Cardiovascular Diabetology最新文献

{"title":"Crosstalk between perivascular adipose tissue and adipocyte-derived peptide in the pathogenesis of diabetic cardiomyopathy.","authors":"Yingjie Feng, Yajing Wang, Yifan Deng, Peifen Li, Penghua Fang, Zhenwen Zhang","doi":"10.1186/s12933-025-02863-w","DOIUrl":"10.1186/s12933-025-02863-w","url":null,"abstract":"<p><p>Diabetic cardiomyopathy (DCM) is a prevalent complication in diabetic patients, and its pathogenic mechanism involves multiple endocrine and metabolic factors, with dyslipidemia playing a pivotal role in the pathogenesis of the disease. Recent studies have highlighted the importance of peptides in energy metabolism and their potential effect on the onset and development of DCM by affecting the function of perivascular adipose tissue (PVAT). The present review aims to examine the effect of these peptides on perivascular adipose tissue and myocardial metabolism during the pathogenesis of DCM, focusing on the role of peptides distributed in perivascular adipose tissue in cardioprotection and their underlying mechanisms of action. In addition, we will explore future research directions and potential clinical applications of these peptides in the treatment of DCM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"332"},"PeriodicalIF":10.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844512","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 triglyceride-glucose-related indices with all-cause and cause-specific mortality in individuals with prediabetesss.","authors":"Liwen Zhang, Weili Zhao, Panpan Zheng, Fang Huang, Lili Zhang, Yuxin Zhang, Xian Xiu, Pei Zhang, Zanchao Liu, Lipeng Liu","doi":"10.1186/s12933-025-02883-6","DOIUrl":"10.1186/s12933-025-02883-6","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index has been linked to the occurrence of prediabetes, but there is limited evidence regarding its association with mortality in individuals with prediabetes. Thus, this study aimed to explore the association between TyG-related indices and all-cause and cause-specific mortality in individuals with prediabetes.</p><p><strong>Method: </strong>Based on NHANES data from 1999 to 2018, the TyG index, TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR) were calculated. Mortality data including all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were determined as of December 31, 2019. Kaplan-Meier curves, Cox regression analysis, and restricted cubic splines (RCS) were used to assess associations of TyG-related indices with all-cause and cause-specific mortality (CVD and cancer) in individuals with prediabetes. Subgroup and sensitivity analyses were used to confirm the robustness of the results.</p><p><strong>Results: </strong>In total, 9,574 participants with prediabetes were included. Kaplan-Meier curves indicated that overall survival and cancer-specific survival were associated with different quartiles of the TyG index, with quartile 1 having the lowest all-cause mortality (P = 0.042 and P = 0.008). TyG-WHtR was negatively correlated with overall survival and CVD-specific survival (P < 0.001 and P = 0.012). Multivariate Cox regression analysis showed a significant positive correlation between the TyG index and cancer mortality (Q4: HR = 1.957, 95% CI: 1.126-3.402, P = 0.017). High quartiles of TyG-WC were significantly associated with cancer mortality in participants with prediabetes (HR = 2.397, 95% CI, 1.062-5.409, P = 0.035). Similarly, higher quartiles of TyG-WHtR were positively associated with all-cause, CVD, and cancer mortality. RCS analysis showed that TyG-WC and TyG-WHtR were nonlinearly correlated with cancer mortality (P for nonlinear = 0.028 and 0.006).</p><p><strong>Conclusion: </strong>Elevated TyG and TyG-WC levels were significantly associated with increased cancer mortality risk, while TyG-WHtR showed stronger associations with all-cause and cause-specific mortality in individuals with prediabetes. These indices could serve as surrogate biomarkers for follow-up and clinical management of individuals with prediabetes.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"330"},"PeriodicalIF":10.