World Journal of Diabetes最新文献

{"title":"Trends in baseline blood lipid levels in randomized placebo-controlled trials of overweight or obesity from 1990 to 2024.","authors":"Ya-Qi Wang, Quan-Zhou Xiao, Zhen-Ming Zhang, Yan Yang","doi":"10.4239/wjd.v16.i9.110639","DOIUrl":"10.4239/wjd.v16.i9.110639","url":null,"abstract":"<p><strong>Background: </strong>The global rise in overweight and obesity has reached alarming levels, substantially increasing the risk of metabolic disorders such as dyslipidemia. We outlined the evolving trends in baseline blood lipid levels among patients experiencing overweight or obesity, as observed in placebo-controlled randomized trials, to address the unmet clinical requirements.</p><p><strong>Aim: </strong>To assess long-term trends in lipid profiles in overweight or obese populations and their association with clinical and treatment factors.</p><p><strong>Methods: </strong>EMBASE, PubMed, Cochrane Library, and Web of Science databases were searched up to October 9, 2024. Randomized placebo-controlled trials of participants with overweight or obesity, with reports of baseline lipid levels, were included. The main outcome was a correlation between pooled baseline levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with study year. Subgroup analysis was conducted based on characteristics of the populations and intervention types.</p><p><strong>Results: </strong>A comprehensive meta-analysis encompassing 866 studies across nearly 60 countries and regions worldwide, involving 3300 participants, revealed significant temporal trends in baseline lipid profiles. The analysis revealed a significant decline in TG (Rs = -0.704, <i>P</i> < 0.001, <i>I</i> ² = 98.6%), TC (Rs = -0.884, <i>P</i> < 0.001, <i>I</i> ² = 99.6%), and LDL-C (Rs = -0.808, <i>P</i> < 0.001, <i>I</i> ² = 96.8%) levels. In contrast, HDL-C (Rs = 0.336, <i>P</i> = 0.041, <i>I</i> ² = 99.2%) levels exhibited a progressive increase over the study period. Subgroup analyses revealed that sex, body mass index, blood pressure, diabetes status, and type of intervention influenced the observed trends, especially with patients receiving pharmacological therapies demonstrating more pronounced improvements (TG: Rs = -0.449, <i>P</i> _adj = 0.011; <i>I</i> ² = 98.9%; TC: Rs = -0.650, <i>P</i> _adj = 0.001; <i>I</i> ² = 99.4%; HDL-C: Rs = 0.650, <i>P</i> _adj = 0.002; <i>I</i> ² = 98.6%; LDL-C: Rs = -0.417, <i>P</i> _adj = 0.031; <i>I</i>² = 98.0%).</p><p><strong>Conclusion: </strong>Despite rising obesity rates, lipid control has improved over three decades among individuals with overweight or obesity, reflecting the positive impact of public health efforts and effective dyslipidemia treatment strategies.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"110639"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Ras homolog enriched in brain 1 to restore β-cell mass and function: A potential therapeutic strategy for diabetes.","authors":"Yao Peng, Dong-Dong Zhang, Ling Gan, Jia-Qi Zhang","doi":"10.4239/wjd.v16.i9.109768","DOIUrl":"10.4239/wjd.v16.i9.109768","url":null,"abstract":"<p><p>This editorial highlighted the central role of pancreatic β-cell dysfunction in the pathogenesis of diabetes mellitus and discussed the emerging significance of Ras homolog enriched in brain 1 (Rheb1) as a key regulator of β-cell mass and insulin-secretory capacity. While molecular mechanisms governing β-cell homeostasis remain incompletely defined, Yang <i>et al</i> have recently demonstrated that Rheb1 could promote β-cell proliferation through dual activation of mechanistic target of rapamycin complex 1 and AMP-activated protein kinase signaling pathways, rather than relying solely on mechanistic target of rapamycin complex 1. Notably, Rheb1 expression is higher in pancreatic islets from younger individuals and upregulates hepatocyte nuclear factor 4 alpha, which is recognized as a transcription factor essential for β-cell identity and insulin production. These insights position Rheb1 as a pivotal regulator of β-cell growth and metabolic function, with potential therapeutic implications for diabetes. Targeting Rheb1 may shift treatment paradigms from conventional glucose-lowering strategies toward β-cell restoration, providing a novel approach to preserve or enhance functional β-cell mass in diabetic patients. Further investigation into Rheb1's upstream regulators and downstream effectors may provide innovative therapeutic directions.