BMJ Open Diabetes Research & Care最新文献

{"title":"Mechanism of TGIF1 on glycolipid metabolism disorders in mice with type 2 diabetes.","authors":"Fuyan Bai, Liping Zheng, Li Tao, Shikai Wang, Yuchen Li, Lijun Hou","doi":"10.1136/bmjdrc-2024-004509","DOIUrl":"10.1136/bmjdrc-2024-004509","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes (T2D) is a chronic condition characterized by high levels of blood glucose resulting from the inefficiency of insulin. This study aims to explore the mechanism of TGFB-induced factor homeobox 1 (TGIF1) in the glycolipid metabolism of mice with T2D.</p><p><strong>Research design and methods: </strong>Mice with T2D were induced by high-fat diet and low-dose streptozotocin (STZ) injection. After TGIF1 was overexpressed in mice with T2D, the weight was monitored. The levels of fasting plasma glucose, fasting serum insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured. Staining assays were performed to observe liver tissue pathology and lipid accumulation. Liver function and oxidative stress were measured. Palmitic acid (PA)-induced primary hepatocytes were used to establish cell models. After TGIF1 was overexpressed in the cells, cell viability, cellular glucose uptake and consumption, and intracellular glycogen content were detected. The expression of TGIF1, miR-106b-5p, and early growth response 2 (EGR2) was detected and their binding relationships were analyzed. Combined experiments were conducted to validate the mechanism.</p><p><strong>Results: </strong>TGIF1 was downregulated in mice with T2D. TGIF1 overexpression reduced hyperglycemia and hyperlipidemia, improved insulin resistance, increased liver glycogen content, and attenuated lipid accumulation and glycolipid metabolism disorders in mice with T2D. TGIF1 was enriched on the miR-106b-5p promoter and promoted miR-106b-5p expression. miR-106b-5p inhibited EGR2 expression. miR-106b-5p inhibition or EGR2 overexpression partially reversed the alleviative effect of TGIF1 overexpression on glycolipid metabolism disorders.</p><p><strong>Conclusion: </strong>TGIF1 reduces glycolipid metabolism disorders in mice with T2D through the miR-106b-5p/EGR2 axis.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of renal complications and death in young and middle-aged Swedes with parental type 1 diabetes: a nation-wide, prospective cohort study.","authors":"Marie Fredriksson, Emma Persson, Anna Möllsten, Torbjörn Lind","doi":"10.1136/bmjdrc-2024-004709","DOIUrl":"10.1136/bmjdrc-2024-004709","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate if individuals with childhood-onset type 1 diabetes having a parent with the same condition (parental diabetes) had worse metabolic control and an increased risk of death and renal failure compared with those with parents without type 1 diabetes (sporadic diabetes).</p><p><strong>Research design and methods: </strong>We conducted a population-based cohort study using data from the Swedish Childhood Diabetes Register, including cases with onset of type 1 diabetes before the age of 15 and recorded between 1977 and 2010. The cohort was linked to national registers to compare mortality, renal failure, and glycated hemoglobin (HBA1c) levels.</p><p><strong>Results: </strong>We identified 16 572 incident cases of childhood-onset type 1 diabetes. Of these, 15 701 had data on parental diabetes status, with 1390 (8.9%) having at least one parent with this condition. HbA1c data were available in 9105 individuals at 20-30 years of age, with the parental group showing higher levels compared with the sporadic diabetes group (8.4% (68 mmol/mol) vs 8.2% (66 mmol/mol), p=0.004). The Cox proportional HR for death in parental diabetes was 1.33 (95% CI 1.00 to 1.75), and the competing risk HR for renal failure was 1.27 (95% CI 1.08 to 1.50). Women in the parental diabetes group had a higher risk of early death (HR 1.79, 95% CI 1.17 to 2.72) compared with the sporadic diabetes group.