Cardiovascular diabetology. Endocrinology reports最新文献

{"title":"Early-onset, treatment-cycle-linked hyperinsulinaemic insulin resistance during capivasertib therapy: a case report.","authors":"Yosuke Motai, Shotaro Nakamura, Naoki Sekine, Daisuke Sugimoto, Hiroaki Satoh","doi":"10.1186/s40842-026-00330-3","DOIUrl":"https://doi.org/10.1186/s40842-026-00330-3","url":null,"abstract":"<p><strong>Introduction: </strong>Capivasertib is an oral AKT inhibitor used with fulvestrant for hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer with relevant pathway alterations. Hyperglycaemia is a recognised on-target adverse effect, but its early biochemical phenotype has not been fully characterised in patients without known diabetes.</p><p><strong>Case presentation: </strong>A 43-year-old Japanese woman with metastatic breast cancer and no history or family history of diabetes started capivasertib on a 4-days-on/3-days-off schedule. Before treatment, fasting plasma glucose was 89 mg/dL and glycated haemoglobin was 5.6%. Although this glycated haemoglobin was within the non-diabetic range, impared glucose tolerance could not be excluded because a pre-treatment oral glucose tolerance test was not performed. On the day after treatment initiation, the 2-h postprandial plasma glucose level increased to 256 mg/dL. On day 2, fasting plasma glucose was 103 mg/dL, fasting insulin was 22.8 µU/mL, C-peptide was 3.40 ng/mL, and HOMA-IR was 5.80, indicating hyperinsulinaemic insulin resistance with preserved endogenous insulin secretion. During a subsequent drug-free interval, fasting plasma glucose decreased to 87 mg/dL, fasting insulin to 5.4 µU/mL, and HOMA-IR to 1.16 without glucose-lowering medication. HOMA-IR measured on day 4 declined form 3.16 in the first cycle to 2.50 and 1.52 in the 10th and 19th cycles, respectively, suggesting that the metabolic effect was greatest early after treatment initiation and may have partially attenuated during repeated treatment. Glycoalbumin gradually increased from 14.9% to 17.9%.</p><p><strong>Conclusion: </strong>Capivasertib may induce very early hyperinsulinaemic insulin resistance, even in patients without known diabetes. In this patient, the initial metabolic disturbance improved during the drug-free interval and appeared less pronounced during later cycles. Early, cycle-aware glucose monitoring, including postprandial assessment, should be considered from treatment initiation.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805469","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":"Metabolic signatures and machine learning identify gut-liver-heart axis dysfunction as a potential link to major adverse cardiovascular events in coronary artery disease.","authors":"Min-Qing Lin, Chun-Ka Wong, Ka-Wing Au, Chloe Yu-Yan Cheung, Yee-Man Lau, Song-Yan Liao, Karen Siu-Ling Lam, Aimin Xu, Hung-Fat Tse","doi":"10.1186/s40842-026-00329-w","DOIUrl":"10.1186/s40842-026-00329-w","url":null,"abstract":"<p><strong>Background: </strong>Traditional risk factors do not fully account for the residual cardiometabolic risk of major adverse cardiovascular events (MACE) in coronary artery disease (CAD). We aimed to identify circulating metabolic signatures associated with MACE susceptibility and uncover potential pathobiological mechanisms underlying the gut-liver-heart axis.</p><p><strong>Methods: </strong>In this retrospective case-control study, untargeted high-performance liquid chromatography-mass spectrometry (HPLC-MS) was performed on fasting serum from 200 patients with CAD and MACE, 200 with CAD without MACE, and 400 matched non-CAD controls. Metabolomics data were processed using univariate analysis, multivariate analysis, and eXtreme Gradient Boosting (XGBoost) machine learning. Pathway enrichment was conducted using metabolite set enrichment analysis. Circulating fibroblast growth factor 19 (FGF19) was quantified via enzyme-linked immunosorbent assay to validate enterohepatic endocrine disruption.</p><p><strong>Results: </strong>The MACE cohort exhibited a pronounced cardiometabolic phenotype, characterized by significantly highest rates of diabetes, hypertension, and dyslipidemia (p < 0.01). The XGBoost model robustly discriminated patients with CAD and MACE from non-CAD controls (area under the curve [AUC] = 0.984) and from patients with CAD without MACE (AUC = 0.932). Pathway analysis revealed marked dysregulation of linoleic acid metabolism and peroxisome proliferator-activated receptor (PPAR) signaling (p < 0.05). Specifically, pro-inflammatory oxidized linoleic acid metabolites, including 9- and 13-hydroxyoctadecadienoic acid (HODE)-which drive plaque instability-were significantly elevated in the MACE cohort. Furthermore, atheroprotective primary bile acids were significantly depleted in patients with CAD (p < 0.001). This depletion was accompanied by an elevated serum FGF19 level (p = 0.003), reflecting a potential disruption of the gut-liver-heart endocrine axis.