World Journal of Diabetes最新文献

{"title":"Combined effects of glycemic status and adiposity on cardiovascular risk in chronic kidney disease: A nationwide population-based study.","authors":"Eun Hui Bae, Sang Yup Lim, Bong Seong Kim, Kyungdo Han, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Soo Wan Kim","doi":"10.4239/wjd.v17.i1.114624","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.114624","url":null,"abstract":"<p><strong>Background: </strong>Obesity and diabetes are well-established risk factors for cardiovascular disease (CVD), and their coexistence is particularly detrimental in chronic kidney disease (CKD). However, the interactions between various adiposity patterns and glycemic status in influencing CVD outcomes in CKD remain inadequately defined.</p><p><strong>Aim: </strong>To evaluate the combined effects of diabetes, body mass index (BMI), and waist circumference (WC) on CVD risk.</p><p><strong>Methods: </strong>We analyzed data from 1714859 adults with CKD sourced from the Korean National Health Insurance database. Participants were classified into three glycemic groups: Normoglycemia, impaired fasting glucose (IFG), and diabetes mellitus (DM). BMI and WC were further categorized into five and six levels, respectively. Incident CVD events and all-cause mortality were assessed across the combined categories of glycemic status and adiposity. Incidence rates and adjusted hazard ratios were computed using Cox proportional hazards models.</p><p><strong>Results: </strong>A significant interaction was identified between glycemic status and adiposity indices concerning CVD risk (<i>P</i> for interaction < 0.001). Among normoglycemic individuals, both underweight (BMI < 18.5 kg/m²) and central obesity (WC ≥ 100/95 cm in men/women) were associated with increased CVD risk and mortality. In individuals with IFG, underweight remained a consistent risk factor, while WC displayed a linear relationship with CVD but not with mortality. In those with DM, the highest CVD risk was observed in individuals who were underweight (BMI < 18.5 kg/m²) and had low WC (< 80 cm in men/< 75 cm in women).</p><p><strong>Conclusion: </strong>Cardiovascular risk is jointly influenced by glycemic status and adiposity, with diabetes consistently elevating risk across all BMI and WC categories, underscoring the importance of their assessment in CKD.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"114624"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093482","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":"Transverse tibial bone transport promotes distraction osteogenesis and improves blood flow in the management of diabetic foot.","authors":"Mei-Mei Liao, Fan Zhang, Yi-Kai Wang, Meng-Wei Wang, Jia-Rui Cao, Zhi-Hui Jin, Yi-Jun Ren, Sen Chen","doi":"10.4239/wjd.v17.i1.111847","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.111847","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diabetic foot ulcers (DFUs), a common and severe long-term complication of diabetes, are associated with high rates of amputation and mortality. Transverse tibial bone transport (TTT) has recently been applied in DFU management to accelerate wound healing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore the potential mechanism through which TTT aids in the treatment of DF, with a special focus on the role of postoperative distraction osteogenesis and angiogenesis in the affected limb.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifteen patients with DFUs (Wagner grades 2-5) treated with TTT were enrolled. Pain intensity was assessed using the Visual Analog Scale (VAS), and skin temperature and Ankle-brachial index (ABI) were measured at 1 week, 1 month, and 6 months postoperatively. Wound healing was assessed by tracking the duration and rate of healing. Computed tomography (CT) scans of both lower limbs were conducted before and 1 month after surgery to evaluate distraction osteogenesis, and CT values of the corresponding medullary cavities of the bone blocks were recorded. High-frequency color Doppler ultrasonography was used to assess popliteal artery (POA) blood flow, inner diameters, and velocities of the three middle arteries of the lower leg and dorsalis pedis artery, and the number of collateral vessels of the three middle arteries. Plantar microcirculation was measured