Cardiovascular Diabetology最新文献

{"title":"Long-term impact of diabetes on mortality in patients undergoing unprotected left main PCI: a propensity score-matched analysis from the BIA-LM registry.","authors":"Paweł Kralisz, Emil Julian Dąbrowski, Sławomir Dobrzycki, Wiktoria Urszula Kozłowska, Patrycja Oliwia Lipska, Konrad Nowak, Kamil Gugała, Przemysław Prokopczuk, Grzegorz Mężyński, Michał Święczkowski, Marcin Kożuch","doi":"10.1186/s12933-025-02733-5","DOIUrl":"https://doi.org/10.1186/s12933-025-02733-5","url":null,"abstract":"<p><strong>Background: </strong>There is modest data on long-term impact of diabetes on left main coronary artery (LMCA) percutaneous coronary intervention (PCI). This observational study, based on the largest single-center registry of LMCA PCI in Poland, evaluated the impact of diabetes on long-term survival following PCI in a real-world setting.</p><p><strong>Methods: </strong>We retrospectively analyzed 998 patients who underwent LMCA PCI between December 27, 2007, and February 21, 2022. Diabetes and insulin dependence were defined based on medical history, prior records, and prescribed treatment. The endpoint was all-cause mortality at the longest available follow-up (mean 4.2 years). Survival analysis was conducted in the overall cohort and a one-to-one propensity score-matched (PSM) population. Moderation effects and differences between subgroups were analysed in predefined groups of PSM cohort.</p><p><strong>Results: </strong>The median age was 71 (63-79) years; 212 (28.2%) were women, and 250 (33.2%) had diabetes. In the overall cohort, diabetes was associated with a worse prognosis (HR 1.35, 95% CI 1.03-1.76, P = 0.03). PSM resulted in 214 well-balanced pairs (median age 73 years (66-79)), with no significant difference in all-cause mortality between groups (adjusted HR 1.27, 95% CI 0.91-1.77, P = 0.16). After PSM subgroup analysis showed worse outcomes for patients with diabetes undergoing two-stent angioplasty (HR 3.70, 95% CI 1.64-8.34, P = 0.002) and elective PCI (HR 2.07, 95% CI 1.29-3.31, P = 0.003). Conversely, among patients presenting with myocardial infarction (MI), people with diabetes had better survival than the control group (HR 0.56, 95% CI 0.35-0.90, P = 0.02). No significant differences in outcomes were observed in patients with heart failure (HR 1.29, 95% CI 0.88-1.89, P = 0.19), chronic kidney disease (HR 1.08, 95% CI 0.69-1.71, P = 0.19), intravascular imaging use (HR 1.38, 95% CI 0.70-2.71, P = 0.35), or concomitant multivessel disease (HR 1.14, 95% CI 0.75-1.73, P = 0.53).</p><p><strong>Conclusions: </strong>No significant association was observed between diabetes and overall mortality following LMCA PCI. Sensitivity analyses showed worse survival outcomes in diabetic patients treated with two-stent techniques and undergoing non-emergency PCI. These findings suggest the overall safety of PCI for LMCA in people with diabetes and highlight the need for randomized trials, especially investigating indicated high-risk subgroups.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"175"},"PeriodicalIF":8.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The association of triglyceride-glucose and triglyceride-glucose related indices with the risk of heart disease in a national cohort study.","authors":"Xiaodi Tang, Kexin Zhang, Rong He","doi":"10.1186/s12933-025-02726-4","DOIUrl":"https://doi.org/10.1186/s12933-025-02726-4","url":null,"abstract":"","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"174"},"PeriodicalIF":8.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980209","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":"Exploring the effect of dapagliflozin on coronary inflammation in type 2 diabetes patients based on the coronary artery perivascular fat attenuation index.","authors":"Xuehua Liu, Tian Zhang, Rong Fu, Dan Liu, Jingyi Zhang, Qing Hu, Guangyao Song, Luping Ren","doi":"10.1186/s12933-025-02723-7","DOIUrl":"https://doi.org/10.1186/s12933-025-02723-7","url":null,"abstract":"<p><strong>Background: </strong>The pericoronary fat attenuation index (FAI) is a novel biomarker that serves as an indicator of coronary artery inflammation. Dapagliflozin has become an important component of standard treatment for type 2 diabetes because of its cardioprotective and renoprotective effects. The objective of this research was to explore how dapagliflozin impacts coronary artery inflammation in T2DM patients and to establish a novel theoretical framework for the protective role of dapagliflozin in the cardiovascular system.