Cardiovascular Diabetology最新文献

{"title":"Association between triglyceride glucose-body mass index and the trajectory of cardio-renal-metabolic multimorbidity: insights from multi-state modelling.","authors":"Haoxian Tang, Jingtao Huang, Xuan Zhang, Xiaojing Chen, Qinglong Yang, Nan Luo, Hanyuan Lin, Jianan Hong, Shiwan Wu, Cuihong Tian, Mengyue Lin, Junshuang Tang, Jiasheng Wen, Pan Chen, Liwen Jiang, Youti Zhang, Kaihong Yi, Xuerui Tan, Yequn Chen","doi":"10.1186/s12933-025-02693-w","DOIUrl":"10.1186/s12933-025-02693-w","url":null,"abstract":"<p><strong>Background: </strong>Although some studies have examined the association between the triglyceride glucose-body mass index (TyG-BMI) and cardiovascular outcomes in the cardio-renal-metabolic (CRM) background, none have explored its role in the progression of CRM multimorbidity. In addition, prior research is limited by small sample sizes and a failure to account for the competitive effects of other CRM diseases.</p><p><strong>Methods: </strong>In this study, data obtained from the large-scale, prospective UK Biobank cohort were used. CRM multimorbidity was defined as the new-onset of ischemic heart disease, type 2 diabetes mellitus, or chronic kidney disease during follow-up. Multivariable Cox regression was used to analyse the independent association between TyG-BMI and each CRM multimorbidity (first, double, or triple CRM diseases). The C-statistic was calculated for each model, and a restricted cubic spline was applied to assess the dose-response relationship. A multi-state model was used to investigate the association between TyG-BMI and the trajectory of CRM multimorbidity (from baseline [without CRM disease] to the first CRM disease, the first CRM disease to double disease, and double disease to triple disease), with disease-specific analyses.</p><p><strong>Results: </strong>This study included 349,974 participants, with a mean age of 56.05 (standard deviation [SD], 8.08), 55.93% of whom were female. Over a median follow-up of approximately 14 years, 56,659 (16.19%) participants without baseline CRM disease developed at least one CRM disease, including 8451 (14.92%) who progressed to double CRM disease and 789 (9.34%) who further developed triple CRM disease. In the crude model, each SD increase in TyG-BMI was associated with a 47% higher risk of the first CRM disease, a 72% higher risk of double CRM disease, and a 95% higher risk of triple CRM disease, with C-statistics of 0.625, 0.694, and 0.764, respectively. Multi-state model analysis showed a 32% increased risk of new CRM disease, a 24% increased risk of progression to double CRM disease, and a 23% increased risk of further progression for those with double CRM diseases. TyG-BMI was significantly associated with the onset of all individual first CRM diseases (except for stroke) and with the transition to double CRM disease. Significant interactions were also observed, but TyG-BMI remained significantly associated with CRM multimorbidity across subgroups. Sensitivity analyses, including varying time intervals for entering states and an expanded CRM definition (including atrial fibrillation, heart failure, peripheral vascular disease, obesity, and dyslipidaemia), confirmed these findings.</p><p><strong>Conclusion: </strong>TyG-BMI remarkably influences the onset and progression of CRM multimorbidity. Incorporating it into CRM multimorbidity prevention and management could have important public health implications.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"133"},"PeriodicalIF":8.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676774","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":"Accelerometer-derived \"weekend warrior\" physical activity pattern and incident type 2 diabetes.","authors":"Zhi Cao, Jiahao Min, Chenjie Xu","doi":"10.1186/s12933-025-02676-x","DOIUrl":"10.1186/s12933-025-02676-x","url":null,"abstract":"<p><strong>Background: </strong>The guidelines provided by the World Health Organization (WHO) recommend a minimum of 150 min/week of moderate-to-vigorous physical activity (MVPA) for optimal overall health benefits. However, it remains unclear whether there are differential effects on the risk of incident type 2 diabetes (T2D) between concentrated and evenly distributed physical activity (PA) patterns. We aimed to investigate the associations of accelerometer-derived weekend warrior and regularly active pattern with risk of T2D.