Cardiovascular Diabetology最新文献

{"title":"Meal-induced changes in cardiometabolic peptides in the context of acute cardiovascular diseases and glucose metabolism.","authors":"G Lishkova, O Schweizerhof, J Großmann, K von Rohr, U Landmesser, F Edelmann, K U Eckardt, M Endres, J E Weber, U Grittner, T Pischon, J Schulz-Menger, D N Müller, J Spranger, L Li, K Mai","doi":"10.1186/s12933-026-03424-5","DOIUrl":"https://doi.org/10.1186/s12933-026-03424-5","url":null,"abstract":"<p><strong>Background: </strong>Natriuretic peptides (NPs) and copeptin are established cardiovascular biomarkers which can partly affect human metabolism. However, impact of human metabolism on their postprandial regulation in high-risk patients remains insufficiently understood. We aimed to characterize meal-induced changes in MR-proANP, NT-proBNP, and copeptin and to assess how these dynamics relate to acute cardiovascular (CV) events, type 2 diabetes (T2D) and insulin resistance (IR).</p><p><strong>Methods: </strong>Within the BeLOVE cohort, a subset of 373 participants with acute coronary syndrome, stroke or very high chronic CV risk underwent standardized study-specific mixed-meal testing approximately 3 months after the acute event or 1 month after enrollment for the chronic high-risk group. Fasting and 120-min postprandial concentrations of MR-proANP, NT-proBNP, copeptin, insulin and glucose were assessed. Structural equation models were used to evaluate direct and indirect associations of acute CV events, T2D, and IR (HOMA-IR) with fasting levels and postprandial changes, adjusted for age, sex and BMI.</p><p><strong>Results: </strong>MR-proANP showed the most pronounced meal-induced suppression. NT-proBNP demonstrated only minor and inconsistent postprandial changes. For all peptides, fasting concentrations were the main determinant of their postprandial changes. A recent acute CV event was associated with higher fasting NP levels (MR-proANP: standardized β = 0.22 [0.09; 0.34]; NT-proBNP: β = 0.28 [0.15; 0.41]), but not substantially with their postprandial changes after accounting for their baseline levels. T2D showed no consistent association with fasting or postprandial NP responses. In contrast, higher HOMA-IR was associated with lower fasting MR-proANP (β=-0.19 [-0.30; -0.07]) and a stronger postprandial decline (β=-0.18 [-0.33; -0.04]). Similarly, higher HOMA-IR was linked to lower fasting NT-proBNP (β=-0.15 [-0.28; -0.03]) but showed no clear association to its postprandial change. Copeptin dynamics were largely independent of acute CV disease and metabolic status.</p><p><strong>Conclusions: </strong>In patients after a recent ACS or stroke, postprandial MR-proANP dynamics are linked to insulin resistance, rather than diabetes status. In contrast, the limited postprandial variability of NT-proBNP and the largely fasting-related changes of copeptin make these markers less suited for capturing short-term metabolic responses. Together, these findings highlight the value of postprandial phenotyping for understanding cardiometabolic regulation and support further evaluation of MR-proANP as a potential biomarker in future prospective studies with cardiovascular outcomes across subjects with and without acute CV event.</p><p><strong>Trial registration: </strong>The study protocol was approved by the institutional ethics committee (EA1/066/17) and registered in the German Clinical Trials Register (DRKS00016852).</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antecedent, landmark, and two-visit cumulative triglyceride-glucose index and non-traditional lipid measures in relation to incident cardiovascular disease in adults with cardiovascular-kidney-metabolic syndrome (CKM) stages 0-3: a nationwide prospective cohort study.","authors":"Aomen Lu, Qian Xu","doi":"10.1186/s12933-026-03386-8","DOIUrl":"10.1186/s12933-026-03386-8","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index and non-traditional lipid parameters (nTLPs) are inexpensive markers of overlapping metabolic and lipoprotein burden. Their CVD-specific longitudinal associations and incremental prognostic contribution in adults with cardiovascular-kidney-metabolic (CKM) stages 0-3 remain uncertain.</p><p><strong>Methods: </strong>We conducted a 2015 landmark analysis in the China Health and Retirement Longitudinal Study. TyG was evaluated jointly with the atherogenic index of plasma (AIP), non-HDL cholesterol (non-HDL-C), Castelli risk indices I and II (CRI-I and CRI-II), and the lipoprotein combine index (LCI). We examined antecedent 2011 values, 2015 landmark values, and a two-visit time-weighted cumulative measure from 2011 to 2015. The primary analysis family comprised five cumulative dual-high versus dual-low comparisons for incident CVD. Cause-specific Cox and Fine-Gray models were fitted, with Benjamini-Hochberg correction. Secondary analyses addressed heart disease, stroke, dose response, effect modification, robustness, and censoring-aware five-year prediction.