</p><p><strong>Methods: </strong>This research retrospectively included 271 T2DM patients treated with coronary computed tomography angiography (CCTA) at Hebei Provincial People's Hospital from January 2021 to November 2024, with 103 patients receiving dapagliflozin therapy (dapagliflozin+) and 168 patients not receiving dapagliflozin (dapagliflozin-) (oral dapagliflozin 10 mg/day for no less than 6 months). Baseline clinical information, laboratory markers, and CCTA-related metrics were collected and analysed across both groups. The relationship between dapagliflozin treatment and the pericoronary FAI was analysed using multiple linear regression to control for confounding variables, and the correlation between the two variables was further examined across various subgroups.</p><p><strong>Results: </strong>Compared with those in the dapagliflozin- group, the patients in the dapagliflozin+ group were younger (P<0.001), and the proportion of men was higher (P<0.05). There were no between-group differences in the baseline data, such as diabetes course, BMI, and blood lipid status (P>0.05). The FAI of the LAD and RCA in the dapagliflozin+ group was lower than that in the other groups, and the average FAI of the three coronary arteries was also significantly lower, while there was no significant difference in the LCX (LAD: dapagliflozin- group: -85.50 (-90.43, -78.27)，dapagliflozin+ group：-86.94 (-92.81, -81.57)，P= 0.044；RCA：dapagliflozin- group：-86.31 (-92.12, -80.09), dapagliflozin+ group：-88.79 (-94.59, -83.31), P= 0.019; Mean: dapagliflozin- group: -84.05 (-87.73, -77.45), dapagliflozin+ group: -84.88 (-89.82, -79.67), P= 0.022; LCX: dapagliflozin- group：-77.81 (-82.57, -71.75), dapagliflozin+ group: -78.25 (-84.56, -72.15), P = 0.260). Multiple linear regression analyses revealed an independent association between dapagliflozin treatment and a decreased in FAI in the LAD and RCA (LAD: β=-2.449; RCA: β=-3.897; P values are all less than 0.05). This association was different across various subsets of T2DM patients.</p><p><strong>Conclusion: </strong>Dapagliflozin treatment is associated with a significant reduction in coronary artery inflammation in T2DM patients, which may partly explain its beneficial effects on reducing cardiovascular risk.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"171"},"PeriodicalIF":8.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954868","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":"Sex differences in myocardial flow reserve among individuals with type 2 diabetes: insights from the DiaHeart study.","authors":"Anne-Cathrine Skriver-Møller, Philip Hasbak, Ida K B Rasmussen, Martin B Blond, Victor S Wasehuus, Mats C H Lassen, Morten Lindhardt, Allan Kofoed-Enevoldsen, Urd L Kielgast, Emilie H Zobel, Jens P Goetze, Lene Holmvang, Tor Biering-Sørensen, Peter Rossing, Andreas Kjaer, Rasmus S Ripa, Tine W Hansen","doi":"10.1186/s12933-025-02717-5","DOIUrl":"https://doi.org/10.1186/s12933-025-02717-5","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes is a stronger risk factor for cardiovascular disease (CVD) in women compared with men possibly due to higher susceptibility to develop myocardial microvascular dysfunction. We investigated sex-dependent effects of risk factors on myocardial blood flow (MBF) and myocardial flow reserve (MFR) in individuals with type 2 diabetes without overt CVD.</p><p><strong>Methods: </strong>Cross-sectional analysis of a prospective study including 901 individuals recruited between 2020 and 2023. All participants underwent a cardiac 82-Rubidium positron emission tomography/computed tomography scan to quantify MBF at rest and during pharmacologically induced stress, allowing for calculation of MFR. Linear regression, with/without interaction terms for sex, was used to test whether sex modified the association between MFR/MBF and risk factors.