</p><p><strong>Conclusions: </strong>Individuals with parental diabetes had slightly higher HbA1c and elevated risks of renal failure and death compared with those with sporadic diabetes, especially pronounced in women. Although the exact mechanisms behind these differences are unclear, we suggest that individualized care may benefit individuals with parental type 1 diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome evaluation and cost-effectiveness analysis for an integrated multidisciplinary diabetic limb salvage program: a combined observational and simulation study.","authors":"Lixia Ge, Yan Sun, Elaine Tan, Huiling Liew, Jeremy Hoe, Jaime Lin, Joseph Molina, Gary Ang, Xiaoli Zhu, Kai Qiang Low, Theophilus Yap, Nur Aberleen Syafirah Binte Azmi, Enming Yong, Tiffany Chew, Hui Yan Koo, Chelsea Law, Dexter Yak Seng Chan, Claris Shi, Julia Choo, Wai Han Hoi, Sadhana Chandraskear, Jo Ann Lim, Jemes Siow, Sabariah Binte Kaspon, Subramaniam Tavintharan, Daniel Chew, John Abisheganaden, Zhiwen Joseph Lo","doi":"10.1136/bmjdrc-2024-004688","DOIUrl":"10.1136/bmjdrc-2024-004688","url":null,"abstract":"<p><strong>Introduction: </strong>To compare the clinical outcomes and healthcare utilization of patients enrolled in the multidisciplinary Diabetic Foot in Primary and Tertiary (DEFINITE) Care program with a matched historical cohort and estimate the program's long-term cost-effectiveness using simulation.</p><p><strong>Research design and methods: </strong>This study consisted of two components: a 1-year observational outcome evaluation and a long-term simulation-based cost-effectiveness analysis (CEA). We conducted an observational study to analyze 2798 patients with diabetic foot ulcers (DFUs) enrolled in the program between June 2020 and June 2021 (DEFINITE Care group) and 5462 patients with DFUs from June 2016 to December 2017 as historical controls. One-to-one propensity score matching (PSM) with replacement was conducted to estimate the treatment effect of the program on clinical outcomes and healthcare utilization over 1 year. For the simulation component, a long-term CEA was performed using a Markov state transition model on a simulated cohort of 10 000 patients with DFUs over a 20-year period, assessing transitions between health states, including minor and major amputations and death. The incremental cost-effectiveness ratio (ICER) was calculated for the DEFINITE Care program relative to routine care.</p><p><strong>Results: </strong>The estimation of average treatment effects based on propensity scores showed that the DEFINITE Care group exhibited a 9% lower mortality, 5% higher lower extremity amputation (LEA)-free survival, yet a 5% higher minor LEA rate compared with the matched historical controls. Additionally, they experienced fewer inpatient admissions (0.98 fewer episodes) and shorter hospital stays (5.5 fewer days) within 1 year (p-value <0.001). The ICER was US$22 707 (SE: 430) per quality-adjusted life year gained, indicating long-term cost-effectiveness. Probabilistic sensitivity analysis supported these findings.</p><p><strong>Conclusions: </strong>The integrated multidisciplinary DEFINITE Care program improved LEA-free survival, reduced inpatient admissions and length of stay within 1 year and demonstrated long-term cost-effectiveness managing DFUs.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological markers of exocrine pancreatic function are differentially informative for distinguishing individuals progressing to type 1 diabetes.","authors":"MacKenzie D Williams, Catherine Ramsey Grace, Amanda L Posgai, Kieran M McGrail, Maigan A Brusko, Michael J Haller, Laura Jacobsen, Desmond Schatz, Todd M Brusko, Mark Atkinson, Rhonda Bacher, Clive H Wasserfall","doi":"10.1136/bmjdrc-2024-004655","DOIUrl":"10.1136/bmjdrc-2024-004655","url":null,"abstract":"<p><strong>Introduction: </strong>Altered serum levels of growth hormones, adipokines, and exocrine pancreas enzymes have been individually linked with type 1 diabetes (T1D). We collectively evaluated seven such biomarkers, combined with islet autoantibodies (AAb) and genetic risk score (GRS2), for their utility in predicting AAb/T1D status.