Cardiovascular Diabetology最新文献

{"title":"Metabolic profiling of frailty, associations with type 2 diabetes and interaction with genetic susceptibility.","authors":"Yuxiang Wang, Shuang Chen, Yue Li, Qi Lu, Rui Li, Jun-Xiang Chen, Ji-Juan Zhang, Hancheng Yu, Hanrui Xu, Jinchi Xie, Xianli Li, Gang Liu, An Pan, Tingting Geng, Yun-Fei Liao","doi":"10.1186/s12933-025-02776-8","DOIUrl":"10.1186/s12933-025-02776-8","url":null,"abstract":"<p><strong>Background: </strong>Individuals with frailty are at increased risk of type 2 diabetes (T2D), but the underlying mechanisms are unclear. We aimed to investigate whether the frailty-T2D association is mediated by alterations in the metabolome and assess potential interaction with genetic susceptibility to diabetes.</p><p><strong>Methods: </strong>This retrospective analysis, using data from a large prospective population-based cohort, included a total of 197,502 adults with baseline metabolomics data from the UK Biobank. Frailty was defined using the Fried frailty phenotype according to five components. Elastic net regression was applied to create a frailty-related metabolic signature. We assessed hazard ratios (HR) and its 95% confidence interval (CI) of incident T2D in relation to the baseline metabolic signature of frailty and examined the mediating role of the metabolic signature in the effect of frailty on T2D. Additive interaction between the metabolic signature and polygenic risk score for T2D (PRS-T2D) on the incidence of T2D was assessed as relative excess risk due to interaction (RERI).</p><p><strong>Results: </strong>Compared with non-frailty, the HR (95% CI) of incident T2D in pre-frailty and frailty was 1.33 (1.26, 1.40) and 1.59 (1.46, 1.74), respectively. The metabolic signature of frailty (comprised of 53 metabolites) was positively associated with T2D risk (HR per standard deviation increment: 1.45; 95% CI: 1.42, 1.48), and explained 31.0% (95% CI: 25.8, 36.8) of the association between frailty and T2D. An additive interaction between metabolic signature of frailty and PRS-T2D was found (RERI: 9.43; 95% CI: 6.06, 12.80).</p><p><strong>Conclusions: </strong>The increased risk of T2D in individuals with frailty may be mediated through effects on the metabolome, and the influence of such metabolic alterations on diabetes risk may be amplified in individuals with genetic susceptibility to T2D.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"226"},"PeriodicalIF":8.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141362","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":"Refining the link between obesity and heart failure: insights from GLP-1 receptor agonist trials and studies adopting direct adiposity measures.","authors":"Nicola Riccardo Pugliese, Francesco Paneni, Domenico Tricò, Alessandra Violet Bacca, Nicolò De Biase, Hermann Dalpiaz, Alessandro Mengozzi, Agostino Virdis, Lorenzo Ghiadoni, Stefano Taddei, Reinhold Kreutz, Konstantinos Tsioufis, Stefano Masi","doi":"10.1186/s12933-025-02778-6","DOIUrl":"10.1186/s12933-025-02778-6","url":null,"abstract":"<p><p>Overweight and obesity are major risk factors for heart failure (HF), contributing to its development through metabolic, neurohormonal, haemodynamic, and inflammatory alterations. While overweight/obesity increases the risk of developing HF, its impact on patient outcomes remains complex. The \"obesity paradox\" suggests that a higher BMI may be associated with improved survival in patients with established HF. However, recent GLP-1 receptor agonist (GLP-1 RA) trials suggest that intentional weight loss positively influences outcomes in overweight/obese patients with HF. This seemingly contradictory evidence highlights the need for a deeper understanding of the mechanisms linking adiposity to HF outcomes. A more precise characterization of adiposity phenotypes using alternative and accurate measures of pathological fat accumulation is crucial in identifying individuals who may benefit most from anti-obesity treatments. In this context, recent research underscores the role of epicardial adipose tissue (EAT) in HF pathophysiology, as it directly influences cardiac function and structure through inflammatory, metabolic, and mechanical effects. This narrative review summarises current evidence on the impact of weight loss on HF outcomes, focusing on recent GLP-1 RA trial results. Additionally, it highlights epidemiological and molecular data supporting EAT as a novel adiposity measure that might allow refining patient selection for pharmacological weight-loss treatments. Finally, it emphasizes the need for future research to identify causal pathways linking alternative measures of visceral fat accumulation to HF outcomes. These efforts will be essential in optimizing the benefits of novel weight-loss treatments, ensuring effective and individualized therapeutic strategies for overweight or obese patients with HF.