Cardiovascular diabetology. Endocrinology reports最新文献

{"title":"Determinants of diabetic retinopathy among adult and elderly individuals with diabetes.","authors":"Wondimnew Desalegn Addis, Wubet Taklual Admas, Anegu Achenef Ayalew, Getasew Yirdaw, Wolde Melese Ayele, Ahmed Fentaw Ahmed, Assefa Andargie Kassa, Tilahun Degu Tsega, Tesfaneh Shimels, Rahel Mulatie Anteneh, Abathun Temesgen, Gashaw Melkie Bayeh, Almaw Genet Yeshiwas, Habitamu Mekonen, Berhanu Abebaw Mekonnen, Meron Asmamaw Alemayehu, Sintayehu Simie Tsega, Zeamanuel Anteneh Yigzaw, Amare Genetu Ejigu, Chalachew Yenew, Birhanemaskal Malkamu, Abraham Teym, Kalaab Esubalew Sharew, Daniel Adane, Chalachew Abiyu Ayalew, Getaneh Atikilt Yemata","doi":"10.1186/s40842-025-00237-5","DOIUrl":"10.1186/s40842-025-00237-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy is the most prevalent long-term impact of diabetes and the main cause of visual loss and impairment in persons with both type 1 and type 2 diabetes especially among adult and elderly diabetics. However, there are limited studies on the determinants of diabetic retinopathy in the study area. Hence, this study aimed to assess the determinants of diabetic retinopathy among adult and elderly diabetic patients on follow up at Debre Tabor and Felege Hiwot comprehensive specialized Hospitals, Northwest Ethiopia, 2024.</p><p><strong>Methods: </strong>An institution-based unmatched case-control study design was conducted at Debre Tabor and Felege Hiwot comprehensive specialized hospitals Northwest, Ethiopia from March 30, 2024 to May 29, 2024 using proportional allocation of stratified sampling technique. Diabetic patients with retinopathy were cases in the study and with no retinopathy were controls. Data were collected using a pretested interviewer administered questionnaire, Topcon retinal examination, and a record review. The collected data were entered into Epi Data version 4.6 Software and analyzed using STATA Version 17. Multivariate logistic regression analysis was used to assess the determinants of diabetic retinopathy at 95% confidence interval with P-Value < 0.05.</p><p><strong>Results: </strong>A total of 356 patients (178 cases and 178 controls) were included in the study. The mean age for the cases and the controls were 49.7 (SD: ±14.1) and 44.97 (SD: ±14.67) respectively. Patients with glucometer at home (AOR(Adjusted odds ratio); 0.38, 95%CI; 0.2-0.8), exercise adherence (AOR; 0.4, 95%CI; 0.2-0.9), with systemic complication (AOR; 3.6, 95%CI; 1.5-8.7), health information on diabetic complications(AOR; 0.34, 95%CI; 0.17-0.7), appointments every month (AOR; 0.15, 95%CI; 0.04-0.49),diabetes duration (AOR; 1.12, 95%CI; 1.03-1.18), difficulty of eye examination(AOR; 2.6, 95%CI; 1.2-5.8) and poor blood Glucose control(AOR; 2.1, 95%CI; 1.1-3.9) were significant determinants at p value of 0.05.</p><p><strong>Conclusion and recommendation: </strong>Factors such as glucometer at home, exercise, health information on complications, appointments frequency, duration, difficulty of eye examination, blood glucose control and systemic complication status were determinants for diabetic retinopathy. Interventional strategies that promote patient's adherence of glycaemic control and eye examination should be designed and implemented.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12576998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411348","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":"Diabetes mellitus in Pakistan: prevalence and preventive management strategies - a comprehensive literature review.","authors":"Muhammad Ajmal Dina, Anam Arshed, Asifa Karamat, Muhammad Bilal, Muhammad Shakeel Basit","doi":"10.1186/s40842-025-00235-7","DOIUrl":"10.1186/s40842-025-00235-7","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to impaired insulin secretion, action, or both. As a major global health concern, its prevalence is rapidly increasing, particularly in low- and middle-income countries like Pakistan. This review aims to assess the epidemiological trends of DM in Pakistan, identify key risk factors, and explore diagnostic practices and preventive strategies.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using peer-reviewed national and international publications from multiple databases. The review focused on the prevalence of DM in Pakistan, associated risk factors, urban-rural disparities, diagnostic criteria (ADA vs. WHO), complications, technological applications in disease management, and levels of awareness and treatment practices.