</p><p><strong>Methods: </strong>A total of 84,656 general participants from the UK Biobank with validated accelerometry data and free of T2D was included. Data on PA was collected using the Axivity AX3 wrist-based triaxial accelerometer worn for one week. Participants were categorized into three PA patterns: inactive (< 150 min/week of MVPA), weekend warrior (≥ 150 min/week with ≥ 50% of total MVPA occurring within 1-2 days), and regularly active (≥ 150 min/week but not meeting weekend warrior criteria).</p><p><strong>Results: </strong>During a median follow-up of 8.4 years, 2464 cases of T2D were documented. In multivariable-adjusted models, the weekend warrior pattern (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.67-0.84) and the regularly active pattern (HR 0.80, 95% CI 0.69-0.94) exhibited a comparable lower risk of T2D compared to physically inactive participants. When stratified by genetic risk score (PRS) of T2D, the weekend warrior pattern was associated with T2D in the higher PRS group (HR 0.78, 95% CI 0.67-0.91), intermediate PRS group (HR 0.78, 95% CI 0.62-0.97) and lowest PRS group (HR 0.59, 95% CI 0.43-0.80).</p><p><strong>Conclusions: </strong>Engaging in the weekend warrior pattern is associated with a similarly lower risk of T2D to the regularly active pattern, even among individuals with high genetic risk. These findings highlight the weekend warrior pattern as a significant and flexible alternative in preventive intervention strategies for T2D, particularly for those unable to maintain daily activity routines.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"130"},"PeriodicalIF":8.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676852","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 impact of hypercortisolism beyond metabolic syndrome on left ventricular performance: a myocardial work analysis.","authors":"Floran Sahiti, Mario Detomas, Vladimir Cejka, Kristina Hoffmann, Götz Gelbrich, Stefan Frantz, Mathias Kroiss, Peter U Heuschmann, Stefanie Hahner, Martin Fassnacht, Timo Deutschbein, Stefan Störk, Caroline Morbach","doi":"10.1186/s12933-025-02680-1","DOIUrl":"10.1186/s12933-025-02680-1","url":null,"abstract":"<p><strong>Background and aims: </strong>Endogenous Cushing's syndrome (CS) is characterized by an unfavorable cardiovascular (CV) and metabolic risk profile, but the potential adverse effects of hypercortisolism on myocardial function are not well known. Myocardial Work analysis is a new echocardiographic method that utilizes left ventricular pressure-strain loops to quantify cardiac performance independent of afterload.</p><p><strong>Methods and results: </strong>In a cross-sectional analysis, we compared four groups: patients with overt endogenous CS (n = 31, mean age 47 ± 12 years, 71% women), patients with endogenous CS in long-term remission after medical cure (CS-LTR; n = 49, 53 ± 12 years, 78% women), healthy subjects (n = 439; 49 ± 11 years, 57% women), and individuals with metabolic syndrome (n = 305, 59 ± 10 years, 37% women). Both CS patient groups exhibited a CV risk pattern and metabolic profile worse than healthy subjects but better than individuals with metabolic syndrome. Analyses adjusted for sex and age revealed higher Wasted Work both in overt CS (median; quartiles: 105 mmHg%; 74, 147) and CS-LTR (97 mmHg%; 69, 158), respectively, when compared to healthy individuals (75 mmHg%; 54, 109, p < 0.01) or individuals with metabolic syndrome (95 mmHg%, 65, 136, p < 0.05), resulting in compromised Work Efficiency (p < 0.05).</p><p><strong>Conclusion: </strong>Left ventricular performance is compromised in overt CS beyond alterations found in individuals with metabolic syndrome sharing equal CV risk factors and remains so despite biochemical remission during the LTR period. Myocardial Work analysis is suited to detect the subtle yet clinically relevant differences between different phenotypes of myocardial involvement.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"132"},"PeriodicalIF":8.