Acta Diabetologica最新文献

{"title":"Association of baseline and changes in estimated glucose disposal rate and risk of chronic kidney disease: evidence from a national longitudinal study.","authors":"Fan Zhang, Jiao Li, Xueling Li, Liuyang Huang, Yifei Zhong","doi":"10.1007/s00592-025-02528-w","DOIUrl":"https://doi.org/10.1007/s00592-025-02528-w","url":null,"abstract":"<p><strong>Objective: </strong>This study explored the relationship between baseline estimated glucose disposal rate (eGDR), its trajectories, and the risk of chronic kidney disease (CKD).</p><p><strong>Methods: </strong>Participants from the China Health and Retirement Longitudinal Study were included. eGDR was calculated using a validated formula, and CKD was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73m2 or self-reported. Group-based trajectory modeling identified distinct eGDR patterns, and Cox proportional hazards models assessed associations between eGDR and CKD risk.</p><p><strong>Results: </strong>A total of 5,238 participants were analyzed, with 436 incident CKD cases during the 5-year follow-up. Higher baseline eGDR (≥ 8 mg/kg/min) was associated with a reduced CKD risk (Hazard Ratio [HR] = 0.40; 95% Confidence Interval [CI]: 0.19-0.88; P = 0.022). An L-shaped relationship was observed between eGDR and CKD risk. Three eGDR trajectories were identified: low-stability (41.8%), decreasing (14.5%), and high-stability (43.7%). Only the high-stability trajectory significantly reduced CKD risk (HR = 0.77; 95% CI: 0.62-0.96; P = 0.019) compared to the low-stability group.</p><p><strong>Conclusion: </strong>Higher baseline eGDR and consistently high eGDR trajectories were linked to a lower CKD risk, highlighting the significance of maintaining insulin sensitivity for CKD prevention.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223981","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":"Crosstalk of immunity and metabolism: interaction of toll-like receptors (TLRs) and gut microbiota.","authors":"Shabana, Saleem Ullah Shahid, Uzma Irfan, Sumreen Hayat, Sumbal Sarwar","doi":"10.1007/s00592-025-02532-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02532-0","url":null,"abstract":"<p><p>The human gut is the largest interface between the external environment and the human body. The gut immune system should, therefore, be able to differentiate between the normal nonpathogenic residents of the gut and any pathogenic invaders. This differentiation is based on the tiny molecular differences on the cell surfaces of the microorganisms. The first interaction between the pathogen and the immune system is thus crucial. This sensing by the immune system is done by a family of pattern recognition receptors (PRRs), among which the most important are the toll-like receptors (TLRs). The distribution of TLRs in the different areas of gastrointestinal tract (GIT)c depends on the type of commensal residents of that area. The interaction between gut microbiota and TLRs on one hand restricts the colonization of particular microbes to a particular area and on the other hand, dictates the type of TLRs distributed in a particular gut location. This interaction promotes tolerance to the normal residents, but the same time enables the gut associated lymphoid tissue to be able to detect any foreign and potentially pathogenic invaders. The numbers and polarization of the underlying populations of macrophages and dendritic cells beneath the Paneth and M-cells depends upon the trophic factors released by the intestinal epithelial cells as a result of signaling through TLRs. The interaction between these two players is not only immune related, but also has many metabolic consequences. The link between inflammation and many metabolic diseases has been consistently reported. The role of TLRs in the metabolic reprogramming of immune cells is crucial which facilitates the conservation of metabolic energy to be harnessed for immune functions. The knowledge on the TLR-microbiota interaction, its role in immune and metabolic functions, and the results of manipulations with this interaction are the subject of this review.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223985","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":"Proximity extension assay inflammatory profiling cannot distinguish the presence of residual C-peptide in patients with long-standing type 1 diabetes.","authors":"Ebrahim Anvari, Per Lundkvist, Kailash Singh, Daniel Espes","doi":"10.1007/s00592-025-02537-9","DOIUrl":"https://doi.org/10.1007/s00592-025-02537-9","url":null,"abstract":"<p><strong>Objective: </strong>Many patients with long-standing type 1 diabetes (T1D) have remaining low levels of C-peptide, i.e. and indirect sign of remaining functional beta-cells. This study focused on identifying differences in immunological and inflammatory biomarkers in patients with longstanding T1D and remaining C-peptide.