</p><p><strong>Research design and methods: </strong>Cross-sectional serum samples (n=154 T1D, n=56 1AAb+, n=77 ≥2AAb+, n=256 AAb-) were assessed for IGF1, IGF2, adiponectin, leptin, amylase, lipase, and trypsinogen (n=543, age range 2.7-30.0 years) using random forest modeling.</p><p><strong>Results: </strong>GRS2, age, lipase, trypsinogen, and AAb against ZnT8, GAD65, and insulin were the most informative markers. Notably, these variables were differentially informative according to AAb/T1D status. Higher GRS2 (p<0.001) and lower lipase levels (p=0.002) favored ≥2AAb+ versus AAb- classification. AAb against ZnT8 (p<0.01), GAD65 (p=0.021), or insulin (p=0.01) each independently favored ≥2AAb+ versus 1AAb+ classification. Reduced trypsinogen (p<0.001) and increased lipase levels (p<0.001) favored recent-onset T1D versus ≥2AAb+ classification.</p><p><strong>Conclusions: </strong>Among the serological markers tested, lipase and trypsinogen levels were the most informative for differentiating among clinical groups, with the utility of each enzyme varying according to GRS2 and AAb/T1D status. These data support exocrine pancreas enzymes as candidates for longitudinal follow-up.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions.","authors":"Tim Snel, Tanja Krone, Regina J M Kamstra, Hannah M Eggink, Hanno Pijl, Albert A de Graaf, Iris M de Hoogh","doi":"10.1136/bmjdrc-2024-004506","DOIUrl":"10.1136/bmjdrc-2024-004506","url":null,"abstract":"<p><strong>Introduction: </strong>Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.</p><p><strong>Research design and methods: </strong>38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity, sleep and dietary intake, while continuously monitoring interstitial glucose concentrations for 11 periods of four consecutive days each. A linear mixed-effects model was used to quantify the effect of sleep, stress, current glucose, carbohydrate intake and exercise on glucose levels 2 hours later.</p><p><strong>Results: </strong>The final model identified carbohydrate intake (grams) in the past 5 min as well as in the past 30 min, sleep duration during the previous night (hours) and physical activity (metabolic equivalents) over the past 12 hours as significant fixed effects that influenced glucose concentrations 2 hours later. In addition, carbohydrate intake in the past 5 and past 30 min, and physical activity in the past and future 30 min were included as random or individualized effects. Although carbohydrate intake led to increased glucose concentrations in 2 hours in all individuals, the magnitude of this effect varied between individuals. The physical activity on glucose concentrations in 2 hours varied among individuals as well, in terms of magnitude and in terms of direction (showing either increase or decline).</p><p><strong>Conclusions: </strong>Carbohydrate intake, sleep and physical activity at specific points in time have both fixed as well as individualized effects on glucose concentrations 2 hours later in individuals with type 2 diabetes. Interindividual differences in glycemic response to lifestyle components call for personalized advice in the management of type 2 diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial associations between measures of public transportation and diabetic foot ulcer outcomes in the state of Georgia: 2016-2019.","authors":"Lauren T Vanasse, Howard H Chang, Rohan D'Souza, Mohammed K Ali, Lance Waller, Marcos C Schechter","doi":"10.1136/bmjdrc-2024-004461","DOIUrl":"10.1136/bmjdrc-2024-004461","url":null,"abstract":"<p><strong>Introduction: </strong>There are limited data regarding the associations between public transportation reliance, availability, and diabetic foot ulcer (DFU)-related amputations.