Maturitas最新文献

{"title":"Validation of self-reported endometriosis","authors":"Dereje G. Gete ,&nbsp;Annette J. Dobson ,&nbsp;Sally Mortlock ,&nbsp;Grant W. Montgomery ,&nbsp;Richard Hockey ,&nbsp;Jenny Doust ,&nbsp;Gita D. Mishra","doi":"10.1016/j.maturitas.2025.108642","DOIUrl":"10.1016/j.maturitas.2025.108642","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the validity and reliability of self-reported diagnoses of endometriosis.</div></div><div><h3>Study design</h3><div>The study included 8572 women from two Australian birth cohorts (1989–95 and 1973–78), using data from the Genetic variants, Early Life exposures, and Longitudinal Endometriosis Symptoms Study (GELLES), a sub-study of the Australian Longitudinal Study on Women's Health. Validity was assessed using predictive values, and reliability was evaluated with kappa statistics.</div></div><div><h3>Main outcome measures</h3><div>Self-reported endometriosis diagnoses from the GELLES question “Has a doctor or healthcare provider ever diagnosed you with endometriosis?” were validated using a longitudinal survey and linked administrative records as the gold standard.</div></div><div><h3>Results</h3><div>The findings from the 1989–95 and 1973–78 cohorts showed good agreement for overall self-reported endometriosis diagnosis, with uncorrected kappa values of 0.67 and 0.70 (or 0.86 and 0.83 after correction for bias and prevalence effects), and positive predictive values of 0.75 and 0.84, respectively. The agreement was notably stronger for self-reported surgical diagnoses, with uncorrected kappa values of 0.87 and 0.79, and positive predictive values of 0.84 and 0.85, respectively. However, the validity of clinically suspected diagnoses was lower due to the higher occurrence of discrepancies in case assignments.</div></div><div><h3>Conclusions</h3><div>The findings indicate that self-reported endometriosis obtained from two questions about diagnoses made by doctors and specified methods (surgical or clinical) are valid and reliable, particularly for surgical diagnoses. Women's responses to these questions can be reliable for identifying endometriosis cases in epidemiological research. Self-reported data of clinically suspected diagnoses (i.e. without surgical confirmation) should be interpreted cautiously.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108642"},"PeriodicalIF":3.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review on the relationship between menopausal hormone replacement therapy, sarcopenia, and sarcopenia-related parameters","authors":"Marc F. Österdahl ,&nbsp;Mary Ni Lochlainn ,&nbsp;Carly Welch ,&nbsp;Janice Rymer ,&nbsp;Mark Ashworth ,&nbsp;Julie Whitney ,&nbsp;Emma L. Duncan ,&nbsp;Claire J. Steves","doi":"10.1016/j.maturitas.2025.108609","DOIUrl":"10.1016/j.maturitas.2025.108609","url":null,"abstract":"<div><h3>Objective</h3><div>Whilst the beneficial effect of menopausal hormone replacement therapy (HRT) on osteoporosis is well established, its effect on sarcopenia is less clear. We conducted a systematic review of evidence exploring the relationship between HRT and sarcopenia.</div></div><div><h3>Methods</h3><div>We searched OVID Medline, Embase, CINAHL and Web of Science to 8 August 2024, identifying both in randomised controlled trials (RCTs) and observational studies of community-dwelling women. We excluded articles focussed on androgen therapy, or hormone therapy for indications other than menopause.</div><div>Our primary outcome was the effect of HRT upon sarcopenia defined by a consensus set of criteria (e.g. the definition proposed by the European Working Group on Sarcopenia in Older People 2). Grip strength, measures of physical performance, and radiological measures of muscle quantity were included as secondary outcomes. Reporting follows PRISMA guidelines.</div></div><div><h3>Results</h3><div>Searches identified 6090 articles, of which 43 were included in our final analysis. No studies used a consensus definition of sarcopenia. Most used data over 20 years old, with older formulations of HRT, though formulations were inconsistently reported.</div><div>Of the 15 RCTs included, two of six suggested a beneficial effect on grip strength, one of six on physical performance, and seven of 12 on radiologically assessed muscle quantity.</div><div>Of the 28 observational studies included, three of 11 suggested a beneficial effect on grip strength, two of seven on physical performance and three of 18 on radiologically assessed muscle quantity.</div><div>No studies reported detrimental effects on muscle. Risk of bias was high/severe. Observational models seldom adjusted for confounders.