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Tang L, Ding K, Li M, Chao X, Sun T, Guo Y, Peng X, Jia W, Chen T, Xie G, Feng L. Differences in oral microbiota associated with type 2 diabetes mellitus between the Dai and Han populations. J Oral Microbiol 2025; 17. [DOI: 10.1080/20002297.2024.2442420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 12/02/2024] [Accepted: 12/04/2024] [Indexed: 01/04/2025] Open
Affiliation(s)
- Lingtong Tang
- Department of Clinical Laboratory, The People’s Hospital of Gao County, Yibin, Sichuan, China
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Keke Ding
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengci Li
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaowen Chao
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Sun
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhuai Guo
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xufei Peng
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Jia
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, China
| | - Tianlu Chen
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoxiang Xie
- Human Metabolomics Institute Inc, Shenzhen, China
| | - Lei Feng
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, China
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Chew BH, Lai PSM, Sivaratnam DA, Basri NI, Appannah G, Mohd Yusof BN, Thambiah SC, Nor Hanipah Z, Wong PF, Chang LC. Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study. Health Syst Reform 2025; 11:2417788. [PMID: 39761168 DOI: 10.1080/23288604.2024.2417788] [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: 06/05/2024] [Revised: 08/28/2024] [Accepted: 10/14/2024] [Indexed: 01/11/2025] Open
Abstract
There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Family Medicine Specialist Clinic, Hospital Sultan Abdul Aziz Shah (HSAAS Teaching Hospital), Persiaran MARDI - UPM, Serdang, Selangor, Malaysia
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, School of Medical and Life Sciences, Sunway University, Kuala Lumpur, Selangor, Malaysia
| | - Dhashani A/P Sivaratnam
- Department of Opthalmology, Faculty of .Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Subashini C Thambiah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zubaidah Nor Hanipah
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | | | - Li-Cheng Chang
- Kuang Health Clinic, Pekan Kuang, Gombak, Selangor, Malaysia
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Yazbeck AS, Nguyen SN, Escobar ML. How Health Systems World-wide Fail Type 2 Diabetics. Health Syst Reform 2025; 11:2437898. [PMID: 39847757 DOI: 10.1080/23288604.2024.2437898] [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: 07/23/2024] [Revised: 11/24/2024] [Accepted: 12/01/2024] [Indexed: 01/25/2025] Open
Abstract
For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease. Using a health systems prism to review the extensive medical and nutritional T2DM published research, we identified three main shortcomings of health systems in T2DM: (i) failure in early detection; (ii) failure in understanding the actionable lifestyle drivers; and (iii) subsidizing the causes of the disease. Although small-scale success stories in T2DM control exist, the lack of documented evidence of any country-wide health system's successful attempt to address this epidemic is alarming. The immense and ever-growing health and economic burdens of T2DM should provide all the motivation needed for national and global efforts to counteract the political-economy constraints standing in the way of successful whole-of-system approaches to T2DM.
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Affiliation(s)
- Abdo S Yazbeck
- Lead Economist and Adjunct Faculty, Johns Hopkins University, Baltimore, USA
| | - Son Nam Nguyen
- Lead Health Specialist, The World Bank, Washington, DC, USA
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Qiu M, Chen S, Chen J, Gao H. Bibliometric study and visual analysis of postoperative diabetes mellitus in kidney transplant recipients based on WoSCC database. Ren Fail 2025; 47:2444383. [PMID: 39806790 PMCID: PMC11734397 DOI: 10.1080/0886022x.2024.2444383] [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: 08/06/2024] [Revised: 11/12/2024] [Accepted: 12/15/2024] [Indexed: 01/16/2025] Open
Abstract
BACKGROUND In recent years, the increase of the post-transplantation diabetes mellitus (PTDM) after renal transplantation encourages people to do a lot of research on the disease. This paper conducted a bibliometric study on PTDM related literature to explore the risk factors of diabetes after kidney transplantation, as well as the current status, hotspots and development trends of PTDM research, so as to provide reference for researchers in related fields. METHODS We searched the Web of Science Core Collection (WoSCC) database for PTDM literature from January 1, 1990, to August 20, 2023, and used VOSviewer, CiteSpace, and the R package 'bibliometrix' to do bibliometric analysis. RESULTS Obesity, 3 months after transplantation tacrolimus concentration >10 ng/mL, temporary hyperglycemia, delayed graft function, acute rejection is specific risk factors related to PTDM in renal transplant recipients. In addition, 74 countries led by China and the United States published 1546 papers, and the number of PTDM-related publications is increasing every year. Primary institutions included the University of California, Los Angeles, Mayo Clinic, University of Oslo, and University of Toronto. The Journal of Transplantation is the most widely read journal in the subject. The authors with the most published literature are Trond Jenssen and Adnan Sharif, and the most cited author is Kasiske BL. Expectations for continued growth in global PTDM research are increasingly high. Future studies will mainly focus on exploring the risk factors of PTDM and identifying new therapeutic approaches and targets.
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Affiliation(s)
- Minhua Qiu
- Graduate School, Guangxi University of Chinese Medicine, Nanning, China
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
- Guangxi Clinical Research Center for Kidney Diseases of Integrated Traditional Chinese and Western Medicine, Nanning, China
| | - Sheng Chen
- Graduate School, Guangxi University of Chinese Medicine, Nanning, China
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
- Guangxi Clinical Research Center for Kidney Diseases of Integrated Traditional Chinese and Western Medicine, Nanning, China
| | - Jibing Chen
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
- Guangxi Clinical Research Center for Kidney Diseases of Integrated Traditional Chinese and Western Medicine, Nanning, China
| | - Hongjun Gao
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
- Guangxi Clinical Research Center for Kidney Diseases of Integrated Traditional Chinese and Western Medicine, Nanning, China
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Yu M, Ning FTE, Liu C, Liu YC. Interconnections between diabetic corneal neuropathy and diabetic retinopathy: diagnostic and therapeutic implications. Neural Regen Res 2025; 20:2169-2180. [PMID: 39359077 PMCID: PMC11759029 DOI: 10.4103/nrr.nrr-d-24-00509] [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: 05/06/2024] [Revised: 06/28/2024] [Accepted: 07/24/2024] [Indexed: 10/04/2024] Open
Abstract
Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus. Diabetic corneal neuropathy refers to the progressive damage of corneal nerves. Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature. However, growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit, which includes both the retinal vascular structures and neural tissues. Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening. However, diabetic corneal neuropathy is commonly overlooked and underdiagnosed, leading to severe ocular surface impairment. Several studies have found that these two conditions tend to occur together, and they share similarities in their pathogenesis pathways, being triggered by a status of chronic hyperglycemia. This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy, whether diabetic corneal neuropathy precedes diabetic retinopathy, as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy. We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.