</p><p><strong>Results: </strong>Among 4,420 participants with CKM stages 0-3 and valid post-landmark CVD follow-up, 827 developed CVD; endpoint-specific analyses included 4,411 participants with 571 heart-disease events and 4414 with 328 stroke events. For cumulative dual-high exposure, adjusted Cox HRs for CVD ranged from 1.29 (95% CI 1.09-1.52) to 1.45 (1.20-1.74), and Fine-Gray SHRs ranged from 1.28 (1.09-1.50) to 1.43 (1.19-1.72); all primary FDR q values were < 0.003. Secondary stroke estimates were generally larger. The covariate-only C-index was 0.616 and five-year IPCW AUC was 0.634 (0.608-0.659). The best expanded model, TyG plus CRI-II, yielded a C-index of 0.628 and AUC of 0.665 (0.640-0.690), corresponding to changes of 0.012 and 0.031, respectively.</p><p><strong>Conclusions: </strong>Higher two-visit cumulative TyG-nTLP burden was associated with incident CVD after accounting for competing death. However, incremental discrimination was small, and shared laboratory components limit claims of biological independence or synergy. These indices may provide additional information for epidemiologic risk characterization, while their incremental clinical predictive value appears limited and warrants further validation.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild autonomous cortisol secretion (MACS) is associated with increased mortality in patients with adrenal adenomas only in the presence of type 2 diabetes: a retrospective cohort study.","authors":"Luise Bellach, Sarah Hofer-Zeni, Dorota Sluková, Dorothea Kalender, Clemens Zimmermann, Naima Michler, Liliana Gard, Sabina Baumgartner-Parzer, Rodrig Marculescu, Greisa Vila, Peter Wolf, Alexandra Kautzky-Willer, Michael Leutner","doi":"10.1186/s12933-026-03360-4","DOIUrl":"10.1186/s12933-026-03360-4","url":null,"abstract":"<p><strong>Background: </strong>Hypercortisolism and type 2 diabetes mellitus (T2D) independently contribute to an increased burden of cardiometabolic morbidity and mortality. However, data on the interaction of hypercortisolism and T2D are scarce-thus, we aimed to assess the cortisol-associated morbidity and mortality in the context of T2D and adrenal mild autonomous cortisol secretion (MACS).</p><p><strong>Methods: </strong>This is a retrospective cohort study including 668 patients with adrenal adenomas, who were visiting the endocrine outpatient clinic at the Vienna General Hospital between 01.01.2000 to 31.12.2022. Of those, 151 were diagnosed with T2D at the time of their 1 mg dexamethasone suppression test (DST), other diabetes types were excluded. MACS was defined as a post 1 mg DST cortisol of > 1.8 µg/dL in the absence of Cushing's stigmata and after biochemical exclusion of ACTH-dependency. The database was linked to the governmental death registry and patients alive after 01.12.2024 were censored. Kaplan Meier curves and cox proportional hazard models were analyzed via RStudio.</p><p><strong>Results: </strong>Patients with T2D had a higher post 1 mg DST cortisol level and were more often diagnosed with hypertension, dyslipidemia and cardiovascular disease (CVD) compared to those without T2D. Compared to patients with non-functioning adrenal adenomas (NFAA) without T2D, MACS was strongly linked to increased mortality only in T2D (HR 2.51 [CI95% 1.41-4.48], p < 0.01) but not in those without T2D, even after adjustment for age, sex, BMI, smoking, hypertension, dyslipidemia and CVD at baseline. The T2D cohort with MACS had higher HbA1c and a 3-fold elevation in CVD prevalence compared to those without hypercortisolism. They did not differ according to age, sex or other cardiometabolic risk parameters (dyslipidemia, hypertension, BMI).</p><p><strong>Conclusions: </strong>Among patients with adrenal adenomas, MACS is related to increased CVD prevalence and is associated with mortality in patients with T2D. These findings highlight the need for confirmatory prospective studies incorporating larger sample sizes to further assess the importance of earlier identification and treatment of MACS in patients with T2D.