Cardiovascular Diabetology最新文献

{"title":"Stress hyperglycemia ratio and machine learning model for prediction of all-cause mortality in patients undergoing cardiac surgery.","authors":"Yingjian Pei, Yajun Ma, Ying Xiang, Guitao Zhang, Yao Feng, Wenbo Li, Yinghua Zhou, Shujuan Li","doi":"10.1186/s12933-025-02644-5","DOIUrl":"10.1186/s12933-025-02644-5","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) was developed to reduce the effects of long-term chronic glycemic factors on stress hyperglycemia levels, which was associated with adverse clinical outcomes. This study aims to evaluate the relationship between the postoperative SHR index and all-cause mortality in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>Data for this study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were categorized into four groups based on postoperative SHR index quartiles. The primary outcome was 30-day all-cause mortality, while the secondary outcomes included in-hospital, 90-day and 360-day all-cause mortality. The SHR index was analyzed using quartiles, and Kaplan-Meier curves were generated to compare outcomes across groups. Cox proportional hazards regression and restricted cubic splines (RCS) were employed to assess the relationship between the SHR index and the outcomes. LASSO regression was used for feature selection. Six machine learning algorithms were used to predict in-hospital all-cause mortality and were further extended to predict 360-day all-cause mortality. The SHapley Additive exPlanations method was used for visualizing model characteristics and individual case predictions.</p><p><strong>Results: </strong>A total of 3,848 participants were included in the study, with a mean age of 68 ± 12 years and female participants comprised 30.6% (1,179). Higher postoperative SHR index levels were associated with an increased risk of in-hospital, 90-day and 360-day all-cause mortality as shown by Kaplan-Meier curves (log-rank P < 0.05). Cox regression analysis revealed that the highest postoperative SHR quartile was associated with a significantly higher risk of mortality at these time points (P < 0.05). RCS analysis demonstrated nonlinear relationships between the postoperative SHR index and all-cause mortality (P for nonlinear < 0.05). The Naive Bayes model achieves the highest area under the curve (AUC) for predicting both in-hospital mortality (0.7936) and 360-day all-cause mortality (0.7410).</p><p><strong>Conclusion: </strong>In patients undergoing cardiac surgery, higher postoperative SHR index levels were significantly associated with increased risk of in-hospital, 90-day and 360-day all-cause mortality. The SHR index may serve as a valid tool for assessing the severity after cardiac surgery and guiding treatment decisions.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"77"},"PeriodicalIF":8.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425053","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 the systemic immune-inflammation index and metabolic syndrome and its components: results from the multi-ethnic study of atherosclerosis (MESA).","authors":"Azra Ramezankhani, Maryam Tohidi, Farzad Hadaegh","doi":"10.1186/s12933-025-02629-4","DOIUrl":"10.1186/s12933-025-02629-4","url":null,"abstract":"<p><strong>Background: </strong>The Systemic Immune-Inflammation Index (SII) is a novel biomarker of systemic inflammation. We explored the association between the SII and metabolic syndrome (MetS) and its components in middle-aged and older adults.</p><p><strong>Methods: </strong>We included 2755 participants (1305 men) aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort from examination 5 (2010-2012). Logistic regression was employed to assess the relationship between the SII and MetS, as well as its components.</p><p><strong>Results: </strong>A total of 1082 participants (463 men) were diagnosed with MetS. On a continuous scale, the SII was positively associated with MetS (odds ratio (OR): 1.23, 95% confidence interval (CI): 1.05-1.46) and its components including hyperglycemia (1.23: 1.05-1.44) and elevated blood pressure (BP) (1.47: 1.14-1.89). When analyzed on a quartile scale, participants in the quartile 4 of SII had 32% and 63% higher prevalence of hyperglycemia and elevated BP, respectively, compared to those in the quartile 1 (P for trend: 0.021 and < 0.001, respectively). Additionally, we identified 40% higher prevalence of low HDL-C in quartile 2 of the SII compared to quartile 1 (1.40; 1.07-1.83) (P trend = 0.454). In subgroup analysis, general obesity status modified the relationship between SII and abdominal obesity, showing a positive association in obese individuals (1.72: 1.00-2.95) and a negative association (0.80: 0.66-0.97) in non-obese individuals (P for interaction = 0.009).