Acta Diabetologica最新文献

{"title":"Mediation analysis of brain magnetic resonance imaging variables with all-cause and cardiovascular disease-specific mortalities in persons with type 2 diabetes.","authors":"Cheng-Chieh Lin, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Jiaxin Yu, Shing-Yu Yang, Tsai-Chung Li","doi":"10.1007/s00592-024-02387-x","DOIUrl":"https://doi.org/10.1007/s00592-024-02387-x","url":null,"abstract":"<p><strong>Aim: </strong>Glucose variation (GV) has emerged as a predictor of morbidity and mortality in persons with diabetes. However, no study has examined whether brain magnetic resonance imaging (MRI) variables mediated the association between mortality and GV.</p><p><strong>Materials and methods: </strong>This study was a retrospective cohort comprising 3,961 individuals with type 2 diabetes (T2D), whose electronic medical records were retrieved from a medical center between January 2001 and October 2021. GV was quantified using coefficient of variation of fasting plasma glucose (FPG-CV) and glycated hemoglobin (HbA1c). The MRI variables included the presence or absence of cerebrovascular abnormality and white matter hyperintensity (WMH). All deaths and deaths resulting from expanded cardiovascular disease (CVD) were identified through annual record linkage with National Death Datasets. Cox proportional hazards models were applied to evaluate associations of MRI variable or GV with mortality. Mediation analyses were performed to assess the relative contributions of MRI variables for GV on mortality.</p><p><strong>Results: </strong>Among 3,961 patients, 2,114 patients (53.4%) had cerebrovascular abnormality and 1,888 patients (47.7%) had WMH. The results showed cerebrovascular abnormality and WMHs were significantly associated with all-cause and expanded CVD mortality after considering GV. The largest mediated effects of GV on all-cause and expanded CVD mortality were observed by cerebrovascular abnormality (5.26% and 8.49%, respectively).</p><p><strong>Conclusions: </strong>Our study suggests cerebrovascular abnormality and WMHs are important predictors of mortality in patients with T2D after considering GV. In addition, MRI variables of cerebrovascular abnormality expressed weak but significant mediation effect on the associations between GV and mortality.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492589","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 combination of next generation sequencing and technological devices allows a precision medicine approach in congenital hyperinsulinism: the case of a pregnant mother and the child she gave birth.","authors":"Marina Valenzano, Antonella Peduto, Anna Comba, Claudia Menzaghi, Vincenzo Trischitta","doi":"10.1007/s00592-024-02395-x","DOIUrl":"https://doi.org/10.1007/s00592-024-02395-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492628","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":"Assessment of left atrial function and left atrioventricular coupling via cardiac magnetic resonance in individuals with prediabetes and diabetes.","authors":"Shanshan Zhou, Zhen Zhang, Yiyuan Gao, Gengxiao Li, Yuefu Zhan, Shurong Liu, Zhiwei Zhao, Gerald M Pohost, Kai Sun, Kuncheng Li","doi":"10.1007/s00592-024-02380-4","DOIUrl":"https://doi.org/10.1007/s00592-024-02380-4","url":null,"abstract":"<p><strong>Aims: </strong>Assessment of left atrial (LA) function and the left atrioventricular coupling index (LACI) have recently been increasingly recognized as important indices for cardiovascular diseases associated with the presence of prediabetes and diabetes. We aimed to evaluate LA function and the LACI in patients with prediabetes and diabetes via cardiac magnetic resonance (CMR).</p><p><strong>Methods: </strong>In this retrospective study, we included 35 patients with prediabetes, 32 patients with diabetes, and 84 healthy control participants. The LACI and LA total, passive, and active emptying fractions (LATEmF, LAPEmF, and LAAEmF, respectively) were calculated. The LA reservoir, conduit, and booster pump strains (ε_s, ε_e, and ε_a), and peak positive, peak early negative, and peak late negative strain rates (SRs, SRe, and SRa) were obtained via CMR-feature tracking (CMR-FT). For the statistical analyses, one-way analysis of variance, the Kruskal-Wallis test, and linear regression were conducted, and Pearson's and interclass correlation coefficients were calculated.