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Affiliation(s)
- Mingyi Yu
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore
| | - Faith Teo En Ning
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chang Liu
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore
| | - Yu-Chi Liu
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore
- Department of Cornea and External Eye Disease, Singapore National Eye Center, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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Figueroa-Perez CA, Romero-Ibarguengoitia ME, Garza-Silva A, Fernández-Chau IF, Cepeda-Medina AB, Garza-González S, Gutierrez-González D, González-Cantú A. Sudoscan ® reclassifies cardiovascular risk in patients with type 2 diabetes mellitus according to the ESC 2023. J Diabetes Metab Disord 2025; 24:50. [PMID: 39845906 PMCID: PMC11748664 DOI: 10.1007/s40200-024-01548-7] [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: 10/28/2024] [Accepted: 12/05/2024] [Indexed: 01/24/2025]
Abstract
Objectives The objective of this study is to determine if the detection of DAN through Sudoscan® can reclassify cardiovascular risk in patients with T2DM according to the European Society of Cardiology guidelines 2023 (ESC 2023) compared to other risk scales. Methods A retrospective cross-sectional analytical study was conducted on 161 patients with T2DM who had undergone Sudoscan® in a Northern Mexico Hospital between December 2022 and July 2023. We compared the cardiovascular risk with SCORE-2, SMART, ADVANCE, ASCVD plus, and Globo Risk scales. Results Estimated cardiovascular risk according to the ESC 2023 without consideration of DAN was low for 91 (57%), moderate for 53 (33%), high for 11 (7%) and very high for 22 (3%) of patients. While inclusion of DAN resulted in low risk in 81 (51%), moderate in 46 (28%9, high in 9(5%) and very high risk for 25 ((16%), p = 0.004). The majority of patients were classified as low or moderate risk using other scales such as ASCVD plus, SCORE-2, Globo Risk, ADVANCE, and SMART. Conclusions Sudoscan® enhances cardiovascular risk assessment in T2DM by accurately diagnosing microvascular complications, ensuring comprehensive patient evaluation.
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Affiliation(s)
- Cesar Alejandro Figueroa-Perez
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
| | - Maria Elena Romero-Ibarguengoitia
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
- Endocrinology Department, Hospital Clinica Nova de Monterrey, San Nicolas de los Garza, Nuevo León, 66450 México
| | - Arnulfo Garza-Silva
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
| | - Iván Francisco Fernández-Chau
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
| | - Andrea Belinda Cepeda-Medina
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
| | - Sofía Garza-González
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
| | - Dalia Gutierrez-González
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
| | - Arnulfo González-Cantú
- Research Department, Hospital Clinica Nova de Monterrey, Av. Del Bosque 139 Cuahtemoc, San Nicolas de los Garza, Nuevo León, 66450 México
- Escuela de Medicina Vicerrectoria de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza Garcia, Nuevo Leon, 66238 México
- Endocrinology Department, Hospital Clinica Nova de Monterrey, San Nicolas de los Garza, Nuevo León, 66450 México
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7
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Bhatia Z, Kumar S, Seshadri S. Fecal microbiota transplantation as a potential therapeutic approach to improve impaired glucose tolerance via gut microbiota modulation in rat model. J Diabetes Metab Disord 2025; 24:28. [PMID: 39735176 PMCID: PMC11680516 DOI: 10.1007/s40200-024-01518-z] [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: 06/22/2024] [Accepted: 11/06/2024] [Indexed: 12/31/2024]
Abstract
Objectives To investigate the impact of diet-induced gut microbiota alterations on type 2 diabetes and assess the therapeutic potential of Fecal Microbiota Transplantation (FMT) in restoring a balanced gut microenvironment. Methods To induce type 2 diabetes, rats were fed a high-sugar high-fat diet (HSFD) for 90 days. After diabetes induction, animals were divided into an HSFD control group, a metformin group (100 mg/kg), and an FMT group (100 mg/kg), receiving treatment for an additional 90 days. Fasting blood glucose levels, glucose tolerance, serum markers (HbA1C, free fatty acids, lipopolysaccharides, pro-inflammatory and anti-inflammatory cytokines), and gut microbiota profiles via cecal metagenome sequencing were analyzed post-treatment. Results FMT effectively restored gut microbiota composition to a profile similar to healthy controls, rebalancing the Firmicutes/Bacteroidetes ratio and increasing beneficial taxa, including Prevotella ruminicola, Akkermansia muciniphila, Roseburia, and Faecalibacterium prausnitzii. These microbial shifts corresponded with significant metabolic improvements: FMT reduced inflammatory markers (LPS and FFA), lowered HbA1c, and improved glucose tolerance. Enhanced gut barrier integrity observed in FMT-treated animals likely contributed to reduced endotoxemia and systemic inflammation, distinguishing FMT's metabolic effects from those of metformin. Notably, FMT addressed the dysbiosis associated with HSFD, promoting microbial resilience and mitigating the metabolic disruptions linked to type 2 diabetes. Conclusion These findings underscore the potential of FMT as a targeted therapeutic approach to modulate gut microbiota composition and mitigate metabolic dysregulation induced by high sugar high fat diet.
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Affiliation(s)
- Zeel Bhatia
- Institute of Science, Nirma University, Ahmedabad, Gujarat 382481 India
| | - Sunny Kumar
- Institute of Science, Nirma University, Ahmedabad, Gujarat 382481 India
| | - Sriram Seshadri
- Institute of Science, Nirma University, Ahmedabad, Gujarat 382481 India
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Bahadoran Z, Mirmiran P, Ghasemi A, Azizi F. Excessive exposure to nitrate and nitrite boosts progression of isolated impaired fasting glucose to type 2 diabetes: a cohort study. J Diabetes Metab Disord 2025; 24:8. [PMID: 39697867 PMCID: PMC11649602 DOI: 10.1007/s40200-024-01517-0] [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: 07/18/2024] [Accepted: 11/08/2024] [Indexed: 12/20/2024]
Abstract
Objectives This cohort study investigated the possible association of dietary nitrate (NO3)/nitrite (NO2) intake and risk of progression to type 2 diabetes (T2D) across different phenotypes of prediabetes (Pre-DM). Methods A total of 1586 adults diagnosed with Pre-DM [i.e., 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT), and 18.8% combined IFG-IGT] in the third (2006-2008) and fourth (2009-2011) examinations of the Tehran Lipid and Glucose Study, were assessed for dietary intake of NO3 and NO2 and were followed up to 2015-2017. Cox proportional hazard models, stratified by Pre-DM phenotypes, were used to plot cumulative hazard curve and calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing T2D across tertile categories and per every 100 mg/d NO3 and 2 mg/d NO2 intake exceeded the acceptable daily intake (ADI). Results The mean age of the participants was 47.2 ± 12.9 years at baseline, and 52.2% were men. Highest intake of NO3 (≥ 645 vs. < 451 mg/d) and NO2 (≥ 11.5 vs. <9.0 mg/d) increased risk of T2D among subjects with iIFG (HR = 1.69, 95% CI = 1.04-2.74 and HR = 2.07, 95% CI = 1.29-3.32). The cumulative hazards were higher in the highest compared to the lowest NO3 and NO2 intake in subjects with iIFG phenotype. Every 100 mg/d of NO3 and 2 mg/d NO2 intake exceeded ADI was associated with an increased risk of progression from iIFG to T2D by 13 and 25%, respectively. Conclusion High exposure to dietary NO3 and NO2 may be a risk factor for developing T2D in subjects with iIFG.
