Cardiovascular diabetology. Endocrinology reports最新文献

{"title":"Effects of SGLT2 inhibitors on cardiac structure and function in stage A and B heart failure with type 2 diabetes: a systematic review and meta-analysis.","authors":"Vishwani Khanna, Aarushi Batra, Ashok Kumar, Samragyi Juneja, Abhishek Pandeya","doi":"10.1186/s40842-026-00306-3","DOIUrl":"10.1186/s40842-026-00306-3","url":null,"abstract":"<p><strong>Background: </strong>Stage A and B heart failure (HF) in type 2 diabetes (T2DM) represents a critical window for prevention. Although SGLT2 inhibitors (SGLT2i) are recommended for early HF risk reduction, their direct structural effects on pre-symptomatic myocardium remain insufficiently characterized in this population.</p><p><strong>Methods: </strong>MEDLINE, Cochrane Central, Scopus, and ClinicalTrials.gov were searched from inception to February 2026 for studies comparing SGLT2i with placebo in T2DM with Stage A and B HF. Risk of bias was assessed with RoB 2.0. R (version4.5.2) was used to analyse outcomes. Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Ten trials (n = 773) showed significant reductions in LV mass (-3.37 g), LVMI (-1.84 g/m²) and E/e' (-0.81). SGLT2i improved weight, BMI, HbA1c, and systolic blood pressure. Safety outcomes were favorable, with no diabetic ketoacidosis reported.</p><p><strong>Conclusions: </strong>SGLT2i use was associated with a significant reduction in LV mass and improvements in filling pressures, suggesting a favorable modification of underlying myocardium in Stage A and B HF. These changes likely reflect hemodynamic unloading and mass regression rather than immediate functional recovery.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304552","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":"Pulmonary adverse events associated with GLP-1 receptor agonists: a systematic review of respiratory safety signals.","authors":"Aarushi Ahuja, Sai Prasad, Sahana Manoharan, Arya Sen, Richa Rana, Mansi Mody, Fnu Paras, Archita Archita, Sana Shaik, Kartik Mehta, Rachel Manoj, Prakashini Mishra, Subhi Mehta, Pulkit Kapoor","doi":"10.1186/s40842-026-00311-6","DOIUrl":"10.1186/s40842-026-00311-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the most rapidly growing drug classes in contemporary medicine, approved for type 2 diabetes mellitus (T2DM) and obesity management. Although gastrointestinal adverse effects are well characterised, the pulmonary safety profile of GLP-1 RAs remains incompletely defined, representing an important evidence gap given the scale of global prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review aims to synthesise published evidence on respiratory adverse events temporally associated with GLP-1 RA therapy in adults, characterise their patterns and severity, appraise the risk of bias using validated design-appropriate tools, describe proposed pathophysiological mechanisms, and grade the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Given the heterogeneity of the included evidence-spanning case reports, pharmacovigilance analyses, and observational cohorts-this review is framed primarily as a signal-detection and evidence-mapping exercise rather than a causal-inference analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Adults (≥ 18 years) receiving any approved GLP-1 RA for any indication. Eligible study designs included randomised controlled trials (RCTs), retrospective and prospective observational cohorts, pharmacovigilance disproportionality analyses, and case reports or series. Studies were excluded if they enrolled paediatric populations, involved animal or in vitro experiments, reported only metabolic or cardiovascular outcomes without respiratory adverse-event data, or were narrative reviews, editorials, or commentaries without primary data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420261305875). PubMed, Embase, and Scopus were searched from inception to January 2026. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool for RCTs, the Newcastle-Ottawa Scale (NOS) for cohort studies, and Joanna Briggs Institute (JBI) checklists for case reports, case series, and pharmacovigilance studies. GRADE was applied at the outcome-domain level; evidence from uncontrolled designs (case reports, case series, pharmacovigilance analyses) was initially rated very low certainty, as these designs are inherently uncontrolled and start below the lowest GRADE tier. Given substantial heterogeneity, meta-analytic pooling was not performed; a pre-specified narrative synthesis following the Synthesis Without Meta-Analysis (SWiM) reporting guideline was conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen studies met inclusion criteria: four RCTs (n = 1,884 participants), five retrospective cohort studies (n = 1,122,653 participants), three pharmacovigilance analyses (n = 498,892 spontaneous adverse-event reports), and seven case reports or case series (n = 13 patients). Spontaneous reports do not repre","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280826","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":"Acute vascular redox modulation by SGLT2 inhibition in non-diabetic patients.","authors":"Katica Cvitkusic Lukenda, Ana Cipak Gasparovic, Mirta Milic, Barbara Radovani, Frano Vuckovic, Jelena Jakab, Domagoj Vucic, Ana Kovacevic, Ivan Gudelj","doi":"10.1186/s40842-026-00304-5","DOIUrl":"10.1186/s40842-026-00304-5","url":null,"abstract":"<p><strong>Background: </strong>Coronary angiography induces oxidative stress through contrast media exposure and ionizing radiation, potentially contributing to vascular and renal injury. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) exert antioxidant and anti-inflammatory effects beyond glycemic control. We investigated whether a single pre-procedural dose of empagliflozin modulates oxidative stress and inflammatory glycosylation patterns in non-diabetic patients undergoing elective coronary angiography.</p><p><strong>Methods: </strong>In this prospective, randomized, double-blind study, 60 patients undergoing elective coronary angiography were assigned to standard care or empagliflozin 10 mg administered 2 h before the procedure. Blood samples were collected at baseline, 4 h, and 24 h post-procedure. Total antioxidant capacity (TAC), oxidative DNA damage (alkaline comet assay), and N-glycosylation profiles of immunoglobulin G (IgG) and total plasma proteins were analyzed. Longitudinal changes were assessed using mixed-effects models with correction for multiple testing.</p><p><strong>Results: </strong>Baseline characteristics and procedural variables were comparable between groups. Empagliflozin administration was associated with attenuation of oxidative DNA damage 24 h after angiography and stabilization of antioxidant capacity compared with standard care. Directional shifts in IgG N-glycosylation toward a less pro-inflammatory profile were observed in the intervention group, including reduced agalactosylated and core-fucosylated glycans and relative preservation of galactosylated structures. Similar modulatory trends were detected in total plasma protein glycosylation patterns. Although several glycomic changes did not reach statistical significance after correction for multiple testing, the overall biological signal consistently favored reduced oxidative and inflammatory activation in the empagliflozin group.</p><p><strong>Conclusions: </strong>A single pre-procedural dose of empagliflozin was associated with attenuation of oxidative stress-related DNA damage and modulation of inflammatory glycosylation patterns following coronary angiography. These findings suggest a potential peri-procedural cytoprotective role of SGLT2 inhibition that warrants confirmation in larger studies.</p><p><strong>Trial registration: </strong>ISRCTN11022820. Registered 13 October 2025. Retrospectively registered.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274620","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":"Association between the atherogenic index of plasma trajectory and risk of cardiovascular diseases among hypertensive patients: a prospective cohort study.","authors":"Weiqiang Wu, Peng Fu, Zefeng Cai, Yuxian Wang, Kuangyi Wu, Hong Zheng, Guanlin Chen, Zekai Chen, Yulong Lan, Yanjuan Chen, Shouling Wu, Youren Chen","doi":"10.1186/s40842-026-00302-7","DOIUrl":"10.1186/s40842-026-00302-7","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) remains the leading cause of global mortality, with hypertension and dyslipidemia synergistically exacerbating the atherogenic risk. The atherogenic index of plasma (AIP), calculated as log (triglycerides/HDL-C), reflects lipid-driven atherosclerosis; however, evidence of long-term AIP trajectory patterns and their cardiovascular implications in hypertensive populations remains scarce.