Cardiovascular Diabetology最新文献

{"title":"The association between the triglyceride-glucose index and vulnerable plaques in patients with type 2 diabetes mellitus: insights from coronary computed tomography angiography.","authors":"Yu-Shan Zhang, Rui Shi, Yi-Ning Jiang, Yue Gao, Yu Jiang, Jin Wang, Wen-Rong Li, Jia-Ke Li, Zhi-Gang Yang, Yuan Li","doi":"10.1186/s12933-025-02673-0","DOIUrl":"https://doi.org/10.1186/s12933-025-02673-0","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride‒glucose index (TyG index) has been verified to be a useful predictor of insulin resistance (IR), and is associated with the occurrence of acute coronary syndrome (ACS). However, the effect of the TyG index on vulnerable plaques (VP), which were identified when at least two high-risk features are present within the same lesion, in type 2 diabetes mellitus (T2DM) patients is not fully understood. This study aimed to explore the association between the TyG index and the presence of VP.</p><p><strong>Methods: </strong>We retrospectively enrolled 2056 T2DM patients who underwent coronary computed tomography angiography (CCTA) examinations at West China Hospital from February 2017 to February 2022. These patients were divided into four groups on the basis of the quartiles of the TyG index. The high-risk coronary plaque features, vulnerable plaques, plaque type, coronary artery stenosis, segment involvement score (SIS), segment stenosis score (SSS) and multivessel disease (MVD) based on CCTA data were evaluated and compared among the four groups.</p><p><strong>Results: </strong>Patients with a higher TyG index had more noncalcified and mixed plaques, high-risk plaque features, vulnerable plaques and fewer calcified plaques (P < 0.05 for all). The proportion of patients with high-risk plaque features, including low-attenuation noncalcified plaques, positive remodeling and \"napkin ring\" sign was associated with the TyG index (P for trend < 0.05 for all). Multivariate analysis revealed that the TyG index was significantly associated with vulnerable plaques in T2DM patients [OR = 1.23 (95% CI 1.00-1.51), P = 0.046]. Subgroup analysis revealed that the association between the TyG index and vulnerable plaques varied with age and the prevalence of cardiovascular (CVD) symptoms, even after controlling for confounding factors (P for interaction < 0.05 for both).</p><p><strong>Conclusion: </strong>The TyG index was independently associated with vulnerable plaques of the coronary artery among patients with T2DM. The TyG index could be regarded as a marker to reduce the incidence of cardiovascular events in the targeted population of T2DM patients.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"169"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979107","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":"Integrative metabolomics and genomics reveal molecular signatures for type 2 diabetes and its cardiovascular complications.","authors":"Chunxiao Cheng, Yuanjiao Liu, Lingyun Sun, Jiayao Fan, Xiaohui Sun, Ju-Sheng Zheng, Lin Zheng, Yimin Zhu, Dan Zhou","doi":"10.1186/s12933-025-02718-4","DOIUrl":"https://doi.org/10.1186/s12933-025-02718-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Metabolites are pivotal in the biological process underlying type 2 diabetes (T2D) and its cardiovascular complications. Nevertheless, their contributions to these diseases have not been comprehensively evaluated, particularly in East Asian ancestry. This study aims to elucidate the metabolic underpinnings of T2D and its cardiovascular complications and leverage multi-omics integration to uncover the molecular pathways involved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This study included 1180 Chinese participants from the Zhejiang Metabolic Syndrome Cohort (ZMSC). A total of 1912 metabolites were profiled using high-coverage widely targeted and non-targeted metabolic techniques. Multivariable logistic regression models and orthogonal partial least squares discriminant analysis were used to identify T2D-related metabolites. A metabolome-wide genome-wide association study (GWAS) in ZMSC, followed by two-sample Mendelian randomization (MR) analyses, was conducted to explore potential causal metabolite-T2D associations. To enhance cross-ancestry generalizability, MR analyses were conducted in European ancestry to explore the potential causal effects of serum metabolites on T2D and its cardiovascular complications. Furthermore, multi-omics evidence was integrated to explore the underlying molecular mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified six metabolites associated with T2D in Chinese, supported by metabolome analysis and genetic-informed causal inference. These included two potential protective factors (PC [O-16:0/0:0] and its derivative LPC [O-16:0]) and four potential risk factors ([R]-2-hydroxybutyric acid, 2-methyllactic acid, eplerenone, and rauwolscine). Cross-ancestry metabolome-wide analysis further revealed four shared potential causal metabolites, highlighting the potential protective role of creatine for T2D. Through multi-omics integration, we revealed a potential regulatory path initialized by a genetic variant near CPS1 (coding for a urea cycle-related mitochondrial enzyme) influencing serum creatine levels and subsequently modulating the risk of T2D. MR analyses further demonstrated that nine urea cycle-related metabolites significantly influence cardiovascular complications of T2D.