Cardiovascular Diabetology最新文献

{"title":"Effect of changes in the triglyceride-glucose index on atherogenic lipid profiles in coronary artery disease patients receiving lipid-lowering therapy: a prospective cohort study.","authors":"Zhi-Fan Li, Zheng Yin, Xi Li, Meng-Ying Lu, Wen-Jia Zhang, Fang Luo, Yan-Lu Xu, Jian-Jun Li, Ke-Fei Dou, Xiao Wang, Hong Qiu, Na-Qiong Wu","doi":"10.1186/s12933-025-02910-6","DOIUrl":"10.1186/s12933-025-02910-6","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a key driver of cardiovascular disease. The triglyceride-glucose (TyG) index, derived from fasting triglyceride and glucose levels, has been proposed as a surrogate marker of IR. However, its effect on lipid control in patients with coronary artery disease (CAD) receiving lipid-lowering therapy (LLT) remains unclear.</p><p><strong>Methods: </strong>In this prospective cohort study, biochemical parameters of 1393 CAD patients were measured and followed over a median of one year. Participants received either low-/moderate-intensity LLT or high-intensity LLT. Linear regression models, logistic regression analyses, and change-to-change analyses were conducted to comprehensively assess the associations between baseline levels, longitudinal changes, and status transitions of the TyG index and lipid parameters.</p><p><strong>Results: </strong>Lipid levels differed significantly across TyG index tertiles, with the highest tertile showing more adverse profiles at baseline and follow-up. Higher baseline TyG levels were independently associated with increased follow-up atherogenic lipid parameters and failure to achieve targets of non-high-density lipoprotein cholesterol (Non-HDL-C, OR = 1.23, 95% CI 1.01-1.51) and remnant cholesterol (RC, OR = 1.38, 95% CI 1.09-1.76). Participants in the highest tertile had the highest odds of not achieving targets for LDL-C, Non-HDL-C, and RC. Each 1% increase in the index was associated with percent increases in lipids including LDL-C (β = 1.10), Non-HDL-C (β = 1.81), and RC (β = 4.92, all P < 0.001). Patients transitioning from the lowest to the highest TyG tertile showed significant lipid worsening, while improvement from the highest to the lowest tertile was associated with reductions in RC and Non-HDL-C. High-intensity LLT led to greater reductions in TyG and lipid levels, mitigating the adverse lipid effects of TyG elevation. The adverse effects were also more evident in women and in those with obesity or prior revascularization.</p><p><strong>Conclusions: </strong>Higher TyG levels were positively associated with atherogenic lipid profiles and failure to achieve lipid goals. In addition, upward changes in TyG over time were related to worsened atherogenic lipid status, particularly among patients receiving low-/moderate-intensity LLT. These findings support the routine monitoring of TyG to identify patients at risk of poor lipid control who may require high-intensity LLT.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"372"},"PeriodicalIF":10.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198390","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 and renal outcomes of dual combination therapies with glucagon-like peptide-1 receptor agonists and sodium-glucose transport protein 2 inhibitors: a systematic review and meta-analysis.","authors":"Arveen Shokravi, Jayant Seth, G B John Mancini","doi":"10.1186/s12933-025-02900-8","DOIUrl":"10.1186/s12933-025-02900-8","url":null,"abstract":"<p><strong>Background: </strong>Combination therapy with glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose co-transporter 2 inhibitors (SGLT2i), and/or finerenone offers a strategy to reduce the risk of adverse cardiovascular and renal outcomes. This study aimed to quantify the cardiorenal benefits of combination regimens with GLP-1RA, SGLT2i, and/or finerenone versus corresponding monotherapies.</p><p><strong>Methods: </strong>MEDLINE and Embase were systematically searched, yielding four post hoc analyses of randomized controlled trials (RCTs) and ten observational studies that met prespecified inclusion criteria. Among RCTs, a random-effects meta-regression was performed to assess whether the effect of GLP-1RAs on cardiorenal outcomes differed based on baseline SGLT2i use. Additionally, for observational studies, random-effects meta-analyses were performed to estimate the effect of combination therapy versus monotherapy on the risk of cardiorenal outcomes.