World Journal of Diabetes最新文献

{"title":"Association of dietary index for gut microbiota and all-cause and cardiovascular mortality in patients with diabetes or prediabetes.","authors":"Zheng Wang, Fa-Chao Shi, Shan-Bing Hou, Quan-Quan Sun, Cao-Yang Fang","doi":"10.4239/wjd.v16.i7.107111","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.107111","url":null,"abstract":"<p><strong>Background: </strong>The dietary index for gut microbiota (DI-GM) demonstrates associations with diabetes prevalence and related mortality outcomes, serving as a nutritional assessment tool for microbial community evaluation.</p><p><strong>Aim: </strong>To investigate connections between DI-GM values and survival endpoints in populations with impaired glucose metabolism, incorporating both total mortality and cardiovascular-related fatal events.</p><p><strong>Methods: </strong>Cox proportional hazards modeling through survival analysis evaluated the relationship between DI-GM quartile classifications and fatal event probabilities. Restricted cubic spline modeling evaluated non-linear associations between continuous DI-GM values and mortality endpoints. Stratified analyses and robustness checks ensured the validity of the results.</p><p><strong>Results: </strong>Higher DI-GM values showed a statistically significant negative correlation with total mortality risk [hazard ratio (HR) = 0.96, 95%CI: 0.93-1.00] and cardiovascular-related fatal outcomes (HR = 0.93, 95%CI: 0.87-0.99). When comparing quartiles, analysis indicated that participants in the upper quartile (Q4) had 17% decreased likelihood of all-cause death (HR = 0.83, 95%CI: 0.69-0.99) and 25% lower probability of cardiovascular mortality (HR = 0.75, 95%CI: 0.54-1.00) relative to those in the lowest quartile (Q1).</p><p><strong>Conclusion: </strong>These findings position DI-GM as a protective determinant against mortality in glucose metabolism disorders. Dietary pattern optimization targeting DI-GM enhancement could constitute a strategic intervention in diabetes care protocols.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107111"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692043","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":"Systemic immune indicators: Early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.","authors":"Basavraj S Nagoba, Ajay M Gavkare, Neeta Nanaware, Sachin S Mumbre, Sachin Bhavthankar","doi":"10.4239/wjd.v16.i7.108209","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.108209","url":null,"abstract":"<p><p>This editorial delves into the potential of systemic immune indicators (SIIs) as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus. By exploring the recent study published by Cao <i>et al</i>, this article aims to highlight the importance of early detection and intervention. This study comprehensively analyzes various SIIs, examining their correlation with renal complications in newly diagnosed type 1 diabetic children. The findings reveal a significant association between immune system dysregulation and the onset of renal damage, suggesting that certain immune indicators can be early markers for predicting renal complications. This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care. It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes. Additionally, it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"108209"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692105","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":"Chronic hepatitis B with type 2 diabetes mellitus: Association between glycemic control and liver fibrosis.","authors":"Yan Luo, Rui Li, Jun Kang, Ben-Nan Zhao, Li-Juan Lan, Feng-Jiao Gao, Xiao-Xia Ren, Yan-Feng Zhu, Da-Feng Liu","doi":"10.4239/wjd.v16.i7.107256","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.107256","url":null,"abstract":"<p><strong>Background: </strong>The interplay between abnormal glucose metabolism and the progression of liver fibrosis in patients with both chronic hepatitis B (CHB) and type 2 diabetes mellitus (T2DM) remains unclear. Previous studies have suggested that the coexistence of these conditions may exacerbate liver inflammation and fibrosis; however, the impacts of dynamic changes in glucose metabolism indicators, hypoglycemic medication regimens, and glycemic control status on liver fibrosis require further elucidation.</p><p><strong>Aim: </strong>To explore the effect of glycemic control on hepatic fibrosis in patients with CHB and T2DM.</p><p><strong>Methods: </strong>A total of 420 patients with CHB and T2DM admitted to the Public Health Clinical Center of Chengdu between October 2018 and January 2022 were retrospectively included and classified according to liver stiffness measurement and glycemic control for between-group comparisons.</p><p><strong>Results: </strong>Significant differences were observed in the alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, AST/ALT ratio, total bilirubin, direct bilirubin, diabetes treatment program, and thrombin time values among the liver fibrosis groups (adjusted <i>P</i> < 0.05). Significant differences in albumin and gamma-glutamyl transferase levels were observed among the groups categorized by glucose status at admission (adjusted <i>P</i> < 0.05). A positive correlation between fasting plasma glucose (FPG) and liver stiffness measurement was found to be mediated by ALT and AST. Fibrinogen and the international normalized ratio were positively correlated with glycated hemoglobin A1c, while the fibrosis-4 score, ALT, AST/ALT ratio, type III procollagen N-terminal peptide, ferritin, and activated partial thromboplastin time were correlated with FPG at admission. Additionally, AST was positively correlated with FPG at discharge (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Specific glucose metabolic parameters, hypoglycemic agents, and glycemic control status markers are associated with hepatic fibrosis in patients with both CHB and T2DM. Close blood glucose monitoring, optimized use of hypoglycemic agents, and continuous maintenance of good glycemic control may slow the progression of liver fibrosis in patients with CHB and T2DM.