Clinics (Sao Paulo, Brazil)最新文献

{"title":"Healthcare professionals' knowledge of organic foods and their health impact: a survey-based analysis.","authors":"Angela Cristine Bersch-Ferreira, Stela Verzinhasse Peres, Patrick Araujo Terezan, Gisele Medeiros Bastos, Rozana Mesquita Ciconelli, Fúlvio Alexandre Scorza","doi":"10.1016/j.clinsp.2025.100720","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100720","url":null,"abstract":"<p><strong>Background: </strong>Organic foods are often considered healthier and more sustainable, yet healthcare professionals' understanding and perceptions remain unclear. This study aimed to evaluate their knowledge and perceptions related to organic foods and associated barriers.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among employees at a large hospital in São Paulo, Brazil, between June and July 2024. Using a non-probabilistic convenience sample, an online questionnaire collected sociodemographic data, lifestyle characteristics, and information on participants' knowledge and perception of organic foods. Descriptive statistics, Chi-Square tests, and logistic regression were applied to identify factors associated with the lack of knowledge.</p><p><strong>Results: </strong>A total of 199 questionnaires were completed. Nearly half of the respondents (49.2 %) were not fully aware of what defines organic food. Women represented 80.2 % of the sample. Smoking was significantly associated with a lack of knowledge regarding organic foods. Approximately 30 % were uncertain about cardiovascular risks related to non-organic foods, and cost was identified as a major barrier to consumption. Although most recognized environmental benefits and a potential role in reducing global warming, understanding how organic consumption intersects with human health has remained limited. Adjusted analyses revealed that higher education (without postgraduate training), smoking, and comorbidities were associated with knowledge gaps.</p><p><strong>Conclusion: </strong>These findings highlight substantial knowledge gaps among healthcare professionals regarding organic foods.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100720"},"PeriodicalIF":2.4,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of airway clearance techniques versus control in non-hospitalized infants with moderate acute viral bronchiolitis: A randomized controlled clinical trial.","authors":"Vanesa González-Bellido, Noelia Rama Suárez, Gustavo Adolfo Yánez Yepez, Maria Del Carmen Jimeno Esteo, Rubén García Caraballo, Sagrario Mayoralas Alises, Juan Nicolás Cuenca Zaldívar, Márcio Vinícius Fagundes Donadio, Eleuterio A Sánchez Romero, Samuel Fernández Carnero","doi":"10.1016/j.clinsp.2025.100735","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100735","url":null,"abstract":"<p><strong>Background: </strong>Acute viral bronchiolitis is the most common lower respiratory tract infection in infants < 2-years of age. Airway Clearance Techniques (ACTs) aim to reduce airway obstruction, thereby decreasing airway resistance, improving gas exchange, and reducing respiratory load, all of which can lead to improved clinical stability.</p><p><strong>Methods: </strong>One hundred ninety-two infants were randomly allocated to one of the following ACTs using flow-based techniques: Assisted Autogenic Drainage (AAD; n = 62), Prolonged Slow Expiration (PSE; n = 63), or a control group (n = 67). The sessions were performed in an outpatient setting, with a duration of 20 min and repeated 48 h later. The outcome measures were the Acute Bronchiolitis Severity Scale (ABSS), Bronchiolitis Score of Sant Joan de Déu (BROSJOD), and peripheral oxygen saturation (SpO₂) recorded immediately after each intervention.</p><p><strong>Results: </strong>Both airway clearance techniques, PSE and AAD, demonstrated significant improvements in clinical severity scores (ABSS and BROSJOD) and SpO₂ levels compared to the control group, with PSE showing the most pronounced effects. ABSS (ATSboot p = 0.001; η²_p = 0.105) and BROSJOD (ATSboot p = 0.003; η²_p=0.037) significantly differed and interacted with time, decreasing from baseline to 48 h post-treatment. PSE outperformed the controls in reducing ABSS (p < 0.001; Hedges' g = 1.4 vs. g = 0.37). ACTs improved ABSS and BROSJOD scores compared to controls, with PSE showing the greatest SpO₂ increase and wheezing reduction at 20 minutes and one hour post-baseline. At 48 h, the AAD and PSE groups had greater ABSS changes than the controls and fewer retractions at 20 min post-baseline. The AAD group had a lower heart rate, while the controls had higher respiratory rates, and the PSE group had the lowest heart rate. No significant clinical adverse effects were observed.</p><p><strong>Conclusions: </strong>Both ACTs using flow-based techniques significantly reduced ABSS and BROSJOD scores immediately after treatment and 48 h later in non-hospitalized infants with moderate acute viral bronchiolitis than in the control group. However, PSE intervention showed greater effectiveness in reducing ABSS and increasing SpO₂ than the control and AAD groups.