Cardiovascular Diabetology最新文献

{"title":"Coronary flow reserve increase after 4-year dapagliflozin treatment in patients with type 2 diabetes: the DAPAHEART follow-up study.","authors":"Francesca Cinti, Cassandra Morciano, Andrea Guarneri, Luigi Cappannoli, GianPio Sorice, Shawn Gugliandolo, Umberto Capece, Amelia Splendore, Adriana Avolio, Teresa Mezza, Patricia Iozzo, Alfredo Pontecorvi, Maria Lucia Calcagni, Francesco Burzotta, Domenico D'Amario, Filippo Crea, Lucia Leccisotti, Andrea Giaccari","doi":"10.1186/s12933-025-02912-4","DOIUrl":"10.1186/s12933-025-02912-4","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular (CV) outcome trials have shown that sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce CV mortality in type 2 diabetes (T2DM). We previously found that 4 weeks of SGLT2i treatment increased coronary flow reserve (CFR) by 30% and reduced epicardial adipose tissue (EAT) thickness by 19% in T2DM patients with stable coronary artery disease (CAD). However, long-term effects remain unclear. This pilot study aimed to assess the long-term impact of dapagliflozin on CFR and EAT thickness in T2DM patients with CAD.</p><p><strong>Methods: </strong>Patients with T2DM and stable CAD were enrolled in the DAPAHEART trial, a single-center, 4-week, randomized (1:1 dapagliflozin 10 mg vs. placebo), double-blind, controlled study. At the end of the trial, placebo group patients also transitioned to dapagliflozin. CFR and EAT thickness were measured at baseline, after 4 weeks, and after 4 years using ¹³N-ammonia PET/CT.</p><p><strong>Results: </strong>CFR increased 34.4% after 4 years (from 2.15 ± 0.19 at baseline to 2.85 ± 0.26, p = 0.001) with 29.18% reduction in EAT thickness (p = 0.03). BMI decreased in all patients (p = 0.001), but changes in BMI and EAT thickness were not significantly correlated (R²= 0.0662; p = 0.5), suggesting a weight-independent effect of dapagliflozin on EAT.</p><p><strong>Conclusion: </strong>The 30% CFR improvement seen after 4 weeks of dapagliflozin persisted at 4 years, together with a significant reduction in EAT thickness, possibly explaining CFR improvement. Similar results in the placebo group after treatment strongly support a causal relationship and underscore the long-term CV benefits of dapagliflozin and its role in reducing CV risk in T2DM patients.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"351"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943811","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":"The triglyceride-glucose index: updating evidence from clinical settings to molecular mechanisms in ageing-related cerebrovascular diseases.","authors":"Haishuang Tang, Kaiwen Wang, Kaige Zheng, Zheng Wen, Yi Yang, Xin Nie, Qingyuan Liu, Shuo Wang","doi":"10.1186/s12933-025-02914-2","DOIUrl":"https://doi.org/10.1186/s12933-025-02914-2","url":null,"abstract":"<p><p>Cerebrovascular ageing is a complex process characterized with increased vessel stiffness, decreased sensitivity to vasodilators and vasoconstrictors, and reduced angiogenesis, which is mediated via time-dependent manner. The triglyceride-glucose (TyG) index, calculated by ln[fasting triglycerides (TG) (mg/dl) × fasting blood glucose (FBG) (mg/dl)/2], has recently been evidenced as a reliable surrogate of insulin resistance (IR). Currently extensive studies provide robust statistical evidence of the predictability of the TyG index in the development and prognosis of ageing-related cerebrovascular diseases. Yet the application of the TyG index in ageing-related cerebrovascular diseases has not been systemically evaluated in clinical practice, and also the underlying shared mechanism has not been disentangled. Therefore, revealing novel treatment strategies and identifying the potential mechanisms targeting the TyG index is of significant importance. On this basis, more studies are warranted to standardize the optimal care taken in clinical referring TyG index, which will benefit patients with high cerebrovascular diseases risk. Here, we searched the Cochrane Library, Embase, Medline, Web of Science, PubMed, and other relevant English databases and related websites from inception to August 2025 and reviewed existing literature and describe the current scope and impact of the TyG index on ageing-related cerebrovascular diseases, aiming to highlight its application value and underlying mechanism.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"350"},"PeriodicalIF":10.