</p><p><strong>Conclusions: </strong>Higher SII scores were associated with an increased likelihood of MetS, hyperglycemia, and high BP among middle-aged and older adults. Longitudinal studies are needed to determine the causal relationships between SII and the development of MetS, as well as to assess the potential role of SII as a screening tool in clinical practice.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"78"},"PeriodicalIF":8.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425017","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 the GMI/HbA1c ratio and preclinical carotid atherosclerosis in type 1 diabetes: impact of the fast-glycator phenotype across age groups.","authors":"Carlos Puig-Jové, Clara Viñals, Ignacio Conget, Carmen Quirós, Irene Vinagre, Belén Berrocal, Antonio-Jesús Blanco-Carrasco, Montserrat Granados, Alex Mesa, Tonet Serés-Noriega, Marga Giménez, Verónica Perea, Antonio J Amor","doi":"10.1186/s12933-025-02637-4","DOIUrl":"10.1186/s12933-025-02637-4","url":null,"abstract":"<p><strong>Background: </strong>Since the arrival of continuous glucose monitoring (CGM), the relationship between the glucose management indicator (GMI) and HbA1c has been a topic of considerable interest in diabetes research. This study aims to explore the association between the GMI/HbA1c ratio and the presence of preclinical carotid atherosclerosis in type 1 diabetes (T1D).</p><p><strong>Methods: </strong>Individuals with T1D and no prior history of cardiovascular disease were recruited from two centers. Carotid ultrasonography was performed using a standardized protocol and carotid plaques were defined as intima-media thickness ≥ 1.5 mm. CGM-derived data were collected from a 14-day report. A GMI/HbA1c ratio < 0.90 was selected to identify \"fast-glycator\" phenotype.</p><p><strong>Results: </strong>A total of 584 participants were included (319 women, 54.6%), with a mean age of 48.8 ± 10.7 years and a mean diabetes duration of 27.5 ± 11.4 years. Carotid plaques were present in 231 subjects (39.6%). Approximately 43.7% and 13.4% of participants showed absolute differences of ≥ 0.5 and ≥ 1.0 between 14-day GMI and HbA1c, respectively. Among patients ≥ 48 years, the fast-glycator phenotype was independently associated with presence of plaques (OR 2.27, 95%CI: 1.06-4.87), even after adjusting for non-specific and T1D-specific risk factors and statin treatment. No significant association was observed in younger subjects (p for interaction < 0.05).</p><p><strong>Conclusions: </strong>Fast-glycator phenotype is independently associated with atherosclerosis in T1D individuals aged ≥ 48 years, suggesting an age-related increase in the glycation risk. These findings highlight the potential of the GMI/HbA1c ratio for cardiovascular risk stratification in this population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"75"},"PeriodicalIF":8.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425013","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":"Cardiac autonomic neuropathy is associated with ectopic fat distribution in autoimmune but not in type 2 diabetes.","authors":"Renata Risi, Rocco Amendolara, Angelo Lauria Pantano, Valeria Fassino, Luca D'Onofrio, Lucia Coraggio, Daniela Luverà, Davide Masi, Mikiko Watanabe, Lucio Gnessi, Raffaella Buzzetti, Ernesto Maddaloni","doi":"10.1186/s12933-025-02635-6","DOIUrl":"10.1186/s12933-025-02635-6","url":null,"abstract":"<p><strong>Background: </strong>Cardiac autonomic neuropathy (CAN) is a life-threatening complication of diabetes. While obesity is a well-known risk factor of dysautonomia, the association between CAN and body fat distribution has not been fully clarified, especially in autoimmune diabetes (AD).