</p><p><strong>Results: </strong>Across RCTs, p for interaction was > 0.05 for major adverse cardiac events (MACE) (p = 0.730), cardiovascular (CV) mortality (p = 0.889), non-fatal myocardial infarction (MI) (p = 0.237), non-fatal stroke (p = 0.696), all-cause mortality (p = 0.682), heart failure (HF) hospitalization (p = 0.257), and renal composite outcome (p = 0.890), supporting that GLP-1RAs result in a consistent reduction in outcomes irrespective of baseline SGLT2i use. In observational trials, compared to SGLT2i monotherapy, GLP-1RA and SGLT2i combination therapy significantly reduced MACE (HR 0.59, 95% CI 0.47-0.75), MI (HR 0.73, 95% CI 0.61-0.88), stroke (HR 0.72, 95% CI 0.53-0.97), all-cause mortality (HR 0.57, 95% CI 0.48-0.67), and HF hospitalization/events (HR 0.71, 95% CI 0.59-0.86). Compared to GLP-1RA monotherapy, SGLT2i and GLP-1RA combination therapy significantly reduced CV mortality (HR 0.35, 95% CI 0.15-0.81), MI (HR 0.93, 95% CI 0.88-0.97), stroke (HR 0.92, 95% CI 0.88-0.96), all-cause mortality (HR 0.59, 95% 0.49-0.70), HF hospitalization/events (HR 0.84, 95% CI 0.81-0.88), and serious renal events (HR 0.43, 95% CI 0.23-0.80). Compared to either SGLT2i or finerenone monotherapy, SGLT2i and finerenone combination therapy significantly reduced all-cause mortality and major adverse kidney events.</p><p><strong>Conclusion: </strong>Combination therapy with GLP-1RA, SGLT2i, or finerenone confers cardiorenal protection beyond monotherapy in T2D, as supported by concordant evidence from RCTs and large real-world cohorts. These findings support broader clinical adoption of dual-agent strategies but also underscore the need for dedicated prospective trials powered to assess hard clinical outcomes with dual-agent strategies.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"370"},"PeriodicalIF":10.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198404","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":"Accelerated biological aging mediates the associations of stress hyperglycemia ratio (SHR) with mortality in type 2 diabetes and obesity (diabesity).","authors":"Jinling Xu, Hui Zhou, Zhongjing Wang","doi":"10.1186/s12933-025-02931-1","DOIUrl":"10.1186/s12933-025-02931-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stress hyperglycemia ratio (SHR) has emerged as an innovative biomarker for stress-induced hyperglycemia and various disease prognosis, yet its relationship with mortality in patients with type 2 diabetes and obesity (termed as diabesity) remains unclear. Accelerated biological aging increases susceptibility to chronic diseases and death. This study sought to examine the association between SHR and mortality in type 2 diabetes and obesity, and also investigate the potential mediating effects of accelerated biological aging in this relationship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed 4253 individuals with type 2 diabetes and obesity from National Health and Nutritional Examination Survey, with mortality outcomes ascertained through linkage to the National Death Index (NDI). Two accelerated biological aging (PhenoAgeAccel and KDMAgeAccel) were calculated using chronological age and blood biomarkers. The clinical endpoints encompassed all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality. We visualized survival differences through Kaplan-Meier methodology. We employed multivariable Cox regression, restricted cubic spline (RCS) analysis, and general linear regression models to evaluate the relationships. Mediation analysis was performed to quantify the accelerated biological aging' contribution to the SHR-mortality link. Subgroup and sensitivity assessments were applied to verify the robustness of findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over a median follow-up period of 110.00 months (interquartile range, 40.00-152.00 months), we recorded 1139 all-cause deaths (26.78%), including 318 CVD deaths (7.48%), and 215 cancer death (5.06%). Kaplan-Meier curves showed higher SHR levels were associated with reduced survival (P &lt; 0.001). After full adjustment for covariates, participants in the highest SHR tertile exhibited significantly elevated hazard ratios (HRs) compared to the reference tertile, with adjusted HRs of 1.32 for all-cause mortality, 1.38 for CVD mortality, and 1.61 for cancer mortality (all P &lt; 0.001). RCS analysis revealed U-shaped relationships for all-cause and CVD mortality, while cancer mortality showed a linear positive correlation with SHR. Both two aging metrics exhibited linear relationships with the mortalities, with SHR positively correlated with KDMAgeAccel and PhenoAgeAccel (β = 5.00 and 1.15, respectively, both P &lt; 0.01). Mediation analysis indicated KDMAgeAccel mediated 10.31%, 12.81%, and 3.65% of SHR's effects on all-cause, CVD, and cancer mortality, respectively (all P &lt; 0.05), while PhenoAgeAccel showed the suppression effect of SHR on all-cause and CVD mortality, as well as exacerbated SHR's effect on cancer mortality. These findings remained consistent across all subgroup and sensitivity analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both SHR and accelerated biological aging independently predict higher all-cause, CVD, and cancer mortality in patients with ty","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"368"},"PeriodicalIF":10.