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100735"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of functionality and quality of life in patients with lower limb fractures after traffic accidents admitted to IOT-HCFMUSP.","authors":"Aline Ferreira Guimarães Gubolin, Julia Maria D'Andrea Greve, Vanderlei Carneiro da Silva","doi":"10.1016/j.clinsp.2025.100742","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100742","url":null,"abstract":"<p><strong>Introduction: </strong>Traffic accidents pose a significant public health concern, particularly for motorcyclists, who are especially susceptible to severe and debilitating injuries. These injuries can impair work activities and diminish the overall quality of life.</p><p><strong>Objective: </strong>This study aims to assess the functionality, quality of life, and return-to-work status of patients who sustained lower limb fractures due to traffic accidents.</p><p><strong>Methods: </strong>The authors conducted a retrospective observational study involving patients hospitalized with lower limb fractures due to traffic accidents at the Institute of Orthopedics and Traumatology at the Hospital das Clínicas, Faculty of Medicine, University of São Paulo, from 2018 to 2022. The authors performed the Timed Up and Go (TUG) test, and the 10-meter walk test, and administered the SF-12 questionnaire to evaluate quality of life. Additional questions regarding their return to work were also included.</p><p><strong>Results: </strong>A total of thirty-nine patients were evaluated six months or more following their last surgery. The results indicated that the average TUG time was 12.3 ± 3.3 seconds, and the average speed in the 10-meter walk test was 1.6 ± 0.3 m/s. The SF-12 results revealed a mean score of 48.6 ± 10.9 points in the mental domain and 39.9 ± 9.5 points in the physical domain. Notably, 72 % of patients had not returned to work. The length of hospital stay and the severity of injuries were significant factors influencing patient recovery.</p><p><strong>Conclusion: </strong>Although patients demonstrated normal functional status, the majority reported difficulties in performing daily activities and experienced low quality of life even after rehabilitation. This highlights the considerable impact that traffic accidents have on individuals' lives.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100742"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inverse relationship between serum haptoglobin and acute kidney injury in critically Ill patients with sepsis: A retrospective cohort study of the MIMIC-IV 3.0 database.","authors":"Yue Liao, Qilin Yang, Daxue Li, Yulong Wang","doi":"10.1016/j.clinsp.2025.100725","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100725","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have indicated that perioperative serum haptoglobin levels are associated with the risk of Acute Kidney Injury (AKI). However, the relationship between haptoglobin and AKI in sepsis patients remains unclear. This study aimed to investigate the association between serum haptoglobin levels and AKI in critically ill sepsis patients.</p><p><strong>Methods: </strong>The authors conducted a retrospective cohort study using data extracted from the Medical Information Mart for the Intensive Care (MIMIC) IV database version 3.0. Multivariable logistic regression analysis was used to control for potential confounders. Curve fitting was performed to assess the linearity of the association, and subgroup analyses were conducted to validate the robustness of the findings.</p><p><strong>Results: </strong>This study included 1324 participants (mean age 64.7 ± 17.6 years; 53.8 % male). The fully adjusted model showed an inverse association between serum haptoglobin levels and AKI. Each 10 mg/dL increase in haptoglobin decreased AKI odds by 1.4 % (OR = 0.986, 95 % CI 0.973‒0.999, p = 0.037). Patients in the highest haptoglobin group had 34.5 % lower AKI risk versus the lowest group (OR = 0.655, 95 % CI 0.439‒0.976, p = 0.038). The linear relationship (p for non-linearity = 0.152) remained robust in subgroup analyses.</p><p><strong>Conclusion: </strong>The present findings suggest that elevated serum haptoglobin levels may serve as a protective factor against AKI in critically ill sepsis patients. Nevertheless, prospective, randomized, controlled studies are required to confirm the findings presented in this investigation.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100725"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between mechanical ventilation and in-hospital mortality in cardiac intensive care units: A propensity score-matched cohort study.","authors":"XiangTing Tian, Meng Zheng, ShengQing Zhuo, BaoJuan Zheng","doi":"10.1016/j.clinsp.2025.100728","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100728","url":null,"abstract":"<p><strong>Objective: </strong>Mechanical Ventilation (MV) is a common intervention in Cardiac Intensive Care Units (CICUs); however, its effect on in-hospital mortality remains controversial. This study aimed to investigate the association between MV and in-hospital mortality among patients in the CICU using data from the eICU Collaborative Research Database.</p><p><strong>Methods: </strong>Patients were categorized based on whether they received MV, and propensity score matching was applied to adjust for baseline differences. The primary outcome was in-hospital mortality, which was analyzed using logistic regression and sensitivity analyses.