Cardiovascular Diabetology最新文献

{"title":"Relationship between hemoglobin glycation index and myocardial mechano-energetic efficiency in non-diabetic individual.","authors":"Chiara M A Cefalo, Mariangela Rubino, Teresa Vanessa Fiorentino, Velia Cassano, Gaia Chiara Mannino, Alessia Riccio, Elena Succurro, Maria Perticone, Angela Sciacqua, Francesco Andreozzi, Giorgio Sesti","doi":"10.1186/s12933-025-02710-y","DOIUrl":"10.1186/s12933-025-02710-y","url":null,"abstract":"<p><strong>Background and aims: </strong>The hemoglobin glycation index (HGI) has been linked to cardiovascular disease in diabetic patients. However, it remains unclear whether an elevated HGI similarly affects the cardiovascular system in individuals with normal glucose tolerance or prediabetes. In this cross-sectional study, we aimed to determine whether increased HGI levels are associated with a reduction in myocardial mechano-energetic efficiency (MEE), a key predictor of cardiovascular events and heart failure, in non-diabetic subjects.</p><p><strong>Methods: </strong>Myocardial MEE per gram of left ventricular mass (MEEi) was assessed via echocardiography in a cohort of 1,074 adults with different glucose tolerance statuses, enrolled in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study. HGI was defined as the difference between the measured HbA1c and the predicted HbA1c, the latter calculated from the linear association between HbA1c and fasting plasma glucose levels.</p><p><strong>Results: </strong>Subjects in the highest HGI quartile exhibited significantly elevated myocardial oxygen consumption and a marked reduction in MEEi compared to those in the lowest quartile. A significant inverse correlation was observed between HGI and MEEi (r = - 0.210, P < 0.001). A multivariate linear regression analysis confirmed the strong relationship between higher HGI levels and lower MEEi, even after adjusting for several potential confounders, including sex, age, body mass index, waist circumference, smoking status, triglycerides, HDL cholesterol, 2-hour post-load glucose, glucose tolerance status, fasting insulin, HOMA-IR, hs-CRP, antihypertensive therapy, and lipid-lowering therapy.</p><p><strong>Conclusions: </strong>These findings support the hypothesis that higher HGI values may affect myocardial mechano-energetic efficiency in non-diabetic individuals.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"148"},"PeriodicalIF":8.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771505","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":"Improved prediction and risk stratification of major adverse cardiovascular events using an explainable machine learning approach combining plasma biomarkers and traditional risk factors.","authors":"Xi-Ru Zhang, Wen-Fang Zhong, Rui-Yan Liu, Jie-Lin Huang, Jing-Xiang Fu, Jian Gao, Pei-Dong Zhang, Dan Liu, Zhi-Hao Li, Yan He, Hongwei Zhou, Zhuang Li","doi":"10.1186/s12933-025-02711-x","DOIUrl":"10.1186/s12933-025-02711-x","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality globally. Traditional risk models, primarily based on established risk factors, often lack the precision needed to accurately predict new-onset major adverse cardiovascular events (MACE). This study aimed to improve prediction and risk stratification by integrating traditional risk factors with biochemical and metabolomic biomarkers.</p><p><strong>Methods: </strong>We analyzed data from 229,352 participants in the UK Biobank (median age 58.0 years; 45.4% male) who were free of baseline MACE. Biomarker selection was conducted using area under the curve (AUC), minimal joint mutual information maximization (JMIM), and correlation analyses, while Cox proportional hazards models were employed to evaluate the predictive performance of combined traditional risk factors and biomarkers. Optimal binary thresholds were determined utilizing CatBoost and SHAP, leading to the calculation of a Biomarker Risk Score (BRS) for each participant. Multivariable Cox models were conducted to assess the associations of each concerned biomarker and BRS with new-onset endpoints.