</div></div><div><h3>Conclusions</h3><div>No studies used modern consensus definitions of sarcopenia. For secondary outcomes, there was no consistent evidence of benefit, with methodological flaws, and outmoded HRT formulations.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108609"},"PeriodicalIF":3.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of motion sensor-based human activity recognition for supporting independence in smart homes","authors":"Moid Sandhu ,&nbsp;Marlien Varnfield ,&nbsp;Sanka Amadoru ,&nbsp;Paul A. Yates ,&nbsp;Brano Kusy ,&nbsp;David Silvera-Tawil","doi":"10.1016/j.maturitas.2025.108632","DOIUrl":"10.1016/j.maturitas.2025.108632","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigates the feasibility of leveraging Internet of Things (IoT) and artificial intelligence (AI) technologies to accurately identify key human activities critical for evaluating the ability of older adults to live independently.</div></div><div><h3>Methods</h3><div>Seventeen clinically relevant activities for assessing independent living of older adults were identified using standard clinical tools and insights from in-depth discussions with clinicians in geriatric care. Real-world data were then collected within a home environment using 20 IoT wearable and object sensors, as healthy adult participants performed each activity. A comprehensive set of features was extracted from the collected data, using both time and frequency domains, which were then used to develop a random forest machine learning algorithm to accurately recognize these activities.</div></div><div><h3>Results</h3><div>Data from 10 participants (7 male, 3 female) showed that the proposed algorithm achieved an average accuracy of 87.5 % in recognizing 17 key activities. Additionally, the algorithm achieved 97.95 % accuracy in identifying four functional areas namely mobility, hygiene, nutrition and hydration, and medication intake.</div></div><div><h3>Discussion</h3><div>These findings highlight the potential of IoT and AI-driven technologies to identify key activities essential for independent living in a home environment. The high accuracy of activity recognition enables reliable monitoring, offering valuable insights into the capabilities of older adults to live independently. This approach could be used to empower caregivers and clinicians to deliver timely, tailored care, fostering improved support and quality of life.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108632"},"PeriodicalIF":3.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Influence of gender and menopausal status on gut microbiota” [Maturitas Vol. 116 (2018) 43-53]","authors":"Jose A. Santos-Marcos ,&nbsp;Oriol A. Rangel-Zuñiga ,&nbsp;Rosa Jimenez-Lucena ,&nbsp;Gracia M. Quintana-Navarro ,&nbsp;Sonia Garcia-Carpintero ,&nbsp;Maria M. Malagon ,&nbsp;Blanca B. Landa ,&nbsp;Manuel Tena-Sempere ,&nbsp;Pablo Perez-Martinez ,&nbsp;Jose Lopez-Miranda ,&nbsp;Francisco Perez-Jimenez ,&nbsp;Antonio Camargo","doi":"10.1016/j.maturitas.2025.108641","DOIUrl":"10.1016/j.maturitas.2025.108641","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108641"},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth cohort differences in multimorbidity over time among Chinese oldest-old adults","authors":"Junmin Zhu ,&nbsp;Yafei Wu ,&nbsp;Siyu Duan ,&nbsp;Ya Fang","doi":"10.1016/j.maturitas.2025.108631","DOIUrl":"10.1016/j.maturitas.2025.108631","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity imposes a significant burden on healthcare systems worldwide. Understanding longitudinal changes multimorbidity among the oldest-old (i.e., those aged 80 or more) is essential yet remains limited. This study investigated birth cohort differences in multimorbidity over time among Chinese oldest-old adults using two longitudinal surveys in different decades.</div></div><div><h3>Methods</h3><div>Data were drawn from the Chinese Longitudinal Healthy Longevity and Happy Family Study. 2703 and 2533 participants aged 80 or more were included in the 1998 and 2008 surveys, both with a one-decade follow-up, respectively. The multimorbidity count was assessed as the number of conditions an individual had from a list of 12 common chronic conditions. Generalized linear mixed models were employed to assess birth cohort differences, adjusting for demographic, lifestyle, and socioeconomic factors. Inverse probability weighting was applied to mitigate attrition bias.