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Zhou Y, Zhang L, Zheng T, Li H, Han Y, Meng W, Kuang H, Dong C, Yu ZL, Zhu X, Hu G, Dong GH, Yu Y. Metals link to diabetes: Insights from a national cross-sectional investigation. J Environ Sci (China) 2025; 155:720-729. [PMID: 40246503 DOI: 10.1016/j.jes.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 04/19/2025]
Abstract
Diabetes and impaired fasting glucose (IFG) are significant global health concerns. However, the potential effects of mixed heavy metal exposure on these conditions remain underexplored. This study aims to investigate the combined effects of multiple metals on diabetes risk and explore the mediating role of Body Mass Index (BMI) in rural China. A cross-sectional analysis involved 2313 adults from 12 provinces in rural China. Urinary levels of zinc (Zn), chromium (Cr), nickel (Ni), cadmium (Cd), and lead (Pb) were quantified using inductively coupled plasma mass spectrometry. Fasting blood glucose (FBG) levels were measured with an automatic biochemical analyzer. Logistic regression models and the Bayesian Kernel Machine Regression (BKMR) model were used to examine associations and interactions. Mediation analysis was performed to assess the role of BMI. The results of our study indicate that there is a significant association between urinary Zn (OR = 2.38, 95 % CI: 1.57, 3.60), Cr (OR = 1.24, 95 % CI: 1.31, 1.61), and Ni (OR = 1.51, 95 % CI: 1.05, 2.18) and the diabetes risk. The study revealed that exposure to Ni amplified the associations between Zn, Cr and diabetes/IFG risk. Additionally, BMI was identified as a significant mediator in the relationship between metal exposure, particularly Cr/Cd, and diabetes risk. These findings reveal a complex link between multiple metals, such as Zn, Cr, and Ni, and diabetes risk, and emphasize the potential opposite mediating effects of BMI in different metal-induced diabetes mechanisms. Further investigation of these mechanisms is warranted.
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Affiliation(s)
- Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Long Zhang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Tong Zheng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Hongyan Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Yajing Han
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Wenjie Meng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Hongxuan Kuang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Chenyin Dong
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Zi Ling Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Xiaohui Zhu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Guocheng Hu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China.
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Jia HY, He PY, Lu C, Zhou MJ, Zhan ST, Zhong HQ, Xu XM. Association of Isolated Maternal Hypothyroxinemia with Gestational Diabetes Mellitus and Perinatal Outcomes. Eur J Obstet Gynecol Reprod Biol 2025; 311:114015. [PMID: 40318435 DOI: 10.1016/j.ejogrb.2025.114015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Revised: 03/27/2025] [Accepted: 04/26/2025] [Indexed: 05/07/2025]
Abstract
OBJECTIVE This study aimed to examine the association between isolated maternal hypothyroxinemia (IMH) during the first and second trimesters and the risk of gestational diabetes mellitus (GDM), as well as its association with adverse perinatal outcomes. METHODS The study included 2,741 pregnant women who visited the obstetric outpatient clinic at Shanghai General Hospital and underwent routine obstetric examinations between January 2020 and June 2021. Participants diagnosed with IMH in the first trimester were categorized as H1(+), while those without as H1(-). Similarly, those diagnosed with IMH in the second trimester were categorized as H2(+), and those without as H2(-). Based on these classification, four groups were formed: group A H1(-) H2(-), (n = 1,886); group B H1(+) H2(-), (n = 99); group C H1(-) H2(+), (n = 613); and group D H1(+) H2(+), (n = 143). Retrospective analysis was performed to examine clinical data, including pregnancy complications, across all four groups. RESULTS The incidence of GDM was significantly higher in groups B, C, and D compared to group A (all p < 0.001), with the following trend: group D > group C > group B > group A. Specifically, group D exhibited the highest incidence of GDM [n% = 93.01 %, p3 < 0.001]). Logistic regression analysis, adjusted for confounding factors identified IMH during the first trimester, IMH during the second trimester, and persistent IMH across both trimesters as significant risk factors for GDM. Notably, the risk of GDM in cases of persistent IMH was 73.97 times higher than the normal risk (aOR = 73.97, p < 0.001). The study also found that isolated maternal hypothyroxinemia (IMH) was significantly associated with adverse perinatal outcomes. CONCLUSION IMH during either the first or second trimester, and particularly persistent IMH across both trimesters, is strongly associated with a higher risk of GDM and insulin resistance. Our findings highlight the importance of monitoring and managing IMH during pregnancy to mitigate the risk of adverse perinatal outcomes. Early intervention may improve both maternal and neonatal health.
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Affiliation(s)
- Hao-Yi Jia
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Peng-Yuan He
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Cong Lu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Meng-Jie Zhou
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Shi-Tong Zhan
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Hui-Qin Zhong
- Department of Obstetrics and Gynecology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201600, China.
| | - Xian-Ming Xu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China.
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Strom A, Strassburger K, Ziegler D, Sipola G, Prystupa K, Wagner R, Roden M, Bönhof GJ, GDS Group. Changes Over 10 Years in Peripheral Nerve Function in People With Well-Controlled Type 2 Diabetes and Those With Normal Glucose Tolerance. Neurology 2025; 104:e213780. [PMID: 40440593 PMCID: PMC12123752 DOI: 10.1212/wnl.0000000000213780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Accepted: 04/09/2025] [Indexed: 06/02/2025] Open
Abstract
BACKGROUND AND OBJECTIVES There is a lack of knowledge on the changes in peripheral nerve function in people with well-controlled, recently diagnosed type 2 diabetes compared with those with normal glucose tolerance (NGT). In this study, we aimed to investigate the natural course of the function of lower extremity small and large nerve fibers in people with NGT and its decline in those with well-controlled type 2 diabetes. METHODS This prospective observational study assessed changes in nerve function in participants of the German Diabetes Study with recently diagnosed (≤1 year) type 2 diabetes and age-matched and sex-matched individuals with NGT after 5 years and in a larger group of participants with type 2 diabetes after 5 and 10 years. Reference tests of lower extremity peripheral nerve function included peroneal motor nerve conduction velocity (MNCV) and sural sensory nerve conduction velocity (SNCV), sural sensory nerve action potential (SNAP), malleolar vibration perception threshold (VPT), and thermal detection thresholds (TDTs). Data were analyzed using multiple linear or logistic regression analyses. RESULTS At baseline, all 5 nerve function measures showed impairment in the 52 individuals in the diabetes group (33% female, median age 51.7 years) compared with the 52 individuals in the matched NGT group (33% female, median age 51.4 years). After 5 years, 2 nerve indices declined in the diabetes group (peroneal MNCV and VPT) and 3 in the NGT group (peroneal MNCV, VPT, and TDT for cold), with similar 5-year declines observed in both groups after adjustment for baseline values and pairwise matching. In addition, the Neuropathy Disability Score increased in the NGT group but not in the diabetes group. Comparable patterns of decline after 5 and 10 years were found in the larger diabetes cohort of 141 individuals (39% female, median baseline age 53.6 years). The observed 10-year prevalence of abnormal NCVs closely matched estimates based on natural aging-related decline (14.2% vs 12.8% for peroneal MNCV and 30.2% vs 31.0% for sural SNCV). DISCUSSION These findings suggest that nerve function deterioration in well-controlled type 2 diabetes is primarily influenced by nerve function status at diagnosis and physiologic aging, rather than diabetes-related progression.
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Affiliation(s)
- Alexander Strom
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Klaus Strassburger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany; and
| | - Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
| | - Gundega Sipola
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
| | - Katsiaryna Prystupa
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Robert Wagner
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Gidon J Bönhof
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
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Niknam M, Hosseinpour-Niazi S, Jalali-Farahani S, Amiri P, Mirmiran P, Hosseini-Esfahani F, Ainy E, Azizi F. Exploring the relationship between dietary patterns and health-related quality of life among Iranian adult population: Tehran lipid and glucose study. BMC Nutr 2025; 11:114. [PMID: 40490839 DOI: 10.1186/s40795-025-01103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/29/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND The current study aims to investigate the association between dietary patterns and health-related quality of life (HRQoL) in a large Iranian adult population. METHODS This cross-sectional study was conducted using the Tehran Lipid and Glucose Study (TLGS) data. Data from 5711 adults (53.0% female) collected by trained interviewers were analyzed. For assessments of dietary intakes and HRQoL, the 147-item semi-quantitative Food Frequency Questionnaire (FFQ) and Short-Form 12-Item Health Survey version 2 (SF-12v2) were used, respectively. The physical component summary (PCS) and mental component summary (MCS) scores of HRQoL were calculated using the appropriate scoring algorithms. Dietary patterns were identified using factor analysis. General linear models were used to assess the association between dietary patterns and HRQoL scores. RESULTS Two dietary patterns, labeled as healthy and western, were identified. In men, the median (interquartile range (IQR)) of PCS and MCS were 51.4 (47.2-55.0) and 52.2 (44.2-58.2), respectively. For women, the median (IQR) of PCS and MCS were 48.9 (42.6-53.7) and 47.7 (39.6-55.2), respectively. Significant increasing trends in MCS scores were observed in both men and women across tertiles of healthy dietary pattern. For PCS scores, a significant increasing trend was noted only in women. The Western dietary pattern was not significantly associated with either PCS or MCS in women. However, in men, a significant decreasing trend in MCS scores was observed across tertiles of the Western dietary pattern. CONCLUSIONS The present study suggests a more beneficial effect of healthy dietary pattern on women's HRQoL. On the other hand, in men, the healthy dietary pattern is positively associated with the mental dimension of HRQoL, whereas the Western dietary pattern is negatively linked to the mental dimension of HRQoL.
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Affiliation(s)
- Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
| | - Sara Jalali-Farahani
- Institute of Public Health and Wellbeing, University of Essex, Colchester, England
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Elaheh Ainy
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhao Y, Jia J. DAGSLAM: causal Bayesian network structure learning of mixed type data and its application in identifying disease risk factors. BMC Med Res Methodol 2025; 25:154. [PMID: 40481414 PMCID: PMC12142989 DOI: 10.1186/s12874-025-02582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Accepted: 04/29/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Identifying and understanding disease risk factors is crucial in epidemiology, particularly for chronic and noncommunicable diseases that often have complex interrelationships. Traditional statistical methods struggle to capture these complexities, necessitating more sophisticated analytical frameworks. Bayesian networks and directed acyclic graphs (DAGs) provide powerful tools for exploring the complex relationships between variables. However, existing DAG structure learning algorithms still have limitations in handling mixed-type data (including continuous and discrete variables), which restricts their practical utility. Therefore, developing DAG structure learning methods that can effectively handle mixed data is highly important for obtaining an in-depth understanding of disease risk factors and pathogenic mechanisms. METHODS This study proposes an extension of the NOTEARS algorithm, termed DAGSLAM, which is designed for Bayesian network structure learning with mixed-type data. The algorithm integrates continuous and categorical variables through a tailored loss function, enhancing its applicability to real-world epidemiological datasets. RESULTS Extensive simulations were conducted across eight distinct scenarios, specifically, variations in the number of nodes, changes in the proportion of categorical nodes, different sample sizes, levels of categorical nodes, variations in edge sparsity, adjustments to the weight scale, different graph types, and diverse noise distributions. These scenarios demonstrate that DAGSLAM consistently outperforms existing methods such as HC, TABU, mDAG, and DAGBagM across key metrics, including precision, recall, F1 score, and structural Hamming distance (SHD). Furthermore, the robustness of DAGSLAM is validated through its application to the National Health and Nutrition Examination Survey (NHANES) dataset, revealing critical causal relationships among risk factors for CHD and diabetes. CONCLUSIONS DAGSLAM provides a powerful and scalable tool for uncovering causal relationships in complex disease networks, with significant implications for risk factor identification and public health research.
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Affiliation(s)
- Yuanyuan Zhao
- Department of Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Jinzhu Jia
- Department of Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China.
- Center for Statistical Science, Peking University, Beijing, 100871, China.
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Sonmezoz GB, Yilmaz M. Association of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-to-high-density lipoprotein ratio with diabetic nephropathy. Ther Apher Dial 2025; 29:428-436. [PMID: 40119545 DOI: 10.1111/1744-9987.70008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 02/22/2025] [Accepted: 03/07/2025] [Indexed: 03/24/2025]
Abstract
INTRODUCTION The aim of this study was to determine the relationship between albuminuria and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-high density lipoprotein-cholesterol ratio (MHR). METHODS Patients with type 2 diabetes mellitus diagnosis, aged over 18, had estimated glomerular filtration rate (eGFR) ≥60 mL/dk/1.73 m2 included. Patients were divided into groups according to ACR values: <30 mg/g (group 1), 30-300 mg/g (group 2) and >300 mg/g (group 3). We examined whether there was a significant difference in NLR, PLR, and MHR among the three groups. RESULTS A total of 360 patients were included in the study. NLR was significantly higher in group 3 than in group 1 (p = 0.016). There was no significant difference in PLR or MHR among the three groups (p = 0.312 and p = 0.687, respectively). A significant difference was detected in NLR in comparison between the groups with and without diabetic nephropathy, but there was no significant difference in PLR or MHR (p = 0.028; p = 0.950 and p = 0.389, respectively). NLR correlated with creatinine and ACR (r: 0.166, p = 0.002; r: 0.144, p = 0.006, respectively). MHR correlated positively with creatinine (r: 0.25.3, p = 0.016, respectively). CONCLUSION NLR was significantly higher in the diabetic nephropathy group than in the non-diabetic nephropathy group. This may suggest that NLR can be used as a prognostic marker in diabetic nephropathy. Although there was no significant relationship between MHR and albuminuria, MHR positively correlated with creatinine and negatively correlated with eGFR. Therefore, MHR may be useful in monitoring the development and progression of chronic kidney disease in diabetic patients rather than in the early stages. However, further studies are needed.
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Affiliation(s)
- Gulru Birce Sonmezoz
- Taksim Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | - Murvet Yilmaz
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
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Kamel R, Kassouf S, Nasser SM, Mcheik A, Hayeck N, Abi-Ramia E, ElKazzaz H, Khalil C, Abi-Gerges A. Pulmonary effects of waterpipe generated smoke in adult diabetic rats. Toxicol Appl Pharmacol 2025; 499:117319. [PMID: 40185287 DOI: 10.1016/j.taap.2025.117319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 03/30/2025] [Accepted: 03/31/2025] [Indexed: 04/07/2025]
Abstract
Waterpipe smoking (WPS) is associated with pulmonary inflammation and DNA damage. Tobacco use among diabetic patients adds substantial clinical and public health burden. This study aims to investigate the combined pulmonary effects of diabetes and smoking. To achieve this goal, type 1 diabetes (T1D) was induced in adult male rats by Streptozotocin (65 mg/kg) injection. Rats were then exposed either to fresh air or WPS for one hour daily over five weeks (five days/week). Lung remodeling was evaluated by histology. Changes affecting inflammation, oxidative stress, apoptosis and survival pathways were characterized by real-time quantitative PCR and Western blot. Our findings showed that T1D was associated with pulmonary remodeling characterized by increases in lung weight/BW ratio, exacerbated by WPS, and elevated alveolar count. Both T1D and WPS exposure led to an accumulation of alveolar foamy macrophages and decreased alveolar septal thickness. Upregulation in the transcript levels of pro-inflammatory cytokine, TNF-α and anti-inflammatory marker, IL-10, were reported in diabetic lungs irrespective of WPS exposure. Moreover, diabetic lungs also displayed significant changes in the expression of mitochondrial complexes III and IV and antioxidant enzyme, SOD2, irrespective of the exposure condition. We also noted significant downregulation in the expression of caspases 3 and 9, p-P53/P53 ratio and JNK protein in diabetic lungs compared to control irrespective of the exposure condition. Lastly, diabetes and WPS exposure triggered significant decreases in EGFR expression. In conclusion, we show for the first time pulmonary remodeling and damages caused by the combined effects of T1D and smoking. Our findings highlight the pressing need for future better management of waterpipe consumption among patients with diabetes.
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Affiliation(s)
- Rima Kamel
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Sibelle Kassouf
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Selim M Nasser
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Amale Mcheik
- Department of Physical Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Nathalie Hayeck
- Department of Physical Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Elias Abi-Ramia
- Animal Facility, Institutional Review Board Office, Graduate Studies and Research, Lebanese American University, Lebanon
| | - Hanan ElKazzaz
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Christian Khalil
- School of Arts and Sciences, Department of Biological Sciences, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Aniella Abi-Gerges
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon.