</p><p><strong>Results: </strong>Compared with healthy control participants, patients with prediabetes or diabetes presented lower ε_s and ε_e values and a relatively preserved LACI. Patients with diabetes presented considerably reduced SRs, SRe, and LAPEmF. Elevated glycated haemoglobin (HbA1c) levels were independently associated with decreased magnitudes of ε_s, SRs, ε_e, and SRe. No significant associations were found between the LACI and the HbA1c or LA deformation parameters. We observed significant correlations between LATEmF and ε_s, LAPEmF and ε_e and between LAAEmF and ε_a.</p><p><strong>Conclusions: </strong>CMR-FT provides a potential noninvasive approach for the early detection of alterations in the LA reservoir and conduit function in individuals with prediabetes and diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455405","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 regulatory variant rs9379874 in T1D risk region 6p22.2 affects BTN3A1 expression regulating T cell function.","authors":"Liying Jiang, Min Shen, Saisai Zhang, Jie Zhang, Yun Shi, Yong Gu, Tao Yang, Qi Fu, Bingwei Wang, Yang Chen, Kuanfeng Xu, Heng Chen","doi":"10.1007/s00592-024-02389-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02389-9","url":null,"abstract":"<p><strong>Objective: </strong>Genome-wide association studies (GWAS) have identified that 6p22.2 region is associated with type 1 diabetes (T1D) risk in the Chinese Han population. This study aims to reveal associations between this risk region and T1D subgroups and related clinical features, and further identify causal variant(s) and target gene(s) in this region.</p><p><strong>Methods: </strong>2608 T1D and 4814 healthy controls were recruited from East, Central, and South China. Baseline data and genotyping for rs4320356 were collected. The most likely causal variant and gene were identified by bioinformatics analysis, dual-luciferase reporter assays, expression quantitative trait loci (eQTL), and functional annotation of the non-coding region within the 6p22.2 region.</p><p><strong>Results: </strong>The leading variant rs4320356 in the 6p22.2 region was associated with T1D risk in the Chinese and Europeans. However, this variant was not significantly associated with islet function or autoimmunity. In silico analysis suggested rs9379874 was the most potential causal variant for T1D risk among thymus, spleen, and T cells, overlapping with the enhancer-related histone mark in multiple T cell subsets. Dual luciferase reporter assay and eQTL showed that the T allele of rs9379874 increased BTN3A1 expression by binding to FOXA1. Public single-cell RNA sequencing analysis indicated that BTN3A1 was related to T-cell activation, ATP metabolism, and cytokine metabolism pathways, which might contribute to T1D development.</p><p><strong>Conclusion: </strong>This study indicates that a functional variant rs9379874 regulates BTN3A1 expression, expanding the genomic landscape of T1D risk and offering a potential target for developing novel therapies.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455404","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":"Effects of APOE isoforms in diabetic nephropathy patients of South India.","authors":"Preethi Basavaraju, Puthamohan Vinayaga Moorthi, Arun Meyyazhagan, Ilakkiyapavai Devaraj, Kavipriya Babu, Emanuele Panza, Antonio Orlacchio","doi":"10.1007/s00592-024-02374-2","DOIUrl":"https://doi.org/10.1007/s00592-024-02374-2","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a grave complication and the most common renal dysfunction of diabetes mellitus. Genetic factors, including Apolipoprotein E (APOE) isoforms, have been implicated in the pathogenesis of DN.</p><p><strong>Methods: </strong>A total of 577 type 2 Diabetes mellitus subjects were categorized into diabetes non-nephropathic (Controls: n = 321), diabetes nephropathic (DN: n = 256) groups. Demographic, clinical, and biochemical parameters including age, BMI, lipid profiles (TC, LDL-C, HDL-C, TG), glucose metabolism (plasma glucose, HbA1c, serum insulin), renal function (UACR, PCR), and blood pressure (SBP, DBP) were assessed. APOE variant frequencies were determined using restriction fragment length polymorphism (RFLP) analysis, validated against Hardy-Weinberg equilibrium (HWE), and statistically correlated with each clinical and biochemical parameter.