</p><p><strong>Results: </strong>The combination of PANEL + All Biochemistry + Cor0.95 of Nonov Met predictors demonstrated significantly improved discriminative performance compared to traditional models, such as Age + Sex and ASCVD, across all endpoints. Although the prediction for hemorrhagic stroke was suboptimal (C-index = 0.699), C-index values for other outcomes surpassed 0.75, with the highest value (0.822) recorded for CVD-related mortality. Key predictors of new-onset MACE included cystatin C, HbA1c, GlycA, and GGT, while IGF-1 and DHA exhibited potential protective effects. The BRS stratified individuals into low-, intermediate-, and high-risk groups, with the strongest effect observed for CVD death, where the high-risk group had a relative risk of 2.76 (95% CI 2.48-3.07) compared to the low-risk group.</p><p><strong>Conclusion: </strong>Integrating traditional risk factors and biomarkers improves prediction and risk stratification of new-onset MACE. The BRS shows promise as a tool for identifying high-risk individuals, with the potential to support personalized CVD prevention and management strategies.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"153"},"PeriodicalIF":8.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771485","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":"Elevated triglyceride-glucose index is a risk factor for cardiovascular events in adults with type 1 diabetes: a cohort study.","authors":"Rosa Oh, Seohyun Kim, Sang Ho Park, Myunghwa Jang, So Hyun Cho, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Gyuri Kim, Jae Hyeon Kim","doi":"10.1186/s12933-025-02712-w","DOIUrl":"10.1186/s12933-025-02712-w","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index is recognized as an indicator of insulin resistance and is linked to cardiovascular disease (CVD) in patients with type 2 diabetes. However, its utility in patients with Type 1 diabetes (T1DM) has not been studied.</p><p><strong>Methods: </strong>In this nationwide cohort study, we enrolled 14,543 patients with T1DM between 2009 and 2015, with a median follow-up duration of 7.52 years. The primary outcome was the incidence of CVD, including myocardial infarction, ischemic stroke, and heart failure. The secondary outcome was the all-cause mortality. The risk of CVD across the TyG index quartiles was compared using the Cox proportional hazards model.</p><p><strong>Results: </strong>The cut-off points for the TyG quartiles were 8.46, 9.03, and 9.60. Patients in the highest TyG quartile exhibited a higher burden of cardiometabolic risk factors, including obesity, hypertension, dyslipidemia, and lower HDL cholesterol levels. Compared to the lowest quartile, the highest TyG quartile group showed a significantly increased risk of CVD (Composite CVD: adjusted hazard ratio [aHR] = 1.80; 95% confidence interval [CI] = 1.62-2.00, myocardial infarction: aHR = 1.70;95% CI = 1.38-2.10, ischemic stroke: aHR = 2.11; 95% CI = 1.78-2.50, heart failure: aHR = 1.65, 95% CI = 1.45-1.88) and all-cause mortality (aHR = 1.60, 95% CI = 1.41-1.81).</p><p><strong>Conclusions: </strong>A higher TyG index was significantly associated with an increased risk of CVD and all-cause mortality in patients with T1DM.</p><p><strong>Research insights: </strong>What is currently known about this topic? 1. The TyG index is associated with insulin resistance and cardiovascular disease in both patients with type 2 diabetes and the general population. What is the key research question? 1. Could the TyG index also be utilized to assess insulin resistance and cardiovascular disease risk in patients with type 1 diabetes? What is new? 1. In patients with type 1 diabetes, those in the higher TyG quartile showed a higher prevalence of metabolic dysfunction such as obesity, hypertension and dyslipidemia. 2. A higher TyG index in patients with type 1 diabetes was associated with an increased risk of all-cause mortality and cardiovascular disease including myocardial infarction, heart failure and stroke. How might this study influence clinical practice? 1. The TyG index, a simple and non-invasive marker composed of triglycerides and fasting glucose, could be used to identify patients with type 1 diabetes who have high insulin resistance and cardiovascular disease risk.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"150"},"PeriodicalIF":8.