World Journal of Diabetes最新文献

{"title":"Higher glycated hemoglobin amplifies the effect of apolipoprotein E epsilon 4-related cognition and olfaction impairments in type 2 diabetes.","authors":"Ya-Rong Wang, Yang Gao, Yan-Chao Liu, Zhi-Peng Xu, Yu-Ying Wang, Hai-Bo Xu, Jian-Zhi Wang, Yao Zhang","doi":"10.4239/wjd.v16.i8.106664","DOIUrl":"10.4239/wjd.v16.i8.106664","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein E epsilon 4 (APOE4) is recognized as a genetic risk factor for cognitive decline and neurodegeneration in both type 2 diabetes mellitus (T2DM) and Alzheimer's disease, while glycated hemoglobin (HbA1c) reflects persistent hyperglycemia and serves as a key indicator of long-term glycemic control in T2DM. Although both factors have been individually linked to neurobehavioral deficits, it remains uncertain whether HbA1c contributes to APOE4-related cognitive and olfactory impairment in individuals with T2DM.</p><p><strong>Aim: </strong>To investigate the role of HbA1c in APOE4-associated cognitive and olfactory dysfunction in patients with T2DM.</p><p><strong>Methods: </strong>Of 636 T2DM patients were recruited from five medical centers in Wuhan, Hubei Province, China. APOE genotyping was evaluated by polymerase chain reaction using Gerard's method. Cognitive and olfactory functions were assessed by mini-mental state examination and Connecticut chemosensory clinical research center test, respectively. Regression analysis was employed to assess the independent and interactive effects of HbA1c on APOE4-associated cognitive and olfactory function.</p><p><strong>Results: </strong>APOE4 was associated with increased risks of cognitive impairment [odds ratios (OR) = 1.815, <i>P</i> = 0.021] and olfactory dysfunction (OR = 2.588, <i>P</i> < 0.001). Higher HbA1c levels were also related to worse cognitive (OR = 1.189, <i>P</i> < 0.001) and olfactory performance (OR = 1.149, <i>P</i> = 0.011). HbA1c exerted a moderating effect, yet not a mediating effect, between APOE4 and its impacts on cognition and olfaction. Specifically, a higher level of HbA1c exacerbated the damaging effect of APOE4, as shown by significant interaction effects on both cognitive impairment (OR = 2.687, <i>P</i> < 0.001) and olfactory dysfunction (OR = 1.440, <i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>Elevated HbA1c levels are associated with increased risks of cognitive and olfactory impairments in patients with T2DM and may exacerbate the detrimental effects of APOE4. These findings underscore the need for early preventive strategies targeting individuals with both poor glycemic control and APOE4 carriage to mitigate neurodegenerative risk.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"106664"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066081","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":"Autologous platelet rich gel in treatment of lower limb atherosclerotic occlusive disease in diabetic patients.","authors":"Miao Chen, Jing-Tang Li, Jia-Bao Gao, Ling Zhang, Qi-Hang Gao, Xiong Zeng, Qiang Liu","doi":"10.4239/wjd.v16.i8.106215","DOIUrl":"10.4239/wjd.v16.i8.106215","url":null,"abstract":"<p><strong>Background: </strong>Lower limb atherosclerotic occlusive disease (LAOD) is a common complication in diabetic patients, leading to significant symptoms and reduced quality of life.</p><p><strong>Aim: </strong>To investigate the efficacy of autologous platelet-rich gel (APRG) as an innovative treatment for LAOD, focusing on clinical outcomes such as symptom relief, flow values, ankle-brachial index (ABI), walking distance, and claudication severity.</p><p><strong>Methods: </strong>This retrospective study involved an analysis of electronic medical records (EMR) from 150 patients diagnosed with LAOD. Participants were assigned to either a treatment group (<i>n</i> = 80) or a control group (<i>n</i> = 70). Both groups received standard care and underwent dressing changes. In addition, the treatment group was given APRG. Primary outcomes included changes in pain levels, wound healing rates, flow values assessed by plethysmography, ABI measurements, walking distance, and claudication severity. Statistical analyses were conducted to determine the significance of the results.</p><p><strong>Results: </strong>The APRG group showed significant improvements after 12 weeks, including a 70% reduction in pain, a 65% increase in wound healing rates, and an average walking distance increase of 150 meters. Flow values improved by 20%, with significant enhancements in ABI measurements (<i>P</i> < 0.01). Additionally, patient satisfaction was higher, and 60% of patients reported improved claudication severity, confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.