Cardiovascular Diabetology最新文献

{"title":"Associations of triglyceride glucose-body mass index with short-term mortality in critically ill patients with ischemic stroke.","authors":"Qingrong Ouyang, Lei Xu, Ming Yu","doi":"10.1186/s12933-025-02583-1","DOIUrl":"10.1186/s12933-025-02583-1","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride glucose-body mass index (TyG-BMI) has been established as a convenient and reliable marker for assessing insulin resistance (IR) and has been shown to be significantly correlated with stroke. However, only a few studies have been conducted in this field, with conflicting conclusions.</p><p><strong>Methods: </strong>This study based on the eICU database, investigated the association between TyG-BMI and 28-day mortality in critically ill ischemic stroke (IS) patients. Multivariate Cox regression models were employed to analyze the impacts of the TyG-BMI on 28-day hospital and ICU mortality. Restricted cubic splines (RCS) were applied to explore the nonlinear relationship between the TyG-BMI and 28-day mortality. K‒M curves were utilized for outcome comparisons among different TyG-BMI groups. Additionally, interaction and subgroup analyses were performed to validate the robustness of the results.</p><p><strong>Results: </strong>A total of 1,362 critically ill patients with IS were enrolled, with a mean age of 68.41 ± 14.16 years; 47.50% were male. Multivariate Cox regression analysis revealed that, the high TyG-BMI group had significantly higher 28-day hospital mortality(HR = 1.734, P = 0.032) and ICU mortality (HR = 2.337, p = 0.048). RCS analysis showed a nonlinear positive correlation between the TyG-BMI and 28-day hospital mortality. Below the inflection point of the TyG-BMI = 380.37, each increase of 1 standard deviation (SD) (approximately 25.5 units) in the TyG-BMI was associated with a 37.3% increase in 28-day hospital mortality (HR = 1.373, P = 0.015), and above 380.376, each 1-SD increase in the TyG-BMI resulted in an 87.9% decrease in 28-day hospital mortality (HR = 0.121, P = 0.057). The log-likelihood ratio test P value = 0.004. For 28-day ICU mortality, the TyG-BMI exhibited a significant positive linear correlation in RCS.</p><p><strong>Conclusions: </strong>Elevated TyG-BMI is significantly associated with an increased risk of short-term all-cause mortality in patients with critically ill IS in the United States. This result provides compelling evidence to address the existing discrepancies in this research domain, indicating that the TyG-BMI could serve as a straightforward and efficient biomarker for identifying critically ill IS patients at high risk of mortality.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"91"},"PeriodicalIF":8.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid-lowering therapy and LDL target attainment in type 2 diabetes: trends from the Italian Associations of Medical Diabetologists database.","authors":"Antonio Rossi, Davide Masi, Rita Zilich, Fabio Baccetti, Walter Baronti, Pierpaolo Falcetta, Lelio Morviducci, Nicoletta Musacchio, Marco Muselli, Alessandro Ozzello, Enrica Salomone, Damiano Verda, Maria Vezenkova, Riccardo Candido, Paola Ponzani","doi":"10.1186/s12933-025-02648-1","DOIUrl":"10.1186/s12933-025-02648-1","url":null,"abstract":"<p><strong>Background: </strong>Hypercholesterolemia is a major cardiovascular risk factor, particularly in individuals with type 2 diabetes (T2DM), where cardiovascular events are more prevalent. Adherence to low-density lipoprotein cholesterol (LDL-c) targets remains suboptimal globally and in Italy. This study evaluates trends in LDL-c target achievement and lipid-lowering treatment with a stratification by cardiovascular risk among Italian patients with type 2 diabetes from 2019 to 2022.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using the AMD Annals database, encompassing over 700,000 patients with T2DM. Patients were categorized by cardiovascular risk levels, LDL-c ranges and therapy types (statins, ezetimibe, PCSK9 inhibitors). Linear trends across the four years were evaluated.