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944122","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":"Atherogenic index of plasma and its 5-year changes associated with type 2 diabetes risk: a 10-Year cohort study.","authors":"Liuding Wen, Yuying Wu, Xueru Fu, Weifeng Huo, Aijun Xu, Canjie Piao, Jingli Kong, Yaqin Su, Jinliang Liang, Botang Guo, Ming Zhang, Dongsheng Hu, Yang Zhao","doi":"10.1186/s12933-025-02903-5","DOIUrl":"https://doi.org/10.1186/s12933-025-02903-5","url":null,"abstract":"<p><strong>Background: </strong>The global burden of type 2 diabetes mellitus (T2DM) is increasing, particularly in resource-limited settings like rural China. Although traditional blood glucose remains an essential measurement for diabetes screening, Atherogenic Index of Plasma (AIP) is emerging as a complementary predictor of T2DM risk. Over time, however, the association between AIP and T2DM risk remains insufficiently understood.</p><p><strong>Objective: </strong>To investigate the association between baseline AIP levels and its 5-year changes with the risk of T2DM in a rural Chinese cohort.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 14,968 participants without baseline diabetes from a rural Chinese population. AIP was calculated (log(TG/HDL-C)) and used to classify participant results into quartiles. We conducted multivariate Cox proportional hazards regression analysis, restricted cubic spline analyses, subgroup analyses, and sensitivity analyses to determine the association between baseline AIP and 5-year changes in AIP with the 10-year risk of T2DM.</p><p><strong>Results: </strong>Over a median follow-up of 10.4 years, 2,165(N = 14,968) participants developed T2DM. The hazard ratios [aHRs; 95% confidence interval (CI)] for T2DM increased with quartiles 2, 3, and 4 (versus quartile 1) of AIP: 1.17 (1.00-1.38), 1.38 (1.18-1.62), and 1.96 (1.68-2.29), respectively (p for trend < 0.0001) after multivariable adjustment. Regarding 5-year changes in AIP, participants with increased AIP levels had a 18% higher risk of developing T2DM (aHRs 1.18, 95% CIs: 1.00-1.40) compared to those maintaining stable levels, while those with decreased AIP showed a 20% reduction in risk (aHRs 0.80, 95% CIs: 0.67-0.95). RCS analyses showed linear relationships for both baseline AIP (p for nonlinearity = 0.927) and 5-year changes in AIP (p for nonlinearity = 0.083) with T2DM risk.</p><p><strong>Conclusions: </strong>Our findings indicate that both baseline AIP levels and the 5-year changes in those levels are significantly associated with the risk of T2DM. Individuals with higher baseline AIP or 5-year increases in AIP were more likely to develop T2DM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"349"},"PeriodicalIF":10.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943850","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":"Associations between steatotic liver disease subtypes and incident atrial fibrillation in young adults: a nationwide cohort study.","authors":"Jeayeon Park, Goh Eun Chung, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho","doi":"10.1186/s12933-025-02905-3","DOIUrl":"https://doi.org/10.1186/s12933-025-02905-3","url":null,"abstract":"<p><strong>Background/aim: </strong>Metabolic dysfunction is emerging as a significant risk factor for atrial fibrillation (AF) and serves as a foundational component of both metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with moderate alcohol intake (MetALD). As the prevalence of steatotic liver disease (SLD) rises among young adults, clarifying its association with AF in this population has become a clinical priority. Accordingly, we aimed to investigate the link between different SLD subtypes and the risk of incident AF in young adults.</p><p><strong>Methods: </strong>In this nationwide cohort study, we analyzed data from the Korean National Health Insurance Service and included individuals aged 20-39 years who underwent health screening examinations between 2009 and 2012. The participants were categorized into either the non-SLD group or the SLD group, which was defined by a fatty liver index ≥ 30. SLD was further subclassified into MASLD, MetALD, and alcohol-associated liver disease (ALD) for analysis. The risk of incident AF was evaluated using Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 6,375,710 young adults (mean age 30.9 years; 59.4% male) were included, with a median follow-up period of 10.6 years. The prevalence of SLD was 27.8%, which included cases of MASLD (81.7%), MetALD (13.5%), and ALD (4.7%). The risk of incident AF was significantly elevated in individuals with SLD, with progressive increases across MASLD, MetALD, and ALD subtypes. Compared with those of the non-SLD group, the adjusted hazard ratios for AF were 1.09 (95% confidence interval [CI], 1.05-1.31) in the MASLD group, 1.29 (95% CI, 1.22-1.36) in the MetALD group, and 1.52 (95% CI, 1.41-1.65) in the ALD group.