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Pina L, Nguyen-Lee J, Wood GC, Furey MJ, Petrick AT, Parker DM. Bariatric surgery significantly reduces progression from prediabetes to diabetes compared with the general population: 15-year single-institution data. Surg Obes Relat Dis 2025; 21:689-694. [PMID: 40016078 DOI: 10.1016/j.soard.2025.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 10/31/2024] [Accepted: 01/25/2025] [Indexed: 03/01/2025]
Abstract
BACKGROUND There is a paucity of literature on the impact for bariatric surgery on the progression from prediabetes (PDM) to type II diabetes mellitus (T2DM). OBJECTIVES To evaluate the progression from PDM to T2DM in bariatric surgery compared with a nonsurgical cohort. SETTING Single academic institution, Center of Bariatric Excellence. METHODS This retrospective study of patients with morbid obesity with patients with PDM who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2001 and 2022. Nonsurgical controls from a primary care cohort were directly matched by hemoglobin A1c, age, sex, and body mass index. DM was defined as a clinical diagnosis of type II diabetes or hemoglobin A1c ≥6.5%. Kaplan-Meier analysis was used to estimate time until T2DM. Cox regression was used to compare time until T2DM in RYGB versus sleeve gastrectomy and in bariatric surgery versus nonsurgical controls. RESULTS A total of 1326 bariatric cases with PDM (n = 1154 RYGB, n = 172 SG) were identified. The cohort was 83% female, mean age = 45.3 years, mean body mass index 46.9 kg/m2, and follow-up was 65% over 15 years. In bariatric cases, PDM progression to T2DM at 5, 10, and 15 years after surgery was 1.8%, 3.3%, and 6.7%, respectively. PDM progression to T2DM was almost 20 times greater in matched nonsurgical controls at 5, 10, and 15 years 31.1%, 51.4%, and 68.7%, respectively (hazard ratio 19.8, 95% confidence interval 13.9-28.4, P < .0001). When stratifying by bariatric surgery type, those with SG were 4 times more likely to progress to T2DM versus RYGB (hazard ratio 4.01, 95% confidence interval 1.71-9.39, P = .0014). CONCLUSIONS Bariatric surgery significantly decreases the conversion from PDM to T2DM. The impact was significantly greater for RYGB compared with SG.
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Affiliation(s)
- Luis Pina
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania
| | - Joseph Nguyen-Lee
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania
| | - G Craig Wood
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania
| | - Michael J Furey
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania
| | - Anthony T Petrick
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania
| | - David M Parker
- Division of Bariatric and Foregut Surgery, The Obesity Institute, Geisinger Health System, Danville, Pennsylvania.
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Martin A, La Rosa GRM, Rice H, Bertuzzi A, Witkowski M, Anastasi E, Geraci G, Polosa R. Pharmacological interventions for smoking cessation in Type 2 diabetes: A systematic review with meta-analysis and GRADE evaluation. Diabetes Res Clin Pract 2025; 224:112202. [PMID: 40294654 DOI: 10.1016/j.diabres.2025.112202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2024] [Revised: 04/15/2025] [Accepted: 04/23/2025] [Indexed: 04/30/2025]
Abstract
AIMS To evaluate the efficacy and safety of pharmacological therapies for smoking cessation in individuals with Type 2 Diabetes Mellitus (T2DM) through a systematic review, meta-analysis, and GRADE evaluation. METHODS PubMed and Scopus were searched on 7 June 2024 using relevant keywords. Randomized controlled trials and prospective cohort studies involving adult smokers with T2DM receiving pharmacological treatments for smoking cessation were included. Data were extracted independently by two reviewers. Random-effects meta-analyses were conducted, and the certainty of evidence was assessed using GRADE. RESULTS Eighteen studies (19 publications) were included. Pharmacotherapy significantly increased continuous abstinence rates at 12 and 24 weeks (p < 0.001), with ORs of 4.17 (95 % CI: 2.71-6.42) and 3.80 (95 % CI: 2.52-5.72), respectively. At 52 weeks, varenicline was more effective than placebo (OR: 2.84, 95 % CI: 1.41-5.69, p = 0.003). Adverse events were more frequent with varenicline, but not significantly (OR: 1.40, 95 % CI: 0.98-1.98, p = 0.06). CONCLUSIONS Varenicline appears effective for smoking cessation in T2DM, with an acceptable tolerability profile. Bupropion and NRT show potential efficacy. However, most evidence comes from post hoc analyses in which diabetes was not a predefined variable, warranting cautious interpretation.
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Affiliation(s)
| | | | | | | | | | - Erika Anastasi
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Giulio Geraci
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
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10
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Bhasin G, Dafale RS, Annapoorna K, Kamath SU, Matlani D, Rana R, Prabhu MM, Pandey AK, Shetty S, Shetty L, Vasanthalaxmi K, Manjula S. Therapeutic Yoga: A feasible complementary approach for glycemic control in individuals with impaired fasting glucose and elevated HbA1c. Contemp Clin Trials Commun 2025; 45:101493. [DOI: 10.1016/j.conctc.2025.101493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2025] Open
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11
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Ghanei A, Fattahi MA, Banadkoki MG. Investigating predictive factors in treatment response with metformin in patients with gestational diabetes mellitus: a cross-sectional analytical-descriptive study. J Diabetes Metab Disord 2025; 24:5. [PMID: 39697861 PMCID: PMC11649588 DOI: 10.1007/s40200-024-01520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 11/03/2024] [Indexed: 12/20/2024]
Abstract
Objective As the utilization of metformin for gestational diabetes mellitus (GDM) treatment continues to rise, a substantial segment of these patients will ultimately necessitate insulin during their therapeutic journey. Hence, assessing patients' clinical and laboratory attributes becomes invaluable in determining their likelihood of responding favorably to metformin medication. This discernment aids in selecting an optimal management approach, wherein the patients most likely to benefit significantly from metformin are identified, while alternative therapies like insulin are considered for individuals with a lower probability of treatment response. Method This was a cross-sectional analytical-descriptive study of individuals with GDM. Initially, the subject's laboratory results and demographic information were submitted. Following that, metformin was administered to all subjects along with counseling on maintaining a healthy diet and lifestyle. Following a 4-week interval, the patients were reassessed and divided into two groups based on their response to metformin medication and then analyzed. Result 807 people participated in this study, of which 329 people (40.8%) responded to treatment and the failure rate of metformin treatment was 59.2%. This research revealed that the predictive factors of response to metformin medication were, respectively, the amount of 1-hour oral glucose tolerance test (OGTT) (OR = 62.66), 2-hour postprandial plasma glucose (OR = 54.04), 2-hour OGTT (OR = 17.37), followed by the history of abortion (OR = 14.88), the number of pregnancies (gravida 3 and more) (OR = 5.06) and history of infertility (OR = 2.6). Conclusion The current study's findings indicated that to enhance GDM care, metformin prescriptions should be prescribed to patients depending on their clinical characteristics and laboratory results.
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Affiliation(s)
- Azam Ghanei
- Division of Endocrinology and Metabolism, Department of Medicine, Shahid Sadoughi university of medical sciences, Yazd, Iran
| | - Mohammad Ali Fattahi
- Department of Medicine, Shahid Sadoughi university of medical sciences, Yazd, Iran
| | - Mohammadreza Gholami Banadkoki
- Department of Medicine, Shahid Sadoughi university of medical sciences, Yazd, Iran
- Internal Medicine Research Department, Shahid Sadoughi Hospital, Yazd, Iran
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12
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Gaeini Z, Mirmiran P, Alvirdizadeh S, Azizi F. Dairy-derived saturated fats were not associated with risk of type 2 diabetes mellitus and metabolic syndrome: Tehran Lipid and Glucose Study. Diabetol Metab Syndr 2025; 17:178. [PMID: 40442820 PMCID: PMC12121133 DOI: 10.1186/s13098-025-01751-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 05/20/2025] [Indexed: 06/02/2025] Open
Abstract
Emerging evidence indicates that the health effects of saturated fatty acids (SFA) may differ depending on the food source from which they are derived. We aimed to determine the association between dairy-derived SFA and the risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). This research was carried out in the Tehran Lipid and Glucose Study, a cohort study of 2256 T2DM-free adults and 1713 MetS-free adults. Adjusted hazard ratios and 95% confidence intervals of T2DM and MetS were calculated in tertile categories of dairy-derived SFA. The risk of T2DM and MetS was estimated through multivariable Cox regression to substitute dairy-derived SFA with other sources of SFA. Participants in the second tertile of dairy-derived SFA had a higher risk of T2DM (HR = 1.59, 95% CI = 1.14-2.21); however, the association did not remain significant in the third tertile (P for trend = 0.082). There were no associations between dairy-derived SFA and the risk of MetS. Substituting dairy-derived SFA for other dietary sources of SFA was not related to the risk of T2DM or MetS. The association between dairy-derived SFA and the risk of T2DM and MetS is still an ongoing research topic. When making dietary choices, it is advisable to consider an overall balanced diet and lifestyle factors.
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Affiliation(s)
- Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, 19395-4763, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, 19395-4763, Iran.
| | - Sevda Alvirdizadeh
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, 19395-4763, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kumar A, Kumar V, Pramanik J, Rustagi S, Prajapati B, Jebreen A, Pande R. Lactiplantibacillus Plantarum as a Complementary Approach for Diabetes Treatment and Management. Curr Nutr Rep 2025; 14:72. [PMID: 40434575 DOI: 10.1007/s13668-025-00664-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2025] [Indexed: 05/29/2025]
Abstract
PURPOSE OF REVIEW This review explores the impact of Lactiplantibacillus plantarum on diabetes management and discusses the potential mechanism. RECENT FINDINGS Recent studies have highlighted that gut dysbiosis has emerged as a key factor in the development of diabetes. In this context, probiotics, specifically Lactiplantibacillus plantarum, offer potential benefits in modulating gut microbiota and improving metabolic health. Several studies have demonstrated the positive impact of L. plantarum on glycemic control, insulin sensitivity, and inflammatory markers in diabetic animal models. The potential mechanisms of action of L. plantarum in diabetes management include inhibiting enzymes involved in glucose metabolism, modulating inflammatory responses, improving insulin sensitivity, restoring gut microbiota, and producing short-chain fatty acids. SUMMARY The article concludes that L. plantarum is a promising candidate for managing glucose hemostasis, thus offering a potential alternative or adjunct to conventional approaches. However, further clinical studies are necessary to understand the exact mechanism and long-term effects of L. plantarum in humans.
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Affiliation(s)
- Akash Kumar
- MMICT & BM (Hotel Management), Maharishi Markandeshwar (Deemed to be University), Mullana, India.
| | - Vikram Kumar
- Department of Food Technology, SRM University, Delhi NCR, Sonepat, India
| | - Jhilam Pramanik
- Department of Food Technology, William Carey University, Shillong, 793019, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, India
- Department of Food Technology, School of Agriculture, Maya Devi University, Dehradun, Uttrakhand, India
| | - Bhupendra Prajapati
- Centre for Research Impact & Outcome, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, 140401, India
- Department of Industrial Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 73000, Thailand
| | - Ali Jebreen
- Department of Therapeutic Medical Nutrition, Faculty of Applied Medical Sciences, Palestine Ahliya University, Bethlehem, Palestine
| | - Ranjana Pande
- Department of Life Science, School of Basic Sciences and Research, Sharda University, Greater Noida, India.
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Aljoghaiman E, Alzahrani A, Albarqi R, Alqbbani S, Alshiddi H, AlSharief M, Alsaati M, Al Jofi FE. Association Between Diabetes and Vertical Bone Defects in Periodontitis Using Cone Beam Computed Tomography: A Cross-Sectional Study in the Eastern Province, Saudi Arabia. Clin Pract 2025; 15:95. [PMID: 40422276 DOI: 10.3390/clinpract15050095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2024] [Revised: 04/09/2025] [Accepted: 04/15/2025] [Indexed: 05/28/2025] Open
Abstract
Background: The association between diabetes and periodontal disease is well established, but its impact on intrabony periodontal defects remains unclear. Aims: This study examines the relationship between diabetes and intrabony periodontal defects using cone beam computed tomography (CBCT). Methods: A retrospective analysis of 99 CBCT images from Imam Abdurrahman bin Faisal University (2010-2022) was conducted. Intrabony periodontal defects were assessed, and logistic regression was used to analyze their association with diabetes. Results: Intrabony periodontal defects were detected in 66% of the sample, with 36% exhibiting multiple defects. Crude logistic regression showed a significant association between diabetes and intrabony periodontal defects (OR 3.986, 95% CI 1.454-10.922) and defect count (OR 3.382, 95% CI 1.430-8.003). However, multiple regression analysis did not confirm diabetes as an independent predictor (adjusted OR 0.740, 95% CI 0.087-6.314). Conclusions: Diabetes was not significantly associated with the prevalence or number of intrabony periodontal defects after adjusting for the confounders. However, these findings highlight the multifactorial nature of periodontal bone loss and the need for comprehensive patient assessment. Clinically, this underscores the importance of integrating both systemic and local periodontal evaluations in diabetic patients to improve early detection and personalized treatment planning. Further research with larger, more diverse samples and integrated clinical assessments is needed to refine our understanding of this relationship and enhance patient management.
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Affiliation(s)
- Eman Aljoghaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdullah Alzahrani
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
| | - Rakan Albarqi
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
| | - Saad Alqbbani
- College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
| | - Hamad Alshiddi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Mishali AlSharief
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | | | - Faisal E Al Jofi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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15
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Araújo Gontijo C, Barbosa Domingos J, Tibiletti Balieiro LC, Pereira Teixeira G, Fahmy WM, de Paiva Maia YC, Crispim CA. Is the Underreporting of Energy Intake Associated with Chrononutritional and Clinical Parameters During Pregnancy? JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2025:1-10. [PMID: 40387125 DOI: 10.1080/27697061.2025.2497483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 02/28/2025] [Accepted: 04/21/2025] [Indexed: 05/20/2025]
Abstract
INTRODUCTION Underreporting of food intake corresponds to distortions in self-reported food consumption and can lead to inadequacies in dietary prescriptions, which play an important role in preventing excessive weight gain during pregnancy. Recent studies in the field of chrononutrition indicate that meal times influence the quality, quantity, and distribution of calories throughout the day. OBJECTIVE To evaluate the association of energy intake underreporting with chrononutritional and clinical variables throughout pregnancy. MATERIAL AND METHODS Prospective cohort study carried out with 100 pregnant women followed up in the three gestational trimesters. Food intake assessment was conducted using three 24-h dietary recalls. Chrononutritional variables evaluated included eating duration, overnight fasting, timing of first and last meals, and the number of eating episodes. The clinical variables evaluated were the adequacy of weight gain and fasting glucose. The occurrence of underreporting was calculated using the Goldberg method and the pregnant women were categorized into three groups: Underreporters (UR), Potential Underreporters (PUR) and Normal Reporters (NR). Generalized estimating equations (GEE) adjusted for confounders were used to assess the association between three groups of levels of energy notification (independent variables) and chrononutritional and clinical variables (dependent variables) throughout pregnancy. RESULTS Underreporters group reported having first meal later (mean ± standard error: UR-9:26 ± 0:11 vs PUR-8:34 ± 0:09 and NR-8:32 ± 0:08), last meal earlier (UR-19:47 ± 0:10 vs PUR-20:17 ± 0:07 and NR-20:46 ± 0:08), shorter eating duration (UR-10:22 ± 0:14 vs PUR-11:43 ± 0:12 and NR-12:12 ± 0:12), longer overnight fasting (UR-10:58 ± 0:08 vs PUR-10:30 ± 0:08 and NR-10:05 ± 0:08), lower number of eating episodes (UR-4.16 ± 0.13 vs PUR-4.90 ± 0.12 and NR-5.11 ± 0.12), exhibited higher fasting glucose (UR-80.33 ± 1.30 vs NR-74.45 ± 1.90) during pregnancy and greater excessive weight gain in the third trimester (UR-2.20 ± 0.26 vs NR-1.58 ± 0.19). CONCLUSION Distinct chrononutritional patterns observed in women who underreported food intake suggest that underreporting is associated not only with overall food intake but also with meal patterns, particularly the timing of the first and last meals of the day. Further studies are needed to validate this hypothesis.
