Acta Diabetologica最新文献

{"title":"BFGF alleviates diabetic endothelial dysfunction by downregulating Endoplasmic reticulum stress.","authors":"Fei Hu, Jie Li, Xin Zhang, Yueyue Fu, Yufei Mao, Songlin Tong, Hongming Xu","doi":"10.1007/s00592-025-02504-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02504-4","url":null,"abstract":"<p><p>Diabetes is a chronic metabolic disorder characterized by hyperglycemia, resulting from absolute or relative insufficiency in insulin secretion and disorder in insulin utilization. Diabetes has emerged as a global public health issue, with its incidence rate escalating year on year. Its vascular complications pose a severe challenge in clinical practice and constitute one of the principal causes of death among diabetes patients. Basic fibroblast growth factor, a member of the fibroblast growth factor family, exhibits a robust protective effect on numerous diseases. Consequently, it has become a research focus in the treatment of vascular complications related to diabetes. Nevertheless, the specific mechanism underlying basic fibroblast growth factor's vascular protective effect remains unclear. This study aims to explore whether basic fibroblast growth factor can alleviate endothelial dysfunction in diabetes by inhibiting endoplasmic reticulum stress. The research outcomes demonstrated that basic fibroblast growth factor significantly decreased the production of endoplasmic reticulum stress in db/db mice and endothelial cells incubated with high glucose and palmitic acid, augmented nitric oxide production, and reduced endothelial cell apoptosis. Treatment with the endoplasmic reticulum stress inducer Tunicamycin nullified the basic fibroblast growth factor mediated reduction in endoplasmic reticulum stress generation and endothelial protective effects. In conclusion, these discoveries imply that the endothelial protective effect of basic fibroblast growth factor in diabetes can be partially ascribed to its inhibition of endoplasmic reticulum stress.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 14-year prospective cohort study of type 2 diabetes development in Dutch healthy adults of South Asian origin: risk factors and the association with metabolic syndrome and HOMA-IR.","authors":"Sebastian B Beckmann, Priyanti Bhawan, Tobias Bruning, T Martijn Kuijper, Sjaam Jainandunsing","doi":"10.1007/s00592-025-02513-3","DOIUrl":"https://doi.org/10.1007/s00592-025-02513-3","url":null,"abstract":"<p><strong>Objective: </strong>Type 2 Diabetes (T2D) imposes a disproportionate burden on the South Asian population. Their phenotype is characterized by heightened insulin resistance, even in individuals without overt T2D. Commonly used screening tools underestimate the T2D incidence in this population. The Metabolic syndrome (MetS) and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) are indicators of insulin resistance; however, their predictive value for the development of T2D remains unexplored.</p><p><strong>Methods: </strong>Among 698 initially enrolled healthy South Asian adults aged 30 to 65 in a Rotterdam-based cardiovascular disease prevention study, 270 participants were included after a 14-year follow-up. At baseline, an extensive history, physical examination, and metabolic screening were taken. A follow-up assessment of incident T2D was conducted. Multivariable logistic regression models calculated odds ratios (ORs) for MetS, its components, and HOMA-IR and adjusted for confounders.</p><p><strong>Results: </strong>33 (12.2%) of participants developed T2D. The presence of MetS at baseline showed an adjusted OR of 2.6, (95% confidence interval (CI) 1.2-5.7, p = 0.02) for incident T2D. Fasting plasma glucose was the most strongly associated component of MetS (OR 3.0, CI 1.1-8.6, p = 0.04) HOMA-IR was also associated and showed an OR of 1.2 per point increase (CI 1.0-1.4, p=0.05).</p><p><strong>Conclusions: </strong>MetS and FPG were the most important predictors of T2D development in this South Asian cohort. These results underscore the value of diverse variables in T2D detection and give insight into which screening tools for T2D prediction should be used in this high-risk population.