</p><p><strong>Results: </strong>The percentage of patients achieving LDL-c targets improved across all risk levels. In very high-risk patients, LDL-c < 55 mg/dL was achieved by 16.3% in 2019, increasing to 23.6% in 2022. High-risk patients achieving LDL-c < 70 mg/dL rose from 20.3 to 26.6% over the same period. Use of PCSK9 inhibitors, particularly in combination with statins, was associated with the highest target achievement rates, reaching 62% in very high-risk patients by 2022. We observed a reduction of moderate-intensity statins use in favor of combination therapies across the four years. Despite this, nearly one-third of patients still had LDL-c levels ≥ 100 mg/dL in 2022.</p><p><strong>Conclusions: </strong>While LDL-c management in Italian patients with T2DM has improved, significant gaps remain, particularly for very high-risk individuals. Expanding the use of advanced therapies like PCSK9 inhibitors and adhering more closely to guideline-based recommendations are critical to improve cardiovascular risk in this population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"94"},"PeriodicalIF":8.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531107","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 triglyceride glucose index and biological aging in U.S. adults: National Health and Nutrition Examination Survey.","authors":"Li-Ya Pan, Li Jin","doi":"10.1186/s12933-025-02631-w","DOIUrl":"10.1186/s12933-025-02631-w","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) has been reported to be associated with aging; however, few studies have investigated the relationship between IR and biological age (BA). The Triglyceride-glucose (TyG) index is a recognized marker of IR. Currently, there is insufficient evidence regarding the relationship between the TyG index and biological aging. This study aims to provide deeper insights into the connections between the TyG index and biological aging.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES), including 12,074 adults (aged 20 and older) from the 2001-2010 and 2015-2018 cycles. Comprehensive TyG and BA data were extracted for analysis. To explore the relationship between the TyG index and BA, linear regressions were employed, while logistic regression models were used to examine the association between the TyG index and accelerated aging. Additionally, trend tests, subgroup analyses, and smoothed fitted curves were conducted to assess the robustness of the findings.</p><p><strong>Results: </strong>We included 12,074 participants with a mean age of 46.91 years (SD, 16.64); of these, 50.25% were female and 49.75% were male. Each 1-unit increase in the TyG index was associated with a 1.64-year rise in Klemera-Doubal method (KDM) biological age and a 117% higher risk of accelerated aging. Similarly, each 1-unit increase in the TyG index corresponded to a 0.40-year increase in phenotypic age, resulting in a 15% higher risk of accelerated aging. The analysis also revealed nonlinear positive relationships between the TyG index and biological aging, particularly for KDM biological age (P for non-linearity < 0.001) and phenotypic age (P for non-linearity = 0.005), with a turning point at 8.66. Across all subgroups, the TyG index consistently showed a positive correlation with biological aging, even in the presence of significant interactions.</p><p><strong>Conclusions: </strong>There is a significant positive association between the TyG index and biological aging. Higher TyG levels are linked to increased biological age and a greater risk of accelerated aging.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"100"},"PeriodicalIF":8.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531253","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 novel metabolic parameters and all-cause/cardiovascular mortality in patients with metabolic syndrome is modified by age.","authors":"Jiajun Liu, Yihui Fu, Pengpeng Liang, Zhangxiao Song, Yue Li, Hongyan Wu","doi":"10.1186/s12933-025-02587-x","DOIUrl":"10.1186/s12933-025-02587-x","url":null,"abstract":"<p><strong>Background: </strong>Triglyceride glucose index (TyG) serves as an effective parameter for assessing metabolic status. However, it remains uncertain whether TyG and other metabolic parameters can predict clinical outcomes in people with metabolic syndrome (MetS). We investigated the association of TyG, triglyceride glucose-waist to height ratio (TyG-WHtR), and metabolic score for insulin resistance (METS-IR) with all-cause and cardiovascular mortality in the MetS cohort and determined whether this association changes with age.