</p><p><strong>Conclusions: </strong>In conclusion, dysregulated linoleic acid oxidation, altered PPAR signaling, and disturbed primary bile acid-FGF19 metabolism may represent key metabolic pathways associated with MACE susceptibility. Integrating these gut-liver-heart axis signatures into machine learning models holds significant promise for refining cardiovascular risk stratification and guiding targeted preventive interventions.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715215","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":"Prevalence and factors associated with atrial fibrillation among adults with type 2 diabetes mellitus at Hoima Regional Referral Hospital, Western Uganda: a cross-sectional study.","authors":"Abdisamad Guled Hersi, Abdisalam Ahmed Sandeyl, Farah Dubad Abdi, Mohamed Jayte, Venance Emmanuel Mswelo, Zakarie Abdullahi Hussein, Hanan Asad, Hamdi Ahmed Jama, Abdirizak Abdinasir Yusuf, Abdifatah Hersi Karshe, Ezera Agwu, Mutaz Ali Abdallah, Jacinto Amandua, Abishir Mohamud Hirsi","doi":"10.1186/s40842-026-00327-y","DOIUrl":"10.1186/s40842-026-00327-y","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (Afib) and type 2 DM (T2DM) are common conditions associated with substantial cardiovascular morbidity and mortality. However, data on the burden of Afib among patients with T2DM in sub-Saharan Africa remain limited. This study aimed to determine the prevalence, clinical features, and factors associated with Afib among adults with T2DM at Hoima Regional Referral Hospital (HRRH), western Uganda.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted among 355 adults with T2DM attending HRRH. Participants underwent clinical evaluation, glycated hemoglobin (HbA1c) testing, and 12-lead electrocardiography (ECG) for Afib diagnosis. Logistic regression analysis was used to identify factors associated with Afib, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The prevalence of Afib was 7.9% (28/355). Patients with Afib commonly presented with palpitations, dizziness, fatigue, chest pain, and dyspnea, with tachycardia and irregular pulse frequently observed on examination. In multivariable analysis, hypertension (aOR 3.027, 95% CI 1.419-6.431; p = 0.020), human immunodeficiency virus (HIV) infection (aOR 2.026, 95% CI 1.738-6.538; p = 0.048), body mass index (BMI ≥ 25 kg/m²) (aOR 3.014, 95% CI 1.242-7.930; p = 0.029), and poor glycemic control (HbA1c ≥ 8%) (aOR 3.813, 95% CI 1.762-8.265; p = 0.007) were independently associated with Afib.</p><p><strong>Conclusion: </strong>Afib is relatively common among adults with T2DM in western Uganda, affecting nearly one in ten patients. Hypertension, HIV infection, obesity, and poor glycemic control were significant associated factors. Integrating ECG screening into diabetes care, particularly for high-risk patients may improve early detection and management in resource-limited settings.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698738","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 effect of sumac and cinnamon on lipid profile and quality of life in patients with acute myocardial infarction, type 2 diabetes, and overweight/obesity: study protocol for a randomized double-blind controlled trial.","authors":"Ashkan Golmohammadi, Amir Peikar, Farzad Karimpour, Fatemeh Zadeh Bagheri, Seyed Bahman Panahande","doi":"10.1186/s40842-026-00326-z","DOIUrl":"10.1186/s40842-026-00326-z","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) are a leading cause of global mortality, with ischemic heart disease, stroke, and other related conditions contributing to over one-third of deaths worldwide. The rising prevalence of CVDs is driven by aging populations and various risk factors, including poor diet, physical inactivity, and dyslipidemia. Recent studies suggest that natural supplements like sumac (Rhus coriaria L.) and cinnamon (Cinnamomum verum J. Presl) may have beneficial effects on lipid profiles and overall cardiovascular health. This study is designed to investigate the combined effects of sumac and cinnamon supplementation on lipid profiles and quality of life in a high-risk population of patients with acute myocardial infarction (MI), type 2 diabetes, and overweight/obesity.