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study provides novel insights into the metabolic underpinnings of T2D and its cardiovascular complications, emphasizing the role of urea cycle-related metabolites in disease risk and progression. These findings advance our understanding of circulating metabolites in the etiology of T2D, offering potential biomarkers and therapeutic targets for future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Metabolites are crucial for understanding diabetes biology.Multi-omics integration aids in revealing complex mechanisms. WHAT IS THE KEY RESEARCH QUESTION?: How do serum metabolites affect diabetes and its cardiovascular outcomes? WHAT IS N","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"166"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976969","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":"Estimated glucose disposal rate outperforms other insulin resistance surrogates in predicting incident cardiovascular diseases in cardiovascular-kidney-metabolic syndrome stages 0-3 and the development of a machine learning prediction model: a nationwide prospective cohort study.","authors":"Bingtian Dong, Yuping Chen, Xiaocen Yang, Zhengdong Chen, Hua Zhang, Yuan Gao, Enfa Zhao, Chaoxue Zhang","doi":"10.1186/s12933-025-02729-1","DOIUrl":"https://doi.org/10.1186/s12933-025-02729-1","url":null,"abstract":"<p><strong>Background: </strong>The American Heart Association recently introduced the concept of cardiovascular-kidney-metabolic (CKM) syndrome, highlighting the increasing importance of the complex interplay between metabolic, renal, and cardiovascular diseases (CVD). While substantial evidence supports a correlation between the estimated glucose disposal rate (eGDR) and CVD events, its predictive value compared with other insulin resistance (IR) indices, such as triglyceride-glucose (TyG) index, TyG-waist circumference, TyG-body mass index, TyG-waist-to-height ratio, triglyceride-to-high density lipoprotein cholesterol ratio, and the metabolic score for insulin resistance, remains unclear.</p><p><strong>Methods: </strong>This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The individuals were categorized into four subgroups based on the quartiles of eGDR. The associations between eGDR and incident CVD were evaluated using multivariate logistic regression analyses and restricted cubic spline. Seven machine learning models were utilized to assess the predictive value of the eGDR index for CVD events. To assess the model's performance, we applied receiver operating characteristic (ROC) and precision-recall (PR) curves, calibration curves, and decision curve analysis.</p><p><strong>Results: </strong>A total of 4,950 participants (mean age: 73.46 ± 9.93 years), including 50.4% females, were enrolled in the study. During follow-up between 2011 and 2018, 697 (14.1%) participants developed CVD, including 486 (9.8%) with heart disease and 263 (5.3%) with stroke. The eGDR index outperformed six other IR indices in predicting CVD events, demonstrating a significant and linear relationship with all outcomes. Each 1-unit increase in eGDR was associated with a 14%, 14%, and 19% lower risk of CVD, heart disease, and stroke, respectively, in the fully adjusted model. The incorporation of the eGDR index into predictive models significantly improved prediction performance for CVD events, with the area under the ROC and PR curves equal to or exceeding 0.90 in both the training and testing sets.</p><p><strong>Conclusions: </strong>The eGDR index outperforms six other IR indices in predicting CVD, heart disease, and stroke in individuals with CKM syndrome stages 0-3. Its incorporation into predictive models enhances risk stratification and may aid in the early identification of high-risk individuals in this population. Further studies are needed to validate these findings in external cohorts.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"163"},"PeriodicalIF":8.