</p><p><strong>Results: </strong>The prevalence of DM in Pakistan increased significantly from 5.2 million adults in 2000 to approximately 33 million in 2021. Contributing factors include urbanization, sedentary lifestyles, poor dietary habits, and limited healthcare access, especially in rural regions. Urban areas showed higher detection rates, while rural areas exhibited significant barriers to diagnosis and management. Technological solutions, such as telemedicine and mobile health applications, offer promise but face obstacles like limited infrastructure and affordability. Diabetes-related complications particularly cardiovascular and kidney diseases-are widespread. Despite treatment availability, awareness and adherence remain low, with notable disparities between knowledge and practice.</p><p><strong>Conclusion: </strong>Pakistan is facing an escalating diabetes epidemic influenced by both behavioral and systemic factors. Immediate action is needed to implement targeted public health interventions, improve healthcare accessibility, and promote awareness and lifestyle modification. Leveraging technology and aligning with standardized diagnostic frameworks may significantly enhance early detection and effective management, ultimately reducing the national burden of DM.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357474","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":"Patterns of lipid profile and genetic variations in South Asians.","authors":"Mahdi Rahmanian","doi":"10.1186/s40842-025-00246-4","DOIUrl":"10.1186/s40842-025-00246-4","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular diseases (CVDs) are the leading cause of death worldwide, imposing a substantial burden on healthcare systems. Dyslipidemia is a primary risk factor for CVDs. South Asians (SAs) are proven to be more at risk of dyslipidemia and the development of CVDs. In this review, we will provide an overview of dyslipidemia and its various types, followed by a closer examination of the pattern of dyslipidemia in SAs and their associated genetic variations.</p><p><strong>Methods: </strong>A PubMed, Scopus, and Web of Science search using the relevant keywords was conducted without any time limitation. Afterwards, the articles were screened based on their title and abstract. The remaining articles were selected for full-text review.</p><p><strong>Results: </strong>LDL levels have been found to be similar or lower in SAs than in white Europeans. However, it seems that compared with white Europeans, LDL leads to CVDs at lower serum levels in SAs. Denser and smaller LDL particles in SAs are more atherogenic. In addition, SAs have higher levels of lipoprotein (a) than white Europeans. Also, the rate of hypertriglyceridemia in SAs, affecting as high as 70% of their population, is significantly higher than that of white Europeans. A higher level of HDL is associated with a weaker protective effect in SAs compared with other ethnicities. SAs have variations in genes related to lipid metabolism, such as apoliprotein H, lipoprotein lipase, MBOAT7, SGPP1, SPTLC3, PCSK9, and CELSR2.</p><p><strong>Conclusion: </strong>SAs are more prone to dyslipidemia, leading to a higher risk of CVDs compared with other ethnic groups.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260569","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":"Non-diabetic hypoglycemia: bridging gaps in diagnosis and treatment: a position statement report by the Arabic Association for the Study of Diabetes and Metabolism (AASD).","authors":"Amin Roshdy Soliman, Rabab Mahmoud Ahmed, Amr Abdel Hady El Meligi, Ahmed Haroun Abdelmoaty, Mona A Hegazy, Ahmed Saad, Sahar Alwakil, Nadine Alaa Sherif, Shereen Abdelghaffar, Ebtesam Fahmy, Saeed Soliman, Dina Farouk, Inass Shaltout","doi":"10.1186/s40842-025-00234-8","DOIUrl":"10.1186/s40842-025-00234-8","url":null,"abstract":"<p><strong>Background: </strong>Non-diabetic hypoglycemia presents a substantial diagnostic challenge due to its diverse and often nonspecific symptomatology. The resultant delay in diagnosis can lead to a myriad of misdiagnoses. This misidentification not only prolongs patient suffering but also elevates the risk of severe complications, such as permanent neurologic damage and mortality. Recognizing the clinical nuances of non-diabetic hypoglycemia is paramount for timely and accurate diagnosis, which ultimately enhances patient outcomes and safety.