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Affiliation(s)
- Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Micronutrient Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Anoush M, Taghaddosi N, Bokaei Hosseini Z, Rahmati F, Bijani S, Kalantari-Hesari A, Hosseini MJ. Neuroprotective effects of empagliflozin against scopolamine-induced memory impairment and oxidative stress in rats. IBRO Neurosci Rep 2025; 18:163-170. [PMID: 39896712 PMCID: PMC11786754 DOI: 10.1016/j.ibneur.2025.01.008] [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: 04/11/2024] [Revised: 12/31/2024] [Accepted: 01/09/2025] [Indexed: 02/04/2025] Open
Abstract
Alzheimer's disease (AD) is one of the most common age-related neurodegenerative disorders. The main medicinal theory for the management of AD belongs to the acetyl-cholinesterase-inhibition pathway and NMDA antagonism. Recent investigation proposed memory improvement by sodium-glucose co-transporter 2 (SGLT2) inhibitors which indicated to improve glycemic control in adults with type 2 diabetes mellitus. According to the lack of sufficient evidence about the efficacy of empagliflozin (EMPA) for memory improvement, in comparison with donepezil (DON), the present research was carried out in order to investigate this hypothesis towards scopolamine-induced neurotoxicity on experimental male Wistar rats. The animals divided into two sets, each included 4 groups: The first set of Healthy animals [Control, EMPA (4 or 10 mg/kg), DON (1 mg/kg)]. The second set of rat Alzheimer model, which received 2 mg/kg Scopolamine by intraperitoneal route for 10 days followed by other treatments [AD, AD+ EMPA (4 or 10 mg/kg) and AD+DON]. Normal rats and AD rats, with each group receiving different substances for 8 consecutive days and 24 h after the accomplishment of the drug administrations, the memory functions assessed through Morris water maze (MWM) paradigm. This task was followed by decapitation of rats in order to evaluate the biochemical oxidative stress parameters in brain tissue. Our data indicated that EMPA significantly improved animals' performance in the behavioral test with a significant decrease in oxidative stress and antioxidant imbalance. In addition, EMPA (4 mg/kg) significantly reduced both cellular malondialdehyde and protein carbonyl content while conversely increased the total reduced glutathione content. Besides, the levels of total as well as endogenous antioxidants in the ferric reducing antioxidant power assay reported to be augmented. It seems that EMPA significantly improved both cellular biochemical aspects and memory performance in animal models in accordance with histopathological assessments. Conclusively, 4 mg/kg EMPA demonstrated better results in all aspects that were evaluated during this research.
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Affiliation(s)
- Mahdieh Anoush
- Zanjan Applied Pharmacology Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Neda Taghaddosi
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zahra Bokaei Hosseini
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fatemeh Rahmati
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soroush Bijani
- Zanjan Applied Pharmacology Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Kalantari-Hesari
- Department of Basic Sciences, Faculty of Veterinary Medicine, Bu-Ali Sina University, Hamedan, Iran
| | - Mir-Jamal Hosseini
- Zanjan Applied Pharmacology Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
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Prado dos Santos V, de Mello Ferreira L, Queiroz AB, Silveira Alves CA. Rotational flap versus long plantar flap for transmetatarsal amputation closure following revascularization. J Vasc Surg Cases Innov Tech 2025; 11:101696. [PMID: 39811745 PMCID: PMC11732539 DOI: 10.1016/j.jvscit.2024.101696] [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: 10/04/2024] [Accepted: 11/18/2024] [Indexed: 01/16/2025] Open
Abstract
Objective The integrity of the plantar flap is important for transmetatarsal amputation (TMA) classic closure. However, in ischemic wounds, the plantar flap can be compromised, making the TMA coverage difficult. The aim of this study was to compare the outcomes of rotational vs long plantar flaps for transmetatarsal amputation closure in patients with dysvascular partial foot amputations. Methods We conducted an observational study including revascularized patients with established forefoot gangrene who required TMA. The coverage was performed by classical long plantar flap or rotational flap due to the lack of adequate plantar skin. Seventeen patients were included in the study. TMA was performed after lower limb revascularization in all cases. We compared the wound healing and functional outcomes of the two groups (rotational vs long plantar flap). Results The mean age of the sample was 66.5 years (±8.3 years). Eight cases (47%) had open surgical bypass, and nine (53%) had endovascular procedures. Eight cases of rotational flaps (7 medial plantar rotational flaps) and nine classical long plantar flaps were analyzed. Our results demonstrated an overall healing rate of 77% in the sample. There was no significant difference between the surgical techniques evaluated. The healing percentage for the rotational flap group was 75% (6 cases) and 78% (7 cases) for the classical long plantar flap closure (P = .6). Conclusions Rotational flap provides a feasible alternative to classical long plantar flap for TMA coverage, showing a satisfactory healing rate for dysvascular foot following revascularization.
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Affiliation(s)
| | - Lucas de Mello Ferreira
- Hospital Universitário Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
| | - André Brito Queiroz
- Hospital Universitário Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
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Rahman MS, Ghorai S, Panda K, Santiago MJ, Aggarwal S, Wang T, Rahman I, Chinnapaiyan S, Unwalla HJ. Dr. Jekyll or Mr. Hyde: The multifaceted roles of miR-145-5p in human health and disease. Noncoding RNA Res 2025; 11:22-37. [PMID: 39736851 PMCID: PMC11683234 DOI: 10.1016/j.ncrna.2024.11.001] [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: 08/02/2024] [Revised: 10/14/2024] [Accepted: 11/09/2024] [Indexed: 01/01/2025] Open
Abstract
MicroRNAs (miRNAs) are classified as small, non-coding RNAs that play crucial roles in diverse biological processes, including cellular development, differentiation, growth, and metabolism. MiRNAs regulate gene expression by recognizing complementary sequences within messenger RNA (mRNA) molecules. Recent studies have revealed that miR-145-5p functions as a tumor suppressor in several cancers, including lung, liver, and breast cancers. Notably, miR-145-5p plays a vital role in the pathophysiology underlying HIV and chronic obstructive pulmonary diseases associated with cigarette smoke. This miRNA is abundant in biofluids and shows potential as a biomarker for the diagnosis and prognosis of several infectious diseases, such as hepatitis B, tuberculosis, and influenza. Additionally, numerous studies have indicated that other non-coding RNAs, including long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs), can regulate miR-145-5p. Given the significance of miR-145-5p, a comprehensive overview focusing on its roles in health and disease is essential. This review discusses the dual role of miR-145-5p as a protagonist and antagonist in important human diseases, with particular emphasis on disorders of the respiratory, digestive, nervous, reproductive, endocrine, and urinary systems.
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Affiliation(s)
- Md. Sohanur Rahman
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Suvankar Ghorai
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Kingshuk Panda
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Maria J. Santiago
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
- Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Saurabh Aggarwal
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Ting Wang
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
- Center for Translational Science, Florida International University, Port Saint Lucie, FL 34987, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Srinivasan Chinnapaiyan
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Hoshang J. Unwalla
- Department of Cellular and Molecular Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
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12
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Locatelli M, Farina C. Role of copper in central nervous system physiology and pathology. Neural Regen Res 2025; 20:1058-1068. [PMID: 38989937 PMCID: PMC11438321 DOI: 10.4103/nrr.nrr-d-24-00110] [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: 01/26/2024] [Revised: 03/21/2024] [Accepted: 04/23/2024] [Indexed: 07/12/2024] Open
Abstract
Copper is a transition metal and an essential element for the organism, as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs, including the central nervous system. Central copper dysregulations have been evidenced in two genetic disorders characterized by mutations in the copper-ATPases ATP7A and ATP7B, Menkes disease and Wilson's disease, respectively, and also in multifactorial neurological disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and multiple sclerosis. This review summarizes current knowledge about the role of copper in central nervous system physiology and pathology, reports about unbalances in copper levels and/or distribution under disease, describes relevant animal models for human disorders where copper metabolism genes are dysregulated, and discusses relevant therapeutic approaches modulating copper availability. Overall, alterations in copper metabolism may contribute to the etiology of central nervous system disorders and represent relevant therapeutic targets to restore tissue homeostasis.