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"224"},"PeriodicalIF":8.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126844","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 predictive significance of the triglyceride-glucose index in forecasting adverse cardiovascular events among type 2 diabetes mellitus patients with co-existing hyperuricemia: a retrospective cohort study.","authors":"Jianyong Zhao, Na Li, Shiqi Li, Jiaqing Dou","doi":"10.1186/s12933-025-02783-9","DOIUrl":"10.1186/s12933-025-02783-9","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index serves as a crucial indicator for evaluating insulin resistance (IR) and cardiovascular risk among patients with type 2 diabetes mellitus (T2DM). Concurrently, hyperuricemia (HUA) strongly correlates with adverse cardiovascular outcomes. However, the prognostic value of the TyG index, particularly in patients exhibiting both conditions, remains inadequately defined. This study assessed the association between TyG index measurements and the incidence of major adverse cardiovascular events (MACEs) among patients simultaneously diagnosed with T2DM and HUA.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included 628 patients diagnosed with both T2DM and HUA at the Chaohu Hospital (Anhui Medical University) between 2019 and 2024. Participants were stratified into tertiles based on their TyG index values. Kaplan-Meier survival curves with log-rank tests estimated the risk of MACEs, and Cox regression analyses calculated hazard ratios. The additional predictive contribution of the TyG index was evaluated using C statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) metrics.</p><p><strong>Results: </strong>During the 38.00 ± 8.78 months follow-up period, 74 MACEs were recorded. A significant proportional relationship emerged between the TyG index and cardiovascular events-patients in the highest tertile demonstrated markedly increased risk compared with those in the lowest tertile (HR = 2.45, 95% CI 1.23-4.95). A pivotal threshold was identified at TyG > 8.40, beyond which each standard deviation increase corresponded to a 66% higher probability of MACEs (HR = 1.66, 95% CI 1.36-2.36, P = 0.014). Integrating the TyG index into traditional risk models significantly improved predictive performance (C statistic increase: 0.64 → 0.67, P = 0.029; NRI = 0.14, IDI = 0.02, both P < 0.05).</p><p><strong>Conclusion: </strong>The TyG index constitutes an autonomous MACE predictor specifically within the distinctive cohort of patients manifesting both T2DM and HUA. This study is the first to validate the TyG > 8.40 threshold in T2DM patients with HUA and identify a synergistic interaction between serum uric acid (SUA) and TyG, providing a novel stratification tool for managing dual metabolic disorders.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"218"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118841","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 between atherogenicity indices and prediabetes: a 5-year retrospective cohort study in a general Chinese physical examination population.","authors":"Xianli Qiu, Yong Han, Changchun Cao, Yuheng Liao, Haofei Hu","doi":"10.1186/s12933-025-02768-8","DOIUrl":"10.1186/s12933-025-02768-8","url":null,"abstract":"<p><strong>Background and objective: </strong>Atherogenicity indices have emerged as promising markers for cardiometabolic disorders, yet their relationship with prediabetes risk remains unclear. This study aimed to comprehensively evaluate the associations between six atherogenicity indices and prediabetes risk in a Chinese population, and explore the predictive value of these atherosclerotic parameters for prediabetes.</p><p><strong>Methods: </strong>This retrospective cohort study included 97,151 participants from 32 healthcare centers across China, with a median follow-up of 2.99 (2.13, 3.95) years. Six atherogenicity indices were calculated: Castelli's Risk Index-I (CRI-I), Castelli's Risk Index-II (CRI-II), Atherogenic Index of Plasma (AIP), Atherogenic Index (AI), Lipoprotein Combine Index (LCI), and Cholesterol Index (CHOLINDEX). To address the natural relationships between the atherogenicity indices and risk of prediabetes, we applied Cox proportional hazards regression with cubic spline functions and smooth curve fitting, using a recursive algorithm to calculate inflection points. Machine learning approach (XGBoost and Boruta methods) to address the high collinearity among indices and assess their relative importance, combined with time-dependent ROC analysis to evaluate the predictive performance at 3-, 4-, and 5-year follow-up.