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Affiliation(s)
- Cristiana Araújo Gontijo
- Graduate Program in Health Science, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Juliana Barbosa Domingos
- Nutrition course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Laura Cristina Tibiletti Balieiro
- Graduate Program in Health Science, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Gabriela Pereira Teixeira
- Nutrition course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Walid Makin Fahmy
- Department of Obstetrics, Hospital and Municipal Maternity of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Science, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cibele Aparecida Crispim
- Graduate Program in Health Science, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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16
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Sharma S, Kishen A. Dysfunctional crosstalk between macrophages and fibroblasts under LPS-infected and hyperglycemic environment in diabetic wounds. Sci Rep 2025; 15:17233. [PMID: 40383800 PMCID: PMC12086240 DOI: 10.1038/s41598-025-00673-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 04/29/2025] [Indexed: 05/20/2025] Open
Abstract
Diabetic wounds, especially diabetic foot ulcers, present a major clinical challenge due to delayed healing and prolonged inflammation. Macrophage-fibroblast interactions are essential for wound repair, yet this crosstalk is disrupted in diabetic wounds due to hyperglycemia and bacterial infection. This study investigates the dysfunctional communication between macrophages and fibroblasts, focusing on autocrine, paracrine, and juxtacrine signaling in simulated diabetic environments. Using monoculture and co-culture models of THP-1-derived macrophages and primary human dermal fibroblasts, we simulated conditions of normal glucose, LPS-induced infection, high glucose (with AGEs), and combined high glucose (with AGEs) and LPS. Macrophages in hyperglycemic and LPS-infected environments exhibited a pro-inflammatory M1 phenotype with elevated expression of CD80, and STAT1 and increased production of IL-1β, TNF-α, and MMP9. Fibroblast migration was significantly impaired under high glucose conditions, particularly in paracrine model. Secretome profiling showed heightened pro-inflammatory cytokines and proteases, with reduced anti-inflammatory markers (IL-10 and VEGF-A) under hyperglycemic conditions. Paracrine signaling exacerbated the inflammatory response, while juxtacrine signaling showed more moderate effects, conducive to healing. These findings highlight the pathological macrophage-fibroblast crosstalk in diabetic wounds, particularly under hyperglycemic and LPS-infected conditions, offering insights for potential immunomodulatory therapies aimed at restoring effective signaling and improving wound healing outcomes.
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Affiliation(s)
- Shivam Sharma
- The Kishen Lab, Dental Research Institute, University of Toronto, Toronto, Canada
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada
| | - Anil Kishen
- The Kishen Lab, Dental Research Institute, University of Toronto, Toronto, Canada.
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada.
- Department of Dentistry, Mount Sinai Hospital, Toronto, Canada.
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Kezić A, Gajić S, Ostojić AR, Bekić I, Bontić A, Pavlović J, Baralić M, Popović L. Glycemic Control in Patients with Diabetes on Peritoneal Dialysis: From Glucose Sparing Approach to Glucose Monitoring. Life (Basel) 2025; 15:798. [PMID: 40430224 PMCID: PMC12113379 DOI: 10.3390/life15050798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2025] [Revised: 05/05/2025] [Accepted: 05/14/2025] [Indexed: 05/29/2025] Open
Abstract
Optimized glycemic management is crucial for controlling atherosclerosis and consequent cardiovascular morbidity in patients with diabetes. Due to the continuous glucose burden from glucose-containing peritoneal dialysis (PD) solutions, PD patients with diabetes experience difficulties in glucose level regulation with glucose hypervariability and worsening dyslipidemia. Even in non-diabetic PD patients, glucose-containing PD solutions aggravate insulin resistance and cause overweight. Additionally, glucose degradation products (GDP) from glucose-based PD solutions provoke oxidative stress and complex inflammatory processes, leading to chronic deleterious and fibrotic peritoneal membrane changes. In this narrative review, we searched the literature using PubMed, MEDLINE, and Google Scholar over the last three decades to summarize the most important facts relevant to the presented issues, aiming to inform both endocrinologists and nephrologists in providing the best currently available care for people with diabetes on PD. We not only focus on adequate tailoring of insulin therapy adapted at the time of PD exchange with hypertonic glucose solution., but also emphasize the use of continuous glucose monitoring (CGM) that allows assessment of mean glucose values and time spent in normal, hypo, and hyperglycemia. However, the routine use of CGM in PD patients is limited due to high cost, and hemoglobin A1c (HbA1c) analysis is still recommended as a basic clinical tool for the assessment of glycemic control. Possible choices of antidiabetic drugs were considered given the narrowed choice due to contraindications for metformin and sulfonylurea. The other important therapeutic approach in PD patients with diabetes is using glucose-sparing PD regimens based on icodextrin and amino acid PD solutions with the addition of just one or two bags of low glucose concentration PD solution daily. This glucose-sparing approach not only reduces the glucose load and improves glycoregulation with correction of the lipid profile but also maintains the viability of the peritoneal membrane by reducing the harmful effects of GDPs.
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Affiliation(s)
- Aleksandra Kezić
- Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (S.G.); (A.B.); (J.P.); (M.B.)
- Faculty of Medicine, University of Belgrade, Dr. Subotića 8, 11000 Belgrade, Serbia;
| | - Selena Gajić
- Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (S.G.); (A.B.); (J.P.); (M.B.)
| | - Ana Račić Ostojić
- Department of Nephrology, Clinical Hospital Center Zemun, Vukova 9, 11080 Belgrade, Serbia;
| | - Ivana Bekić
- Children’s Hospital for Lung Diseases and Tuberculosis, Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Heroja Milana Tepića 1, 11000 Belgrade, Serbia;
| | - Ana Bontić
- Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (S.G.); (A.B.); (J.P.); (M.B.)
- Faculty of Medicine, University of Belgrade, Dr. Subotića 8, 11000 Belgrade, Serbia;
| | - Jelena Pavlović
- Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (S.G.); (A.B.); (J.P.); (M.B.)
- Faculty of Medicine, University of Belgrade, Dr. Subotića 8, 11000 Belgrade, Serbia;
| | - Marko Baralić
- Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (S.G.); (A.B.); (J.P.); (M.B.)
- Faculty of Medicine, University of Belgrade, Dr. Subotića 8, 11000 Belgrade, Serbia;
| | - Ljiljana Popović
- Faculty of Medicine, University of Belgrade, Dr. Subotića 8, 11000 Belgrade, Serbia;
- Center for Diabetes and Lipid Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr. Subotića 13, 11000 Belgrade, Serbia
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18
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Liu N, Yan WT, Xiong K. Plantamajoside: A potentially novel botanical agent for diabetes mellitus management. World J Diabetes 2025; 16:104311. [DOI: 10.4239/wjd.v16.i5.104311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 02/08/2025] [Accepted: 02/20/2025] [Indexed: 04/25/2025] Open
Abstract
Diabetes mellitus (DM) and its associated complications are metabolic disorders characterized by hyperglycemia, leading to high morbidity and reduced quality of life worldwide. This global healthcare problem imposes substantial personal and social burdens that warrant comprehensive and in-depth investigation. Plantamajoside (PMS), a naturally bioactive ingredient derived from the traditional Chinese medicinal herb Plantaginis Herba, exhibits a range of pharmacological properties, including anti-inflammatory, antioxidative, and antitumor effects, and has been traditionally utilized in clinical applications such as removing phlegm and clearing heat. However, the potential biological impact of PMS on DM remains largely unexplored. Recent research by Wang et al reported the therapeutic potential of PMS in type 2 DM (T2DM) and elucidated the underlying molecular mechanisms. Specifically, PMS mitigates endoplasmic reticulum stress and apoptosis of pancreatic β-cells by upregulating DnaJ heat shock protein family (Hsp40) member C1, thereby alleviating pancreatic β-cell damage and ameliorating T2DM progression. Given the novel and protective effect of PMS on pancreatic β-cells, this natural ingredient emerges as an innovative and promising therapeutic strategy for improving DM outcomes. PMS has been shown to modulate key signaling pathways involved in multiple types of regulated cell death (RCD), such as apoptosis and autophagy. Various forms of RCD, including apoptosis, ferroptosis, pyroptosis, autophagy, and PANoptosis, contribute to the pathogenesis of DM and its associated complications. There is significant potential for PMS to exert protective effects on β-cells against these forms of RCD and to provide a multitarget approach to DM therapy. Therefore, further exploration into whether PMS shields pancreatic β-cells from these types of RCD, coupled with elucidating the underlying molecular mechanisms, will facilitate the development of more effective therapeutic strategies for DM. Additionally, further investigation on PMS in conjunction with other therapeutic approaches is warranted to enhance therapeutic efficacy for DM.
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Affiliation(s)
- Na Liu
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha 410013, Hunan Province, China
| | - Wei-Tao Yan
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha 410013, Hunan Province, China
| | - Kun Xiong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha 410013, Hunan Province, China
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Chen AM, He QY, Wu YC, Chen JQ, Ma XQ, Hu LY, Wang GNY, Wang ZT, Wu ZY, Zheng ZJ, Jia YJ. Association of quantified cardiovascular health status with all-cause mortality risk in prediabetic patients. World J Diabetes 2025; 16:102052. [DOI: 10.4239/wjd.v16.i5.102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 12/04/2024] [Accepted: 03/21/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND Patients with prediabetes are at increased risk of developing cardiovascular disease. The Life's Essential 8 (LE8) score, updated by the American Heart Association in 2022, is a tool used to quantify cardiovascular health (CVH). Quantifying healthy living status on the basis of the uniform standard LE8 will be useful for confirming whether health interventions can reduce the risk of death in prediabetic patients.
AIM To investigate the associations between all-cause mortality risk and CVH status (as quantified by the LE8 score) in prediabetic patients.
METHODS This study included 5344 participants with prediabetes (age: 52.9 ± 15.8 years; 51.6% men). The LE8 score includes four health indicators and four health behaviors. Cox proportional hazard ratios were calculated for all-cause mortality in the high CVH (LE8 ≥ 80), low CVH (LE8 ≤ 50), and moderate CVH (LE8 50-79) subgroups, and restricted cubic spline analyses were performed. Separate analyses of the associations of all-cause mortality risk with each LE8 component and CVH health behaviors and indicators were also performed.
RESULTS In the median follow-up period of 8.33 years, 658 deaths occurred. Compared with those among participants with high CVH, the covariate-adjusted HRs (95% confidence intervals) for mortality among participants with moderate and low CVH were 2.55 (1.23-5.31) and 3.92 (1.70-9.02), respectively. There was a linear relationship between an improvement in CVH status and a reduction in all-cause mortality risk (P-overall < 0.0001, P-nonlinear = 0.7989). Improved CVH health behaviors had a more significant protective effect on patients with prediabetes than did the improvement in CVH health indicators.
CONCLUSION High CVH status (as quantified by the LE8 score) is significantly associated with reduced mortality risk in prediabetic adults in the United States.
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Affiliation(s)
- Ao-Miao Chen
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Qiu-Yu He
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Yi-Chuan Wu
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- School of Stomatology, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Jia-Qi Chen
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Xiao-Qin Ma
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Ling-Yuan Hu
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Ge-Ning-Yue Wang
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- School of Stomatology, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Zhuo-Tong Wang
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Zhi-Yong Wu
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- College of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Zong-Ji Zheng
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Yi-Jie Jia
- Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- De Feng Academy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
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de Souza MC, Agneis MLG, das Neves KA, de Almeida MR, Feltran GDS, Souza Cruz EM, Schoffen JPF, Chuffa LGDA, Seiva FRF. Melatonin Improves Lipid Homeostasis, Mitochondrial Biogenesis, and Antioxidant Defenses in the Liver of Prediabetic Rats. Int J Mol Sci 2025; 26:4652. [PMID: 40429795 PMCID: PMC12111231 DOI: 10.3390/ijms26104652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 04/25/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025] Open
Abstract
Type 2 diabetes mellitus represents a major global health burden and is often preceded by a prediabetic state characterized by insulin resistance and metabolic dysfunction. Mitochondrial alterations, oxidative stress, and disturbances in lipid metabolism are central to the prediabetes pathophysiology. Melatonin, a pleiotropic indolamine, is known to regulate metabolic and mitochondrial processes; however, its therapeutic potential in prediabetes remains poorly understood. This study investigated the effects of melatonin on energy metabolism, oxidative stress, and mitochondrial function in a rat model of prediabetes induced by chronic sucrose intake and low-dose streptozotocin administration. Following prediabetes induction, animals were treated with melatonin (20 mg/kg) for four weeks. Biochemical analyses were conducted to evaluate glucose and lipid metabolism, and mitochondrial function was assessed via gene expression, enzymatic activity, and oxidative stress markers. Additionally, hepatic mitochondrial dynamics were examined by quantifying key regulators genes associated with biogenesis, fusion, and fission. Prediabetic animals exhibited dyslipidemia, hepatic lipid accumulation, increased fat depots, and impaired glucose metabolism. Melatonin significantly reduced serum glucose, triglycerides, and total cholesterol levels, while enhancing the hepatic high-density lipoprotein content. It also stimulated β-oxidation by upregulating hydroxyacyl-CoA dehydrogenase and citrate synthase activity. Mitochondrial dysfunction in prediabetic animals was evidenced by the reduced expression of peroxisome proliferator-activated receptor gamma coactivator-1 alpha and mitochondrial transcription factor A, both of which were markedly upregulated by melatonin. The indolamine also modulated mithocondrial dynamics by regulating fusion and fission markers, including mitosuin 1 and 2, optic atrophy protein, and dynamin-related protein. Additionally, melatonin mitigated oxidative stress by enhancing the activity of superoxide dismutase and catalase while reducing lipid peroxidation. These findings highlight melatonin's protective role in prediabetes by improving lipid and energy metabolism, alleviating oxidative stress, and restoring mitochondrial homeostasis. This study provides novel insights into the therapeutic potential of melatonin in addressing metabolic disorders, particularly in mitigating mitochondrial dysfunction associated with prediabetes.
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Affiliation(s)
- Milena Cremer de Souza
- Department of Parasitology, Immunology and General Pathology, State University of Londrina (UEL), Londrina 86057-970, Paraná, Brazil
- Department of Chemistry and Biochemistry, São Paulo State University (UNESP), Botucatu 18618-693, São Paulo, Brazil
| | - Maria Luisa Gonçalves Agneis
- Department of Chemistry and Biochemistry, São Paulo State University (UNESP), Botucatu 18618-693, São Paulo, Brazil
| | - Karoliny Alves das Neves
- Department of Chemistry and Biochemistry, São Paulo State University (UNESP), Botucatu 18618-693, São Paulo, Brazil
| | - Matheus Ribas de Almeida
- Department of Chemistry and Biochemistry, São Paulo State University (UNESP), Botucatu 18618-693, São Paulo, Brazil
| | - Geórgia da Silva Feltran
- Department of Chemistry and Biochemistry, São Paulo State University (UNESP), Botucatu 18618-693, São Paulo, Brazil
| | - Ellen Mayara Souza Cruz
- Department of Parasitology, Immunology and General Pathology, State University of Londrina (UEL), Londrina 86057-970, Paraná, Brazil
| | - João Paulo Ferreira Schoffen
- Center of Biological Sciences, State University of Northern Paraná (UENP), Bandeirantes 86360-000, Paraná, Brazil
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21
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Nie C, Ma Q, Liu C, Chen L, Wang C, Hou X. Associations of serum uric acid to eGFR ratio with diabetic retinopathy in individuals with type 2 diabetes. Sci Rep 2025; 15:16625. [PMID: 40360591 PMCID: PMC12075814 DOI: 10.1038/s41598-025-00765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 04/30/2025] [Indexed: 05/15/2025] Open
Abstract
Serum uric acid (SUA) is closely associated with diabetes and its complications. The relationship between SUA and diabetic retinopathy (DR) remains unclear, with conflicting results from current studies on SUA in DR Patients. Since uric acid is primarily excreted by the kidneys, the ratio of SUA to eGFR (SUA/eGFR) serves as a renal function-corrected indicator of SUA levels. We tested whether SUA/eGFR might be involved in the pathogenesis and progression of DR. We collected data from 1,399 patients with type 2 diabetes mellitus (T2DM) who were hospitalized between January 2023 and April 2024. They were divided into diabetes without DR (nondiabetic retinopathy, NDR) group (N = 438), non-proliferative diabetic retinopathy (NPDR) group (N = 902) and proliferative diabetic retinopathy (PDR) group (N = 59). Univariate and multivariate logistic regression analyses were used to analyze the relationship between SUA/eGFR and DR and its severity. The SUA/eGFR levels increased with the severity of DR (P<0.05). In the multinomial logistic regression model using patients without DR as the reference, SUA/eGFR was significantly linked with PDR (OR = 1.07, 95%CI 1.00-1.14; P = 0.036), while NPDR group showed no significant difference (P>0.05). In T2DM patients younger than 60 years, SUA/eGFR was positively associated with an increased risk of DR (OR = 1.20, 95%CI 1.05-1.38, P = 0.01). Among T2DM patients with HbA1c > 7%, higher SUA/eGFR levels were linked to a greater risk of DR(OR = 1.10, 95%CI 1.00-1.20, P = 0.045). Stratified analysis by age showed that in T2DM patients younger than 60 years, SUA/eGFR was positively correlated with the severity of DR (NPDR:OR = 1.20, 95%CI 1.04-1.38, P = 0.01; PDR: OR = 1.20, 95%CI 1.04-1.38, P = 0.012). Additionally, stratified analysis by HbA1c levels indicated that among T2DM patients with HbA1c > 7%, those with higher SUA/eGFR levels had an increased risk of DR severity (NPDR:OR = 1.09, 95%CI 1.00-1.19, P = 0.049; PDR: OR = 1.10, 95%CI 1.01-1.20, P = 0.037). Our study reported a positive association between SUA/eGFR and DR and its severity in younger T2DM patients with poorly controlled blood glucose levels. T2DM patients with higher SUA levels had an increased risk of more severe DR (progressing from NPDR to PDR). However, more prospective and high-quality clinical evidence is needed to confirm these current findings.
