World Journal of Diabetes最新文献

{"title":"<i>Lactobacillus rhamnosus</i> LRa05 on glycemic control and gut microbiota in patients with type 2 diabetes.","authors":"Lin Geng, Ting-Ting Sun, Wen-Bo Xia, Yin Qin, Di Huo, Guang-Jing Qu","doi":"10.4239/wjd.v16.i7.106821","DOIUrl":"10.4239/wjd.v16.i7.106821","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a metabolic disorder linked to high blood glucose and gut dysbiosis. Probiotics like <i>Lactobacillus rhamnosus</i> LRa05 may improve glycemic control and gut microbiota.</p><p><strong>Aim: </strong>To explore the impact of LRa05 with hypoglycemic medications on glycemic control and intestinal flora in T2DM patients with gut dysbiosis.</p><p><strong>Methods: </strong>Seventy-six participants were randomly assigned to receive either LRa05 (0.1 g 2 × 10¹⁰ CFU) (<i>n</i> = 38) or a placebo (<i>n</i> = 38) for 12 weeks. Baseline characteristics were recorded, and changes in glycated hemoglobin, fasting blood glucose, and other biochemical indices were assessed using repeated measures one-way analysis of variance. Additionally, gut microbiota diversity was analyzed through species accumulation and alpha and beta diversity metrics.</p><p><strong>Results: </strong>The intervention group showed statistically significant improvements in lipid profiles, particularly in high-density lipoprotein cholesterol levels, which increased significantly over time (<i>P</i> < 0.001). Additionally, fasting blood glucose was significantly reduced in the LRa05 group compared with the placebo group (<i>P</i> < 0.001). No significant changes were observed in glycated hemoglobin, insulin sensitivity, or systemic inflammatory markers such as C-reactive protein. Furthermore, gut microbiota analysis revealed significant shifts in composition following the intervention, particularly an increase in <i>Bifidobacterium</i> and a decrease in <i>Bacillota</i>, indicating beneficial effects on gut health.</p><p><strong>Conclusion: </strong>This study demonstrated that the combination of <i>Lactobacillus rhamnosus</i> LRa05 and hypoglycemic medications positively impacted glycemic control, specifically reflected in improved levels of high-density lipoprotein and fasting blood glucose. Additionally, significant alterations in gut microbiota composition were observed in patients with T2DM, indicating a potential synergistic effect between gut health and blood glucose regulation.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"106821"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692039","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":"Analysis of nasal secretion culture results in diabetic patients with chronic rhinosinusitis and factors influencing postoperative recurrence.","authors":"Xing Liu, Qian-Qian Wang, Shou-Yan Qiao, Xiao-Ning Zhu","doi":"10.4239/wjd.v16.i7.104970","DOIUrl":"10.4239/wjd.v16.i7.104970","url":null,"abstract":"<p><strong>Background: </strong>In diabetic patients, persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria, resulting in severe complications. Consequently, chronic rhinosinusitis (CRS) complicated by diabetes is highly prevalent in clinical settings.</p><p><strong>Aim: </strong>To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 203 diabetic patients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023. Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial susceptibility. Based on a one-year follow-up, patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data. Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.</p><p><strong>Results: </strong>Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS. A total of 134 pathogenic bacteria strains were isolated and identified, including 81 strains (60.4%) of gram-positive bacteria and 53 strains (39.6%) of gram-negative bacteria. Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin, while remaining highly sensitive to vancomycin, gentamicin, and rifampicin. Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin, but showed high sensitivity to imipenem, meropenem, cefepime, and ceftazidime. Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels, smoking history, Lund-Mackay scores, visual analog scale (VAS) scores, nasal septum deviation, allergic rhinitis, bronchial asthma, postoperative infection, long-term use of nasal decongestants, and adherence to medical prescriptions. Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.