</p><p><strong>Results: </strong>During follow-up, 11,199 participants developed prediabetes (incidence rate: 3.71 per 100 person-years). Significant nonlinear associations were observed between all atherogenicity indices and prediabetes risk. Through Z-score standardization of atherogenicity indices and comprehensive Cox proportional hazards regression and advanced machine learning techniques, we identified AIP as the most significant predictor of prediabetes [HR = 1.057 (95% CI 1.035-1.080, P < 0.0001)], with LCI emerging as a secondary important marker [HR = 1.020 (95% CI 1.002-1.038, P = 0.0267)]. Our innovative XGBoost and Boruta analysis uniquely validated these findings, providing robust evidence of AIP and LCI's critical role in prediabetes risk assessment. Time-dependent ROC analysis further validated these findings, with LCI and AIP demonstrating comparable discrimination, with overlapping AUC ranges of 0.5952-0.6082. Notably, the combined indices model achieved enhanced predictive performance (AUC: 0.6753) compared to individual indices, suggesting the potential benefit of using multiple atherogenicity indices for prediabetes risk prediction.</p><p><strong>Conclusion: </strong>This study identifies statistically significant associations between atherogenicity indices and prediabetes risk, highlighting their nonlinear relationships and combined effects. While the predictive performance of these indices is modest (AUC 0.55-0.68), these findings may contribute to improved risk stratification when incorporated into comprehensive assessment strategies.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"220"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118808","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 SGLT2-inhibitors on acute kidney injury in diabetic patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI).","authors":"Pasquale Paolisso, Marta Belmonte, Emanuele Gallinoro, Roberto Scarsini, Luca Bergamaschi, Leonardo Portolan, Matteo Armillotta, Giuseppe Esposito, Elisabetta Moscarella, Claudio Montalto, Elayne Kelen de Oliveira, Francesco Angeli, Mateusz Orzalkiewicz, Margherita Fabroni, Verdiana Galli, Nurcan Baydaroglu, Francesca Di Lenarda, Pasquale Policastro, Carlo Terrone, Davide Ausiello, Giose Vincelli, Matteo Casenghi, Lucia Scisciola, Raffaele Marfella, Felice Gragnano, Edoardo Conte, Dario Pellegrini, Alfonso Ielasi, Daniele Andreini, Jacopo Andrea Oreglia, Paolo Calabrò, Antonio L Bartorelli, Tullio Palmerini, Francesco Saia, Flavio Ribichini, Michelangela Barbieri, Marc Vanderheyden, Carmine Pizzi, Emanuele Barbato","doi":"10.1186/s12933-025-02773-x","DOIUrl":"10.1186/s12933-025-02773-x","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated with significantly worse outcomes, leading to increased short- and long-term mortality. We sought to evaluate the impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the risk of AKI in patients with type 2 diabetes mellitus (T2DM) and severe aortic stenosis (AS) undergoing TAVI.</p><p><strong>Methods: </strong>Multicenter international registry of consecutive T2DM patients with severe AS undergoing TAVI between 2021 and 2024. The study population was stratified by the presence of chronic kidney disease (CKD), defined according to the KDIGO guideline, and anti-diabetic therapy at hospital admission (SGLT2i versus no-SGLT2i users). AKI was defined according to the Valve Academy Research Consortium 3 (VARC-3) criteria.</p><p><strong>Results: </strong>The study population consisted of 514 patients stratified into those without CKD (n = 226, 44%), of whom 43 (19%) were treated with SGLT2i, and 288 (56%) with CKD, of whom 71 (24.7%) were on SGLT2i treatment. The median age was 81 [77-84] years, and 60.1% were males. SGLT2i use did not impact renal function in patients without CKD, with AKI occurring in 7.1% of the cases, regardless of SGLT2i use. Among CKD patients, AKI occurred more frequently in no-SGLT2i users compared to those receiving SGLT2i (19.8% versus 8.5%, p = 0.027), with a significant increase in post-TAVI and discharge serum creatinine values for no-SGLT2i users (p = 0.001 after TAVI and p < 0.001 at hospital discharge). Only in the CKD group, the use of SGLT2i was identified as an independent predictor of a lower rate of AKI (OR 0.70, 95%CI 0.42-0.91, p = 0.014). Patients who developed AKI had a higher incidence of major adverse cardiovascular events during follow-up, regardless of CKD (p < 0.025 for both groups).