</p><p><strong>Results: </strong>Mean (SD) age was 65 (8.9) years, diabetes duration was 14 (8.4) years, and 266 (29.5%) were women. Women had higher MBF at rest and stress but had lower MFR (mean (SD) 2.44 (0.67) vs. 2.59 (0.77), p = 0.003) than men. A similar proportion of men and women (21.1% vs. 23.7%) had an MFR < 2. The decline in predicted MFR with age differed between sexes. At age 55, women had a mean MFR that was 0.29 lower than men (95% CI: - 0.44 to - 0.14), but by age 75, this difference had nearly disappeared (- 0.04, 95% CI: - 0.19 to 0.11). However, after adjustment for other risk factors, the interaction between sex and age was not statistically significant (p = 0.057). No other risk factors exhibited significant sex-dependent interactions.</p><p><strong>Conclusions: </strong>In individuals with type 2 diabetes without overt CVD, women exhibited lower MFR than men, primarily due to higher MBF at rest, suggesting sex-related differences. While MFR declined in both sexes, the sex difference was more pronounced in younger individuals and diminished over time. These findings underscore the need for further research into sex-specific thresholds for MFR in cardiovascular risk stratification.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"172"},"PeriodicalIF":8.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of diabetes and glycemic status on ventricular-arterial coupling in the general population.","authors":"Hannes Holm, Haris Zilic, Amra Jujic, Linda Johnsson, Gunnar Engström, Peter M Nilsson, Carl Johan Östgren, David Kylhammar, Jan Engvall, Martin Magnusson","doi":"10.1186/s12933-025-02731-7","DOIUrl":"https://doi.org/10.1186/s12933-025-02731-7","url":null,"abstract":"<p><strong>Background/aims: </strong>Ventricular-arterial coupling (VAC) plays a crucial role in cardiovascular physiology, affecting cardiac function and arterial properties for optimal organ perfusion. Considering that diabetes mellitus (DM) is a known risk factor for incident heart disease and vascular damage, this study aims to investigate whether changes in VAC due to DM occur earlier, even before the onset of clinically evident cardiovascular disease in the general population.</p><p><strong>Methods: </strong>This retrospective study included 2,884 participants (mean age 57 years, 48% male) of the Swedish CArdioPulmonary BioImage Study (SCAPIS), where data on echocardiography and Pulse wave velocity (PWV) were available. Of these, 162 individuals (6%) had prevalent type 2 diabetes (DM), and 334 (12%) had prediabetes. VAC was quantified as the ratio of PWV to Global longitudinal strain (GLS). Linear regression models were used to assess associations between glycemic status (DM, prediabetes), HbA1c, fasting plasma glucose (fP-glucose), and VAC, adjusting for relevant covariates.</p><p><strong>Results: </strong>I the fully adjusted model, prevalent DM and the combination of DM and prediabetes were significantly associated with increased values of PWV/GLS (Beta = 0.28, p < 0.001 and Beta = 0.14, p < 0.001 respectively), while no significant association was found between prediabetes and PWV/GLS. Increasing values of HbA1c and fP-glucose were significantly associated with higher values of PWV/GLS (Beta = 0.01,p < 0.001 and Beta = 0.07,p < 0.001, respectively) signaling worse VAC. In participants without prevalent DM, higher HbA1c levels were linked to increased PWV/GLS in the age- and sex-adjusted model; however, this association was attenuated after further adjustment for additional confounders. Conversely, fP-glucose remained significantly associated with elevated PWV/GLS across all adjusted models.</p><p><strong>Conclusions: </strong>This study demonstrates a significant association between DM and impaired VAC, as reflected by elevated PWV/GLS, while no such link was observed in prediabetes. The transition from prediabetes to DM appears critical for VAC deterioration. Additionally, higher HbA1c and fP-glucose levels, even in non-diabetic individuals, were associated with worsened VAC, highlighting the impact of glycemic control on vascular function.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"173"},"PeriodicalIF":8.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976316","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":"Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study.","authors":"Dong Liu, Chun Dou, Chaojie Ye, Lijie Kong, Zheng Zhu, Mingling Chen, Jie Zheng, Min Xu, Yu Xu, Mian Li, Zhiyun Zhao, Jieli Lu, Yuhong Chen, Guang Ning, Weiqing Wang, Yufang Bi, Tiange Wang","doi":"10.1186/s12933-025-02681-0","DOIUrl":"https://doi.org/10.1186/s12933-025-02681-0","url":null,"abstract":"<p><strong>Background: </strong>Delineating the causal chain effects of reproductive traits and fat- and muscle-related traits on cardiovascular disease (CVD) is essential for optimizing precision prevention and control of cardiovascular health in women.