</p><p><strong>Methods: </strong>This randomized, double-blind controlled trial will involve 76 participants meeting the specified criteria. Participants will be randomly assigned to one of four groups: sumac (S), cinnamon (C), a combination of sumac and cinnamon (S + C), or a placebo, for eight weeks. The primary outcome is the change in serum low-density lipoprotein cholesterol (LDL-C) from baseline to week 8. Secondary outcomes include other lipid parameters (HDL-C, TG, TC, VLDL), pain levels, quality of life (QoL), and inflammatory markers such as interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and erythrocyte sedimentation rate (ESR). A Complete Blood Count (CBC) will be performed as well. Blinding success will be assessed using the Bang Blinding Index (BBI). Blood samples will be collected at baseline and at the end of the intervention period to measure the relevant biomarkers. Lipid profiles will be measured using standard photometric/enzymatic methods, while IL-6 and hs-CRP will be assayed using ELISA. Data analysis will involve comparisons between the four groups using ANCOVA, adjusting for baseline values and statin intensity.</p><p><strong>Discussion: </strong>This study will provide valuable insights into the potential of sumac and cinnamon, both individually and in combination, as complementary therapies for managing lipid profiles and improving the quality of life in patients with CVDs. The findings could contribute to the development of novel dietary interventions aimed at reducing cardiovascular risk and promoting heart health. Additionally, the study will explore the combined effect of sumac and cinnamon, offering insights into whether their joint use provides synergistic benefits beyond those observed with each supplement individually.</p><p><strong>Trial status: </strong>Version 4.1 - Protocol, dated 10 June 2026. Recruitment will commence on February 10, 2026.</p><p><strong>Trial registration: </strong>Iranian Registry of Clinical Trials (irct.ir) IRCT20150711023153N5 ( https://irct.behdasht.gov.ir/trial/70581 ). Registered on 6 December 2023.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687627","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":"Development and internal validation of an ICU mortality prediction model for patients with concurrent sepsis and heart failure: a retrospective cohort study based on eICU-CRD.","authors":"Mao Ye, He Huang, Suqi Lv, Dingchao Lv, Xiaolan Wang","doi":"10.1186/s40842-026-00323-2","DOIUrl":"10.1186/s40842-026-00323-2","url":null,"abstract":"<p><strong>Background: </strong>Sepsis and heart failure are common critical conditions within the ICU, and their coexistence significantly increases the difficulty of patient management and mortality risk. This study aims to develop and validate a practical nomogram for predicting ICU mortality, thereby facilitating risk stratification and clinical decision-making for patients coded as having both sepsis and heart failure.</p><p><strong>Methods: </strong>This study constitutes a retrospective cohort investigation. Patients meeting inclusion criteria for both sepsis and heart failure were identified via the eICU-CRD database, subsequently randomised in a 7:3 ratio to form training and validation cohorts. Variable selection employed the Least Absolute and Selective Operator (LASSO) regression, with nomogram analysis constructed. Model discriminatory ability was assessed via area under the receiver operating characteristic curve (AUC). Calibration was evaluated using calibration curves and the Hosmer-Lemeshow test. Decision curves and clinical impact curves were plotted to evaluate the model's net benefit and clinical applicability.</p><p><strong>Results: </strong>A total of 1,394 patients were included and divided into a training set (975 cases) and a validation set (419 cases) at a ratio of 7:3. The final model integrated eight independent predictors: mechanical ventilation, lactate, respiratory rate, white blood cell count, age, platelet count, systolic blood pressure, and oxygen saturation. The model demonstrated acceptable to good discriminatory performance in both training and validation cohorts (AUC 0.826 [95% CI 0.789-0.863] and 0.798 [95% CI 0.732-0.864], respectively), with good calibration (Brier scores: training cohort 0.090, validation cohort 0.091; Hosmer-Lemeshow goodness-of-fit test P-values > 0.05), and demonstrated clear clinical net benefit.