</p><p><strong>Conclusion: </strong>The APRG demonstrates significant efficacy in managing LAOD in diabetic patients, improving key clinical parameters including flow values, ABI, walking distance, and claudication. These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"106215"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066161","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":"Electroacupuncture with different current intensities can improve gastrointestinal motility in diabetic gastroparesis <i>via</i> vagal and sympathetic pathways.","authors":"Yi-Wen Tang, You Zhang, Jin Zhou, Yu-Ting Peng, Yan Zi, Yan-Rong Wei, Zeng-Hui Yue","doi":"10.4239/wjd.v16.i8.107779","DOIUrl":"10.4239/wjd.v16.i8.107779","url":null,"abstract":"<p><strong>Background: </strong>Diabetic gastroparesis (DGP) disrupts gastric motility. Electroacupuncture (EA) at Zusanli (ST36) may alleviate DGP symptoms <i>via</i> neural pathways.</p><p><strong>Aim: </strong>To investigate how EA current intensities at ST36 regulate neural pathways and improve gastric motility in DGP models.</p><p><strong>Methods: </strong>A DGP model was established using intraperitoneal injection of streptozotocin. Gastrointestinal motility was measured in rats after 2 weeks of continuous EA at ST36. Current intensity was selected as 0.5 mA, 1 mA, and 3 mA. Gastric electrodynamics were detected by recording and analyzing the number of gastric discharges. The gastric emptying rate and propulsion rate of the small intestine were measured to assess dynamic gastrointestinal function. Hematoxylin-eosin staining was conducted to measure histopathological changes in the gastric sinus. Reverse transcription-polymerase chain reaction was conducted to determine mRNA levels of Rho guanine nucleotide-binding protein A and Rho-associated coiled-coil forming protein kinase. Western blotting was conducted to determine the expression levels of choline acetyltransferase, tyrosine hydroxylase, Rho guanine nucleotide-binding protein A, and Rho-associated coiled-coil forming protein kinase. Immunofluorescence staining in the stomach was conducted to detect the distribution of C-kit, an interstitial cell of Cajal marker. An enzyme-linked immunosorbent assay was conducted to detect serum levels of acetylcholine and norepinephrine.</p><p><strong>Results: </strong>Treatment with EA improved gastric emptying and gastric smooth muscle disorders in rats with DGP, mitigated pathological damage, and restored the function of interstitial cells of Cajal. In addition, different current intensities of EA affected gastrointestinal function of rats with DGP. The 0.5 mA, 1 mA, and 3 mA EA groups all improved gastrointestinal function. 0.5 mA EA increased acetylcholine levels by increasing protein expression of choline acetyltransferase (<i>P</i> < 0.05), thereby upregulating vagus nerve activity and enhancing parasympathetic nerve regulation. 3 mA EA increased norepinephrine levels (<i>P</i> < 0.05) by increasing protein expression of tyrosine hydroxylase, thereby activating the sympathetic nervous pathway. 1 mA coordinated the function of the vagus and sympathetic nerves to improve gastrointestinal motility.</p><p><strong>Conclusion: </strong>EA with ST36 improved gastric motility in rats with DGP. 0.5 mA EA activated the vagus nerve, while 3 mA EA regulated gastrointestinal motility by activating the sympathetic nerves.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"107779"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974956","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":"Intraoperative blood perfusion factors in free anterolateral thigh flap repair for diabetic foot ulcers: A retrospective analysis.","authors":"Hong-Liang Wu, Huan Huang, Bin-Qi Chen, Jian Xia, Li-Bing Jiang","doi":"10.4239/wjd.v16.i8.105532","DOIUrl":"10.4239/wjd.v16.i8.105532","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) in patients with type 2 diabetes (T2D) are associated with heightened risks of infection and amputation and thus require effective surgical interventions to enhance outcomes. Free anterolateral thigh (ALT) perforator flap is a promising reconstructive method; however, diabetic vasculopathy challenges optimal perfusion. This study analyzes factors influencing intraoperative blood perfusion in ALT flap repair for DFUs.</p><p><strong>Aim: </strong>To identify key factors affecting intraoperative blood perfusion during free ALT perforator flap repair in patients with T2D and DFUs, thereby providing insights to improve surgical outcomes.</p><p><strong>Methods: </strong>This retrospective case-control study included 100 patients with T2D who underwent ALT flap repair at our institution between June 2016 and June 2024. Patients were categorized into normal (<i>n</i> = 50) and abnormal (<i>n</i> = 50) blood perfusion groups based on intraoperative perfusion assessments. Data on demographics, clinical characteristics, vascular status, metabolic control, and preoperative laboratory parameters were collected. Statistical analyses, including univariate and multivariate logistic regression, were conducted to identify significant predictive factors for perfusion outcomes.</p><p><strong>Results: </strong>Old age, high body mass index, long diabetes duration, and presence of diabetic peripheral neuropathy were associated with impaired perfusion. Abnormal perfusion was correlated with poor ankle-brachial index and elevated glycated hemoglobin (HbA1c), creatinine, triglycerides, and partial pressure of carbon dioxide. Conversely, high hemoglobin, albumin, and prealbumin levels and partial pressure of oxygen (PaO₂) were protective. Multivariate analysis identified diabetes duration, HbA1c, PaCO₂, PaO₂, and albumin as independent predictors of perfusion, underscoring the roles of metabolic control and vascular health.