before and 1 month after surgery using the laser Doppler flowmetry system PeriScan PIM3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Complete wound healing occurred in all patients, with a mean healing duration of 10.1 ± 3.7 weeks. The regenerated skin showed no clear boundary with the surrounding tissue and revealed a visible dermatoglyphic pattern. CT imaging 1 month postoperatively revealed substantial bone formation beneath the distracted bone block, with alignment consistent with the direction of distraction; showing a transverse arrangement, no obvious bone aggregation was observed in the corresponding part of the medullary cavity before surgery. Postoperative assessments revealed significantly increased foot skin temperature and ABI values, accompanied by significant reductions in VAS scores (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). CT values of the distracted bone block increased significantly compared to the baseline. POA blood flow was significantly greater at 1 month postoperatively than before surgery. B-ultrasound examinations revealed that collateral branches around the three middle arteries of the lower leg were sparse preoperatively. One month after surgery, the number of collateral vessels increased significantly, although their inner diameters showed no significant change, while blood flow velocity increased significantly. Laser Doppler analysis further revealed that the plantar skin blood flow signals were sparse, indicating poor microcirculatory perfusion before surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with DR, TTT appears to promote ulcer healing by enhancing l","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"111847"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094498","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":"Fractional carbon dioxide laser-induced photothermal activation of mesenchymal stem cell-derived exosomes accelerates diabetic wound healing by enhancing angiogenesis.","authors":"Jin-Yuan Chen, Zhe Ji, Kang Guo, Hao-Nan Wang, Chen-Chen Zhu, Tao Li, Xiang-Bin Zhao, Yu-Ting Wang, Qiang Li, Pei-Sheng Jin, Xue-Yang Li","doi":"10.4239/wjd.v17.i1.112942","DOIUrl":"10.4239/wjd.v17.i1.112942","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Exosomes (Exos) derived from mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option for diabetic wound healing owing to their strong pro-angiogenic potential. Nevertheless, their relatively low bioactivity remains a major barrier to successful clinical application. Fractional CO&lt;sub&gt;2&lt;/sub&gt; laser therapy offers a precise and controllable form of photothermal stimulation that may potentiate exosome activity without the need for additional exogenous agents, possibly promoting more effective diabetic wound repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the mechanisms through which low-energy fractional Exos derived from CO&lt;sub&gt;2&lt;/sub&gt; laser-preconditioned adipose-derived MSCs (Ad-MSCs) (CO&lt;sub&gt;2&lt;/sub&gt; laser-Exos) promote the healing of diabetic wounds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ad-MSCs were subjected to a single exposure of fractional CO&lt;sub&gt;2&lt;/sub&gt; laser at energy densities of 30 mJ/cm&lt;sup&gt;2&lt;/sup&gt;, 40 mJ/cm&lt;sup&gt;2&lt;/sup&gt;, or 50 mJ/cm&lt;sup&gt;2&lt;/sup&gt;. Infrared thermography was employed to monitor temperature fluctuations in the culture medium. To determine the optimal energy level, western blotting was performed to assess heat shock protein 90 expression, while apoptosis was analyzed by flow cytometry. Exos were subsequently isolated through ultracentrifugation, and sphingosine-1-phosphate (S1P) concentrations within the Exos were measured using enzyme-linked immunosorbent assay. The therapeutic efficacy and underlying mechanisms of CO&lt;sub&gt;2&lt;/sub&gt; laser-Exos were further investigated through a series of &lt;i&gt;in vitro&lt;/i&gt; and &lt;i&gt;in vivo&lt;/i&gt; experiments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following a single exposure to fractional CO&lt;sub&gt;2&lt;/sub&gt; laser, the culture medium temperature increased rapidly and then gradually declined. Among the tested groups, Ad-MSCs treated with 40 mJ/cm&lt;sup&gt;2&lt;/sup&gt; demonstrated the highest heat shock protein 90 expression and exhibited reduced