</p><p><strong>Methods: </strong>This longitudinal study included 20,013 hypertensive participants (mean age: 56.8 ± 11.0 years; 81.9% male) from the Kailuan cohort, China. The AIP trajectories (2006-2010) were modeled using latent mixture modeling. Cox proportional hazards models were used to assess associations between AIP trajectories and incident CVD (2010-2020), adjusting for demographics, comorbidities, and medications.</p><p><strong>Results: </strong>Four distinct AIP trajectories were identified: Low-stable group (n = 2,920; AIP range: -0.84 to -0.72), Moderate low-stable group (n = 11,121; AIP range: -0.14 to -0.10), Moderate high-stable group (n = 5,067; AIP range: 0.42 to 0.53), Elevated-increasing group (n = 905; AIP range: 1.12 to 1.46). Over a median of 11.9 (interquartile range 11.3-12.3) years of follow-up, 2,332 CVD events occurred. Compared with the low-stable group, participants in the elevated-increasing trajectory exhibited a 43% higher CVD risk (HR = 1.43, 95% CI:1.14-1.79; P-trend = 0.001), with significantly elevated risks of myocardial infarction (HR = 1.80, 1.09-2.51; P-trend < 0.001) and ischemic stroke (HR = 1.40, 1.08-1.80; P-trend = 0.001). Young hypertensives (< 45 years) with rising AIP trajectories demonstrated a 3.4-fold higher CVD risk (HR = 3.40, 1.03-11.16), whereas no associations were observed for hemorrhagic stroke (P-trend = 0.734).</p><p><strong>Conclusions: </strong>Sustained elevation in AIP trajectories is associated with a higher risk of CVD in individuals with hypertension. Sustained maintenance of optimal AIP levels through regular monitoring, combined with blood pressure control and antihypertensive medication adherence, may reduce the CVD risk in hypertensive populations.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230513","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 of hyperuricemia among patients with non-communicable diseases in Ethiopia: a systematic review and meta-analysis.","authors":"Afewerk Habtamu, Zewudu Mulatie, Mikiyas Shemelis Achame, Sisay Desale, Saleamlak Sebsibe, Yonas Erkihun, Yeshimebet Kassa, Tesfaye Gessese, Mihreteab Alebachew, Mahider Shimelis Feyisa, Bruktawit Eshetu","doi":"10.1186/s40842-026-00301-8","DOIUrl":"10.1186/s40842-026-00301-8","url":null,"abstract":"<p><strong>Background: </strong>Hyperuricemia is one of the driving factors for the onset and progression of cardiovascular diseases, type 2 diabetes and hypertension. However, hyperuricemia is not measured regularly for these patients, and its worsening effect is underestimated. Thus, this systematic review and meta-analysis aimed to determine the pooled magnitude of hyperuricemia among patients with non-communicable diseases in Ethiopia.</p><p><strong>Methods and materials: </strong>This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Bibliographic databases and gray literature were extensively searched for relevant articles. Eligible articles were extracted using Microsoft Excel and exported to STATA version 17 software for statistical analysis. The pooled magnitude of hyperuricemia computed with Random-effects model. Furthermore, Sensitivity and subgroup analysis was done. Heterogeneity was determined using the I² value. Funnel plot and Egger's test statistics was used to assess publication bias.