</p><p><strong>Results: </strong>The DN group had an increased prevalence of hypertension, fatty liver, and dyslipidemia compared to the Control group. Biochemical analyses revealed elevated levels of TC (213.41 mg/dL vs. 189.32 mg/dL), LDL-C (134.46 mg/dL vs. 107.56 mg/dL), and reduced HDL-C (58.13 mg/dL vs. 65.32 mg/dL) in DN cases compared to Controls (all p < 0.0001). The APOE variants distribution showed a significant increase in E2 allele frequency (69.1% vs. 15.3%) and corresponding homozygous genotype (E2/2: 42.2% vs. 5.6%) in DN cohorts.</p><p><strong>Conclusion: </strong>The study found a higher frequency of E2 allele in the DN group compared to Controls, though no statistically significant risk of DN was linked to this allele. The results suggest a potential association for APOE polymorphisms, requiring broader studies to clarify the role of APOE polymorphisms in DN susceptibility.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455406","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":"Facilitation of diabetic wound healing by far upstream element binding protein 1 through augmentation of dermal fibroblast activity.","authors":"Shali Ou, Chao Sima, Zhihe Liu, Xiaojian Li, Bing Chen","doi":"10.1007/s00592-024-02360-8","DOIUrl":"https://doi.org/10.1007/s00592-024-02360-8","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes mellitus (DM) often leads to wound healing complications, partly attributed to the accumulation of advanced glycosylation end products (AGEs) that impair fibroblast function. Far Upstream Element Binding Protein 1 (FUBP1) regulates cell proliferation, migration, and collagen synthesis. However, the impact of FUBP1 on diabetic wound healing remains unknown. This study is designed to explore the function and mechanisms of FUBP1 in diabetic wound healing.</p><p><strong>Methods: </strong>Eighteen Sprague-Dawley rats (weighing 220-240 g) were randomly assigned to three groups (n = 6): a control group (NC) of healthy rats, a model group (DM) of untreated diabetic rats, and a treatment group (DM + FUBP1) of diabetic rats accepting FUBP1 treatment. A 10 mm diameter circular full-thickness skin defect was created on the back of each rat. On days 1 and 7, rats in the treatment group received local injections of 5 µg FUBP1 protein at the wound site, whereas the control group and model group were administered saline. Wound healing was documented on days 0, 3, 7, 10, and 14, with tissue samples from the wound areas collected on day 14 for histological analysis, including H&E staining, Masson's trichrome staining, and immunohistochemistry. Western blot analysis was utilized to assess the expression of GSK-3β, Wnt3a, and β-catenin. In vitro, the effects of various concentrations of AGEs on cell viability and FUBP1 expression were examined in human dermal fibroblasts (HDF). Cells were genetically modified to overexpress FUBP1 using lentiviral vectors and were cultured for 48 h in media with or without AGEs. The impacts on fibroblast proliferation, migration, and Wnt/β-catenin signaling were evaluated using CCK-8, scratch assays, and Western blot analysis.</p><p><strong>Results: </strong>Animal investigation revealed that from day 7 onwards, the wound healing rate of the treatment group was higher than that of the model group but lower than the control group. On day 14, the wound healing rates were as follows: control group (0.97 ± 0.01), model group (0.84 ± 0.03), and treatment group (0.93 ± 0.01). These differences were statistically significant. Histological analysis indicates that FUBP1 promotes granulation tissue formation, re-epithelialization, and collagen deposition in treatment group. Additionally, FUBP1 protein expression decreased in dermal fibroblasts when exposed to AGEs. Overexpression of FUBP1 significantly enhanced fibroblast proliferation and migration, activating the Wnt/β-catenin pathway and mitigating the inhibitory effects of AGEs.</p><p><strong>Conclusions: </strong>Our results suggest that FUBP1 can be a promising therapeutic target for diabetic wound healing, potentially counteracting the detrimental effects of AGEs on dermal fibroblasts through the Wnt/β-catenin pathway.