</p><p><strong>Research design and methods: </strong>Adult patients (n = 120) with long-standing T1D (≥ 10 years) and healthy controls (HC) (n = 50) were recruited at Uppsala University Hospital. Residual beta-cell function was determined with an ultrasensitive C-peptide ELISA under fasting conditions. T1D patients were divided into two groups (C-peptide positive vs. C-peptide negative). Using the OLINK Explore Inflammation proximity extension assay (PEA), 368 circulating immunological and inflammatory biomarkers were analyzed in plasma.</p><p><strong>Results: </strong>The three groups could not be distinguished by principal component analysis and when correcting for multiple testing we found no differences in circulating biomarkers. However, based on uncorrected p-values there were six biomarkers that were different when comparing all T1D patients with HC and eight markers that were different when comparing C-peptide positive vs. negative T1D patients.</p><p><strong>Conclusion: </strong>A wide inflammatory assay analysis cannot distinguish patients with longstanding T1D and remaining C-peptide from patients with a complete loss of C-peptide nor from HC.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223990","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":"Obesity paradox: association between lipid metabolism indices and skeletal muscle mass in older adults: the mediating role of uric acid.","authors":"Chaofan Sun, Xiaohui Yang, Xingzhong Feng","doi":"10.1007/s00592-025-02527-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02527-x","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to explore the relationships between lipid metabolism indices-the Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), Cardiac Metabolic Index (CMI), and Atherogenic Index of Plasma (AIP)-and sarcopenia in individuals aged ≥ 60 years, and to investigate the mediating role of uric acid (UA) in these relationships. The goal was to provide scientific evidence and practical guidance for preventing and treating sarcopenia in older adults.</p><p><strong>Methods: </strong>Data from 2001 participants aged ≥ 60 years in the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were analyzed. Statistical analyses, including logistic regression, restricted cubic splines (RCS), subgroup analysis, and mediation analysis, were conducted to examine the associations among various lipid metabolism indices, UA levels, and sarcopenia.</p><p><strong>Results: </strong>Multivariable-adjusted models revealed significant inverse associations between lipid metabolism indices and sarcopenia (all P < 0.05). In the fully adjusted model (model III), the adjusted odds ratios (OR) for LAP, VAI, CMI, and AIP were 0.97 (95% CI: 0.97-0.98), 0.78 (0.68-0.89), 0.32 (0.21-0.49), and 0.27 (0.15-0.52), respectively (all P < 0.05). RCS analyses revealed inverse dose-response relationships between lipid metabolism indices and sarcopenia. The ROC analysis revealed that LAP showed the highest diagnostic value among the four indices. Subgroup analyses showed no significant differences in this relationship across different subgroups. Notably, UA partially mediated these associations (mediation proportions: 8.91-20.66%). These findings suggest that maintaining lipid homeostasis and UA levels may offer protective benefits against age-related sarcopenia.</p><p><strong>Conclusions: </strong>Our findings advance the understanding of the obesity paradox by revealing that higher lipid metabolism indices (LAP, VAI, CMI, AIP) and UA levels are inversely associated with sarcopenia in the elderly, with UA partially mediating these protective effects. These results highlight the importance of maintaining lipid and UA levels within normal ranges as a potential novel strategy for preventing and managing sarcopenia. These findings suggest that reconsidering these biomarkers in the management of geriatric muscle health is necessary, highlighting their importance in understanding and addressing the pathogenesis of sarcopenia in aging populations.