, physical inactivity, and prolonged screen time, are also strongly associated with MASLD. Additionally, genetic predisposition and environmental influences have been implicated. Conversely, the protective factors included higher levels of physical activity, adherence to healthy dietary patterns, and favorable metabolic profiles. The quality of evidence varied across the predictors, underscoring the need for further high-quality studies.</div></div><div><h3>Conclusion</h3><div>The findings highlight the multidimensional nature of MASLD in young adults, which is driven by metabolic, lifestyle, and genetic determinants. Early identification of high-risk individuals and targeted lifestyle interventions are crucial to reduce the future burden of this disease.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 5","pages":"Article 103435"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985004","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":"Response to Letter to the Editor regarding “Prediction of retinopathy risk: A prospective cohort study in China”","authors":"Xiaohan Xu ,&nbsp;Duolao Wang ,&nbsp;Uazman Alam ,&nbsp;Shanhu Qiu ,&nbsp;Yuzhi Ding ,&nbsp;Zilin Sun ,&nbsp;Anupam Garrib","doi":"10.1016/j.dsx.2026.103414","DOIUrl":"10.1016/j.dsx.2026.103414","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 4","pages":"Article 103414"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147660309","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":"Comparison of the American diabetes association risk test, BMI, and estimated cardiorespiratory fitness with incident prediabetes and type 2 diabetes: A cohort study","authors":"Robert A. Sloan ,&nbsp;Jaca Maison Lailo ,&nbsp;Sang-Ah Lee ,&nbsp;Jiae Shin ,&nbsp;Soyoung Yu ,&nbsp;Marco Visentini-Scarzanella ,&nbsp;Duck-Chul Lee ,&nbsp;Xuemei Sui","doi":"10.1016/j.dsx.2026.103421","DOIUrl":"10.1016/j.dsx.2026.103421","url":null,"abstract":"<div><h3>Aim(s)</h3><div>To compare associations of nonexercise estimated cardiorespiratory fitness (eCRF), the American Diabetes Association Risk Test (ADART), and body mass index (BMI) with incident prediabetes and type 2 diabetes in adults with normoglycemia.</div></div><div><h3>Methods</h3><div>Participants were 10,715 healthy men and women aged 20–81 years from the Aerobics Center Longitudinal Study. eCRF was calculated in metabolic equivalents using sex-specific equations including age, BMI, resting heart rate, blood pressure, and smoking status. Incident prediabetes and type 2 diabetes were identified by fasting glucose or diagnosis. Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for risk factors.</div></div><div><h3>Results</h3><div>Over a median follow-up of 5.1 years for prediabetes and 6.7 years for type 2 diabetes, 3912 and 320 cases occurred, respectively. Compared with unfit participants, fit individuals had a lower risk of prediabetes (HR: 0.83; 95% CI: 0.77–0.90) and type 2 diabetes (HR: 0.72; 95% CI: 0.55–0.95). Associations were significant in men for both outcomes and in women for prediabetes only. ADART and BMI predicted prediabetes but not type 2 diabetes after adjustment.</div></div><div><h3>Conclusions</h3><div>eCRF demonstrated reliability as a noninvasive risk assessment tool for determining prediabetes and type 2 diabetes risk, particularly in men, highlighting its potential value for early risk assessment in lower-risk populations. All tools effectively assessed prediabetes risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 4","pages":"Article 103421"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795114","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":"Letter to the editor-The predictive value of estimated glucose disposal rate for all-cause and cardiovascular mortality in the US non-diabetic population aged ≥60 years: A population-based cohort study","authors":"Longqian Li ,&nbsp;ZhuoLin Qin ,&nbsp;Cheng Wang","doi":"10.1016/j.dsx.2026.103419","DOIUrl":"10.1016/j.dsx.2026.103419","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 4","pages":"Article 103419"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795096","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":"Letter to the editor: “Prediction of retinopathy risk: A prospective cohort study in China”","authors":"Rachana Mehta ,&nbsp;Ranjana Sah","doi":"10.1016/j.dsx.2026.103415","DOIUrl":"10.1016/j.dsx.2026.103415","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 4","pages":"Article 103415"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635614","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}