</p><p><strong>Research design and methods: </strong>We used visit-level data from the Georgia 2016-2019 Healthcare Cost and Utilization Project database and obtained transportation variables from open sources. Using Bayesian spatial-temporal models, we assessed the associations between transportation and DFU-related amputations within each quartile of poverty status indicators at the ZIP code tabulation area (ZCTA) level. We used the proportion of adults who use public transportation to commute, distance to nearest transit stop, and per capita expense on public transportation as proxies for public transportation reliance, availability, and both, respectively.</p><p><strong>Results: </strong>Of 114 606 DFUs, 21 388 (19%) were associated with a major or minor amputation. Among ZCTAs at the highest income quartile, reduced amputation risk was associated with the proportion of adults who use public transportation to commute to work (relative risk (RR)=0.29, 95% CI 0.09 to 0.97 per IQR increase of 1.13%) and per capita expense on public transportation (RR=0.78, 95% CI 0.63 to 0.78 per IQR increase of 6 cents). In metropolitan Georgia, a 1 IQR (261 m) increase in distance to the nearest transit stop was associated with lower amputation risk among ZCTAs at the lowest income quartile (RR=0.47, 95% CI 0.26 to 0.85).</p><p><strong>Conclusion: </strong>In Georgia, public transportation reliance and availability are protective against DFU-related amputations in high-income but not among low-income ZCTAs. Reducing disparities in DFU-related amputations requires interventions to mitigate transportation barriers to care.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin secretion, sensitivity, and clearance in normoglycemic Black and White adults with parental type 2 diabetes: association with incident dysglycemia.","authors":"Chimaroke Edeoga, Peace Asuzu, Jim Wan, Samuel Dagogo-Jack","doi":"10.1136/bmjdrc-2024-004545","DOIUrl":"10.1136/bmjdrc-2024-004545","url":null,"abstract":"<p><strong>Introduction: </strong>Ethnic disparities in the prevalence and pathophysiology of type 2 diabetes are well documented, but prospective data on insulin dynamics vis-à-vis pre-diabetes/early dysglycemia risk in diverse populations are scant.</p><p><strong>Research design and methods: </strong>We analyzed insulin secretion, sensitivity, and clearance among participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study. The POP-ABC study followed initially normoglycemic offspring of parents with type 2 diabetes for 5.5 years, the primary outcome being incident dysglycemia. Assessments included anthropometry, oral glucose tolerance test, insulin sensitivity (hyperinsulinemic euglycemic clamp, HEC), insulin secretion (intravenous glucose tolerance test, IVGT), and disposition index (DI). Insulin clearance was derived as the molar ratio of plasma C peptide to insulin and by calculating the metabolic clearance rate during HEC.</p><p><strong>Results: </strong>POP-ABC participants who completed IVGT and HEC at baseline (145 African American, 123 European American; 72% women; mean age 44.6±10.1 years) were included in the present analysis. The baseline fasting plasma glucose was 91.9±6.91 mg/dL (5.11±0.38 mmol/L) and 2-hour plasma glucose was 123±25.1 mg/dL (6.83±1.83 mmol/L). African American offspring of parents with type 2 diabetes had higher insulin secretion and DI, and lower insulin sensitivity and clearance, than their European American counterparts. During 5.5 years of follow-up, 91 of 268 participants developed incident dysglycemia and 177 maintained normoglycemia. In Cox proportional hazards models, insulin secretion (HR 0.997 (95% CI 0.996 to 0.999), p=0.005), insulin sensitivity (HR 0.948 (95% CI 0.913 to 0.984), p=0.005), DI (HR 0.945 (95% CI 0.909 to 0.983), p=0.005) and basal insulin clearance (HR 1.030 (95% CI 1.005 to 1.056), p=0.018) significantly predicted incident dysglycemia.</p><p><strong>Conclusions: </strong>Insulin sensitivity, secretion, and clearance differ significantly in normoglycemic African American versus European American offspring of parents with type 2 diabetes and are associated with the risk of incident dysglycemia.