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771483","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":"Lipidomic analysis reveals metabolism alteration associated with subclinical carotid atherosclerosis in type 2 diabetes.","authors":"Maria Barranco-Altirriba, Joana Rossell, Núria Alonso, Ralf J M Weber, Emilio Ortega, Gavin R Lloyd, Marta Hernandez, Oscar Yanes, Jordi Capellades, Catherine Winder, Alexandra Junza, Mireia Falguera, Josep Franch-Nadal, Warwick B Dunn, Alexandre Perera-Lluna, Esmeralda Castelblanco, Didac Mauricio","doi":"10.1186/s12933-025-02701-z","DOIUrl":"10.1186/s12933-025-02701-z","url":null,"abstract":"<p><strong>Background: </strong>Disruption of lipid metabolism contributes to increased cardiovascular risk in diabetes.</p><p><strong>Methods: </strong>We evaluated the associations between serum lipidomic profile and subclinical carotid atherosclerosis (SCA) in type 1 (T1D) and type 2 (T2D) diabetes, and in subjects without diabetes (controls) in a cross-sectional study. All subjects underwent a lipidomic analysis using ultra-high performance liquid chromatography-electrospray ionization tandem mass spectrometry, carotid ultrasound (mode B) to assess SCA, and clinical assessment. Multiple linear regression models were used to assess the association between features and the presence and burden of SCA in subjects with T1D, T2D, and controls separately. Additionally, multiple linear regression models with interaction terms were employed to determine features significantly associated with SCA within risk groups, including smoking habit, hypertension, dyslipidaemia, antiplatelet use and sex. Depending on the population under study, different confounding factors were considered and adjusted for, including sample origin, sex, age, hypertension, dyslipidaemia, body mass index, waist circumference, glycated haemoglobin, glucose levels, smoking habit, diabetes duration, antiplatelet use, and alanine aminotransferase levels.</p><p><strong>Results: </strong>A total of 513 subjects (151 T1D, 155 T2D, and 207 non-diabetic control) were included, in whom the percentage with SCA was 48.3%, 49.7%, and 46.9%, respectively. A total of 27 unique lipid species were associated with SCA in subjects with T2D, in former/current smokers with T2D, and in individuals with T2D without dyslipidaemia. Phosphatidylcholines and diacylglycerols were the main SCA-associated lipidic classes. Ten different species of phosphatidylcholines were up-regulated, while 4 phosphatidylcholines containing polyunsaturated fatty acids were down-regulated. One diacylglycerol was down-regulated, while the other 3 were positively associated with SCA in individuals with T2D without dyslipidaemia. We discovered several features significantly associated with SCA in individuals with T1D, but only one sterol could be partially annotated.</p><p><strong>Conclusions: </strong>We revealed a significant disruption of lipid metabolism associated with SCA in subjects with T2D, and a larger SCA-associated disruption in former/current smokers with T2D and individuals with T2D who do not undergo lipid-lowering treatment.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"152"},"PeriodicalIF":8.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771504","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":"Joint association of the triglyceride-glucose index and stress hyperglycemia ratio with incidence and mortality risks of new-onset atrial fibrillation during sepsis: a retrospective cohort study.","authors":"Zhihong Zuo, Zijing Zhou, Qiang Liu, Ruizheng Shi, Ting Wu","doi":"10.1186/s12933-025-02709-5","DOIUrl":"10.1186/s12933-025-02709-5","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index and stress hyperglycemia ratio (SHR) have been linked to the cardiovascular risks in critical ill patients. However, little is known about the predictive power of the TyG index, SHR and their combination on the incidence and mortality risks of new-onset atrial fibrillation (NOAF) in patients with sepsis.</p><p><strong>Method: </strong>This retrospective study included patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Primary outcomes were defined as the incidence and 360-day mortality of in-hospital NOAF among patients with sepsis. Logistic model, Cox proportional hazard model, Kaplan-Meier analysis and receiver-operating characteristic (ROC) were performed to explore the association between the indices and clinical outcomes. Machine learning approach also was constructed to evaluate and compare the indices in predicting mortality risks.