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Affiliation(s)
- Chenyu Nie
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China
| | - Qiaofeng Ma
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China
| | - Chunyao Liu
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China
| | - Li Chen
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China
| | - Chuan Wang
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China.
| | - Xinguo Hou
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
- Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering research center for advanced Technologies in Prevention and Treatment of Chronic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, Shandong, China.
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22
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Yu L, Liu Y, Guo R, Yang T, Pan G, He Y, Gao S, Yang R, Li Z, Li L, Yu C. The metabolic syndrome-insulin resistance index: a tool for identifying dyslipidemia across varied glucose metabolic score in patients with cardiovascular disease. Front Endocrinol (Lausanne) 2025; 16:1473308. [PMID: 40421238 PMCID: PMC12104048 DOI: 10.3389/fendo.2025.1473308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 04/15/2025] [Indexed: 05/28/2025] Open
Abstract
Purpose The METS-IR index, a non-insulin-based metabolic score, represents a new marker closely linked to insulin resistance. This study aimed to evaluate the relationship between the METS-IR index and dyslipidemia in individuals diagnosed with Cardiovascular disease (CVD), as well as to delve deeper into how varying glucose metabolic conditions influence this relationship. Methods This multicenter retrospective investigation encompassed 214,717 individuals diagnosed with CVD across China, spanning from September 1, 2014, to June 1, 2022, ultimately incorporating 17,632 cases in the conclusive analysis. All cases were grouped according to quartiles of METS-IR. The American College of Cardiology classifies dyslipidemia into four distinct categories: hyper-triglyceridemia (hyper-TG), hyper-cholesterolemia (hyper-TC), hypo-high-density lipoprotein cholesterolemia (hypo-HDL), and hyper-low-density lipoprotein cholesterolemia (hyper-LDL). Dyslipidemia is diagnosed when any one of these conditions is present. Logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI), assessing the relationship between the METS-IR index and dyslipidemia risk in patients with CVD. To evaluate the precision of the METS-IR index in identifying dyslipidemia, receiver operating characteristic (ROC) curve was produced. Results The results of the baseline analysis showed that 11,934 cases had dyslipidemia, with notable variations observed in the clinical and biological attributes among CVD cases (P < 0.05 to < 0.001). Logistic regression analysis showed that the METS-IR index was significantly associated with the risk of dyslipidemia (odds ratio [OR]: 1.14; 95% confidence interval [CI] 1.13-1.15; P < 0.001). The OR for dyslipidemia in Q4 of the METS-IR index was 11.94 (95% CI 10.60-13.45; p < 0.001) compared to Q1. ROC analysis revealing an area under the curve (AUC) of 0.747 (95% CI 0.739-0.754; P < 0.001). The association between the METS-IR index and dyslipidemia proved significant across all glycemic status groups, with the highest OR observed in the Q4 subgroup of cases with NGR (OR: 15.43; 95% CI 12.21-19.49). Conclusion The risk of developing dyslipidemia is positively associated with heightened METS-IR levels in individuals afflicted with CVD, and these relationships hold significance across all glycemic metabolic conditions. METS-IR could potentially aid in forecasting the risk of dyslipidemia development in individuals diagnosed with CVD.
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Affiliation(s)
- Lu Yu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yutong Liu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ruiying Guo
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tong Yang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guangwei Pan
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuanyuan He
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shan Gao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongrong Yang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhu Li
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lin Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunquan Yu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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23
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Chauhan S, Khatib MN, Ballal S, Bansal P, Bhopte K, Gaidhane AM, Tomar BS, Ashraf A, Kumar MR, Chauhan AS, Shabil M, Jena D, Bushi G, Satapathy P, Jain L, Jaiswal V, Pant M. The rising burden of diabetes and state-wise variations in India: insights from the Global Burden of Disease Study 1990-2021 and projections to 2031. Front Endocrinol (Lausanne) 2025; 16:1505143. [PMID: 40421244 PMCID: PMC12104079 DOI: 10.3389/fendo.2025.1505143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Accepted: 04/09/2025] [Indexed: 05/28/2025] Open
Abstract
Background Diabetes is a major public health concern in India, contributing significantly to morbidity and mortality. With variations in disease burden across states, a detailed understanding of trends in incidence, prevalence, and Disability Adjusted Life Years (DALYs) is essential for targeted interventions. Methods This study utilized Global Burden of Disease (GBD) data from 1990 to 2021 to examine trends in diabetes across Indian states. Age-standardized incidence, prevalence, mortality, and DALYs were analyzed using Join point regression to estimate Annual Percentage Change (APC). Autoregressive Integrated Moving Average (ARIMA) models were employed to project diabetes trends up to 2031.While the GBD data provide robust national and regional estimates, their modeled nature may not capture the full spectrum of local epidemiological variations. Results Diabetes incidence increased from 162.74 to 264.53 per 100,000 between 1990 and 2021, with an APC of 0.63%. Joinpoint analysis identified episodic surges in incidence, with APCs of 2.25% during 1996-1999 and 2.07% during 2005-2011, suggesting intervals of accelerated increase relative to the gradual progression typically observed in chronic conditions. Mortality rose from 23.09 to 31.12 per 100,000 (APC: 0.12%). Southern and Western states, such as Tamil Nadu and Goa, exhibited the highest prevalence and DALYs. Forecasted trends indicate that by 2031, the prevalence will reach 8585.45 per 100,000, and DALYs will exceed 1241.57 per 100,000. Conclusion The burden of diabetes in India has risen markedly over the past three decades. These findings underscore the urgent need for health policies that emphasize lifestyle modifications and improved healthcare access. A comprehensive approach that integrates primary prevention through community-based health education, dietary counseling, and initiatives to promote physical activity with secondary prevention measures such as systematic screening and timely clinical management, is essential for effective diabetes control and management in high-burden states.
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Affiliation(s)
- Shubham Chauhan
- Evidence for Policy and Learning, Global Center for Evidence Synthesis, Chandigarh, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Suhas Ballal
- Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
| | - Pooja Bansal
- Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan, India
| | - Kiran Bhopte
- Infotech Education Society (IES) Institute of Pharmacy, IES University, Bhopal, Madhya Pradesh, India
| | - Abhay M. Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Balvir S. Tomar
- Institute of Pediatric Gastroenterology and Hepatology, National Institute of Medical Sciences University, Jaipur, India
| | - Ayash Ashraf
- Chandigarh Pharmacy College, Chandigarh Group of College, Mohali, Punjab, India
| | - M. Ravi Kumar
- Department of Chemistry, Raghu Engineering College, Visakhapatnam, Andhra Pradesh, India
| | - Ashish Singh Chauhan
- Division of Research and Innovation, Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Muhammed Shabil
- University Center for Research and Development, Chandigarh University, Mohali, Punjab, India
| | - Diptismita Jena
- Department of Computer Science and Engineering, Graphic Era (Deemed to be University), Dehradun, India
| | - Ganesh Bushi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | - Prakasini Satapathy
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, Iraq
| | - Lara Jain
- Department of Dentistry, Graphic Era (Deemed to be University), Dehradun, India
| | - Vaibhav Jaiswal
- Department of Dentistry, Graphic Era (Deemed to be University), Dehradun, India
| | - Manvi Pant
- New Delhi Institute of Management, Delhi, India
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24
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Aboutorabi R, Hariri G, Bakhshi A, Alizadeh M, Mehrad-Majd H. Association between serum spexin levels and diabetic nephropathy in patients with type 2 diabetes: a cross-sectional study. Int Urol Nephrol 2025:10.1007/s11255-025-04556-5. [PMID: 40348896 DOI: 10.1007/s11255-025-04556-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Accepted: 04/26/2025] [Indexed: 05/14/2025]
Abstract
BACKGROUND Diabetic nephropathy (DN) is a serious complication of diabetes, with a high prevalence ranging from 21.8% in China, 35.3% in African countries, and an overall prevalence of 20-40% worldwide. This study investigated serum spexin levels in patients with type 2 diabetes, comparing those with and without DN, and explored its association with metabolic parameters. METHODS This cross-sectional study was conducted among patients with type-2 diabetes according to ADA guidelines. After obtaining informed consent, urine albumin-to-creatinine-ratio (ACR) was determined and patients were categorized into two groups: with-nephropathy (ACR ≥ 30) and without-nephropathy (ACR < 30). The correlation between spexin and demographic, anthropometric, and biochemical variables was further determined. Logistic regression analysis was used to assess the relationship between spexin and the likelihood of DN. Receiver Operating Characteristic (ROC) curve analysis determined the optimal serum spexin cutoff for distinguishing between groups. RESULTS A total of 97 diabetic individuals (33 with DN, 64 without) participated in the study. Serum spexin was significantly lower in patients with DN compared to those without DN (p < 0.001). Spexin concentrations showed an inverse correlation with LDL and ACR levels. Lower spexin levels were associated with a reduced likelihood of DN (OR 0.46, 95% CI 0.31-0.69; p < 0.001). ROC curve analysis identified a cutoff value of 81.10 ng/ml, with an area under the curve of 0.986, demonstrating 95.3% sensitivity and 94.1% specificity for diagnosing DN. CONCLUSION Lower serum spexin levels are associated with impaired kidney function, indicating its potential as a predictive biomarker for diabetic nephropathy. However, further validation in larger and more diverse cohorts is needed to address limitations such as sample size and unmeasured confounders.
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Affiliation(s)
- Robab Aboutorabi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Golrokh Hariri
- Department of Internal Medicine, School of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Aida Bakhshi
- Clinical Research Development Center, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Alizadeh
- Blood Borne Infectious Research Center, Academic Center for Education, Culture, and Research, Mashhad, Razavi Khorasan, Iran
| | - Hassan Mehrad-Majd
- Clinical Research Development Center, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
- Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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25
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El-Haddad AE, El-Khalik SMA, Abdel-Hafez LJM, Zaki JT, Gabr NM. Impact of microbial biotransformation on Zygophyllum decumbens delile through comparative metabolic insights and evaluation of antihyperglycemic and antimicrobial activities. Sci Rep 2025; 15:16244. [PMID: 40346366 PMCID: PMC12064765 DOI: 10.1038/s41598-025-99590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Accepted: 04/21/2025] [Indexed: 05/11/2025] Open
Abstract
Zygophyllum is known to be used traditionally in the management of several medical conditions, including diabetes, infections, and hypertension. This study aims to monitor the effect of microbial biotransformation on both antihyperglycemic and antimicrobial activities of Zygophyllum decumbens Delile using Aspergillus niger. The metabolic profile before and after biotransformation of the ethyl acetate extract was compared using HPLC-ESI-TOF-MS/MS. Pancreatic lipase, α-amylase, and α-glucosidase in vitro inhibition assays and agar diffusion method were used to evaluate the antihyperglycemic and antimicrobial activities, respectively. Eighty-six metabolites, mainly flavonoids and phenolic acids, with a few miscellaneous metabolites, were tentatively identified in both tested extracts. A 36% potentiation in antihyperglycemic activity was observed following microbial biotransformation. Regarding antimicrobial activity, the minimum inhibitory concentration (MIC) against both E. coli and P. aeruginosa decreased from 0.62 to 0.31 mg/ml, representing a nearly 50% reduction. It was noticed that microbial biotransformation altered 27 of the identified metabolites, which may contribute to the enhanced biological activities detected. The study depicts the first report of metabolic profiles and biological differences of Z. decumbens before and after biotransformation. It also validates the traditional use of Z. decumbens for hyperglycemia and its potential as a natural antimicrobial source.
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Affiliation(s)
- Alaadin E El-Haddad
- Pharmacognosy Department, Faculty of Pharmacy, October 6 University, Giza, 12585, Egypt
| | - Soad M Abd El-Khalik
- Pharmacognosy Department, Faculty of Pharmacy, Helwan University, Cairo, 11795, Egypt
| | - Lina J M Abdel-Hafez
- Microbiology & Immunology Department, Faculty of Pharmacy, October 6 University, Giza, 12585, Egypt
| | - Jaky T Zaki
- Pharmacognosy Department, Faculty of Pharmacy, October 6 University, Giza, 12585, Egypt
- Pharmacognosy Department, Faculty of Pharmacy, Helwan University, Cairo, 11795, Egypt
| | - Nagwan M Gabr
- Pharmacognosy Department, Faculty of Pharmacy, Helwan University, Cairo, 11795, Egypt.
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Wang F, Guo Y, Tang Y, Zhao S, Xuan K, Mao Z, Lu R, Hou R, Zhu X. Combined assessment of stress hyperglycemia ratio and glycemic variability to predict all-cause mortality in critically ill patients with atherosclerotic cardiovascular diseases across different glucose metabolic states: an observational cohort study with machine learning. Cardiovasc Diabetol 2025; 24:199. [PMID: 40346649 PMCID: PMC12065353 DOI: 10.1186/s12933-025-02762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Accepted: 04/28/2025] [Indexed: 05/11/2025] Open
Abstract
BACKGROUND Stress hyperglycemia ratio (SHR) and glycemic variability (GV) reflect acute glucose elevation and fluctuations, which correlate with adverse outcomes in patients with atherosclerotic cardiovascular disease (ASCVD). However, the prognostic significance of combined SHR-GV evaluation for ASCVD mortality remains unclear. This study examines associations of SHR, GV, and their synergistic effects with mortality in patients with ASCVD across different glucose metabolic states, incorporating machine learning (ML) to identify critical risk factors influencing mortality. METHODS Patients with ASCVD were screened in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and stratified into normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM) groups based on glucose metabolic status. The primary endpoint was 28-day mortality, with 90-day mortality as the secondary outcome. SHR and GV levels were categorized into tertiles. Associations with mortality were analyzed using Kaplan-Meier(KM) curves, Cox proportional hazards models, restricted cubic splines (RCS), receiver operating characteristic (ROC) curves, landmark analyses, and subgroup analyses. Five ML algorithms were employed for mortality risk prediction, with SHapley Additive exPlanations (SHAP) applied to identify critical predictors. RESULTS A total of 2807 patients were included, with a median age of 71 years, and 58.78% were male. Overall, 483 (23.14%) and 608 (29.13%) patients died within 28 and 90 days of ICU admission, respectively. In NGR and Pre-DM subgroups, combined SHR-GV assessment demonstrated superior predictive performance for 28-day mortality versus SHR alone [NGR: AUC 0.688 (0.636-0.739) vs. 0.623 (0.568-0.679), P = 0.028; Pre-DM: 0.712 (0.659-0.764) vs. 0.639 (0.582-0.696), P = 0.102] and GV alone [NGR: 0.688 vs. 0.578 (0.524-0.633), P < 0.001; Pre-DM: 0.712 vs. 0.593 (0.524-0.652), P < 0.001]. Consistent findings were observed for 90-day mortality prediction. However, in the DM subgroup, combined assessment improved prediction only for 90-day mortality vs. SHR alone [AUC 0.578 (0.541-0.616) vs. 0.560 (0.520-0.599), P = 0.027], without significant advantages in other comparisons. CONCLUSIONS Combined SHR and GV assessment serves as a critical prognostic tool for ASCVD mortality, providing enhanced predictive accuracy compared to individual metrics, particularly in NGR and Pre-DM patients. This integrated approach could inform personalized glycemic management strategies, potentially improving clinical outcomes.