apoptosis. &lt;i&gt;in vitro&lt;/i&gt;, CO&lt;sub&gt;2&lt;/sub&gt; laser-Exos markedly promoted the proliferation, migration, and tube formation of human umbilical vein endothelial cells, while their S1P content was higher than that of unconditioned Exos. Under high-glucose conditions, human umbilical vein endothelial cells showed increased expression of S1P receptor 1 (S1PR1). Silencing S1PR1 significantly impaired the pro-angiogenic activity of CO&lt;sub&gt;2&lt;/sub&gt; laser-Exos and suppressed the expression of phosphorylated protein kinase B, hypoxia-inducible factor 1 alpha, and vascular endothelial growth factor-A. &lt;i&gt;In vivo&lt;/i&gt;, compared with Exos, CO&lt;sub&gt;2&lt;/sub&gt; laser-Exos substantially accelerated diabetic wound healing by promoting neovascularization within the wound bed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Low-energy fractional CO&lt;sub&gt;2&lt;/sub&gt; laser irradiation augments the biological activity of MSC-derived Exos through photothermal stimulation. These Exos, in turn, enhance endothelial cell functions by activating the S1PR1/protein kinase B/hypoxia-induc","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"112942"},"PeriodicalIF":5.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094459","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":"Endothelial cell-derived exosomes inhibit high glucose-induced osteoblast ferroptosis by activating microRNA-335-3p/prostaglandin endoperoxide synthase 2.","authors":"Chen Shao, Li-Jian Zhang, Yi-Lin Song, Yan-Qiu Wang, Xiu-Jing Zha, Juan Li, Cheng-Song Ye, Ling-Ling Chen, Ming-Wei Chen, Guo-Xi Jin","doi":"10.4239/wjd.v17.i1.111165","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.111165","url":null,"abstract":"<p><strong>Background: </strong>Diabetic osteoporosis (DOP), a serious complication of type 2 diabetes mellitus (T2DM), involves ferroptosis-mediated disruption of bone metabolism. While endothelial cell-derived exosomes (EC-Exos) demonstrate inherent bone-targeting properties, their role in counteracting high glucose (HG)-induced osteoblast ferroptosis remains unexplored.</p><p><strong>Aim: </strong>To investigate whether EC-Exos protect against HG-induced osteoblast ferroptosis through microRNA (miR)-335-3p-mediated regulation of prostaglandin endoperoxide synthase 2 (PTGS2) and evaluate clinical relevance in DOP.</p><p><strong>Methods: </strong>Mouse vascular endothelial cells (bEND.3) and osteoblasts (MC3T3E1) were used. Exosomes were isolated and subsequently characterized by transmission electron microscopy, nanoparticle tracking analysis, and western blotting for CD63 and CD81. miR expression profiles were compared between HG-treated osteoblasts and exosome-cocultured groups using high-throughput sequencing and quantitative reverse transcription polymerase chain reaction. Targeting of <i>PTGS2</i> mRNA by miR-335-3p was validated by dual-luciferase reporter assay. Ferroptosis markers, reactive oxygen species, malondialdehyde, glutathione (GSH), PTGS2, GSH peroxidase 4, solute carrier family 7 member 11, and solute carrier family 3 member 2, were quantified following miR-335-3p inhibition. Serum samples from 30 T2DM patients and 32 DOP patients were analyzed. miR-335-3p levels were measured by quantitative reverse transcription polymerase chain reaction, and PTGS2 concentrations were determined <i>via</i> enzyme-linked immunosorbent assay. Diagnostic performance was assessed using receiver operating characteristic curves and logistic regression.</p><p><strong>Results: </strong>EC-Exos significantly reduced reactive oxygen species levels and malondialdehyde, while increasing GSH in HG-treated osteoblasts. miR-335-3p expression increased 3.7-fold in exosome-treated cells <i>vs</i> HG controls. miR-335-3p directly bound the PTGS2 3' untranslated region. Inhibition of miR-335-3p abolished exosomal protection against ferroptosis, as demonstrated by increased PTGS2 expression and reduced levels of GSH peroxidase 4, solute carrier family 7 member 11, and solute carrier family 3 member 2. DOP patients exhibited lower serum miR-335-3p and higher PTGS2 compared with T2DM controls, showing a strong inverse correlation. miR-335-3p demonstrated diagnostic potential for DOP.</p><p><strong>Conclusion: </strong>EC-Exos affect ferroptosis in osteoblasts induced by HG by activating miR-335-3p/PTGS2. Serum miR-335-3p may be a novel diagnostic biomarker.