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977302","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 systemic inflammation biomarkers and incident cardiovascular disease in 423,701 individuals: evidence from the UK biobank cohort.","authors":"Pei Qin, Frederick K Ho, Carlos A Celis-Morales, Jill P Pell","doi":"10.1186/s12933-025-02721-9","DOIUrl":"https://doi.org/10.1186/s12933-025-02721-9","url":null,"abstract":"<p><strong>Background: </strong>The associations between systemic inflammation biomarkers and cardiovascular disease (CVD) remain not well explored. This study aimed to investigate associations between different systemic inflammation biomarkers and incident CVD and main CVD subtypes - ischaemic heart disease (IHD), stroke, and heart failure - explore dose-response relationships, and compare their predictive performance.</p><p><strong>Methods: </strong>This prospective cohort study included 423,701 UK Biobank participants free of CVD at baseline. Baseline neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and system inflammation response index (SIRI) were derived. Cox-proportional regression models were used to investigate the associations.</p><p><strong>Results: </strong>NLR, PLR, SII, and SIRI was positively and LMR was negatively associated with all four of the outcomes investigated. The relationships were non-linear for all biomarkers with CVD and were linear for NLR, SII, and SIRI and non-linear for LMR and PLR with IHD, stroke and heart failure. Compared with the more established biomarkers, all four of the novel biomarkers had statistically superior predictive performance for three of the outcomes investigated (CVD, IHD and heart failure) and three of them were superior at predicting stroke. Compared to a model of CVD prediction with classical risk factors (C-index = 0.702), discrimination was improved on the addition of inflammation markers for CVD (C-index change 0.0069, 95% CI 0.0033 to 0.0107), IHD (C-index change 0.0054, 95% CI 0.0013 to 0.0095), and heart failure (C-index change 0.0153, 95% CI 0.0089 to 0.0218).</p><p><strong>Conclusions: </strong>There were independent and dose-response relationships between the novel systemic inflammation biomarkers and CVD outcomes. Addition of the inflammation biomarkers including novel inflammation biomarkers showed improved discrimination of the traditional risk prediction model. With accumulated evidence, these biomarkers should be considered for inclusion in risk tools and prevention.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"162"},"PeriodicalIF":8.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin resistance quantified by estimated glucose disposal rate predicts cardiovascular disease incidence: a nationwide prospective cohort study.","authors":"Shiyi Tao, Lintong Yu, Jun Li, Ji Wu, Xuanchun Huang, Zicong Xie, Tiantian Xue, Yonghao Li, Lilan Su","doi":"10.1186/s12933-025-02672-1","DOIUrl":"https://doi.org/10.1186/s12933-025-02672-1","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is an important pathologic component in the occurrence and development of cardiovascular disease (CVD). The estimated glucose disposal rate (eGDR) is a measure of glucose handling capacity, that has demonstrated utility as a reliable marker of IR. The study aimed to determine the predictive utility of IR assessed by eGDR for CVD risk.</p><p><strong>Methods: </strong>This nationwide prospective cohort study utilized data of 6416 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were free of CVD but had complete data on eGDR at baseline. The Boruta algorithm was performed for feature selection. Multivariate Cox proportional hazards regression models and restricted cubic spline (RCS) analysis were conducted to examine the associations between eGDR and CVD, and the results were expressed with hazard ratio (HR) and 95% confidence interval (CI) values. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, Hosmer-Lemeshow test, net reclassification improvement (NRI), and decision curve analysis (DCA) were employed to evaluate the clinical efficacy of eGDR in identifying CVD. Subgroup analysis was performed to explore the potential association of with CVD in different populations.</p><p><strong>Results: </strong>During a median follow-up of 106.5 months, 1339 (20.87%) incident CVD cases, including 1025 (15.96%) heart disease and 439 (6.84%) stroke, were recorded from CHARLS. The RCS curves demonstrated a significant and linear relationship between eGDR and all endpoints (all P for nonlinear > 0.05). After multivariate adjustment, the lower eGDR levels were found to be significantly associated with a greater prevalence of CVD. Compared to the lowest quartile, the highest eGDR quartile was associated with a decreased risk of CVD (HR 0.686, 95% CI 0.545-0.862). When assessed as a continuous variable, individuals with a unit increasement in eGDR was related to a 21.2% (HR 0.788, 95% CI 0.669-0.929) lower risk of CVD, a 18.3% (HR 0.817, 95% CI 0.678-0.985) decreased risk of heart disease, and 39.5% (HR 0.705, 95% CI 0.539-0.923) lower risk of stroke. The eGDR had an excellent predictive performance according to the results of ROC (AUC = 0.712) and χ² likelihood ratio test (χ² = 4.876, P = 0.771). NRI and DCA analysis also suggested the improvement from eGDR to identify prevalent CVD and the favorable clinical efficacy of the multivariate model. Subgroup analysis revealed that the trend in incident CVD risk were broadly consistent with the main results across subgroups.