</p><p><strong>Conclusion: </strong>In diabetic patients with CKD undergoing TAVI, SGLT2i therapy was associated with a lower occurrence of AKI compared to those not treated with SGLT2i, suggesting a potential nephroprotective effect in this high-risk population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"221"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118839","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":"Perivascular adipose tissue dysfunction contributes to thoracic aortic aneurysm development.","authors":"Zhenguo Wang, Wenjuan Mu, Ruiyan Xu, Juan Zhong, Wenhao Xiong, Xiangjie Zhao, Xiubin Liang, Yanhong Guo, Jifeng Zhang, Zhi-Sheng Jiang, Bo Yang, Y Eugene Chen, Lin Chang","doi":"10.1186/s12933-025-02765-x","DOIUrl":"10.1186/s12933-025-02765-x","url":null,"abstract":"<p><strong>Background: </strong>Thoracic aortic aneurysm (TAA) is a life-threatening disease with high morbidity and mortality rates due to fatal complications such as aortic rupture. However, molecular mechanisms underlying TAA pathogenesis remain to be fully elucidated. The aorta is naturally surrounded by perivascular adipose tissue (PVAT), which produces and releases adipokines and other factors in a paracrine manner that are pivotal for vascular physiology and pathophysiology. Under healthy conditions, thoracic PVAT resembles brown adipose tissue (BAT) and maintains vascular homeostasis. In response to pathogenic stimuli, PVAT can undergo whitening and become dysfunctional, contributing to the development of vascular diseases. However, a causal relationship between PVAT dysfunction and TAA pathogenesis, as well as the underlying mechanisms, remain unknown. This study investigated the roles of PPARg (a key determinant of adipogenesis) and PRDM16 (a key determinant of brown adipocyte development) in PVAT on TAA development.</p><p><strong>Methods: </strong>PVAT samples from TAA patients were collected and evaluated. Mice lacking PVAT and those with dysfunctional PVAT were generated by crossbreeding Ucp1 promoter-driven Cre mice with Pparg floxed mice (brown adipocyte-specific Pparg knockout, Pparg^BAKO) and Prdm16 floxed mice (brown adipocyte-specific Prdm16 knockout, Prdm16^BAKO), respectively. TAA formation was induced by perivascular application of porcine pancreatic elastase (PPE) and evaluated through histological staining. Luciferase reporter assays and chromatin immunoprecipitation-quantitative PCR (ChIP-qPCR) were used to determine PRDM16 target genes.</p><p><strong>Results: </strong>We found that PVAT near TAA lesions in patients exhibited reduced expression of browning markers and increased expression of whitening markers. Pparg^BAKO mice showed impaired PVAT development, while Prdm16^BAKO mice displayed a loss of browning in PVAT. Both Pparg^BAKO and Prdm16^BAKO mice exhibited aggravated TAA formation. We identified decorin, a small proteoglycan of the extracellular matrix, as a transcriptional repressive target gene of PRDM16. The expression of decorin was increased in dysfunctional PVAT and the plasma of TAA patients.</p><p><strong>Conclusions: </strong>The development and maintenance of brown-like characteristics in PVAT are necessary to protect against TAA formation. PVAT dysfunction contributes to TAA development. Our study provides a promising therapeutic strategy for preventing TAA progression by inducing PVAT browning.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"223"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118840","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":"Cardiovascular disease in women with type 1 diabetes: a narrative review and insights from a population-based cohort analysis.","authors":"Alex Mesa, Josep Franch-Nadal, Elena Navas, Dídac Mauricio","doi":"10.1186/s12933-025-02791-9","DOIUrl":"10.1186/s12933-025-02791-9","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading cause of mortality among people with type 1 diabetes (T1D), with cardiovascular mortality rates 2-5 times higher than in the general population. A concerning sex disparity exists within this high-risk population, as the cardioprotective advantage typically observed in women without diabetes appears attenuated or eliminated in individuals with T1D. This disparity is evident across the CVD spectrum, including coronary artery disease, stroke, heart failure, and cardiovascular mortality, with women consistently experiencing an excess burden of disease. These differences are particularly pronounced in women with early-onset T1D, leading to a substantial loss of life-years-approximately 18 years for women compared to 14 for men. Several factors may contribute to this sex disparity. First, the effect of hyperglycemia on CVD appears to have a sex-based differential impact and women with T1D often demonstrate more difficulties to achieve optimal glycemic control. Second, although women with T1D generally exhibit a more favorable CVD risk factor profile than men with T1D, the presence of hypertension, smoking or diabetic kidney disease seem