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223988","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":"Advanced hybrid closed loop system (MiniMed 780G) achieving significant improvement of glucose control in a patient with maternally inherited diabetes and deafness: a case report.","authors":"Michalis K Picolos, Anastasia Papapostolou, Anastasia Christodoulou, George A Tanteles, Anna Kyriakidou, Georgios Papaetis","doi":"10.1007/s00592-025-02524-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02524-0","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223980","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":"Diabetic ketoacidosis in a patient with type I diabetes treated with tirzepatide.","authors":"Ernest Roche, Julie Chapon, Laura Bogenmann, Cédric Luyton, Lucien Marchand","doi":"10.1007/s00592-025-02535-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02535-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223986","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 of GLP-1 receptor agonists with risk of intestinal obstruction in patients with type 2 diabetes mellitus: a retrospective cohort study.","authors":"Zhenxiang Gao, Tomasz Tabernacki, Ian Dorney, Pingjian Ding, David C Kaelber, Rong Xu","doi":"10.1007/s00592-025-02525-z","DOIUrl":"https://doi.org/10.1007/s00592-025-02525-z","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes and weight loss. There have been concerns that GLP-1RAs may increase the risk of intestinal obstruction.</p><p><strong>Objective: </strong>Investigate the association between GLP-1RAs use and intestinal obstruction in a large cohort of patients with type 2 diabetes mellitus (T2DM) in the U.S.</p><p><strong>Design: </strong>A retrospective cohort study was conducted using longitudinal electronic health records sourced from TriNetX, a large-scale, population-based health database.</p><p><strong>Participants: </strong>The study included over 1.2 million T2DM patients who were prescribed anti-diabetic medications, including 181,795 prescribed GLP-1RAs between April 2013 and April 2019.</p><p><strong>Main measures: </strong>The incidence of intestinal obstruction was compared between GLP-1RAs and each of six other classes of non-GLP-1RA anti-diabetic medications. Hazard ratios (HRs) at 1, 3, and 5-year follow-up periods were calculated using Cox proportional hazards analysis. Separate analyses were performed in T2DM patients with and without obesity.</p><p><strong>Key results: </strong>The risk of intestinal obstruction did not differ between GLP-1RAs and other anti-diabetic medications except for a reduced risk compared with insulins. The results were consistent for 1, 3, and 5-year follow-up periods and in patients with and without obesity.</p><p><strong>Conclusions: </strong>Our findings do not support an increased risk of intestinal obstruction in T2DM patients prescribed GLP-1 RAs compared to other anti-diabetic medications.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223982","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":"Correlation analysis between hemoglobin and type 2 diabetic nephropathy: a two-center retrospective study.","authors":"Xiaoling Liu, Ze Zhang, Lu Lin, Jinghui Li, Bende Liu, Xiangjin Xu, Huaqian Chen, Junwei Zhou, Pin Chen","doi":"10.1007/s00592-025-02529-9","DOIUrl":"https://doi.org/10.1007/s00592-025-02529-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between hemoglobin (Hb) levels and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>We recruited patients with T2DM from two centers, collected their clinical data, and analyzed the relationship between Hb levels and DN using binary logistic regression analysis and restricted cubic spline squares (RCS) plots.</p><p><strong>Results: </strong>A total of 1956 patients with T2DM were enrolled, including 784 (40.1%) with DN. After adjusting for several confounding factors, the proportion of patients with DN in Q1 of Hb was significantly higher than that in the other group. The RCS curve revealed that Hb levels were inversely proportional to DN. Subgroup analysis demonstrated that age, gender, history of hypertension, history of nonalcoholic fatty liver disease and history of diabetic retinopathy exhibited no significant correlation with Hb levels and DN.</p><p><strong>Conclusions: </strong>Low Hb level is closely associated with DN occurrence, and can be used as a predictive biomarker for DN.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223984","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":"NF-κB p65 mediated lnc-Traf3ip2 exacerbates renal fibrosis in diabetic kidney disease.","authors":"Keqian Wu, Peiling Li, He Zha, Tianhui Wu, Handeng Liu, Rui Peng, Dan Lv, Ziyue Lin, Xiaohui Liao, Yan Sun, Zheng Zhang","doi":"10.1007/s00592-025-02515-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02515-1","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic kidney disease (DKD) is the predominant type of end-stage renal disease. The fibrotic response in glomerular mesangial cells (MCs) acts as an initial injury during DKD progression, but the molecular mechanism remains to be explored. Here, this present study aimed to investigate the role of NF-κB p65 mediated long noncoding RNA (lncRNA) lnc-Traf3ip2 in renal fibrosis and DKD progression.