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"111165"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094071","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":"Microtubule affinity-regulating kinase 4 exacerbates diabetic cardiomyopathy by inhibiting UNC-51-like kinase 1-mediated mitochondrial autophagy.","authors":"Yi Wu, Wei-Yi Wang, Jing-Qi Zhang, Sai Wang, Zhi Zeng, Lu Fu, Bin Li","doi":"10.4239/wjd.v17.i1.112027","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.112027","url":null,"abstract":"<p><strong>Background: </strong>The incidence of diabetic cardiomyopathy (DCM) is increasing significantly as the population ages. DCM is one of the main causes of heart failure and mortality among patients with diabetes. Impaired mitophagy leads to mitochondrial dysfunction, which in turn aggravates DCM progression. Microtubule affinity-regulating kinase 4 (MARK4) is a key regulator of autophagy in adipocytes.</p><p><strong>Aim: </strong>To investigate the role of MARK4 in mitophagy in DCM.</p><p><strong>Methods: </strong>A mouse model of type 2 DCM was developed by administration of low-dose streptozotocin (50 mg/kg) combined with a high-fat diet. After 12 weeks MARK4 expression was knocked down in the mice by injection of the adeno-associated virus AAV9 into the tail vein. Four weeks later, cardiac function and structure were evaluated by echocardiography, and blood glucose levels and body weights were recorded. Mitochondrial ultrastructure and autophagosomes were assessed using electron microscopy. Mitochondrial membrane potentials were examined using fluorescence microscopy while the MARK4 and mitophagy-associated protein levels were investigated using western blotting. The downstream factors of MARK4 were identified using RNA-seq sequencing and bioinformatics with empirical confirmation.</p><p><strong>Results: </strong>MARK4 levels were markedly increased in the DCM animal and cardiomyocyte models. Downregulation of MARK4 in DCM mice reduced myocardial tissue injury, increased mitophagy, and mitigated damage to cardiac function. RNA-seq indicated that MARK4 downregulation promoted mitophagy <i>via</i> upregulation of UNC-51-like kinase 1, alleviating myocardial injury in mice. This was confirmed in cell rescue experiments. Bioinformatics predicted interaction between MARK4 and the autophagy marker protein microtubule-associated protein 1 light chain 3B. This was verified using co-immunoprecipitation.</p><p><strong>Conclusion: </strong>Downregulation of MARK4 in DCM mice can reduce myocardial injury, protect mitochondrial function, and promote mitophagy by upregulating UNC-51-like kinase 1, protecting against cardiac damage.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"112027"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094514","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":"Association of serum and vitreous homocysteine and uric acid concentrations with post-vitrectomy prognosis in patients with proliferative diabetic retinopathy.","authors":"Qi-Bo Ran, Chun-Yan Lei, Sheng Gao, Xiang-Gang Yang, Fei-Peng Jiang, Mei-Xia Zhang","doi":"10.4239/wjd.v17.i1.111808","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.111808","url":null,"abstract":"<p><strong>Background: </strong>Proliferative diabetic retinopathy (PDR) is a major cause of vision loss, often requiring pars plana vitrectomy (PPV). Systemic and intraocular metabolic alterations, including dysregulation of homocysteine (Hcy) and uric acid (UA), may influence surgical outcomes. While prior studies suggest associations between these biomarkers and retinal pathology, the role of these biomarkers in postoperative prognosis remains unclear. This study hypothesized that elevated serum and vitreous Hcy and UA levels are associated with visual, structural, and microvascular changes following PPV in patients with PDR.</p><p><strong>Aim: </strong>To evaluate the associations between serum and vitreous Hcy/UA concentrations with postoperative outcomes in patients with PDR following PPV.