</p><p><strong>Conclusion: </strong>Optimizing metabolic control, vascular health, and nutritional status was crucial to enhance intraoperative blood perfusion in diabetic patients undergoing ALT perforator flap repair for DFUs.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"105532"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066123","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":"Vitamin D supplementation reduces infection rate and promotes wound healing in patients with diabetic foot ulcers.","authors":"Yue-Qiao Gao, Ying-Hui Gao, Jun-Hui Xing","doi":"10.4239/wjd.v16.i8.108166","DOIUrl":"10.4239/wjd.v16.i8.108166","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) represent a common and serious complication of diabetes, characterized by impaired wound healing and an increased risk of infection. These infections severely impact patient health, necessitating extensive medical intervention, and increasing the risk of amputation. Vitamin D (VD) plays a critical role in immune regulation and tissue repair.</p><p><strong>Aim: </strong>To investigate the effects of VD supplementation on infection rates, wound healing, and immune function in patients with DFUs.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted involving 120 patients with DFUs. Participants were randomly assigned to either a control group (<i>n</i> = 60), which received standard care without VD supplementation, or an intervention group (<i>n</i> = 60), which received 2000 IU of oral VD3 (cholecalciferol) daily for 12 weeks. The primary outcomes included the incidence and severity of infections, whereas the secondary outcomes included wound healing rate, serum 25-hydroxyvitamin D level, levels of immune markers (cathelicidin, interleukin-6 and tumor necrosis factor-α), and adverse events, such as hypercalcemia.</p><p><strong>Results: </strong>The incidence of infection was significantly lower in the VD supplementation group (25%) compared with the control group (45%) (<i>P</i> = 0.01). Severe infections requiring systemic antibiotics or hospitalization were also less frequent in the VD supplementation group. Wound healing was notably enhanced in the VD supplementation group, with a 60% reduction in ulcer size compared with a 35% reduction in the control group (<i>P</i> < 0.01). Serum 25(OH)D level significantly increased in the VD supplementation group (from 16.5 ng/mL to 35.2 ng/mL), confirming the efficacy of VD supplementation. Immune function improved, as demonstrated by a 30% rise in cathelicidin level and a 20% decline in levels of pro-inflammatory cytokines. No adverse effects, including hypercalcemia, were reported.</p><p><strong>Conclusion: </strong>The VD supplementation effectively reduced infection rate, promoted wound healing, and strengthened immune responses in patients with DFUs. These findings support the incorporation of VD as a safe and effective adjunctive therapy in the clinical management of DFUs.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"108166"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975047","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":"Mapping evidence and identifying risks: A systematic scoping review of meal replacements in type 2 diabetes.","authors":"Leong Chen Lew, Arimi Fitri Mat Ludin, Zahara Abdul Manaf, Noorlaili Mohd Tohit, Suzana Shahar","doi":"10.4239/wjd.v16.i8.104371","DOIUrl":"10.4239/wjd.v16.i8.104371","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) is a major health concern globally and its prevalence is expected to continue to escalate. Lifestyle intervention is an integral part of T2D management. Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs. There are various trials being carried out to date; however, a thorough review regarding the usage of meal replacement on its types, dosage and associated outcomes and adverse events is still lacking.</p><p><strong>Aim: </strong>To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D, and map out glycemic and weight-related outcomes along with adverse effects incidences.</p><p><strong>Methods: </strong>This scoping review is conducted based on Arksey and O'Malley's seminal framework for scoping reviews. A systematic search has been done for studies published between January 2020 and January 2024 across six online databases (Cochrane Library, PubMed, Science Direct, Scopus, Web of Science and Ebscohost Discovery) using specific keywords. Two researchers independently assessed the eligibility of the studies and extracted the data. The selected articles and extracted data were reviewed by all researchers.</p><p><strong>Results: </strong>The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening. Included studies were categorized based on meal replacement type into low calorie/energy, low glycemic index, protein-rich, low-fat, diabetes-specific formulas, and combined lifestyle intervention programs. Fifty-nine studies reported improvements on hemoglobin A1c, and 70 studies reported positive changes in weight or BMI after the meal replacement intervention. The combination of meal replacements with education, counseling or structured lifestyle interventions has proved to be effective. Only 13 studies reported occurrence of adverse events related to the intervention. Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.</p><p><strong>Conclusion: </strong>The results suggest that meal replacements, especially when combined with lifestyle intervention programs and counseling, are an effective and safe strategy in glycemic and weight management among patients with T2D.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"104371"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975081","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":"Prevalence of diabetes distress among people with type 2 diabetes in South Asia: A systematic review and meta-analysis.","authors":"Abul Bashar Mohammad Kamrul-Hasan, Joseph M Pappachan, Lakshmi Nagendra, Dimuthu Muthukuda, Deep Dutta, Saptarshi Bhattacharya, Dina Shrestha, Guru Prasad Dhakal, Manilka Sumanatilleke, Syed Abbas Raza, Sanjay Kalra","doi":"10.4239/wjd.v16.i8.109352","DOIUrl":"10.4239/wjd.v16.i8.109352","url":null,"abstract":"<p><strong>Background: </strong>Diabetes distress (DD), an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management, is common among patients with type 2 diabetes (T2D). South Asia has a high T2D burden, and many studies have reported varying prevalence rates of DD in this area.</p><p><strong>Aim: </strong>To estimate the pooled prevalence of DD among patients with T2D in South Asia, as it is crucial for developing effective therapeutic strategies.</p><p><strong>Methods: </strong>This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD. The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30, 2025, using prespecified search terms. Four authors screened and extracted data independently. Meta-analyses were conducted using RStudio software with a random-effects model. The primary outcome was the pooled prevalence of DD.</p><p><strong>Results: </strong>Thirty-seven cross-sectional studies (28 from India, five from Bangladesh, and two each from Pakistan and Sri Lanka) with mostly high methodological quality involving 11500 subjects were included. The pooled prevalence of DD was 44% (95% confidence interval: 35-53, <i>I</i> ² = 97.4%). The prevalence of DD was highest in Pakistan (85%), followed by India and Bangladesh (42% each), and Sri Lanka (25%). Emotional burden was the most prevalent form of DD (60%), followed by treatment regimen-related distress (51%), interpersonal distress (31%), and physician-related distress (17%). Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year, sample size, proportion of females, age, duration of diabetes, insulin usage, glycated hemoglobin levels, or diabetic complications.</p><p><strong>Conclusion: </strong>South Asians with T2D seem to experience a relatively high burden of DD, and the emotional burden is the most common form of DD in this area. Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"109352"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975141","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":"Triglyceride glucose-body mass index is associated with cardiovascular outcomes and overall mortality in type-2 diabetes mellitus patients.","authors":"Mao-Jun Liu, Sun-Min Xiang, Xin-Qun Hu","doi":"10.4239/wjd.v16.i8.108839","DOIUrl":"10.4239/wjd.v16.i8.108839","url":null,"abstract":"<p><strong>Background: </strong>Although recent studies have reported the reliability of triglyceride-glucose index (TyG) as a biomarker for evaluation of insulin resistance, the research exploring the association of TyG-body mass index (BMI) with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus (T2DM) population remains scarce.</p><p><strong>Aim: </strong>To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.</p><p><strong>Methods: </strong>Data were drawn from the ACCORD trial and its subsequent follow-up (ACCORDION), which together included 10190 participants. To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients, Cox's proportional-hazards model was employed. Non-linear associations and thresholds were investigated by performing restricted cubic spline regression, fitting smooth curves, and conducting piecewise regression. Additionally, we examined whether the above findings were robust through interaction and subgroup analyses. The robustness of results was further verified by a series of sensitivity assessments. Through the area under the receiver operating characteristic curve estimation, the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.</p><p><strong>Results: </strong>Applying multivariable Cox regression analysis, we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality. Specifically, after adjusting for multiple confounders, the cardiovascular mortality, congestive heart failure (CHF) and overall mortality risks in the highest TyG-BMI quartile were 1.74, 2.65 and 1.42 times greater, respectively, when compared to the lowest quartile. The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality, while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality. TyG-BMI was found to correlate positively with future CHF. Additionally, introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.