</div></div><div><h3>Results</h3><div>The 1998 survey (mean age: 89.32 ± 6.87 years, 51.17 % female) revealed no significant birth cohort differences in multimorbidity (<em>P</em> &gt; 0.05). In contrast, the 2008 survey (mean age: 91.12 ± 7.13 years, 59.97 % female) demonstrated that each successive birth cohort experienced a higher multimorbidity count than its predecessors (<em>P</em> &lt; 0.05). Compared to the cohort born in 1924–1928, participants from the cohort born in 1909–1913 had an estimated 0.217 fewer multimorbidity count (95 % CI: −0.397, −0.037), whereas those from the cohort born in 1919–1923 exhibited a reduction of 0.094 (95 % CI: −0.185, −0.002). Additionally, the multimorbidity count was significantly higher among smokers, alcohol consumers, and those with a lower intake of fresh fruit.</div></div><div><h3>Conclusion</h3><div>Multimorbidity is progressively increasing among recent birth cohorts among Chinese oldest-old adults. These findings highlight the urgent need for comprehensive policies and early interventions to promote healthy ageing.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108631"},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the incidence of vulvar malignant melanoma in Denmark and Sweden: Two nationwide studies covering >40 years","authors":"Kirstine Duffau ,&nbsp;Guoqiao Zheng ,&nbsp;Christian Munk ,&nbsp;Karin Sundström ,&nbsp;Jiangrong Wang ,&nbsp;Louise Baandrup ,&nbsp;Merete Hædersdal ,&nbsp;Susanne K. Kjær","doi":"10.1016/j.maturitas.2025.108633","DOIUrl":"10.1016/j.maturitas.2025.108633","url":null,"abstract":"<div><h3>Objectives</h3><div>Vulvar malignant melanoma (VuMM) represents a rare malignancy. This study examines and compares the incidence and trends in incidence of VuMM in Denmark and in Sweden over a period of &gt;40 years.</div></div><div><h3>Study design</h3><div>A nationwide, population-based registry study conducted in two countries.</div></div><div><h3>Main outcome measures</h3><div>We identified incident VuMM cases in the Danish and Swedish Cancer Registries. Information on age at diagnosis, anatomical site, histology, and stage of disease was retrieved. We calculated age-specific and age-standardized incidence rates (ASRs) with temporal trends in incidence evaluated by estimated annual percent change (EAPC) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 524 women with VuMM, encompassing 171 women in Denmark (1978–2022) and 353 women in Sweden (1978–2018), were included. The age-specific incidence rates increased with age throughout the study period in both countries. The ASR decreased in both countries: in Denmark, from 1.03 (95 % CI: 0.59–1.48) per 1,000,000 to 0.55 (95 % CI: 0.26–0.83); and in Sweden from 1.25 (95 % CI: 0.22–2.28) to 0.76 (95 % CI: 0.42–0.84). This corresponded to EAPCs of −1.65 (95 % CI: −2.45; −0.84) in Denmark and −1.22 (95 % CI: −1.69; −0.75) in Sweden.</div></div><div><h3>Conclusions</h3><div>The age-standardized and age-specific VuMM incidence rates were nearly identical in Denmark and Sweden, which are countries with similar demographic characteristics, and a free-of-charge healthcare system. The incidence of VuMM showed an equal and statistically significant decrease in Denmark and Sweden during the last four decades. The explanation for the decrease is currently unknown.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108633"},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating biomarkers for the preoperative diagnosis of uterine sarcoma: A systematic review and meta-analysis","authors":"Cristina Taliento ,&nbsp;Christine De Bruyn ,&nbsp;Jolien Ceusters ,&nbsp;Dirk Timmerman ,&nbsp;Thierry Van den Bosch ,&nbsp;An Coosemans","doi":"10.1016/j.maturitas.2025.108634","DOIUrl":"10.1016/j.maturitas.2025.108634","url":null,"abstract":"<div><h3>Objective</h3><div>A way to improve the early diagnosis of uterine sarcoma is by identifying circulating protein biomarkers that allow for differentiation between uterine sarcoma and benign leiomyomas. However, to date, no systematic review has gathered data on the diagnostic accuracy of these biomarkers as diagnostic tools for uterine sarcomas.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis. An electronic search was conducted using PubMed, EMBASE, Web of Science, and CENTRAL (Cochrane) to identify clinical studies investigating the potential role of circulating biomarkers for the diagnosis of uterine sarcoma. We selected only studies that compared patients with a histologically confirmed diagnosis of leiomyoma versus uterine sarcoma. This study was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies statement.