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107256"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692069","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":"Comparison of three diagnostic imaging modalities for use in diabetic inferior arterial lesions.","authors":"Ying Bo, Jia Xie, Fan Xu, Guo Yang, Dong-Ling Li, Xiao-Hang Yan","doi":"10.4239/wjd.v16.i7.107187","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.107187","url":null,"abstract":"<p><strong>Background: </strong>Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences. Hence, clinicians have focused on early diagnosis and treatment.</p><p><strong>Aim: </strong>To investigate the effectiveness of the combination of doppler ultrasonography (DUS), three-dimensional dynamic contrast-enhanced magnetic resonance angiography (CE-MRA), and CT angiography (CTA) in assessing lower extremity arterial disease in diabetes mellitus (DM).</p><p><strong>Methods: </strong>This study retrospectively analyzed the imaging and clinical data of 116 patients diagnosed with DM complicated with lower extremity vascular diseases from January 2021 to June 2023. All patients underwent unilateral or bilateral DUS, CTA, and CE-MRA as well as invasive digital subtraction angiography (DSA). The application values of DUS, CE-MRA, and CTA were compared.</p><p><strong>Results: </strong>A total of 152 lower extremity arteries in the 116 patients were graded following the classification of vascular branches. The Kappa values between DUS and DSA were 0.780, 0.755, and 0.806 for diagnosing moderate stenosis and 0.484, 0.699, and 0.449 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CE-MRA and DSA were 0.784, 0.814, and 0.835 for diagnosing moderate stenosis and 0.694, 0.748, and 0.606 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CTA and DSA were 0.900, 0.858, and 0.878 for diagnosing moderate stenosis and 0.882, 0.823, and 0.756 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively.</p><p><strong>Conclusion: </strong>DUS, CE-MRA, and CTA demonstrated comparable accuracy in diagnosing lower extremity arterial disease in DM, and the consistency between CTA and DSA diagnoses was higher than the other two imaging methods.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107187"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692070","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":"Stem cell therapy for diabetes: Advances, prospects, and challenges.","authors":"Dian-Bao Zuo, Chun-Hua Wang, Ming Sang, Xiao-Dong Sun, Guo-Ping Chen, Kang-Kang Ji","doi":"10.4239/wjd.v16.i7.107344","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.107344","url":null,"abstract":"<p><p>Diabetes mellitus, a global epidemic, represents a major public health threat. Stem cell therapy, with its regenerative capacity, has emerged as a promising approach for diabetes mellitus management. This paper reviews recent advancements, prospects, and challenges in stem cell-based treatments for diabetes mellitus, focusing on the applications of induced pluripotent stem cells and mesenchymal stem cells, the development of pancreatic islet organoids, and the potential for personalized medicine. The review critically assesses the efficacy and safety of stem cell therapies in clinical trials and examines their applications in both type 1 and type 2 diabetes mellitus. Despite the promising potential, challenges such as safety concerns, transplantation efficiency, ethical considerations, and immune rejection remain prevalent. Lastly, the paper discusses future directions, including the integration of stem cell therapy with other treatments and the advancement of personalized therapeutic strategies, offering new perspectives and hope for diabetes mellitus management.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107344"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692104","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":"Illuminating diabetes <i>via</i> multi-omics: Unraveling disease mechanisms and advancing personalized therapy.","authors":"Chen-Meng Song, Ta-Hui Lin, Hou-Tan Huang, Jeng-Yuan Yao","doi":"10.4239/wjd.v16.i7.106218","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.106218","url":null,"abstract":"<p><p>Diabetes mellitus (DM) comprises distinct subtypes-including type 1 DM, type 2 DM, and gestational DM - all characterized by chronic hyperglycemia and substantial morbidity. Conventional diagnostic and therapeutic strategies often fall short in addressing the complex, multifactorial nature of DM. This review explores how multi-omics integration enhances our mechanistic understanding of DM and informs emerging personalized therapeutic approaches. We consolidated genomic, transcriptomic, proteomic, metabolomic, and microbiomic data from major databases and peer-reviewed publications (2015-2025), with an emphasis on clinical relevance. Multi-omics investigations have identified convergent molecular networks underlying β-cell dysfunction, insulin resistance, and diabetic complications. The combination of metabolomics and microbiomics highlights critical interactions between metabolic intermediates and gut dysbiosis. Novel biomarkers facilitate early detection of DM and its complications, while single-cell multi-omics and machine learning further refine risk stratification. By dissecting DM heterogeneity more precisely, multi-omics integration enables targeted interventions and preventive strategies. Future efforts should focus on data harmonization, ethical considerations, and real-world validation to fully leverage multi-omics in addressing the global DM burden.