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical cardiac involvement during diabetic ketoacidosis at type 1 diabetes onset in youth: biomarker elevation, altered diastolic filling, and reduced global longitudinal strain: a prospective cohort study.","authors":"Jantje Weiskorn, Sophia Hotze, Alexander Freiherr von Gise, Marlene Busse, Olga Kordonouri","doi":"10.1186/s12933-026-03377-9","DOIUrl":"10.1186/s12933-026-03377-9","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) may be associated with cardiac involvement. Increased cardiac biomarkers and abnormalities in cardiac function were mainly reported in adults with type 1 diabetes (T1D). Pediatric data are lacking. This study therefore assessed cardiac biomarker alterations and echocardiographic changes, including strain analysis, in children with diabetic ketoacidosis at the onset of type 1 diabetes.</p><p><strong>Research design and methods: </strong>In this prospective, observational, cohort study, patients < 18 years with T1D onset were consecutively enrolled at a single center from January 2024 to March 2025 and classified as DKA or non-DKA. Cardiac biomarkers (troponin I, NT-proBNP) were measured before and 24 h after therapy initiation in all patients, and additionally at 48 and 72 h in those with DKA. Echocardiography, including speckle-tracking strain analysis, was performed after 24 h in both groups and after 6 days in the DKA group.</p><p><strong>Results: </strong>Eighty-one patients were included (60% male; median age 9.8 years [5.2-14.1]); 43 (53.1%) had DKA. Troponin I and NT-proBNP were significantly higher in the DKA group at baseline (troponin I: 5.7 [4.1-10.8] vs. 3.9 [3.9-4.6] ng/L, p < 0.001; NT-proBNP: 87.0 [41.0-231.0] vs. 40.0 [16.8-69.0] ng/L, p = 0.002) and remained elevated at 24 h. Echocardiography showed lower E/A ratios, higher peak a'-wave velocities, and a significantly reduced left ventricular global longitudinal strain (GLS) in the DKA group (-  19.2 [-  20.4 to - 18.1] vs. - 21.5 [-  23.0 to - 18.9], p = 0.029), with most values within the normal range. In multivariable analysis, lower bicarbonate (indicating greater DKA severity) was independently associated with higher troponin I and NT-proBNP, and younger age with higher NT-proBNP.</p><p><strong>Conclusions: </strong>In children with T1D, DKA at onset is associated with subclinical cardiac involvement, reflected by elevated cardiac biomarkers, altered diastolic filling parameters, and reduced left ventricular GLS. These findings indicate myocardial stress during the acute phase of DKA; whether they carry prognostic significance requires studies with longer-term follow-up.</p><p><strong>Trial registration: </strong>The study was registered in the German Clinical Trial Register (DRKS00032719).</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic and genetic factors modifying the association between diet quality and incident type 2 diabetes: the EPIC-Potsdam cohort.","authors":"Christine El-Khoury, Fabian Eichelmann, Franziska Jannasch, Matthias B Schulze","doi":"10.1186/s12933-026-03356-0","DOIUrl":"10.1186/s12933-026-03356-0","url":null,"abstract":"<p><strong>Background: </strong>Benefits of healthy diets for type 2 diabetes (T2D) prevention are established. It remains unclear whether such recommendations should be tailored to specific subgroups according to their susceptibility to the disease. This study aimed to assess whether the association of diet quality with T2D risk differs across subgroups with different genetic or epigenetic susceptibility.</p><p><strong>Methods: </strong>We used data from a case-cohort within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (random subsample with genetic data of 2204 participants, 750 verified incident T2D cases; random subsample with epigenetic data of 1065 participants, 676 verified incident T2D cases). The Alternative Healthy Eating Index (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), Dietary Inflammatory Index (DII) and the Mediterranean Diet Pyramid score (MedPyr) were used to assess diet quality. A blood DNA methylation risk score (MRS) was used to reflect epigenetic risk. Genetic risk was characterized using global polygenic risk scores (PRS) and pathway-specific polygenic risk scores (pPRS). Cox proportional hazards models were used to assess the modification of the diet quality-diabetes risk association by the risk scores.</p><p><strong>Results: </strong>Higher adherence to the AHEI-2010 was associated with a lower risk of T2D, while higher MRS, PRS and pPRS predictably indicated higher risk in this population. We detected significant modification of the diet quality-T2D association by the MRS for AHEI-2010 (p = 0.008) and MedPyr (p < 0.0001) and DII (p = 0.010) but only the AHEI-2010 × MRS interaction was robust across all sensitivity analyses. However, we did not find evidence of interaction between diet quality and genetic risk.