</p><p><strong>Conclusion: </strong>SLD is associated with new-onset AF, with a progressively increased risk across MASLD, MetALD, and ALD subtypes in young adults. Given the modifiable nature of these risks, early interventions are essential to prevent long-term cardiovascular complications and reduce the future disease burden.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"348"},"PeriodicalIF":10.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943828","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":"Impact of changes in conventional risk factors induced by once-weekly GLP-1 receptor agonist exenatide on cardiovascular outcomes: an EXSCEL post hoc analysis.","authors":"Ruth L Coleman, Amanda I Adler, Robert J Mentz, Marat Fudim, Naveed Sattar, Rury R Holman","doi":"10.1186/s12933-025-02866-7","DOIUrl":"https://doi.org/10.1186/s12933-025-02866-7","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the degree to which conventional cardiovascular (CV) risk factor changes induced by once-weekly exenatide (EQW) might explain the placebo-controlled differences in CV outcomes observed in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).</p><p><strong>Methods: </strong>We entered participant-level risk factor values over time into a validated type 2 diabetes-specific clinical outcomes model to estimate event rates, and compared simulated with observed relative risk changes in EXSCEL. We performed simulations for each participant to minimize uncertainty and to optimize confidence interval precision around risk point estimates. Six outcomes were examined: major adverse CV event (MACE), all-cause mortality (ACM), CV death, fatal or nonfatal myocardial infarction (MI), fatal or nonfatal stroke, and hospitalization for heart failure (hHF). We also performed a mediation analysis using Cox regression models to evaluate potential key mediators for ACM.</p><p><strong>Results: </strong>Model simulations explained only modest proportions of the observed relative risk reductions for MACE (29%), ACM (15%), CV death (18%), and stroke (29%), but greater proportions for hHF (67%) and MI (200%). Mediation analysis suggested that baseline-to-6 or 12-month changes in HbA_1c, blood pressure, heart rate, low-density lipoprotein cholesterol, triglycerides, and weight did not mediate the EQW effect on ACM.</p><p><strong>Conclusions: </strong>These model simulations explain only a modest proportion of the impact of observed EQW-induced changes in conventional CV risk factors on EXSCEL outcomes, apart from hHF and MI. Up to 1-year changes in conventional risk factors did not mediate the observed ACM risk reduction.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"347"},"PeriodicalIF":10.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943980","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":"Lipid metabolism-related inflammatory indices (LMIIs) and incident peripheral artery diseases (PAD) in patients with type 2 diabetes mellitus (T2DM): a multicohort study from China and the UK biobank.","authors":"Yingying Wang, Qijing Jiang, Xiaoyan Li, Bichen Ren, Bingzhe Li, Hao Li, Yuan Fang, Zhihui Dong, Lihong Huang","doi":"10.1186/s12933-025-02887-2","DOIUrl":"https://doi.org/10.1186/s12933-025-02887-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lipid metabolism-related inflammatory indices (LMIIs) have been recognized as potential biomarkers for the risks of atherosclerosis and major adverse cardiovascular events. This study aims to explore the associations of LMIIs, including neutrophil to high-density lipoprotein cholesterol ratio (NHR), monocyte to high-density lipoprotein cholesterol ratio (MHR), platelet to high-density lipoprotein cholesterol ratio (PHR), and lymphocyte to high-density lipoprotein cholesterol ratio (LHR), with the risk of incident peripheral artery disease (PAD) in elderly T2DM patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 2837 participants aged ≥ 60 years with T2DM from the Jinshan Cohort (China) and 13,542 participants from the UK Biobank (UK) were included in the primary analyses. According to the type of outcome variables, logistic regression models and Cox proportional-hazards models were used to estimate the risks of incident PAD associated with LMIIs. The methods of generalized propensity score (GPS), E-value and negative control exposure (NCE) were applied to control the potential confounding. Additionally, stratified analyses were performed across various populations to examine potential heterogeneity in the effects of LMIIs on PAD risk. Mediation effects of liver and kidney function-related indicators on associations between LMIIs and incident PAD were also explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results from traditional regression models suggested positive associations of incident PAD with all four LMIIs. In the Jinshan Cohort, the odds ratios (ORs) and 95% confidence intervals (CIs) of PAD for one-unit increase in NHR (10&lt;sup&gt;9&lt;/sup&gt; mmol), MHR (10&lt;sup&gt;8&lt;/sup&gt; mmol), PHR (10&lt;sup&gt;11&lt;/sup&gt; mmol) and LHR (10&lt;sup&gt;9&lt;/sup&gt; mmol) were 1.24 (1.11-1.39), 1.22 (1.08-1.37), 1.69 (1.32-2.15) and 1.57 (1.22-2.01), respectively. While in the UK Biobank, the corresponding hazard ratios (HRs) and 95%CI were 1.14 (1.10-1.18), 1.03 (1.01-1.04), 1.19 (1.09-1.29) and 1.11 (1.07-1.14), respectively, These associations remained robust in regression models weighted by GPS methods. The E-values for the effects of each LMII on PAD were consistently found to be significantly larger than their corresponding observed effects in both cohorts. NCE analyses revealed no statistically significant associations between any selected NCE and PAD in either cohort. On calibration using NCEs, the calibrated P values confirmed significant effect sizes for associations between LMIIs and incident PAD (all for P &lt; 0.05). Additionally, subgroup analyses in the Jinshan Cohort showed different associations varied across sex, residential area, smoking status and HbA1c level, with pronounced HRs in females, urban residents, smokers and individuals with HbA1c ≥ 7%. Findings from the UK Biobank further suggested that aspirin use and HbA1c level may modify the effects of LMIIs on PAD risk (P-interaction &lt; 0.05). Mediation analyses indicated that estimated glo","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"346"},"PeriodicalIF":10.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944072","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":"Effect of SGLT2 inhibitors on cardiac structure and function assessed by cardiac magnetic resonance: a systematic review and meta-analysis.","authors":"Isabella Leo, Nadia Salerno, Stefano Figliozzi, Angelica Cersosimo, Jessica Ielapi, Kamil Stankowski, Giandomenico Bisaccia, Santo Dellegrottaglie, Giovanni Canino, Salvatore De Rosa, Sabato Sorrentino, Chiara Bucciarelli-Ducci, Daniele Torella","doi":"10.1186/s12933-025-02904-4","DOIUrl":"https://doi.org/10.1186/s12933-025-02904-4","url":null,"abstract":"<p><strong>Background and aim: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in patients with heart failure (HF) but underlying mechanisms remain incompletely understood. Cardiac magnetic resonance (CMR) is key in evaluating cardiac structure and function, enabling accurate assessment of reverse remodeling. Aim of this systematic review and meta-analysis was to assess the effects of SGLT2i on cardiac remodeling evaluated by CMR changes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies assessing changes in CMR parameters in patients treated with SGLT2i (PROSPERO registration: CRD42024574302). Databases were searched through April 30, 2025. Random-effects models were used to pool mean changes in left and right ventricular volumes, mass, function, stroke volume, global longitudinal strain, left atrial volume, and tissue characterization indices. Meta-regression and sensitivity analyses were performed to evaluate potential sources of heterogeneity.</p><p><strong>Results: </strong>Twenty-three studies and 1008 patients were included. Treatment with SGLT2i was associated with significant reductions in left ventricular (LV) end-diastolic volume (- 7.10 mL; 95% CI: -13.01 to - 1.19, p = 0.023), left ventricular mass (- 4.24 g; 95% CI: -7.88 to - 0.60, p = 0.027) and epicardial adipose tissue (-4.94 ml; 95% CI: -9.06, -0.82, p = 0.019). A subgroup analysis in patients with reduced LV ejection fraction showed improvement in LV stroke volume. Meta-regression revealed no significant effect of age, male sex or diabetes prevalence on pooled estimates.