</p><p><strong>Results: </strong>4276 patients meeting the inclusion criteria were enrolled and 764 individuals developed NOAF during hospitalization. The multivariable adjusted odds ratios (95%, CI) of incidence of NOAF in patients with sepsis in the highest group versus the lowest group were 1.36 (1.10-1.69), 1.35 (1.09-1.67) and 1.58 (1.23-2.02), respectively, for the TyG index, SHR and the TyG index-SHR combination. However, the predictive powers of these indices were relatively low. Among septic patients who developed in-hospital NOAF, those in the highest TyG index group and the highest SHR group exhibited an increased risk of 360-day mortality compared with those with the lowest TyG index and the lowest SHR (the TyG index: hazard ratio [HR] 1.59, 95% CI 1.00-2.62; SHR: HR 1.67, 95% CI 1.03-2.70). Patients with both the highest the TyG index and the highest SHR demonstrated the highest risk of 360-day mortality (HR 1.72, 95% CI 1.08-2.72). The ROC also confirmed the TyG index-SHR combination had more robust predictive power for 360-day mortality among septic patients with NOAF than the TyG index and SHR itself (p < 0.05). The random forest model validated that the predictive capability was significantly enhanced with the integration of the TyG index and SHR.</p><p><strong>Conclusion: </strong>The TyG index and SHR were associated with the incidence of in-hospital NOAF during sepsis, although their predictive powers were limited. In septic patients with in-hospital NOAF, high levels of the TyG index and SHR were significantly associated with increased 360-day mortality risks, with their combination demonstrating superior predictive power. Joint assessments of the TyG index and SHR could help identify individuals at high risks of mortality post-discharge, enabling clinicians to prioritize follow-up care and improve patient management.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"149"},"PeriodicalIF":8.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771488","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":"Joint association of estimated glucose disposal rate and systemic inflammation response index with mortality in cardiovascular-kidney-metabolic syndrome stage 0-3: a nationwide prospective cohort study.","authors":"Yuwen Chen, Wenbin Lian, Lunzhe Wu, An'an Huang, Deliang Zhang, Bingchen Liu, Yuangang Qiu, Qucheng Wei","doi":"10.1186/s12933-025-02692-x","DOIUrl":"10.1186/s12933-025-02692-x","url":null,"abstract":"<p><strong>Background: </strong>The Cardiovascular-Kidney-Metabolic (CKM) syndrome underscores the complex interactions among metabolic disorders, kidney disease, and cardiovascular conditions. Insulin resistance (IR) and inflammation are crucial in CKM syndrome development, but their combined effect in stages 0-3 remains unclear.</p><p><strong>Methods: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES), we included 18,295 participants with CKM syndrome stages 0-3 from 10 cycles between 1999 and 2018. IR was assessed using the estimated glucose disposal rate (eGDR), and systemic inflammation was evaluated using the Systemic Inflammation Response Index (SIRI). The primary endpoint was all-cause mortality, and the secondary endpoint was cardiovascular disease (CVD) mortality.</p><p><strong>Results: </strong>Over an average follow-up period of 121 months, we recorded 1,998 all-cause deaths and 539 CVD deaths. Both eGDR and SIRI were independent risk factors for mortality. The hazard ratios (HR) for eGDR were 0.90 (0.86, 0.94) for all-cause mortality and 0.85 (0.78, 0.93) for CVD mortality, per unit increase in eGDR. For SIRI, the HRs were 1.16 (1.11, 1.21) for all-cause mortality and 1.33 (1.19, 1.46) for CVD mortality, per unit increase in SIRI. Compared to individuals with high eGDR and low SIRI levels, those with low eGDR and high SIRI levels exhibited significantly higher mortality risks, with HRs of 1.97 (1.58, 2.44) for all-cause mortality and 2.35 (1.48, 3.73) for CVD mortality. Subgroup analysis revealed that the combined impact of eGDR and SIRI was particularly significant in patients under 60 years old.