</p><p><strong>Conclusions: </strong>The associations of healthy diets with T2D could depend on the diabetes risk captured by blood DNA methylation profiles, but they do not seem to depend on the genetic predisposition for T2D. Confirmation of the effect modification by the MRS in independent populations is further required before considering clinical application.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Note to: Dipeptidyl peptidase-4 (DPP-4) inhibition with linagliptin reduces western diet-induced myocardial TRAF3IP2 expression, inflammation and fibrosis in female mice.","authors":"Annayya R Aroor, Javad Habibi, Hemanth Kumar Kandikattu, Mona Garro-Kacher, Brady Barron, Dongqing Chen, Melvin R Hayden, Adam Whaley-Connell, Shawn B Bender, Thomas Klein, Jaume Padilla, James R Sowers, Bysani Chandrasekar, Vincent G DeMarco","doi":"10.1186/s12933-026-03370-2","DOIUrl":"10.1186/s12933-026-03370-2","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative plasma proteomic network analysis identifies physical activity-associated protein modules potentially mediating type 2 diabetes risk.","authors":"Zhenqian Wang, Chen-Yang Su, Jiawen Lu, Masashi Hasebe, Alejandro Mejia-Garcia, Hsuan Megan Tsao, Jingyi Hu, Tianyuan Lu, Sirui Zhou","doi":"10.1186/s12933-026-03363-1","DOIUrl":"10.1186/s12933-026-03363-1","url":null,"abstract":"<p><strong>Background: </strong>Moderate-to-vigorous physical activity (MVPA) lowers the risk of type 2 diabetes (T2D). Identifying protein modules that mediate this association may help dissect these biological underpinnings, but they remain incompletely characterized.</p><p><strong>Methods: </strong>We studied 28,842 diabetes-free UK Biobank participants with baseline plasma proteomics. Guideline-adherent MVPA was defined as ≥ 600 metabolic equivalent of task-minutes per week. We first evaluated associations of MVPA with incident T2D and 2910 plasma proteins, followed by mediation analyses of individual proteins. We then identified protein co-expression modules using multiscale embedded gene co-expression network analysis (MEGENA), tested module-level associations with MVPA, and mediation of incident T2D. Protein modules were further evaluated using module-level Mendelian randomization, whole-genome-sequencing genome-wide association studies, human pancreatic islet single-cell RNA sequencing, leave-one-out sensitivity analyses, and pathway enrichment analyses.</p><p><strong>Results: </strong>Over a median 13.60 years (IQR: [12.82, 14.35]), 1225 participants developed incident T2D. Guideline-adherent MVPA was associated with lower T2D risk and with 650 circulating proteins, of which 451 were Bonferroni-significant mediators. MEGENA analysis identified 171 robust modules, with 67 mediating the MVPA-T2D association. Twelve terminal modules, representing the finest-resolution functions, were selected for further analysis based on their significant mediated effects and enrichment in potential individual mediators. Genetic and functional analyses highlighted two modules: CKB-IGFBP2-centric module was positively associated with MVPA (β [95% CI] 0.196 [0.168, 0.224]) and genetically associated with lower T2D risk (OR [95% CI] 0.57 [0.43, 0.77]). Conversely, RIDA-PCBD1-centric module was inversely associated with MVPA (- 0.134 [- 0.162, - 0.108]) and genetically associated with higher T2D risk (1.54 [1.13, 2.09]). Compared to individual protein analyses, these modules captured unique pathways, supporting the CKB-IGFBP2-centered and RIDA-PCBD1-centered modules as antigen-presentation-enriched and complement/apoptic-cell-clearance-enriched modules, respectively. Finally, the constituent genes of both modules were enriched in T2D-related gene changes in pancreatic β-cells, with the antigen-presentation-enriched module showing additional enrichment across α-, δ-, and ductal cells.</p><p><strong>Conclusions: </strong>MVPA may reduce T2D risk through two coordinated plasma protein networks rather than only through individual circulating proteins. Evaluating coordinated protein modules may provide a system-level biological framework for understanding how exercise protects against T2D.