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109768"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic foot ulcer with overlap syndrome: A case report and review of literature.","authors":"Shi-Yi Sun, Da-Wei Chen, Jing Wu, Yan Li, Xing-Wu Ran","doi":"10.4239/wjd.v16.i9.109597","DOIUrl":"10.4239/wjd.v16.i9.109597","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcer (DFU) is a common and serious complication among individuals with diabetes. However, the co-occurrence of DFU with overlap syndrome, particularly involving anti-synthetase syndrome (ASS) and systemic sclerosis (SSc), is exceptionally rare.</p><p><strong>Case summary: </strong>We report a case of overlap syndrome (ASS and SSc) with diabetes manifesting as biped gangrene. The patient, a 60-year-old female, presented with painful ulcers on both heels that had persisted for nine months. She was diagnosed with DFU, which was likely attributable to SSc, suboptimal long-term glycemic control, and glucocorticoid therapy. Following four months of treatment, the patient demonstrated significant improvement and was subsequently discharged. At the one-year follow-up, the patient developed new cyanotic ulcers on the right 4^th and 5^th toes ten months post-discharge that resolved completely within 3 months following conservative management. The four-year follow-up revealed persistent intermittent cyanosis without ulcer recurrence, although progressive interstitial lung disease necessitated prolonged bed rest.</p><p><strong>Conclusion: </strong>SSc-related foot ulcers demonstrate favorable outcomes when managed with conventional wound care combined with vasoactive agents.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109597"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of inositol supplementation in the prevention and treatment of gestational diabetes mellitus: A meta-analysis.","authors":"Ru-Tong Wang, Ying-Qi Feng, Meng-Yao Wang, Yan-Hong Wei, Yu-Jun Huang, Yu-Jia Guo, Xuan Liu, Xiao-Can Lei, Kong-Wei Huang, Hua Huang","doi":"10.4239/wjd.v16.i9.107871","DOIUrl":"10.4239/wjd.v16.i9.107871","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) poses a substantial health risk during pregnancy. However, the role of myo-inositol (MI) in GDM prevention and management remains controversial due to conflicting evidence and methodological limitations in previous studies.</p><p><strong>Aim: </strong>To assess the efficacy of MI in preventing and treating GDM, providing evidence-based guidance for clinical practice.</p><p><strong>Methods: </strong>A systematic review was conducted on studies published on the PubMed, Web of Science, and Embase databases from their inception date to July 2024. Twelve studies encompassing 9018 patients were included in the meta-analysis using fixed-effect and random-effects models. Heterogeneity was quantified with <i>I</i> ² statistics and the Cochrane <i>Q</i> test, and study quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 checklist.</p><p><strong>Results: </strong>MI significantly reduced GDM incidence [relative risk (RR): 0.37; 95% confidence interval (CI): 0.32-0.42], fasting blood glucose [standard mean differences (SMD): -1.31 mg/dL; 95%CI: -1.83 to -0.79], and improved glucose tolerance test outcomes at 1-hour (SMD: -2.63 mg/dL; 95%CI: -3.87 to -1.40) and 2-hour (SMD: -0.95 mg/dL; 95%CI: -1.56 to -0.34). It also decreased the risk of preterm birth (RR: 0.37; 95%CI: 0.28-0.47) and pregnancy-induced hypertension (RR: 0.34; 95%CI: 0.25-0.47). A non-significant trend towards reduced cesarean section rates was observed (RR: 0.82; 95%CI: 0.71-0.94). MI reduced birth weight (SMD: -0.25 kg; 95%CI: -0.32 to -0.17), but had no effect on neonatal hypoglycemia (RR: 0.30; 95%CI: 0.08-1.21) or gestational age at birth (SMD: -0.13 weeks; 95%CI: -0.04 to 0.29).</p><p><strong>Conclusion: </strong>MI demonstrates therapeutic potential in GDM prevention and management, supporting its potential use as a preventive supplement in early pregnancy for high-risk women. Nonetheless, its therapeutic effects in women diagnosed with GDM require further validation.