</p><p><strong>Results: </strong>A total of 12,480 patients in the CICU were included, with 4390 receiving MV and 8090 not receiving MV. In-hospital mortality was notably higher among MV patients (16.0 %) than among those who did not receive MV (4.7 %, p < 0.001). After adjusting for confounding factors, MV remained associated with increased mortality, with an odds ratio of 4.16 (95 % CI 3.40‒5.12) in the matched cohort. Sensitivity analyses confirmed these findings, particularly in patients with acute respiratory failure and shock.</p><p><strong>Conclusion: </strong>These results demonstrate that CICU patients receiving MV have a higher mortality risk, underscoring the need for judicious clinical use of MV.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100728"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory unsupervised machine learning of angiogenesis biomarkers in a phase II advanced cervical cancer trial of radiochemotherapy with or without neoadjuvant chemotherapy.","authors":"Roberto J Arai, Thiago R da Costa, Renata Colombo Bonadio, Silvaneide Ferreira, Laura Sichero, Hugo P Monteiro, Arnold Stern, Maria Del Pilar Estevez-Diz","doi":"10.1016/j.clinsp.2025.100723","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100723","url":null,"abstract":"<p><strong>Objective: </strong>In a prospective, randomized phase II study, exploratory data analysis was conducted to evaluate angiogenesis-associated plasma protein levels in patients with locally advanced cervical cancer METHODS: Participants were divided into two groups: Group A received neoadjuvant cisplatin and gemcitabine treatment (NAC) followed by chemoradiation with cisplatin and brachytherapy (CRT), while Group B received only CRT. Plasma samples were collected from patients in Group A at three time points: baseline, after NAC, and after CRT. Group B patients had samples taken at two time points: baseline and after CRT. The study analyzed an angiogenesis-associated panel of plasma proteins, including angiopoietin-2, G-CSF, endothelin-1, FGF-1, FGF-2, follistatin, IL-8, HGF, EGF, HB-EGF, PLGF, VEGF-A, VEGF-C, and VEGF- D. Receiver Operating Characteristic (ROC) analyses assessed the predictive value of baseline biomarkers for 12, 24, and 36-month survival outcomes. Additionally, Principal Component Analysis (PCA) was applied to post-CRT biomarker changes to identify coordinated modulation patterns. PCA was based on normalized delta values and eigenvector loadings, enabling identification of biomarkers aligned with Progression-Free Survival (PFS) and Overall Survival (OS).</p><p><strong>Results: </strong>Significant differences were observed in the levels of HB-EGF, IL-8, PLGF, and VEGF-C between Groups A and B following CRT. Additionally, angiopoietin-2 levels showed a significant increase in Group B only. NAC treatment in Group A appeared to downregulate IL-8. CRT induced significant changes in HB-EGF, IL-8, PLGF, and VEGF-C levels in both groups. Patients in Group B demonstrated improved PFS and OS compared to those in Group A. Despite these differences in survival outcomes, the authors observed no significant intergroup differences in the tested biomarkers after completion of CRT. ROC analysis of baseline angiogenesis biomarkers demonstrated limited predictive sensitivity for survival outcomes. However, PCA of biomarker changes following CRT highlighted VEGF-A, HB-EGF, and angiopoietin-2 as variables associated with PFS and OS.</p><p><strong>Conclusion: </strong>Baseline biomarker levels were not predictive of long-term outcomes. In contrast, CRT alone modulated key angiogenic biomarkers, and post-CRT biomarker changes were associated with improved survival. Such biomarker alterations were not observed following NAC, which was not associated with clinical benefit in this study. These findings underscore the value of dynamic biomarker evaluation and highlight how treatment strategies differentially impact biomarker profiles in advanced cervical cancer.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100723"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum uric acid levels and the risk of hemorrhagic stroke: Insights from a two-sample Mendelian randomization study.","authors":"Zi-Wen Wang, Fang Zhao, Jin-Chao Liu, Dan-Feng Li","doi":"10.1016/j.clinsp.2025.100726","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100726","url":null,"abstract":"<p><strong>Background and aims: </strong>Observational studies have indicated a potential association between serum uric acid levels and the risk of intracerebral hemorrhage and subarachnoid hemorrhage. To explore whether this relationship is causal, the authors performed a two-sample Mendelian randomization analysis.</p><p><strong>Methods and results: </strong>The authors sourced data on single-nucleotide polymorphisms related to serum uric acid levels from the European Bioinformatics Institute ‒ Association database, along with information on intracerebral hemorrhage and subarachnoid hemorrhage from the same repository. The primary analysis for the Mendelian Randomization was conducted using the inverse variance weighted method, accompanied by sensitivity analyses to validate the findings. The Mendelian Randomization analysis revealed a positive causal association between serum uric acid and the risk of ICH Odds Ratio (OR = 1.29; 95 % CI 1.07-1.54, p = 0.007) and SAH (OR = 1.27; 95 % CI 1.04-1.54, p = 0.018).