</p><p><strong>Conclusion: </strong>A lower level of eGDR was found to be associated with increased risk of incident CVD, suggesting that eGDR may serve as a promising and preferable predictor for CVD.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"161"},"PeriodicalIF":8.5,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974869","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":"Preeclampsia as an independent predictor of atherosclerosis progression in women with type 1 diabetes: a 5-year prospective study.","authors":"Alex Mesa, Carlos Puig-Jové, Adriana Pané, Irene Vinagre, Eva López-Quesada, Eva Meler, Núria Alonso-Carril, Carmen Quirós, Antonio J Amor, Verónica Perea","doi":"10.1186/s12933-025-02719-3","DOIUrl":"https://doi.org/10.1186/s12933-025-02719-3","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia (PE) and type 1 diabetes (T1D) are significant risk factors for cardiovascular disease (CVD), but their combined effect on atherosclerosis progression has not been fully explored. This study aimed to evaluate the impact of T1D and PE on the progression of atherosclerosis.</p><p><strong>Methods: </strong>Prospective cohort study of 112 women divided into four groups: T1D + /PE + (n = 28), T1D + /PE- (n = 28), T1D-/PE + (n = 28), and T1D-/PE- (n = 28). Participants underwent an initial assessment and a follow-up visit five years later, which included anthropometric evaluation, blood tests, and carotid ultrasound. Atherosclerosis progression was defined as an increase in carotid plaque number or the occurrence of a cardiovascular event (CVE) during follow-up (fatal or non-fatal ischemic heart disease, fatal or non-fatal stroke, and/or heart failure).</p><p><strong>Results: </strong>A total of 104 women (92.9%) completed the follow-up (54 with T1D, mean age at inclusion 45.2 ± 7.6 years, mean follow-up 5.3 ± 1.2 years). An increase in carotid plaques was identified in 34 women (32.7%), and 3 CVEs (2.9%) occurred. In women with T1D, a history of PE was associated with a twofold increase in atherosclerosis progression (57.7% vs 25.0%, p = 0.015). In multivariate models adjusted for age, T1D and cardiovascular risk factors, PE [OR 4.97 (1.61-15.29), p = 0.005] and PE + T1D [OR 7.69 (1.25-47.29), p = 0.028] were independently associated with atherosclerosis progression.</p><p><strong>Conclusions: </strong>PE was a strong independent predictor of atherosclerosis progression over a 5-year follow-up period, with an additive effect in T1D. These findings highlight preeclampsia as a significant CVD risk enhancer in young women with T1D.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"160"},"PeriodicalIF":8.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963692","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":"Exercise and dietary interventions in the management of diabetic cardiomyopathy: mechanisms and implications.","authors":"Ling Zhong, Xiaojie Hou, Yan Tian, Xianghui Fu","doi":"10.1186/s12933-025-02702-y","DOIUrl":"https://doi.org/10.1186/s12933-025-02702-y","url":null,"abstract":"<p><p>The global prevalence of diabetes is rapidly increasing, significantly raising the risk of various cardiovascular diseases. Among these, diabetic cardiomyopathy (DCM) is a distinct and critical complication characterized by ventricular hypertrophy and impaired myocardial contractility, ultimately progressing to heart failure and making it a leading cause of mortality among diabetic patients. Despite advances in pharmacological therapies, the effectiveness of managing cardiac dysfunction in DCM remains challenging. Consequently, exploring additional therapeutic strategies for the prevention and treatment of DCM is urgently needed. Beyond pharmacological approaches, lifestyle modifications, particularly exercise and dietary interventions, play a fundamental role in managing DCM due to their significant cardiovascular benefits in diabetic patients. This review synthesizes recent advancements in the field, elucidating the underlying mechanisms through which exercise and dietary interventions influence DCM pathophysiology. By integrating these strategies, we aim to facilitate the development of personalized exercise and dietary regimens that effectively mitigate or prevent DCM progression.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"159"},"PeriodicalIF":8.