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834110","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 novel triglyceride‒glucose-weighted adjusted waist index as a supplementary diagnostic tool for heart failure: evidence of improved reclassification beyond traditional TyG-related indices from a cross-sectional study.","authors":"Yuqin Fan, Dan Ye, Kebin Zhou, Lu Cai, Longhui Yu","doi":"10.1186/s12933-025-02896-1","DOIUrl":"10.1186/s12933-025-02896-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Heart failure (HF) remains a major public health burden, necessitating reliable biomarkers for early risk stratification. The triglyceride glucose weight-adjusted waist index (TyG-WWI), a novel metabolic indicator, has emerged as a potential predictor, but its association with HF in the general population remains underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cross-sectional study included 22,575 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018, 704 of whom had HF. The TyG-WWI was calculated, and its association with HF risk was analyzed via multivariable logistic regression (adjusted for demographics, lifestyle factors, disease history, and medication use), restricted cubic splines (with 4 knots), and subgroup analyses. Additionally, interaction tests by different survey cycles were performed to account for temporal effects. ROC analysis with DeLong's test and net reclassification improvement (NRI) were used to compare the diagnostic performance of the TyG-WWI with that of conventional TyG-related parameters (TyG, TyG-WC, TyG-WHtR) and traditional HF prognostic factors. Sensitivity analyses with multiple imputation for missing data were performed to assess the robustness of the results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population had a mean age of 49.5 years, with 48.34% males. Baseline characteristics differed significantly between the HF and non-HF groups in terms of demographics, lifestyle, disease history, and medication use. After full adjustment for demographic, clinical, and lifestyle factors, each standard deviation increase in the TyG-WWI was associated with a 52% greater HF risk (OR 1.52, 95% CI 1.27-1.81). Restricted cubic spline analysis revealed a linear positive correlation between the TyG-WWI and HF risk. ROC analysis demonstrated that compared with conventional TyG-WWI (AUC = 0.697, 95% CI 0.678-0.715), TyG-WWI exhibited superior discriminative performance for HF diagnosis (TyG: AUC = 0.616; TyG-WC: AUC = 0.665; TyG-WHtR: AUC = 0.673) and traditional prognostic factors (BMI: 0.592; waist circumference: 0.654; fasting blood glucose: 0.524, all DeLong-P &lt; 0.001 after Bonferroni correction). NRI analysis revealed that TyG-WWI provided an 11.41% NRI compared with TyG, 4.20% compared with TyG-WC, and 2.99% compared with TyG-WHtR. Further subgroup analyses revealed that this association was more pronounced in men, patients not using β-blockers, and nondiabetic individuals. Sensitivity analyses reinforced the robustness of the findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In the general population, the TyG-WWI is strongly, independently, and dose-dependently associated with heart failure (HF) risk. Notably, its diagnostic performance for HFs surpasses that of traditional TyG-related indices, and it has incremental value as a supplementary parameter to existing TyG-derived metrics. These findings support the use of th","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"329"},"PeriodicalIF":10.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834111","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":"Improving cardiovascular risk stratification: the role of abdominal obesity in predicting MACEs.","authors":"Carlo De Matteis, Stefano Petruzzelli, Giusi Graziano, Fabio Novielli, Ersilia Di Buduo, Salvatore Cantatore, Elsa Berardi, Gianfranco Antonica, Maria Arconzo, Marica Cariello, Marilina Florio, Lucilla Crudele, Antonio Moschetta","doi":"10.1186/s12933-025-02885-4","DOIUrl":"10.1186/s12933-025-02885-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate cardiovascular risk (CVR) stratification remains challenging, particularly in identifying individuals with residual risk despite current screening tools. Abdominal obesity reflects visceral adipose tissue, which is metabolically active and strongly linked to pro-inflammatory and atherogenic states. This study aimed to evaluate the predictive utility of baseline cardiometabolic risk factors, with a particular focus on abdominal obesity as quantified by waist circumference (WC), alongside established 10-year CVR scores, for incident Major Adverse Cardiovascular Events (MACEs).