to have a strong impact on CVD in women. Diabetes also appears to diminish sex-based differences in lipid metabolism, and a trend towards increased obesity rates among women with T1D has been observed. Lastly, female-specific factors, which are more prevalent in T1D, exacerbate cardiovascular risk. These include premature menopause, pregnancy-related disorders (such as preeclampsia), polycystic ovary syndrome, and autoimmune diseases, which disproportionately affect women. This narrative review examines the epidemiological evidence highlighting the aspects regarding the excess risk of CVD in women with T1D and evaluates sex disparities in both traditional and female-specific risk factors. Finally, we include a sex-based analysis from the Catalan Registry, which highlights the critical need for greater awareness and enhanced early detection and management of CVD risk factors in this population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"217"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118736","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 between the atherogenic index of plasma and incident hypertension across different blood pressure states: a national cohort study.","authors":"Degang Mo, Peng Zhang, Miao Zhang, Hongyan Dai, Guoan Wang","doi":"10.1186/s12933-025-02775-9","DOIUrl":"10.1186/s12933-025-02775-9","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major public health concern, making effective preventive strategies essential. The atherogenic index of plasma (AIP), a new lipid metabolic index that is associated with insulin resistance and cardiovascular diseases. However, the association between AIP and the incidence of hypertension remains unexplored. To address this knowledge gap, we designed a large-scale retrospective cohort study to investigate the association between AIP and the occurrence of hypertension across different blood pressure (BP) states, including individuals with normal BP and those with elevated BP.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS) involving participants aged 45 and older, assessed in 2011 and followed up in 2020. AIP was calculated using the logarithmic ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C). Logistic regression models, restricted cubic splines models, and threshold analyses were employed to examine the relationship between AIP and the incidence of hypertension. Receiver Operating Characteristic analysis was utilized to assess the ability of AIP to predict the incidence of hypertension. Subgroup analyses were conducted across various demographic and health-related factors. Sensitivity analyses were employed to address biases arising from self-reported data.</p><p><strong>Results: </strong>Among 6540 participants, 1909 (29.19%) developed hypertension over nine years. The AIP is an independent risk factor for the development of hypertension, with an adjusted odds ratio of 1.84 [95% confidence interval (CI) 1.41-2.39, p < 0.001] in individuals with normal BP and 1.88 (95% CI 1.40-2.52, p < 0.001) in those with elevated BP. A nonlinear relationship between AIP and the incidence of hypertension was identified in both normal BP and elevated BP population. AIP has a better predictive ability for the occurrence of hypertension compared to the single indicators of TG and HDL-C. Age significantly impacted AIP's predictive value, especially in those aged 45 to 60 in normal BP population. Sensitivity analyses further validated the nonlinear relationship between AIP and the occurrence of hypertension.</p><p><strong>Conclusions: </strong>AIP is a significant predictor of hypertension, demonstrating a nonlinear association with its occurrence in normal BP and elevated BP population.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"219"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118811","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":"Cardiovascular risk profile in subjects with diabetes: Is SCORE2-Diabetes reliable?","authors":"Sabrina Scilletta, Maurizio Di Marco, Nicoletta Miano, Stefania Capuccio, Marco Musmeci, Giosiana Bosco, Francesco Di Giacomo Barbagallo, Marina Martedì, Francesca La Rocca, Alessio Vitale, Roberto Scicali, Salvatore Piro, Antonino Di Pino","doi":"10.1186/s12933-025-02769-7","DOIUrl":"10.1186/s12933-025-02769-7","url":null,"abstract":"<p><strong>Background: </strong>People living with type 2 diabetes (T2D) are at a two- to four-fold higher risk of developing cardiovascular disease (CVD) compared with those without T2D, making early assessment of their CV risk essential. European Society of Cardiology (ESC) has developed a new model to estimate 10-year CV risk in people with T2D aged ≥ 40 years: SCORE2-Diabetes. Despite its advantages, several aspects remain to be clarified. This study evaluated the association between CV risk stratified by SCORE2-Diabetes and early CV damage assessed through arterial stiffness, intima-media thickness (IMT), and carotid atherosclerosis. Additionally, it examined the agreement between risk stratification by SCORE2 and SCORE2-Diabetes and their concordance with vascular damage.