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Affiliation(s)
- Martina Locatelli
- Institute of Experimental Neurology, Division of Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Cinthia Farina
- Institute of Experimental Neurology, Division of Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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13
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Kwon M, Lee Y, Kim KS. Biomimetic gradient hydrogel with fibroblast spheroids for full-thickness skin regeneration. BIOMATERIALS ADVANCES 2025; 169:214152. [PMID: 39708659 DOI: 10.1016/j.bioadv.2024.214152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 12/12/2024] [Accepted: 12/14/2024] [Indexed: 12/23/2024]
Abstract
Hydrogel-based scaffolds have been widely investigated for their use in tissue engineering to accelerate tissue regeneration. However, replicating the physiological microenvironments of tissues with appropriate biological cues remains challenging. Recent advances in gradient hydrogels have transformed tissue-engineering research by providing precise structures that mimic the extracellular matrix of natural tissues. Unlike conventional homogeneously structured hydrogels, gradient hydrogels provide a better bio-mimicking microenvironment for combined cell therapies in chronic wound treatment by regulating various cell behaviors, such as proliferation, migration, and differentiation. Here, we present the integration of L929 mouse fibroblast spheroids into gradient hydrogels to mimic the dermal stiffness microenvironment and we investigated their impact on full-thickness skin regeneration. A stiffness gradient was achieved by modulating the concentration of methacrylated hyaluronic acid (HA-MA) with varying degrees of methacrylation, using a dual-syringe pump system. The encapsulation of L929 spheroids with gradient hydrogel facilitated skin cell organization in a hierarchically ordered configuration, leading to full-thickness wound healing that was 1.53 times faster than the untreated group in a rat model. This study provides a method for investigating the potential role of gradient hydrogels in various tissue engineering and regeneration applications.
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Affiliation(s)
- Mina Kwon
- School of Chemical Engineering, Pusan National University, Busan 46241, Republic of Korea.
| | - Yuhan Lee
- Department of Anaesthesiology, Perioperative and Pain Medicine, Center for Accelerated Medical Innovation, Center for Nanomedicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - Ki Su Kim
- School of Chemical Engineering, Pusan National University, Busan 46241, Republic of Korea; Department of Organic Materials Science and Engineering, Pusan National University, Busan 46241, Republic of Korea; Institute of Advanced Organic Materials, Pusan National University, Busan 46241, Republic of Korea.
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14
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Chafekar D. Optimizing chronic kidney disease management: The potential of a multi-strain probiotic formulation. World J Nephrol 2025; 14:101515. [DOI: 10.5527/wjn.v14.i1.101515] [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: 09/17/2024] [Revised: 10/21/2024] [Accepted: 12/03/2024] [Indexed: 01/20/2025] Open
Abstract
Chronic kidney disease (CKD), which represents a significant global health concern, is characterized by a gradual decline in kidney function, leading to complications such as electrolyte imbalance, cardiovascular disease, and immune dysfunction. Standard CKD management includes dietary modifications, ketoanalogues supplementation, blood pressure and blood glucose control, hydration maintenance, and treatment of the underlying causes. Emerging evidence has indicated a significant role of the gut microbiota in CKD, and that dysbiosis of the gut microbiota contributes to the progression of CKD towards end-stage renal disease. Probiotics and prebiotics have recently garnered attention owing to their potential to enhance gastrointestinal health and well-being by restoring the balance of the gut microbiota. Specific probiotic strains, including Lactobacillus and Bifidobacterium, promote beneficial bacterial growth, suppress harmful bacteria, and exert anti-inflammatory, antihypertensive, and antidiabetic effects. The combination of Streptococcus thermophilus, Lactobacillus acidophilus, Bifidobacterium longum, and Bacillus coagulans has demonstrated potential as a therapeutic formulation for CKD management in various studies, highlighting its promise in treating CKD; however, supporting evidence remains limited, making it crucial to conduct further investigations to determine the specific effects of different probiotic formulations on outcomes in patients with CKD.
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Affiliation(s)
- Deodatta Chafekar
- Dr V N Pawar Medical College, Director Supreme Kidney Care, Nashik 422005, Mahārāshtra, India
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15
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Wei XY, Shen HN. Transient extreme insulin resistance in a critically ill patient: A case report. World J Clin Cases 2025; 13:100889. [DOI: 10.12998/wjcc.v13.i8.100889] [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: 08/29/2024] [Revised: 10/29/2024] [Accepted: 11/22/2024] [Indexed: 12/04/2024] Open
Abstract
BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients, typically managed with insulin infusion. However, the occurrence of transient extreme insulin resistance (EIR) requiring exceptional high-dose insulin is rare.
CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest, subsequently developing transient EIR following a new episode of sepsis. Remarkably, insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour (a total of 18224 units on that day), and it was promptly titrated down to zero upon achieving the target glucose level.
CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR, which is typically transient. Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
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Affiliation(s)
- Xiu-Yu Wei
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Hsiu-Nien Shen
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan 710, Taiwan
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16
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Prabhahar A, Batta A, Hatwal J, Kumar V, Ramachandran R, Batta A. Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings. World J Diabetes 2025; 16:100592. [DOI: 10.4239/wjd.v16.i3.100592] [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: 08/20/2024] [Revised: 12/18/2024] [Accepted: 12/27/2024] [Indexed: 01/21/2025] Open
Abstract
Diabetes is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) worldwide. While both haemodialysis (HD) and peritoneal dialysis (PD) are commonly used treatment options for ESKD, the choice of dialysis modality in diabetic ESKD patients remains a critical decision influenced by various patient-related, healthcare system, and socio-economic factors. This article examines the factors influencing the selection of dialysis modalities for diabetic patients, with a focus on the challenges and opportunities in low-resource settings. Key considerations include the impact of comorbidities such as peripheral arterial disease and CKD-related mineral bone disorder (MBD), as well as patient preferences, caregiver burden, and the availability of healthcare infrastructure. The article highlights the need for personalized approaches to dialysis selection, considering both clinical outcomes and quality of life. It also emphasizes the potential benefits of home dialysis, including home HD and PD, in improving patient autonomy and long-term survival. The article advocates for better government policies, increased awareness, and improved support systems to enhance the accessibility and efficacy of dialysis treatments, particularly in underserved populations. Further research comparing the outcomes of different dialysis modalities across diverse settings is essential to guide global treatment strategies for diabetic ESKD patients.
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Affiliation(s)
- Arun Prabhahar
- Department of Telemedicine (Internal Medicine and Nephrology), Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Akshey Batta
- Department of Urology and Renal Transplant, Neelam Hospital, Rajpura 140401, Punjab, India
| | - Juniali Hatwal
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Vivek Kumar
- Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Raja Ramachandran
- Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
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17
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Yang YJ, Zhou XC, Tian HR, Liang FX. Electroacupuncture relieves type 2 diabetes by regulating gut microbiome. World J Diabetes 2025; 16:103032. [DOI: 10.4239/wjd.v16.i3.103032] [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: 11/05/2024] [Revised: 12/30/2024] [Accepted: 01/08/2025] [Indexed: 01/21/2025] Open
Abstract
Cumulative studies have shown that the composition of the gut microbiome is strongly associated with the development of type 2 diabetes mellitus (T2DM). Electroacupuncture (EA) therapy has been reported to alleviate various diseases, including T2DM, by targeting specific acupuncture points and regulating metabolic homeostasis. A recent review published in the World Journal of Diabetes detailed the role of the gut microbiome in T2DM, discussing the role of therapeutic strategies developed to alleviate T2DM and its complications based on gut microbiome in ameliorating T2DM, as well as the effects of multiple diabetes medications on gut microbiome. However, the review did not elucidate the therapeutic role of EA therapy, a common non-pharmacological intervention for T2DM. This letter complemented the effect of EA therapy on glucose metabolism by adjusting the gut microbiome composition, which reveals the underlying mechanism of glucose lowering by EA therapy and provides a scientific basis for the application of EA therapy in clinical treatment.