</p><p><strong>Results: </strong>A total of 2292 patients from 8 studies were included in this systematic review and meta-analysis. The overall pooled prevalence of hyperuricemia among all patients with non-communicable diseases was 34.64% (95% CI: 29.27%, 40.02%). The prevalence of hyperuricemia among patients with cardiovascular diseases was 42.15% (95% CI: 38.08, 46.21), hypertension 34.79% (95% CI: 20.16, 49.42) and type 2 diabetes 30.87% (95% CI: 24.54, 37.20). The highest prevalence was found in Amhara region (36.73%, 95% CI: 26.12, 47.33), and the lowest was in Central Ethiopia (32.01%, 95% CI: 22.68, 41.34). The magnitude of hyperuricemia among females and males was 34.71% (95% CI: 27.79, 41.63) and 34.51% (95% CI: 29.91, 39.10) respectively. Hyperuricemia among participants aged < 45 years and > 45 years was 27.33% (95% CI: 19.82, 34.85) and 39.68% (95% CI: 34.08, 45.29) respectively.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis showed high prevalence of hyperuricemia among patients with non-communicable diseases. Therefore, regular monitoring of uric acid level is required to prevent its pathophysiological role in patients with non-communicable diseases.</p><p><strong>Systematic review registration: </strong>PROSPERO (2025: CRD420251174980).</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221596","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":"Clinical characteristics and outcomes of diabetic ketoacidosis in patients with type 2 diabetes during acute systemic stress.","authors":"Rania Al Sayed Abd Albaky Mohamed, Laila Mahmoud Ali Hendawy, Eman Elsayed Mahmoud Farghaly, Amr Mahmoud Mohamed Abd El Hady Saleh","doi":"10.1186/s40842-026-00293-5","DOIUrl":"10.1186/s40842-026-00293-5","url":null,"abstract":"<p><p>BACKGROUND: Many reports indicate that diabetes is one of the main risk factors for COVID-19 complications. Nevertheless, few studies have examined how DKA develops in T2DM patients who have SARS-CoV-2 infection. OBJECTIVES: This study aimed to assess β-cell function, identify risk factors for DKA, and evaluate clinical outcomes in hospitalized patients with T2DM and COVID-19. METHODS: A retrospective, single-center, case–control study was conducted at Ain Shams University Isolation Hospital from August 2021 to August 2022. The study included 70 adults with T2DM and confirmed COVID-19, categorized into two groups: 35 patients with DKA (cases) and 35 patients without DKA (controls). Clinical, laboratory, and outcome data were extracted from medical records. RESULTS: Fasting C-peptide levels did not differ significantly between the DKA and non-DKA groups (median difference: −0.06 ng/mL, 95% CI − 0.28 to 0.16; p = 0.363), suggesting that absolute insulin deficiency was not the primary driver of DKA in this cohort. The DKA group was significantly older (mean difference: 9.8 years, 95% CI 4.2 to 16.0; p = 0.003) and had a longer median diabetes duration (median difference: 3.7 years, 95% CI 1.3 to 6.1; p = 0.009). These patients also presented increased levels of inflammatory and stress markers, including D-dimer (mean difference: 0.21 ng/mL, 95% CI 0.05 to 0.37; p = 0.020) and HOMA-IR (median difference: 1.93, 95% CI 0.45 to 3.60; p = 0.012). Mortality was significantly greater in the DKA group (22.9% vs. 0%, risk difference 22.9%, 95% CI 8.4% to 37.4%; p = 0.003). CONCLUSION: In patients with T2DM and COVID-19, DKA was not characterized by absolute insulinopenia but was associated with older age, longer diabetes duration, severe insulin resistance, and systemic inflammation. These factors contribute to significantly increased morbidity and mortality. Our findings highlight the multifactorial nature of DKA in this setting and underscore the importance of aggressive monitoring and management in high-risk patients. CLINICAL TRIAL NUMBER : Not applicable. </p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202177","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":"Updated perspectives on vitamin D deficiency, screening, supplementation and clinical guidance.","authors":"Muhammad Ajmal Dina, Asif Hanif, Anam Arshed, Asifa Karamat, Muhammad Shakeel Basit, Muhammad Akram Bhutta, Muhammad Orangzaib Ehsan","doi":"10.1186/s40842-026-00300-9","DOIUrl":"10.1186/s40842-026-00300-9","url":null,"abstract":"<p><p>Vitamin D functions like a hormone and plays a crucial role in regulating calcium levels and maintaining normal bone metabolism. A deficiency of vitamin D can lead to an increased risk of fractures, osteoporosis and osteomalacia that’s why research has linked vitamin D deficiency to various