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Affiliation(s)
- Fuxu Wang
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Guo
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuru Tang
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shuangmei Zhao
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Kaige Xuan
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhi Mao
- Department of Critical Care Medicine, The First Medical Center of PLA General Hospital, Beijing, China
| | - Ruogu Lu
- Medical Innovation Research Department, Chinese PLA General Hospital, Beijing, China.
| | - Rongyao Hou
- Department of Neurology, The Affiliated Hiser Hospital of Qingdao University, Qingdao, China.
| | - Xiaoyan Zhu
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Li Y, Gu S, Mo Z, Li X, Jiang Y, Liu C, Guo F, Mao G, Wang Y, Huang X, Li H, Chen Z, Wang X, Lou X. Trajectories of Maternal Urinary Iodine Concentration Are Associated With Gestational Diabetes Mellitus. Clin Endocrinol (Oxf) 2025; 102:517-525. [PMID: 39829219 DOI: 10.1111/cen.15197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 12/26/2024] [Accepted: 12/27/2024] [Indexed: 01/22/2025]
Abstract
OBJECTIVES The relationship between iodine status and gestational diabetes mellitus (GDM) is inconclusive. This study aimed to explore the trajectories of urinary iodine concentrations (UIC) in pregnant women before GDM diagnosis and to assess the associations between maternal UIC trajectories and the risk of developing GDM. METHODS A prospective cohort study was conducted in China. Data from 1076 pregnant women who were recruited between August 2019 and December 2021 were analyzed. GDM screening was performed at the 28th week of pregnancy. Arsenic and cerium catalysis spectrophotometry was used to measure UIC. The latent class model was used to identify distinct UIC trajectories in pregnant women, using multiple urine specimens. We evaluated the association of UIC trajectories with the risk of GDM by logistic regression analysis. RESULTS Three maternal UIC trajectories were identified: (1) high-stable trajectory (72.12%), (2) high-decreasing trajectory (3.07%), and (3) low-stable trajectory (24.81%). Compared with the pregnant women in high-stable trajectory group, women in the low-stable UIC trajectory group showed an increased risk of GDM before adjustment of covariates (OR: 1.58, 95% CI: 1.08-2.27). After adjusting for different covariates, a statistically significant association was observed only between low-stable trajectory trajectories and GDM. CONCLUSIONS This study highlights a relationship between UIC and the risk of GDM. To better prevent iodine deficiency and GDM, persistent sufficient iodine status from pregnancy to delivery, should be emphasized.
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Affiliation(s)
- Yahui Li
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Simeng Gu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Zhe Mo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xueqing Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yujie Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Chenyang Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Fanjia Guo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Guangming Mao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyang Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xuemin Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Hong Li
- Zhejiang Salt Industry Group Co., Ltd, Hangzhou, Zhejiang, China
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaoming Lou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Oksen D, Aslan M, Yavuz YE, Kaynak C, Tekin EE. Early detection of ventricular dysfunction in LADA using novel tissue Doppler parameters: A case-control study. Diab Vasc Dis Res 2025; 22:14791641251346268. [PMID: 40411336 PMCID: PMC12103687 DOI: 10.1177/14791641251346268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 04/24/2025] [Accepted: 05/11/2025] [Indexed: 05/26/2025] Open
Abstract
Introduction & ObjectiveLatent autoimmune diabetes mellitus (LADA), a heterogeneous disease, is much more common in society than thought. Although it has been claimed that LADA is similar to type 2 diabetes mellitus (T2DM) from a cardiovascular perspective, there is no clear consensus. In this context, the objective of this study is to assess subclinical dysfunction in the left and right ventricles in patients with LADA using novel tissue Doppler imaging (TDI) parameters.Materials &MethodsThe sample of this observational case-control study consisted of 57 consecutive patients aged between 30 and 70 years who applied to the endocrinology and metabolism outpatient clinics, were diagnosed with LADA, and were referred to the cardiology clinic for echocardiographic (ECHO) evaluation. The control group consisted of 60 healthy volunteers. Participants' demographic and clinical characteristics and laboratory findings were recorded. All participants underwent ECHO using conventional ECHO and TDI. Subclinical left ventricular dysfunction was assessed using the myocardial performance index (MPI) and isovolumic myocardial acceleration (IVA).ResultsThere were no significant differences between the patient and control groups in terms of conventional ECHO parameters. The left ventricular (LV) MPI was significantly higher in the patient group than in the control group (0.54 ± 0.11 vs 0.47 ± 0.07, p = 0.008). There was no significant difference between the groups in right ventricular (RV) MPI (0.49 ± 0.10 vs 0.46 ± 0.70, p = 0.217). IVA was decreased in both ventricles (IVA mitral: 3.03 ± 1.44 vs 3.78 ± 1.66, p = 0.008 and IVA tricuspid: 2.67 ± 0.88 vs 3.42 ± 0.97, p = 0.034). Both LV IVA and RV IVA were found to be significantly correlated with glutamic acid decarboxylase antibodies' (GADA) levels in the negative direction (R = -0.290, p = 0.005 and R = -0.340, p = 0.001).ConclusionsIt was observed that LADA negatively affected the systolic and diastolic functions of both ventricles, with its effect being more pronounced in the left ventricle. Glycemic control and autoantibody titers were found to be correlated with TDI parameters, emphasizing their relevance in assessing cardiac dysfunction.
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Affiliation(s)
- Dogac Oksen
- Department of Cardiology, Altinbas University, Istanbul, Turkey
| | - Muzaffer Aslan
- Department of Cardiology, Siirt University, Siirt, Turkey
| | | | - Cagdas Kaynak
- Department of Cardiology, Siirt University, Siirt, Turkey
| | - Esra Erturk Tekin
- Department of Cardiovascular Surgery, Mersin City Hospital, The Health Science University, Mersin, Turkey
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Sánchez-Cardona Y, Cuartas-Gómez E, Echeverri-Cuartas CE, Arévalo-Enríquez K, Londoño López ME, Moreno-Castellanos N. Effects of neutralization and functionalization on chitosan/gelatin/polyvinyl alcohol scaffolds in insulin-producing cell culture. Int J Biol Macromol 2025; 305:140800. [PMID: 39924037 DOI: 10.1016/j.ijbiomac.2025.140800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 01/24/2025] [Accepted: 02/06/2025] [Indexed: 02/11/2025]
Abstract
Diabetes is a disease that affects the patient's quality of life. Although there are several studies of therapeutic alternatives, there is still no definitive cure. Polymeric scaffolds represent a promising therapeutic strategy to preserve cell mass through 3D cultures. The aim of this study is to explore an alternative polymeric scaffold based on a mix of chitosan (Chi), gelatin (Ge), and polyvinyl alcohol (PVA) functionalized with VEGF for the culture of insulin-producing cells. The scaffolds were obtained by freeze-thaw cycles and lyophilization, followed by neutralization and, functionalization with vascular endothelial growth factor (VEGF). Physicochemical characteristics, biocompatibility and functionality were evaluated. Scaffolds obtained had interconnected heterogeneous pores. The presence of functional groups confirmed the integration of all the components without significantly losing thermal stability and mass. The functionalized and neutralized scaffolds positively impacted the biocompatibility and insulin secretion. Cell respiration was sustained, and cell morphology demonstrated the formation of cell clusters. It can be concluded that neutralization and functionalization of the scaffolds combined with VEGF are necessary to improve biocompatibility and functionality. Moreover, all these characteristics generated encouraging results on the diffusion of nutrients and cell adhesion, which could be valuable in the translational application for diabetes treatment.
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Affiliation(s)
- Yesenia Sánchez-Cardona
- Grupo de Investigación en Ingeniería Biomédica EIA (GIBEC), Programa de Ingeniería Biomédica, Escuela de Ciencias de la Vida, Universidad EIA, km 2 + 200 Vía al Aeropuerto José María Córdova, Envigado 055428, Colombia
| | - Elías Cuartas-Gómez
- CICTA Research Group, Department of Basic Sciences, Medicine School, Health Faculty, Universidad Industrial de Santander, Cra 27 calle 9, Bucaramanga 680002, Colombia
| | - Claudia E Echeverri-Cuartas
- Grupo de Investigación en Ingeniería Biomédica EIA (GIBEC), Programa de Ingeniería Biomédica, Escuela de Ciencias de la Vida, Universidad EIA, km 2 + 200 Vía al Aeropuerto José María Córdova, Envigado 055428, Colombia
| | - Karol Arévalo-Enríquez
- Grupo de Investigación en Ingeniería Biomédica EIA (GIBEC), Programa de Ingeniería Biomédica, Escuela de Ciencias de la Vida, Universidad EIA, km 2 + 200 Vía al Aeropuerto José María Córdova, Envigado 055428, Colombia
| | - Marta E Londoño López
- Grupo de Investigación en Ingeniería Biomédica EIA (GIBEC), Programa de Ingeniería Biomédica, Escuela de Ciencias de la Vida, Universidad EIA, km 2 + 200 Vía al Aeropuerto José María Córdova, Envigado 055428, Colombia
| | - Natalia Moreno-Castellanos
- CICTA Research Group, Department of Basic Sciences, Medicine School, Health Faculty, Universidad Industrial de Santander, Cra 27 calle 9, Bucaramanga 680002, Colombia.
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Plengvidhya N, Suthon S, Nakdontri T, Teerawattanapong N, Ingnang S, Tangjittipokin W. Islet autoantibodies in Thai individuals diagnosed with type 1 diabetes before 30 years of age: a large multicentre nationwide study. Diabetologia 2025; 68:961-968. [PMID: 39971754 PMCID: PMC12021985 DOI: 10.1007/s00125-025-06373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 01/07/2025] [Indexed: 02/21/2025]
Abstract
AIMS/HYPOTHESIS Type 1 diabetes is categorised into autoantibody positive and autoantibody negative. Most type 1 diabetes research has focused on European populations, leaving a gap in understanding in relation to other ethnic groups, including Thai populations. This lack of data is significant given Thailand's poor prevention and therapeutic management strategies. We aimed to investigate the frequency and distribution of islet autoantibodies among Thai individuals with long-standing type 1 diabetes diagnosed before the age of 30 years. METHODS We conducted a nationwide population-based study involving 48 hospitals in Thailand from May 2020 to September 2023, enrolling 953 participants. Demographic and clinical characteristics of individuals with autoantibody-positive and -negative type 1 diabetes were analysed. The autoantibodies GAD65, IA-2 and ZnT8 were measured using ELISA. A random C-peptide level was detected by electrochemiluminescence immunoassay. RESULTS Thai individuals with autoantibody-negative type 1 diabetes comprised 34.2% of the population. Among all individuals, the frequency of GAD65, IA-2 and ZnT8 was 56%, 37% and 33%, respectively. Autoantibody-negative individuals with type 1 diabetes were older at diagnosis, had higher BMI and had higher random C-peptide levels compared with autoantibody-positive individuals with type 1 diabetes. Female individuals had a higher prevalence of type 1 diabetes than male individuals (58% vs 42%; p=1.531 × 10-5). The southern region of Thailand exhibited a distinct pattern of autoantibody frequency compared with other regions (p=0.0001561). CONCLUSIONS/INTERPRETATION The frequency, distribution and characteristics of autoantibody-positive and -negative long-standing type 1 diabetes in Thailand showed uniqueness from other populations. This provides insight into the disease that may have implications for type 1 diabetes prediction, treatment and pathogenesis, especially in the Southeast Asian population.
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Affiliation(s)
- Nattachet Plengvidhya
- Division of Endocrinology and Metabolism, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sarocha Suthon
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence Management, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tassanee Nakdontri
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence Management, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nipaporn Teerawattanapong
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Saranya Ingnang
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence Management, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Watip Tangjittipokin
- Siriraj Center of Research Excellence for Diabetes and Obesity, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Topcu O, Sendur SN, D'Alessandro HD, Batuk MO, Sennaroglu G. Temporal Sensitivity in Patients With Type 1 Diabetes Mellitus and Insights Into Their Everyday Auditory Performance. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2025:1-14. [PMID: 40299762 DOI: 10.1044/2025_jslhr-24-00554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2025]
Abstract
PURPOSE This study aimed to investigate the effects of Type 1 diabetes mellitus (T1DM) on low-frequency (LF) pitch and speech-in-noise perception linked to temporal sensitivity and everyday auditory performance. The relationships between these outcomes and potential confounders, such as diabetes duration, glycemic control, and neuropathy, were also examined. METHOD The participants consisted of 18 young patients with T1DM. They were matched with 18 healthy controls based on age, gender, and audiometric thresholds (up to 20 kHz). Measurements included behavioral measures of temporal sensitivity using the low-pass-filtered Word Stress Pattern (WSP-LPF) test and the Hearing in Noise Test (HINT), as well as self-reported measure using the Speech, Spatial and Qualities of Hearing Scale. RESULTS Patients with T1DM showed significantly poorer performance on both the WSP-LPF (p < .001), and HINT (p = .004) tests compared to healthy controls. Specifically, patients with T1DM showed impaired perception of lexical stress cued by LF pitch and required higher signal-to-noise ratios to effectively perceive speech in complex listening situations. Self-report measures indicated reduced hearing satisfaction in patients with T1DM (p = .001). Statistically significant correlations were found between WSP-LPF and diabetes duration (p = .021). CONCLUSIONS The present findings reveal that T1DM negatively affects the perception of lexical stress and speech-in-noise performance, reflecting disruptions in temporal sensitivity. These impairments are present even in patients with normal audiometric thresholds, and addressing these deficits may be crucial for improving auditory function and developing targeted interventions.
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Affiliation(s)
- Ozlem Topcu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
- Department of Electrical and Electronics Engineering, Middle East Technical University, Ankara, Turkey
- METU MEMS Research and Applications Center, Ankara, Turkey
| | - Süleyman Nahit Sendur
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Merve Ozbal Batuk
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Malpeli A, Stallings V, Sala M, Fasano MV, Varea A, Disalvo L, Matamoros N, Tournier A, Gonzalez HF. Influence of excess weight on metabolic risk factors in Argentinian preschool children. J Pediatr Endocrinol Metab 2025; 38:351-358. [PMID: 39953719 DOI: 10.1515/jpem-2024-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 01/17/2025] [Indexed: 02/17/2025]
Abstract
OBJECTIVES Evaluate the differences in metabolic risk factors in preschool children with normal weight (NWG) or with some degree of excess weight (OWG). METHODS Body mass index (BMI), umbilical waist circumference (WC), mid-upper arm circumference (MUAC) and total body fat (TBF) in children aged 1-5.9 years. The following metabolic risk factors were measured: blood pressure, fasting glycaemia, fasting serum insulin, HOMA IR Index, total cholesterol (TC), LDL cholesterol (LDL-C) HDL cholesterol (HDL-C) and triacylglycerol (TG). RESULTS In population evaluated (n=689) MUAC, WC, TBF, HOMA IR were higher in OWG compared to NWG and significantly higher in OWG girls compared to boys (two ways ANOVA). Positive associations were found between diastolic blood pressure, insulin and HOMA-IR and WC, MUAC, TBF, BMI z score in the adjusted and unadjusted model. CONCLUSIONS MUAC may emerge as an indicator with predictive power for metabolic risk and would be very useful to measure in many setting. There is a need for in-depth research into sex difference.