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Affiliation(s)
- Ya-Jing Yang
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
| | - Xu-Chang Zhou
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Hao-Ran Tian
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
| | - Feng-Xia Liang
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
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18
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Yang J, Zhang CZ, Zhang J. From metabolic regulation to kidney protection: β-arrestin 2 as a dual-function therapeutic target. World J Diabetes 2025; 16:102014. [DOI: 10.4239/wjd.v16.i3.102014] [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: 10/05/2024] [Revised: 11/21/2024] [Accepted: 01/02/2025] [Indexed: 01/21/2025] Open
Abstract
We are deeply interested in the recent findings on β-arrestin 2. Liu et al demonstrated that β-arrestin 2 knockout provides significant protection in diabetic nephropathy, underscoring its potential as a promising therapeutic target for diabetic nephropathy treatment. Furthermore, the role of β-arrestin 2 in metabolic regulation is equally critical, particularly in insulin signaling, hepatic glucose production, and adipose tissue function. Although β-arrestin 2 plays a distinct role in metabolism and kidney protection, its tissue-specific regulation opens up valuable avenues for developing targeted therapeutic strategies centered on β-arrestin 2.
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Affiliation(s)
- Jian Yang
- Hubei Key Laboratory of Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Hubei Provincial Clinical Research Center for Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
| | - Cheng-Zhi Zhang
- Hubei Key Laboratory of Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Hubei Provincial Clinical Research Center for Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
| | - Jing Zhang
- Hubei Key Laboratory of Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Hubei Provincial Clinical Research Center for Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
- Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
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19
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Geng XQ, Chen SF, Wang FY, Yang HJ, Zhao YL, Xu ZR, Yang Y. Correlation between key indicators of continuous glucose monitoring and the risk of diabetic foot. World J Diabetes 2025; 16:99277. [DOI: 10.4239/wjd.v16.i3.99277] [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: 07/18/2024] [Revised: 11/09/2024] [Accepted: 12/23/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Continuous glucose monitoring (CGM) metrics, such as time in range (TIR) and glycemic risk index (GRI), have been linked to various diabetes-related complications, including diabetic foot (DF).
AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus (T2DM).
METHODS A total of 591 individuals with T2DM (297 with DF and 294 without DF) were enrolled. Relevant clinical data, complications, comorbidities, hematological parameters, and 72-hour CGM data were collected. Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.
RESULTS Individuals with DF exhibited higher mean blood glucose (MBG) levels and increased proportions of time above range (TAR), TAR level 1, and TAR level 2, but lower TIR (all P < 0.001). Patients with DF had significantly lower rates of achieving target ranges for TIR, TAR, and TAR level 2 than those without DF (all P < 0.05). Logistic regression analysis revealed that GRI, MBG, and TAR level 1 were positively associated with DF risk, while TIR was inversely correlated (all P < 0.05). Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels (P < 0.05). Additionally, achieving TAR was influenced by fasting plasma glucose, body mass index, diabetes duration, and antidiabetic medication use.
CONCLUSION CGM metrics, particularly TIR and GRI, are significantly associated with the risk of DF in T2DM, emphasizing the importance of improved glucose control.
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Affiliation(s)
- Xin-Qian Geng
- Department of Endocrinology, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Shun-Fang Chen
- Department of Endocrinology, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Fei-Ying Wang
- Department of Endocrinology, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Hui-Jun Yang
- Department of Endocrinology, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Yun-Li Zhao
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education and Yunnan Province, Yunnan University, Kunming 650500, Yunnan Province, China
| | - Zhang-Rong Xu
- The Diabetic Center of PLA, The Ninth Medical Center of PLA General Hospital (306th Hosp PLA), Beijing 100101, China
| | - Ying Yang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
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20
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Li ZP, Sun JK, Fu WP, Zhang CJ. Optimizing risk management for post-amputation wound complications in diabetic patients: Focus on glycemic and immunosuppressive control. World J Diabetes 2025; 16:102899. [DOI: 10.4239/wjd.v16.i3.102899] [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: 11/01/2024] [Revised: 12/19/2024] [Accepted: 12/27/2024] [Indexed: 01/21/2025] Open
Abstract
This study highlights the importance of identifying and addressing risk factors associated with wound complications following transtibial amputation in diabetic patients. These amputations, often necessitated by severe diabetic foot ulcers, carry significant risks of postoperative complications such as infection and delayed wound healing. Elevated hemoglobin A1c levels, indicative of poor glycemic control, and a history of kidney transplantation, due to required immunosuppressive therapy, are key factors influencing these outcomes. This paper emphasizes the need for enhanced glycemic management and personalized postoperative care, particularly for immunocompromised individuals, to minimize complications and improve patient prognosis. Future research should focus on prospective studies to validate targeted interventions and optimize care strategies, ultimately aiming to reduce the healthcare burden associated with diabetic foot complications.
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Affiliation(s)
- Zhi-Peng Li
- Second Department of Orthopedics, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
- Tianjian Advanced Biomedical Laboratory, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Jin-Ke Sun
- Third Department of Orthopedics, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Wei-Ping Fu
- Second Department of Orthopedics, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Chang-Jiang Zhang
- Second Department of Orthopedics, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
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21
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Liang LF, Zhao JQ, Wu YF, Chen HJ, Huang T, Lu XH. SMAD specific E3 ubiquitin protein ligase 1 accelerates diabetic macular edema progression by WNT inhibitory factor 1. World J Diabetes 2025; 16:101328. [DOI: 10.4239/wjd.v16.i3.101328] [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: 09/11/2024] [Revised: 12/06/2024] [Accepted: 01/02/2025] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Diabetic macular edema (DME) is the most common cause of vision loss in people with diabetes. Tight junction disruption of the retinal pigment epithelium (RPE) cells has been reported to induce DME development. SMAD-specific E3 ubiquitin protein ligase (SMURF) 1 was associated with the tight junctions of cells. However, the mechanism of SMURF1 in the DME process remains unclear.
AIM To investigate the role of SMURF1 in RPE cell tight junction during DME.
METHODS ARPE-19 cells treated with high glucose (HG) and desferrioxamine mesylate (DFX) for establishment of the DME cell model. DME mice models were constructed by streptozotocin induction. The trans-epithelial electrical resistance and permeability of RPE cells were analyzed. The expressions of tight junction-related and autophagy-related proteins were determined. The interaction between insulin like growth factor 2 mRNA binding protein 2 (IGF2BP2) and SMURF1 mRNA was verified by RNA immunoprecipitation (RIP). SMURF1 N6-methyladenosine (m6A) level was detected by methylated RIP.
RESULTS SMURF1 and vascular endothelial growth factor (VEGF) were upregulated in DME. SMURF1 knockdown reduced HG/DFX-induced autophagy, which protected RPE cell tight junctions and ameliorated retinal damage in DME mice. SMURF1 activated the Wnt/β-catenin-VEGF signaling pathway by promoting WNT inhibitory factor (WIF) 1 ubiquitination and degradation. IGF2BP2 upregulated SMURF1 expression in an m6A modification-dependent manner.
CONCLUSION M6A-modified SMURF1 promoted WIF1 ubiquitination and degradation, which activated autophagy to inhibit RPE cell tight junctions, ultimately promoting DME progression.