</p><p><strong>Methods: </strong>We prospectively followed 736 outpatients (347 males, 389 females) from an Italian Internal Medicine Unit, initially free of MACEs. Baseline data included anthropometrics, biochemical markers, and calculated Framingham Risk Score (FRS) and SCORE2/SCORE2-OP. Abdominal obesity was defined according to the International Diabetes Federation criteria for Metabolic Syndrome (MetS) as a WC ≥ 94 cm in males and ≥ 80 cm in females. Incident MACEs were recorded during follow-up. Statistical analyses included t-tests, Chi-Square, ANOVA, and logistic regression.</p><p><strong>Results: </strong>Over a median follow-up of 84.9 months, 132 participants (17.9%) developed MACEs. Baseline abdominal obesity, present in 78.1% of the cohort, was significantly associated with incident MACEs (OR = 1.784, 95% CI = 1.04-3.118, p = 0.038), whereas BMI-defined obesity showed no such association (p = 0.394). Low HDL-cholesterol also emerged as a key predictor (OR = 1.672, 95% CI = 1.115-2.482, p = 0.012). In multivariate logistic regression, adjusted for age and other MetS components, abdominal obesity (OR = 2.2, 95% CI = 1.6-4.2, p = 0.001) and low HDL-c (OR = 1.9, 95% CI = 1.4-3.5, p = 0.001) remained robustly associated with MACEs. Notably, individuals within the SCORE2/SCORE2-OP 'Moderate-Risk' category, despite not being the highest risk overall, exhibited the highest baseline LDL-c levels and accounted for the largest proportion of MACEs (36.4%). Even among participants without baseline abdominal obesity, those who developed MACEs had significantly higher WC (p < 0.0001) and lower HDL-c (p = 0.0078) at baseline.</p><p><strong>Conclusion: </strong>Abdominal obesity and low HDL-c are potent, independent predictors of cardiovascular events, outperforming traditional markers like BMI. Together with the need of reaching LDL-c serum target levels, these biomarkers are crucial for unmasking the residual risk missed by current stratification models.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"328"},"PeriodicalIF":10.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820621","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":"Global detection and management of dysglycaemic patients with coronary artery disease results from the INTERASPIRE survey from 14 countries across six WHO regions.","authors":"Safi Moayad Al-Azzawy, John William McEvoy, Isabelle Johansson, Agnieszka Adamska, Guy De Backer, Iris Erlund, Sandra Ganly, Catriona Jennings, Kornelia Kotseva, Gregory Y H Lip, Linda Mellbin, Kausik K Ray, Terhi Vihervaara, David Wood, Ana Abreu, Wael Almahmeed, Ade Meidian Ambari, Junbo Ge, Hosam Hasan-Ali, Yong Huo, Piotr Jankowski, Rodney M Jimenez, Yong Li, Syadi Mahmood Zuhdi, Abel Makubi, Amam Chinyere Mbakwem, Lilian Mbau, Jose Luis Navarro Estrada, Okechukwu Samuel Ogah, Elijah Nyainda Ogola, Adalberto Quintero-Baiz, Mahmoud Umar Sani, Maria Ines Sosa Liprandi, Jack Wei Chieh Tan, Miguel Alberto Urina Triana, Tee Joo Yeo, Dirk De Bacquer, Lars Rydén","doi":"10.1186/s12933-025-02878-3","DOIUrl":"10.1186/s12933-025-02878-3","url":null,"abstract":"<p><strong>Objective: </strong>Dysglycaemia, defined as type 2 diabetes mellitus (T2DM) or impaired glucose tolerance (IGT), increases the cardiovascular risk and prognosis. INTERASPIRE performed in 14 countries across 6 WHO regions evaluated guideline adherence and management of patients with coronary artery disease (CAD) and dysglycaemia.</p><p><strong>Methods: </strong>A total of 4,548 CAD patients (18-80 years) were interviewed 6 months-2 years after hospital admission. All without diabetes were eligible for an oral glucose test (OGTT).</p><p><strong>Results: </strong>Overall, 1990 (44%) had known T2DM. The OGTT revealed that 808 (40%) had previously unknown dysglycaemia (T2DM 12% and IGT 28%). Two thirds of all dysglycaemic patients were obese. A similar proportion reported low physical activity and only one third received dietary advice. Only half of dysglycemic patients were prescribed all guideline recommended cardioprotective drugs. A majority did not reach recommended blood pressure, lipids or HbA1c targets. Only 16% had attended a diabetes education program.</p><p><strong>Conclusions: </strong>The INTERASPIRE study shows that screening for glucose perturbations in coronary patients is inadequate, achievement of lifestyle recommendations suboptimal and pharmacological management insufficient resulting in a poor risk factor control. Patients with coronary disease, especially those with glucose perturbations require professional support to achieve healthier lifestyles, and prescription of all cardioprotective medications to achieve guideline targets.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"327"},"PeriodicalIF":10.