Acta Diabetologica最新文献

{"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":"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":"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}

{"title":"Correction: Predictive association between the γ-glutamyltransferase-high-density lipoprotein cholesterol ratio and all-cause mortality in the Korean genome and epidemiology study: health examinees cohort.","authors":"Hee Youn Han, Dong Hyuk Jung, Seok-Jae Heo, Yong Jae Lee","doi":"10.1007/s00592-025-02511-5","DOIUrl":"10.1007/s00592-025-02511-5","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957337","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 diabetes phenotypes with hypertension and cardiovascular diseases, using single-sample confirmatory testing: a national study.","authors":"Danial Molavizadeh, Samaneh Asgari, Borna Ali Assarian, Fereidoun Azizi, Farzad Hadaegh","doi":"10.1007/s00592-025-02484-5","DOIUrl":"https://doi.org/10.1007/s00592-025-02484-5","url":null,"abstract":"<p><strong>Aim: </strong>To investigate, for the first time, the association between undiagnosed diabetes-using a single-sample confirmatory definition-and prevalent hypertension and cardiovascular diseases (CVD) in an Iranian national population. A few studies on this topic have been limited to Western populations.</p><p><strong>Methods: </strong>The study included 16328 adults aged ≥ 30 years. Diabetes phenotypes were classified as: 1-no diabetes: fasting plasma glucose (FPG) < 7 mmol/L (126 mg/dL) and glycated hemoglobin (HbA1c) < 6.5% (48 mmol/mol), as reference; 2-unconfirmed undiagnosed diabetes: having elevated levels of either FPG or HbA1c; 3-confirmed undiagnosed diabetes: having elevated levels of both tests; 4-known diabetes: self-reported history of glucose-lowering medications. Hypertension was defined using American Heart Association criteria. Self-reported history of CVD is defined as prevalent CVD. Multivariable logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (CI) of the association between diabetes phenotypes with hypertension and CVD.</p><p><strong>Results: </strong>Prevalence of unconfirmed undiagnosed-, confirmed undiagnosed-, and known -diabetes was calculated as 2.70, 3.10, and 5.64%, respectively. Unconfirmed undiagnosed-, confirmed undiagnosed-, and known -diabetes were associated with hypertension with corresponding OR were, 1.30, 1.37, and 1.62; the related values for CVD were 1.80, 1.61, and 2.38; and for the coexistence of CVD and hypertension were 1.86, 1.79, and 2.80, respectively (all P _values < 0.05). Furthermore, isolated HbA1c elevation was significantly associated with prevalent CVD [2.04 (1.20-3.45)], and coexistence of hypertension and CVD [1.89 (1.00-3.55)].</p><p><strong>Conclusions: </strong>Both unconfirmed- and confirmed- undiagnosed -diabetes were significantly associated with hypertension and CVD, the issue that was mainly attributable to high HbA1c.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954828","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":"Psychological well-being over time among adults with diabetes: a cross-sectional study","authors":"Dennis Wesselbaum","doi":"10.1007/s00592-025-02461-y","DOIUrl":"10.1007/s00592-025-02461-y","url":null,"abstract":"<div><p>This study examines the relationship between diabetes duration and well-being using data from 115,039 U.S. adults (2005–2017). Logistic regression shows a significant negative correlation, with each year of diabetes reducing well-being by 0.05%. This effect is stronger in men (3.7%) than women (1.9%), highlighting the need for psychological management in diabetes care.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"62 5","pages":"773 - 776"},"PeriodicalIF":3.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-025-02461-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: 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, Bin Chen","doi":"10.1007/s00592-025-02510-6","DOIUrl":"https://doi.org/10.1007/s00592-025-02510-6","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960464","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}