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Affiliation(s)
- Li-Fang Liang
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
| | - Jia-Qi Zhao
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
| | - Yi-Fei Wu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
| | - Hui-Jie Chen
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
| | - Tian Huang
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
| | - Xiao-He Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 515282, Guangdong Province, China
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22
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Zhang YL, Peng GL, Leng WL, Lian Y, Cheng LQ, Li X, Wang YL, Zhou L, Long M. Association between serum retinol-binding protein and lower limb atherosclerosis risk in type 2 diabetes mellitus. World J Diabetes 2025; 16:98590. [DOI: 10.4239/wjd.v16.i3.98590] [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: 06/30/2024] [Revised: 11/13/2024] [Accepted: 12/30/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Serum retinol-binding protein (RBP) is the primary transport protein of circulating vitamin A. RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis. Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications. However, the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus (T2DM).
AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.
METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis (n = 1913) and lower limb atherosclerosis groups (n = 2515) based on lower limb arterial ultrasonography results. At hospital admission, baseline serum RBP levels were assessed, and all subjects were categorized into three groups (Q1-Q3) based on RBP tertiles. Logistic regression, restricted cubic spline regression, subgroup analysis, and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.
RESULTS Among 4428 individuals with T2DM, 2515 (56.80%) had lower limb atherosclerosis. Logistic analysis showed that lower limb atherosclerosis risk increased by 1% for every 1 unit rise in serum RBP level (odds ratio = 1.01, 95% confidence interval: 1.00-1.02, P = 0.004). Patients in the highest tertile group (Q3) had a higher lower limb atherosclerosis risk compared to the lowest tertile group (Q1) (odds ratio = 1.36, 95% confidence interval: 1.12-1.67, P = 0.002). The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile (P for trend = 0.005). Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk (non-linear P < 0.05). Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.
CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.
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Affiliation(s)
- Yu-Ling Zhang
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
- Department of Endocrinology, Southwest Hospital Jiangbei Area (The 958th Hospital of Chinese People’s Liberation Army), Chongqing 400000, China
| | - Gui-Liang Peng
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
| | - Wei-Ling Leng
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
| | - Yu Lian
- Department of Endocrinology, Southwest Hospital Jiangbei Area (The 958th Hospital of Chinese People’s Liberation Army), Chongqing 400000, China
| | - Li-Qing Cheng
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
- Department of Endocrinology, Southwest Hospital Jiangbei Area (The 958th Hospital of Chinese People’s Liberation Army), Chongqing 400000, China
| | - Xing Li
- Department of Endocrinology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210093, Jiangsu Province, China
- Department of Endocrinology, Jinling Hospital, Nanjing Medical University, Nanjing 210093, Jiangsu Province, China
- Department of Endocrinology, Jinling Hospital, School of Medicine, Southeast University, Nanjing 210093, Jiangsu Province, China
| | - Yu-Lin Wang
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
| | - Ling Zhou
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
| | - Min Long
- Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing 400038, China
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Parveen K, Hussain MA, Anwar S, Elagib HM, Kausar MA. Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management. World J Diabetes 2025; 16:100329. [DOI: 10.4239/wjd.v16.i3.100329] [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: 08/13/2024] [Revised: 11/27/2024] [Accepted: 12/27/2024] [Indexed: 01/21/2025] Open
Abstract
Diabetic foot (DF) is a major public health concern. As evident from numerous previous studies, supervision of DF ulcer (DFU) is crucial, and a specific quality check-up is needed. Patients should be educated about glycaemic management, DFUs, foot lesions, proper care for injuries, diet, and surgery. Certain reasonably priced treatments, such as hyperbaric oxygen and vacuum-assisted closure therapy, are also available for DFUs, along with modern wound care products and techniques. Nonetheless, DF care (cleaning, applying antimicrobial cream when wounded, and foot reflexology), blood glucose monitoring to control diabetes, and monthly or quarterly examinations in individuals with diabetes are effective in managing DFUs. Between 50% and 80% of DF infections are preventable. Regardless of the intensity of the lesion, it needs to be treated carefully and checked daily during infection. Tissue regeneration can be aided by cleaning, dressing, and application of topical medicines. The choice of shoes is also important because it affects blood circulation and nerve impulses. In general, regular check-ups, monitoring of the patient’s condition, measuring blood glucose levels, and providing frequent guidance regarding DFU care are crucial. Finally, this important clinical problem requires involvement of multiple professionals to properly manage it.
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Affiliation(s)
- Kehkashan Parveen
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Malik Asif Hussain
- Department of Pathology, College of Medicine, University of Ha’il, Ha'il 53962, Saudi Arabia
| | - Sadaf Anwar
- Department of Biochemistry, College of Medicine, University of Ha’il, Ha'il 53962, Saudi Arabia
| | | | - Mohd Adnan Kausar
- Department of Biochemistry, College of Medicine, University of Ha’il, Ha'il 53962, Saudi Arabia
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Nassar M, Gill AS, Marte E. Investigating the impact of intestinal glucagon-like peptide-1 on hypoglycemia in type 1 diabetes. World J Diabetes 2025; 16:99142. [DOI: 10.4239/wjd.v16.i3.99142] [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: 07/14/2024] [Revised: 11/30/2024] [Accepted: 01/02/2025] [Indexed: 01/21/2025] Open
Abstract
Recent advances in understanding type 1 diabetes (T1D) highlight the complexity of managing hypoglycemia, a frequent and perilous complication of diabetes therapy. This letter delves into a novel study by Jin et al, which elucidates the role of intestinal glucagon-like peptide-1 (GLP-1) in the counterregulatory response to hypoglycemia in T1D models. The study employed immunofluorescence, Western blotting, and enzyme-linked immunosorbent assay to track changes in GLP-1 and its receptor expression in diabetic mice subjected to recurrent hypoglycemic episodes. Findings indicate a significant increase in intestinal GLP-1 and GLP-1 receptor expression, correlating with diminished adrenal and glucagon responses, crucial for glucose stabilization during hypoglycemic events. This letter aims to explore the implications of these findings for future therapeutic strategies and the broader understanding of T1D management.
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Affiliation(s)
- Mahmoud Nassar
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY 14221, United States
- Department of Research, American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE), Lewes, DE 19958, United States
| | - Angad Singh Gill
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY 14221, United States
- Department of Research, American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE), Lewes, DE 19958, United States
| | - Erlin Marte
- Department of Endocrine, WNY VA Hospital, Buffalo, NY 14215, United States
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Duan ZW, Li ZN, Zhai YJ, Liu TF, Zhang CC, Hu T, Wei XE, Rong LQ, Liu HY. Effects of glycemic indicators on early neurological outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. World J Diabetes 2025; 16:94491. [DOI: 10.4239/wjd.v16.i3.94491] [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: 03/27/2024] [Revised: 10/01/2024] [Accepted: 12/09/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Stress hyperglycemia (SH) is a common phenomenon that is present in about 50% of patients with acute ischemic stroke (AIS). It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis (IVT).
AIM To investigate the predictive value of glycemic indicators for early neurological outcomes (ENOs) in patients with AIS treated with IVT.
METHODS We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, between January 2017 and June 2022. ENO included early neurological improvement (ENI) and early neurological deterioration (END), defined as a decrease or increase in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 24 hours after IVT. We analyzed the associations between glycemic indicators [including admission hyperglycemia (AH), fasting blood glucose (FBG), and SH ratio (SHR)] and ENO in all patients and in subgroups stratified by diabetes mellitus (DM).