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820620","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":"Development and validation of a machine learning model for predicting vulnerable carotid plaques using routine blood biomarkers and derived indicators: insights into sex-related risk patterns.","authors":"Yimin E, Zhichao Yao, Maolin Ge, Guijun Huo, Jian Huang, Yao Tang, Zhanao Liu, Ziyi Tan, Yuqi Zeng, Junjie Cao, Dayong Zhou","doi":"10.1186/s12933-025-02867-6","DOIUrl":"10.1186/s12933-025-02867-6","url":null,"abstract":"<p><strong>Background: </strong>Early detection of vulnerable carotid plaques is critical for stroke prevention. This study aimed to develop a machine learning model based on routine blood tests and derived indices to predict plaque vulnerability and assess sex-specific risk patterns across biomarker value ranges.</p><p><strong>Methods: </strong>We retrospectively included 1701 hospitalized patients from Suzhou Municipal Hospital (2019-2020), selected from an initial cohort of 10,028 individuals. All patients underwent carotid ultrasound, with vulnerable plaques identified using predefined imaging criteria. A total of 30 laboratory variables-including blood count, coagulation, and biochemistry-were extracted, alongside derived indices such as triglyceride-glucose index (TyG), atherogenic index of plasma (AIP), neutrophil-to-lymphocyte ratio (NLR) and others. Features were standardized and selected based on statistical and clinical relevance. Five machine learning models were trained using a 7:3 train-test split and evaluated by cross-validation. Model performance was assessed using AUC, sensitivity, and specificity. The best model was interpreted using SHapley Additive exPlanations (SHAP) analysis. Sex differences were explored using Mann-Whitney U tests and restricted cubic spline (RCS) modeling across value intervals.</p><p><strong>Results: </strong>The Random Forest model showed the highest predictive performance (AUC = 0.847; 95% CI 0.791-0.895; specificity = 89.4%; sensitivity = 64.2%). SHAP analysis identified gender, age, fibrinogen, NLR, creatinine, fasting blood glucose, uric acid to high-density lipoprotein ratio (UHR), TyG, systemic inflammation response index (SIRI), and lymphocyte count as top predictors. Significant sex-specific differences in SHAP values were observed for key biomarkers, including age, UHR, TyG, SIRI, and others. RCS modeling further revealed distinct sex-related patterns in plaque vulnerability across biomarker value ranges.</p><p><strong>Conclusion: </strong>A Random Forest model integrating routine blood markers and derived indices accurately predicted vulnerable carotid plaques. The results underscore the importance of sex-specific risk assessment, highlighting differential effects of key biomarkers across genders and value intervals.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"326"},"PeriodicalIF":10.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815784","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":"Epicardial adipose tissue volume is associated with impaired left ventricular strain in patients with metabolic syndrome: the mediating role of myocardial energetic efficiency.","authors":"Wei-Feng Yan, Jin Wang, Yuan Li, Shi-Qin Yu, Yu Jiang, Xue-Ming Li, Yi-Ning Jiang, Ke Shi, Yue Gao, Shan Huang, Zhi-Gang Yang","doi":"10.1186/s12933-025-02859-6","DOIUrl":"10.1186/s12933-025-02859-6","url":null,"abstract":"<p><strong>Background: </strong>Epicardial adipose tissue volume (EATV) has been linked to cardiac dysfunction in metabolic syndrome (MetS), but the underlying mechanisms remain unclear. The aim of this study was to investigate whether myocardial energetic efficiency partially explains the relationship between EATV and impaired left ventricular (LV) myocardial strain in MetS patients using cardiac magnetic resonance (CMR).</p><p><strong>Methods: </strong>A total of 225 patients with MetS and 68 age - and sex - matched controls underwent CMR. LV myocardial energetic efficiency index (MEEI), EATV, and myocardial strain-including global radial, circumferential, and longitudinal peak strain (GLPS)-were measured. Pearson correlation analysis, multivariable linear regression and mediation analysis (bootstrapped 95% confidence intervals) were performed to evaluate the direct and MEEI-mediated effects of EATV on LV myocardial strain.