Cardiovascular Diabetology最新文献

{"title":"Correction: Use of an insulin titration protocol based on continuous glucose monitoring in postoperative cardiac surgery patients with type 2 diabetes and prediabetes: a randomized controlled trial.","authors":"Sun-Joon Moon, Min-Su Kim, Yun Tae Kim, Ha-Eun Lee, Young-Woo Lee, Su-Ji Lee, Euy-Suk Chung, Cheol-Young Park","doi":"10.1186/s12933-025-02908-0","DOIUrl":"10.1186/s12933-025-02908-0","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"361"},"PeriodicalIF":10.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058369","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":"Insulin resistance assessed by estimated glucose disposal rate predicts cardiovascular disease in stages 0-3 of cardiovascular-kidney-metabolic syndrome: a UK biobank cohort study.","authors":"Hao Zhang, Sizhuang Huang, Yanwen Fang, Haihua Zhang, Weixian Yang, Mengyue Yu","doi":"10.1186/s12933-025-02860-z","DOIUrl":"10.1186/s12933-025-02860-z","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) has been recognized as a critical factor in the progression of cardiovascular disease (CVD), yet its association with cardiovascular-kidney-metabolic (CKM) syndrome remains incompletely understood. This study aimed to evaluate the impact of IR, as measured by the estimated glucose disposal rate (eGDR), on the risk of future CVD events in individuals with CKM stages 0-3.</p><p><strong>Methods: </strong>This study included 325,312 participants from the UK Biobank with CKM stages 0-3. IR was quantified using eGDR, a non-insulin-dependent metric, with lower values indicating greater IR. Participants were stratified into quartiles based on eGDR distribution. The primary outcome was incident CVD, including coronary heart disease, stroke, atrial fibrillation, heart failure, and peripheral artery disease.</p><p><strong>Results: </strong>In the CKM 0-3 cohort, eGDR demonstrated the highest predictive value for future CVD events among non-insulin-dependent IR metrics. Incorporating eGDR significantly improved the predictive performance of the PREVENT Cardiovascular Disease Risk Equations (AUC: PREVENT Equations + eGDR 0.743 vs. PREVENT Equations 0.719, p < 0.001). Over a median follow-up of 13.57 years, 48,433 incident CVD cases were identified. The adjusted rates of CVD incidence (95% confidence interval [CI]) across eGDR quartiles (Q1-Q4) were 3.84 (3.62-4.07), 3.82 (3.66-3.98), 3.53 (3.41-3.65), and 3.37 (3.25-3.50) per 1000 person-years. RCS analysis revealed a significant nonlinear association between eGDR and CVD incidence (p for overall < 0.001; p for nonlinear = 0.020), with greater risk reduction at higher eGDR levels. A significant trend toward reduced CVD risk was observed across higher eGDR quartiles, with Q3 and Q4 demonstrating statistically significant reductions relative to Q1 (HR 0.920, 95% CI 0.871-0.971; and 0.883, 95% CI 0.827-0.942, respectively; p for trend < 0.001). Kaplan-Meier analysis further confirmed a graded decrease in CVD risk with increasing eGDR levels (log-rank p < 0.001).</p><p><strong>Conclusion: </strong>This study establishes a strong association between IR severity and long-term CVD risk in individuals with CKM syndrome stages 0-3. The eGDR, a reliable surrogate marker of IR, independently predicts future CVD events and provides incremental predictive value beyond the PREVENT equations. These findings underscore the clinical utility of eGDR for risk stratification in CKM populations.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"360"},"PeriodicalIF":10.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Empagliflozin on the plasma lipidome in patients with type 2 diabetes mellitus: results from the EmDia clinical trial.","authors":"Katrin I Bauer, Dhanwin Baker, Raissa Lerner, Thomas Koeck, Gregor Buch, Zlatka Fischer, Robin Martens, Ekaterina E Esenkova, Maximilian Nuber, Miguel A Andrade-Navarro, Vincent Ten Cate, Stefan Tenzer, Philipp S Wild, Laura Bindila, Elisa Araldi","doi":"10.1186/s12933-025-02916-0","DOIUrl":"10.1186/s12933-025-02916-0","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as Empagliflozin, are antidiabetic drugs that reduce glucose levels and have emerged as a promising therapy for patients with heart failure (HF), although the exact molecular mechanisms underlying their cardioprotective effects remain to be fully elucidated. The EmDia study, a randomized, double-blind trial conducted at the University Medical Center of Mainz, has confirmed the beneficial effects of Empagliflozin in HF patients after both one and twelve weeks of treatment. In this work, we aimed to assess whether changes in lipid profiles driven by Empagliflozin use in HF patients in the EmDia trial could assist in gaining a better understanding of its cardioprotective mechanisms.