</p><p><strong>Methods: </strong>In this prospective observational study at a tertiary care center, 44 patients with PDR and 46 non-diabetic controls undergoing PPV between June 2021 and December 2022 were enrolled. Serum and vitreous Hcy and UA levels were measured. Best-corrected visual acuity, multimodal retinal imaging, and capillary density metrics were evaluated preoperatively and postoperatively. Correlation analyses assessed the relationships between biomarkers and clinical outcomes.</p><p><strong>Results: </strong>Patients with PDR showed significantly higher serum and vitreous Hcy and UA concentrations compared to those of controls. Serum Hcy and UA levels correlated with vitreous levels. In patients with PDR, elevated vitreous Hcy correlated with worse best-corrected visual acuity at 1 day and reduced peripapillary retinal nerve fiber layer thickness at 7 days and 90 days. It also correlated with foveal avascular zone enlargement at 90 days and inferior superficial capillary plexus (SCP) width density at 7 days. Vitreous UA had negative correlations at 30 days with nasal SCP length density and temporal/inner ring SCP width density.</p><p><strong>Conclusion: </strong>Vitreous, but not serum, Hcy predicts post-PPV impairment, underscoring the prognostic value of the local ocular environment over systemic factors in PDR.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"111808"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094724","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":"Exploring novel pathways and potential therapeutic targets for diabetic nephropathy: The interplay of podocytes and proximal tubular epithelial cells.","authors":"Tarek S Abdelaziz","doi":"10.4239/wjd.v17.i1.114082","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.114082","url":null,"abstract":"<p><p>This article discusses a recent article by Zha <i>et al</i>, which explores new pathogenic pathways contributing to diabetic nephropathy in a study conducted on male mice. Diabetic kidney disease outcomes remain suboptimal; it is the leading cause of end-stage kidney disease in the developed world. Previous knowledge about diabetic nephropathy focused on glomerular pathology. Advancing knowledge led to the introduction of new pathogenic concepts beyond glomerulopathy. This work by Zha <i>et al</i> explored an important podocyte pathway and its link to the proximal tubular cells. Podocytes are essential for maintaining glomerular health and preserving body proteins. In a state of hyperglycaemic stress, podocytes show features of internalisation of nephrin, an integral surface protein of the podocytes. The novel pathway uncovered in this experimental study involved crosstalk between the podocytes and the proximal tubular cells, more precisely, the secretion of interleukin 6 (IL-6) and Rab5 by the proximal tubular cells. When the podocytes were cultured in the conditioned medium, this resulted in podocyte dysfunction. IL-6 neutralising antibodies ameliorated this effect. Nicotinamide mononucleotide is essential for the integrity of the proximal tubular cells. Interestingly, it has been found that nicotinamide mononucleotide treatment can disrupt the IL-6-Rab signalling between the proximal tubules and podocytes, leading to improved podocyte morphology and function. The clinical applicability of this novel pathway is yet to be explored; however, it is one of the key pathways mediating inflammation and dysfunction in diabetic nephropathy.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"114082"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094532","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":"Combined assessment with stress hyperglycemia ratio and time in range: Associations with twenty-eight-day mortality in surgical intensive care unit patients.","authors":"Shuang Liu, Bai-Ge Cao, Yue Ma, Jin-Fang Xu, Quan-Hong Zhou, Cong-Rong Wang","doi":"10.4239/wjd.v17.i1.112621","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.112621","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) reflects patients' acute hyperglycemia status, and the time in range (TIR) captures glucose control dynamics during their intensive care unit (ICU) stays.</p><p><strong>Aim: </strong>To investigate the independent and combined associations of SHR and TIR with 28-day mortality among surgical ICU patients.