</p><p><strong>Results: </strong>MetS patients exhibited impaired myocardial strain and lower MEEI compared to controls. EATV negatively correlated with MEEI (r =  - 0.224, P < 0.001) and with LV myocardial peak strain in all three directions (r =  - 0.174 to - 0.332, P < 0.01). Multivariable regression analysis confirmed EATV as an independent predictor of lower LV GLPS (β =  - 0.178, P = 0.01) and MEEI (β =  - 0.268, P < 0.01). Mediation analysis revealed that approximately 29% of the total negative effect of EATV on GLPS was accounted for reduced MEEI (standardized indirect effect β = - 0.081, 95% CI - 0.137 to - 0.0029, P < 0.01).</p><p><strong>Conclusions: </strong>In patients with metabolic syndrome, increased EATV was independently associated with impaired LV myocardial strain, with reduced MEEI partly explaining the observed EATV-LV dysfunction association.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"325"},"PeriodicalIF":10.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811833","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":"Cardiometabolic risk stratification in pediatric obesity: evaluating the clinical utility of fasting insulin and BMI-SDS.","authors":"Rasmus Stenlid, Sami El Amrani, Sara Y Cerenius, Banu K Aydin, Hannes Manell, Katharina Mörwald, Julia Lischka, Julian Gomahr, Thomas Pixner, Iris Ciba, Stefan K James, Anders Forslund, Daniel Weghuber, Peter Bergsten","doi":"10.1186/s12933-025-02882-7","DOIUrl":"10.1186/s12933-025-02882-7","url":null,"abstract":"<p><strong>Background: </strong>Patients with obesity during childhood have an increased risk of fatal and non-fatal cardiovascular events during adulthood. The severity of obesity is commonly determined by BMI. However, children with relatively low BMI may have high cardiometabolic risk. Indeed, BMI-based obesity classifications might miss children at high cardiometabolic risk. Insulin has been suggested as a marker of cardiometabolic risk. In this study, we therefore estimated and compared cardiometabolic risk using either the BMI standard deviation score (BMI-SDS) or fasting insulin in an international cohort of children and adolescents with obesity and lean controls.</p><p><strong>Methods: </strong>Study participants (712 with obesity and 99 lean controls), aged 3 to 18 years, were categorized according to their BMI-SDS as lean or obesity class I, II, or III, or by their fasting insulin quartiles as quartile 1, 2, 3, or 4 with the lean subjects in a separate control group. Prevalence of cardiometabolic risk factors was assessed in each group. Sensitivity and specificity analyses for cardiometabolic risk were conducted for both BMI-SDS and fasting insulin. Multiple regression, logistic regression, and receiver operating characteristic (ROC) analyses were performed between fasting insulin, BMI-SDS and cardiometabolic risk factors.</p><p><strong>Results: </strong>An elevated prevalence of the cardiometabolic risk factors dyslipidemia, dysglycemia and hypertension was observed in both increasing BMI-SDS classes and increasing fasting insulin quartiles. Fasting insulin demonstrated higher areas under the curve (AUC) for detecting dyslipidemia, dysglycemia, and the combination of dyslipidemia, dysglycemia, and hypertension, compared to BMI-SDS. BMI-SDS demonstrated a higher AUC for detecting hypertension compared to fasting insulin. The same patterns were seen for the logistic regression. However, fasting insulin had an overall stronger association with the cardiometabolic risk factors studied compared to BMI-SDS.</p><p><strong>Conclusions: </strong>In children and adolescents with obesity, fasting insulin provides complementary information to BMI-SDS in identifying those with elevated cardiometabolic risk factors. While neither marker alone offers strong predictive accuracy, incorporating fasting insulin into clinical assessment may help prioritize individuals who require more detailed evaluation. An elevated fasting insulin value may warrant further investigation among children and adolescents with obesity, independent of obesity class based on BMI-SDS.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"324"},"PeriodicalIF":10.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803581","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":"Acetylsalicylic acid and vorapaxar are less active, while 4-methylcatechol is more active, in type 1 diabetic patients compared to healthy controls.","authors":"Markéta Paclíková, Lukáš Konečný, Alejandro Carazo, Kateřina Matoušová, Lenka Kujovská Krčmová, Vladimír Blaha, Alena Šmahelová, Přemysl Mladěnka","doi":"10.1186/s12933-025-02891-6","DOIUrl":"10.1186/s12933-025-02891-6","url":null,"abstract":"<p><strong>Introduction: </strong>It is well known that platelets from diabetic patients can be resistant to clinically used antiplatelet drugs.