</p><p><strong>Methods: </strong>Lipid analysis of blood plasma from 144 patients from the EmDia trial was conducted using 4D-LC-TIMS/IMS lipidomics. Lipid signatures after treatment for one and twelve weeks, respectively, were obtained with sparse group LASSO regularized regression models. Linear regression models were employed to highlight associations between significantly changed clinical traits and lipids.</p><p><strong>Results: </strong>The lipid signatures after one week of treatment consisted of 37 lipids from the lipid groups lysophosphatidylcholine (LPC), phosphatidylcholine (PC), phosphatidylethanolamine (PE), sphingomyelin (SM), and triacylglycerol (TG). After twelve weeks, the signature comprised 24 lipids from the same five lipid groups, along with Ceramides (Cer). Three of five lipids altered at both time points showed consistent directional trends. Empagliflozin treatment led to significant alterations in the lipidome, including increases in both beneficial lipids, such as LPCs, and potentially harmful species, notably ceramides, which have been implicated in lipotoxicity and cardiovascular risk.</p><p><strong>Conclusion: </strong>This study identified distinct lipid signatures associated with Empagliflozin treatment after both one and twelve weeks, respectively, with five lipids overlapping between signatures and three with consistent directions, revealing that some of the beneficial effects of Empagliflozin could be through lipid modulation. Notably, Empagliflozin-modulated lipids associated with changes in clinical traits and lipid-specific profiles among clinical subgroups were observed. However, challenges remain in establishing direct associations between individual lipids and clinical outcomes. Future research integrating lipidomics data with other omics datasets could provide a more comprehensive understanding of the identified lipid signatures and their potential roles in health and diseases.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov; NCT02932436. Registration date, 2016/10/13.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"359"},"PeriodicalIF":10.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022845","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-waist height ratio index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study.","authors":"Longyan Lv, Ping Zhang, Xuerui Chen, Yan Gao","doi":"10.1186/s12933-025-02919-x","DOIUrl":"10.1186/s12933-025-02919-x","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic multimorbidity (CMM) imposes a progressively severe health burden worldwide. Triglyceride-glucose (TyG) index and waist-to-height ratio (WHtR), as indicators of insulin resistance and central adiposity, respectively, have been shown to be strongly associated with CMM. However, there is currently a lack of research combining the two for CMM risk assessment. This study aims to investigate the relationship between TyG-WHtR index and CMM.</p><p><strong>Methods: </strong>This prospective cohort study analyzed data from Chinese adults aged ≥ 45 years participating in the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). We employed the Kaplan-Meier curves, multivariable Cox regression analysis, and restricted cubic spline (RCS) to examine the relationship between the TyG-WHtR index and the risk of CMM. Time-dependent receiver operating characteristic (ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses were utilized to evaluate predictive performance. Additionally, subgroup analyses and sensitivity tests were conducted to assess the robustness of the findings.</p><p><strong>Results: </strong>During a median follow-up of 9 years, 413 (9.4%) of the 4393 participants developed CMM. Multivariable Cox regression analysis revealed progressively higher risks of CMM across increasing TyG-WHtR quartiles. Compared to participants in the lowest quartile (Q1) of the TyG-WHtR index, the hazard ratios (HRs) and 95% confidence intervals (CIs) for those in quartiles Q2, Q3, and Q4 were 1.75 (1.18-2.6), 2.33 (1.58-3.43), and 3.13 (2.08-4.7), respectively. Consistently, elevated cumulative TyG-WHtR independently increased CMM risk. The RCS analysis indicated a positive linear relationship between the TyG-WHtR index and the incidence of CMM. Moreover, both baseline and cumulative TyG-WHtR significantly improved reclassification metrics (NRI/IDI) and discriminative ability (AUC). Sensitivity analyses corroborated these primary findings.</p><p><strong>Conclusion: </strong>This study suggests that TyG-WHtR independently predicts CMM risk. The linear dose-response relationship highlight the potential utility of TyG-WHtR in early risk assessment and prevention strategies for CMM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"358"},"PeriodicalIF":10.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944161","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 dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction.","authors":"Haiyan Jia, Weifeng Zhang, Shengqi Jia, Xinwei Jia, Shixin Kang","doi":"10.1186/s12933-025-02858-7","DOIUrl":"10.1186/s12933-025-02858-7","url":null,"abstract":"<p><strong>Background: </strong>The Triglyceride-Glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with cardiovascular outcomes. However, most studies used single-timepoint measurements, failing to capture its dynamic changes after STEMI.