</p><p><strong>Conclusions: </strong>This study developed and internally validated a predictive nomogram based on eight routine clinical variables for ICU mortality in patients coded for both sepsis and heart failure. The model demonstrated acceptable discrimination and calibration. However, given the broad, code-based case definition and the lack of heart failure-specific variables, this tool should be reframed as an internally validated ICU mortality prediction model for this high-risk population, rather than as a cardiology-specific or clinically actionable nomogram. External validation is required before any clinical application.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672042","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":"AI-enabled chest x-ray potentially detects subclinical diastolic dysfunction in diabesity and monitors its functional responses to GLP-1 or GLP-1/GIP receptor agonists: initial exploration and proof-of-concept.","authors":"Richard D White, Mutlu Demirer, Barbaros Selnur Erdal, Grace Lin","doi":"10.1186/s40842-026-00312-5","DOIUrl":"10.1186/s40842-026-00312-5","url":null,"abstract":"<p><strong>Introduction: </strong>The evaluation of diastolic function in patients with diabesity (i.e., combined obesity and type-2 diabetes mellitus) undergoing incretin-based therapy could facilitate its early detection and help prevent its progression to heart failure.</p><p><strong>Methodology: </strong>In this small descriptive study, performed for exploratory and proof-of-concept purposes, a group of 15 diabesity cases with chest x-ray examinations (< 1 month) before and after ≥ 12 months of incretin-based therapy (absent ventricular/valvular dysfunction) were identified. Standard diabesity characteristics (Body Weight (kg), Body Mass Index (kg/m²), and Hemoglobin A1c) and AI-model diagnostic predictions of pulmonary venous hypertension (aka \"pulmonary congestion\") [None; Stage 1: vascular distention/redistribution but minimal interstitial edema; or Stage ≥ 2: vascular congestion with ≥ mild interstitial or alveolar edema] by validated AI-enabled chest x-ray staging, representing mean left atrial pressure in diastolic dysfunction, were evaluated pre- and post-therapy.</p><p><strong>Results: </strong>According to weight-loss response to incretin therapy, cases clustered into equal-sized therapeutic categories as follows: (1) Significant Responders (9-30% decreases); (2) Insignificant Responders (0-2% decreases); and (3) Non-Responders (2-12% increases). Regarding hemoglobin A1c changes: (1) Significant Responders collectively decreased; (2) Insignificant Responders varied; and (3) Non-Responders were largely stable. Pre-therapy, all 15 cases demonstrated AI-enabled chest x-ray pulmonary venous hypertension staging evidence of diastolic dysfunction; post-therapy, 4 improved (especially the cases of greatest weight loss or hemoglobin A1c reduction), 5 were stable, and 6 worsened. Per therapeutic category, AI-enabled chest x-ray signs of functional response were: (1) Significant Responders (all demonstrating unequivocally decreased obesity and improved diabetes) collectively showed stable-decreased dysfunction; (2) Insignificant Responders (all demonstrating at most minimally decreased obesity, but stable-worsening diabetes in most) reflected stable-increased dysfunction in 60%; and (3) Non-Responders (all demonstrating increased obesity, but stable-improved diabetes) showed increased dysfunction in 80%.</p><p><strong>Conclusion: </strong>AI-enabled chest x-ray pulmonary venous hypertension staging potentially detects background subclinical diastolic dysfunction in diabesity and monitors its functional response to incretin-based therapy. The confirmation (or disproof), and assessments of durability and generalizability, of these preliminary results await a larger more definitive and controlled prospective study on the subject.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655610","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":"Tirzepatide in recurrent hypertriglyceridemia-mediated pancreatitis and type 2 diabetes: a case report.","authors":"Benjamin Lechner, Katharina Lechner, Ines Freibothe, Anja Vogt","doi":"10.1186/s40842-026-00318-z","DOIUrl":"10.1186/s40842-026-00318-z","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia‑mediated acute pancreatitis (HTG‑AP) is a clinically relevant complication of severe metabolic dysfunction, yet incretin‑based therapy is often withheld because current recommendations discourage its use in patients with a history of pancreatitis.