RESULTS A total of 819 patients with AIS treated with IVT were included. Among these, AH was observed in 329 patients (40.2%). Compared with patients without AH, those with AH were more likely to have a higher prevalence of DM (P < 0.001) and hypertension (P = 0.031) and presented with higher admission NIHSS scores (P < 0.001). During the first 24 hours after IVT, END occurred in 208 patients (25.4%) and ENI occurred in 156 patients (19.0%). Multivariate mixed logistic regression analyses indicated that END was independently associated with AH [odds ratio (OR): 1.744, 95% confidence interval (CI): 1.236-2.463; P = 0.002]. Subjects were classified into four groups representing quartiles. Compared with Q1, patients in the higher quartiles of SHR (Q2: OR: 2.306, 95%CI: 1.342-3.960; P = 0.002) (Q3: OR: 2.284, 95%CI: 1.346-3.876; P = 0.002) (Q4: OR: 3.486, 95%CI: 2.088-5.820; P = 0.001) and FBG (Q3: OR: 1.746, 95%CI: 1.045-2.917; P = 0.033) (Q4: OR: 2.436, 95%CI: 1.476-4.022; P = 0.001) had a significantly higher risk of END in the overall population. However, none of the glycemic indicators were found to be associated with ENI in patients with or without DM.
CONCLUSION Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.
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Affiliation(s)
- Zuo-Wei Duan
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Zhi-Ning Li
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Yu-Jia Zhai
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Teng-Fei Liu
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Cui-Cui Zhang
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Ting Hu
- Department of Neurology, Medical School of Nanjing University, Xuzhou 221006, Jiangsu Province, China
| | - Xiu-E Wei
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Liang-Qun Rong
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
| | - Hai-Yan Liu
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
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Li MZ, Tang F, Liu YF, Lao JH, Yang Y, Cao J, Song R, Wu P, Wang YB. Risk factors and a predictive model of diabetic foot in hospitalized patients with type 2 diabetes. World J Diabetes 2025; 16:95644. [DOI: 10.4239/wjd.v16.i3.95644] [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: 04/15/2024] [Revised: 11/20/2024] [Accepted: 12/19/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND The risk factors and prediction models for diabetic foot (DF) remain incompletely understood, with several potential factors still requiring in-depth investigations.
AIM To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.
METHODS We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021. A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors. Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions. The Cox model was further employed to evaluate the impact of risk factors on DF. The area under the curve (AUC) was measured to evaluate the accuracy of the prediction model.
RESULTS Seventy-five diabetic inpatients experienced DF. The incidence density of DF was 4.5/1000 person-years. A long duration of diabetes, lower extremity arterial disease, lower serum albumin, fasting plasma glucose (FPG), and diabetic nephropathy were independently associated with DF. Among these risk factors, the serum albumin concentration was inversely associated with DF, with a hazard ratio (HR) and 95% confidence interval (CI) of 0.91 (0.88-0.95) (P < 0.001). Additionally, a U-shaped nonlinear relationship was observed between the FPG level and DF. After adjusting for other variables, the HRs and 95%CI for FPG < 4.4 mmol/L and ≥ 7.0 mmol/L were 3.99 (1.55-10.25) (P = 0.004) and 3.12 (1.66-5.87) (P < 0.001), respectively, which was greater than the mid-range level (4.4-6.9 mmol/L). The AUC for predicting DF over 3 years was 0.797.
CONCLUSION FPG demonstrated a U-shaped relationship with DF. Serum albumin levels were negatively associated with DF. The prediction nomogram model of DF showed good discrimination ability using diabetes duration, lower extremity arterial disease, serum albumin, FPG, and diabetic nephropathy (Clinicaltrial.gov NCT05519163).
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Affiliation(s)
- Ming-Zhuo Li
- Department of Plastic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Jinan Clinical Research Center for Tissue Engineering Skin Regeneration and Wound Repair, Jinan 250012, Shandong Province, China
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Shandong Data Open Innovative Application Laboratory, Jinan 250012, Shandong Province, China
| | - Fang Tang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Shandong Data Open Innovative Application Laboratory, Jinan 250012, Shandong Province, China
| | - Ya-Fei Liu
- Shandong Mental Health Center, Shandong University, Jinan 250012, Shandong Province, China
| | - Jia-Hui Lao
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Shandong Data Open Innovative Application Laboratory, Jinan 250012, Shandong Province, China
| | - Yang Yang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Shandong Data Open Innovative Application Laboratory, Jinan 250012, Shandong Province, China
| | - Jia Cao
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Shandong Data Open Innovative Application Laboratory, Jinan 250012, Shandong Province, China
| | - Ru Song
- Department of Plastic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Jinan Clinical Research Center for Tissue Engineering Skin Regeneration and Wound Repair, Jinan 250012, Shandong Province, China
| | - Peng Wu
- Department of Plastic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
- Jinan Clinical Research Center for Tissue Engineering Skin Regeneration and Wound Repair, Jinan 250012, Shandong Province, China
| | - Yi-Bing Wang
- Department of Plastic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250012, Shandong Province, China
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Xia Y, Hu Y, Ma JH. Premixed insulin: Advantages, disadvantages, and future. World J Diabetes 2025; 16:102526. [DOI: 10.4239/wjd.v16.i3.102526] [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: 10/20/2024] [Revised: 12/30/2024] [Accepted: 01/08/2025] [Indexed: 01/21/2025] Open
Abstract
Premixed insulin combines two types of insulin in a single injection. This combination streamlines dosing for patients with type 1 or type 2 diabetes, thereby enhancing convenience. However, patients receiving premixed insulin commonly have less satisfactory blood glucose control. The fixed ratio of insulin in these formulations frequently fails to account for the nuanced demands of individualized glucose-lowering therapy. Moreover, local absorption of mixed insulin and potential systemic autoimmune responses may further compromise glycaemic control. The co-formulation of insulin degludec and insulin aspart introduces a new combination of the two insulin types within a single injection, offering a promising solution for mitigating the limitations inherent in premixed insulin.
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Affiliation(s)
- Yan Xia
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi 214000, Jiangsu Province, China
| | - Yun Hu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi 214000, Jiangsu Province, China
| | - Jian-Hua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
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Cheng CH, Hao WR, Cheng TH. Selenoprotein P1 as a biomarker of insulin resistance in pediatric obesity: Insights and implications. World J Clin Pediatr 2025; 14:99652. [DOI: 10.5409/wjcp.v14.i1.99652] [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: 07/26/2024] [Revised: 10/31/2024] [Accepted: 11/12/2024] [Indexed: 12/20/2024] Open
Abstract
This editorial discusses the findings of Elbarky et al on the role of selenoprotein P1 (SEPP1) in pediatric obesity and insulin resistance. Their study uncovered significantly lower SEPP1 Levels in children who were obese compared with healthy peers, demonstrating a negative correlation between SEPP1 levels and measures of adiposity and insulin resistance. These findings suggest that SEPP1 is a biomarker useful in the early identification of insulin resistance in pediatric populations. This editorial emphasizes the clinical implications of the study and calls for further research to validate and explore the role of SEPP1 in metabolic health.
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Affiliation(s)
- Chun-Han Cheng
- Department of Medical Education, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei 23561, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11002, Taiwan
| | - Tzu-Hurng Cheng
- Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, Taichung 404328, Taiwan
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29
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Shamsad A, Gautam T, Singh R, Banerjee M. Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes. World J Clin Pediatr 2025; 14:99231. [DOI: 10.5409/wjcp.v14.i1.99231] [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: 07/17/2024] [Revised: 10/03/2024] [Accepted: 10/31/2024] [Indexed: 12/20/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a metabolic disorder, recognised during 24-28 weeks of pregnancy. GDM is linked with adverse newborn outcomes such as macrosomia, premature delivery, metabolic disorder, cardiovascular, and neurological disorders. Recent investigations have focused on the correlation of genetic factors such as β-cell function and insulin secretary genes (transcription factor 7 like 2, potassium voltage-gated channel subfamily q member 1, adiponectin etc.) on maternal metabolism during gestation leading to GDM. Epigenetic alterations like DNA methylation, histone modification, and miRNA expression can influence gene expression and play a dominant role in feto-maternal metabolic pathways. Interactions between genes and environment, resulting in differential gene expression patterns may lead to GDM. Researchers suggested that GDM women are more susceptible to insulin resistance, which alters intrauterine surroundings, resulting hyperglycemia and hyperinsulinemia. Epigenetic modifications in genes affecting neuroendocrine activities, and metabolism, increase the risk of obesity and type 2 diabetes in offspring. There is currently no treatment or effective preventive method for GDM, since the molecular processes of insulin resistance are not well understood. The present review was undertaken to understand the pathophysiology of GDM and its effects on adverse neonatal outcomes. In addition, the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.