</p><p><strong>Method: </strong>Participants enrolled in the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018 were selected and categorized into two groups: younger individuals (age < 65 years) and older individuals (age ≥ 65 years). Three new metabolic indices of TyG, TyG-WHtR, and METS-IR were constructed. The weighted Cox proportional hazards model and restricted cubic spline (RCS) models were employed to evaluate the relation between three indices and mortality outcomes. The time-dependent receiver operating characteristic (ROC) curve assessed the ability of different indices to predict mortality. Sensitivity analysis was conducted to evaluate the robustness and reliability of the findings.</p><p><strong>Results: </strong>The study comprised a total of 8271 participants, including 5456 younger participants and 2815 older participants, and 1407 deaths were observed over a median follow-up period of 8.3 years. Compared with the first quartile (Q1), the fourth quartile's (Q4) TyG, TyG-WHtR, and METS-IR were linked to an increased risk of all-cause mortality (HR 1.63, 95% CI 1.12-2.39; HR 2.78, 95% CI 1.68-4.61; HR 1.36, 95% CI 1.12-2.02, respectively) and cardiovascular mortality (HR 2.04, 95% CI 1.15-4.90; HR 4.99, 95% CI 1.76-14.11; HR 2.69, 95% CI 1.89-8.15, respectively) in the younger group but not in the older group. The RCS results showed no significant non-linear associations between TyG, TyG-WHtR, METS-IR, and all-cause (P = 0.082; P = 0.712; P = 0.062, respectively) or cardiovascular mortality (P = 0.176; P = 0.793; P = 0.482, respectively) in the older age group. TyG-WHtR demonstrated the highest area under the curve for predicting 3-year mortality in the younger age group, with values of 0.653 for all-cause mortality and 0.688 for cardiovascular mortality.</p><p><strong>Conclusion: </strong>Our results highlight the predictive value of TyG, TyG-WHtR, and METS-IR in the MetS population, providing new evidence for medical practice and public health.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"96"},"PeriodicalIF":8.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531270","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":"Cellular crosstalk in organotypic vasculature: mechanisms of diabetic cardiorenal complications and SGLT2i responses.","authors":"Wenting Wang, Yanfei Liu, Qian Xu, Longkun Liu, Mengmeng Zhu, Yiwen Li, Jing Cui, Keji Chen, Yue Liu","doi":"10.1186/s12933-025-02655-2","DOIUrl":"10.1186/s12933-025-02655-2","url":null,"abstract":"<p><strong>Background: </strong>Diabetic panvascular disease (DPD) is the leading clinical complication of diabetes mellitus (DM), characterized by atherosclerosis across multiple organ vessels. It is a major cause of high disability and mortality rates in DM. However, the pathological mechanisms and key mediators of DPD remain unclear.</p><p><strong>Methods: </strong>This study constructed a single-cell organotypic atlas of the vasculature containing 321,358 cells by integrating 14 single-cell datasets from 8 major mouse organs and tissues. A total of 63 cell types were identified, including 9 vascular cell subtypes, whereas the cell-to-cell interaction (CCI) patterns of the organotypic vasculature were systematically analyzed.</p><p><strong>Results: </strong>Endothelial cells (ECs) were identified as the major cell type involved in CCI within the vasculature, with their ligands interacting with receptors of various cell types, which contribute to multiple biological processes such as stem cell differentiation and immune regulation. Notably, the study examined the cellular communication characteristics of different EC subtypes. Additionally, the inter-organ communication between the heart and kidney-key tissues in DPD-was analyzed. The BMP signaling pathway emerged as a critical communication pathway leading to cardiorenal complications in DM, with SGLT2i having a regulatory role in BMP6 modulation.