</p><p><strong>Conclusion: </strong>In CKM syndrome stages 0-3, eGDR and SIRI have joint effect on mortality. Combining these markers can help identify high-risk individuals early, enabling timely monitoring and intervention to improve outcomes.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"147"},"PeriodicalIF":8.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742514","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":"Oxidative stress and inflammation mediate the adverse effects of cadmium exposure on all-cause and cause-specific mortality in patients with diabetes and prediabetes.","authors":"Jingqi Liu, Kehan Chen, Mingyuan Tang, Qunzheng Mu, Shirong Zhang, Jiayuan Li, Jiaqiang Liao, Xia Jiang, Chuan Wang","doi":"10.1186/s12933-025-02698-5","DOIUrl":"10.1186/s12933-025-02698-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The effect of cadmium exposure on mortality risk among individuals with diabetes and prediabetes remains unclear, particularly regarding potential mediation by oxidative stress and inflammation. This study aimed to investigate the associations of blood cadmium levels with all-cause, cardiovascular disease (CVD), and cancer mortality and the mediating effects of oxidative stress and inflammation biomarkers in patients with diabetes and prediabetes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective cohort study, we analyzed 17,687 adults with diabetes and prediabetes from the National Health and Nutrition Examination Survey (NHANES, 1999-2018). Nine biomarkers related to oxidative stress (gamma-glutamyl transferase [GGT], uric acid [UA], high-density lipoprotein [HDL], UA to HDL ratio [UHR]) and inflammation (neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio [MLR], neutrophil-monocyte-lymphocyte ratio [NMLR], systemic inflammation response index [SIRI], systemic immune-inflammation index [SII]) were systematically assessed. Kaplan-Meier survival analysis, Cox proportional hazards models, and restricted cubic splines (RCS) were applied to evaluate the association of cadmium with mortality risk. Generalized linear models were used to assess the association of cadmium with oxidative stress and inflammation biomarkers, while Cox regression and RCS evaluated their effects on mortality. Causal mediation analysis identified biological pathways mediated by oxidative stress and inflammation. Stratified and sensitivity analyses were further employed to confirm the robustness of the results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 161,047.75 person-years of follow-up, 3562 deaths occurred, including 1214 from CVD and 680 from cancer. Higher blood cadmium levels were associated with increased risks of all-cause mortality (fully adjusted hazard ratio [HR]: 2.17; 95% confidence interval [CI] 1.69-2.79, comparing highest vs. lowest quartile), CVD mortality (HR 2.06; 95% CI 1.41-3.02), and cancer mortality (HR 2.38; 95% CI 1.47-3.85), without evidence of nonlinear relationship. Mediation analyses indicated that UA, NLR, MLR, NMLR, and SIRI partially mediated the associations of cadmium with all-cause and CVD mortality, although the mediated proportions were relatively modest (ranging from 1.4 to 4.8%). Additionally, GGT mediated a small fraction of the associations with all-cause and cancer mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Cadmium exposure increases the risk of all-cause, CVD, and cancer mortality in patients with diabetes and prediabetes. Oxidative stress and inflammation appear to partially mediate this adverse effect. These findings emphasize the urgent need for targeted interventions to reduce cadmium-related mortality risks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;What is currently known about this topic? Cadmium exposure is linked to increased mortality. Oxidative stress and inflammation are critical","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"145"},"PeriodicalIF":8.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742516","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":"Anti-CD3 monoclonal antibody in treating patients with type 1 diabetes: an updated systematic review and meta-analysis.","authors":"Qi Wu, Rui Wei, Xinyue Liao, Xiaona Cui, Haining Wang, Tianpei Hong","doi":"10.1186/s12933-025-02696-7","DOIUrl":"10.1186/s12933-025-02696-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of anti-CD3 monoclonal antibody (mAb) in patients with type 1 diabetes (T1D) and identify the influencing factors.