</p><p><strong>Methods: </strong>In this study, we applied the two-sample Mendelian randomization (MR) analyses and two-step MR framework to investigate the causal chain effects and the mediating effect pathways among reproductive factors and fat- and muscle-related traits on CVD outcomes in women, applying the genome-wide association study summary statistics of 16 women's reproductive traits across puberty and pre-pregnancy, pregnancy and postpartum, and menopausal transition stages, 16 women's fat- and muscle-related traits, and five CVD outcomes of coronary artery disease (CAD), myocardial infarction (MI), heart failure, atrial fibrillation, and ischemic stroke (IS) from over one million individuals of European descent.</p><p><strong>Results: </strong>The MR analyses revealed the associations of genetically predicted nine reproductive traits (i.e., age at menarche [odds ratio (OR) for CAD: 0.92], age at first sexual intercourse [AFS; 0.71], age at first birth [AFB; 0.89], hypertensive disorders of pregnancy [HDP; 1.21], pre-eclampsia [PE; 1.34], preterm birth [PTB; 1.09], sex hormone-binding globulin [SHBG; 0.73], bioavailable testosterone [BT; 1.17], and number of stillbirths [OR for IS: 2.14]) and 13 fat- and muscle-related traits with at least one of five CVD outcomes. Two-step MR identified 30 causal pathways where AFS, AFB, HDP, PE, PTB, SHBG, and BT mediated the effects of body composition on five CVD outcomes, and nine pathways where waist-to-hip ratio, trunk-trunk fat ratio, abdominal subcutaneous adipose tissue, and gluteofemoral adipose tissue mediated the effects of reproductive traits on CAD and MI.</p><p><strong>Conclusions: </strong>Lifecourse reproductive characteristics and fat- and muscle-related traits manifested reciprocal mediating effects on CVD, informing targeted strategies for bridging cardiovascular health inequalities in women.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"170"},"PeriodicalIF":8.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954088","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 cardiac branched-chain amino acid metabolism in a novel model of diabetic cardiomyopathy.","authors":"Junko Asakura, Manabu Nagao, Masakazu Shinohara, Tetsuya Hosooka, Naoya Kuwahara, Makoto Nishimori, Hidekazu Tanaka, Seimi Satomi-Kobayashi, Sho Matsui, Tsutomu Sasaki, Tadahiro Kitamura, Hiromasa Otake, Tatsuro Ishida, Wataru Ogawa, Ken-Ichi Hirata, Ryuji Toh","doi":"10.1186/s12933-025-02725-5","DOIUrl":"https://doi.org/10.1186/s12933-025-02725-5","url":null,"abstract":"<p><strong>Background: </strong>Systemic insulin resistance plays an important role in the pathogenesis of type 2 diabetes and its complications. Although impaired branched-chain amino acid (BCAA) metabolism has been reported to be involved in the development of diabetes, the relationship between cardiac BCAA metabolism and the pathogenesis of diabetic cardiomyopathy (DbCM) remains unclear.</p><p><strong>Objectives: </strong>The aim of this study was to investigate BCAA metabolism in insulin-resistant hearts by using a novel mouse model of DbCM.</p><p><strong>Methods: </strong>The cardiac phenotypes of adipocyte-specific 3'-phosphoinositide-dependent kinase 1 (PDK1)-deficient (A-PDK1KO) mice were assessed by histological analysis and echocardiography. The metabolic characteristics and cardiac gene expression were determined by mass spectrometry or RNA sequencing, respectively. Cardiac protein expression was evaluated by Western blot analysis.</p><p><strong>Results: </strong>A-PDK1KO mouse hearts exhibited hypertrophy with prominent insulin resistance, consistent with cardiac phenotypes and metabolic disturbances previously reported as DbCM characteristics. RNA sequencing revealed the activation of BCAA uptake in diabetic hearts. In addition, the key enzymes involved in cardiac BCAA catabolism were downregulated at the protein level in A-PDK1KO mice, leading to the accumulation of BCAAs in the heart. Mechanistically, the accumulation of the BCAA leucine caused cardiac hypertrophy via the activation of mammalian target of rapamycin complex 1 (mTORC1).