</p><p><strong>Aim: </strong>To evaluate if the association between CAN and body fat distribution differs between AD and type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Body fat distribution was evaluated by Dual X-Ray Absorptiometry in 143 people with diabetes (44 with ADand 99 with T2D) undergoing clinical screening for CAN. The association of CAN with markers of ectopic fat distribution was evaluated in multivariate regression models adjusting for confounders and testing for the interaction between diabetes type and CAN.</p><p><strong>Results: </strong>A significant interaction between CAN and diabetes type was found with respect to markers of ectopic fat distribution. Specifically, people with CAN had significantly higher amount of visceral adipose tissue (530 [376-665]g versus 251[189-360]g, p = 0.001), total fat mass (22708[20200-27845]g versus 15434[12981-21879]g, p = 0,016), and trunk-to-leg ratio (0.88 [0.75-1.04] versus 0.70 [0.56-0.78], p = 0,023) compared to those without CAN only in participants with AD, but not in T2D (p-values for interaction < 0.05 for all comparisons).</p><p><strong>Conclusion: </strong>Ectopic fat distribution is more strongly associated with CAN in AD than in T2D. This highlights the distinct role of fat distribution in the cardiometabolic health of people with AD, suggesting the need for further studies to better understand the pathophysiology and implications of overweight in this population.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"74"},"PeriodicalIF":8.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425022","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":"Clonal hematopoiesis of indeterminate potential, health indicators, and risk of cardiovascular diseases among patients with diabetes: a prospective cohort study.","authors":"Ying Sun, Yuefeng Yu, Lingli Cai, Bowei Yu, Wenying Xiao, Xiao Tan, Yu Wang, Yingli Lu, Ningjian Wang","doi":"10.1186/s12933-025-02626-7","DOIUrl":"10.1186/s12933-025-02626-7","url":null,"abstract":"<p><strong>Background: </strong>Clonal hematopoiesis of indeterminate potential (CHIP) was associated with diabetes and cardiovascular diseases (CVD). However, the effect of CHIP on CVD have not been evaluated among patients with diabetes, and whether maintaining the healthy indictors could mitigate the adverse influence was also unclear.</p><p><strong>Methods: </strong>A total of 22,239 adults from the UK Biobank with diabetes and available whole-exome sequence data, and free of CVD were included. Multivariable-adjusted Cox regressions were used to explore the associations of any CHIP (variant allele fraction ≥ 2%), large CHIP (variant allele fraction ≥ 10%), and the top 10 commonly mutated driver genes for CHIP and with risk of CVD. The joint associations between health indicators (body mass index [BMI], HbA1c, blood pressure [BP], and low-density lipoprotein cholesterol [LDL]) and CHIP were further investigated.</p><p><strong>Results: </strong>Over a median follow-up of 13.2 years, 5366 participants with diabetes developed CVD events. The hazard ratios (HRs) (95% confidence intervals [CIs]) of any CHIP and large CHIP were (1.21, 1.08-1.36) and (1.25, 1.09-1.43) for incident CVD, respectively. Significant associations between any CHIP and coronary heart disease (HR, 95%CI: 1.18, 1.03-1.36) and heart failure (1.73, 1.46-2.06) were observed, but not for stroke (1.14, 0.89-1.48). Gene-specific analyses suggested that the greatest association were for SF3B1 (HR, 95%CI: 2.50, 1.25-5.01) and TET2 (HR, 95%CI: 1.36, 1.07-1.77) with risk of CVD. There was no significant interaction between the four health indicators and CHIP in relation to incident CVD. Compared to patients without CHIP, those with any CHIP and ideal health indicators still exhibited significantly or nonsignificantly higher HRs (BMI: 1.18, 0.82-1.68; HbA1c: 1.12, 0.96-1.30; BP: 1.24, 1.03-1.49; LDL: 1.29, 1.09-1.53). Similar results were demonstrated using large CHIP.</p><p><strong>Conclusions: </strong>CHIP is independently associated with an increased risk of CVD in patients with diabetes, regardless of health indicator levels. Diabetic patients with CHIP but ideal health indicators still exhibited higher CVD risk compared with diabetic patients without CHIP.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"72"},"PeriodicalIF":8.