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six months of hybrid closed-loop therapy improves diabetes-specific positive well-being, and reduces diabetes distress and fear of hypoglycemia: secondary analysis of a randomized controlled trial.","authors":"Jennifer A Halliday, Sienna Russell-Green, Benjamin Lam, Steven Trawley, Sybil A McAuley, Leon A Bach, Morton G Burt, Neale D Cohen, Peter G Colman, Elizabeth A Davis, Deborah Jane Holmes-Walker, Alicia J Jenkins, Joey Kaye, Anthony C Keech, Melissa H Lee, Roland W McCallum, Barbora Paldus, Stephen N Stranks, Vijaya Sundararajan, Glenn Ward, Timothy W Jones, David O'Neal, Jane Speight, Christel Hendrieckx","doi":"10.1136/bmjdrc-2024-004428","DOIUrl":"10.1136/bmjdrc-2024-004428","url":null,"abstract":"<p><strong>Introduction: </strong>This analysis aimed to investigate diabetes-specific psychological outcomes among adults with type 1 diabetes (T1D) using hybrid closed-loop (HCL) versus standard therapy.</p><p><strong>Research design and methods: </strong>In this multicenter, open-label, randomized, controlled, parallel-group clinical trial, adults with T1D were allocated to 26 weeks of HCL (MiniMed™ 670G) or standard therapy (insulin pump or multiple daily injections without real-time continuous glucose monitoring). Psychological outcomes (awareness and fear of hypoglycemia; and diabetes-specific positive well-being, diabetes distress, diabetes treatment satisfaction, and diabetes-specific quality of life (QoL)) were measured at enrollment, mid-trial and end-trial. Linear mixed models were conducted, using restricted maximum likelihood estimation, unadjusted and adjusted (for covariates: age, sex, diabetes duration, glycated hemoglobin, recent severe hypoglycemia, pre-trial insulin delivery modality, enrollment and mid-study scores).</p><p><strong>Results: </strong>120 participants (mean age 44±12 years) were randomized to intervention (n=61) or standard therapy (n=59). At 13 weeks, the HCL group had better diabetes-specific positive well-being than the standard therapy group (unadjusted: Δ=1.0, p=0.025; adjusted: Δ=1.1, p=0.01), which was maintained at 26 weeks (unadjusted: Δ=0.9, p=0.042; adjusted: Δ=1.0, p=0.023). At 26 weeks, the HCL group also had less diabetes distress (adjusted: Δ=-6.4, p=0.039), fear of hypoglycemia (\"maintain high\": adjusted: Δ=-0.8, p=0.034; and \"worry\": adjusted: Δ=-1.8, p=0.048), and perceived \"unacceptably high glucose levels\" (unadjusted: Δ=-1.1, p<0.001; adjusted: Δ=-1.1, p<0.001). HCL did not improve diabetes treatment satisfaction, diabetes-specific QoL, hypoglycemia awareness, or perceived frequency of unacceptably low glucose levels.</p><p><strong>Conclusions: </strong>These findings imply that HCL offers important psychological benefits. In particular, improvement in diabetes-specific positive well-being was observed 13 weeks after HCL initiation and maintained at 26 weeks. Reduction in the perceived frequency of hyperglycemia was also apparent by 26 weeks. Adjusted analyses showed significant reductions in diabetes distress and fear of hypoglycemia at 26 weeks, suggesting these benefits were apparent for people with particular characteristics.</p><p><strong>Trial registration number: </strong>Australian New Zealand Clinical Trials Registry: ACTRN12617000520336.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of urinary trace elements in diabetic kidney disease: a cross-sectional analysis.","authors":"Tianrui Gao, Jia Lv, Lizhen Lu, Lijuan Guo, Weitian Tang, Fengmin Shao, Shiwei Zhu, Yuchen Zhang, Ruiqi Jia, Jing Zhou, Chang Gao, Yue Gu","doi":"10.1136/bmjdrc-2024-004454","DOIUrl":"10.1136/bmjdrc-2024-004454","url":null,"abstract":"<p><strong>Introduction: </strong>The balance of trace elements plays an important role in diabetic kidney disease (DKD) patients. However, studies on the differences in urinary trace elements across different DKD stages are scarce. This study aimed to explore the associations between nine essential trace elements and DKD.