</p><p><strong>Methods: </strong>In this retrospective cohort study, 1,092 STEMI patients undergoing PCI were followed for five years. TyG index was measured at baseline and at 3, 6, 9, and 12 months post-discharge. Group-Based Trajectory Modeling (GBTM) was used to identify TyG index trajectories. Cox regression and Kaplan-Meier analysis evaluated their association with major adverse cardiovascular events (MACE).</p><p><strong>Results: </strong>Three distinct TyG trajectories were identified: persistently high (n = 92), moderate (n = 196), and rapid decline (n = 804). The rapid decline group had significantly lower MACE incidence compared to the persistently high group (P < 0.001). TyG trajectory was an independent predictor of outcomes.</p><p><strong>Conclusion: </strong>Distinct TyG trajectories after STEMI are associated with long-term prognosis. A persistently high TyG trajectory indicates elevated cardiovascular risk, suggesting its potential role in secondary prevention.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"357"},"PeriodicalIF":10.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943842","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":"Nocturnal hypoxemic burden is associated with worsening prognosis of chronic kidney disease in patients with type 2 diabetes.","authors":"Sarah Driendl, Stefan Stadler, Mathias Baumert, Klaus J Stark, Iris M Heid, Jan Pec, Florian Zeman, Adrian Preiss, Carsten A Böger, Tobias Bergler, Michael Arzt","doi":"10.1186/s12933-025-02918-y","DOIUrl":"10.1186/s12933-025-02918-y","url":null,"abstract":"<p><strong>Introduction: </strong>Lower estimated glomerular filtration rate (eGFR) and more severe albuminuria categories are associated with increased risk for adverse outcomes such as mortality, cardiovascular and kidney outcomes. The aim of the analysis was to evaluate whether nocturnal hypoxemic burden (NHB) is associated with worsening prognosis of CKD in a population with T2D.</p><p><strong>Methods: </strong>Overnight oximetry data from patients enrolled in the DIACORE (DIAbetes COhoRtE) sleep-disordered breathing sub-study, a prospective cohort study of patients with T2D, was analyzed and NHB as cumulative time spent below 90% oxygen saturation (T90) was quantified. Very-high-risk CKD was defined according to KDIGO risk classification: eGFR < 30 ml/min/1.73 m² regardless of urinary albumin-to-creatinine ratio (uACR); eGFR < 45 ml/min/1.73 m² and uACR > 30 mg albumin/g creatinine; or eGFR < 60 ml/min/1.73 m² and uACR > 300 mg/g. Logistic regression analyses adjusting for known risk factors for CKD prognosis were performed to assess the association between NHB and incident very-high-risk CKD.</p><p><strong>Results: </strong>The analysis population comprised 857 participants (41% female, mean age 65 years, median diabetes duration 9.0 years, median eGFR 82 ml/min/1.73 m²). During follow-up, 72 (8.4%) patients developed very-high-risk CKD, and patients with high T90 significantly more often developed very-high-risk CKD than patients with lower T90 (quartile 4 vs. quartiles 1-3: 15.0 vs. 6.2%, p < 0.001). NHB was significantly associated with an increased incidence of very-high-risk CKD. Patients in the highest quartile of T90 had a 3.0-fold higher risk compared to patients in the lowest quartile, independently of other risk factors for CKD prognosis such as age, sex, waist-hip ratio, hypertension, antihypertensive and lipid-lowering medication, HbA1c, diabetes duration, and eGFR and hemoglobin levels at baseline (OR 2.96, 95% CI (1.24; 7.07), p = 0.014; p for trend 0.013).</p><p><strong>Conclusion: </strong>We identified NHB as a novel risk factor for worsening CKD prognosis in patients with T2D. Further research is needed to ascertain whether T90 reduction constitutes a clinically meaningful prevention target.</p><p><strong>Trial registration: </strong>German Clinical Trials Register DRKS00010498.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"354"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944177","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":"Left ventricular ejection fraction reserve and its association with myocardial perfusion, coronary calcification, and strain in type 2 diabetes without overt cardiovascular disease.","authors":"Adam Chebli, Ida K B Rasmussen, Anne-Cathrine Skriver-Møller, Philip Hasbak, Martin B Blond, Victor S Wasehuus, Mats C H Lassen, Morten Lindhardt, Allan Kofoed-Enevoldsen, Urd L Kielgast, Emilie H Zobel, Lene Holmvang, Tor Biering-Sørensen, Peter Rossing, Rasmus S Ripa, Andreas Kjaer, Tine W Hansen","doi":"10.1186/s12933-025-02886-3","DOIUrl":"https://doi.org/10.1186/s12933-025-02886-3","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease (CVD), but the relationships between myocardial function, microvascular function, and atherosclerotic burden remain underexplored in asymptomatic individuals. This study investigates the associations between left ventricular ejection fraction (LVEF)-reserve, myocardial flow reserve (MFR), perfusion defects, coronary artery calcium score (CACS), and global longitudinal strain (GLS) in individuals with T2D but without overt CVD.