</p><p><strong>Case presentation: </strong>We report on a woman born in 1993 with severe hypertriglyceridemia known since 2018, type 2 diabetes diagnosed in 2022, recurrent HTG-AP from 2023 onward, chronic fibrosing pancreatitis, and severe metabolic dysfunction-associated steatotic liver disease (MASLD). Despite lifestyle measures, fenofibrate, high-dose omega-3 fatty acids, and intensified insulin therapy, she presented again in March 2025 with acute pancreatitis and triglycerides of 4.400 mg/dL. After stabilization of acute pancreatitis and marked triglyceride reduction due to prolonged fasting and intensified insulin therapy, tirzepatide was started on March 27, 2025. At initiation, triglycerides were 335 mg/dL and HbA1c was 7.0%. During follow-up, insulin was fully discontinued, triglycerides normalized to 137 mg/dL at 3 months and 85 mg/dL at 12 months, HbA1c improved to 5.5%, inflammatory markers normalized, and no further pancreatitis episodes occurred.</p><p><strong>Conclusion: </strong>This single-patient case observation illustrates that tirzepatide may be considered on an individualized basis in selected cases of metabolically driven pancreatitis, particularly when metabolic dysfunction is presumed to be the dominant driver. However, the favorable clinical course observed in this case represents an association only and does not establish causality.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650515","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":"Metabolic disorder-MASLD-cardiovascular disease-kidney disease (MMCK) syndrome: an expansion of the Cardiovascular-Kidney-Metabolic (CKM) framework.","authors":"Yan Guo, Ying Zhang, Suxuan Liu, Dajin Zou","doi":"10.1186/s40842-026-00317-0","DOIUrl":"10.1186/s40842-026-00317-0","url":null,"abstract":"<p><strong>Background: </strong>The Cardiovascular-Kidney-Metabolic (CKM) syndrome framework acknowledges metabolic dysfunction-associated steatotic liver disease (MASLD) as a major manifestation, yet hepatic involvement remains insufficiently incorporated into risk stratification. This review proposes the metabolic disorder-MASLD-cardiovascular disease-kidney disease (MMCK) syndrome as an operational extension that integrates hepatic fibrosis assessment into cardiometabolic-renal care.</p><p><strong>Methods: </strong>We conducted a comprehensive narrative review across PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus through March 2026. We synthesized evidence on pathophysiological crosstalk, proposed the Multi-Organ Risk Score (MORS)-enabled MMCK staging criteria (Stages 0-4), and developed stage-specific management algorithms.</p><p><strong>Results: </strong>The MMCK framework introduces four key operational advances: (i) quantitative multi-organ risk stratification through the MORS (L + C + B + K, range 0-12) with mandatory FIB-4/VCTE-based hepatic fibrosis assessment as the L-Score; (ii) stage-specific therapeutic thresholds linked to objective clinical cutoffs; (iii) a structured multidisciplinary team governance model with MORS-based electronic health record triggers; and (iv) a three-tiered endpoint framework for quality improvement and prospective validation. Observational evidence indicates that incorporating MASLD fibrosis into cardiometabolic staging improves coronary artery disease risk prediction. The MMCK framework positions MASLD as a cardiovascular risk-modifying axis within established cardiometabolic-renal care.</p><p><strong>Conclusions: </strong>The MMCK syndrome operationalizes hepatic integration within established cardiometabolic-renal care by providing a quantitative, stage-specific framework for multi-organ risk assessment and management. Future research should prospectively validate MORS-based staging in diverse cohorts and evaluate whether MMCK-guided management improves clinical outcomes compared with CKM-guided care alone.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633507","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":"Baseline versus cumulative cholesterol, high-density lipoprotein, and glucose index and stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0-3: evidence from the CHARLS study.","authors":"Chen Chen, Xiao Yang, Cheng Li, Qiqi Xi, Yi Ding","doi":"10.1186/s40842-026-00315-2","DOIUrl":"10.1186/s40842-026-00315-2","url":null,"abstract":"<p><strong>Background: </strong>The cholesterol, high-density lipoprotein, and glucose (CHG) index has been linked to stroke risk. However, evidence is largely based on single-time-point measurements and has not been compared with cumulative exposure, nor evaluated in individuals with cardiovascular-kidney-metabolic syndrome (CKM) stages 0-3. This study aimed to compare the associations of baseline and cumulative CHG index with incident stroke risk in this population.