</div></div><div><h3>Results</h3><div>A total of 20 observational studies were included, with a total of 13 biomarkers. Five studies reported data on diagnostic accuracy, including sensitivity and specificity. Lactate dehydrogenase levels showed a statistically significant difference between patients with uterine sarcoma and controls with leiomyoma (p &lt; 0.001), with a sensitivity and specificity ranging between 0.47 and 1.00 and 0.86 to 1.00, respectively. Three studies reported data on diagnostic accuracy of carbohydrate antigen 125: the estimates for sensitivity and specificity ranged from 0.43 to 0.64 and 0.50 to 0.77, respectively, with substantial heterogeneity between the studies. Data on diagnostic accuracy for C-reactive protein was available for two studies, with sensitivity and specificity ranging between 0.84 and 0.87 and 0.83 to 0.89, respectively. Data for two biomarkers, human epididymal protein 4 and D-dimer, were insufficient, as each was evaluated in only one study.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis showed that the most encouraging results were available for lactate dehydrogenase. Other biomarkers may also prove to be useful tools in differentiating between leiomyomas and uterine sarcomas; however, further studies are needed to replicate these findings.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108634"},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive impact of a menopause website – MyMenoplan.org – on treatment intentions, knowledge, and decision making: A randomized controlled trial","authors":"Leslie B. Snyder ,&nbsp;Katherine M. Newton ,&nbsp;Hui Xin Ng ,&nbsp;Susan D. Reed ,&nbsp;Katherine A. Guthrie ,&nbsp;Viviana Zambrano ,&nbsp;Andrea Z. LaCroix","doi":"10.1016/j.maturitas.2025.108630","DOIUrl":"10.1016/j.maturitas.2025.108630","url":null,"abstract":"<div><h3>Objective</h3><div>Assess the impact of a new website, <span><span>MyMenoplan.org</span><svg><path></path></svg></span>, on menopause knowledge, decision-making progress, treatment and coping intentions among people experiencing perimenopause and menopause. The website was designed to provide women and their clinicians with comprehensive, evidence-based information and decision-making tools about a broad range of symptoms and treatments, address common questions and facilitate conversations with clinicians when desired.</div></div><div><h3>Study design</h3><div>Women were recruited online and randomized to interact with the <span><span>MyMenoplan.org</span><svg><path></path></svg></span> website created by MsFLASH investigators (<em>n</em> = 200) or control websites (<em>n</em> = 210) for at least 20 min before completing an online survey. Women in the control arm could choose any website(s), including three suggested high-quality websites from governmental or non-profit organizations. Fraud-detection protocols were followed. Outcome differences by arm were estimated via adjusted linear regression models.</div></div><div><h3>Primary outcomes</h3><div>Behavioral change intentions, menopause knowledge, decision-making progress, and user website experience.</div></div><div><h3>Results</h3><div>99 % of controls visited at least one recommended website. Compared with the control arm, the <span><span>MyMenoplan.org</span><svg><path></path></svg></span> arm reported significantly higher levels of intent to change treatment (3.87 vs. 3.61), knowledge of menopause symptoms and treatments (4.17 vs. 3.85), treatment decision-making progress (3.94 vs. 3.71), clarity about benefits and risks of treatments (4.04 vs. 3.81), perceived website quality (4.05 vs. 3.70), intentions to return to the website (4.40 vs. 3.97), and likelihood of recommending it to others (4.35 vs. 4.04; each <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div><span><span>MyMenoplan.org</span><svg><path></path></svg></span> is the first NIH-funded website shown to be effective in helping women learn and make decisions about management of the menopause transition. The website serves as a model for providing much-needed, evidence-based information for health-care providers and women nearing or in perimenopause and menopause.</div><div>Clinical Trial Registration Number: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID <span><span>NCT05299983</span><svg><path></path></svg></span></div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108630"},"PeriodicalIF":3.