</p><p><strong>Methods: </strong>Cross-sectional analysis of 871 individuals with T2D without overt CVD, recruited between 2020 and 2023. All underwent cardiac 82-Rubidium PET/CT to assess LVEF-reserve, MFR, perfusion defects, and CACS. GLS was measured using echocardiography. Associations were examined using linear regression adjusted for cardiovascular risk factors and cardiometabolic therapies.</p><p><strong>Results: </strong>Mean (SD) age was 64.9 (± 9.0) years, diabetes duration was 13.9 (± 8.4) years, and 262 (30%) were women. Higher MFR was associated with higher LVEF-reserve (β = 1.63, 95% CI: 1.16 to 2.10, p < 0.001). Individuals with CACS > 300 had lower LVEF-reserve than those with CACS ≤ 300 (β = - 1.25, 95% CI: - 1.97 to - 0.53, p < 0.001). Presence of Perfusion defects were associated with lower LVEF-reserve (β = - 1.49, 95% CI: - 2.23 to - 0.75, p < 0.001). LVEF-reserve was not associated with GLS (p = 0.23). Sensitivity analysis excluding 248 participants with perfusion defects confirmed the association between MFR and LVEF-reserve (β = 1.45 (95% CI: 0.92, 1.97), p < 0.001).</p><p><strong>Conclusions: </strong>In individuals with T2D without overt CVD, lower MFR, presence of perfusion defects, and CACS > 300 were associated with lower LVEF-reserve. Underscoring a potential role of microvascular dysfunction in subclinical systolic impairment.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"352"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944067","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":"SGLT2 inhibitors and GLP-1 receptor agonists: impact on mortality in diabetic patients with cardiovascular disease.","authors":"Ziad Arow, Tzipi Hornik-Lurie, Ranin Hilu, Ela Giladi, Yoav Arnson, Hana Vaknin-Assa, Abid Assali, David Pereg","doi":"10.1186/s12933-025-02874-7","DOIUrl":"10.1186/s12933-025-02874-7","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2-I) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to reduce cardiovascular risk and mortality in patients with type 2 diabetes mellitus (T2D), yet remain underutilized in clinical practice. This study aimed to evaluate real-world treatment patterns and associated mortality outcomes among patients with T2D and established atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Methods: </strong>The CARdiovascular and DIABetes (CARDIAB) cohort included 138,397 patients with T2D and ASCVD. Patients were categorized into four treatment groups: (i) both SGLT2-I and GLP-1RA, (ii) SGLT2-I only, (iii) GLP-1RA only, and (iv) neither medication. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Of the 138,397 patients, 57% received neither SGLT2-I nor GLP-1RA, 17% received both, 20% received SGLT2-I only, and 6% received GLP-1RA only. Female sex, older age, non-coronary ASCVD, and absence of follow-up in specialized cardiology or diabetes clinics were associated with lower treatment rates. Compared to those receiving neither medication, all-cause mortality was significantly lower among patients treated with SGLT2-I only (HR 0.28, 95% CI 0.27-0.29), GLP-1RA only (HR 0.39, 95% CI 0.37-0.40) and both agents (HR 0.17, 95% CI 0.16-0.18). This association remained significant following a multivariate analysis.</p><p><strong>Conclusion: </strong>In patients with T2D and ASCVD, treatment with SGLT2-I and GLP-1RA, especially in combination, is associated with a substantial reduction in mortality. These findings highlight significant gaps in implementation and the urgent need to optimize use of evidence-based therapies in this high-risk population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"353"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944102","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":"Pericoronary adipose tissue radiomics to improve risk stratification for patients with acute coronary syndrome: a multicenter retrospective cohort study.","authors":"Jin Shang, Yanhua Zhen, Zhezhe Zhang, Ziyi Wang, Hang Xu, Yilong Pan, Hongyu Chen, Lu Sun, Xin Pan, Ronghui Ju, Yang Hou","doi":"10.1186/s12933-025-02913-3","DOIUrl":"10.1186/s12933-025-02913-3","url":null,"abstract":"<p><strong>Background: </strong>Pericoronary adipose tissue (PCAT) radiomics derived from coronary computed tomography angiography (CCTA) for predicting major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) remains unclear. This study aimed to assess whether PCAT radiomics could further provide complementary predictive value for the risk of MACE during long-term follow-up.