Cardiovascular Diabetology最新文献

{"title":"Metabolomic signatures of hepatic steatosis reveal heterogeneity in cardiometabolic risk and responses to lifestyle interventions in type 2 diabetes: a post hoc analysis.","authors":"Xianglin Wu, Yi Ding, Feixue Shao, Qiuyu Cao, Youjin Jiang, Xiaoran Li, Yu Xu, Zhiyun Zhao, Min Xu, Jieli Lu, Tiange Wang, Shuangyuan Wang, Hong Lin, Jie Li, Yan Liu, Jinli Gao, Guang Ning, Weiqing Wang, Bin Wang, Yufang Bi, Mian Li","doi":"10.1186/s12933-026-03194-0","DOIUrl":"https://doi.org/10.1186/s12933-026-03194-0","url":null,"abstract":"<p><strong>Background: </strong>Hepatic steatosis measured by imaging fails to capture the variation in cardiometabolic risk and intervention response, which may be better characterized by metabolomic profiles. We aimed to construct metabolomics-based indices to define this variation.</p><p><strong>Methods: </strong>Using data from a three-arm lifestyle intervention randomized trial in adults with type 2 diabetes (T2D) and overweight/obesity, we constructed two novel indices from untargeted plasma metabolomics and MRI-measured liver fat: a metabolomics-based liver fat score (mliver fat), and the discordance between mliver fat and MRI-measured liver fat (Δliver fat). We examined their associations with cardiometabolic traits and intervention response.</p><p><strong>Results: </strong>Both mliver fat and Δliver fat were associated with body composition, glucose indices, insulin sensitivity, and triglyceride, but only Δliver fat was independent of MRI-measured liver fat. Despite having comparable MRI-measured liver fat, compared with the participants with a high Δliver fat (mliver fat > MRI-measured liver fat), those with a low Δliver fat (mliver fat < MRI-measured liver fat) had a more favorable cardiometabolic profile and derived greater benefits and more sustained benefits from diet intervention, with more pronounced long-term improvements in weight, insulin sensitivity, and β-cell function.</p><p><strong>Conclusions: </strong>Among individuals with T2D, a metabolomics-based liver fat score, particularly the discordance between metabolomic and imaging assessments, identifies systemic metabolic heterogeneity and differential responsiveness to lifestyle interventions. Future research is warranted to evaluate its performance in improving risk stratification and personalizing lifestyle intervention.</p><p><strong>Trial registration: </strong>NCT03839667.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effects of insulin resistance and revascularization completeness on prognosis in patients with coronary artery calcification.","authors":"Zhangyu Lin, Yanjun Song, Sheng Yuan, Bowen Li, Jining He, Kefei Dou","doi":"10.1186/s12933-026-03196-y","DOIUrl":"https://doi.org/10.1186/s12933-026-03196-y","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and insulin resistance trigger the early onset of adolescent-like sexually dimorphic metabotypes in middle childhood.","authors":"Álvaro González-Domínguez, Jesús Domínguez-Riscart, Otto Savolainen, Alfonso Lechuga-Sancho, Rikard Landberg, Raúl González-Domínguez","doi":"10.1186/s12933-026-03172-6","DOIUrl":"https://doi.org/10.1186/s12933-026-03172-6","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","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 metabolic-dysfunction associated steatotic liver disease: evidence from two cohort studies.","authors":"Guodong Yang, Xin Qiu, Shuang Shen, Peishu Li, Yifei Feng, Jiayuan Zhang, Ze Su, Bangde Xiang","doi":"10.1186/s12933-026-03189-x","DOIUrl":"https://doi.org/10.1186/s12933-026-03189-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Mortality in metabolic dysfunction-associated steatotic liver disease (MASLD) is primarily driven by the synergy between insulin resistance (IR) and systemic inflammation. However, practical tools for integrated risk assessment remain scarce. This study aimed to evaluate the individual and joint prognostic value of the estimated Glucose Disposal Rate (eGDR) and Systemic Inflammation Response Index (SIRI)-validated surrogates for IR and inflammatory status-to refine risk stratification and elucidate their reciprocal associations on MASLD survival.</p><p><strong>Methods: </strong>This observational analysis included 7520 MASLD adults from the continuous National Health and Nutrition Examination Survey (NHANES) (1999-2018) and an independent external validation cohort of 1182 ultrasound-confirmed patients from NHANES III (1988-1994), with mortality linked through 2019. Multivariable Cox models and restricted cubic splines were employed to evaluate the associations between biomarkers and mortality. The combined model's predictive performance and clinical benefit were quantified via Receiver Operating Characteristic curves, Net Reclassification Improvement (NRI), Integrated Discrimination Improvement (IDI), and Decision Curve Analysis. Furthermore, exploratory bidirectional mediation analysis was conducted to assess the potential statistical interplay between the two markers.</p><p><strong>Results: </strong>Over a median follow-up of 138 months, 1375 all-cause and 442 cardiovascular deaths occurred. Lower eGDR and higher SIRI were independently and linearly associated with increased mortality. A low eGDR/high SIRI phenotype was identified as the highest-risk category, exhibiting a 1.860-fold risk of all-cause mortality (95% CI 1.439-2.405) and a 2.395-fold risk of cardiovascular mortality (95% CI 1.379-4.159). The combined model demonstrated superior predictive accuracy (Area Under the Curve (AUC) 0.686-0.848) and significant reclassification improvement (NRI 0.161; IDI 0.017), and higher clinical net benefit than either indicator alone (p < 0.001). Furthermore, mediation analysis suggested that SIRI statistically accounted for 10.31% of the association between eGDR and all-cause mortality, highlighting a potential reciprocal statistical interplay. Crucially, this high-risk 'low eGDR/high SIRI' phenotype was successfully validated in the imaging-confirmed external cohort (ACM: HR = 2.354; CVM: HR = 3.153; both p < 0.001).