</p><p><strong>Research design and methods: </strong>This cross-sectional analysis included 830 diabetic patients. Participants were classified into non-DKD (NDKD) and DKD, the latter was further grouped into mid and end DKD based on estimated glomerular filtration rate (eGFR), and the case and control were matched based on age and sex. The concentration of urinary trace elements was measured with inductively coupled plasma mass spectrometry.</p><p><strong>Results: </strong>Urinary concentrations of copper (Cu) and manganese (Mn) in DKD patients were significantly higher than that of NDKD patients, whereas that of iron (Fe), cobalt, selenium, and nickel (Ni) of DKD were lower. Positive correlations between urinary Mn/Cu and the risk of mid-stage and end-stage DKD were revealed by conditional logistic regression, while Fe and Ni were negatively associated with the risk of DKD. In mixed effect analyses, no significant trend was found for joint trace element exposure and risk of mid DKD, while negative associations between combined effects of trace elements and the risk of end DKD were observed.</p><p><strong>Conclusions: </strong>This study revealed different associations between trace elements and the risk of mid and end DKD using both single and mixture effect modeling. The results suggested that the urinary trace element profile might be associated with the progression of DKD, which provides important insights for understanding the pathogenesis of DKD and developing individualized nutritive management strategies.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-cell, but not autonomic nervous system, function is related to MAFLD in early stages of glucose intolerance.","authors":"Rumyana Dimova, Nevena Chakarova, Mina Serdarova, Cvetelina Marinova, Dimitar Popov, Stefano Del Prato, Tsvetalina Tankova","doi":"10.1136/bmjdrc-2024-004542","DOIUrl":"10.1136/bmjdrc-2024-004542","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have suggested an association between beta-cell and autonomic function and metabolic-associated fatty liver disease (MAFLD). We explored the association between controlled attenuated parameter (CAP) and insulin secretion and action, as well as sympathetic and parasympathetic activity in normal (NGT) and impaired (IGT) glucose tolerance.</p><p><strong>Research design and methods: </strong>Twenty-five NGT (age 44.8±9.6 years; body mass index (BMI) 32.3±6.9 kg/m²) and 27 IGT (47.6±11.8 years; 31.0±6.5 kg/m²) subjects underwent a 75 g oral glucose tolerance test (OGTT) and a mixed meal tolerance test (MMTT) for assessment of glucose and insulin secretion. Parameters of beta-cell function and insulin sensitivity were calculated. Body composition was assessed by bioimpedance analysis (Inbody720). Autonomic function was assessed by ANX V.3.0 monitoring system. CAP was determined by Fibroscan (Echosense) and presence of MAFLD was defined as CAP >233 dB/m.</p><p><strong>Results: </strong>A CAP >233 dB/m was found in 72% of subjects with NGT and 67% of subjects with IGT. Subjects with MAFLD, irrespective of glucose tolerance, had higher BMI and waist circumference, lower insulin secretion and action, and lower parasympathetic activity. On a matrix analysis, after adjustment for age and BMI, CAP was positively related to systolic blood pressure (SBP); insulin action was negatively related to parasympathetic activity. Regression analysis showed that AUC-insulin MMTT remained independently related to MAFLD: OR 24.4 (95% CI 2.17 to 274.77; p=0.010). A \"cut-off\" value of 15,620 uIU/mL^-1*180 min^-1 provided a 75% sensitivity and 75% specificity for CAP >233 dB/m.</p><p><strong>Conclusions: </strong>Our results do not support a role for parasympathetic activity in MAFLD. Rather, they show that stimulated hyperinsulinemia may be associated with greater risk of MAFLD irrespective of glucose tolerance in a high-risk population without diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"12 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}