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid progression of coronary atherosclerosis across glycemic status: a serial coronary computed tomography angiography study from the PARADIGM registry.","authors":"Ki-Bum Won, Byoung Kwon Lee, Martin Hadamitzky, Yong-Jin Kim, Ji Min Sung, Edoardo Conte, Gianluca Pontone, Daniele Andreini, Matthew J Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonathon A Leipsic, Sang-Eun Lee, Sanghoon Shin, Jung Hyun Choi, Habib Samady, Kavitha Chinnaiyan, Jagat Narula, Leslee J Shaw, Jeroen J Bax, James K Min, Hyuk-Jae Chang","doi":"10.1186/s12933-026-03355-1","DOIUrl":"10.1186/s12933-026-03355-1","url":null,"abstract":"<p><strong>Background: </strong>Rapid progression of coronary atherosclerosis is associated with an increased risk of future adverse cardiovascular events. However, evidence regarding the association between glycemic status and rapid plaque progression (RPP) in the major epicardial coronary arteries remains limited.</p><p><strong>Methods: </strong>A total of 1296 subjects (mean age, 61 ± 9 years; 56.9% men) from the PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging) registry who underwent serial coronary computed tomography angiography and had available glycemic data were included. The median inter-scan interval was 3.2 (interquartile range, 2.6-4.4) years. Participants were classified according to glycemic status as having normal glycemic status, prediabetes, or diabetes. Percent atheroma volume (PAV) was calculated as plaque volume divided by vessel volume and multiplied by 100. RPP was defined as an increase in PAV of ≥ 1.0%/year.</p><p><strong>Results: </strong>Annual changes in PAV (%/year) differed significantly across glycemic groups (normal glycemic status, 0.30 [0.00-0.98]; prediabetes, 0.35 [0.04-0.98]; diabetes, 0.65 [0.19-1.54]; overall P < 0.001). Similarly, the incidence of RPP differed significantly across glycemic groups (normal glycemic status, 25.6%; prediabetes, 25.2%; diabetes, 38.5%; overall P < 0.001). In multivariable logistic regression analyses adjusting for clinical risk factors and baseline plaque burden, diabetes was independently associated with higher odds of RPP compared with normal glycemic status, whereas prediabetes was not. Among participants without diabetes at baseline, RPP was more frequent in those who developed new-onset diabetes than in those who did not (36.1% vs. 24.2%; P = 0.039).</p><p><strong>Conclusions: </strong>Diabetes, but not prediabetes, was independently associated with rapid progression of coronary atherosclerosis. Furthermore, the higher incidence of RPP among participants who developed new-onset diabetes suggests that the development of diabetes may represent an important threshold for accelerated coronary plaque progression.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT02803411).</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluative performance of triglyceride-glucose-frailty index versus surrogate insulin resistance indices for advanced cardiovascular-kidney-metabolic syndrome, cardiometabolic multimorbidity, and mortality: the role of estimated glomerular filtration rate.","authors":"Kang Liu, Jia-Yuan Zhang, Hui He, Yu-Qi Hu, Jia-Hui Lai, Jing-Yu Zhang, Bin Wang, Xia-Hong Lin","doi":"10.1186/s12933-026-03349-z","DOIUrl":"10.1186/s12933-026-03349-z","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome and cardiometabolic multimorbidity (CMM) carry substantial mortality, yet whether a composite index integrating insulin resistance and frailty shows stronger associations with advanced CKM syndrome, CMM, and mortality than conventional metabolic markers remains unclear. This study evaluated the associations of the triglyceride-glucose-frailty index (TyG-FI) with CKM, CMM, and all-cause and cardiovascular mortality, and explored the role of baseline estimated glomerular filtration rate (eGFR).</p><p><strong>Methods: </strong>The analysis included 11,228 adults aged 20-79 years from the National Health and Nutrition Examination Survey 2001-2018. TyG-FI was calculated as the TyG index multiplied by the frailty index. Survey-weighted logistic and Cox proportional-hazards models were used to estimate odds and hazard ratios, with sequential adjustment for demographic, socioeconomic, and behavioral confounders. Restricted cubic splines examined non-linear relationships. Overall model performance was assessed using receiver operating characteristic curves with DeLong's test, time-dependent AUC, Harrell's C-index, calibration, and decision curve analysis. Exploratory mediation analyses quantified the proportion of mortality associations accounted for by baseline eGFR. Robustness was verified through multiple sensitivity and subgroup analyses.