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984348","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":"Combined effect of skeletal muscle mass loss and elevated insulin resistance on heart failure risk in older adults: a community-based longitudinal cohort study.","authors":"Weike Liu, Hua Zhang, Xin Wang, Huajing Song, Yanli Yao, Zhendong Liu, Juan Wang, Yuqi Guo","doi":"10.1186/s12933-025-02714-8","DOIUrl":"https://doi.org/10.1186/s12933-025-02714-8","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle mass loss and insulin resistance (IR) are associated with cardiovascular diseases risk. However, it remains unclear whether the combination of skeletal muscle mass loss and elevated IR affects heart failure (HF) risk. Here, we investigate the association between a combination of appendicular skeletal muscle mass index (ASMI) with estimated glucose disposal rate (eGDR) and HF risk in older adults.</p><p><strong>Methods: </strong>A prospective analysis and a dual-trajectory analysis were carried out to investigate the association of the combined effect of ASMI and eGDR with HF risk. A total of 11,596 adults aged ≥ 60 years were enrolled from the community for prospective analysis. Among them, 10,489 were eligible for the dual-trajectory analysis. The temporal evolution of ASMI and eGDR was determined using a dual-trajectory model.</p><p><strong>Results: </strong>In the prospective analysis, 1087 individuals developed HF. Restricted cubic splines analysis showed L-shaped associations between ASMI and eGDR and HF risk. HF risk decreased by 32.3% (hazard ratio (HR): 0.677, 95% confidence interval (CI): 0.623-0.734, P_adj < 0.001) for female and 9.0% (HR 0.910, 95% CI 0.831-0.996, P_adj = 0.003) for male patients per one standard deviation (SD) AMSI increment and 29.4% (HR 0.706, 95% CI 0.647-0.770, P_adj < 0.001) for female and 26.8% (HR 0.732, 95% CI 0.668-0.803, P_adj < 0.001) for male patients per one SD eGDR increment. There was a synergistic effect on HF risk per one SD ASMI and eGDR increment (P_adj < 0.001). Five distinct dual ASMI and eGDR trajectories were identified in the dual-trajectory analysis. A total of 859 (8.85 per 1000 person-years) individuals developed HF. Compared to group 4 with moderate-stable ASMI and eGDR and the lowest incident HF, the HR in group 5 characterized by low-stable ASMI and eGDR was 1.908 (95% CI 1.482-2.457, P_adj < 0.001), followed by 1.716 (95% CI 1.296-2.273, P_adj < 0.001) in group 3 with low-decrease ASMI and high-decrease eGDR.</p><p><strong>Conclusions: </strong>Skeletal muscle mass loss and elevated IR act synergistically to increase the HF risk in older adults. Comprehensive management of muscle mass and IR might be a useful and effective strategy for preventing and controlling HF.</p><p><strong>Trial registration: </strong>Retrospectively registered number ChiCTREOC17013598.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"157"},"PeriodicalIF":8.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976939","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":"AGE induced macrophage-derived exosomes induce endothelial dysfunction in diabetes via miR-22-5p/FOXP1.","authors":"Yang Ji, Huanzhen Chen, Lihua Pang, Changnong Chen, Sha Wang, Jing Chen, Lei Fang, Benrong Liu, Yongruo Cheng, Shiming Liu, Yun Zhong","doi":"10.1186/s12933-025-02715-7","DOIUrl":"https://doi.org/10.1186/s12933-025-02715-7","url":null,"abstract":"<p><strong>Background: </strong>Endothelial dysfunction is a pivotal contributor to cardiovascular complications in individuals with diabetes. However, the precise role of macrophages and their exosomes in the diabetic milieu remains elusive.</p><p><strong>Methods: </strong>Exosomes (Exos) were isolated from the supernatants of macrophages treated with advanced glycation end products (AGE) or bovine serum albumin (BSA) using ultracentrifugation. Following coculture with AGE-Exos or BSA-Exos, human umbilical vein endothelial cells (HUVECs) were subjected to CCK-8, EdU, cell migration, monocyte adhesion, and tube formation assays. ELISA and Western blotting were employed to assess inflammatory cytokine release and protein expression levels in HUVECs. The miRNA expression profiles of AGE-Exos and BSA-Exos were analysed using miRNA arrays. Potential targets of miR-22-5p were predicted via miRNA databases and validated through RT‒qPCR, dual-luciferase reporter assays, and rescue experiments. Furthermore, a Rab27a knockout mouse model of type 2 diabetes mellitus (T2DM) was established by intraperitoneal injection of Streptozotocin. Aortic tissues were analysed via immunofluorescence for CD63 and CD31 expression, immunohistochemistry for VCAM-1 and ICAM-1 expression, and Western blotting for FOXP1 expression.