</p><p><strong>Conclusions: </strong>The study provides, for the first time, a single-cell analysis of the CCI patterns of the organotypic vasculature and highlights the central role of ECs. Moreover, the key role of BMP6 in diabetic cardiorenal complications is elucidated. These findings offer new insights into the mechanisms underlying DPD co-morbidities and provide a novel scientific basis for clinical prevention, treatment strategies for DPD, and the understanding of the action mechanism of SGLT2i.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"90"},"PeriodicalIF":8.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514803","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":"Sacubitril/Valsartan partially alleviates myocardial infarction injury by activating the FGF21 signaling pathway via PPARs.","authors":"Wenjuan Wei, Guangsen Xu, Jiaer Gao, Guiyun Wang, Ye Wang, Caiyan Li, Junwei Zheng, Huiying Lu, Yunyan Lu, Kun Wang, Hongtao Xu, Cong Wang, Xuebo Pan","doi":"10.1186/s12933-025-02627-6","DOIUrl":"10.1186/s12933-025-02627-6","url":null,"abstract":"<p><p>The recent discovery of clinically significant data, alongside novel physiological and pathological occurrences surrounding sacubitril/valsartan (Sac/Val) beyond its approved indications, necessitates an urgent reevaluation of its underlying mechanism of action. In the present investigation, we observed a substantial elevation in the serum levels of fibroblast growth factor 21 (FGF21) among patients with acute myocardial infarction (AMI) who were administered Sac/Val, compared to those who were not, utilizing ELISA-based measurements. Furthermore, through the utilization of a mouse model of myocardial infarction induced by ligation of the left anterior descending branch, we confirmed that FGF21 mediates the cardioprotective effect of Sac/Val, employing both loss-of-function and gain-of-function approaches. Molecular docking and SPR experiments validated that Sac/Val can regulate FGF21 via its interaction with PPARs, and verified the role of PPARs in mediating Sac/Val regulation of FGF21 by inhibiting PPARs. In conclusion, we found that Sac/Val can act as an agonist of FGF21, which provides a new idea for the development of FGF21 drugs, and FGF21 as a new target of Sac/Val to ameliorate myocardial infarction, which provides a basis for new indications for Sac/Val.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"89"},"PeriodicalIF":8.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476301","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":"Deficiency in nucleoside diphosphate kinase B leads to endothelial activation of the hexosamine biosynthesis pathway and cardiac dysfunction.","authors":"Feng Shao, Johanna Wieland, Yixin Wang, Merve Keles, Zenghui Meng, Santosh Lomada, Miao Qin, Veronika Leiss, Abel Martin-Garrido, Manuela Fuhrmann, Yi Qiu, Trogisch Felix, Christiane Vettel, Joerg Heineke, Yuxi Feng","doi":"10.1186/s12933-025-02633-8","DOIUrl":"10.1186/s12933-025-02633-8","url":null,"abstract":"<p><strong>Background: </strong>Nucleoside diphosphate kinase B (NDPKB) deficiency in endothelial cells (ECs) promotes the activation of the hexosamine biosynthesis pathway (HBP), leading to vascular damage in the retina. The aim of this study was to investigate the consequences of NDPKB deficiency in the mouse heart.</p><p><strong>Methods: </strong>NDPKB deficient mice were used in the study. Echocardiography was employed to assess cardiac function in vivo. Characterization of contractility in hiPSC-derived cardiomyocytes (hiPSC-CMs) was measured with the IonOptix contractility system. Immunoblotting and immunofluorescence were carried out to analyze the expression and localization of proteins in cultured cells and left ventricles (LVs).