</p><p><strong>Methods: </strong>A multicenter retrospective study enrolled 777 subjects who underwent pre-intervention CCTA at 3 medical centers. Patients from one institution (n = 664) formed an internal cohort and were randomly split into training and internal test sets (7:3). Multivariable Cox regression models were developed using clinical scores, traditional CCTA, PCAT attenuation (PCATa) and PCAT radiomics, and were tested using the internal test set. Data from two additional institutions (n = 113) were reserved as an external test set to evaluate the applicability and generalizability of models.</p><p><strong>Results: </strong>A total of 777 participants (61.0 ± 9.70 years; 506 males) were analyzed. During a median follow-up of 5.45 years (interquartile range: 4.03, 7.12 years), 177 (22.78%) cases experienced a MACE. Adding culprit PCATa or three vessels-based PCATa did not improve predictive ability for the model containing clinical scores and traditional CCTA, whereas further addition of PCAT_culprit Radscore (C-index: 0.721, 0.652, 0.645) and three vessels-based PCAT Radscore (C-index: 0.725, 0.660, 0.686) improved model predictive performance in the training, internal test and external test sets, without significant differences between datasets or models (all P > 0.05). Adding either the PCAT_culprit Radscore (training: IDI = 0.031, p < 0.001; NRI = 0.256, p < 0.001; external test: IDI = 0.094, p < 0.001; NRI = 0.339, p = 0.02) or the three vessels-based PCAT Radscore (training: IDI = 0.032, p < 0.001; NRI = 0.224, p = 0.02; external test: IDI = 0.126, p < 0.001; NRI = 0.480, p < 0.001) to a clinical model yielded a significant improvement in discrimination and reclassification ability in the training and external test sets, respectively.</p><p><strong>Conclusions: </strong>PCAT radiomics can enhance long-term prediction of MACE in ACS patients beyond current clinical scores, traditional CCTA and PCATa. Addition of PCAT radiomics to a conventional risk assessment improves the identification of high-risk individuals with MACE.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"356"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944148","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":"Weight-independent amelioration of adipokine profile by enavogliflozin, a selective SGLT2 inhibitor, in patients with type 2 diabetes.","authors":"Young Sang Lyu, Hansol Lee, Kyung-Soo Kim, Sangmo Hong, Cheol-Young Park","doi":"10.1186/s12933-025-02917-z","DOIUrl":"10.1186/s12933-025-02917-z","url":null,"abstract":"<p><strong>Background and objective: </strong>The metabolic benefits of sodium-glucose co-transporter 2 inhibitors in clinical application are well established; however, there is dearth of knowledge on their impact on adipokine regulation. This study investigated the effect of enavogliflozin on adiponectin and leptin in patients with type 2 diabetes.</p><p><strong>Methods: </strong>This secondary analysis of a phase III randomized, double-blind, placebo-controlled trial evaluated changes in serum adiponectin and leptin over 24 weeks. Analysis of covariance was used with baseline values and weight change as covariates to examine whether the effects of enavogliflozin persisted after adjusting for weight change. Correlations between adipokine changes and key metabolic parameters were also assessed.</p><p><strong>Results: </strong>Over the 24 weeks, the enavogliflozin group showed increased adiponectin levels with a least squares (LS) mean difference of 0.98 mg/L compared with the placebo group, while leptin levels showed a significant decrease with an LS mean difference of -2.99 µg/L. Enavogliflozin significantly reduced leptin levels over 24 weeks after adjusting for weight change; however, adiponectin changes were not significant after adjusting for weight change. Adiponectin levels significantly increased across weight loss categories, but leptin showed no significant differences. Leptin changes over 24 weeks significantly were positively correlated with changes in homeostasis model assessment of insulin resistance and homeostasis model assessment of β-cell function but significantly negatively correlated with changes in serum ketone and urinary glucose-to-creatinine ratio.</p><p><strong>Conclusions: </strong>Enavogliflozin treatment decreased leptin over 24 weeks in patients with type 2 diabetes, and this effect remained significant after adjusting for weight change, suggesting an improved adipokine profile. Reductions in leptin were also associated with improvements in insulin resistance and increases in serum ketone levels. These results highlight enavogliflozin as a potential treatment beyond glycemic control, offering additional benefits in managing metabolic dysregulation associated with type 2 diabetes.</p><p><strong>Trial registration: </strong>Not applicable (post hoc analysis).</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"355"},"PeriodicalIF":10.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944173","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}