</p><p><strong>Conclusion: </strong>Among T2DM individuals, a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality, highlighting its utility as a predictive marker for these risks.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"108839"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975052","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 social determinants of health and cardiovascular complications in type 2 diabetes in Colombia.","authors":"Oswaldo Rincon, Catalina Uscategui, Pedro Mancera, Maria Luna, Alba Rodriguez, Mauricio Alvarez, Isaac Guzman","doi":"10.4239/wjd.v16.i8.106927","DOIUrl":"10.4239/wjd.v16.i8.106927","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health are social and economic factors that influence health intervention outcomes. Type 2 diabetes is a highly prevalent disease, primarily affecting individuals in low-to-middle-income countries. However, the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.</p><p><strong>Aim: </strong>To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota, Colombia. Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included. A total of 583 patients participated in the study. We performed descriptive, bivariate, and binary logistic regression analyses, adjusting for confounding variables.</p><p><strong>Results: </strong>Among the 583 patients included, urban residency [odds ratio (OR) = 3.05, 95% confidence interval (CI): 1.01-9.20] and a middle or high educational level (OR = 2.33, 95%CI: 1.14-4.72) were associated with an increased risk of coronary artery disease. Additionally, receiving diabetes education beyond that provided by the clinic (OR = 2.15, 95%CI: 1.14-4.05) and lack of access to spaces for physical activity (OR = 4.05, 95%CI: 1.31-12.5) were associated with a higher risk of diabetic nephropathy and cerebrovascular disease, respectively.</p><p><strong>Conclusion: </strong>Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs. Population-based studies are needed to guide targeted interventions and clarify causal relationships.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"106927"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066078","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":"Activation of farnesoid X receptor upregulates binding immunoglobulin protein expression and alleviates diabetic nephropathy.","authors":"Jian-Ying Tang, Yuan-Jia Chong, Lu Yang, Xue Li, Ying Yang, Jun-Chen Li, Jiao Mu","doi":"10.4239/wjd.v16.i8.105228","DOIUrl":"10.4239/wjd.v16.i8.105228","url":null,"abstract":"<p><strong>Background: </strong>The exact mechanisms underlying diabetic nephropathy (DN) remain incompletely elucidated, prompting researchers to explore new perspectives and identify novel intervention targets in this field.</p><p><strong>Aim: </strong>To explore the role and underlying mechanisms of farnesoid X receptor (FXR) in the development of DN by regulating endoplasmic reticulum stress (ERS) molecular chaperone binding immunoglobulin protein (BiP) expression.</p><p><strong>Methods: </strong>Bioinformatics analyses identified potential FXR-binding elements in the BiP promoter. Dual-luciferase and chromatin immunoprecipitation (ChIP) assays confirmed FXR-BiP binding sites. <i>In vitro</i> studies used SV40 MES 13 cells under varying glucose conditions and treatments with FXR modulators [obeticholic acid (INT-747) and guggulsterones] or BiP small interfering RNA. The expression of BiP and ERS-related proteins [protein kinase R-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1 (IRE1), activating transcription factor 6 (ATF6)] was assessed alongside cell proliferation and extracellular matrix (ECM) synthesis. <i>In vivo</i> studies in DN mice (db/db) examined the effects of FXR activation on renal function and morphology.</p><p><strong>Results: </strong>FXR bound to the target sequence in the BiP promoter region, enhancing transcriptional activity, as confirmed by ChIP experiments. FXR expression decreased in SV40 MES 13 cells stimulated with high glucose and in renal tissues of DN mice compared with control. Treatment of SV40 MES 13 cells with the FXR agonist INT-747 significantly increased intracellular BiP expression, whereas silencing the FXR gene led to the downregulation of BiP levels. <i>In vivo</i> administration of INT-747 significantly elevated BiP levels in renal tissues, improved renal function and fibrosis in DN mice, while inhibiting the expression of ERS-related signaling proteins PERK, IRE1, and ATF6.</p><p><strong>Conclusion: </strong>FXR promotes BiP expression by binding to its promoter, suppressing ERS pathways, and reducing mesangial cell proliferation and ECM synthesis. These findings highlight FXR as a potential therapeutic target for diabetic glomerulosclerosis.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 8","pages":"105228"},"PeriodicalIF":4.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975001","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}