</p><p><strong>Methods: </strong>Randomized controlled trials comparing anti-CD3 mAb with placebo or standard care in T1D participants were screened from PubMed, Embase, and Cochrane databases until 31 May 2024. Changes in area under the curve (AUC) of C-peptide, HbA1c level and daily insulin requirement were main outcomes. Results were computed as standardized mean difference (SMD) and 95% confidence interval (CI). Meta-regression and subgroup analyses were also performed.</p><p><strong>Results: </strong>Eleven eligible trials involving 1573 T1D participants were included in this meta-analysis. Compared with control group, anti-CD3 mAb significantly increased AUC of C-peptide (SMD = 0.337, 95% CI 0.105 to 0.569, P = 0.004) and decreased daily insulin requirement (SMD =  - 0.598, 95% CI  - 0.927 to - 0.269, P < 0.001). Subgroup analysis revealed that low average age (≤ 18 years old: SMD = 0.546, 95% CI 0.203 to 0.889, P < 0.001), high cumulative dose of anti-CD3 mAb (≥ 25 mg: SMD = 0.588, 95% CI 0.424 to 0.752, P < 0.001), and short T1D diagnosis duration before enrollment (≤ 6 weeks: SMD = 0.609, 95% CI 0.405 to 0.814, P < 0.001) were significantly associated with an increase in AUC of C-peptide. Notably, meta-regression analysis revealed that cumulative dose was the most critical factor, masking the effect of average age and T1D diagnosis duration. Most adverse events were transient and could be medically treated.</p><p><strong>Conclusion: </strong>Anti-CD3 mAb effectively preserves C-peptide secretion and reduces insulin requirement in patients with T1D. Younger age (≤ 18 years), earlier treatment initiation (≤ 6 weeks post-diagnosis), higher cumulative doses (≥ 25 mg) may present better therapeutic effect.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"146"},"PeriodicalIF":8.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742461","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":"Heart rate variability tests for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus in advanced stages of kidney disease.","authors":"João Soares Felício, Maria Antônia Matos Araújo, Gabriela Nascimento de Lemos, Isabel Jacob Fernandes, Licia Oliveira Ruivo, Ester da Gama Chambouleyron, Lilian de Souza D'Albuquerque Silva, Caroline Filgueira Nunes, Gisely Mouta de Andrade Paes, Franciane Trindade Cunha de Melo, Pedro Paulo Freire Piani, Ana Regina Bastos Motta, Valéria Suênya Galvão Leal, Ana Carolina Contente Braga de Souza, Natercia Neves Marques de Queiroz, Márcia Costa Dos Santos, Karem Mileo Felício, Priscila Alcântara Barbosa de Figueiredo","doi":"10.1186/s12933-025-02666-z","DOIUrl":"10.1186/s12933-025-02666-z","url":null,"abstract":"<p><p>Cardiovascular Autonomic Neuropathy (CAN) is one of the most devastating complications of Diabetes Mellitus (DM) and presents high morbidity and mortality. Its association with diabetic kidney disease (DKD) worsens the condition even further. CAN diagnosis remains a challenge and is being based on reflex tests which are laborious, risky and difficult to perform. Heart Rate Variability (HRV) tests has been suggested as having high utility in diagnosing CAN, but this issue remains controversial. The aim is to evaluate the sensitivity and specificity of HRV tests to diagnose CAN in patients with type 2 diabetes mellitus (T2DM) and DKD with severely increased albuminuria. This is a cross-sectional study in patients with T2DM and DKD with severely increased albuminuria. A total of 48 subjects were recruited and underwent laboratory and neuropathy assessment. The diagnosis of CAN was first confirmed in 75% (36/48) of patients based on cardiovascular autonomic reflex tests (CARTs). HRV tests (VLF, LF, TP and SDNN) differed between groups with and without CAN (212 vs. 522 ms², p = 0.024; 57 vs. 332 ms², p = 0.025; 359.5 vs. 2733 ms², p = 0.007; 20 vs. 48 ms, p = 0.012), respectively. The best cut-off points based on ROC curve were < 1,117 ms², < 152.5 ms², < 1,891 ms² and < 46.5 ms, respectively. VLF and TP reached highest sensitivity values (97% and 92%) and F1 Score of 90%, while LF had best specificity (75%) and TP had best accuracy (85%). Our best model of serial algorithm using VLF as first screening test and TP in sequency obtained a sensitivity of 97% and accuracy of 90%, reducing in 90% the need to perform CARTs. Our findings suggest that it is possible to achieve high sensitivity and accuracy using an algorithm with VLF and TP parameters analyzed in series. It could enable a simpler and early diagnosis, avoiding CARTs complications.