</p><p><strong>Conclusions: </strong>A-PDK1KO mice closely mimic the cardiac phenotypes and metabolic alterations observed in human DbCM and exhibit impaired BCAA metabolism in the heart. This model may contribute to a better understanding of DbCM pathophysiology and to the development of novel therapies for this disease.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"167"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954423","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 atherogenic index of plasma and new-onset stroke in a population with cardiovascular-kidney-metabolic syndrome stages 0-3: insights from CHARLS.","authors":"Yingcheng Liu, Wenlong Li, Hanwen Zhou, Haijiao Zeng, Jiaming Jiang, Qian Wang, Tian Liu, Xinjing Liu, Pinyi Chen, Xiaoni Zhong","doi":"10.1186/s12933-025-02732-6","DOIUrl":"https://doi.org/10.1186/s12933-025-02732-6","url":null,"abstract":"<p><strong>Background: </strong>The associations between atherogenic index of plasma (AIP) and cardiovascular disease (CVD) have been widely reported; However, such association to the incidence of stroke in the population with Cardiovascular-Kidney-Metabolic (CKM) syndrome remains ambiguous.</p><p><strong>Methods: </strong>A total of 7754 participants with CKM syndrome stages 0-3 from the China Health and Retirement Longitudinal Study were enrolled in this study. The incidence of new-onset stroke events was the primary outcome of this study. We used Kaplan-Meier survival curves and Cox proportional hazards models to explore the association between baseline AIP levels and the risk of stroke in the population with CKM syndrome stages 0-3. Additionally, we utilized restricted cubic spline plots to analyze the form of this association.</p><p><strong>Results: </strong>During a median follow-up of 6.8 years, 455 participants (5.9%) with CKM syndrome experienced their first stroke events. AIP was positively associated with the risk of stroke in the population with CKM syndrome stages 0-3. Kaplan-Meier curves analysis demonstrated a significant difference in stroke incidence across the AIP groups among the entire cohort. In the fully adjusted Model 3, the results revealed a significantly elevated risk of stroke for participants in the Q2, Q3, and Q4 groups compared to those in the Q1 group, with respective HR (95% CI) value of 1.352 (1.009-1.811), 1.421 (1.064-1.897), and 1.414 (1.052-1.900). Restricted cubic spline plots revealed the association of AIP and stroke risk was nonlinear (P-overall < 0.05, P-non-linear < 0.05), with inflection points of 0.32.</p><p><strong>Conclusion: </strong>This study provides evidence that baseline AIP levels were significantly positively associated with the risk of stroke in individuals with CKM syndrome stages 0-3, and AIP may serve as an effective risk marker for early identification of high-risk individuals prone to stroke within the CKM stages syndrome 0-3 population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"168"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976936","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":"A different perspective on studying stroke predictors: joint models for longitudinal and time-to-event data in a type 2 diabetes mellitus cohort.","authors":"F J San Andrés-Rebollo, J Cárdenas-Valladolid, J C Abanades-Herranz, P Vich-Pérez, J M de Miguel-Yanes, M Guillán, M A Salinero-Fort","doi":"10.1186/s12933-025-02713-9","DOIUrl":"https://doi.org/10.1186/s12933-025-02713-9","url":null,"abstract":"<p><strong>Background: </strong>Most predictive models rely on risk factors and clinical outcomes assessed simultaneously. This approach does not adequately reflect the progression of health conditions. By employing joint models of longitudinal and survival data, we can dynamically adjust prognosis predictions for individual patients. Our objective was to optimize the prediction of stroke or transient ischemic attack (TIA) via joint models that incorporate all available changes in the predictive variables.