chronic diseases and certain types of cancer, thereby enhancing interest in its overall health implications. vitamin D deficiency is still prevalent among many populations. It is often found in older adults, individuals with chronic health conditions, those residing in care facilities and women who are either pregnant or nursing. There exists significant variability in clinical practices. Experts have differing opinions on who should undergo screening, what serum levels indicate sufficiency and the appropriate timing for initiating supplementation. This narrative review explores the key reservations that influence the diagnosis and management of vitamin D deficiency and current perspectives on screening, identifies high-risk populations that may benefit from testing and delineates circumstances in which empirical supplementation is a sensible and effective approach. Monitoring is beneficial and discusses how target levels correlate with bone health outcomes. A specific focus is directed towards the frequently cited 25(OH)D threshold of 30 ng/mL which is broadly linked to optimal bone health and underscores the synergistic significance of vitamin D and calcium in the management of osteoporosis and elucidates the reasons that why cholecalciferol is the favored formulation of vitamin D due to its advantageous pharmacological characteristics.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160454","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":"Association of acylcarnitine species and diabetes incidence in a population-based apparently healthy cohort.","authors":"Ko Ko Maung, Rebecca Borreggine, Hector Gallart-Ayala, Julijana Ivanisevic, Pedro Marques-Vidal","doi":"10.1186/s40842-026-00298-0","DOIUrl":"10.1186/s40842-026-00298-0","url":null,"abstract":"<p><p>BACKGROUND: Current diabetes risk scores often fail to detect early metabolic changes. Acylcarnitines species (ACs), intermediates of mitochondrial fatty acid oxidation, may indicate early dysregulation in diabetes, but prospective evidence is limited. We investigated the associations between circulating ACs and 10-year incidence of diabetes, and whether AC improve the predictive performance of established diabetes risk scores. METHODS: Data from 1,976 apparently healthy adults in a population-based cohort. Incident diabetes was defined as HbA1c ≥ 48 mmol/mol or initiation of glucose-lowering medication at follow-up. Associations were analysed using bivariate and multivariate models, and predictive value was assessed by adding ACs individually to FINDRISC, SDA, Kahn clinic, Kahn clinic+biologic, Wilson, Balkau and Griffin scores. RESULTS: Over 10 years, 35 participants developed diabetes. Higher baseline levels of Propionyl-, Isovaleryl-, Hexanoyl-, and Octenoylcarnitine were associated with incident diabetes in bivariate analysis whereas only Propionylcarnitine remained associated in multivariate analyses, mean ± sem 376.3 ± 2.7 vs. 419.1 ± 20.4 nmol/L in non-Diabetes and incident diabetes, respectively, p < 0.05. Sensitivity analyses using both diabetes and prediabetes incidence showed similar pattern of associations compared to the primary analysis. In predictive analyses, Propionyl- and Isovalerylcarnitine remained independently associated with incident diabetes after adjustment for each established diabetes risk scores. Adding Isovalerylcarnitine to the risk scores improved discrimination in three out of seven risk scores: AUC 0.785 (0.710–0.859), 0.841 (0.789–0.892), and 0.841 (0.789–0.892) for Balkau, SDA and FINRISK, respectively. CONCLUSION: Specific AC species, particularly Propionyl- and Isovalerylcarnitine, predicted 10-year risk of diabetes and improved predictive performance beyond established risk scores, suggesting their potential as early metabolic markers. </p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140741","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-specific roles of insulin-like growth factor-1, lean mass and fat mass in type 2 diabetes prevention: Mendelian randomization studies in Western and East Asian populations.","authors":"Man Ki Kwok, Parco Ming Fai Siu, Shan Luo, Shiu Lun Au Yeung, Gabriel M Leung, Catherine