</p><p><strong>Conclusion: </strong>In CRS patients with nasal polyps (CRSwNP), the detection rate of nasal pathogens is relatively high, and most of the isolated bacteria exhibit antimicrobial resistance. Additionally, the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"104970"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692042","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":"Extra-renal role of urate transporter-1 in diabetes.","authors":"Tian-Shu Yang, Min Du, Ling-Yun Luo, Li Lin, Xue-Lian Luo","doi":"10.4239/wjd.v16.i7.107673","DOIUrl":"10.4239/wjd.v16.i7.107673","url":null,"abstract":"<p><p>The rising global incidence of diabetes mellitus (DM) and hyperuricemia presents a growing challenge to public health systems worldwide. Urate transporter-1 (URAT1), a key renal urate transporter, has emerged as a promising therapeutic target for managing DM and its associated complications. Growing evidence suggests that URAT1's role in metabolic disorders extends beyond its function in the kidney. Specifically, URAT1 can influence uric acid metabolism in multiple tissues including neural, hepatic, vascular smooth muscle, cardiac, and adipose tissue, thereby contributing to insulin resistance, inflammation, and end-organ damage. In this review, we comprehensively examine the extra-renal functions of URAT1, focusing on its roles in the hematopoietic system, heart, liver, adipose tissue, and vascular endothelium in the context of DM. This analysis highlights the multi-organ mechanisms through which URAT1 exerts its effects, offering valuable insights into its potential as a therapeutic target for this complex systemic metabolic disorder.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107673"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692077","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":"Prognostic value of microRNA-495-3p, adiponectin, and cardiometabolic index in type 2 diabetic nephropathy.","authors":"Xu-Chun Xu, He-Jing Fang, Hua-Ying Huang","doi":"10.4239/wjd.v16.i7.108262","DOIUrl":"10.4239/wjd.v16.i7.108262","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetic nephropathy (T2DN) is a severe complication of diabetes mellitus, and identifying biomarkers for its prognosis remains a critical challenge. Previous studies have suggested potential roles of microRNAs (<i>e.g.</i>, miR-495-3p), adiponectin (ADPN), and cardiometabolic index (CMI) in metabolic and renal pathologies. However, their combined predictive value for T2DN prognosis is not well understood.</p><p><strong>Aim: </strong>To explore serum miR-495-3p, ADPN, and CMI levels in T2DN and their value in predicting prognosis.</p><p><strong>Methods: </strong>A total of 98 T2DN patients (study group) and 49 type 2 diabetic patients with normal renal function (control group) were enrolled from February 2020 to February 2022. Serum levels of miR-495-3p, ADPN, and CMI were measured in both groups. Patients were followed up for 6 months to assess prognosis. Differences between groups were analyzed, and multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the predictive value of these biomarkers.</p><p><strong>Results: </strong>The study group exhibited significantly lower miR-495-3p levels and higher ADPN and CMI levels compared to the control group (<i>P</i> < 0.05). Poor prognosis patients had even lower miR-495-3p and higher ADPN and CMI levels than those with good prognosis (<i>P</i> < 0.05). Multivariate analysis identified alanine aminotransferase, aspartate aminotransferase, urea nitrogen, serum creatinine, miR-495-3p, ADPN, and CMI as independent predictors of prognosis (<i>P</i> < 0.05). ROC analysis revealed area under the curve values of 0.762 (miR-495-3p), 0.902 (ADPN), 0.757 (CMI), 0.899 (alanine aminotransferase), 0.852 (aspartate aminotransferase), 0.916 (urea nitrogen), and 0.910 (serum creatinine) for predicting poor prognosis (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Low miR-495-3p and high ADPN and CMI levels are linked to T2DN and poor prognosis, highlighting their potential for risk prediction and clinical management.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"108262"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692101","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":"Impact of intensive insulin therapy on dynamic cardiac function in critically ill patients with stress-induced hyperglycemia.","authors":"Yu-Dan Wang, Jing-Jing Yu","doi":"10.4239/wjd.v16.i7.107767","DOIUrl":"10.4239/wjd.v16.i7.107767","url":null,"abstract":"<p><strong>Background: </strong>Stress-induced hyperglycemia (SIH) is common in critically ill patients and has been associated with adverse cardiovascular outcomes. Intensive insulin therapy (IIT) has been proposed to mitigate these risks by achieving tighter glycemic control.</p><p><strong>Aim: </strong>To evaluate the efficacy of IIT for managing SIH in critically ill patients and to explore its potential effect on cardiac function.