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Affiliation(s)
- Agustina Malpeli
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
| | | | - Marisa Sala
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
| | - María Victoria Fasano
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
- Centro de Matemática de La Plata (CMaLP), Facultad de Ciencias Exactas, Universidad Nacional La Plata (UNLP) - CIC-PBA, La Plata, Buenos Aires, Argentina
| | - Ana Varea
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
| | - Liliana Disalvo
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
| | - Natalia Matamoros
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
| | - Andrea Tournier
- Laboratorio Central, HIAEP "Sor María Ludovica" de La Plata, La Plata, Argentina
| | - Horacio F Gonzalez
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), HIAEP "Sor María Ludovica" de La Plata - Comisión de Investigaciones Científicas de La Provincia de Buenos Aires (CIC-PBA), La Plata, Buenos Aires, Argentina
- Cátedra de posgrado de nutrición humana- Facultad de Ciencias Médicas- UNLP- La Plata, Argentina
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Hussain HR, Ahmed N, Akram MW, Gulzar F, Khan JA, Asad M, Tahseen S, Ahmed T, Malik A, Akhtar S, Shahid A, Noor M, Pervaiz M, Rahman MU. Fear of hypoglycemia: a key predictor of sleep quality among the diabetic population. Front Endocrinol (Lausanne) 2025; 16:1456641. [PMID: 40357213 PMCID: PMC12066330 DOI: 10.3389/fendo.2025.1456641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 03/27/2025] [Indexed: 05/15/2025] Open
Abstract
Introduction Every one in seven people with Type-I or Type-II diabetes suffers from fear of hypoglycemia (FOH). Its impact on quality of life, glycemic control, and health outcomes is well studied. However, its relationship with sleep quality remains underexplored, particularly in developing societies. We hypothesize that FOH is a key predictor of sleep quality in Type-I and Type-II patients with diabetes and, therefore, needs detailed investigation. Methods A multicentric study was conducted across five cities and six centers of Punjab. Data from 310 diabetes patients were analyzed using the Hypoglycemia Fear Survey-II (HFS-II) Scale and the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses explored subgroup variations, correlations, regression models, and receiver operator curve (ROC) estimation. Results The study reports 57.70% of patients with poor sleep among whom 47% had elevated FOH. Sleep quality, age, gender, diabetes duration, and insulin route significantly correlated with FOH (p < 0.05), while glycemic control and insulin use did not. Binary logistics regression showed that for every one-unit increase in FOH, the odds of experiencing poor sleep increased by approximately 3.7% (p < 0.001; OR 1.037). Five out of seven sleep components (sleep quality, efficiency, disturbance, medication use, and daytime dysfunction) were significantly related to FOH. We hypothesize that FOH might specifically influence the quality rather than the initiation or termination of the sleep cycle. ROC analysis revealed that HFS-II may be better at diagnosing poor sleep in patients than by chance (p < 0.001) with an AUC of 0.691. Conclusion FOH is a key predictor of sleep quality among patients with diabetes. Healthcare providers should prioritize patient education targeting common FOH concerns and assess patients with disturbed sleep for elevated FOH levels, as it may contribute to sleep disturbances.
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Affiliation(s)
| | - Nabeel Ahmed
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | | | | | - Jawad Akbar Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan
| | | | - Sana Tahseen
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Tanveer Ahmed
- Ahmad Polyclinic and Diabetic Center, Sargodha, Pakistan
| | - Abdul Malik
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Akhtar
- Department of Biochemistry, A.T. Still University of Health Sciences, Kirksville, MO, United States
| | - Ayesha Shahid
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Mah Noor
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Maryam Pervaiz
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
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Hu M, Hao X, Zhang Y, Sun X, Zhang M, Zhao J, Wang Q. Long-term exposure to particulate air pollution associated with the progression of type 2 diabetes mellitus in China: effect size and urban-rural disparities. BMC Public Health 2025; 25:1565. [PMID: 40287677 PMCID: PMC12034171 DOI: 10.1186/s12889-025-22394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 03/19/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND Recent Western studies link long-term particulate matter (PM) exposure to type 2 diabetes mellitus (T2DM) progression, but little is known for low- and middle-income countries. This study aimed to estimate the relationship between PM exposure and T2DM progression in China, and also assess urban-rural disparities. METHODS Using 7-year cohort data of 1.3 million Chinese over 40, a multistate model estimated the associations of PM exposure with T2DM progression. Covariates included demographics, socioeconomic status, health behaviors, medication, and meteorological factors. Sub-sample analyses were done for rural and urban areas. RESULTS For participants exposed to high levels of PM 2.5 , the 5-year absolute risks of developing T2DM and its complications were 4.31% (95% CI: 4.22-4.40) and 31.04% (95% CI: 29.97-32.08), respectively. In the low- PM 2.5 -exposure group, these risks were 3.82% (95% CI: 3.74-3.91) and 30.55% (95% CI: 29.43-31.65). For each 10 µg/m3 increase in PM 2.5 exposure, the HRs (95% CI) for the progression from no T2DM diagnosis to a T2DM diagnosis were 1.13 (1.13-1.14), and for the progression from T2DM to the development of T2DM complications were 1.04 (1.03-1.06). Moreover, the HRs (95% CI) for mortality risk were 1.09 (1.08-1.09) for participants without T2DM, 1.06 (1.00-1.14) for those with T2DM, and 1.10 (1.05-1.16) for those with T2DM complications. Similar associations were observed for other PM-related metrics. In rural areas, PM exposure was more strongly associated with the progression from T2DM and its complications to death. Conversely, in urban areas, PM exposure had a stronger association with the progression from a non-T2DM state to a formal T2DM diagnosis. Urban residents are exposed to higher levels of toxic components like heavy metals, potentially increasing T2DM risk, yet urban healthcare infrastructure offers protection against T2DM-related mortality. CONCLUSIONS PM exposure is significantly associated with T2DM progression. Urban areas should focus on primary prevention, while rural areas need to improve secondary and tertiary prevention like healthcare services.
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Affiliation(s)
- Mengxiao Hu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China
| | - Xiaowei Hao
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Xiaofeng Sun
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China
| | - Meng Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China
| | - Jingyi Zhao
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, 250012, China.
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P LP, Ghosh T, Sri R, B V B. Advancements in polymer-based approaches in diabetic wound healing: a comprehensive review. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2025:1-15. [PMID: 40279098 DOI: 10.1080/09205063.2025.2492777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Accepted: 04/04/2025] [Indexed: 04/26/2025]
Abstract
Diabetes, both Type 1 and Type 2, often leads to chronic wounds due to impaired healing processes, marked by prolonged inflammation, delayed blood vessel formation, and abnormal collagen production. These issues disrupt normal tissue regeneration, slowing healing. To address these challenges, polymer-based wound dressings are being explored as a promising solution. Natural polymers like alginate, chitosan, and hyaluronic acid, as well as synthetic ones like PCL, PLA, and PLGA, offer potential for more effective healing. These materials can be used in advanced delivery systems, such as nanofibrous scaffolds, nanoparticles, and hydrogels, which help deliver medications, maintain a moist healing environment, and stimulate cell growth. By improving the wound environment, polymer-based systems provide new hope for diabetic patients with slow-to-heal wounds, enhancing therapeutic outcomes and accelerating healing. These innovations could significantly improve the management of chronic wounds in diabetes.
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Affiliation(s)
| | - Tanmoy Ghosh
- Department of Pharmaceutics, Faculty of Pharmacy, MS Ramaiah University of Applied Sciences, Bengaluru, India
| | - Ramya Sri
- Department of Pharmaceutics, Faculty of Pharmacy, MS Ramaiah University of Applied Sciences, Bengaluru, India
| | - Basavaraj B V
- Department of Pharmaceutics, Faculty of Pharmacy, MS Ramaiah University of Applied Sciences, Bengaluru, India
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Damiani F, Giuliano MG, Cornuti S, Putignano E, Tognozzi A, Suckow V, Kalscheuer VM, Pizzorusso T, Tognini P. Multi-site investigation of gut microbiota in CDKL5 deficiency disorder mouse models: Targeting dysbiosis to improve neurological outcomes. Cell Rep 2025; 44:115546. [PMID: 40220293 PMCID: PMC12014524 DOI: 10.1016/j.celrep.2025.115546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 01/31/2025] [Accepted: 03/19/2025] [Indexed: 04/14/2025] Open
Abstract
Cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD) is a rare neurodevelopmental disorder often associated with gastrointestinal (GI) issues and subclinical immune dysregulation, suggesting a link to the gut microbiota. We analyze the fecal microbiota composition in two CDKL5 knockout (KO) mouse models at postnatal days (P) 25, 32 (youth), and 70 (adulthood), revealing significant microbial imbalances, particularly during juvenile stages. To investigate the role of the intestinal microbiota in CDD and assess causality, we administer antibiotics, which lead to improved visual cortical responses and reduce hyperactivity. Additionally, microglia morphology changes, indicative of altered surveillance and activation states, are reversed. Strikingly, fecal transplantation from CDKL5 KO to wild-type (WT) recipient mice successfully transfers both visual response deficits and hyperactive behavior. These findings show that gut microbiota alterations contribute to the severity of neurological symptoms in CDD, shedding light on the interplay between microbiota, microglia, and neurodevelopmental outcomes.
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Affiliation(s)
- Francesca Damiani
- Laboratory of Biology BIO@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy
| | - Maria Grazia Giuliano
- Laboratory of Biology BIO@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy; Health Science Interdisciplinary Center, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Sara Cornuti
- Laboratory of Biology BIO@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy
| | - Elena Putignano
- Institute of Neuroscience, National Research Council, Via G. Moruzzi 1, 56124 Pisa, Italy
| | - Andrea Tognozzi
- Laboratory of Biology BIO@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy; PhD Program in Clinical and Translational Science, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Vanessa Suckow
- Max Planck Institute for Molecular Genetics, Ihnestraße 63, 14195 Berlin, Germany
| | - Vera M Kalscheuer
- Max Planck Institute for Molecular Genetics, Ihnestraße 63, 14195 Berlin, Germany
| | - Tommaso Pizzorusso
- Laboratory of Biology BIO@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy; Institute of Neuroscience, National Research Council, Via G. Moruzzi 1, 56124 Pisa, Italy
| | - Paola Tognini
- Health Science Interdisciplinary Center, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.
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Goedecke JH, Danquah I, Abidha CA, Agyemang C, Albers HM, Amoah S, Brunius C, Chorell E, Hoosen F, Fortuin-de Smidt M, Hörnsten Å, Karlsson T, Lindholm L, Mendham AE, Micklesfield LK, Meili KW, Noerman S, Otten J, Söderberg S, van der Linden EL, Wittenbecher C, Landberg R, Olsson T. Omics Approach for Personalised Prevention of Type 2 Diabetes Mellitus for African and European Populations (OPTIMA): a protocol paper. BMJ Open 2025; 15:e099108. [PMID: 40262963 PMCID: PMC12015709 DOI: 10.1136/bmjopen-2025-099108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Accepted: 04/04/2025] [Indexed: 04/24/2025] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) within sub-Saharan Africa (SSA) is increasing. Despite the pathophysiology of T2D differing by ethnicity and sex, risk stratification and guidelines for the prevention of T2D are generic, relying on evidence from studies including predominantly Europeans. Accordingly, this study aims to develop ethnic-specific and sex-specific risk prediction models for the early detection of dysglycaemia (impaired glucose tolerance and T2D) to inform clinically feasible, culturally acceptable and cost-effective risk management and prevention strategies using dietary modification in SSA and European populations. METHODS AND ANALYSIS This multinational collaboration will include the prospective cohort data from two African cohorts, the Middle-Aged Soweto Cohort from South Africa and the Research on Obesity and Diabetes among African Migrants Prospective cohort from Ghana and migrants living in Europe, and a Swedish cohort, the Pre-Swedish CArdioPulmonary bioImage Study. Targeted proteomics, as well as targeted and untargeted metabolomics, will be performed at baseline to discover known and novel ethnic-specific and sex-specific biomarkers that predict incident dysglycaemia in the different longitudinal cohorts. Dietary patterns that explain maximum variation in the biomarker profiles and that associate with dysglycaemia will be identified in the SSA and European cohorts and used to build the prototypes for dietary interventions to prevent T2D. A comparative cost-effectiveness analysis of the dietary interventions will be estimated in the different populations. Finally, the perceptions of at-risk participants and healthcare providers regarding ethnic-specific and sex-specific dietary recommendations for the prevention of T2D will be assessed using focus group discussions and in-depth interviews in South Africa, Ghana, Germany (Ghanaian migrants) and Sweden. ETHICS AND DISSEMINATION Ethical clearance has been obtained from all participating sites. The study results will be disseminated at scientific conferences and in journal publications, and through community engagement events and diabetes organisations in the respective countries.
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Affiliation(s)
- Julia H Goedecke
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- South African Medical Research Council/WITS Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
| | - Ina Danquah
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Transdisciplinary Research Area "Technology and Innovation for Sustainable Futures" and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Carol Akinyi Abidha
- Transdisciplinary Research Area "Technology and Innovation for Sustainable Futures" and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hannah Maike Albers
- Transdisciplinary Research Area "Technology and Innovation for Sustainable Futures" and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
| | - Stephen Amoah
- Transdisciplinary Research Area "Technology and Innovation for Sustainable Futures" and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
| | - Carl Brunius
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Elin Chorell
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Fatima Hoosen
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | | | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Therese Karlsson
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Amy E Mendham
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, Berri, South Australia, Australia
| | - Lisa K Micklesfield
- South African Medical Research Council/WITS Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
| | | | - Stefania Noerman
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Julia Otten
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Eva L van der Linden
- Department of Public and Occupational Health, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands
| | - Clemens Wittenbecher
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
- SciLifeLab, Stockholm, Sweden
| | - Rikard Landberg
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Zhang Y, Zhang Z, Tu C, Chen X, He R. Advanced Glycation End Products in Disease Development and Potential Interventions. Antioxidants (Basel) 2025; 14:492. [PMID: 40298887 PMCID: PMC12024296 DOI: 10.3390/antiox14040492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 04/09/2025] [Accepted: 04/16/2025] [Indexed: 04/30/2025] Open
Abstract
Advanced glycation end products (AGEs) are a group of compounds formed through non-enzymatic reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs can be generated in the body or introduced through dietary sources and smoking. Recent clinical and animal studies have highlighted the significant role of AGEs in various health conditions. These compounds accumulate in nearly all mammalian tissues and are associated with a range of diseases, including diabetes and its complications, cardiovascular disease, and neurodegeneration. This review summarizes the major diseases linked to AGE accumulation, presenting both clinical and experimental evidence. The pathologies induced by AGEs share common mechanisms across different organs, primarily involving oxidative stress, chronic inflammation, and direct protein cross-linking. Interventions targeting AGE-related diseases focus on inhibiting AGE formation using synthetic or natural antioxidants, as well as reducing dietary AGE intake through lifestyle modifications. AGEs are recognized as significant risk factors that impact health and accelerate aging, particularly in individuals with hyperglycemia. Monitoring AGE level and implementing nutritional interventions can help maintain overall health and reduce the risk of AGE-related complications.
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Affiliation(s)
- Yihan Zhang
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou Higher Education Mega Center, Panyu District, Guangzhou 510006, China; (Y.Z.); (Z.Z.)
- BYHEALTH Institute of Nutrition & Health, No. 916, Huangpu Avenue East, Huangpu District, Guangzhou 510799, China; (C.T.); (X.C.)
| | - Zhen Zhang
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou Higher Education Mega Center, Panyu District, Guangzhou 510006, China; (Y.Z.); (Z.Z.)
- BYHEALTH Institute of Nutrition & Health, No. 916, Huangpu Avenue East, Huangpu District, Guangzhou 510799, China; (C.T.); (X.C.)
| | - Chuyue Tu
- BYHEALTH Institute of Nutrition & Health, No. 916, Huangpu Avenue East, Huangpu District, Guangzhou 510799, China; (C.T.); (X.C.)
| | - Xu Chen
- BYHEALTH Institute of Nutrition & Health, No. 916, Huangpu Avenue East, Huangpu District, Guangzhou 510799, China; (C.T.); (X.C.)
| | - Ruikun He
- BYHEALTH Institute of Nutrition & Health, No. 916, Huangpu Avenue East, Huangpu District, Guangzhou 510799, China; (C.T.); (X.C.)