Mary Schooling","doi":"10.1186/s40842-026-00285-5","DOIUrl":"10.1186/s40842-026-00285-5","url":null,"abstract":"<p><p>BACKGROUND: Sex-specific effects of body composition and its drivers, including insulin-like growth factor-1 (IGF-1), on type 2 diabetes mellitus (T2DM) are understudied across ethnicity. We assessed the role of IGF-1 in T2DM and mediation by lean or fat mass, by sex in Western and East Asian populations, using Mendelian randomization (MR). METHODS: Genetic predictors of exposure (IGF-1) and mediators (fat or lean mass) were applied to genetic associations with T2DM in Europeans (n = 898,130) and East Asians (n = 433,540). Univariable and multivariable MR (MVMR) were used to obtain total and direct effects of IGF-1 and fat or lean mass on T2DM. Mediation analyses were conducted to obtain indirect effects. RESULTS: In the Western population, genetically predicted higher IGF-1 was positively associated with T2DM in women [odds ratio (OR) 1.21, 95% confidence interval (CI) 1.11 to 1.32] but not men, and in both sexes with lean mass but not fat mass. Lean mass in both sexes decreased and fat mass in women increased T2DM risk. In the East Asian population, genetically predicted higher IGF-1 was positively associated with T2DM in both sexes (1.07, 95% CI 1.02 to 1.12), and with lean mass and fat mass in men. Lean and fat mass were unrelated to T2DM. The association of IGF-1 with T2DM was not mediated by lean or fat mass. CONCLUSIONS: IGF-1 may directly increase T2DM risk, independent of body composition, in Western women and East Asians. Fat mass in women and less lean mass in both sexes may also increase T2DM risk in Western populations. </p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059525","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":"Estimated glucose disposal rate and risk of first myocardial infarction in people with diabetes.","authors":"Linn Glynn, Martina Persson, Tomas Andersson, Robin Hofmann, Thomas Nyström","doi":"10.1186/s40842-026-00294-4","DOIUrl":"10.1186/s40842-026-00294-4","url":null,"abstract":"<p><strong>Background: </strong>The estimated glucose disposal rate (eGDR), calculated from glycated hemoglobin (HbA1c), hypertension status and BMI, is a proxy for insulin resistance. We examined the association between eGDR and the risk of first myocardial infarction (MI) and post-MI mortality in individuals with type 1 and type 2 diabetes.</p><p><strong>Methods: </strong>Using nationwide health registry data (2006-2020), we identified individuals with type 1 and type 2 diabetes. Follow-up started at the first time a complete eGDR could be calculated. eGDR was then handled as a time-updated exposure until first MI, with person-time assigned according to the most recent available value. Among those with MI, follow-up for post-MI mortality started at the event, and covariates were fixed at their last value before MI. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression with adjustment for blood lipids, albuminuria, estimated glomerular filtration rate and physical activity.</p><p><strong>Results: </strong>We included 46,155 individuals with type 1 diabetes and 570,230 individuals with type 2 diabetes (both 43% women). During a median follow up of 7.7 person-years, 1997 (4.3%) and 34,237 (6.0%) experienced first MI, respectively. Adjusted HRs (95% CIs) for first MI across eGDR categories ≤4, 4-6, 6-8, and ≥8 mg/kg/min) were: 3.73 (3.35-4.16), 3.09 (2.85-3.35), 2.40 (2.15-2.69) and 0.96 (0.79-1.17) for type 1 diabetes, respectively. Corresponding HRs for type 2 diabetes were 1.71 (1.62-1.82), 1.54 (1.46-1.62), 1.43 (1.35-1.51) and 1 (reference). Similar associations were observed for post-MI mortality, however non-significant across all eGDR categories.</p><p><strong>Conclusions: </strong>Lower eGDR, reflecting greater insulin resistance, was associated with a higher risk of first MI, with a stronger association observed in type 1 diabetes. These findings support insulin resistance as a potential modifiable cardiovascular risk factor in people with diabetes.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020477","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}