</p><p><strong>Main body: </strong>A position statement has been formulated by the Arabic Association for the Study of Diabetes and Metabolism (AASD) to address the complexities of diagnosing non-diabetic hypoglycemia. This statement highlights the challenges and pitfalls, covering key areas such as the vast spectrum of non-diabetic hypoglycemia within underreported subspecialties. It aims to elucidate the critical need for heightened clinical awareness and multidisciplinary management approaches to mitigate the profound impacts on patient health. Additionally, the statement provides guidance for overcoming barriers to optimal care. The team has distilled their experience into clinical algorithms to simplify information for healthcare professionals.</p><p><strong>Conclusion: </strong>Non-diabetic hypoglycemia is a rare condition that requires a comprehensive approach, including detailed history, medication review, and physical examination. Common pitfalls in diagnosis and management should be understood to avoid unnecessary evaluation and costs while avoiding misdiagnosis of patients with treatable or serious disorders.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234894","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":"From needles to pills: oral GLP-1 therapy enters the obesity arena.","authors":"Gaetano Santulli","doi":"10.1186/s40842-025-00245-5","DOIUrl":"10.1186/s40842-025-00245-5","url":null,"abstract":"<p><p>Obesity remains a major global health challenge, driving type 2 diabetes, cardiovascular disease, and other complications. Despite effective lifestyle and surgical interventions, pharmacotherapy uptake has historically been limited. Injectable GLP-1 receptor agonists, including semaglutide and tirzepatide, have redefined expectations for medical obesity therapy, achieving 15–20% weight reductions in clinical trials. However, barriers such as injections, cost, and adherence limit their real-world use. In September 2025, two pivotal phase-3 trials of oral GLP-1 therapies were published. ATTAIN-1 evaluated orforglipron in 3,127 adults with obesity over 72 weeks, demonstrating a mean weight loss of 11.2%, ≥ 10% weight loss in 54.6%, and improvements in cardiometabolic parameters. OASIS-4 studied oral semaglutide 25 mg in 307 adults over 64 weeks, showing a mean weight loss of 13.6%, ≥ 10% weight loss in 63%, and favorable metabolic changes. Both agents exhibited gastrointestinal adverse events consistent with the GLP-1 class; additionally, orforglipron had five mild pancreatitis cases, while oral semaglutide reported mild dysesthesia. These results confirm that oral GLP-1 receptor agonists can produce clinically meaningful weight loss and metabolic benefits, expanding options beyond injectables. Real-world adoption will hinge on adherence, tolerability, long-term safety, patient preference, and payer coverage. Oral GLP-1 therapies represent a transformative step in obesity management, offering a convenient alternative that may broaden access and optimize individualized care.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240813","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":"Sex differences in ventricular muscle energetics in a type 2 diabetic rat model.","authors":"Maryam Rahmani, Toan Pham, Linley Nisbet, David J Crossman, Kenneth Tran, Andrew J Taberner, June-Chiew Han","doi":"10.1186/s40842-025-00236-6","DOIUrl":"10.1186/s40842-025-00236-6","url":null,"abstract":"<p><strong>Background: </strong>Sex differences in cardiac function under diabetic conditions have been extensively studied. However, the impacts of type 2 diabetes on cardiac energetics between sexes remain poorly defined. Likewise, whether sex-specific differences in cardiac efficiency reported at the whole heart level manifest at the muscle level is uncertain. This study is the first to assess sex-specific cardiac energetics in type 2 diabetes by directly measuring heat production in isolated rat left ventricular trabeculae.</p><p><strong>Methods: </strong>Induction of diabetes in Wistar rats by a high-fat diet (23.5% kcal vs. 5% kcal from fat) and low-dose streptozotocin (30 mg/kg) was assessed through measurements of fasting blood glucose and glucose tolerance, and plasma biomarkers. Mechanoenergetics of isolated trabeculae were characterised using our work-loop calorimeter at body temperature. Experiments were conducted under loading conditions of varying muscle lengths, contraction modes, and afterloads. Force, muscle length, and heat output were simultaneously recorded. Metrics including twitch kinetics, shortening, mechanical work, activation heat, and cross-bridge heat were extracted, and mechanical efficiency was estimated and evaluated over a wide range of loading conditions.