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676762","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":"Piezo1 deletion mitigates diabetic cardiomyopathy by maintaining mitochondrial dynamics via ERK/Drp1 pathway.","authors":"Weipin Niu, Xin Liu, Bo Deng, Tianying Hong, Cuifen Wang, Yameng Yan, Jiali Liu, Yuehua Jiang, Jing Li","doi":"10.1186/s12933-025-02625-8","DOIUrl":"10.1186/s12933-025-02625-8","url":null,"abstract":"<p><strong>Objective: </strong>Increasing evidence highlights the critical role of Piezo1 in cardiovascular diseases, with its expression upregulated in diabetic heart. However, the involvement of Piezo1 in the pathogenesis of diabetic cardiomyopathy (DCM) remains unclear. This study aims to elucidate the regulatory role of Piezo1 in mitochondrial dynamics within the context of DCM and to investigate the underlying mechanisms.</p><p><strong>Methods: </strong>We constructed cardiac-specific knockout of Piezo1 (Piezo1^∆Myh6) mice. Type 1 diabetes was induced using streptozotocin (STZ) injection while type 2 diabetes was established through a high-fat diet combined with STZ. Echocardiography assessed left ventricular function, histological evaluations used HE and Masson staining to examine cardiac pathology in Piezo1^fl/fl controls, Piezo1^∆Myh6 controls, Piezo1^fl/fl diabetic and Piezo1^∆Myh6 diabetic mice. Mitochondrial function including oxygen species level, mitochondrial morphology, and respiration rate were also assessed.</p><p><strong>Results: </strong>Our findings revealed that Piezo1 expression was upregulated in the myocardium of diabetic mice and in high-glucose-treated cells. Cardiac-specific knockout of Piezo1 improved cardiac dysfunction and ameliorated cardiac fibrosis in diabetic mice. Moreover, Piezo1 deficiency also attenuated mitochondrial impairment. Piezo1^fl/fl diabetic mice exhibited increased calpain activity and excessive mitochondrial fission mediated by Drp1 and obvious reduced fusion; however, Piezo1 deficiency restored calpain levels and mitochondrial dysfunction. These observations were also corroborated in H9C2 cells and neonatal mouse cardiomyocytes. Cardiac-specific knockout of Piezo1 increased phosphorylation of Drp1 and ERK1/2 in vivo and in vitro. Piezo1 knockout or treatment with inhibitor improved mitochondrial function.</p><p><strong>Conclusions: </strong>This study provides the first evidence that Piezo1 is elevated in DCM through the modulation of mitochondrial dynamics, which is reversed by Piezo1 deficiency. Thus, Piezo1 inhibition may provide a promising therapeutic strategy for the treatment of DCM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"127"},"PeriodicalIF":8.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669194","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":"Evaluation of glycemic status and subclinical atherosclerosis in familial hypercholesterolemia subjects with or without LDL receptor mutation.","authors":"Francesco Di Giacomo Barbagallo, Giosiana Bosco, Maurizio Di Marco, Sabrina Scilletta, Nicoletta Miano, Marco Musmeci, Marina Martedì, Ana M González-Lleó, Daiana Ibarretxe, Ernestina Marianna De Francesco, Roberta Malaguarnera, Antonino Di Pino, Luís Masana, Francesco Purrello, Salvatore Piro, Roberto Scicali","doi":"10.1186/s12933-025-02683-y","DOIUrl":"10.1186/s12933-025-02683-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Familial hypercholesterolemia (FH) is a genetic condition characterized by elevated LDL-C and increased cardiovascular risk. Beyond LDL-C levels, the impact of genotype on glucose homeostasis has not been well evaluated. We aimed to evaluate the impact of genotype on glycemic status and on atherosclerotic injury in FH subjects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional study on 322 FH subjects not on lipid-lowering therapy and without history of cardiovascular disease. Biochemical and genetic analyses as well as vascular profile assessment were obtained from all subjects. The study population was divided into two groups according to genotype: LDL receptor (LDLR) group and non-LDLR (NLDLR) group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The LDLR group exhibited a higher prevalence of low glycemic status (LGS) than the NLDLR group (44.1% vs. 26%, p &lt; 0.01), whereas a high glycemic status (HGS) was more prevalent in the NLDLR group compared with LDLR group (74% vs. 55.9%, p &lt; 0.01). The NLDLR group exhibited a higher prevalence of peripheral atherosclerotic plaques than the LDLR group (93.4% vs. 73%, p &lt; 0.05), while coronary artery calcification (CAC) presence was more prevalent in the LDLR group compared with the NLDLR group (74.7% vs. 48%, p &lt; 0.01). In a secondary analysis the study population was stratified into three groups based on LDLR genotype: NLDLR, LDLR defective, LDLR null groups. The prevalence of LGS progressively increased from the NLDLR to the LDLR null group, while HGS showed an inverse trend (p for trend &lt; 0.05). Peripheral atherosclerotic plaque prevalence decreased from the NLDLR to the LDLR null group (p for trend &lt; 0.05), while CAC prevalence increased progressively in the three groups (p for trend &lt; 0.01). Logistic regression analysis showed that FH groups with an LDLR mutation were inversely associated with HGS (p for both &lt; 0.01) and the LDLR null group exhibited the strongest association.