</p><p><strong>Methods: </strong>In total, 706 adult patients with available glucose data were included. SHR was calculated as the ratio of admission glucose levels to glycosylated hemoglobin-derived estimated average glucose. TIR was calculated as percentages of glucose readings within the 3.9-10.0 mmol/L range during the ICU stay. SHR and TIR were divided into quartiles, and patients were allocated to four groups according to combinations of high/low values. The associations of the SHR, TIR, and both combined with mortality were assessed using logistic regression.</p><p><strong>Results: </strong>Logistic regression analysis demonstrated that patients in the highest SHR quartile had a significantly increased risk of 28-day mortality compared with the reference quartile [adjusted odds ratio (OR) = 2.24; 95% confidence interval (CI): 1.06-4.71; <i>P</i> = 0.033]. In contrast, higher TIR were associated with a reduced risk of 28-day mortality. Compared with the lowest TIR quartile (Q1), adjusted ORs in Q2, Q3, and Q4 were 0.43 (95%CI: 0.23-0.93; <i>P</i> = 0.030), 0.43 (95%CI: 0.19-0.99; <i>P</i> = 0.046), and 0.41 (95%CI: 0.17-0.98; <i>P</i> = 0.045), respectively. When the SHR and TIR were analyzed in combination, patients with high SHR and low TIR had the highest risk of 28-day mortality (adjusted OR = 2.19; 95%CI: 1.05-4.58; <i>P</i> = 0.038).</p><p><strong>Conclusion: </strong>Combined SHR and TIR assessment offers prognostic value in surgical ICU patients. Maintaining glucose within the target range may be important to improve short-term outcomes in patients with stress hyperglycemia.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"112621"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094653","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":"Right ventricular dysfunction in type 1 diabetic cardiomyopathy: An overlooked component?","authors":"Ling-Yun Luo, Zi-Xuan Liu, Tian-Shu Yang, Wei Liang, Xue-Lian Luo","doi":"10.4239/wjd.v17.i1.114618","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.114618","url":null,"abstract":"<p><p>While left ventricular (LV) impairment in diabetic cardiomyopathy is well recognized, the contribution of right ventricular (RV) dysfunction has received far less attention. In their longitudinal investigation, Yu <i>et al</i> systematically examined RV and LV performance in a type 1 diabetic mouse model and demonstrated that RV diastolic dysfunction develops later than LV abnormalities, coinciding with structural remodeling marked by fibrosis, hypertrophy, and mild pulmonary hypertension. These observations underscore the progressive yet distinct trajectory of RV pathology in diabetes and point to the importance of incorporating RV assessment into the overall cardiac evaluation of diabetic patients. This letter explores the broader significance of these findings and highlights the urgent need for studies focused on RV-specific mechanisms and targeted therapies aimed at preventing or attenuating biventricular injury in diabetic cardiomyopathy.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"114618"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094481","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":"Improving metabolic and inflammatory balance prevents periodontal complications in diabetes.","authors":"Hong-Wei Tang, Nan Zhang","doi":"10.4239/wjd.v17.i1.115685","DOIUrl":"https://doi.org/10.4239/wjd.v17.i1.115685","url":null,"abstract":"<p><p>Recent real-world evidence suggests that improved regulation of metabolic and inflammatory pathways can substantially lower the risk of periodontal complications in individuals with type 2 diabetes. Periodontitis, a frequent yet often overlooked complication, arises from chronic hyperglycaemia and systemic inflammation, illustrating the bidirectional link between metabolic imbalance and oral health. Recognizing this interplay emphasizes the need for integrative diabetes management strategies that combine glycaemic control with inflammatory modulation to achieve broader health benefits. This letter highlights the clinical and scientific importance of such an approach, calls for interdisciplinary collaboration between endocrinologists and oral health professionals, and advocates for mechanistic and preventive studies addressing oral health as an integral component of comprehensive diabetes care.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"17 1","pages":"115685"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094503","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}