</p><p><strong>Results: </strong>AGE stimulation increased the secretion of exosomes from macrophages. Compared with BSA-Exos, AGE-Exos significantly impaired endothelial cell proliferation, migration, and tube formation capabilities while increasing monocyte adhesion and proinflammatory cytokine release without affecting cell viability. miR-22-5p was enriched in AGE-Exos, which were subsequently transferred to HUVECs, specifically targeting FOXP1, resulting in endothelial dysfunction. Overexpression of miR-22-5p in HUVECs using lentiviral vectors recapitulated the inflammatory effects observed with AGE-Exos, whereas anti-miR-22-5p conferred protective effects. Rab27a knockout significantly reduced exosome accumulation in T2DM model mouse aortic tissues, alleviating endothelial discontinuity, downregulating VCAM-1 and ICAM-1 expression, and upregulating FOXP1 expression.</p><p><strong>Conclusions: </strong>AGE-induced release of macrophage-derived exosomes may partially depend on Rab27a transport, which delivers miR-22-5p to ECs. This miR-22-5p targets FOXP1 in ECs, leading to inflammation and resulting in endothelial dysfunction that accelerates the development of diabetic vascular lesions.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"158"},"PeriodicalIF":8.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062337","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":"Temporal prevalence and prognostic impact of diabetes mellitus and albuminuria in heart failure with preserved ejection fraction.","authors":"Nousjka P A Vranken, Xinyu Li, Heleen Bouman, Sanne G J Mourmans, Anouk Achten, Arantxa Barandiarán Aizpurua, Hans-Peter Brunner-La Rocca, Christian Knackstedt, Vanessa P M van Empel, Jerremy Weerts","doi":"10.1186/s12933-025-02708-6","DOIUrl":"10.1186/s12933-025-02708-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Most patients with heart failure with preserved ejection fraction (HFpEF) have a metabolic phenotype in which comorbidities including diabetes mellitus play an important role. Factors related to impaired glucose metabolism, such as kidney disease, may contribute to adverse clinical events. Albuminuria is an early marker of kidney disease. We assessed the prevalence of impaired glucose metabolism and albuminuria in HFpEF over time, and evaluated its prognostic implications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive patients referred to our outpatient clinic and diagnosed with HFpEF between March 2015-November 2023 were included in this study. Patients with type 1 diabetes were excluded. Patients were stratified according to baseline glucose metabolism status (DM + for prediabetes and diabetes, or DM-) and albuminuria status (ALB+ or ALB- for albuminuria &gt; 3.0 mg/mmol and normoalbuminuria, respectively). The primary outcome was a composite of HF hospitalizations (HFH) and all-cause mortality, and was analysed using multivariable-adjusted Cox-regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 332 patients with HFpEF (median age 77 years; 67% female), 121 (36.4%) were classified as DM-/ALB-, 106 (31.9%) as DM+ /ALB-, 44 (13.3%) as DM-/ALB+, and 61 (18.4%) as DM+ /ALB+. Both baseline DM and ALB were independently associated with the primary outcome after approximately 3 years: adjusted hazard ratio (aHR) 1.93; 95% confidence interval (CI) 1.25-2.97 and 1.58; 95%CI 1.04-2.41, respectively. Patients in the DM+ /ALB+ group showed the highest risk (aHR 2.85; 95%CI 1.57-5.15). After one year, DM/ALB status was re-evaluated in 250 (75%) patients. New DM+ and ALB+ incidence was 3.9% and 22%in those at risk, respectively. Patients particularly changed ALB groups compared to baseline (n = 63, 25.2%); 27 (10.8%) patients recovered from albuminuria. At 3 years follow-up, the primary outcome mainly occurred in patients who consistently showed albuminuria (27.1%) or who recovered from albuminuria (22.2%), and less so in patients who developed albuminuria after one year (13.9%) or who remained free of albuminuria (8.6%) (p = 0.008).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DM and albuminuria are prevalent in HFpEF at baseline, and re-evaluation one year later still reveals new diagnoses. Both factors are independently associated with adverse outcomes. Albuminuria at any time point remains predictive of adverse outcomes in HFpEF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research insights: &lt;/strong&gt;WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Diabetes mellitus is an important cardiovascular risk factor in patients with HFpEF, contributing to disease progression and worse outcomes. Albuminuria is a prognostic marker in heart failure patients and more prevalent in patients with diabetes WHAT IS THE KEY RESEARCH QUESTION?: What is prevalence of impaired glucose metabolism and albuminuria in HFpEF over time and how does this translate to prognosis? WHAT IS NEW?: Bo","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":"24 1","pages":"156"},"PeriodicalIF":8.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787959","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}