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;FH subjects with NLDLR mutations exhibited a worse glycemic profile, while null LDLR mutations showed the strongest inverse association with HGS. The integrations of genetic, lipid and glucose data could be useful to better identify the metabolic profile and the atherosclerosis distribution in FH subjects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Familial hypercholesterolemia (FH) is characterized by elevated LDL-C levels. LDLR null mutations protected pancreatic β-cells from cholesterol accumulation. NGS has improved FH diagnosis by analysis of all genes implicated in the lipid disorder. WHAT IS THE KEY RESEARCH QUESTION?: What is the impact of FH genotype (monogenic with or without LDLR mutation/polygenic) on glycemic status? WHAT IS NEW?: FH population was characterized by a heterogeneous glycemic profile according to LDLR mutation. LDL-C and plasma glucose could modulate the distribution of subclinical atheroscle","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"126"},"PeriodicalIF":8.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669192","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":"Dysglycaemia is associated with the pattern of valvular calcification in micro-computed tomography analysis: an observational study in patients with severe aortic stenosis.","authors":"Magdalena Kopytek, Kamila W Undas, Jacek Tarasiuk, Sebastian Wroński, Michał Ząbczyk, Joanna Natorska","doi":"10.1186/s12933-025-02691-y","DOIUrl":"10.1186/s12933-025-02691-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diabetes mellitus (DM) has been shown to increase the rate of aortic stenosis (AS) progression. However, the impact of impaired plasma glucose on valvular calcification remains poorly understood. Using ex vivo micro-computed tomography (micro-CT), we aimed to determine whether plasma glucose, glycated haemoglobin (HbA&lt;sub&gt;1c&lt;/sub&gt;), or concentrations of advanced glycation end products (AGEs) and their soluble receptor (sRAGE) are associated with a specific pattern of valvular calcification in severe AS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this case-control study, 14 (48%) normoglycaemic patients with AS were compared to 15 individuals (52%) with elevated glucose levels (≥ 5.6 mmol/L), all with HbA&lt;sub&gt;1c&lt;/sub&gt; ≤ 6.5%. Stenotic aortic valves obtained surgically were analysed using micro-CT to assess structure of tissue mineralization. Calcium volume (CV), surface volume (SV), CV/SV ratio, and trabecular thickness (TbTh) were evaluated. Plasma AGEs and sRAGE were assessed by ELISAs. DM patients or those using antidiabetic agents were excluded from the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients with impaired and high glucose, including 10 (67%) with glucose between 5.6 and 6.9 mmol/L and 5 (33%) ranging from 7 to 7.6 mmol/L, exhibited higher HbA&lt;sub&gt;1c&lt;/sub&gt; (+ 17%) and AGEs levels (+ 44.6%), but not sRAGE compared to those with normal glucose. Patients with impaired and high glucose had also 19.2% higher maximal transvalvular pressure gradient (PG&lt;sub&gt;max&lt;/sub&gt;) and 9.3% higher peak transvalvular velocity (V&lt;sub&gt;max&lt;/sub&gt;) compared to normoglycaemic individuals. Micro-CT indices correlated with fasting glucose, HbA&lt;sub&gt;1c&lt;/sub&gt;, and AGEs levels (all p &lt; 0.05), but not with sRAGE (p &gt; 0.05). Valves extracted from patients with impaired and high glucose exhibited higher mineralization volume, folding, and structural integrity, as reflected by increased CV (+ 127.6%), CV/SV ratio (+ 59%) and calcium deposits microarchitecture as indicated by about 50% higher TbTh, compared to normoglycaemic patients. When patients