</p><p><strong>Conclusion: </strong>The present research offers direct evidence suggesting that higher serum uric acid levels could raise the risk of Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH). Additional investigations are needed to explore the mechanisms by which serum uric acid influences these types of hemorrhagic events.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100726"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Lactylated histone H3K18 as a potential biomarker for the diagnosis and prediction of the severity of pancreatic cancer\".","authors":"Rachana Mehta, Ranjana Sah","doi":"10.1016/j.clinsp.2025.100729","DOIUrl":"https://doi.org/10.1016/j.clinsp.2025.100729","url":null,"abstract":"","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100729"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the relationship between antidepressants and seizures based on the food and drug administration's adverse event reporting system database.","authors":"Dan Zou, Qiaozhi Hu, Lei Yu, Bin Wu","doi":"10.1016/j.clinsp.2025.100727","DOIUrl":"10.1016/j.clinsp.2025.100727","url":null,"abstract":"<p><strong>Background: </strong>Antidepressants, a cornerstone of depression treatment, are increasingly scrutinized for their safety concerns. The seizure risk of antidepressants has garnered attention. However, the current research on the relationship between antidepressant use and seizures remains unclear, prompting this study to investigate potential associations using data from the FAERS database.</p><p><strong>Aim: </strong>This study sought to assess the correlation between seizures and different antidepressants in individuals without pre-existing epilepsy or neurological comorbidities, as well as to explore potential variations in the occurrence of adverse events linked to each specific antidepressant drug.</p><p><strong>Methods: </strong>A disproportionality analysis was conducted to identify potential risk indicators within the FAERS database. Signals were detected using both the Reporting Odds Ratio (ROR) via the frequency approach and the Information Component (IC) through the Bayesian approach.</p><p><strong>Results: </strong>A total of 15,940,383 FAERS reports from January 1, 2004, to December 31, 2023, were analyzed. 14 antidepressant drugs were associated with seizures, as defined by 41 preferred terms.</p><p><strong>Conclusion: </strong>This study identified 14 antidepressant drugs that showed significant associations with seizures. Bupropion had the highest seizure ROR among the antidepressant drugs evaluated in this study.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100727"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New evidence for the effect of type 2 diabetes and glycemic traits on lung function: a Mendelian randomization and mediation analysis.","authors":"Shuo Xie, Liping Yu, Lulu Song, Fei Chen, Wanlu Ma, Yifan He, Xiaoping Chen, Ying Yang, Bo Zhang","doi":"10.1016/j.clinsp.2025.100693","DOIUrl":"10.1016/j.clinsp.2025.100693","url":null,"abstract":"<p><strong>Background: </strong>Type 2 Diabetes Mellitus (T2DM) is common worldwide. Patients with T2DM often experience reduced lung function, but the relationship between the two conditions remains uncertain. This study employed Mendelian Randomization (MR) to explore the causal link between T2DM and lung function, and to identify the factors that mediate this relationship.</p><p><strong>Methods: </strong>Genome-wide association study data were obtained from public databases. Four glycemic traits were considered exposures, whereas lung function was considered an outcome. Inverse Variance Weighting (IVW) was used to investigate causality, supplemented by MR-Egger and weighted medians methods. Multivariable MR (MVMR) analysis investigated whether T2DM had an independent impact on lung function. Mediation analysis was employed to examine potential mediating impacts.</p><p><strong>Results: </strong>IVW revealed that T2DM was associated with decreased forced expiratory volume in 1s (FEV1) (p = 0.012) and Forced Vital Capacity (FVC) (p = 0.004). After adjusting for potential confounders, the effects of T2DM on FEV1 and FVC remained significant. Mediation analysis demonstrated that smoking and Systolic Blood Pressure (SBP) partially mediated the causal relationship between T2DM, and FEV1 and FVC. The proportions mediated by smoking, SBP, and both factors on FEV1 were 0.302, 0.412, and 0.418, respectively, while the proportion mediated by SBP on FVC was 0.594.</p><p><strong>Conclusions: </strong>This study validated the causal relationship between T2DM and decreased lung function, with smoking and SBP acting as mediators. This study provides a novel perspective on the occurrence and development mechanisms of reduced lung function as well as potential new targets for metabolic intervention in treatment.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"80 ","pages":"100693"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}