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Yogesh M, Patel M, Gandhi R, Patel A, Kidecha KN. Sarcopenia in type 2 Diabetes mellitus among Asian populations: prevalence and risk factors based on AWGS- 2019: a systematic review and meta-analysis. BMC Endocr Disord 2025; 25:101. [PMID: 40247215 PMCID: PMC12004733 DOI: 10.1186/s12902-025-01935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 04/14/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND Sarcopenia is increasingly recognized as a significant complication in type 2 diabetes mellitus (T2DM), yet its prevalence and risk factors in Asian populations remain incompletely understood using the updated Asian Working Group for Sarcopenia (AWGS) 2019 criteria. The present review aimed to evaluate the prevalence of sarcopenia among Asian T2DM patients and identify associated risk factors using AWGS-2019 criteria through systematic review and meta-analysis. METHODS A comprehensive systematic review of PubMed, SCOPUS, Crossref, Google Scholar, Semantic Scholar, and OpenAlex followed PRISMA guidelines to identify observational studies assessing the magnitude of sarcopenia in type-2 Diabetes mellitus. Random-effect models were used to estimate pooled prevalence and odds ratios (OR) for associated factors. Heterogeneity was quantified using I2 statistics and Cochran's Q test, where I2 values of 25%, 50%, and 75% indicated low, moderate, and high heterogeneity, respectively. Subgroup analyses and meta-regression explored heterogeneity sources across all studies. The quality of the studies was assessed by the Joanna Briggs Institute (JBI) criteria. Publication bias was assessed by funnel plot and Egger's test. FINDINGS Thirty nine studies, including approximately 19,902 participants, were analyzed. The pooled prevalence of confirmed sarcopenia was 23% (95% CI: 18%-27%, p < 0.001) among Asian T2DM patients, with notably higher rates of possible sarcopenia at 61% (95% CI: 28%-86%, p < 0.001) and lower rates of severe sarcopenia at 12.1% (95% CI: 8.4%-16.7%, p < 0.001). Regional variations showed a higher prevalence in Southeast Asia (37.46%) compared to Western Pacific (21.95%). Meta-analysis revealed significant risk factors including older age (OR: 1.13, 95% CI: 1.11-1.16, p < 0.0001), male gender (OR: 2.37, 95% CI: 1.33-4.21, p = 0.0033), hypertension (OR: 3.65, 95% CI: 1.06-12.65, p = 0.0409), diabetes duration (OR: 1.35, 95% CI: 1.05-2.13, p = 0.02), and reduced physical activity (OR: 2.54, 95% CI: 1.92-3.36, p < 0.0001). Higher BMI (OR: 0.63, 95% CI: 0.53-0.75, p < 0.0001) and better vitamin D levels (OR: 0.91, 95% CI: 0.87-0.95, p < 0.001) demonstrated protective effects. Recent studies (2023-2024) showed a higher prevalence than pre-2022 studies (27.85% vs 18.42%, p = 0.0440). DXA-based measurements yielded higher prevalence estimates than BIA-based assessments (29.86% vs 19.52%, p = 0.7121). INTERPRETATION Sarcopenia affects nearly one-quarter of Asian T2DM patients, with significant regional variations. Age, male gender, hypertension, and physical inactivity were key risk factors, while maintaining a healthy BMI and good nutrition appeared protective. These findings emphasize the importance of regular screening and early intervention strategies, particularly for high-risk patients.
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Affiliation(s)
- M Yogesh
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.
| | - Monika Patel
- Department of Community Medicine, GMERS Medical College, Morbi, Gujarat, India
| | - Rohankumar Gandhi
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Abhishek Patel
- Department of Internal Medicine, GMERS Medical College · Valsad, IND, Valsad, India
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Sourij H, Azhar K, Aziz F, Kojzar H, Sourij C, Fasching P, Clodi M, Ludvik B, Mader JK, Resl M, Rega-Kaun G, Ress C, Stechemesser L, Stingl H, Tripolt NJ, Wascher T, Kaser S. Interplay of health-related quality of life and comorbidities in people with type 2 diabetes mellitus treated in primary care settings in Austria: a countrywide cross-sectional study. BMJ Open 2025; 15:e092951. [PMID: 40233961 PMCID: PMC12001361 DOI: 10.1136/bmjopen-2024-092951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 03/13/2025] [Indexed: 04/17/2025] Open
Abstract
OBJECTIVES This study assessed the health-related quality of life (HRQoL) and its relationship with clinical factors and comorbidities in people with type 2 diabetes mellitus (T2DM) treated in primary care settings. DESIGN Cross-sectional study design: This study assessed the HRQoL using a 36-item Short Form Survey (SF-36) tool in eight domains. The HRQoL scores ranged from 0% to 100% for each domain, with higher scores indicating better HRQoL. Linear regression was used to assess the association of HRQoL domain scores with clinical covariates and comorbidities. SETTING A countrywide study was conducted on individuals with established T2DM (N=635) attending primary healthcare services for various conditions across nine federal states of Austria from 2021 to 2023. PARTICIPANTS A total of 635 individuals, aged above 50 years and diagnosed with T2DM, were recruited by the attending physician to evaluate their HRQoL in relation to T2DM and its associated comorbidities. RESULTS The mean SF-36 scores for physical functioning (69±28), role-physical (62±42), mental health (72±20), role-emotional (73±41), social functioning (79±25), bodily pain (67±28) and vitality (55±22) were satisfactory, except for general health (41±10). Age and body mass were inversely associated with physical, mental and social HRQoL (p<0.05). Women had lower mental health (β: -5.44 [95% CI -9.43 to -1.44], p<0.05) than men. Smokers and those with cardiovascular and chronic lung diseases reported worse general, mental and physical health and vitality (p<0.05 each). Depression (p<0.001) and multimorbidity (p<0.05) severely deteriorated all HRQoL domains: physical functioning (Depression:-25.34 [95% CI -33.84 to -16.84], p<0.001); (Multimorbidity: -19.37 [95% CI -26.30 to -12.44], p<0.001), physical role limitations (-22.96 [95% CI -36.65 to -9.27], p<0.001); (-18.53 [95% CI -29.59 to -7.48], p<0.001), social functioning (-24.38 [95% CI -32.41 to -16.35], p<0.001); (-8.86 [95% CI -15.66 to -2.07], p<0.05), emotional well-being (-19.80 [95% CI -26.22 to -13.38], p<0.001); (-9.54 [95% CI -14.95 to -4.13], p<0.001), emotional role limitations (-28.26 [95% CI -41.01 to -15.52], p<0.001); (-8.15 [95% CI -18.78 to 2.49], p=0.133), bodily pains (-23.09 [95% CI -32.21 to -13.97], p<0.001); (-14.52 [95% CI -22.08 to -6.95], p<0.001), fatigue (-16.47 [95% CI -23.40 to -9.55], p<0.001); (-13.71 [95% CI -19.39 to -8.03], p<0.001), general health (-7.09 [95% CI -10.40 to -3.78], p<0.001); (-7.14 [95% CI -9.83 to -4.46], p<0.001). CONCLUSIONS Our analysis showed that advanced age, obesity, depression, cardiovascular disease, chronic lung diseases and multimorbidity were associated with poor HRQoL of individuals with T2DM at the primary care level. These findings highlight the need for strengthening holistic management in primary care to address the diverse physical, social and emotional needs of individuals with T2DM.
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Affiliation(s)
- Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Kehkishan Azhar
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Harald Kojzar
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Caren Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Cardiology, Medical University of Graz, Graz, Steiermark, Austria
| | - Peter Fasching
- Division of Endocrinology, Rheumatology and Acute Geriatrics, Clinic Ottakring, Vienna, Austria
| | - Martin Clodi
- Clinical Division of Internal Medicine, Saint John of God Hospital Linz, Linz, Austria
| | - Bernhard Ludvik
- Department of Internal Medicine, Metabolic Diseases Landstrasse Clinic, Vienna, Austria
| | - Julia K Mader
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Michael Resl
- Clinical Division of Internal Medicine, Saint John of God Hospital Linz, Linz, Austria
| | - Gersina Rega-Kaun
- Division of Endocrinology, Rheumatology and Acute Geriatrics, Clinic Ottakring, Vienna, Austria
| | - Claudia Ress
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Lars Stechemesser
- Department of Internal Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Harald Stingl
- Department of Internal Medicine, Hospital Mödling, Mödling, Austria
| | - Norbert Joachim Tripolt
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
- Department of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Thomas Wascher
- Department of Medicine, Hanusch Hospital, Vienna, Austria
| | - Susanne Kaser
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
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Yurtseven CE, Kalemci S, Ergün KE, Olukman M, Sarsık Kumbaracı B, Toprak P, Şimşir A. Unveiling the bladder's early response to acute glucosuria: first evidence from an animal study. Int Urol Nephrol 2025:10.1007/s11255-025-04471-9. [PMID: 40221564 DOI: 10.1007/s11255-025-04471-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Accepted: 03/20/2025] [Indexed: 04/14/2025]
Abstract
PURPOSE While chronic damage to the lower urinary tract in diabetic patients is well-known, the specific effects of acute glucosuria on the bladder remain unclear. This study, being the first of its kind in the available literature, aims to exclusively investigate the early effects of acute glucosuria on bladder function and morphology, independent of the broader impacts of diabetes. METHODS Wistar Albino rats were divided into four groups: CONTROL, Empagliflozin (EMPA), Diabetes Mellitus + Empagliflozin (DM + EMPA), and DM. Acute glucosuria was induced using empagliflozin in the EMPA and DM + EMPA groups. The effects on bladder function were assessed through contraction protocols using potassium chloride (KCl), cumulative acetylcholine (ACh) applications and electrical field stimulation studies (EFS). The bladder tissues were also examined histopathologically to evaluate morphological changes. RESULTS In the organ bath studies, a significant increase in the response to KCl was observed in the diabetic group receiving empagliflozin compared to others (p < 0.001). When examining the contraction responses to ACh, it was found that the diabetic group receiving empagliflozin exhibited significantly higher contraction responses (p < 0.001). In the EFS, no significant difference was found between the groups. The histopathological examinations revealed a significant muscularis propria hypertrophy in the groups receiving empagliflozin compared to the control group (p < 0.001). CONCLUSIONS In our study, we found that short-term treatment defined as 15 days with empagliflozin increased the receptor-independent contractile capacity of the bladders in diabetic rats and enhanced their contraction responses to ACh. However, there was no significant difference observed in the EFS studies. Histopathological analysis revealed the development of detrusor hypertrophy in rats receiving empagliflozin treatment.
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Affiliation(s)
- Cemil Emre Yurtseven
- Department of Urology, Dr Yaşar Eryılmaz Doğubayazıt State Hospital, Ağrı, Turkey
| | - Serdar Kalemci
- Department of Urology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Kasım Emre Ergün
- Department of Urology, Faculty of Medicine, Ege University, İzmir, Turkey.
| | - Murat Olukman
- Department of Medical Pharmacology, Faculty of Medicine, Ege University, İzmir, Turkey
| | | | - Pınar Toprak
- Department of Medical Pharmacology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Adnan Şimşir
- Department of Urology, Faculty of Medicine, Ege University, İzmir, Turkey
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Slowik J, Kaczynski L, Kaczor M, Wnuk M. Oral health-related quality of life in patients with type II diabetes mellitus: a systematic review and meta-analysis. BMC Oral Health 2025; 25:485. [PMID: 40186263 PMCID: PMC11969959 DOI: 10.1186/s12903-025-05882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Accepted: 03/26/2025] [Indexed: 04/07/2025] Open
Abstract
BACKGROUND Our study aimed to comprehensively assess the impact of type II diabetes mellitus (T2DM) on oral health-related quality of life (OHRQoL) based on results from the Oral Health Impact Profile (OHIP-14) questionnaire. A secondary objective was to explore how the potential correlation between the OHIP-14 score and T2DM was affected by demographic and clinical characteristics. METHODS We systematically searched the Medline, EMBASE, CINAHL and Scopus databases on January 24, 2024, for evidence starting from database inception. Studies included in the analysis assessed OHRQoL in T2DM patients. We searched trials both with or without comparisons to healthy controls and presenting OHIP-14 results as a severity of impact, namely, the mean OHIP-14 total score. To assess the difference between diabetic and non-diabetic subjects, we calculated weighted mean differences (WMD) with 95% confidence intervals (CI). A meta-analysis of each summary measure was conducted provided that this outcome was evaluated in at least two studies so that model was selected on the basis of heterogeneity assessment. The quality of the included studies was assessed using the tool developed by The National Heart, Lung, and Blood Institute (NHLBI). RESULTS Seven studies fulfilled the inclusion criteria (1,457 patients diagnosed with diabetes mellitus and 216 healthy controls). In patients with T2DM, the mean OHIP-14 total score was approximately 2.7 points higher (an indication of greater oral problems) than in healthy persons; WMD = 2.68 (95% CI: 0.47-4.89); p = 0.0176. Significant differences between diabetic and non-diabetic subjects were also observed for almost all domains of the OHIP-14, except handicap. The calculated average OHIP-14 total score was 12.06 (95% CI: 4.93-19.19), which indicated a slight effect on OHRQoL. Age and sex did not appear to be relevant for assessing the impact of diabetes mellitus on OHRQoL. CONCLUSIONS Our findings confirm that OHRQoL in patients with T2DM is significantly lower and may be influenced by functional problems in addition to various physical and psychological limitations. However, the available data are of low quality and a lack of evidence from high-quality studies with matched control groups exists. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Joanna Slowik
- Department of Periodontology, Clinical Oral Pathology and Prophylaxis, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich St, Krakow, 31-155, Poland
| | | | - Marcin Kaczor
- Jagiellonian University Medical College, 8 Skawinska St, Krakow, 31-066, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, 2 Jakubowskiego St, Krakow, 30- 688, Poland.
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Ryu HE, Heo SJ, Lee JH, Park B, Han T, Kwon YJ. Data-driven cluster analysis of lipids, inflammation, and aging in relation to new-onset type 2 diabetes mellitus. Endocrine 2025; 88:151-161. [PMID: 39743640 DOI: 10.1007/s12020-024-04154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 12/27/2024] [Indexed: 01/04/2025]
Abstract
PURPOSE Early detection and intervention are vital for managing type 2 diabetes mellitus (T2DM) effectively. However, it's still unclear which risk factors for T2DM onset are most significant. This study aimed to use cluster analysis to categorize individuals based on six known risk factors, helping to identify high-risk groups requiring early intervention to prevent T2DM onset. METHODS This study comprised 7402 Korean Genome and Epidemiology Study individuals aged 40 to 69 years. The hybrid hierarchical k-means clustering algorithm was employed on six variables normalized by Z-score-age, triglycerides, total cholesterol, non-high-density lipoprotein cholesterol, high-density lipoprotein cholesterol and C-reactive protein. Multivariable Cox proportional hazard regression analyses were conducted to assess T2DM incidence. RESULTS Four distinct clusters with significantly different characteristics and varying risks of new-onset T2DM were identified. Cluster 4 (insulin resistance) had the highest T2DM incidence, followed by Cluster 3 (inflammation and aging). Clusters 3 and 4 exhibited significantly higher T2DM incidence rates compared to Clusters 1 (healthy metabolism) and 2 (young age), even after adjusting for covariates. However, no significant difference was found between Clusters 3 and 4 after covariate adjustment. CONCLUSION Clusters 3 and 4 showed notably higher T2DM incidence rates, emphasizing the distinct risks associated with insulin resistance and inflammation-aging clusters.
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Affiliation(s)
- Ha-Eun Ryu
- Department of Family Medicine, Yongin Severance Hospital, Gyeonggi-do, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Hee Lee
- Department of Family Medicine, Yongin Severance Hospital, Gyeonggi-do, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Gyeonggi-do, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Taehwa Han
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Gyeonggi-do, Republic of Korea.
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Feleke WM, Olis CS, Endris AH, Hassen SL, Ali YS, Abate Beyene D. Knowledge, Practice, and Associated Factors of Insulin Self-Administration in Patients With Diabetes at Dessie City Governmental Hospital Follow Up Clinic, Amhara Region, North East Ethiopia: Cross-Sectional Study. Health Sci Rep 2025; 8:e70631. [PMID: 40226177 PMCID: PMC11985892 DOI: 10.1002/hsr2.70631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 03/09/2025] [Accepted: 03/25/2025] [Indexed: 04/15/2025] Open
Abstract
Background and Aims Diabetes mellitus is an increasingly prevalent medical condition. The primary method of treating high blood sugar levels is subcutaneous insulin therapy. However, insufficient knowledge and poor practice related to insulin can negatively impact its effectiveness and adherence. Diabetic patients who are unaware of proper insulin self-administration can experience severe complications. Hence, the aim of this study was to assess knowledge, practices, and associated factors related to the self-administration of insulin among diabetic patients. Methods An institutional cross-sectional study used interviewer-administered questionnaires from April 1, 2022, to June 30, 2022. Descriptive statistics were used to summarize sociodemographic data. Univariate and multivariate regression analyses were performed to measure the associations between the dependent and independent variables. A p value of less than 0.05 was generally considered statistically significant. Results In this study, 69.3% of participants had good knowledge and 63.9% had good practice. In multiple logistic regressions, patients' occupation, type of diabetes, membership in the Ethiopian Diabetic Association, and the source of information about diabetes (from health professionals or media) were associated with knowledge of self-administration of insulin. On the other hand, younger age (18-24 years) and duration of insulin therapy > 9 years were associated with good practice of self-administration of insulin. Conclusion The study found that patients had suboptimal knowledge and practice regarding insulin self-administration. Patients must receive adequate education to address these knowledge gaps and improve insulin therapy outcomes.