with AS were divided into three groups based on their glucose levels (&lt; 5.5 mmol/L, 5.6-6.9 mmol/L, and 7.0-7.6 mmol/L), micro-CT analysis showed more distinct structural differences among the groups. The valves in the highest glucose group were the most severely affected. Micro-CT parameters were also associated with both transvalvular pressure gradients (PG&lt;sub&gt;mean&lt;/sub&gt; and PG&lt;sub&gt;max&lt;/sub&gt;), V&lt;sub&gt;max&lt;/sub&gt; and aortic valve area (all p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Strict glycaemic control could potentially reduce the rate of valve mineralization and calcium deposit accumulation in patients with AS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Diabetes mellitus (DM) is a risk factor for the progression of aortic stenosis (AS). Accumulation of advanced glycation end products (AGEs) enhances glycation of valvular proteins. WHAT IS THE KEY RESEARCH Q","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"129"},"PeriodicalIF":8.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669191","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 adverse effect of metabolic syndrome on left ventricular global strains and myocardial energetic efficiency in non-ischemic dilated cardiomyopathy patients: a cardiac magnetic resonance study.","authors":"Meng-Ting Shen, Yuan Li, Ke Shi, Jin Wang, Li Jiang, Yu Jiang, Yue Gao, Shi-Qin Yu, Xue-Ming Li, Wei-Feng Yan, Zhi-Gang Yang","doi":"10.1186/s12933-025-02690-z","DOIUrl":"10.1186/s12933-025-02690-z","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a known risk factor for cardiovascular dysfunction; however, its impact on left ventricular (LV) global strains and myocardial energetic efficiency in non-ischemic dilated cardiomyopathy (NIDCM) remains inadequately understood. This study aimed to investigate the effect of MetS on LV dysfunction in NIDCM patients using cardiovascular magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>A total of 557 NIDCM patients (378 without MetS and 179 with MetS) who underwent CMR examination were included. CMR-derived LV strains, remodeling index (LVRI), global function index (LVGFI), and indexed myocardial energetic efficiency (MEEI) were assessed and compared between the groups. The independent determinants of LV global longitudinal peak strain (GLPS), LVRI, LVGFI, and MEEI were evaluated using multivariable linear regression analyses.</p><p><strong>Results: </strong>Compared to NIDCM patients without MetS, those with MetS had significantly lower LVSVI, LVEF, and LVGFI, along with higher LVMI and LVRI (all p < 0.05). However, no significant differences were found in LVEDVI and LVESVI (both p > 0.05). In terms of LV strain, the NIDCM(MetS+) group exhibited worse global peak strain and peak diastolic strain rate in all three directions, as well as decreased radial and longitudinal peak systolic strain rate (PSSR) compared to the NIDCM (MetS-) group (all p < 0.05), while circumferential PSSR did not differ significantly (p > 0.05). The MEEI was significantly lower in the NIDCM(MetS+) group compared to the NIDCM(MetS-) group (0.30 [0.20, 0.45] ml/s/g vs. 0.39 [0.25, 0.58] ml/s/g, p < 0.001). Multivariable analysis identified the presence of MetS as an independent determinant of LV GLPS (β = 0.211, p < 0.001), LVRI (β = 0.147, p = 0.003), and MEEI (β = - 0.160, p < 0.001).</p><p><strong>Conclusion: </strong>The presence of MetS worsens LV function, remodeling, and myocardial energetic efficiency in patients with NIDCM, as evidenced by declines in LV strain, global function parameters, and indexed myocardial energetic efficiency. These findings suggest that addressing metabolic abnormalities may be crucial for improving LV function and outcomes for patients with NIDCM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"128"},"PeriodicalIF":8.