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191346","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 the triglyceride-glucose index and its combination with obesity indices with cardio-renal-metabolic multimorbidity: two decades of follow-up in the Tehran Lipid and Glucose Study.","authors":"Soroush Soraneh, Navid Ebrahimi, Soroush Masrouri, Maryam Tohidi, Fereidoun Azizi, Farzad Hadaegh","doi":"10.1186/s12933-025-02944-w","DOIUrl":"10.1186/s12933-025-02944-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the associations between the triglyceride-glucose (TyG) index and its obesity-related derivatives with the risk of incident cardio-renal-metabolic multimorbidity (CRMM) in a Middle Eastern adult population initially free of cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD).</p><p><strong>Methods: </strong>In this prospective cohort analysis of 5845 Iranian adults from the Tehran Lipid and Glucose Study, we evaluated the associations of the TyG index and its combinations with body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), and waist-hip ratio (WHR) with the incidence of CRMM. Multivariable Cox proportional hazards models were used to estimate the associations between TyG indices and CRMM risk. The Wald test was used to formally compare the effect sizes of each TyG-related index with that of the TyG index in multivariable models. The predictive performance of these indices was evaluated using Harrell's C-index and the integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>Over a median follow-up of 15.3 years (IQR: 11.9-16.4), 344 individuals (5.9%) developed CRMM. Restricted cubic spline models demonstrated significant linear associations between TyG indices and CRMM risk. The corresponding HRs (95% CI) per 1-SD increase were 1.41 (1.24-1.60) for the TyG index, 1.52 (1.36-1.71) for TyG-BMI, 1.57 (1.38-1.78) for TyG-WC, 1.57 (1.38-1.78) for TyG-WHtR, and 1.42 (1.24-1.63) for TyG-WHR (all P < 0.001). The inclusion of anthropometric measures alongside the TyG index did not substantially enhance its association with CRMM risk (all P for differences ≥ 0.05). Incremental predictive performance analyses showed modest but statistically significant improvements when adding TyG and TyG-obesity indices to conventional risk factors (all P < 0.05), whereas incorporating anthropometric-based indices to a model already containing TyG did not yield additional predictive improvement (all P > 0.05). The majority of associations remained robust after adjustment for homeostatic model assessment of insulin resistance and in sensitivity analyses. The association between TyG-WHR and CRMM was more pronounced among non-obese than obese individuals (P for interaction < 0.001).</p><p><strong>Conclusions: </strong>Higher levels of TyG and TyG-obesity indices were independently associated with an increased risk of CRMM; however, incorporating obesity indices did not confer substantial improvement over the TyG index alone.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"369"},"PeriodicalIF":10.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191300","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 association between triglyceride-glucose index and all-cause/cardiovascular mortality in patients with different glucose metabolism statuses.","authors":"Jiajun Liu, Jinhua Kang, Pengpeng Liang, Zhangxiao Song, Guiyun Li, Xueshan Jin, Hongyan Wu","doi":"10.1186/s12933-025-02826-1","DOIUrl":"10.1186/s12933-025-02826-1","url":null,"abstract":"<p><strong>Objectives: </strong>The triglyceride-glucose index (TyG) is an emerging marker of metabolic health, yet its association with mortality across different glucose metabolism statuses remains unclear. This study aimed to investigate the relationship between the TyG and the risk of all-cause and cardiovascular mortality among individuals with normoglycemia, dysglycemia, and diabetes mellitus.</p><p><strong>Methods: </strong>Participants from nine cycles of the National Health and Nutrition Examination Survey (NHANES) were included and categorized into three groups: normoglycemia, dysglycemia, and diabetes. Cox regression and restricted cubic spline (RCS) analyses were performed to evaluate the linear and nonlinear associations between TyG and mortality. To assess the predictive power of TyG and the atherogenic index of plasma (AIP) for mortality, time-dependent receiver operating characteristic (ROC) curves were constructed. Subgroup analyses were conducted based on age, sex, and blood pressure status.</p><p><strong>Results: </strong>During a median follow-up of 9.2 years, a total of 2199 all-cause deaths and 606 cardiovascular deaths were documented. In the normoglycemic group, a single standard unit increase in TyG was associated with a 35% higher risk of all-cause mortality and a 38% higher risk of cardiovascular mortality (HR: 1.35, 95% CI 1.17-1.56; HR: 1.38, 95% CI 1.04-1.84, respectively). Among participants with diabetes, RCS analysis revealed a U-shaped association between TyG and all-cause/cardiovascular mortality, with an inflection point at 9.1. No significant associations were observed in the dysglycemia group. TyG demonstrated superior predictive performance compared to the AIP for 3-year mortality in both normoglycemic and diabetic individuals. Subgroup analyses identified significant interaction effects of age and sex on the association between TyG and mortality.