</p><p><strong>Methods: </strong>A retrospective study was conducted at our hospital from January 2021 to December 2024, adhering to STROBE guidelines. A total of 186 critically ill patients were divided into normal glycemia (<i>n</i> = 85) and SIH (<i>n</i> = 101) groups. The SIH cohort was further subdivided into conventional treatment (<i>n</i> = 50) and IIT (<i>n</i> = 51) groups. Hemodynamic parameters-including right atrial pressure (RAP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PAWP), cardiac output (CO), cardiac index (CI), and B-type natriuretic peptide (BNP)-were measured at baseline and post-treatment. Clinical outcomes such as intensive care unit (ICU) length of stay, mechanical ventilation requirements, and mortality were also recorded. Statistical analyses were conducted using independent samples <i>t</i>-tests and <i>χ</i> ²/Fisher's exact tests.</p><p><strong>Results: </strong>SIH markedly worsened haemodynamics versus normal glycaemia: RAP 9.8 ± 5.1 <i>vs</i> 6.1 ± 3.5 mmHg, PAP 35.2 ± 16.0 <i>vs</i> 26.2 ± 10.3 mmHg, PAWP 16.0 ± 7.0 <i>vs</i> 8.6 ± 6.4 mmHg, CO 3.3 ± 2.3 <i>vs</i> 6.0 ± 3.3 L/min, CI 1.88 ± 0.24 <i>vs</i> 2.70 ± 0.50 L/min/m², BNP 465 ± 250 <i>vs</i> 180 ± 53 pg/mL (all <i>P</i> < 0.001). Within the SIH cohort, IIT outperformed conventional therapy: RAP 7.0 ± 2.2 <i>vs</i> 8.3 ± 3.9 mmHg (<i>P</i> = 0.04), PAP 21.6 ± 3.7 <i>vs</i> 29.3 ± 6.5 mmHg (<i>P</i> < 0.001), PAWP 10.2 ± 5.4 <i>vs</i> 13.8 ± 5.3 mmHg (<i>P</i> = 0.001), CO 4.9 ± 2.2 <i>vs</i> 4.0 ± 1.4 L/min (<i>P</i> = 0.022), CI 2.58 ± 0.32 <i>vs</i> 2.11 ± 0.31 L/min/m², <i>P</i> < 0.001), BNP 202 ± 62 <i>vs</i> 346 ± 171 pg/mL (<i>P</i> < 0.001). Clinically, IIT shortened ICU stay (10.3 ± 3.4 <i>vs</i> 14.5 ± 2.6 days, <i>P</i> < 0.001), reduced ventilator use (56.9% <i>vs</i> 76.0%, <i>P</i> = 0.042), and lowered mortality (23.5% <i>vs</i> 42.0%, <i>P</i> = 0.048).</p><p><strong>Conclusion: </strong>IIT significantly reduced cardiac filling pressures, improved cardiac function, and was associated with favorable clinical outcomes in SIH patients, suggesting potential benefits of stricter glycaemic control in critically ill patients. However, given the retrospective design and absence of glucose-variability monitoring, these findings should be interpreted with caution.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107767"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692001","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":"Predicting hypertension in type 2 diabetes mellitus: Insights from a nomogram model.","authors":"Jie Liu, Nan Zhang, Tong Liu","doi":"10.4239/wjd.v16.i7.107501","DOIUrl":"10.4239/wjd.v16.i7.107501","url":null,"abstract":"<p><p>The prevalence of type 2 diabetes mellitus (T2DM) is rising, with hypertension as a common comorbidity that significantly increases cardiovascular and microvascular risks. Accurate prediction of hypertension in T2DM is essential for early intervention and personalized management. In this editorial, we comment on a recent retrospective study by Zhao <i>et al</i>, which developed a nomogram model using a large cohort of 26850 patients to predict hypertension risk in patients with T2DM. The model incorporated key independent risk factors, including age, body mass index, duration of diabetes, low-density lipoprotein cholesterol and urine protein levels, demonstrating promising discriminative power and predictive accuracy in internal validation. However, its external applicability requires further confirmation. This editorial discusses the clinical value and limitations of the predictive model, highlighting the unfavorable impact of hypertension on T2DM patients. Future research should evaluate the potential contribution of other risk factors to enhance risk prediction and improve the management of T2DM comorbidities.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107501"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692098","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":"Abnormal peripheral cellular immune profiles in gestational diabetes mellitus: A meta-analysis.","authors":"Yan Yang, Quan-Zhou Xiao, Jian Zhou, Ya-Qi Wang","doi":"10.4239/wjd.v16.i7.105156","DOIUrl":"10.4239/wjd.v16.i7.105156","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) has recently been associated with abnormal profiles of inflammatory cells and cytokines, though the findings remain inconsistent and unclear.</p><p><strong>Aim: </strong>To elucidate the peripheral immune status in GDM.</p><p><strong>Methods: </strong>We systematically screened databases including Web of Science, PubMed, and EMBASE for eligible studies. Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data. The pooled mean difference (MD) with 95% confidence interval (CI) was analyzed as the outcome measure. The Newcastle-Ottawa scale was employed to assess study quality.</p><p><strong>Results: </strong>A total of 19 studies involving various immune cell subgroups were included in our analysis. Specifically, total CD4+ T cells (WMD = 3.08; 95%CI: 0.81-5.35) were significantly increased in GDM groups. In contrast, total lymphocytes (SMD = 0.05; 95%CI: -0.16 to 0.26), CD3+ T cells (SMD = -0.34; 95%CI: -1.01 to 0.32), CD8+ T cells (SMD = 0.21; 95%CI: -0.31 to 0.73), and natural killer T (NKT) Cells (SMD = 0.83; 95%CI: -1.10 to 2.75) showed no significant changes in GDM. Activation markers (HLA-DR+ or CD69+) on CD4+ T cells (WMD = 0.20; 95%CI: 0.06-0.34) were increased in GDM patients. Treg cells, a classical subgroup of CD4+ T cells, showed a decreasing trend in GDM compared to controls (SMD = -0.83; 95%CI: -1.31 to -0.34). These results indicate an abnormal immune status in the peripheral profiles of GDM.</p><p><strong>Conclusion: </strong>GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles, including higher levels of CD4+ T cells and a reduced population of Treg cells. Treating immune dysregulation could be a new direction for GDM management, although further research is needed to understand the precise mechanisms of immune overactivation in GDM.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"105156"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692040","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":"Altered hippocampal subfield volumes are associated with memory and executive function in patients with type 2 diabetes mellitus.","authors":"Shu-Xian Wu, Xiao-Long Liang, Qin-Qin Zhu, Wei Wang, Li Jiang, Huan-Huan Chen, Shui Tian, Ming Qi","doi":"10.4239/wjd.v16.i7.104424","DOIUrl":"10.4239/wjd.v16.i7.104424","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus (T2DM); however, the association between hippocampal subregion volume changes and cognitive decline in different dimensions remains unclear.</p><p><strong>Aim: </strong>To investigate changes in hippocampal subregion volumes in patients with T2DM and their relationship with cognitive function impairment.</p><p><strong>Methods: </strong>Sixty patients with T2DM and 32 healthy controls were recruited. All participants underwent a 3.0 T magnetic resonance scan and a series of clinical assessments. Hippocampal subfield volumes were determined using FreeSurfer 7.4.1. A two-sample <i>t</i>-test was used to evaluate group differences. Partial correlation analysis was performed to assess the relationship between hippocampal subregion volumes and cognitive function. ^a <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Compared with controls, the volume of right hippocampus-amygdala transition area (<i>t</i> = -3.053, <i>P</i> = 0.003) in patients with T2DM was significantly reduced, which was negatively correlated with the required time of the Trail Making Test (TMT)-A (<i>r</i> = -0.331, <i>P</i> = 0.028) and TMT-B (<i>r</i> = -0.402, <i>P</i> = 0.007) and positively correlated with the scores of Symbol Digit Modalities Test (<i>r</i> = 0.381, <i>P</i> = 0.011), Auditory Verbal Learning Test (AVLT)-N7 (<i>r</i> = 0.309, <i>P</i> = 0.041), and Digital Span Test (<i>r</i> = 0.300, <i>P</i> = 0.048). The volume of the right molecular layer (<i>t</i> = -2.998, <i>P</i> = 0.004) was also significantly reduced, which was positively associated with the scores of AVLT-N7 (<i>r</i> = 0.311, <i>P</i> = 0.045). In addition, the left hippocampal fissure volume (<i>t</i> = 3.617, <i>P</i> = 0.002) was significantly increased in patients with T2DM.</p><p><strong>Conclusion: </strong>Declines in cognitive performance, especially memory and executive function, are linked to changes in the volumes of the right hippocampus-amygdala transition area and right molecular layer in patients with T2DM.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"104424"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692041","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":"First metatarsophalangeal joint synovial hypertrophy associated with vitamin D status in type 2 diabetes mellitus: An ultrasound-graded study.","authors":"Qing-Shan Li, Xiao-Hui Xiao, Yu-Ying Cai, Xiao-Peng Xiao, Ping-Xiang Hu, Hong Li","doi":"10.4239/wjd.v16.i7.107019","DOIUrl":"10.4239/wjd.v16.i7.107019","url":null,"abstract":"<p><strong>Background: </strong>The existing semi-quantitative ultrasound grading system inadequately evaluates synovial hypertrophy at the dorsal recess of the first metatarsophalangeal joint (MTPJ). Vitamin D deficiency is prevalent in type 2 diabetes mellitus (T2DM) and may influence joint inflammation. This study hypothesizes that serum 25-hydroxyvitamin D [25(OH)D] levels are inversely associated with synovial hypertrophy severity of the first MTPJ in patients with T2DM.