</p><p><strong>Methods: </strong>To assess the phenomenon in more detail, 50 adult patients suffering from type 1 diabetes mellitus (T1D) were recruited and their responses to 7 platelet aggregation inducers, as well as to 3 clinically used antiplatelet drugs (acetylsalicylic acid /ASA/, ticagrelor and vorapaxar) and one experimental compound, 4-methylcatechol, were assessed ex vivo. A control group of 50 generally healthy age-matched controls was also included for comparison.</p><p><strong>Results: </strong>T1D patients exhibited a lower aggregation reaction to 3 inducers but were conversely more resistant to the effect of ASA and vorapaxar than controls. Ticagrelor tended to be less active in T1D as well. On the other hand, 4-methylcatechol was equally or even more potent in T1D than in healthy controls. Plasma glucose levels above 7 mM were associated with lower platelet aggregation responses to four aggregation inducers. In contrast, the effect of 4-methylcatechol, unlike that of ASA, did not appear to be strongly influenced by glycemia. Further subanalyses, excluding hypertensive patients and significantly more frequently administered drugs, did not substantially modify the results.</p><p><strong>Conclusion: </strong>Conclusively, 4-methylcatechol seems to be a prototypical antiplatelet compound with a strong effect even in diabetic patients.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"323"},"PeriodicalIF":10.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798218","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":"Glucose metabolism in heterozygous familial hypercholesterolemia with a founder effect and a high diabetes prevalence: a cross-sectional study.","authors":"Ana María González-Lleó, Yeray Brito-Casillas, Virginia Martín-Santana, Yaiza Gil-Quintana, Antonio Tugores, Roberto Scicali, Marta Riaño, Luisa Hernández-Baraza, Roberto Jiménez-Monzón, Josefa Girona, Francesco Di Giacomo Barbagallo, Luis Masana, Mauro Boronat, Ana M Wägner, Rosa M Sánchez-Hernández","doi":"10.1186/s12933-025-02857-8","DOIUrl":"10.1186/s12933-025-02857-8","url":null,"abstract":"<p><strong>Background: </strong>Heterozygous familial hypercholesterolemia (HeFH) is typically associated with a lower prevalence of type 2 diabetes mellitus (T2DM). However, individuals carrying the p.[Tyr400_Phe402del]LDLR mutation, which is prevalent in Gran Canaria, exhibit an unexpectedly high prevalence of T2DM. This study aimed to investigate whether the p.[Tyr400_Phe402del] LDLR mutation co-segregates with T2DM and other glucose metabolism abnormalities.</p><p><strong>Methods: </strong>A total of 226 individuals were recruited, with 196 included in the final analysis. This included 90 HeFH patients from Gran Canaria (HeFH-GC) carrying the p.[Tyr400_Phe402del]LDLR mutation, 76 first-degree relatives (non-HeFH), and 30 HeFH patients from Italy (HeFH-It) with other LDLR mutations. Clinical, anthropometric, biochemical, and hematological parameters, including insulin resistance and sensitivity, were assessed via oral glucose tolerance tests (OGTT), and indices such as HOMA-IR, HOMA-beta, QUICKI, and the triglyceride‒glucose ratio were measured.</p><p><strong>Results: </strong>Among HeFH-GC participants, 20% had T2DM, similar to 18.4% in the non-HeFH group (p = NS). HOMA-beta was significantly greater in HeFH-GC patients (86.2 vs. 68.4; p = 0.046). Normoglycemic HeFH-GC individuals had elevated HOMA-IR [2.0 (1.3-2.9) vs. 1.3 (1.0-1.9); p = 0.008]. Compared with HeFH-It patients, HeFH-GC individuals had higher fasting glucose levels (99 vs. 92.5 mg/dL; p = 0.004) and lower 120-min post-OGTT glucose levels (115 vs. 136.5 mg/dL; p = 0.001). Lipid-lowering therapy, hypertension, hypertriglyceridemia, and increased waist circumference were associated with T2DM.</p><p><strong>Conclusions: </strong>HeFH patients from Gran Canaria exhibit a high prevalence of T2DM. The p.[Tyr400_Phe402del]LDLR mutation does not co-segregate with T2DM, but normoglycemic HeFH-GC individuals have greater insulin resistance. Additionally, lipid-lowering therapy, hypertension, hypertriglyceridemia, and increased waist circumference are factors associated with the prevalence of T2DM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"322"},"PeriodicalIF":10.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793551","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}