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"106218"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692000","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":"Decoding androgen excess in polycystic ovary syndrome: Roles of insulin resistance and other key intraovarian and systemic factors.","authors":"Neervana Rambaran, Md Shahidul Islam","doi":"10.4239/wjd.v16.i7.108789","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.108789","url":null,"abstract":"<p><p>Recent studies have potentiated the essential role of androgens in normal folliculogenesis and, therefore, female fertility. Contrastingly, excess androgen levels, <i>i.e.,</i> hyperandrogenism (HA), a hallmark characteristic of polycystic ovary syndrome, overrides the delicate balance of folliculogenesis, leading to follicular arrest and ovulatory issues. Insulin resistance (IR) has a profound effect on elevating androgen secretion and is considered one of the primary factors driving both ovarian androgen production and metabolic dysfunction in polycystic ovary syndrome. Together with IR, disruptions in key intraovarian and systemic factors, including activin, inhibin, follistatin, anti-Mullerian hormone, bone morphogenetic proteins, growth differentiation factor-9 and Kit ligand, as well as dysregulation in both the insulin and the transforming growth factor-β superfamily signaling pathway, contribute to follicular arrest, elevated androgen levels and metabolic dysfunction, exacerbating HA. Additionally, suppression of sex hormone-binding globulin, disrupted adipose-neuroendocrine signaling and altered microRNA expression heighten HA, with IR serving as the fundamental contributor. Emerging evidence implicates impaired atresia together with non-apoptotic cell death, such as ferroptosis and pyroptosis, which have also been associated with ovarian dysfunction. A comprehensive understanding of the most significant factors, particularly IR, which amplifies androgen production through hyperinsulinemia-mediated stimulation of theca cells, is essential for identifying targeted therapeutic strategies.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"108789"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692071","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":"Detect the disrupted brain structural connectivity in type 2 diabetes mellitus patients without cognitive impairment.","authors":"Yi-Fan Li, Yue Wei, Ming-Rui Li, Zhi-Zhong Sun, Wei-Yan Xie, Qian-Fan Li, Chen-Hui Xie, Jing-Yi Xiang, Xin Tan, Shi-Jun Qiu, Yi Liang","doi":"10.4239/wjd.v16.i7.103468","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.103468","url":null,"abstract":"<p><strong>Background: </strong>Cognitive decline in type 2 diabetes mellitus (T2DM) occurs years before the onset of clinical symptoms. Early detection of this incipient cognitive decline stage, which is T2DM without mild cognitive impairment, is critical for clinical intervention, yet it remains elusive and challenging to identify.</p><p><strong>Aim: </strong>To identify structural changes in the brains of T2DM patients without cognitive impairment to gain insights into the early-stage cognitive decline.</p><p><strong>Methods: </strong>Using diffusion tensor imaging (DTI), we constructed structural brain networks in 47 T2DM patients and 47 age-/sex-matched healthy controls. Machine learning models incorporating connectivity features were developed to classify T2DM brains and predict disease duration.</p><p><strong>Results: </strong>T2DM patients exhibited reduced global/local efficiency and small-worldness, alongside weakened connectivity in cortical regions but enhanced subcortical-frontal connections, suggesting compensatory mechanisms. A classification model leveraging 18 connectivity features achieved 92.5% accuracy in distinguishing T2DM brains. Structural connectivity patterns further predicted disease onset with an error of ± 1.9 years.</p><p><strong>Conclusion: </strong>Our findings reveal early-stage brain network reorganization in T2DM, highlighting subcortical-frontal connectivity as a compensatory biomarker. The high-accuracy models demonstrate the potential of DTI-based biomarkers for preclinical cognitive decline detection.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"103468"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692072","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 Xiaokeqing granules and lifestyle intervention in treating prediabetes mellitus considering metabolomic biomarkers: A randomised controlled trial.","authors":"Jin-Dong Zhao, Meng-Zhu Guo, Yi Zhang, Shao-Hua Zhu, Ya-Ting Wang, Yan-Ping Zhang, Xin Liu, Si Cheng, Fei Wang, Qi Xu, Nuo-Bing Ruan, Zhao-Hui Fang","doi":"10.4239/wjd.v16.i7.105219","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.105219","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes mellitus (PDM) is receiving increasing attention as a precursor to type 2 diabetes mellitus. Lifestyle and traditional Chinese medicine (TCM) interventions are effective for PDM prevention and treatment. Therefore, we conducted a preliminary investigation and an exploratory randomised controlled trial to assess the effects of a combined lifestyle and TCM intervention on PDM indicators.