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin ameliorates metabolic and hepatic outcomes in a mouse model of metabolic dysfunction-associated steatotic liver disease and diabetes.","authors":"Xiaoya Sun","doi":"10.1007/s00592-025-02488-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02488-1","url":null,"abstract":"<p><strong>Aims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), has become a great public healthcare burden and is closely associated with type 2 diabetes (T2D) and insulin resistance. However, there is no specific treatment for MASLD. Recent clinical findings have indicated a possible beneficial effect of sodium-glucose cotransporter 2 (SGLT2) on MASLD. This study aimed to investigate the effects of dapagliflozin (Dapa) on MASLD in T2D mice.</p><p><strong>Methods: </strong>Four-week-old ob/ob mice were fed with a high-fat diet (HFD) for 8 weeks and then randomly divided into two groups supplemented with Dapa or vehicle for another 12 weeks. C57BL/6J mice fed with a standard chow diet (CD) were used as the control group. Metabolic outcomes, liver pathology, lipidomics and insulin signaling were assessed.</p><p><strong>Results: </strong>We showed that Dapa reduced body weight and ameliorated hyperglycemia and fatty liver in obese diabetic ob/ob mice. Compared with vehicle, dapa improved the NAFLD activity score mainly by attenuating fat deposition. Importantly, Dapa decreased the expression levels of mRNAs and proteins related to fatty acid synthesis and increased the expression levels of β-oxidation-related factors. We also found that Dapa treatment improved insulin signaling by increasing PI3K and Akt phosphorylation.</p><p><strong>Conclusions: </strong>Dapa protects mice from diet-induced weight gain and improves hepatic lipotoxicity and insulin resistance in diabetic MASLD mice. Our results revealed that Dapa has a therapeutic effect on MASLD and could be a potential drug candidate for the treatment of MASLD.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between complement and macrophage markers with kidney survival in patients with diabetic nephropathy.","authors":"Ozcan Uzun, Cihan Heybeli, Fatma Sema Anar Kutlu, Manolya Celebioglu Pekiner, Filiz Yıldırım, Caner Cavdar, Sulen Sarioglu","doi":"10.1007/s00592-025-02521-3","DOIUrl":"https://doi.org/10.1007/s00592-025-02521-3","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is the leading cause of end-stage kidney disease (ESKD) worldwide. Macrophages and the complement system have interrelated roles in DN. We aimed to determine associations between macrophage and complement markers with the progression of DN.</p><p><strong>Methods: </strong>This retrospective cohort study included patients diagnosed with sole DN by kidney biopsy. Using immunohistochemistry, CD68⁺ and CD163⁺ cells and complement markers were counted in glomerular and tubulointerstitial areas. The primary outcome was evolution to ESKD and/or doubling serum creatinine (SCr).</p><p><strong>Results: </strong>Forty-six patients were included. The median SCr at baseline was 2.7 (1.41-3.1) mg/dL. During the median follow-up of 32 months (range 6-54), 50% of patients reached the primary outcome. Most of the clinical and histological findings were comparable between progressors and non-progressors, while progressors had a higher median number of glomerular CD68+ cells and a higher percentage of glomerulosclerosis. After adjustments for age, sex, and SCr, the median glomerular CD68+ cell number was the sole independent predictor of progression. Glomerular C4d was associated with nephrotic-range proteinuria but not with the progression of kidney failure.</p><p><strong>Conclusions: </strong>Glomerular CD68+ cell count may serve as a promising predictor of kidney disease progression among patients with DN. Glomerular C4d was associated with nephrotic-range proteinuria but not with the progression of kidney failure.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between nailfold capillaroscopic findings and diabetes: a systematic review and meta-analysis.","authors":"Wanling He, Mengjing Zhang, Runxin Mao, Chaoying Han, Lili Shi, Huiqun Wu","doi":"10.1007/s00592-025-02520-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02520-4","url":null,"abstract":"<p><strong>Purpose: </strong>People with diabetes often experience abnormal microcirculation, which can lead to various complications. This study aimed to investigate the relevance of nailfold capillaroscopy-a non-invasive imaging modality-in characterizing microvascular alterations specific to diabetes mellitus (DM).