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413492","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 sodium‒glucose cotransporter-2 inhibitors in patients with recent versus previous myocardial infarction: a systematic review and meta-analysis.","authors":"Pedro Gabriel Scardini, Eric Shih Katsuyama, Alonzo Armani Prata, Julia Marques Fernandes, Christian Ken Fukunaga, Wilson Falco Neto, Ana Carolina Covre Coan, Naieli Machado de Andrade, Abraão Santana Silva, Rafael Petri Pinheiro, Luciana Gioli Pereira, Remo H M Furtado","doi":"10.1186/s12933-024-02540-4","DOIUrl":"10.1186/s12933-024-02540-4","url":null,"abstract":"<p><strong>Background: </strong>Sodium‒glucose cotransporter 2 (SGLT2) inhibitors have been included in heart failure (HF) guidelines because of their benefits in reducing mortality and hospitalization rates. However, the timing and benefits of initiating SGLT2 inhibitors in patients after myocardial infarction (MI) remain controversial. Therefore, we aimed to perform a systematic review and meta-analysis comparing SGLT2 inhibitors with placebo in patients with MI.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis to determine the impact of SGLT2 inhibitors in patients with recent or previous MI. We systematically searched PubMed, Cochrane, and Embase for RCTs comparing SGLT2 inhibitors versus placebo in patients with MI. The primary outcome was (1) HF hospitalization. In this analysis, we also included the following secondary outcomes: (2) major adverse cardiovascular events (MACE) defined as a composite of cardiovascular (CV) death, MI or stroke; and (3) all-cause mortality. A subgroup analysis was conducted for the primary outcome, comparing patients who had experienced an MI more than 8 weeks prior to study enrolment (previous MI) versus those who had experienced an MI within the preceding 8 weeks (acute MI). Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled with a random effects model.</p><p><strong>Results: </strong>Our meta-analysis included 10 RCTs comprising 22,266 patients, of whom 11,339 (51.2%) had type 2 diabetes. The mean age was 62 years, and the median follow-up was 21 months. According to the pooled analysis, HF hospitalization rates were lower in patients on SGLT2 inhibitors compared with placebo (RR 0.77; 95% CI 0.69, 0.85; p < 0.001)). Differences in MACE were also observed in favor of SGLT2 inhibitors versus placebo (RR 0.88; 95% CI 0.79, 0.97; p = 0.012). There was no statistically significant difference in all-cause mortality between the groups (RR 0.88; 95% CI 0.78, 1.00; p = 0.058). Benefits of SGLT2 inhibitors for the primary outcome were consistent regardless of the timing of last MI, with no treatment by subgroup interaction (p for interaction = 0.56).</p><p><strong>Conclusion: </strong>In this meta-analysis of patients who experienced MI, the administration of SGLT2 inhibitors was associated with lower rates of hospitalization for HF. In addition, the treatment effect of SGLT2 inhibitors was consistent regardless of whether they were started in the recent versus previous MI setting.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"73"},"PeriodicalIF":8.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413494","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":"Mural cell dysfunction contributes to diastolic heart failure by promoting endothelial dysfunction and vessel remodelling.","authors":"Mandy O J Grootaert, Alessandra Pasut, Jana Raman, Steven J Simmonds, Bram Callewaert, Ümare Col, Mieke Dewerchin, Peter Carmeliet, Stephane Heymans, Elizabeth A V Jones","doi":"10.1186/s12933-025-02623-w","DOIUrl":"10.1186/s12933-025-02623-w","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a complex cardiovascular disease associated with metabolic comorbidities. Microvascular dysfunction has been proposed to drive HFpEF, likely via endothelial cell (EC) dysfunction, yet the role of the mural cells herein has never been explored.</p><p><strong>Methods: </strong>We used the diabetic db/db mouse given 1% salt as a new model of HFpEF and crossed then with PDGFRβ^tg/tg-CreERT2-EYFP^tg/tg mice to label the mural cells. We combined single-cell RNA sequencing, NichetNet analysis and histology to determine the role of mural cell dysfunction in HFpEF.