</p><p><strong>Conclusion: </strong>TyG was associated with an increased risk of all-cause and cardiovascular death in the normoglycemic subgroup, but not in the dysglycemic subgroup. In the diabetes subgroup, the association between the TyG and mortality was nonlinear. The predictive value of TyG across different glucose metabolism statuses provides new evidence for medical practice.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"367"},"PeriodicalIF":10.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136571","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":"Treatment and associated outcomes of type 2 diabetes mellitus patients with a cardiovascular comorbidity and comparison with guideline recommendations: a German claims data analysis.","authors":"Jens Aberle, Daniel Duerschmied, Martin Grond, Michael Lehrke, Stephan Martin, Sven-Oliver Tröbs, Michael Schultze, Nils Kossack, Lena Margareta Richter, Maximilian Gabler","doi":"10.1186/s12933-025-02864-9","DOIUrl":"10.1186/s12933-025-02864-9","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) patients are at high risk for micro- and macrovascular complications, and cardiovascular (CV) events are a major cause of their increased risk of early death. Despite well-established treatment guidelines for the management of CV disease in T2DM, little is known about the real-world implementation of these guidelines.</p><p><strong>Objectives: </strong>To characterize the real-life treatment patterns of T2DM patients with an incident CV comorbidity in Germany, to establish whether treatment is in line with respective national guidelines, and to assess guideline adherence with respect to the occurrence of serious clinical outcomes.</p><p><strong>Methods: </strong>This was a retrospective observational study using claims data from the WIG2 benchmark database including more than 4.5 million insured individuals. T2DM-prevalent patients with an incident CV comorbidity (ischemic stroke, myocardial infarction [MI], heart failure, or coronary artery disease) were identified between 2016 and 2018. Data on patient demographics and comorbidities were collected at baseline. During follow-up, data on treatment patterns and medical outcomes (all-cause mortality, modified 3P-MACE [composite endpoint of all-cause death or inpatient diagnosis of MI or stroke]) were captured. Guideline adherence was assessed using the medication possession ratio and was categorized as completely, partly or non-adherent.</p><p><strong>Results: </strong>Overall, 17,175 T2DM patients with a mean age of 71.1 years experiencing an incident CV comorbidity during the study period were identified. The most frequently prescribed CV treatments during follow-up were renin-angiotensin-aldosterone system inhibitors (83.9%), diuretics (72.6%) and beta-blocking agents (71.8%). Around 40% of the study population were treated completely adherent to the respective CV guidelines. These patients had a significantly higher chance of survival compared to patients not treated in line with the guidelines (90.8% vs. 82.6% survival within 12 months follow-up). Patients not treated according to CV guidelines had a higher mortality and 3P-MACE risk vs. patients completely adherent to guidelines (HR 1.93, 95% CI 1.65-2.25 and HR 1.49, 95% CI 1.31-1.69, respectively).</p><p><strong>Conclusions: </strong>The results from this claims database study provide important insights into real-world management of CV comorbidities in T2DM patients in Germany and underline that inconsistent guideline adherence is a major unmet challenge to healthcare providers.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"364"},"PeriodicalIF":10.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130024","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":"Correction: Intestinal fatty acid binding protein is associated with coronary artery disease in long-term type 1 diabetes-the Dialong study.","authors":"Marte Narum, Ingebjørg Seljeflot, Vibeke Bratseth, Tore Julsrud Berg, Kari Anne Sveen","doi":"10.1186/s12933-025-02907-1","DOIUrl":"10.1186/s12933-025-02907-1","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"363"},"PeriodicalIF":10.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130030","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 the triglyceride-glucose index combined with a body shape index with all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome stage 0-3: findings from two prospective cohorts.","authors":"Mingjie Chen, Jiajie Guo, Yuwen Shangguan, Zhonghua Sun, Xueling He, Qiang Tu, Qingkai Yan","doi":"10.1186/s12933-025-02921-3","DOIUrl":"10.1186/s12933-025-02921-3","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index, as a measure of insulin resistance, has been confirmed to be associated with adverse clinical outcomes. The new composite indicator, TyG-A body type index (TyG-ABSI), by integrating the TyG index and the A body type index, has demonstrated superior efficacy in predicting the risk of cardiovascular death in the general population compared to traditional indicators. This study aims to deeply explore the association between TyG-ABSI and all-cause mortality and CVD mortality in the population with cardiovascular kidney-metabolic syndrome (CKM) stages 0-3. The analysis will be conducted from multiple dimensions such as the intensity of indicator correlation and potential influencing mechanisms, in order to comprehensively reveal the relationship between the two.