</p><p><strong>Conclusions: </strong>Integrating eGDR and SIRI identifies a high-risk MASLD phenotype with the poorest prognosis, reflecting a synergistic metabolic-inflammatory burden. This joint assessment significantly improves predictive accuracy and offers superior net clinical benefits for long-term mortality prediction.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the estimated glucose disposal rate and cardiometabolic multimorbidity in middle-aged and older adults.","authors":"Cancan Cui, Te Zhang, Jiannan Li, Fenghe Shi, Jinghui Cao, Shixiang Zhao, Huanlin Liu, Zixin Zhang, Yanxi Liu, Lin Liu, Jianshi Du","doi":"10.1186/s12933-026-03179-z","DOIUrl":"https://doi.org/10.1186/s12933-026-03179-z","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic status modifies the predictive value of the C-reactive protein-triglyceride-glucose Index-waist-to-height ratio for major adverse cardiovascular and cerebrovascular events: a prospective cohort study from the China Health and Retirement Longitudinal Study (CHARLS).","authors":"Xuanzhe Li, Yitong Meng, Lishuang Zhang, Tingmin Li, Gen Yan","doi":"10.1186/s12933-026-03181-5","DOIUrl":"https://doi.org/10.1186/s12933-026-03181-5","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study.","authors":"Xiangyang Shao, Tingting Yu, Lei Luo, Hongmei Zheng, Fan Yang, Jin Dong","doi":"10.1186/s12933-026-03195-z","DOIUrl":"https://doi.org/10.1186/s12933-026-03195-z","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging multidimensional biomarker system for cardiovascular-kidney-metabolic syndrome: from multi-omics integration to clinical artificial intelligence.","authors":"Fei-Hong Li, Yuan-Yu Li, Yue Zhang, Liu Yang, Shao-Kang Pan, Dong-Wei Liu, Zhang-Suo Liu, Zhong-Xiuzi Gao, Peng Wu","doi":"10.1186/s12933-026-03178-0","DOIUrl":"https://doi.org/10.1186/s12933-026-03178-0","url":null,"abstract":"<p><p>Cardiovascular-kidney-metabolic (CKM) syndrome is an emerging clinical entity that highlights the complex, bidirectional interplay among cardiovascular disease, chronic kidney disease, and metabolic disorders, representing a substantial and growing global health burden. This conceptualization marks a paradigm shift from viewing these conditions in isolation to understanding them as an interconnected disease continuum. Traditional biomarkers face significant limitations in the early detection, risk stratification, and precise management of CKM, necessitating a transition towards an integrated framework that captures its multisystem nature. This review systematically outlines an emerging multidimensional biomarker system encompassing key pathological axes such as metabolism, immuno-inflammation, oxidative stress, and biological aging, offering refined risk assessment beyond conventional metrics. The development of this system is propelled by revolutionary platforms, including accessible sampling techniques (e.g., dried blood spots), advanced in vitro models (e.g., multi-organ-on-a-chip), and multi-omics technologies. These platforms not only facilitate a deeper dissection of the heterogeneous origins and inter-organ crosstalk in CKM but also accelerate the discovery and validation of novel biomarkers. Concurrently, artificial intelligence serves as a pivotal tool for clinical translation, effectively integrating high-dimensional data to transform complex molecular profiles into actionable clinical insights. By enabling the construction of dynamic risk prediction and decision-support systems, this review charts a pathway toward proactive, individualized, and precise prevention and management of CKM syndrome.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular outcome trials (CVOTs) in cardiorenal metabolic medicine: a decade of transformative progress (2016-2026).","authors":"Song Wen, Congcong Wang, Zhimin Xu, Lijiao Chen, Yanju He, Yishu Ren, Yue Yuan, Yanyan Li, Meiyuan Dong, Min Gong, Chaoxun Wang, Xiucai Li, Dongxiang Xu, Xinlu Yuan, Jianlan Jin, Jiyu Li, Ligang Zhou","doi":"10.1186/s12933-026-03164-6","DOIUrl":"https://doi.org/10.1186/s12933-026-03164-6","url":null,"abstract":"<p><p>The decade from 2016 to 2026 has witnessed an extraordinary transformation in cardiometabolic medicine, propelled by the maturation of cardiovascular outcome trials (CVOTs). What began as regulatory requirements to establish cardiovascular safety for novel glucose-lowering agents has evolved into a robust body of evidence demonstrating profound cardiorenal protective effects-often extending beyond diabetes itself. Landmark trials such as EMPA-REG OUTCOME, LEADER, SELECT, SURPASS-CVOT, and VESALIUS-CV have not only redefined therapeutic priorities but have also catalyzed a conceptual shift from glucocentric management to an integrated cardiorenal metabolic (CRM) framework. This narrative review traces the epidemiological imperatives driving this evolution, chronicles the historical trajectory of CVOTs, synthesizes key findings across major pharmacological classes, and reflects on emerging therapies and risk markers that are shaping the precision-medicine paradigm of 2026.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":" ","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate-intensity statin plus ezetimibe as an alternative to high-intensity statin therapy.","authors":"Areej S Albawa'neh, Bassam R Ali","doi":"10.1186/s12933-026-03188-y","DOIUrl":"https://doi.org/10.1186/s12933-026-03188-y","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"25 1","pages":""},"PeriodicalIF":10.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762352","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}