</p><p><strong>Methods: </strong>PubMed, Web of Science, and Baidu Academic were searched for relavant studies that investigated the associations between nailfold microcirculation abnormalities and DM. The quality of included studies was assessed using the National Institutes of Health (NIH) Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Meta-analysis was conducted to assess the relationship of various nailfold capillaroscopic findings with DM, and subgroup analysis was used to explore heterogeneity.</p><p><strong>Results: </strong>Ten studies with 1,423 participants were included. The quality of two studies was rated as Good, one as Poor, and the other seven were rated as Normal. The pooled analysis revealed significant correlations between various nailfold capillaroscopic findings and DM, including tortuosity (odds ratio [OR] 8.33, 95% confidence interval [CI]: 2.31-30.04), abnormal morphology (OR 5.00, 95% CI 3.03-8.26), ectasia (OR 4.86, 95% CI 2.56-9.20), bushy capillaries (OR 29.09, 95% CI 5.90-143.55), hemorrhage (OR 5.33, 95% CI 2.31-12.34), avascular areas (OR 6.14, 95% CI 1.40-26.86), bizarre capillaries (OR 10.33, 95% CI 2.79-38.31), and meander capillaries (OR: 2.84, 95% CI 1.25-6.45). Subgroup analysis showed strong associations between nailfold capillaroscopic findings and type 2 diabetes mellitus (T2DM).</p><p><strong>Conclusion: </strong>Our findings demonstrated that distinct nailfold capillary abnormalities aresignificantly correlated with DM, particularly T2DM.</p><p><strong>Protocol registration: </strong>Protocol registered in PROSPERO (registration number: CRD42024608214).</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of fluctuations in fasting blood glucose on left ventricular function in patients with type 2 diabetes mellitus and coronary microcirculation dysfunction: a prospective cohort study.","authors":"Wang Qian, Xie Lingli, Lu Dexue, Chen Yangwen, Shan Yongyan, Wu Weihua","doi":"10.1007/s00592-025-02514-2","DOIUrl":"https://doi.org/10.1007/s00592-025-02514-2","url":null,"abstract":"<p><strong>Aims: </strong>To examine the effects of fluctuations in fasting blood glucose (FBG) levels on left ventricular function in patients with T2DM and coronary microcirculation dysfunction (CMD).</p><p><strong>Methods: </strong>A total of 290 patients with T2DM who received glucose-lowering therapy during hospitalization and were subsequently followed up for 18 months at the First Affiliated Hospital of Harbin Medical University, were enrolled in this study. 135 were diagnosed with CMD and were assigned to the CMD group, whereas 155 patients without CMD were allocated to the non-CMD group. The fasting blood glucose coefficient of variation (FBG-CV) was calculated for all participants. The CMD group was further stratified into three subgroups based on their FBG-CV values: CMD1 (FBG-CV > 25%), CMD2 (FBG-CV 15% ~ 25%), and CMD3 (FBG-CV < 15%). The left ventricular function, assessed by left ventricular ejection fraction (LVEF) and the E/e' ratio, was compared within each group before and after the follow-up period. This study was registered in the Chinese Clinical Trial Register, ChiCTR-ORC-16009800.</p><p><strong>Results: </strong>After the end of follow-up, the E/e' ratio in CMD₁ was significantly higher than that in CMD₂ and CMD₃ (14.35 vs 8.57; p < 0.01; 14.35 vs 6.61; p < 0.01), and the E/e' ratio in CMD₂ was significantly higher than that in CMD₃ (8.57 vs 6.61; p < 0.01). Compared to the baseline measurements, the E/e' ratio in CMD₁ showed a significant increase after an average 17.8 months of follow up (14.35 vs 8.44; p < 0.001). We found elevated E/e' ratio was associated with an increased FBG-CV level (odds ratio [OR]: 2.571; 95% CI 1.819-3.634; p < 0.001). In multivariate logistic analysis, course of diabetes (OR:1.062; 1.016-1.11; P = 0.007) and CMD (OR:2.231; 1.303-3.819; P = 0.003), were significantly associated with elevated E/e' ratio, while oral stains drugs (OR = 0.412 95% CI 0.237-0.715; P = 0.002) and insulin injections (OR = 0.536 95% CI 0.311-0.924; P = 0.025) behaved as a protective factor.</p><p><strong>Conclusions: </strong>Our study clarified the association between FBG-CV levels and the E/e' ratio in a prospective cohort study. In T2DM patients with CMD, FBG-CV > 25% may adversely affect left ventricular diastolic function, whereas an optimal FBG-CV is considered to be less than 15%.