</p><p><strong>Methods: </strong>The different expressions of lncRNAs in renal tissues of db/db DKD mice (n = 3) and db/dm controls (n = 3) were screened by scRNA-seq and RNA-seq. Plasma of DKD patients (n = 40) and renal tissues of DKD mice (n = 35) and their controls were further used to examine the expressions of lnc-Traf3ip2. Moreover, the relationship between the expression of lnc-Traf3ip2 and indexes of kidney function was also analyzed by Pearson correlation coefficient analysis. Furthermore, the biological functions of lnc-Traf3ip2 in mesangial cell fibrosis and renal injury were investigated by qRT-PCR, western blot and immunofluorescence in DKD in vivo and in vitro. Finally, the dual-luciferase reporter assay and ChIP were performed to investigate the regulatory mechanism of lnc-Traf3ip2 transcription.</p><p><strong>Results: </strong>In our study, the results of scRNA-seq, RNA-seq and qRT-PCR revealed that lnc-Traf3ip2, which was highly expressed in mesangial cells and upregulated in renal tissues of DKD mice and the plasma of DKD patients. Data also showed lnc-Traf3ip2 was positively correlated with UACR in DKD. Moreover, overexpression of lnc-Traf3ip2 could promote fibrosis of MCs in vitro, whereas silencing lnc-Traf3ip2 alleviated MCs fibrosis under high glucose condition. Additionally, lnc-Traf3ip2 knockdown alleviated renal fibrosis in DKD mice. Mechanistically, transcription factor NF-κB subunit p65 could promote the expression of lnc-Traf3ip2 via directly binding to the promoter of lnc-Traf3ip2.</p><p><strong>Conclusions: </strong>Taken together, our data suggest the role of lnc-Traf3ip2 in fibrogenic factor in DKD induced by transcription factor NF-κB p65 and identified it as an therapeutic target for DKD.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223987","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 external validation of a machine learning model to predict diabetic nephropathy in T1DM patients in the real-world.","authors":"Zouxi Du, Xiaoning Liu, Jiayu Li, Hang Min, Yuhu Ma, Wenting Hua, Leyuan Zhang, Yue Zhang, Mengmeng Shang, Hui Chen, Hong Yin, Limin Tian","doi":"10.1007/s00592-024-02404-z","DOIUrl":"10.1007/s00592-024-02404-z","url":null,"abstract":"<p><strong>Aims: </strong>Studies on machine learning (ML) for the prediction of diabetic nephropathy (DN) in type 1 diabetes mellitus (T1DM) patients are rare. This study focused on the development and external validation of an explainable ML model to predict the risk of DN among individuals with T1DM.</p><p><strong>Methods: </strong>This was a retrospective, multicenter study conducted across 19 hospitals in Gansu Province, China (No: 2022-473). In total, 1368 patients were eligible for analysis among 1633 collected T1DM patients from January 2016 to December 2023. Recursive feature elimination using random forest and fivefold cross-validation was conducted to identify key features. Among the 12 initial ML algorithms, the optimal ML model was developed and validated externally in a distinct population, and its predictive outcomes were explained via the SHapley additive exPlanations method, which offered personalized decision insights.</p><p><strong>Results: </strong>Among the 1368 T1DM patients, 324 had DN. The extreme gradient boosting (XGBoost) model, which achieved optimal performance with an AUC of 83% (95% confidence interval [CI]: 76‒89), was selected to predict the risk of DN among T1DM patients. The DN predictive model included variables such as T1DM duration, postprandial glucose (PPG), systolic blood pressure (SBP), glycated hemoglobin (HbA1c), serum creatinine (Scr) and low-density lipoprotein cholesterol (LDL-C). External validation confirmed the reliability of the model, with an AUC of 76% (95% CI: 70‒82).</p><p><strong>Conclusions: </strong>The ML prediction tool has potential for advancing early and precise identification of the risk of DN among T1DM patients. Although successful external validation indicated that the developed model can provide a promising strategy for clinical adoption and help improve patient outcomes through timely and accurate risk assessment, additional prospective data and further validation in diverse populations are necessary.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"869-879"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611857","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}