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669195","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":"Metabolomic profiling reveals early biomarkers of gestational diabetes mellitus and associated hepatic steatosis.","authors":"Youngae Jung, Seung Mi Lee, Jinhaeng Lee, Yeonjin Kim, Woojoo Lee, Ja Nam Koo, Ig Hwan Oh, Kue Hyun Kang, Byoung Jae Kim, Sun Min Kim, Jeesun Lee, Ji Hoi Kim, Yejin Bae, Sang Youn Kim, Gyoung Min Kim, Sae Kyung Joo, Dong Hyeon Lee, Joon Ho Moon, Bo Kyung Koo, Sue Shin, Errol R Norwitz, Geum-Sook Hwang, Joong Shin Park, Won Kim","doi":"10.1186/s12933-025-02645-4","DOIUrl":"10.1186/s12933-025-02645-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aims to identify early metabolomic biomarkers of gestational diabetes mellitus (GDM) and evaluate their association with hepatic steatosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We compared maternal serum metabolomic profiles between women who developed GDM (n = 118) and matched controls (n = 118) during the first (10-14 gestational weeks) and second (24-28 gestational weeks) trimesters using ultra-performance liquid chromatography coupled with mass spectrometry. Mediation analysis was performed to evaluate the mediating role of metabolic dysfunction-associated steatotic liver disease (MASLD) in the relationship between metabolites and subsequent development of GDM. A refined prediction model was developed to predict GDM using established clinical factors and selected metabolites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant alterations in circulating metabolites, including amino acids, bile acids, and phospholipids, were observed in the GDM group compared to controls during early pregnancy. Mediation analysis revealed that several metabolites, including glycocholic acid (proportion mediated (PM) = 31.9%), butanoyl carnitine (PM = 25.7%), and uric acid (PM = 22.4%), had significant indirect effects on GDM incidence mediated by hepatic steatosis. The refined prediction model composed of clinical factors and selected metabolites in the first trimester demonstrated higher performance in predicting GDM development than the established prediction model composed solely of clinical factors (AUC, 0.85 vs. 0.63, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Women who developed GDM exhibited altered metabolomic profiles from early pregnancy, which showed a significant correlation with GDM, with MASLD as a mediator. Selected metabolomic biomarkers may serve as predictive markers and potential targets for early risk assessment and intervention in GDM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Gestational diabetes mellitus (GDM) is a common pregnancy complication with significant health risks. Early identification of women at high risk for GDM is crucial for timely intervention and improved outcomes. WHAT IS THE KEY RESEARCH QUESTION?: What alterations in circulating metabolites during early pregnancy are associated with subsequent GDM development? Does metabolic dysfunction-associated steatotic liver disease (MASLD) mediate the association between specific metabolites and GDM risk? WHAT IS NEW?: Significant alterations in bile acids, amino acids, phosphatidylethanolamines, and phosphatidylinositols were observed in early pregnancy sera of women who later developed GDM. MASLD significantly mediated the effects of several metabolites on GDM risk, with mediation proportions ranging from 9.7 to 31.9%. A refined prediction model composed of clinical factors and metabolites significantly improved the performance in predicting GDM development. HOW MIGHT THIS STUDY INFLUENCE CLINICAL PR","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"125"},"PeriodicalIF":8.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669193","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":"Association of atherogenic index of plasma trajectory with the incidence of cardiovascular disease over a 12-year follow-up: findings from the ELSA cohort study.","authors":"Xicong Li, Lifei Lu, Yubiao Chen, Baiyun Liu, Bei Liu, Heshen Tian, Huajing Yang, Ruiwei Guo","doi":"10.1186/s12933-025-02677-w","DOIUrl":"10.1186/s12933-025-02677-w","url":null,"abstract":"<p><strong>Background: </strong>Atherogenic index of plasma (AIP) at baseline has been associated with increased morbidity and mortality from cardiovascular disease (CVD). However, the relationship between long-term AIP trajectories and CVD remains unclear. Therefore, this study aimed to investigate the associations between AIP trajectories and the incidence of CVD in the English population.</p><p><strong>Method: </strong>The study data analysis was based on the English Longitudinal Study of Aging (ELSA) from 2004 to 2017. The study population consisted of individuals aged 50 years and older in England. AIP was calculated as log₁₀ (triglycerides/high-density lipoprotein cholesterol). Group-based trajectory model (GBTM) was applied to identify the trajectory of the AIP index from Wave 2 to 8 over a 12-year follow-up. Cox proportional hazard models were then used to analyze the associations between different AIP index trajectory groups and the incidence of CVD.