</p><p><strong>Aim: </strong>To study the effectiveness of Xiaokeqing granules (XQG) and lifestyle interventions in PDM participants while using metabolomics to identify potential markers.</p><p><strong>Methods: </strong>Forty PDM participants with yin deficiency syndrome with excessive heat were recruited and randomly allocated to the control (Con) group or the XQG group (20 <i>per</i> group). The Con group underwent lifestyle interventions, whereas the XQG group underwent lifestyle and XQG interventions. The follow-up duration was 2 months. Fasting blood glucose, 2-hour postprandial glucose (2hPG), glycated haemoglobin A1c, fasting insulin, homeostasis model assessment-insulin resistance levels, and serum metabolomics characteristics were compared <i>via</i> liquid chromatography-tandem mass spectrometry analysis.</p><p><strong>Results: </strong>There were significant differences in 2hPG between the two groups (<i>P</i> < 0.05) in the intention-to-treat analysis and <i>per</i>-protocol analysis. The intervention method used in this study was safe (<i>P</i> > 0.05). Groenlandicine, kaempferol, isomangiferin, <i>etc.</i>, are the XQG constituents absorbed in the blood. N-Nervonoyl methionine and 5-hydroxy-L-tryptophan are core potential metabolomic biomarkers for the effectiveness of XQG and lifestyle interventions. <i>HTR1A</i>, <i>HTR2C</i>, <i>SLC6A4</i>, <i>etc.</i>, are the core targets of XQG and lifestyle interventions, as well as the reason for their clinical efficacy. Possible mechanistic pathways include tryptophan metabolism, pantothenate and certificate of analysis biosynthesis, lysine degradation and biosynthesis of cofactors.</p><p><strong>Conclusion: </strong>This pilot study provides evidence that a combined XQG and lifestyle intervention can improve 2hPG in participants with PDM. The mechanism of action is related to multiple constituents, targets and pathways.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"105219"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692073","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":"Risk factors for pulmonary infection after thoracoscopic radical resection of lung cancer in elderly patients with diabetes mellitus.","authors":"Zi-Yuan Chen, Zhi-Qi Hong, Tie-Qiao Wang, Guo-Mei-Zhi Fu, Wen-Min Su, Cheng-Wei Zhou","doi":"10.4239/wjd.v16.i7.106903","DOIUrl":"https://doi.org/10.4239/wjd.v16.i7.106903","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lung cancer (LC) is one of the most prevalent cancers globally, with a high incidence among the elderly population. Elderly patients, particularly those with diabetes mellitus, are at an increased risk of postoperative complications, including pulmonary infections, due to weakened immune function and metabolic abnormalities. Postoperative pulmonary infection (PPI) is a predominant complication after thoracoscopic radical resection of LC, significantly affecting patient outcomes and increasing healthcare burdens. Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and reducing infection rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To develop and validate a predictive model for PPI in elderly patients with diabetes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022. General clinical information, surgical treatment details, and laboratory test results were collected and analyzed. Patients were grouped according to infection occurrence during the postoperative hospitalization period. Risk factors for PPIs were determined through logistic regression analysis, and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 212 patients [median age: 72 years (interquartile range: 60-82 years)], 41 developed PPI (19.34%), with Gram-negative bacteria being the predominant pathogens (64.14%). Factors, such as age of ≥ 70 years, presence of respiratory diseases, maximum tumor diameter of ≥ 4 cm, stages II-III, receiving neoadjuvant chemotherapy of ≥ 2 times preoperatively, surgery duration of ≥ 3 hours, chest drainage tube placement duration of ≥ 3.5 days, preoperative fasting blood glucose levels, hemoglobin A1c (HbA1c) levels, and multi-leaf resection, were markedly higher in the infection group than in the non-infection group. Conversely, forced expiratory volume in 1 second (FEV1) of ≥ 80% and albumin (Alb) levels were lower in the infection group. Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of ≥ 2 times [odds ratio (OR) = 2.987; &lt;i&gt;P&lt;/i&gt; = 0.036], maximum tumor diameter of ≥ 4 cm (OR = 3.959; &lt;i&gt;P&lt;/i&gt; = 0.013), multi-leaf resection (OR = 3.18; &lt;i&gt;P&lt;/i&gt; = 0.036), preoperative FEV1 of ≤ 80% (OR = 3.305; &lt;i&gt;P&lt;/i&gt; = 0.029), and high HbA1c levels (OR = 2.39; &lt;i&gt;P&lt;/i&gt; = 0.003) as key risk factors for PPI, whereas high Alb levels (OR = 0.507; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) was protective. The nomogram model demonstrated excellent diagnostic ability (area under the curve = 0.901, 0.915), and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The primary path","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"106903"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692102","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}