</p><p><strong>Results: </strong>Db/db mice given 1% salt for 8 weeks developed diastolic dysfunction preceded by capillary density loss, pericyte loss and vessel regression. At 4 weeks of salt, hearts of db/db mice already showed EC dysfunction associated with an anti-angiogenic signature, and an increase in pericyte-EC intracellular space. Db/db + salt hearts were further characterised by increased ACTA2 expression, arteriole wall thickening and vessel enlargement. NicheNet analysis on the single cell transcriptomic data revealed little signalling from the ECs to the mural cells; instead, mural cells signalled strongly to ECs. Mechanistically, pericyte dysfunction induces an EC growth arrest via TNFα-dependent paracrine signalling and downstream signalling through STAT1.</p><p><strong>Conclusion: </strong>Mural cell dysfunction contributes to HFpEF by inducing coronary vessel remodelling, at least in part by reducing EC proliferation and inducing EC inflammation through TNFα-dependent paracrine signalling.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"62"},"PeriodicalIF":8.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370400","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":"Cardiac magnetic resonance quantified epicardial fat volume is associated with complex coronary artery disease among diabetics.","authors":"Shimaa Sayed Khidr, Bakeer Mohamed Bakeer, Hatem Abdel-Rahman Helmy, Heba Mahmoud El-Naggar","doi":"10.1186/s12933-025-02606-x","DOIUrl":"10.1186/s12933-025-02606-x","url":null,"abstract":"<p><strong>Background: </strong>Epicardial and pericardial adipose tissues are two distinct types of visceral fat in close adherence to the heart and were found to be increased among diabetics.</p><p><strong>Aim: </strong>To investigate the correlation between cardiac magnetic resonance (CMR)-quantified epicardial (EFV) and pericardial fat (PFV) volumes and the complexity of coronary artery disease (CAD) among diabetic and non-diabetic patients.</p><p><strong>Methods: </strong>This was a cross-sectional study that included 111 patients having CAD as indicated by coronary angiography and who underwent CMR. Epicardial and pericardial fat volumes were measured along short-axis CMR-derived images. CAD severity and complexity were evaluated using the syntax score (SS). Patients were classified into diabetic and non-diabetic groups based on their HbA1c and were compared regarding clinical, angiographic, and CMR data. Those with high SS were compared against low/intermediate SS. The correlation of measured EFV and PFV with the SS was evaluated, and possible predictors for high-SS were assessed.</p><p><strong>Results: </strong>Diabetic patients (n = 64, 57.7%) had significantly high syntax scores, and significantly larger absolute and indexed EFV and PFV compared to non-diabetics. Both EFV and PFV showed a significant positive correlation with HbA1c and SS. EFV ≥ 119.55 ml significantly predicted high-SS (AUC = 0.84, 95%CI = 0.76-0.91, sensitivity = 77% and specificity = 82.5%) among the study population. Different cutoff points of EFV significantly predicted high SS among diabetics and non-diabetics with respective reasonable sensitivity and specificity. Age and EFV were consistently predictive of high SS on different multivariable regression models.</p><p><strong>Conclusion: </strong>Increased epicardial adipose tissue was a significant independent predictor of severe and complex CAD, representing a possible risk marker and potential therapeutic target, particularly among diabetics.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"64"},"PeriodicalIF":8.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370583","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 sex-disaggregated analysis of the prognostic value of lean type 2 diabetes mellitus in the adult population with acute myocardial infarction.","authors":"Gwyneth Kong, Jaycie Koh, Jobelle Chia, Bryan Neo, Yiming Chen, Grace Cao, Bryan Chong, Mark Muthiah, Hui Wen Sim, Gavin Ng, Chieh Yang Koo, Chin Meng Khoo, Mark Yan-Yee Chan, Poay-Huan Loh, Nicholas W S Chew","doi":"10.1186/s12933-024-02552-0","DOIUrl":"10.1186/s12933-024-02552-0","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence has demonstrated the unfavourable cardiovascular risk of individuals with lean type 2 diabetes mellitus (T2DM). Our study aims to investigate the prognostic value of lean T2DM in patients with acute myocardial infarction (AMI), stratified by sex.