</p><p><strong>Results: </strong>NDPKB deficient mice displayed impaired glucose tolerance and increased heart weight compared to controls. Echocardiographic analysis revealed an increase in the diastolic diameter of the left ventricular posterior wall (LVPW), a decrease in the early diastolic mitral valve E and E' wave, and in the ratios of E/A and E'/A' in NDPKB deficient hearts, suggesting cardiac hypertrophy and diastolic dysfunction. In line with cardiac dysfunction, the phosphorylation of myocardial phospholamban (PLN) and the expression of sarcoplasmic/endoplasmic reticulum Ca²⁺-ATPase 2 (SERCA2) in the NDPKB deficient LVs were significantly reduced. Moreover, the accumulation of collagen, fibronectin as well as the upregulation of transforming growth factor β (TGF-β), were detected in NDPKB deficient LVs. In addition, activation of the HBP and its downstream O-GlcNAc cycle was observed in the LVs and cardiac ECs (CECs) isolated from the NDPKB^-/- mice. Furthermore, a bipolar O-GlcNAc regulation was identified in CMs. O-GlcNAc was decreased in NDPKB-depleted CMs, while conditioned medium from NDPKB-depleted ECs significantly increased O-GlcNAc levels, along with contractile and relaxation dysfunction of the hiPSC-CMs, which was attenuated by inhibiting endothelial HBP activation.</p><p><strong>Conclusions: </strong>Deficiency in NDPKB leads to endothelial activation of the HBP and cardiac dysfunction. Our findings may highlight the crucial role of proper endothelial HBP in maintaining cardiovascular homeostasis.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"84"},"PeriodicalIF":8.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472428","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":"Advanced serum lipoprotein and glycoprotein profiling for cardiovascular event prediction in type 2 diabetes mellitus: the LIPOCAT study.","authors":"Núria Amigó, Esmeralda Castelblanco, Josep Julve, Neus Martínez-Micaelo, Núria Alonso, Marta Hernández, Josep Ribalta, Montse Guardiola, Pere Torán-Monserrat, Victor Lopez-Lifante, Cecilia Herrero-Alonso, Ingrid Arteaga, Emilio Ortega, Josep Franch-Nadal, Didac Mauricio","doi":"10.1186/s12933-025-02636-5","DOIUrl":"10.1186/s12933-025-02636-5","url":null,"abstract":"<p><strong>Background: </strong>Traditional risk factors cannot accurately predict cardiovascular events (CVE) in type 2 diabetes (T2D). The LIPOCAT study aimed to prospectively evaluate the clinical utility of advanced lipoprotein characteristics and glycoproteins to predict future cardiovascular events (CVE) in a large cohort of subjects with type 2 diabetes mellitus (T2D).</p><p><strong>Methods: </strong>From four different Spanish prospective cohorts, a total of 933 T2D subjects were selected to form the LIPOCAT study. Advanced 1H-Nuclear Magnetic Resonance (1H-NMR) analysis included lipoprotein (Liposcale®) and glycoprotein (Glycoscale) profiling. Random forest classification models and Area Under the Receiver Operating Characteristics (AUROC) analysis were used to assess the differential contribution of advanced variables in predicting CVE. Validation was performed using an external cohort.</p><p><strong>Results: </strong>Out of 933 T2D subjects, 104 reported a CVE during follow-up. Analysis of Liposcale®/Glycoscale uncovered elevations in the circulating VLDL-cholesterol(C), remnant IDL-triglycerides (TG) and LDL-TG in subjects with CVE, along with glycoproteins (Glyc) A and B. Moreover, the incorporation of advanced Liposcale® variables to a base model constructed with traditional risk factors significantly improved the prediction of CVE, as evidenced by 1.5-fold increase in the C statistic (AUROC), reaching AUROC values of 0.756. In the independent validation cohort, similar improvements in AUROC values were observed by adding the advanced variables to the traditional models.</p><p><strong>Conclusions: </strong>Advanced 1H-NMR analysis revealed previously hidden lipoprotein and glycoprotein characteristics associated with CVE in T2D subjects.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"88"},"PeriodicalIF":8.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476274","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":"Impaired microcirculation in the skin and subclinical atherosclerosis in individuals with dysglycaemia in a large population-based cohort.","authors":"John Cederqvist, Karin Rådholm, Fredrik H Nystrom, Jan Engvall, Sara Bergstrand, Ingemar Fredriksson, Tomas Strömberg, Carl Johan Östgren","doi":"10.1186/s12933-025-02628-5","DOIUrl":"10.1186/s12933-025-02628-5","url":null,"abstract":"<p><strong>Background and aim: </strong>Dysglycaemia is a known risk factor for cardiovascular disease and microcirculatory dysfunction is associated with an increased cardiovascular disease risk. The aim of this study was to investigate the prevalence of impaired microcirculation, coronary atherosclerosis, and arterial stiffness in individuals with normo- and dysglycaemia.