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of diabetes duration and glycemic control on ejection fraction in heart failure patients.","authors":"Omer Dogan, Hasan Ali Barman, Ebru Serin, Abdullah Omer Ebeoglu, Adem Atici, Ridvan Turkmen, Ibrahim Temel, Isilay Kok, Omer Gok, Ipek Aydin, Pelinsu Elif Ozkan, Ali Nayir, Melike Kaya, Cem Kurt, Aylin Altun, Kursad Oz, Isil Uzunhasan, Murat Kazım Ersanli, Rasim Enar, Sait Mesut Dogan","doi":"10.1007/s00592-025-02519-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02519-x","url":null,"abstract":"<p><strong>Aim: </strong>The potential effects of diabetes duration and glycemic control on ejection fraction (EF) in patients with heart failure (HF) remain unclear. We investigated the impact of diabetes duration and glycemic control on ejection fraction (EF), alongside other risk factors, in HF patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 1265 patients who were admitted and discharged with a diagnosis of HF between January 2010 and January 2022, all of whom had a known diagnosis of T2DM prior to admission. The patients included in the study were divided into two groups: those with heart failure and reduced ejection fraction (HFrEF, EF ≤ 40%) and those with or mid-range or preserved ejection fraction (HFmrEF + HFpEF, EF > 40%).</p><p><strong>Results: </strong>Among the 1265 patients, 697 had HFrEF. The duration of diabetes was significantly longer (13 vs. 7 years, p < 0.001) and HbA1c levels were higher (8.4 ± 1.6% vs. 7.7 ± 1.5%, p < 0.001) in the HFrEF group. Multivariable analysis identified diabetes duration (OR 2.23, p < 0.001), hypertension (OR:6.62, p < 0.001), and the use of oral antidiabetic agents (OR 0.74, p = 0.042) as independent predictors of reduced EF. Prolonged diabetes duration was associated with a reduction in EF (AUC = 0.780, p < 0.001). Conversely, although glycemic control was poorer in the HFrEF group, it was not an independent predictor of EF.</p><p><strong>Conclusion: </strong>Prolonged diabetes duration significantly reduces EF, among HF patients with T2DM, independent of glycemic control and other risk factors. While poor glycemic control was more prevalent in HFrEF patients, it did not independently affect EF.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between atherogenic index of plasma and body mass index with the risk of type 2 diabetes mellitus: insights from CHARLS.","authors":"Genghang Chen, Shaonan Liu, Wenwei Ouyang, Lihong Yang, Yu Chen, Xinfeng Guo","doi":"10.1007/s00592-025-02516-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02516-0","url":null,"abstract":"<p><strong>Background: </strong>The complex relationship between obesity and dyslipidemia in type 2 diabetes mellitus (T2DM) remains an area of interest but is not fully understood. This study aimed to evaluate the intricate links between atherogenic index of plasma (AIP), body mass index (BMI), and T2DM risk.</p><p><strong>Methods: </strong>Based on data from the China Health and Retirement Longitudinal Study, this analysis comprised 6754 individuals aged 45 and over, free of T2DM in 2011. BMI and AIP were the exposures, with T2DM incidence as the primary focus. Logistic regression models generated odds ratios (ORs), and a thorough decomposition of BMI's impact on T2DM revealed natural indirect and direct effects. The study also examined the complex interactions and combined effects of these two exposures.</p><p><strong>Results: </strong>By the end of 2018, 972 individuals were diagnosed with T2DM. The AIP played a significant association in the relationship between BMI and T2DM, explaining 21.7% and 18.9% of the association in different BMI ranges. A significant additive effect was observed between BMI and AIP, with a relative excess risk due to interaction of 0.62. BMI ≥ 24.0 kg/m² and AIP above the median together conferred the highest risk of T2DM, with an OR of 2.31 and a 95% confidence interval (CI) of 1.92-2.79.</p><p><strong>Conclusion: </strong>Exposure to overweight/obesity or high AIP raises T2DM risk among Chinese ≥ 45 years, AIP partly mediates BMI-T2DM link.