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"107871"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging derived biomarkers for the diagnosis of type 2 diabetes with insulin resistance: A pilot study.","authors":"Bo-Wen Hou, Zheng Ran, Yi-Tong Li, Jing Zhang, Yong-Qiang Chu, Nadeer M Gharaibeh, Xiao-Ming Li","doi":"10.4239/wjd.v16.i9.110183","DOIUrl":"10.4239/wjd.v16.i9.110183","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) plays a critical role in the musculoskeletal metabolic disorders associated with type 2 diabetes mellitus (T2DM).</p><p><strong>Aim: </strong>To develop multiparametric magnetic resonance imaging (MRI)-derived biomarkers and diagnostic models for non-invasive identification and stratification of IR.</p><p><strong>Methods: </strong>Parameters of paravertebral muscles and vertebra were evaluated using quantitative chemical shift-encoded MRI and diffusion tensor imaging protocols. Tripartite cohort analyses were conducted through Kruskal-Wallis <i>H</i> tests with <i>post hoc</i> Dunn-Bonferroni correction for MRI-derived metrics. Diagnostic performance for T2DM-IR was assessed after selecting the most significant features through <i>Z</i>-score standardization and multinomial logistic regression models.</p><p><strong>Results: </strong>This study evaluated 97 subjects (control: 39 subjects, T2DM-IR: 18 subjects, T2DM patients without IR: 40 subjects) using multiparametric MRI protocols. Significant intergroup differences were observed in the cross-sectional area (<i>P</i> = 0.047) and apparent diffusion coefficient (<i>P</i> = 0.027) of the psoas, and the cross-sectional area (<i>P</i> = 0.042) of the erector. More intramyocellular lipid (IMCL) in the psoas (<i>P</i> = 0.001) and erector (<i>P</i> = 0.004) were found in the T2DM-IR group. Multinomial receiver operating characteristic curve analysis demonstrated that IMCL of the erector performed better (area under the curve = 0.838, sensitivity: 0.800, specificity: 0.938) in the diagnosis of T2DM-IR.</p><p><strong>Conclusion: </strong>IMCL in erector emerges as a highly discriminative metric for T2DM-IR diagnosis. Multiparametric MRI enables non-invasive quantification of early musculoskeletal metabolic injury, providing reliable biomarkers for IR identification and stratification.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"110183"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism.","authors":"Shi-Qi Liu, Dong Wang, Cheng-Chun Tang","doi":"10.4239/wjd.v16.i9.107693","DOIUrl":"10.4239/wjd.v16.i9.107693","url":null,"abstract":"<p><p>The introduction of drug-eluting stents has significantly reduced the incidence of in-stent restenosis. Despite this, recurrent cardiovascular events related to untreated nontarget lesions (NTLs) are becoming more common and accounting for more than 50% of all recurrent cardiovascular events. In patients with diabetes, factors such as prolonged disease duration, poor glycemic control, insulin use, and inadequate lipid management may exacerbate the progression of NTLs and adverse cardiovascular events. Additionally, glycemic fluctuations have been linked to an increased risk of future cardiovascular events in patients with early glucose metabolism abnormalities and acute hyperglycemia. In this review, we explored the clinical and plaque characteristics of patients with diabetes and early glucose metabolism disorders, the percutaneous coronary intervention strategies for NTLs, and their prognostic implications. Furthermore, we investigated the mechanistic links between adverse cardiovascular outcomes and elevated inflammation, oxidative stress, hypercoagulability, and endothelial dysfunction.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"107693"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albuminuria is independently associated with preclinical left ventricular systolic dysfunction: The TESEO study.","authors":"Federica Barutta, Alessandro Andreis, Matteo Bellettini, Guglielmo Beccuti, Arianna Ferro, Martina Bollati, Stefania Bellini, Giulia Gioiello, Giulio Mengozzi, Gaetano M De Ferrari, Gianluca Alunni, Fabio Broglio, Gabriella Gruden","doi":"10.4239/wjd.v16.i9.106914","DOIUrl":"10.4239/wjd.v16.i9.106914","url":null,"abstract":"<p><strong>Background: </strong>Global longitudinal strain (GLS) of the left ventricular is a highly sensitive and reliable marker of systolic function and GLS outperforms ejection fraction (EF) in detecting preclinical left ventricular systolic dysfunction (LVSD). In patients with type 2 diabetes (DM2) albuminuria is a predictor of symptomatic heart failure, but data on the relationship between GLS and albuminuria are conflicting.