</p><p><strong>Results: </strong>At the organism level, diabetic rats exhibited increased blood glucose levels and impaired glucose handling. While diabetes caused sex-specific effects on body mass, corticosterone, plasma insulin, and biomarkers, our results at the muscle level showed no effects of diabetes on any measured indices of cardiac mechanoenergetics and, hence, mechanical efficiency, in either sex.</p><p><strong>Conclusions: </strong>Effects of type 2 diabetes do not manifest in the mechanoenergetic functional performance of isolated cardiac muscles, even when challenged to a wide range of loading conditions. This conclusion is upheld in both male and female rats. These findings underscore the need for assessing cardiac function beyond the muscle level, as muscle-specific thermodynamics in diabetes may not be captured from systemic whole-organism measurements.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202894","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":"Hypertension in type 2 diabetes mellitus: prevalence, patterns, determinants and implications for cardiovascular risk prediction in a population of Nigerian patients.","authors":"Bruno Basil, Jamila Aminu Mohammed, Izuchukwu Nnachi Mba","doi":"10.1186/s40842-025-00225-9","DOIUrl":"10.1186/s40842-025-00225-9","url":null,"abstract":"<p><p>BACKGROUND: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM), with hypertension, a common comorbidity, being a major contributor to adverse cardiovascular outcomes. In Nigeria, where the burden of T2DM and its associated cardiovascular complications is rising, there is a need to strengthen hypertension control efforts. This study evaluates the prevalence, patterns, and determinants of hypertension in T2DM patients in North Central Nigeria, with a focus on its impact on CVD risk status to inform targeted prevention and management strategies. METHODS: This hospital-based cross-sectional analytical study was conducted among T2DM patients over 13 months. Data on socio-demographic characteristics, medical history, clinical findings and laboratory parameters were collected using a structured proforma. Hypertension was classified based on the 2017 ACC/AHA hypertension guidelines, and 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart for Western sub-Saharan Africa. Statistical analyses, including binary and ordinal logistic regression, were conducted using SPSS version 25, with significance set at p < 0.05. RESULTS: The prevalence of hypertension in this cohort was 65.5%, with diabetes duration (OR = 1.162, 95% CI: 1.053–1.283; p = 0.003) and high-sensitivity C-reactive protein (hsCRP) (OR = 1.351, 95% CI: 1.098–1.663; p = 0.004) identified as independent predictors. Systolic BP (OR = 1.189, 95% CI: 1.141–1.239; p < 0.001) and use of antihypertensive therapy (OR = -0.323, 95% CI: 0.245–0.871; p = 0.017) were significant determinants of 10-year CVD risk in the study population. CONCLUSION: Hypertension is highly prevalent among T2DM patients in North Central Nigeria and is associated with systemic inflammation, prolonged diabetes duration, and elevated CVD risk. These findings emphasize the need for enhanced blood pressure control, routine inflammatory marker monitoring, and early interventions to reduce the long-term risk of cardiovascular complications in resource-limited settings. </p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181075","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":"The heart of diabetes: unraveling metabolic drivers of cardiomyopathy.","authors":"Xue Guan, Can Zhou, Xinyi Zhuo, Wenhui Yang, Haizhen Wang","doi":"10.1186/s40842-025-00231-x","DOIUrl":"10.1186/s40842-025-00231-x","url":null,"abstract":"<p><p>Diabetes mellitus (DM) ignites a global epidemic, with cardiovascular complications claiming most lives among affected patients. Diabetic cardiomyopathy (DCM), a distinct cardiac dysfunction triggered by DM independent of coronary artery disease or hypertension, threatens those with type 1 or type 2 DM, often leading to heart failure. In type 2 DM (T2DM), metabolic disruptions drive cardiac lipotoxicity. Yet, how lipotoxicity impairs function and DM sparks clinical syndromes remains unclear. This review unveils how DM rewires myocardial metabolism-favoring lipids over glucose-and probes emerging therapies, spotlighting clinical challenges at a vital research frontier.