</p><p><strong>Methods: </strong>The study cohort examines the clinical characteristics and long-term outcomes of individuals with AMI, stratified by four phenotypes based on T2DM and lean body category-lean T2DM, non-lean T2DM, lean non-T2DM and non-lean non-T2DM. The primary outcome was long-term all-cause mortality. Cox regression model was constructed to investigate the associations of lean and non-lean T2DM phenotypes with mortality, adjusted for age, ethnicity, previous AMI, AMI type, chronic kidney disease, angiotensin converting enzyme inhibitor or angiotensin receptor blockers, beta-blockers, and smoking status.</p><p><strong>Results: </strong>A cohort of 9545 AMI patients was examined, with a mean follow-up duration of 3.4 ± 2.4 years. Majority had the non-lean T2DM phenotype (40.4%), followed by non-lean non-T2DM (29.8%), lean non-T2DM (15.9%), and lean T2DM (13.9%). In the T2DM group, one-quarter was lean (N = 1324), while the vast majority (74.5%) was non-lean. Individuals with lean T2DM tended to be female and older. Patients with lean T2DM had the highest rates of heart failure (23.3%, p < 0.001), cardiogenic shock (9.1%, p = 0.036), and long-term all-cause mortality (32.6%, p < 0.001). Cox regression demonstrated that lean T2DM was an independent predictor of mortality (adjusted hazard ratio [aHR] 1.171, 95% CI 1.040-1.319, p = 0.009) after adjustment. The presence of higher mortality risk following AMI was present in males (aHR 1.201, 95% CI 1.037-1.391, p = 0.015), but not in females (aHR 1.066, 95% CI 0.869-1.308, p = 0.538).</p><p><strong>Conclusions: </strong>The lean T2DM phenotype was present in one-quarter of the AMI cohort with T2DM. The lean T2DM phenotype was an independent predictor of long-term mortality following AMI, although this association was stronger in males than in females.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"59"},"PeriodicalIF":8.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370568","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":"Assessment of stress hyperglycemia ratio to predict all-cause mortality in patients with critical cerebrovascular disease: a retrospective cohort study from the MIMIC-IV database.","authors":"Yuwen Chen, Jian Xu, Fan He, An'an Huang, Jie Wang, Bingchen Liu, Qucheng Wei","doi":"10.1186/s12933-025-02613-y","DOIUrl":"10.1186/s12933-025-02613-y","url":null,"abstract":"<p><strong>Background: </strong>The association between the stress hyperglycemia ratio (SHR), which represents the degree of acute stress hyperglycemic status, and the risk of mortality in cerebrovascular disease patients in the intensive care unit (ICU) remains unclear. This study aims to investigate the predictive ability of SHR for in-hospital mortality in critically ill cerebrovascular disease patients and to assess its potential to enhance existing predictive models.</p><p><strong>Methods: </strong>We extracted data from the Medical Information Mart for Intensive Care (MIMIC-IV) database for patients diagnosed with cerebrovascular disease and used Cox regression to assess the association between SHR and mortality. To investigate the nature of this association, we applied restricted cubic spline analysis to determine if it is linear. The predictive ability of SHR for mortality risk was evaluated using receiver operating characteristic (ROC) curves and the C-index.</p><p><strong>Results: </strong>We included a total of 2,461 patients, with a mean age of 70.55 ± 14.59 years, and 1,221 (49.61%) being female. Cox regression analysis revealed that SHR was independently associated with both in-hospital mortality (per standard deviation (SD) increase: hazard ratio (HR) 1.35, 95% confidence interval (CI) 1.23-1.48) and ICU mortality (per SD increase: HR 1.37, 95% CI 1.21-1.54). The risk of death increased in an approximately linear fashion when SHR exceeded 0.77-0.79. Subgroup analysis indicated the association was more pronounced in non-diabetic individuals. Additionally, incorporating SHR into existing models improved both discrimination and reclassification performance.</p><p><strong>Conclusion: </strong>SHR serves as an independent risk factor for in-hospital mortality in cerebrovascular disease patients in the ICU. Adding SHR to existing models enhances their predictive performance, offering clinical value in the identification of high-risk patients.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"58"},"PeriodicalIF":8.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370572","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}