</p><p><strong>Aim: </strong>To explore the relationship between GLS and albuminuria in a contemporary cohort of DM2 patients.</p><p><strong>Methods: </strong>The study was performed on DM2 patients consecutively enrolled in the TESEO study. Patients with symptoms/signs of heart failure, EF < 50%, coronary artery, other cardiac diseases, or non-adequate acoustic window for GLS assessment were excluded. We collected clinical data, screened for complications, and measured GLS by speckle-tracking echocardiography. Univariate and multiple linear regression analyses were performed to identify independent explanatory variables associated with GLS. Logistic regression analysis was used to assess whether albuminuria was independently associated with GLS-diagnosed (GLS > -18%) LVSD.</p><p><strong>Results: </strong>Patients (<i>n</i> = 193, age: 60.6 ± 8.1, male: 57%) had a short DM2 duration (3.8 ± 4.9 years) and good metabolic control (glycated haemoglobin A1c: 6.5% ± 1.0). Preclinical GLS-LVSD was present in 21.8% of the patients. GLS values were significantly higher in patients with albuminuria (-19.88 ± 2.16 <i>vs</i> -18.29 ± 2.99, <i>P</i> < 0.001) and in multivariate analysis natural logarithm of albumin-creatinine ratio and uric acid were independent predictors of GLS. In logistic regression analysis, albuminuria was associated with a 6.01 (95% confidence interval: 1.874-19.286) increased odds ratio of GLS-LVSD, independent of age, sex, diastolic blood pressure, chronic kidney disease, EF, mitral annulus velocity lateral, uric acid, and treatments.</p><p><strong>Conclusion: </strong>Albuminuria was independently associated with subclinical LVSD in our contemporary cohort of DM2 patients.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"106914"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exogenous insulin-associated autoimmunity and the emergence of double diabetes in type 2 diabetes.","authors":"Xin-Gang Li, Meng-Ya Qi, Xiang Li, Fan Ping","doi":"10.4239/wjd.v16.i9.109130","DOIUrl":"10.4239/wjd.v16.i9.109130","url":null,"abstract":"<p><strong>Background: </strong>Exogenous insulin may trigger immune-mediated complications, particularly among East Asian populations. Double diabetes, characterized by overlapping features of type 1 diabetes (T1D) and type 2 diabetes (T2D), may arise from insulin-induced autoimmunity. This study aimed to explore the association between high-risk human leukocyte antigen (HLA) class II genotypes and susceptibility to double diabetes in patients initially diagnosed with T2D.</p><p><strong>Aim: </strong>To investigate clinical and immunogenic features of patients who develop double diabetes following exogenous insulin therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed five cases from Peking Union Medical College Hospital and 18 cases identified from published literature. Patients were categorized into two groups: The T2D→T1D group, characterized by autoimmune progression, and the stable T2D (T2D→T2D). Clinical characteristics and HLA class II genotypes were compared descriptively between the two groups.</p><p><strong>Results: </strong>A total of 23 patients were included in the analysis. Of these, 10 progressed from theT2D→T1D with autoimmune features, while 13 remained in the stable T2D→T2D group. There was no statistically significant difference in age at diagnosis between the two groups (57.10 ± 16.11 years <i>vs</i> 60.31 ± 17.41 years). In the T2D→T1D group, 70% of patients carried the HLA-DRB1 04: 05 allele and 40% carried DRB1 09: 01, both of which are commonly associated with a high risk of T1D. In contrast, the T2D→T2D group showed greater genetic heterogeneity, with a broader distribution of HLA-DRB1 alleles, including DRB1 03: 02 (<i>n</i> = 4), DRB1 09: 01 (<i>n</i> = 4), and several lower frequency alleles such as DRB1*04: 05, *08: 03, *03: 01, *04: 06, *14: 01, *04: 01, *12: 02,*15: 02 and *02: 01.