</p><p><strong>Methods: </strong>A total of 3442 patients with type 2 diabetes mellitus (T2DM) and no history of stroke, TIA or myocardial infarction were followed for 12 years. Models were constructed independently for men and women. We used proportional hazards regression models to assess the effects of baseline characteristics (excluding longitudinal data) on the risk of stroke/TIA and linear mixed effects models to assess the effects of baseline characteristics on longitudinal data development over time. Both submodels were then combined into a joint model. To optimize the analysis, a univariate analysis was first performed for each longitudinal predictor to select the functional form that gave the best fit via the deviance information criterion. The variables were then entered into a multivariate model using pragmatic criteria, and if they improved the discriminatory ability of the model, the area under the curve (AUC) was used.</p><p><strong>Results: </strong>During the follow-up period, 303 patients (8.8%) experienced their first stroke/TIA. Age was identified as an independent predictor among males. Among females, age was positively associated with atrial fibrillation (AF). The final model for males included AF, systolic blood pressure (SBP), and diastolic blood pressure (DBP), with albuminuria and the glomerular filtration rate (GFR) as adjustment variables. For females, the model included AF, blood pressure (BP), and renal function (albuminuria and GFR), with HbA1c and LDL cholesterol as adjustment variables. Both models demonstrated an AUC greater than 0.70.</p><p><strong>Conclusions: </strong>Age, AF, and SBP have been confirmed as significant predictive factors in both sexes, whereas renal function was significant only in women. Interestingly, an increase in DBP may serve as a protective factor in our cohort. These factors were particularly relevant in the last 3-7 years of follow-up.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"165"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972051","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":"Joint association of triglyceride glucose index (TyG) and body roundness index (BRI) with stroke incidence: a national cohort study.","authors":"Bingxue Wang, Liying Li, Ying Tang, Xingwu Ran","doi":"10.1186/s12933-025-02724-6","DOIUrl":"https://doi.org/10.1186/s12933-025-02724-6","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR), as quantified by the triglyceride glucose (TyG) index, and visceral obesity, as assessed by the body roundness index (BRI), have been identified as pivotal risk factors for stroke. However, the combined impact of these two indicators on stroke risk has not been thoroughly investigated. This study aims to investigate both the separate and combined associations, as well as potential interactions, between the TyG index and/or BRI with respect to stroke incidence.</p><p><strong>Methods: </strong>This cohort study encompassed 6621 respondents who were free of stroke at baseline from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized based on the median values of the TyG index or/and BRI. Cox proportional hazards regression models were employed to examine the associations between the TyG index alone, BRI alone, and their combined effects on stroke incidence. Both additive and multiplicative interaction effects were further estimated.</p><p><strong>Results: </strong>Among 6621 participants aged 45 years or older, the mean (SD) age was 58.06 (8.57) years, with 2951 (44.6%) being male. During a follow-up period of up to 9 years, 743 individuals experienced stroke events. Compared to participants with low TyG index and low BRI, the adjusted hazard ratios (HRs) were as follows: 1.36 (95% confidence interval [CI] 1.05-1.75) for high TyG index alone, 1.61 (95% CI 1.27-2.05) for high BRI alone, and 1.78 (95% CI 1.40-2.26) for high TyG index and high BRI. Neither additive nor multiplicative interactions between BRI and TyG for incident stroke were statistically significant. The combination of TyG and BRI enhanced the predictive capability for stroke compared to either biomarker alone.</p><p><strong>Conclusion: </strong>We discovered that both the TyG index and BRI are strongly associated with stroke incidence. The joint assessment of TyG and BRI enhances the predictive capability for stroke, underscoring the critical role of IR and visceral adiposity in the identification and screening of stroke risk.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"164"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960520","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}