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theimpact of obesity on perioperative care: Integrating ERAS protocols for improved surgical outcomes","authors":"Maria Fanaki,&nbsp;Dimitrios Haidopoulos,&nbsp;Dimitrios Efthimios Vlachos,&nbsp;Vasileios Lygizos,&nbsp;Antonia Varthaliti,&nbsp;Nikolaos Thomakos,&nbsp;Vasileios Pergialiotis","doi":"10.1016/j.maturitas.2025.108598","DOIUrl":"10.1016/j.maturitas.2025.108598","url":null,"abstract":"<div><div>Obesity represents a global health crisis, affecting over 650 million adults worldwide and markedly influencing surgical outcomes, particularly in the context of gynecologic oncology. It serves as a considerable risk factor for perioperative complications, impacting metabolic, respiratory, immune, and cardiovascular functions. Patients with obesity undergoing surgical procedures in gynecologic oncology exhibit higher incidences of wound infections, thromboembolic events, respiratory failure, and extended hospital stays. The Enhanced Recovery After Surgery (ERAS) protocol has emerged as a robust perioperative strategy to mitigate these risks and enhance surgical outcomes.</div><div>Obesity leads to significant alterations in body composition, including increased adipose tissue, causing chronic inflammation and insulin resistance, which elevate the risk of wound infections and delayed healing. Respiratory complications are exacerbated by reduced lung compliance and obstructive sleep apnea, while cardiovascular strain and thromboembolism risks are heightened by systemic inflammation and coagulation imbalances. Immune dysregulation further impairs recovery by compromising wound healing and increasing susceptibility to infection. ERAS protocols counteract these challenges through multimodal strategies, including prehabilitation, carbohydrate loading, immunonutrition, glycemic control, respiratory optimization, and enhanced mobilization. Implementing ERAS protocols has been shown to reduce postoperative morbidity by 32 %, to decrease the duration of hospital stay, to reduce the readmission rate by 20 % and to enhance overall recovery.</div><div>Integrating ERAS protocols into perioperative care for obese patients is essential for minimizing complications and enhancing recovery. A multidisciplinary, individualized approach that includes metabolic optimization, respiratory management, and thromboprophylaxis is crucial in this high-risk population. Future research should focus on refining ERAS protocols for obesity, exploring personalized nutrition strategies, and investigating long-term surgical outcomes.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108598"},"PeriodicalIF":3.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probability of progression and regression of chronic kidney disease in patients with type 2 diabetes mellitus","authors":"Barry Moses Quan Ren Koh ,&nbsp;Feng He ,&nbsp;Gavin Siew Wei Tan ,&nbsp;Cynthia Ciwei Lim ,&nbsp;Kavita Venkataraman ,&nbsp;Charumathi Sabanayagam","doi":"10.1016/j.maturitas.2025.108599","DOIUrl":"10.1016/j.maturitas.2025.108599","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the annual transitions between the stages of diabetic kidney disease (DKD) in an Asian population with type 2 diabetes.</div></div><div><h3>Study design</h3><div>Longitudinal cohort study.</div></div><div><h3>Main outcome measures</h3><div>We analysed 15,913 clinic visits by 5980 patients (Chinese, Malay and Indian) who attended at least 2 annual primary care visits from 2010 to 2015, with DKD categorised into G1-G5 stages by estimated glomerular filtration rate. We applied a multistate Markov model adjusting for risk factors to estimate annual transition probabilities and sojourn times.</div></div><div><h3>Results</h3><div>Median (interquartile range) follow-up duration was 2.01 (1.11–2.93) years. Annual transition probabilities of progression from G1-G2 to G3 and G3 to G4-G5 were 1.26 % and 1.21 % respectively. Annual death rates among the G1-G2, G3 and G4-G5 groups were 0.92 %, 1.63 %, and 5.84 %, respectively. Estimated sojourn times in the G1-G2, G3 and G4-G5 groups were 43.73, 6.97, and 6.32 years, respectively. Among modifiable risk factors, progression from G1-G2 to G3 was associated with higher systolic blood pressure while death was associated with the presence of diabetic retinopathy, higher hemoglobin A1_c (HbA1c) and lower body mass index.</div></div><div><h3>Conclusions</h3><div>Annual DKD progression in this screened population was slow but death from advanced stages was high. Ongoing surveillance and targeted control of risk factors such as blood pressure, HbA1c, and diabetic retinopathy may help improve outcomes.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"198 ","pages":"Article 108599"},"PeriodicalIF":3.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}