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455407","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":"Glucose metrics and device satisfaction in adults with type 1 diabetes using different treatment modalities: a multicenter, real-world observational study.","authors":"S Di Molfetta, A Rossi, R Gesuita, A Faragalli, A Cutruzzolà, C Irace, N Minuto, D Pitocco, F Cardella, C Arnaldi, A Frongia, E Mozzillo, B Predieri, P Fiorina, F Giorgino, V Cherubini","doi":"10.1007/s00592-024-02381-3","DOIUrl":"https://doi.org/10.1007/s00592-024-02381-3","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate glucose metrics, device satisfaction and diabetes impact in adults with type 1 diabetes using different treatment modalities in a real-life setting in Italy.</p><p><strong>Methods: </strong>This was a multicentre, nationwide, cross-sectional study. Candidates were consecutively evaluated for eligibility during their routine medical visit at the diabetes centre. Researchers collected comprehensive demographic, socioeconomic, anamnestic and clinical data, and administered the Diabetes Impact and Device Satisfaction scale.</p><p><strong>Results: </strong>From 2021 to 2022, a total of 428 subjects, 45% males, with a median age of 32 years (IQR 23-47) were recruited in 11 participating centres from all over Italy. No differences in age, physical activity, and diabetes impact were found for the different treatment modalities. HCL/AHCL and SAP groups reported higher device satisfaction vs. MDI + SMBG and MDI + CGM (p < 0.001). Subjects treated with HCL/AHCL exhibited significantly higher TIR and significantly lower time spent in hypoglycemia level 1, time spent in hyperglycemia, CV and GMI compared to MDI + CGM, and significantly higher TIR and significantly lower time spent in hypoglycemia level 2, time spent in hyperglycemia, and CV compared to SAP. Significant reduction in hypoglycemia level 2 was also found with PLGM compared to SAP. High education attainment was associated with optimal metabolic control.</p><p><strong>Conclusion: </strong>Real-life use of advanced technologies for type 1 diabetes is associated with improved glucose metrics and device satisfaction. Education level also contributes to success of treatment.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455408","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":"Ultra-processed foods and type 2 diabetes mellitus incidence in RaNCD project: a prospective cohort study.","authors":"Parsa Amirian, Mahsa Zarpoosh, Farid Najafi, Ebrahim Shakiba, Bita Anvari, Yahya Pasdar","doi":"10.1007/s00592-024-02385-z","DOIUrl":"https://doi.org/10.1007/s00592-024-02385-z","url":null,"abstract":"<p><strong>Background: </strong>Following rapid population growth and urbanization, global ultra-processed food consumption levels have increased. Additionally, type 2 diabetes mellitus, a non-communicable disease, is affecting one-tenth of the people worldwide. In this study, we aimed to investigate the association between ultra-processed food consumption and the risk of type 2 diabetes mellitus in different scenarios in a prospective cohort study in the western part of Iran.</p><p><strong>Methods: </strong>The RaNCD cohort includes 10,047 participants aged 35 to 65; we included participants susceptible to diabetes at enrolment with follow-up data. We used the widely accepted Nova classification to define ultra-processed foods. A multivariable Cox proportional hazards regression model was used as the main model; furthermore, the Cox model with different adjustments and the logistic regression model were used as sensitive analysis to evaluate the association between ultra-processed foods consumption and type 2 diabetes mellitus.</p><p><strong>Results: </strong>A total of 8827 participants with a mean age of 46.92y, a mean follow-up time of 7.1y, and a mean daily ultra-processed food intake of 87.69 g were included. During the follow-up phases, we included 255 incidences of type 2 diabetes mellitus cases. After adjusting for confounders in the primary model, including age, gender, residence type, socioeconomic status, physical activity, body mass index, and familial history of diabetes despite the elevated hazard ratio of 1.08 (0.75, 1.55) in the fourth quartile compared to the first quartile, the P-value was insignificant (p-value = 0.665); p for trend in the UPF quartiles was also insignificant.</p><p><strong>Conclusion: </strong>Our study has shed light on the association between ultra-processed food consumption and the risk of type 2 diabetes mellitus. However, further investigations are necessary to confirm or refute the UPFs/T2DM association.