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181067","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":"From deep learning discovery to clinical validation: a new composite marker predicts mortality in type 2 diabetes.","authors":"Jianjun Wu, Dawei Yang, Youqi Zhang, Liu Ji, Xiao Tong, Guanghua Chen, Fan Yang","doi":"10.1186/s40842-025-00229-5","DOIUrl":"10.1186/s40842-025-00229-5","url":null,"abstract":"<p><strong>Objective: </strong>Both alkaline phosphatase (ALP) and serum creatinine (sCr) have been individually associated with adverse outcomes in patients with diabetes. This study investigates a novel composite indicator-ln[ALP × sCr]-to predict all-cause and CVD mortality risk among U.S. adults with diabetes.</p><p><strong>Research design and methods: </strong>We analyzed data from 82,091 U.S. adults enrolled in NHANES (1999-2014), with mortality follow-up through December 31, 2019. A deep learning model identified ALP, sCr, and vitamin D as top mortality-related biomarkers. Based on these results, we derived a composite index, ln[ALP × sCr], to reflect integrated cardiac-renal dysfunction. Restricted cubic spline analysis was used to define risk thresholds. Cox proportional hazards models assessed the association between ln[ALP × sCr] and all-cause, cardiovascular, and diabetes-related mortality.</p><p><strong>Results: </strong>Over a median follow-up of 11.4 years, 4,839 T2DM patients in the highest quartile of ln[ALP × Scr] exhibited significantly elevated risks of all-cause (HR 1.47, 95% CI 1.18-1.82), cardiovascular (HR 1.44, 95% CI 1.01-2.04), and diabetes-related mortality (HR 2.50, 95% CI 1.58-3.96), compared to those in the lowest quartile. Mediation analysis indicated that serum vitamin D accounted for 24.3% of the association between the composite biomarker and all-cause mortality (P < 0.001).</p><p><strong>Conclusions: </strong>In this nationally representative cohort, ln[ALP × Scr] showed a J-shaped association with all-cause mortality. These findings highlight the potential utility of ln[ALP × Scr] as a simple, noninvasive biomarker for mortality risk assessment in individuals with diabetes. This study also illustrates the value of integrating AI-based feature selection with traditional epidemiologic modeling to enhance long-term mortality risk stratification and inform public health strategies.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181101","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":"The 2025 AHA/ACC hypertension guidelines: implications for cardiovascular and renal risk in patients with diabetes.","authors":"Gaetano Santulli","doi":"10.1186/s40842-025-00239-3","DOIUrl":"10.1186/s40842-025-00239-3","url":null,"abstract":"<p><p>Hypertension remains a major contributor to cardiovascular and renal complications in patients with diabetes mellitus, increasing the risk of macrovascular and microvascular disease. The 2025 AHA/ACC hypertension guidelines maintain a diagnostic and treatment threshold of 130/80 mmHg, emphasizing earlier and more intensive blood pressure control to reduce cardiovascular events, stroke, heart failure, and progression of diabetic nephropathy. Evidence from clinical trials and meta-analyses supports the benefits of tighter blood pressure targets, while acknowledging potential risks such as hypotension, electrolyte disturbances, and acute kidney injury. Management strategies combine pharmacologic therapy with lifestyle interventions including dietary modification, physical activity, weight management, and smoking cessation. Individualized blood pressure targets are recommended for older or frail patients to balance safety and benefit. Home and ambulatory blood pressure monitoring are highlighted for detecting masked or nocturnal hypertension, enhancing risk stratification, and supporting treatment titration. The guidelines also emphasize integrated risk assessment and multidisciplinary management. The 2025 AHA/ACC hypertension guidelines provide an evidence-based, patient-centered framework to optimize cardiovascular and renal outcomes in patients with diabetes, promoting early intervention, individualized therapy, and comprehensive risk reduction.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181085","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}