</p><p><strong>Results: </strong>A total of 3976 participants with completed AIP data in Wave 2 and more than two AIP measurements between Wave 2 and Wave 8 were enrolled in the ELSA cohort. The participants were divided into three groups [low-stable group (n = 1146), moderate-stable group (n = 2110), high-stable group (n = 720)] using a GBTM model. After adjusting for potential confounders, participants in the high-stable group indicated an increased risk of developing incident of CVD compared to those in the low-stable AIP group [Hazard Ratio (HR) 1.33; 95% Confidence Interval (CI) 1.02-1.74, P = 0.033]. However, no differences in the incidence of CVD (HR 1.20, 95%CI 0.98-1.48, P = 0.082) were observed in the moderate-stable group. Subgroup analysis indicated similar results for participants under 63 years old and those with high alcohol consumption.</p><p><strong>Conclusions: </strong>A high and sustainable level of the AIP index may contribute to the incidence of CVD. The trajectories of the AIP index can help identify older English individuals at increased risk of CVD who deserve primitive preventive and therapeutic approaches.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"124"},"PeriodicalIF":8.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662420","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":"Higher hemoglobin levels are associated with impaired left ventricular global strains in metabolic syndrome: a 3.0 T CMR feature tracking study.","authors":"Xue Li, Shi-Qin Yu, Zhi-Gang Yang, Bi-Yue Hu, Ke Shi, Jing Wang, Xue-Ming Li, Ge Zhang, Wen-Rong Li, Rong Xu, Yuan Li","doi":"10.1186/s12933-025-02664-1","DOIUrl":"10.1186/s12933-025-02664-1","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a known contributor to increased cardiovascular risk and all-cause mortality. Recent literatures suggested that higher hemoglobin (Hb) levels were associated with Mets, left ventricular (LV) dysfunction and adverse events in general population. This study aimed to assess the associations between Hb levels and LV global strains in patients with MetS.</p><p><strong>Methods: </strong>A retrospective analysis included 254 patients with MetS and 78 sex-, age-, and Hb-matched controls. The MetS patients were stratified into five groups based on Hb levels: anemia, low-normal Hb, moderate-normal Hb, high-normal Hb, and high Hb. LV global radial, circumferential, and longitudinal strains (LVGRS, LVGCS, and LVGLS, respectively) were measured using the cardiac magnetic resonance feature tracking technique. Associations between Hb levels and LV global strains were evaluated using multiple linear regression, restricted cubic spline (RCS), and subgroup analyses.</p><p><strong>Results: </strong>After full adjustment, the LV global strains from three directions in the high Hb groups (LVGRS: β = -  4.943, 95% CI -  7.673 to - 2.213; LVGCS: β = -  2.341, 95% CI - 3.608 to - 1.074; LVGLS: β = -2.797, 95% CI - 4.049 to - 1.546, all p < 0.05) were significantly reduced than those in their respective moderate-normal Hb groups. Full adjusted RCS plots revealed inverted L-shaped associations between Hb levels and LV global strains, with significant reductions observed above 143 g/L (all p for nonlinearity < 0.05). Subgroup analyses indicated that the associations were more pronounced in MetS patients with obesity (LVGRS: β = -  0.005 [95% CI - 0.087 to 0.097] versus -0.087 [95% CI - 0.145 to - 0.030]; LVGCS: β = -0.006 [95% CI - 0.045 to 0.034] versus -0.048 [95% CI - 0.075 to - 0.021]; LVGLS: β = -0.011 [95% CI -  0.053 to 0.032] versus -0.063 [95% CI - 0.089 to - 0.036] for non-obese and obese patients; all p for interaction < 0.05).</p><p><strong>Conclusions: </strong>Higher Hb levels are significantly associated with more severe LV dysfunction in MetS patients, particularly in those with obesity. Targeted monitoring and management of higher Hb levels in MetS patients may help mitigate further deterioration of cardiac function.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"123"},"PeriodicalIF":8.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647326","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}