</p><p><strong>Results: </strong>We analyzed data from 13,480 participants in the NHANES cohort (1999-2018) using Cox proportional hazards models and restricted cubic spline functions. The results indicated that elevated TyG-ABSI values were independently associated with a higher risk of all-cause mortality (HR = 1.226, 95% CI 1.104-1.361) and cardiovascular mortality (HR = 1.377, 95% CI 1.149-1.651). Time-dependent receiver operating characteristic (ROC) curves and concordance index evaluations demonstrated that TyG-ABSI yielded more accurate long-term prognostic performance than other TyG-derived metrics. The area under the curve (AUC) of this indicator reached 0.688-0.708 in the prediction of all-cause mortality risk over 5-15 years, and 0.696-0.739 in the prediction of cardiovascular mortality risk. External validation using CHARLS data confirmed the robustness of these findings in predicting all-cause mortality.</p><p><strong>Conclusions: </strong>Among individuals with CKM stages 0-3, TyG-ABSI demonstrates a stronger association with mortality risk and superior predictive ability compared with other TyG-derived metrics. Its performance suggests a potential role in capturing variations across diverse clinical subgroups, and informing optimal timing for preventive interventions.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"366"},"PeriodicalIF":10.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130006","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":"Fixed-dose vs loose-dose combination antidiabetic therapy and cardiorenal outcomes in type 2 diabetes: a nationwide comparative effectiveness study.","authors":"Qiaoling Liu, Paul Welsh, Carlos Celis-Morales, Jennifer S Lees, Patrick B Mark, Laura Pazzagli","doi":"10.1186/s12933-025-02936-w","DOIUrl":"10.1186/s12933-025-02936-w","url":null,"abstract":"<p><strong>Background: </strong>Combination therapy is gaining attention in type 2 diabetes management due to its potential to reach glycaemic goals within a shorter period. However, the long-term comparative cardiorenal effectiveness of fixed- versus loose-dose combinations remains unclear. This study aimed to assess whether oral antidiabetic fixed-dose combination (FDC) therapy is associated with improved cardiorenal outcomes in adults with type 2 diabetes compared with loose-dose combination (LDC) therapy. A secondary objective was to evaluate the mediating role of medication adherence in these associations.</p><p><strong>Methods: </strong>This population-based, new-user, active-comparator cohort study used Swedish national registers. Propensity score matching without replacement was applied. Study outcomes included acute myocardial infarction, atrial fibrillation, unstable angina, heart failure, ischaemic stroke, and eGFR < 30 ml/min/1.73m². Associations with cardiorenal outcomes were assessed using Cox regression. Adherence was defined as the proportion of days covered > 80% during the first year.</p><p><strong>Results: </strong>The median follow-up time was 4.0 years for cardiovascular outcomes and 3.8 years for kidney outcomes. In the matched cohort (mean age 62 years; 67% male), FDC users had higher treatment adherence (68.6 vs. 46.5%). FDC was associated with a lower rate of heart failure (HR = 0.88; 95% CI 0.79, 0.99), with adherence mediating 47% of this association. In people aged ≥ 65 years, FDC was associated with a lower rate of heart failure (HR = 0.79; 95% CI 0.69, 0.91). The observed association was attenuated with further matching for diabetes duration or when drugs were matched at the ATC code level. No associations between FDC use and other outcomes were identified.</p><p><strong>Conclusions: </strong>FDC therapy in people with type 2 diabetes was associated with a lower rate of heart failure, particularly in older adults. Higher medication adherence appeared to mediate nearly half of this association.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"365"},"PeriodicalIF":10.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129978","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":"Correction: Prognostic impact of type 2 diabetes mellitus and coronary microvascular dysfunction in patients undergoing rotational atherectomy during PCI.","authors":"Lijun Feng, Yuxuan Zhang, Chenyun Zhang, Zining Chen, Jingnan Pan, Zhiling Gao, Delong Chen, Abuduwufuer Yidilisi, Jiacheng Fang, Yiyue Zheng, Tingting Mei, Jiantao Liu, Jianping Xiang, Jinlong Zhang, Changling Li, Jifang Cheng, Jian'an Wang, Jun Jiang","doi":"10.1186/s12933-025-02923-1","DOIUrl":"10.1186/s12933-025-02923-1","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"362"},"PeriodicalIF":10.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069212","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}