</p><p><strong>Conclusions: </strong>SGLT2i are associated with reductions in LV volumes and mass in line with an overall favorable reverse remodeling effects as assessed by CMR.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"345"},"PeriodicalIF":10.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943787","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 TyG-ABSI versus traditional indices in relation to cardiovascular disease and mortality: evidence from the U.S. NHANES.","authors":"Xin Zheng, Wenjing Zhang, Feng Yang, Leigang Wang, Bing Yu, Bin Liang","doi":"10.1186/s12933-025-02902-6","DOIUrl":"https://doi.org/10.1186/s12933-025-02902-6","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Syndrome (MetS) significantly increases the risk of cardiovascular disease (CVD), with central obesity and insulin resistance as major contributors. The TyG-ABSI index is a newly proposed composite measure that combines the TyG index and ABSI, aiming to assess both insulin resistance and central obesity simultaneously. Previous studies have shown that TyG-ABSI has potential in predicting cardiovascular mortality, but its applicability in MetS populations remains unclear. This study aims to explore the association between TyG-ABSI and cardiovascular events in individuals with MetS and compare its predictive value with the traditional TyG index in this specific population.</p><p><strong>Methods: </strong>Participants from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018 were selected, with all data weighted for sample design, clustering, and stratification to ensure national representativeness. Associations between TyG-ABSI and other TyG indices with cardiovascular mortality and all-cause mortality were assessed using weighted Cox proportional hazards models; CVD prevalence was analyzed using weighted logistic regression models. Additional analyses included Kaplan-Meier survival curves and restricted cubic spline regression. Model performance was compared between TyG-ABSI, TyG, and its derived indices using ROC curves, NRI, IDI, and DCA. E-value, subgroup analyses, and competing risks models were conducted to assess robustness.</p><p><strong>Results: </strong>This study analyzed data from 12,813 individuals with metabolic syndrome in the NHANES cohort to systematically compare the performance of TyG-ABSI and other TyG-related indices in assessing CVD and mortality. The results revealed significant associations between TyG-ABSI and CVD, cardiovascular mortality, and all-cause mortality. Specifically, for each 1-unit increase in TyG-ABSI, the risk of CVD increased by 28%, cardiovascular mortality by 25%, and all-cause mortality by 28%. These associations showed a dose-response relationship in stratified analyses based on tertiles, and TyG-ABSI outperformed the traditional TyG index in overall analysis. Compared to other TyG-related indices, TyG-ABSI demonstrated superior predictive performance in metrics such as the ROC curve, NRI, and DCA. Further analyses, including competing risks models, E-value estimation, and RCS modeling, confirmed the robustness of these associations. Subgroup analyses also supported the stability of TyG-ABSI, with limited interaction effects.</p><p><strong>Conclusion: </strong>Our study highlights the value of TyG-ABSI in assessing cardiovascular disease and mortality risk in populations with MetS, providing new evidence for medical practice and public health interventions.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"344"},"PeriodicalIF":10.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943890","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":"Comparative cardiovascular outcomes and safety of hypoglycemic drug classes in patients with type 2 diabetes and hypertension: a multicenter cohort analysis.","authors":"Zhiyuan Wei, Wanqian Xu, Yu Wang, Yu Tian, Zhongmin Wang, Shenqi Jing, Weina Liu, Sipeng Shen, Chenlong Qin, Xin Zhang, Jingsong Li, Yun Liu","doi":"10.1186/s12933-025-02892-5","DOIUrl":"https://doi.org/10.1186/s12933-025-02892-5","url":null,"abstract":"<p><strong>Background: </strong>Patients with type 2 diabetes (T2D) and hypertension are at increased risk of adverse cardiovascular (CV) events. However, real-world evidence comparing the CV effectiveness and safety of major hypoglycemic drug classes remains limited in this population. This multicenter pooled analysis aims to directly compare the CV outcomes and safety profiles of these key agents in patients with T2D and hypertension.