</p><p><strong>Aim: </strong>To refine ultrasound grading for the first MTPJ synovial hypertrophy and investigate its association with vitamin D in T2DM.</p><p><strong>Methods: </strong>This cross-sectional study included 56 patients (112 MTPJs) with T2DM from Shenzhen Traditional Chinese Medicine Hospital. Synovial hypertrophy was evaluated using a refined semi-quantitative ultrasound grading system focusing on the dorsal recess overlying the metatarsal bone. Serum 25(OH)D levels were measured. Logistic regression and threshold analyses assessed associations between vitamin D status and hypertrophy severity.</p><p><strong>Results: </strong>Of 112 joints assessed, 98 exhibited synovial hypertrophy (grade 1: 40; grade 2: 50; grade 3: 8). The refined grading system demonstrated strong intra- and inter-observer reliability (intraclass correlation coefficients = 0.79 and 0.73, respectively). Lower serum 25(OH)D (< 24.3 ng/mL) was independently associated with moderate-to-severe hypertrophy [odds ratio (OR) = 0.83; <i>P</i> = 0.0163]. Vitamin D deficiency significantly increased the likelihood of moderate-to-severe hypertrophy compared with non-deficiency (OR = 3.86; <i>P</i> = 0.0422). Threshold analysis identified 23.8 ng/mL as a critical serum 25(OH)D level, below which each increment reduced moderate-to-severe hypertrophy risk by 21% (OR = 0.79; <i>P</i> = 0.0078).</p><p><strong>Conclusion: </strong>The refined ultrasound grading system demonstrated strong reliability. Serum 25(OH)D may serve as a protective factor against the severity of synovial hypertrophy in T2DM patients with lower 25(OH)D levels.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107019"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691999","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":"Impact of longer diabetes duration and lower estimated glomerular filtration rate on cardiovascular complications and mortality: A nationwide population-based study.","authors":"Hong Sang Choi, Bongseong Kim, Kyung-Do Han, Sang Heon Suh, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim","doi":"10.4239/wjd.v16.i7.107647","DOIUrl":"10.4239/wjd.v16.i7.107647","url":null,"abstract":"<p><strong>Background: </strong>Decreased renal function is a well-known risk factor for cardiovascular diseases (CVD) and death. However, the impact of diabetes duration and the glomerular filtration rate (GFR) on cardiovascular complications in patients with type 2 diabetes has not been well studied.</p><p><strong>Aim: </strong>To investigate the complex impact of longer diabetes duration and GFR on CVD and mortality.</p><p><strong>Methods: </strong>Subjects with diabetes age ≥ 20 years, who underwent health check-ups from 2015 to 2016 were identified in the Korean National Health Insurance Service database. Based on diabetes duration, subjects were grouped into new-onset, < 5 years, 5-9 years, or ≥ 10 years. The new-onset diabetes group [estimated GFR (eGFR): ≥ 90 mL/min/1.73 m²] was the reference group. A Cox proportional hazards model adjusted for potential confounders was used to estimate the risk for myocardial infarction (MI), ischemic stroke (IS), and mortality.</p><p><strong>Results: </strong>During a 3.9-year follow-up of 2105228 patients, 36003 (1.7%) MIs, 46496 (2.2%) ISs, and 73549 (3.5%) deaths were documented. Both longer diabetes duration and lower eGFR were independently associated with higher risks of MI, IS, and mortality, which were further amplified when these factors coexisted. Even patients with new-onset diabetes had elevated MI and IS risk at mildly reduced eGFR (60-90 mL/min/1.73 m²). Mortality risk rose appreciably once eGFR declined below 60 mL/min/1.73 m², particularly in those with longer diabetes duration. eGFR ≥ 90 mL/min/1.73 m² subgroups had higher death risk than eGFR 60-90 mL/min/1.73 m² subgroups regardless of diabetic duration.</p><p><strong>Conclusion: </strong>Increasing diabetes duration and decreasing eGFR are associated with increased risk of MI, IS, and mortality. For cardiovascular risk estimation, diabetes duration should be considered an important risk factor.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 7","pages":"107647"},"PeriodicalIF":4.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692002","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}