</p><p><strong>Methods: </strong>Pulse wave velocity (PWV), IMT, and carotid atherosclerosis were assessed in 179 individuals with T2D aged 40-69 years, categorized into SCORE2-Diabetes risk groups: Low (n = 20), Moderate (n = 29), High (n = 44), and very high (n = 37). Patients with a history of atherosclerotic cardiovascular disease (ASCVD) or severe target organ damage (TOD) constituted another group (ASCVD/TOD, n = 49).</p><p><strong>Results: </strong>PWV was significantly increased from Low to very high and ASCVD/TOD groups (7.2 ± 1.1, 8.7 ± 1.9, 9.8 ± 2.3, 12.8 ± 5.1 and 11.5 ± 3.8 m/s, respectively). Similarly, IMT showed a stepwise increase with risk class (0.68 ± 0.11, 0.78 ± 0.13, 0.83 ± 0.12, 0.86 ± 0.19 and 0.87 ± 0.15 mm, respectively). Patients in very high or ASCVD/TOD group showed a higher prevalence of carotid atherosclerosis than other groups (0%, 17.24%, 11.40%, 37.83% and 40.81%, respectively). No significant differences were found between the very high and ASCVD/TOD groups in any parameter. The correlation between PWV values and increasing CV risk was stronger for SCORE2-Diabetes than for SCORE2. ROC curve analysis showed SCORE2-Diabetes had superior predictive performance for carotid atherosclerosis and high PWV compared to SCORE2 (p = 0.048).</p><p><strong>Conclusions: </strong>Higher PWV, IMT, and carotid atherosclerosis prevalence were associated with increasing CV risk stratified by SCORE2-Diabetes, with no significant differences between the very high and ASCVD/TOD groups. SCORE2-Diabetes demonstrated a better identification of preclinical vascular damage compared to SCORE2, supporting its use as a reliable tool for identifying vascular damage in T2D patients without ASCVD or TOD.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"222"},"PeriodicalIF":8.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118838","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 role of diabetes mellitus on delirium onset: a systematic review and meta-analysis.","authors":"Klara Komici, Carlo Fantini, Gaetano Santulli, Leonardo Bencivenga, Grazia Daniela Femminella, Germano Guerra, Pasquale Mone, Giuseppe Rengo","doi":"10.1186/s12933-025-02782-w","DOIUrl":"10.1186/s12933-025-02782-w","url":null,"abstract":"<p><strong>Background: </strong>Delirium may develop in association with an underlying cardiovascular or cerebrovascular disease and complicates one out of three medical admissions representing a significant economic burden for healthcare systems. However, a clear relationship between delirium onset and diabetes mellitus has not been clarified. The purpose of this study was to explore the association between DM and delirium with the following aims: (a) to assess the incidence of delirium among DM patients (b) to assess the risk of delirium onset in patients with DM (c) to assess the role of anti-diabetic drugs on delirium onset.</p><p><strong>Methods: </strong>MEDLINE, Scopus, and Web of Science and ClinicalTrials.gov were searched from inception up to 30th of December 2024. Studies reporting the incidence of delirium in diabetic patients, delirium events in diabetic patients compared to non- diabetic patients, and the role of antidiabetic drugs on delirium development were considered.</p><p><strong>Results: </strong>The pooled incidence of delirium resulted 29% (95% CI 26.0%- 33.0% I2 = 99.6%). The OR for developing delirium resulted: 1.78 (95% CI 1.59-1.99 i2 = 88.3%) Intranasal insulin administration compared to placebo groups was characterized by a RR = 0.34 (95% CI 0.23-0.52). Metformin use compared to non-metformin use in diabetic patients was characterized by lower RR for delirium: pooled RR = 0.71 (95% CI 0.59-0.85, I2 = 84.8%).</p><p><strong>Conclusions: </strong>The incidence of delirium in patients with diabetes is about 29% and patients with diabetes have higher odds of delirium. Chronic use of metformin, and intranasal insulin administration before surgery may offer benefits in the prevention of delirium. These findings are characterized by significant heterogeneity which hampers their interpretation. Future research for developing diabetes-specific delirium screening protocols, and evidence-based preventive interventions is needed.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"216"},"PeriodicalIF":8.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101446","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}