</p><p><strong>Methods: </strong>Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). The exposure measures were the baseline and cumulative levels of the CHG index. Multivariable logistic regression models were employed to examine the association between the baseline and cumulative CHG index and stroke risk. Restricted cubic spline (RCS) analysis was used to test potential dose-response relationships. The receiver operating characteristic (ROC) curve was used to compare the predictive performance of the two measures. Subgroup analyses were conducted to evaluate the consistency of these associations in different populations.</p><p><strong>Results: </strong>Among 4,661 participants with CKM stages 0-3, 476 (10.2%) developed incident stroke during follow-up. After adjustment for demographic characteristics, lifestyle factors, anthropometric measurement, laboratory parameters, medication use and comorbidities, both the baseline CHG index (OR = 1.42, 95% CI: 1.12-1.81) and cumulative CHG index (OR = 1.14, 95% CI: 1.03-1.26) were positively associated with stroke risk. Participants in the highest tertile (T3) of the baseline CHG index had a 35% higher stroke risk than those in the lowest tertile (T1) (OR = 1.35, 95% CI: 1.03-1.76), and a 34% elevated risk was observed for the cumulative CHG index (OR = 1.34, 95% CI: 1.03-1.76). RCS analysis revealed linear relationships for both measures (p for non-linear = 0.331 and 0.817, respectively; overall p < 0.05 for both). ROC curve analysis showed no statistically significant difference in the area under the curve (AUC) between the two measures (0.672 vs. 0.671, p = 0.330). Subgroup analyses indicated that the associations might be modified by gender and drinking status.</p><p><strong>Conclusions: </strong>Among individuals with CKM stages 0-3, both baseline and cumulative CHG indices were independently associated with incident stroke risk. Given its moderate discriminatory capacity, the CHG index-derived from routine blood tests-may serve as a preliminary screening tool to flag high-risk individuals, prompting more comprehensive stroke risk evaluation.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612441","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":"Concomitant use of SGLT2 inhibitors and GLP-1 receptor agonists in patients with heart failure.","authors":"Reza Khademi, Saeed Shoar","doi":"10.1186/s40842-026-00319-y","DOIUrl":"10.1186/s40842-026-00319-y","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a major cardiovascular complication of type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) both improve cardiovascular outcomes, but their comparative roles in HF and the potential value of combination therapy remain uncertain.</p><p><strong>Main body: </strong>SGLT2 inhibitors consistently reduce HF hospitalization and cardiovascular death across the spectrum of ejection fraction, with relative risk reductions of approximately 30-37% (Hazard ratio (HR) 0.63-0.70). In contrast, GLP-1 receptor agonists have a more modest effect on HF hospitalization (approximately 11% risk reduction; HR 0.89) while primarily reducing atherosclerotic cardiovascular events and supporting weight and metabolic control. Mechanistically, SGLT2 inhibitors act predominantly through hemodynamic and cardiorenal pathways, whereas GLP-1 receptor agonists exert metabolic, anti-inflammatory, and anti-atherosclerotic effects, providing a rationale for potential complementarity. Emerging data from meta-analyses, subgroup analyses, and observational studies suggest possible additive benefits of combination therapy; however, most evidence is indirect and not derived from dedicated randomized heart failure trials. Safety data indicate no major excess risk with combination therapy, although gastrointestinal effects and class-specific adverse events remain relevant.</p><p><strong>Conclusion: </strong>SGLT2 inhibitors are established therapies for reducing HF outcomes, whereas GLP-1 receptor agonists primarily address cardiometabolic risk with uncertain direct HF benefit. Combination therapy is mechanistically plausible but remains insufficiently supported by dedicated randomized evidence in HF populations. Further prospective trials are required to define its clinical role.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564144","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}