</p><p><strong>Methods: </strong>The study included 3,300 participants with microcirculatory measurements and information on glycaemic status, aged 50-65 years, from the Linköping site of the Swedish CArdio-Pulmonary bioImage Study (SCAPIS). Microvascular function was assessed in forearm skin using an arterial occlusion and release protocol determining peak blood oxygen saturation (OxyP). Data on pulse wave velocity (PWV) and the Coronary Artery Calcification Score (CACS) were collected. Participants were categorised into three glycaemic categories: normoglycaemia, prediabetes and diabetes.</p><p><strong>Results: </strong>OxyP was lower in the prediabetes group - 1.2%-units, 95% CI (-1.8 to -0.6) and in study participants with diabetes - 2.4%-units, 95% CI (-3.1 to -1.6) compared to the normoglycaemic group 84.3%, 95% CI (83.6 to 84.9). PWV and CACS were higher in participants with dysglycaemia. Prevalent impaired function at three vascular levels (lowest quartile of OxyP + PWV ≥ 10 m/s and CACS ≥ 100) were observed in 0.8%, 2.3% and 7.6% in the glycaemic categories respectively. The difference between the normoglycaemic and the diabetes category and the difference between the pre-diabetes and the diabetes category was significant, p = < 0.05.</p><p><strong>Conclusions: </strong>Patients with prediabetes and diabetes are more likely to have impaired microcirculation in the forearm skin and macrovascular disorders such as arterial stiffness and atherosclerosis in the coronary arteries compared to normoglycaemic individuals.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"86"},"PeriodicalIF":8.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476277","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 glucagon-like peptide-1 receptor agonists with cardiovascular and kidney outcomes in type 2 diabetic kidney transplant recipients.","authors":"Li-Chun Lin, Jui-Yi Chen, Thomas Tao-Min Huang, Vin-Cent Wu","doi":"10.1186/s12933-025-02649-0","DOIUrl":"10.1186/s12933-025-02649-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is a leading cause of post-transplant mortality in kidney transplant recipients (KTRs), especially those with diabetes. Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular and kidney benefits in the general population with type 2 diabetes mellitus (T2DM), evidence regarding their effects in diabetic KTRs is limited.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Global Collaborative Network in TriNetX, spanning January 1, 2006, to June 1, 2023. Propensity score matching (PSM) with 1:1 ratio was employed to create balanced cohorts. Adult KTRs with T2DM who received GLP-1 RAs within 3 months post-transplant were compared to a matched cohort of KTRs who did not. The primary outcome was all-cause mortality, with secondary outcomes including major adverse cardiovascular events (MACEs) and major adverse kidney events (MAKEs).</p><p><strong>Results: </strong>A total of 35,488 adult KTRs with T2DM (mean [SD] age, 57.7 [12.2] years; 57.7% men) were identified and 9.8% patients used GLP-1 RAs among 3 months post-transplant. Following PSM, 3564 GLP-1 RAs users were matched with an equal number of nonusers. After a median follow-up of 2.5 years, GLP-1 RAs users had lower risks of mortality (adjusted hazard ratio (aHR), 0.39; 95% CI 0.31-0.50), MACEs (aHR 0.66; 95% CI 0.56-0.79), and MAKEs (aHR 0.66; 95% CI 0.58-0.75). Adverse effects included higher risks of nausea, vomiting and diarrhea, while risks of suicide, hypoglycemia, retinopathy, and pancreatitis were not increased.</p><p><strong>Conclusions: </strong>In KTRs with T2DM, GLP-1 RAs use was associated with substantial reductions in all-cause mortality, MAKEs, and MACEs compared to nonuse without increasing complications. However, the underutilization of GLP-1 RAs represents a significant opportunity to improve post-transplant outcomes in this high-risk population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"87"},"PeriodicalIF":8.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472425","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}