</p><p><strong>Results: </strong>Over a median follow-up of 90 months (1,220 all-cause and 379 cardiovascular deaths), higher TyG-FI quartiles were associated with graded decreases in survival. Compared with the lowest TyG-FI quartile, the highest quartile yielded markedly elevated odds for advanced CKM syndrome (OR = 4.57, 95% CI: 3.50-5.99) and CMM (OR = 5.09, 95% CI: 2.83-9.16), and higher hazard for all-cause (HR = 3.90, 95% CI: 2.96-5.13) and cardiovascular death (HR = 5.82, 95% CI: 3.38-10.03). Among participants with CMM, the relationship remained for all-cause death (HR = 2.69, 95% CI: 1.69-4.28). The dose-response patterns were non-linear for outcomes (P for non-linearity < 0.001). TyG-FI demonstrated higher discrimination than most surrogate insulin resistance indices, and lower baseline eGFR partly accounted for 16.45% to 26.74% of the associations with mortality. Sensitivity analyses corroborated the consistency of all findings.</p><p><strong>Conclusions: </strong>TyG-FI, which captures both metabolic dysfunction and physiological frailty, showed stronger associations with advanced CKM syndrome, prevalent CMM, and mortality than most surrogate insulin resistance indices. In exploratory analyses, lower baseline eGFR partly accounted for a proportion of the association with mortality. TyG-FI may offer a pragmatic tool for early mortality risk stratification in individuals with high cardiometabolic risk.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite C-reactive protein-triglyceride-glucose adiposity indices and incident cardiovascular-liver-metabolic multimorbidity: a prospective cohort study.","authors":"Jing Chen, Zhonghua Sun, Jiajun Qiu, Zhongqing Zhou, Kaiqi Ma, Yongxin Liang, Chunqun Li, Shicong Liang","doi":"10.1186/s12933-026-03351-5","DOIUrl":"10.1186/s12933-026-03351-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The C-reactive protein-triglyceride-glucose index (CTI) is a comprehensive marker that reflects inflammation and insulin resistance. Cardiovascular-liver-metabolic (CLM) diseases caused by multiple factors may be related to insulin resistance, obesity, metabolism, etc. Our aim is to explore the association between the fat index derived from CTI and a newly identified surrogate-defined CLM multimorbidity (CLMM) phenotype, while also comparing the relative discriminatory performance of these indices and exploring potential biological domains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From the China Health and Retirement Longitudinal Study (CHARLS), a total of 6534 individuals with full baseline records were included in our analysis. Nine CTI-derived adiposity indices were calculated, including CTI, CTI-BMI, CTI-WC, CTI-WHtR, CTI-BRI, CTI-WWI, CTI-CVAI, CTI-ABSI, and CTI-CI. CVD was identified primarily from self-reported physician diagnoses, whereas MASLD was inferred using the lipid accumulation product (LAP) rather than imaging, histology, or clinical adjudication. Because the component conditions were ascertained using different methods and levels of diagnostic accuracy, CLMM was operationalized as a surrogate-defined composite phenotype rather than clinically confirmed CLMM. Associations as well as potential nonlinear relationships were examined using multivariable logistic regression, restricted cubic spline (RCS) modeling, and two-piece segmented regression analyses. Apparent discrimination and exploratory incremental model performance were quantified using receiver operating characteristic (ROC) curve analysis and reclassification measures, specifically the net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Subgroup and sensitivity analyses were performed to assess stability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the approximately four-year follow-up interval, 406 participants (6.2%) met the criteria for the newly identified surrogate-defined CLMM phenotype. Most CTI-derived adiposity indicators were significantly associated with elevated odds of this phenotype, although CTI-ABSI and CTI-WWI showed null associations after full adjustment. In fully adjusted models, CTI-BMI and CTI-CVAI (Q4 OR 3.46 for CTI-BMI; Q4 OR 2.37 for CTI-CVAI) showed the strongest associations (both P &lt;0.001). RCS analyses further indicated significant nonlinear exposure-response relationships for all indices, except for CTI. CTI-BMI had the highest AUC among the evaluated CTI-derived indices (AUC = 0.638, 95% CI 0.611-0.664), although its absolute discriminatory ability was modest. However, CTI-BMI did not materially outperform BMI alone in a direct same-sample comparison (AUC = 0.638 vs 0.638; DeLong P = 0.924), and the IDI for CTI-BMI versus BMI was only 0.02%, despite a positive NRI. When CTI-BMI was added to the fully adjusted baseline model, the AUC increased only slightly from 0.617 to 0.627. Although ","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":15.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}