</p><p><strong>Methods: </strong>We analyzed electronic health records from two databases in a cohort study of T2D patients with hypertension who had initiated metformin as first-line therapy. Propensity score matching (PSM) and Cox proportional hazards models were used to compare the risks of 3-/4-point major adverse cardiovascular events (MACE) and safety outcomes across drug classes added to metformin: insulin, sulfonylureas (SUs), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dipeptidyl peptidase-4 inhibitors (DPP4is), glinides, acarbose, and sodium-glucose transporter 2 inhibitors (SGLT2is).</p><p><strong>Results: </strong>Compared with insulin, GLP-1 RAs, DPP4is, and glinides were associated with a lower risk of 3-point MACE (HR: 0.48 [0.31-0.76], 0.70 [0.57-0.85], and 0.70 [0.52-0.94], respectively). SUs were associated with a higher risk of 3-point MACE compared with DPP4is (HR: 1.30 [1.06-1.59]). DPP4is, GLP-1 RAs, and glinides showed a lower risk of 3-point MACE compared with acarbose (HR: 0.62 [0.51-0.76], 0.47 [0.29-0.75], and 0.59 [0.43-0.81], respectively). Similar patterns were observed for 4-point MACE. For safety outcomes, DPP4is were associated with a reduced risk of chronic kidney disease, while insulin use was associated with reduced risks of inflammatory polyarthritis and insomnia. However, DPP4is were associated with higher risks of coronary atherosclerotic diseases and hypertensive heart disease.</p><p><strong>Conclusions: </strong>This study highlights the differential cardiovascular effectiveness and safety profiles of hypoglycemic therapies in real-world settings, providing valuable insights for optimizing T2D management, particularly in patients with comorbid hypertension.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"343"},"PeriodicalIF":10.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943789","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":"A decline in renal function is associated with a reduction in myocardial mechano-energetic efficiency in individuals at high cardiometabolic risk.","authors":"Chiara M A Cefalo, Teresa Vanessa Fiorentino, Mariangela Rubino, Velia Cassano, Gaia Chiara Mannino, Alessia Riccio, Elena Succurro, Maria Perticone, Angela Sciacqua, Francesco Andreozzi, Giorgio Sesti","doi":"10.1186/s12933-025-02889-0","DOIUrl":"10.1186/s12933-025-02889-0","url":null,"abstract":"<p><strong>Background: </strong>Heart failure and chronic kidney disease are closely interrelated conditions with rising global prevalence and incidence. Depressed myocardial mechano-energetic efficiency (MEE), reflecting the left ventricle's capacity to convert chemical energy from oxidative metabolism into mechanical work, is recognized as an early marker of systolic dysfunction. This cross-sectional study aimed to investigate the relationship between estimated glomerular filtration rate (eGFR) and myocardial MEE in individuals at high cardiometabolic risk.</p><p><strong>Methods: </strong>Myocardial MEE per gram of left ventricular mass (MEEi) (mL/sec*g^-1) was assessed via echocardiography in 3,572 adults participating in the CATAnzaro MEtabolic RIsk factors study. Participants were stratified into four categories based on eGFR (G1-G4), in accordance with the Kidney Disease: Improving Global Outcomes classification.</p><p><strong>Results: </strong>Individuals with mildly to severely reduced eGFR (G2, G3 and G4 categories) exhibited a significant reduction in myocardial MEEi compared to the G1 group. In multivariate linear regression analyses, declining eGFR remained significantly associated with reduced MEEi, even after adjusting for a broad range of cardiometabolic confounders, including age, sex, BMI, lipid profile, glucose tolerance status, hsCRP, HOMA-IR index, and the use of glucose-lowering, antihypertensive, and lipid-lowering medications.</p><p><strong>Conclusions: </strong>Our findings demonstrate that a consistent reduction in renal function across eGFR categories is independently associated with reduced myocardial MEEi in individuals with high cardiometabolic risk suggesting that even a mild decline in nearly normal renal function may contribute to altered myocardial energetics.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"342"},"PeriodicalIF":10.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871577","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}