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"144"},"PeriodicalIF":8.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742467","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":"Pericoronary adipose tissue attenuation predicts compositional plaque changes: a 12-month longitudinal study in individuals with type 2 diabetes without symptoms or known coronary artery disease.","authors":"Katrine Schultz Overgaard, Thomas Rueskov Andersen, Laurits Juhl Heinsen, Gokulan Pararajasingam, Roda Abdulkadir Mohamed, Freja Sønder Madsen, Irmelin Irene Aagaard Biesenbach, Kurt Højlund, Jess Lambrechtsen, Søren Auscher, Kenneth Egstrup","doi":"10.1186/s12933-025-02694-9","DOIUrl":"10.1186/s12933-025-02694-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pericoronary adipose tissue attenuation (PCATa), derived from coronary computed tomography angiography (CCTA), is a novel marker of inflammation in the coronary arteries. Patients with type 2 diabetes mellitus (T2DM) are at elevated risk of coronary artery disease (CAD), potentially due to systemic inflammation. This study evaluated whether baseline PCATa predicts changes in plaque composition and burden over 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective longitudinal study included 200 participants with T2DM, who had neither symptoms nor a prior diagnosis of CAD (mean age 61 ± 9.4 years, 72% male). PCATa was measured at the baseline scan along the proximal 40 mm of each major coronary artery, and the values were averaged to calculate the participant-level PCATa. High PCATa levels were determined using the validated cut-off of -70.1 Hounsfield units. Compositional plaque changes were quantified as the differences between baseline and 12-month scans, and plaque burden was calculated as the normalized atheroma volume. Multivariable regression analyses assessed the associations between baseline PCATa and compositional plaque changes and evaluated risk factors, including high PCATa, in predicting non-calcified plaque burden progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Plaque compositional volumes and burden increased over 12 months, while PCATa remained stable. After multivariable adjustments, baseline PCATa was significantly associated with changes in total plaque volume (β = 0.005, p = 0.005), non-calcified plaque volume (β = 0.006, p = 0.007), total plaque burden (β = 1.7, p = 0.007), and non-calcified plaque burden (β = 2.0, p = 0.006), but not with calcified plaque volume or burden. High baseline PCATa was observed in 44 participants (22%) and was the only independent predictor of non-calcified plaque burden progression (odds ratio 3.5, p = 0.002).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Baseline PCATa is significantly associated with increases in total and non-calcified plaque volumes and burden over 12 months in participants with T2DM without symptoms or known CAD. High PCATa levels uniquely predict non-calcified plaque burden progression, suggesting that PCATa may serve as a marker for subclinical atherosclerosis progression. This warrants further investigation into PCATa for cardiovascular risk assessment, particularly in high-risk populations such as individuals with T2DM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;Trial registration: NCT06644651.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;What is currently known about this topic? 1. Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) share inflammatory mechanisms. 2. Individuals with T2DM face a two- to four-fold increased risk of CAD compared with those without T2DM. 3. Pericoronary adipose tissue attenuation (PCATa) is a novel marker of coronary inflammation. What is the key research question? Can baseline PCATa predict compositional ","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"143"},"PeriodicalIF":8.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742517","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}