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Affiliation(s)
- Wasihun Melaku Feleke
- Department of Adult Health NursingCollege of Health ScienceWollo UniversityDessieEthiopia
| | - Caridad Sanchez Olis
- Department of Adult Health NursingCollege of Health ScienceWollo UniversityDessieEthiopia
| | - Adem Hussien Endris
- Department of Adult Health NursingCollege of Health ScienceWollo UniversityDessieEthiopia
| | | | | | - Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
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Menon JC, Singh P, Archana A, Kanga U, Singh P, Mittal M, Garg A, Seth A, Bhatia V, Dabadghao P, Sudhanshu S, Vishwakarma R, Verma S, Singh SK, Bhatia E. Characterisation of islet antibody-negative type 1 diabetes mellitus in Indian children. Diabet Med 2025; 42:e15477. [PMID: 39556519 DOI: 10.1111/dme.15477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 10/27/2024] [Accepted: 10/30/2024] [Indexed: 11/20/2024]
Abstract
AIMS Islet antibody-negative type 1 diabetes mellitus (T1DM) has not been well characterised. We determined the frequency of antibody-negative T1DM and compared it with antibody-positive T1DM in a cohort of north Indian children. METHODS In a multi-centre, prospective, observational study, 176 Indian children (age 1-18 years) were assessed within 2 weeks of diagnosis of T1DM. Antibodies against GAD65 (GADA), islet antigen-2 (IA-2A) and zinc transporter 8 (ZnT8A), were estimated using validated ELISA. HLA-DRB1, DQA1 and DQB1 alleles were studied by Luminex-based typing. Monogenic diabetes was determined by targeted next-generation sequencing using the Illumina platform. RESULTS After excluding 12 children with monogenic diabetes, GADA, IA-2A and ZnT8A were present in 124 (76%), 60 (37%) and 62 (38%) children, respectively, while 24 (15%) were negative for all antibodies. A single antibody (most frequently GADA) was present in 68 (41%) of children, while all three antibodies were found in 34 (21%). Islet antibody-negative T1DM (n = 24, 15%) did not differ from antibody-positive children in their clinical features, HbA1c or plasma C-peptide, both at onset or after 1 year follow-up (available in 62 children). The frequency of other organ-specific antibodies or high-risk HLA-DR and DQ alleles were also similar. Children with a single islet antibody did not differ from those with multiple antibodies. CONCLUSIONS The frequency of various islet-antibodies, in isolation and combination, differed considerably from studies among children of European descent with T1DM. Children with T1DM who were islet antibody-negative were indistinguishable from those who were antibody-positive.
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Affiliation(s)
- Jayakrishnan C Menon
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pratibha Singh
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Archana Archana
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Uma Kanga
- Department of Immunogenetics and Transplant Immunology, All India Institute of Medical Sciences, New Delhi, India
| | - Preeti Singh
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Medha Mittal
- Department of Paediatrics, Chacha Nehru Bal Chikitsalay, New Delhi, India
| | - Atul Garg
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anju Seth
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Vijayalakshmi Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Preeti Dabadghao
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Siddhnath Sudhanshu
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ruchira Vishwakarma
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shivendra Verma
- Department of Endocrinology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - S K Singh
- Department of Endocrinology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Eesh Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Ayers AT, Ho CN, Billings LK, Misra S, Klonoff DC. Envisioning Tools to Help Classify Type 1 Diabetes and Type 2 Diabetes in New-Onset Adult Diabetes. J Diabetes Sci Technol 2025:19322968251329055. [PMID: 40152433 PMCID: PMC11954134 DOI: 10.1177/19322968251329055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2025]
Abstract
A tool is needed to distinguish type 1 diabetes (T1D) and type 2 diabetes (T2D) in adults with new-onset diabetes because correct classification is needed for correct diagnoses and treatments. Current classification methods are usually applied to biomarkers using binary or quantitative classification with a cut point and may not be adequately nuanced. Combinations of clinical features are not necessarily specific for classifying and may not always indicate a single diagnosis. A probabilistic decision tree classification tool with multiple branches per decision node is needed for adults with new-onset diabetes to avoid misdiagnosis of actual T1D as T2D, misdiagnosis of actual T2D or monogenic diabetes as T1D, and misclassified patients in future population health studies which will lead to incorrect conclusions and suboptimal patient outcomes.
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Affiliation(s)
| | - Cindy N. Ho
- Diabetes Technology Society, Burlingame, CA, USA
| | - Liana K. Billings
- Department of Medicine, Endeavor Health, Skokie, IL, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Shivani Misra
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - David C. Klonoff
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
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Tuersun R, Abudouwayiti A, Li YX, Pan Y, Aimaier S, Wen ZY, Gao WT, Ma LJ, Mahemuti A, Zheng YY. Serum CA125: a prognostic biomarker for mortality in chronic heart failure. BMC Cardiovasc Disord 2025; 25:227. [PMID: 40148772 PMCID: PMC11948815 DOI: 10.1186/s12872-025-04685-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Accepted: 03/18/2025] [Indexed: 03/29/2025] Open
Abstract
OBJECTIVE To examine the relationship between serum Carbohydrate Antigen 125 (CA125) levels and long-term mortality in Chronic Heart Failure (CHF) patients and to assess its predictive value as a biomarker. METHODS This was a retrospective cohort study. We reviewed the medical records of 4,442 consecutive patients admitted to the First Affiliated Hospital of Xinjiang Medical University with a diagnosis of CHF since July 2012. After applying inclusion and exclusion criteria, 1,413 patients with available CA125 level measurements were included. The patients were categorized into three groups based on ejection fraction: HFrEF, HFmrEF, and HFpEF. Demographic details, comorbidities, and laboratory parameters were collected. CA125 levels were measured using an automated chemiluminescent immunoassay. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression. RESULTS The median follow-up was 22.75 months. Elevated CA125 levels were significantly associated with increased all-cause mortality (ACM) across all CHF subtypes (HR = 2.05, 95% CI: 1.60-2.64, P < 0.001), especially in the HFpEF group (HR = 2.32, 95% CI: 1.59-3.40, P < 0.001). The area under the ROC curve for CA125 was 0.655, indicating moderate predictive accuracy. Multivariate analysis revealed that patients with CA125 levels ≥ 20.8 U/mL had a significantly higher risk of ACM (HR = 2.05). Adjustments for confounding factors did not alter these findings. CONCLUSION Our findings suggest that serum CA125 levels may serve as a potential prognostic biomarker for mortality in CHF patients, particularly in the HFpEF subgroup. However, further research is needed to confirm these findings and elucidate the underlying mechanisms.
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Affiliation(s)
- Ruzeguli Tuersun
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Aihaidan Abudouwayiti
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Yan Xiao Li
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Ying Pan
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Salamaiti Aimaier
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Zhi-Ying Wen
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Wei-Tong Gao
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Li-Juan Ma
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China
| | - Ailiman Mahemuti
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China.
| | - Ying-Ying Zheng
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China.
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Safieddine B, Geyer S, Sperlich S, Grasshoff J, Beller J. A vertical-horizontal approach to examine social inequalities in early onset type 2 diabetes in the German workforce through occupational sector, education and income. Sci Rep 2025; 15:10390. [PMID: 40140545 PMCID: PMC11947208 DOI: 10.1038/s41598-025-95326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 03/20/2025] [Indexed: 03/28/2025] Open
Abstract
Early onset type 2 diabetes (T2D) is increasingly recognized as a significant public health concern, leading to more severe complications and a greater decline in quality of life compared to T2D diagnosed later in life. This can have a profound impact on the workforce. Social status-whether assessed vertically through levels of income, education or job position or horizontally through occupational groups-can play a critical role in the risk of developing early onset T2D. While research focusing on vertical socioeconomic inequalities related to T2D is abundant, there is currently no study that combines both vertical and horizontal perspectives to explore vulnerable groups. We aim to combine the vertical and horizontal approaches to examine vulnerable groups within the employed population regarding early onset T2D. Using data from the largest statutory health insurance provider in the state of lower Saxony, Germany for the year 2019 "Allgemeine Ortskrankenkasse Niedersachsen" (AOKN), we examined education and income inequalities in early onset T2D among nine occupational sectors using logistic regression analyses (N = 365059). Age and gender adjusted prevalence rates as illustrated by predicted probabilities were displayed to compare rates of early onset T2D among different education and income levels and occupational groups. Regression tree analysis was used to examine intersectionality between the vertical (levels of income and education) and the horizontal (occupational sector) dimensions in order to determine the most vulnerable groups. Both vertical and horizontal inequalities in early onset T2D exist within the employed population. On the one hand, disparities in education and income were present across various occupational sectors. On the other hand, significant differences in T2D prevalence could be observed within the same education and income levels across different sectors. Notably, affiliation to occupational sector was the primary factor influencing vulnerability to early onset T2D, followed by educational attainment. Individuals with low education working in the "Transport, logistics, protection and security" and "Health, social work, teaching, and education" sectors were among the most vulnerable. It is important to simultaneously examine both vertical and horizontal dimensions of inequalities to identify vulnerable groups within the workforce. Future research should adopt this approach while also exploring other populations and health outcomes.
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Affiliation(s)
- Batoul Safieddine
- Medical Sociology Unit, Hannover Medical School, OE 5420 Carl-Neuberg-Street 1, 30625, Hannover, Germany.
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, OE 5420 Carl-Neuberg-Street 1, 30625, Hannover, Germany
| | - Stefanie Sperlich
- Medical Sociology Unit, Hannover Medical School, OE 5420 Carl-Neuberg-Street 1, 30625, Hannover, Germany
| | - Julia Grasshoff
- Medical Sociology Unit, Hannover Medical School, OE 5420 Carl-Neuberg-Street 1, 30625, Hannover, Germany
| | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, OE 5420 Carl-Neuberg-Street 1, 30625, Hannover, Germany
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Baye AM, Fenta TG, Karuranga S, Nnakenyi ID, Young EE, Palmer C, Pearson ER, Ulasi II, Dawed AY. Performance of fasting plasma glucose for community-based screening of undiagnosed diabetes and pre-diabetes in sub-Saharan Africa. Front Endocrinol (Lausanne) 2025; 16:1501383. [PMID: 40206599 PMCID: PMC11979980 DOI: 10.3389/fendo.2025.1501383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Accepted: 03/03/2025] [Indexed: 04/11/2025] Open
Abstract
Introduction Early diabetes screening is critical in sub-Saharan Africa (SSA), where the prevalence is increasing, yet a large proportion of cases remain undiagnosed. This study aimed to evaluate the performance of fasting plasma glucose (FPG) in screening diabetes and/or prediabetes compared to the 2-hour plasma glucose (2-h PG)-level in SSA. Methods Data from a population-based, cross-sectional diabetes screening survey involving 1550 individuals in Butajira, Ethiopia, and Enugu state, Nigeria were analyzed. Fasting plasma glucose and a 2-hour 75-g oral glucose tolerance test (OGTT) were utilized for diabetes screening. In addition, we determined and plotted the receiver operating characteristic curve for FPG against the reference standard 2-h PG to evaluate the screening tool's sensitivity and specificity. Results The mean (SD) age of the study participants was 44.5 (± 16.43) years, with men comprising 50.4% of the cohort. Among 1550 individuals analyzed, 4.6% and 16.8% demonstrated diabetes and prediabetes, respectively, as identified by either FPG or 2-h PG. The agreement between FPG and 2-h PG in identifying diabetes and prediabetes was moderate, with kappa statistic of 0.56 (95% CI, 0.51 - 0.61; p<0.0001) for diabetes and 0.45 (95% CI, 0.40 - 0.50; p<0.0001) for prediabetes. FPG failed to detect 34.1% of all prediabetes and 44.4% of all diabetes cases. The sensitivity of FPG in identifying diabetes cases was 44.3% at a cut-off 126 mg/dL with a specificity of 99.3%. We identified the optimal FPG cut-off for detecting newly identified diabetes cases using 2-h PG to be 105 mg/dL associated with a sensitivity and specificity of 67.2% and 94.0%, respectively. Conclusion FPG was able to correctly identify 99.3% of individuals with no diabetes but a significant percentage of diabetes cases would have remained undiagnosed if only FPG had been utilized instead of the 2-h PG. The use of 2-h PG test is recommended to diagnose diabetes in older individuals, females and non-obese persons who would be missed if tested by only FPG. Lowering the cut-off value for FPG to 105 mg/dL substantially increases the identification of individuals with diabetes, thus improving the effectiveness of FPG as a screening test for type 2 diabetes.
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Affiliation(s)
- Assefa Mulu Baye
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmaceutics and Social Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teferi Gedif Fenta
- Department of Pharmaceutics and Social Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Suvi Karuranga
- European Society for Emergency Medicine, Antwerp, Belgium
| | - Ifeyinwa Dorothy Nnakenyi
- Department of Chemical Pathology, College of Medicine, University of Nigeria & University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ekenechukwu Esther Young
- Department of Medicine, College of Medicine, University of Nigeria & University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Colin Palmer
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Ewan R. Pearson
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Ifeoma Isabella Ulasi
- Department of Medicine, College of Medicine, University of Nigeria & University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Adem Y. Dawed
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, United Kingdom
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Sun L, Yuan J, Wang T, Ning B, Yuan Q. Association between Hemoglobin Glycation Index and In-Hospital all-cause mortality of patients with Congestive Heart Failure: a retrospective study utilizing the MIMIC-IV database. Front Endocrinol (Lausanne) 2025; 16:1475063. [PMID: 40225324 PMCID: PMC11986639 DOI: 10.3389/fendo.2025.1475063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 01/03/2025] [Indexed: 04/15/2025] Open
Abstract
Background The aim of this study was to explore the relationship between the hemoglobin glycation index (HGI) of Congestive Heart Failure (CHF) patients and their risk of mortality within 365 days. Patients and methods The Medical Information Mart for Intensive Care (MIMIC-IV) database supplied the patient data for this study, which was categorized into quartiles based on the HGI. The primary endpoint was all-cause mortality within a 365-day period. Kaplan-Meier (K-M) analysis was utilized to compare this primary endpoint across the four aforementioned groups. The relationship between the HGI and the endpoint was examined using restricted cubic splines (RCS) and a Cox proportional hazards analysis. Results A total of 985 patients were included in this study. HGI was significantly associated with 30 days mortality (15.9%; HR, 0.79; 95% CI, (0.67~0.92); P=0.003) and 60 days mortality (19.3%; HR, 0.83; 95% CI, (0.72~0.96); P=0.011) and 90 days mortality (22.1%; HR, 0.86; 95% CI, (0.75~0.99); P=0.031) and 365 days mortality (30.7%; HR, 0.97; 95% CI, (0.86~1.09); P=0.611) in patients with critical CHF in the completely adjusted Cox proportional risk model. RCS analysis revealed a U-shaped relationship between HGI and outcome events. KM curves survival analysis suggests a correlation between 30 days and 365 days mortality in HGI and CHF patients. Conclusions A higher HGI has a more protective effect than a low HGI for patients with CHF and was directly associated with short-term mortality rates. These findings may be helpful in the management of patients with CHF.
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Affiliation(s)
- Ling Sun
- Department of Cardiology, Fuyang Tumor Hospital, Fuyang, China
- Department of Cardiology, Fuyang People’s Hospital Affiliated to Anhui Medical University, Fuyang, China
| | - Jie Yuan
- Consultancy Department, Hanyi Data Technology (Shenzhen) Co., Ltd, Shenzhen, China
| | - Tao Wang
- Department of Cardiology, Fuyang Tumor Hospital, Fuyang, China
| | - Bin Ning
- Department of Cardiology, Fuyang People’s Hospital Affiliated to Anhui Medical University, Fuyang, China
| | - Qinghua Yuan
- Department of Cardiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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