</p><p><strong>Conclusion: </strong>These findings suggest that patients in the T2D→T1D group exhibit a stronger autoimmune genetic predisposition, characterized by an enrichment of high-risk HLA class II alleles. In contrast, individuals with stable T2D demonstrate greater HLA diversity and lack definitive autoimmune-associated markers.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109130"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Income and wealth inequality is associated with young-onset type 2 diabetes.","authors":"Fu-Shun Yen, James Cheng-Chung Wei, Yao-Min Hung, Jia-Sin Liu, Chii-Min Hwu, Chih-Cheng Hsu","doi":"10.4239/wjd.v16.i9.108480","DOIUrl":"10.4239/wjd.v16.i9.108480","url":null,"abstract":"<p><strong>Background: </strong>There are only a few studies on the influence of economic inequalities on young-onset type 2 diabetes (T2D).</p><p><strong>Aim: </strong>To examine the impact of different family incomes on the development of young-onset T2D.</p><p><strong>Methods: </strong>We identified 7505336 young adults aged 20-39 years from the 2008 Taiwan National Health Insurance Research Database. The young adults were divided into low-income, middle-income, and high-income groups. Cox proportional hazards models were used to determine the risks of young-onset T2D and all-cause mortality in low-income and middle-income groups compared with the high-income group.</p><p><strong>Results: </strong>With a mean follow-up of 8.0 years, the incidence rates of young-onset T2D were 3.39, 3.10, and 2.88 per 1000 person-years in the low-income, middle-income, and high-income groups, respectively. Compared with the high-income group, the risk of young-onset T2D was significantly higher in the low-income [adjusted hazard ratio (aHR) (95%CI): 1.46 (1.44-1.48)] and middle-income [aHR (95%CI): 1.29 (1.27-1.31)] groups. All-cause mortality was also higher in the low-income [aHR (95%CI): 2.79 (2.70-2.88)] and middle-income [aHR (95%CI): 1.59 (1.53-1.65)] groups. Older age, male sex, obesity, smoking, alcohol-related disorders, hypertension, dyslipidemia, gout, and psychotic disorders were significantly associated with increased risks of both young-onset T2D and mortality.</p><p><strong>Conclusion: </strong>This nationwide cohort study demonstrated that young people from low-income and middle-income groups had a higher risk of youth-onset T2D and mortality than those from the high-income group.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"108480"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saving muscle while losing weight: A vital strategy for sustainable results while on glucagon-like peptide-1 related drugs.","authors":"Maja Cigrovski Berkovic, Lana Ruzic, Vjekoslav Cigrovski, Felice Strollo","doi":"10.4239/wjd.v16.i9.109123","DOIUrl":"10.4239/wjd.v16.i9.109123","url":null,"abstract":"<p><p>Obesity affects over 1 billion people worldwide and is linked to more than 230 health complications, with cardiovascular disease being a leading cause of mortality. Losing 5%-10% of body weight is considered clinically significant for improving health. This weight loss can be achieved through pharmacotherapy, including glucagon-like peptide 1 (GLP-1) receptor agonists, GLP-1/glucose-dependent insulinotropic peptide dual receptor agonists, and GLP-1/glucose-dependent insulinotropic peptide/glucagon triple receptor agonists (such as semaglutide, tirzepatide, and retatrutide, respectively). While much of the weight loss comes from fat mass, these treatments also result in the loss of lean mass, including muscle. This loss of muscle may contribute to difficulties in maintaining weight over the long term and can lead to sarcopenia. Therefore, the focus of new anti-obesity treatments should be primarily on reducing fat mass while minimizing the loss of muscle mass, ideally promoting muscle gain. Research focusing on human myocytes has identified more than 600 myokines associated with muscle contraction, which may play a crucial role in preserving both muscle mass and function. We explored the potential of new anti-obesity agents and their combinations with incretin-based therapies to achieve these outcomes. Further studies are needed to better understand the functional implications of lean mass expansion during weight loss and weight maintenance programs.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109123"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}