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperglycemia in the diabetic range, but not previous diagnosis of diabetes mellitus, is an independent indicator of poor outcome in patients hospitalized for severe COVID-19.","authors":"Alessandra Dei Cas, Raffaella Aldigeri, Elisa Eletto, Andrea Ticinesi, Antonio Nouvenne, Beatrice Prati, Angela Vazzana, Monica Antonini, Valentina Moretti, Emanuela Balestreri, Valentina Spigoni, Federica Fantuzzi, Silvia Schirò, Livia Ruffini, Nicola Sverzellati, Tiziana Meschi, Riccardo Bonadonna","doi":"10.1007/s00592-025-02507-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02507-1","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes mellitus (DM) and hyperglycemia are associated with poor outcome(s) in COVID-19 hospitalized patients, but their independent impact on prognosis remains unclear. We aimed to assess the impact of DM and hyperglycemia on COVID-19 outcomes.</p><p><strong>Methods: </strong>Clinical data/records from COVID-19 patients admitted to the Parma University-Hospital (February 23rd to March 31st, 2020) were retrieved and analysed (NCT04550403). Fasting plasma glucose (FPG), inflammatory markers and the main biochemical variables were collected at admission. Patients underwent chest high-resolution CT and arterial blood gas analysis to determine the PaO₂/FiO₂ ratio (P/F ratio). The primary outcome was a composite of intensive care unit admission and/or death.</p><p><strong>Results: </strong>Among 756 subjects, 143 (19%) had DM. These patients were older with higher comorbidity rates. The primary outcome occurred in 61.5% DM patients versus 43.4% without DM (p < 0.001). In multivariable analysis (accuracy UC = 0.93), older age, cardiovascular and kidney diseases, FPG ≥ 126 mg/dl, C-reactive protein, and P/F ratio, but not previous DM, were independent risk indicators.</p><p><strong>Conclusions: </strong>DM indicated poor COVID-19 outcomes, but not when adjusted for other clinical variables/comorbities, suggesting that its impact was mostly driven by concomitant factors. The independent role of fasting hyperglycemia points to the need for further research on its contribution to COVID-19.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of prediction model for stage I patients with lower extremity atherosclerotic disease in type 2 diabetes mellitus in China.","authors":"Rong Zhu, Weifeng Cui, Ruixia Zhao, Huijuan Liu, Shuxun Yan, Mingyi Shao, Haibin Yu, Yu Fu","doi":"10.1007/s00592-025-02497-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02497-0","url":null,"abstract":"<p><strong>Aims: </strong>Lower extremity atherosclerotic disease (LEAD) is the primary cause of ulcers, gangrene, and amputations in patients with type 2 diabetes mellitus (T2DM), stage I is the crucial time for prevention and intervention to improve the prognosis of T2DM-LEAD. The purpose of this study was to develop and validate a personalized predictive model to determine the risk of outcomes in stage I patients with T2DM-LEAD.</p><p><strong>Methods: </strong>There were 1603 stage I patients with T2DM-LEAD at baseline in this retrospective study. Least absolute shrinkage and selection operator regression was applied to filter predictive variables. Cox regression was used to construct a nomogram prediction model. The model's 3-year and 5-year predictive performance was evaluated in terms of its discrimination, calibration, and clinical utility using the area under the receiver operating characteristic curve, calibration curve, decision curve analysis, respectively.</p><p><strong>Results: </strong>Patients were randomly divided into a development cohort (n = 1122) and a validation cohort (n = 481). Age, cerebrovascular diseases, diabetic kidney disease, diabetic retinopathy, low-density lipoprotein cholesterol, fibrinogen, D-dimer and anti-platelet drugs were selected as predictive factors. The model presented moderate discrimination in development and validation sets with AUCs of 70.3 (95% CI: 65.2-75.3) and 70.1 (95% CI: 64.5-75.7) for the 3-year prediction. Andthe AUC values for the 5-year prediction in development and validation sets were 72.8 (95% CI: 67.6-78.1) and 75.9 (95% CI: 69.0-82.8), respectively. The calibration curve for the 3-year and 5-year predictions demonstrated good agreement between the predicted and actual probabilities, and decision curve analysis showed a wide range of beneficial clinical utility.</p><p><strong>Conclusion: </strong>The prediction model can identify the risk of stage I patients with T2DM-LEAD who are likely to develop outcomes events within 3 years and 5 years. It is valuable for clinical decisions and helps healthcare providers and policy makers to develop more personalized clinical treatment strategies, which has significant public health implications.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}