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379844","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":"Obese have comparable ankle brachial pressure index but higher β-cell function and insulin resistance as compared to normal-weight type 2 diabetes mellitus patients.","authors":"Umashree Yadav, Nilesh Kumar, Kumar Sarvottam","doi":"10.1007/s00592-024-02379-x","DOIUrl":"https://doi.org/10.1007/s00592-024-02379-x","url":null,"abstract":"<p><strong>Objectives: </strong>To compare ankle brachial pressure index (ABPI) in normal weight and obese/overweight type 2 diabetes mellitus patients (T2DM) to see the impact of obesity on the occurrence of peripheral artery disease (PAD) in T2DM patients. Secondly to investigate the relationship between ABPI, insulin resistance, and beta cell function and between adipocytokines and obesity parameters.</p><p><strong>Methods: </strong>A total of 120 BMI-categorized Normal weight (NW) T2DM (n = 53) patients and obese/overweight T2DM (n = 67) patients were recruited in this study. ABPI measurements were performed for the assessment of PAD. The anthropometry and body composition of the patients were measured. Plasma fasting insulin, adiponectin, and IL-6 levels were measured by ELISA kits.</p><p><strong>Results: </strong>ABPI scores were found to be comparable between both groups of patients (p = 0.787). A significant positive correlation was observed between ABPI and beta cell function. Insulin resistance was found to correlate positively while adiponectin negatively with obesity parameters.</p><p><strong>Conclusion: </strong>The ABPI score was comparable between both groups of patients, suggesting that vascular complications may occur at the same rate in NW as well as in obese/overweight diabetic patients. The positive association of insulin resistance as well as the negative association of adiponectin with obesity parameters, are suggestive of the importance of body fat distribution in predicting insulin resistance and the inflammatory status of the cells.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378964","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":"PPAR-γ agonist pioglitazone and the risks of malignancy among type2 diabetes mellitus patients.","authors":"Lai-Chu See, Chao-Yi Wu, Chung-Ying Tsai, Cheng-Chia Lee, Jia-Jin Chen, Chang-Chyi Jenq, Chao-Yu Chen, Yung-Chang Chen, Chieh-Li Yen, Huang-Yu Yang","doi":"10.1007/s00592-024-02378-y","DOIUrl":"https://doi.org/10.1007/s00592-024-02378-y","url":null,"abstract":"<p><strong>Aims: </strong>PPAR-gamma shows promise in inhibiting malignancy cell progression. However, pioglitazone, the sole current PPAR-gamma agonist, was reported to have risks of bladder cancer in previous clinical researches. This study is aimed to assess the influence of pioglitazone on the development of tumors.</p><p><strong>Methods: </strong>By using Taiwan's National Health Insurance Research Database, this nested case-control study identified incident type2 diabetes initiating metformin treatment between 2000 and 2014, and then categorized into two groups based on whether they developed malignancies after enrollment or not. The index date was defined as the date of malignancy diagnosis in the cancer group or a matched date in the non-cancer group. We analyzed the exposure to pioglitazone preceding the index date.</p><p><strong>Results: </strong>47,931 patients in the cancer group and 47,931 patients in the matched non-cancer group were included. The non-cancer group exhibited a significantly higher rate of pioglitazone prescription before the index date for overall malignancies (odds ratios for pioglitazone use were 0.91, 0.92, 0.94, and 0.93 in the first, second, third, and fourth years before the index date). For breast cancer and prostate cancer, pioglitazone was frequently prescribed in the non-cancer group, whereas for pancreatic cancer, pioglitazone use was more common in the cancer group.</p><p><strong>Conclusions: </strong>PPAR-gamma agonists may be associated with reduced risks of overall malignancies, particularly for breast and prostate cancers. However, it may be linked to an elevated risk of pancreatic cancer.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339008","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}