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Affiliation(s)
- Amreen Shamsad
- Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow 226007, Uttar Pradesh, India
| | - Tanu Gautam
- Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow 226007, Uttar Pradesh, India
| | - Renu Singh
- Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Monisha Banerjee
- Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow 226007, Uttar Pradesh, India
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Balakrishnan KR, Selva Raj DR, Ghosh S, Robertson GAJ. Diabetic foot attack: Managing severe sepsis in the diabetic patient. World J Crit Care Med 2025; 14:98419. [DOI: 10.5492/wjccm.v14.i1.98419] [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: 06/25/2024] [Revised: 10/23/2024] [Accepted: 11/15/2024] [Indexed: 12/11/2024] Open
Abstract
Diabetic foot attack (DFA) is the most severe presentation of diabetic foot disease, with the patient commonly displaying severe sepsis, which can be limb or life threatening. DFA can be classified into two main categories: Typical and atypical. A typical DFA is secondary to a severe infection in the foot, often initiated by minor breaches in skin integrity that allow pathogens to enter and proliferate. This form often progresses rapidly due to the underlying diabetic pathophysiology of neuropathy, microvascular disease, and hyperglycemia, which facilitate infection spread and tissue necrosis. This form of DFA can present as one of a number of severe infective pathologies including pyomyositis, necrotizing fasciitis, and myonecrosis, all of which can lead to systemic sepsis and multi-organ failure. An atypical DFA, however, is not primarily infection-driven. It can occur secondary to either ischemia or Charcot arthropathy. Management of the typical DFA involves prompt diagnosis, aggressive infection control, and a multidisciplinary approach. Treatment can be guided by the current International Working Group on the Diabetic Foot/Infectious Diseases Society of America guidelines on diabetic foot infections, and the combined British Orthopaedic Foot and Ankle Society-Vascular Society guidelines. This article highlights the importance of early recognition, comprehensive management strategies, and the need for further research to establish standardized protocols and improve clinical outcomes for patients with DFA.
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Affiliation(s)
- Kisshan Raj Balakrishnan
- Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom
| | - Dharshanan Raj Selva Raj
- Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom
| | - Sabyasachi Ghosh
- Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom
| | - Gregory AJ Robertson
- Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, United Kingdom
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Podobnik J, Prentice KJ. Metabolic interventions as adjunctive therapies to insulin in type 1 diabetes: Current clinical landscape and perspectives. Diabetes Obes Metab 2025; 27:1032-1044. [PMID: 39757938 DOI: 10.1111/dom.16154] [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: 09/03/2024] [Revised: 12/04/2024] [Accepted: 12/14/2024] [Indexed: 01/07/2025]
Abstract
Type 1 diabetes (T1D) is classically characterized as an autoimmune disease wherein the immune system erroneously attacks insulin-producing pancreatic β-cells, causing insulin insufficiency and severe metabolic dysregulation. However, intensive investigation and numerous clinical trials with immunotherapies have been largely unable to significantly alter the course of disease. Currently, there is no effective way to prevent or cure T1D, and insulin remains the cornerstone of T1D treatment. In recent years, a growing body of research suggests that β-cells actively contribute to the immune response and to disease development. Factors including glucotoxicity, lipotoxicity, inflammation, endoplasmic reticulum (ER) and oxidative stress can induce β-cell apoptosis and senescence, further promoting insulitis. Recent studies highlight the importance of targeting metabolic control for T1D management and treatment. Metabolic interventions, through their direct and indirect impacts on β-cells, have shown promise in preserving β-cell function. These interventions can reduce glucose toxicity, alleviate oxidative stress and inflammation, enhance insulin sensitivity, and indirectly mitigate the autoimmune responses. By preserving β-cell function, individuals with T1D attain better glycaemic control, reduced complication risks and exhibit improved overall metabolic health. Here, we provide an overview of insights from clinical studies, systematic reviews and meta-analyses that collectively demonstrate that adjunctive metabolic interventions can enhance glycaemic control, reduce insulin requirements and mitigate adverse effects associated with insulin monotherapy. They also show potential for halting disease progression, preserving residual β-cell function and improving long-term outcomes for newly diagnosed individuals. Future research should focus on optimizing these treatment strategies and establishing their long-term efficacy and safety.
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Affiliation(s)
- Juliana Podobnik
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kacey J Prentice
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Richards J, Dorand MF, Paszkowiak M, Ahmed S, McCorkle C, Kathuria P. Significantly higher rates of KIDINS220 polymorphisms in patients with obesity and end-stage renal disease. OBESITY PILLARS 2025; 13:100155. [PMID: 39801599 PMCID: PMC11719405 DOI: 10.1016/j.obpill.2024.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/04/2024] [Accepted: 12/05/2024] [Indexed: 01/16/2025]
Abstract
Background Kinase D-interacting substrate of 220 kDa ("KIDINS220") is an integral plasma membrane protein essential to signaling throughout the body; abnormalities are linked to a variety of disorders, including obesity, but have never been directly linked to chronic- or end-stage renal disease. Methods Retrospective chart review identified patients with severe obesity who presented for pre-kidney transplant weight management. 20 individuals met criteria for testing for genetic causes of obesity. A χ2 test of independence was utilized to compare genetic mutation rates in this cohort to all individuals tested nationally. Results This case series presents a cohort of patients with severe obesity and end-stage renal disease who were subsequently found to have a significantly higher rate of KIDINS220 mutations (20 %, χ2 = 27.8, p < 0.0001) compared to the national positivity rate of all individuals tested for genetic causes of obesity. Conclusions Mutations within KIDINS220 may play a modulatory role in the progression of chronic kidney disease in patients with obesity, as evidenced by this small retrospective study. The relationship between KIDINS200, kidney disease, and obesity is complex and requires further study, but may represent a potential therapeutic target in the future.
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Affiliation(s)
- Jesse Richards
- Department of Internal Medicine, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
| | - Madisen Fae Dorand
- Department of Internal Medicine, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
| | - Maria Paszkowiak
- College of Medicine, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
| | - Sana Ahmed
- College of Medicine, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
| | - Courtney McCorkle
- College of Medicine, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
| | - Pranay Kathuria
- Department of Nephrology, University of Oklahoma School of Community Medicine, 4502 E. 41st Street, Tulsa, OK, 74135, USA
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Cho JH, Seon SY, Kim SE, Park JH, Lim ST. Need to develop a healthy ageing and fall prevention exercise program for older people with sarcopenia. Australas J Ageing 2025; 44:e13393. [PMID: 39676254 DOI: 10.1111/ajag.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 10/18/2024] [Indexed: 12/17/2024]
Affiliation(s)
- Ji-Hoon Cho
- Department of Sports Medicine, Dongshin University, Naju, Korea
| | - Se-Young Seon
- Department of Leisure Sports, Seowon University, Cheongju, Korea
| | - Seong-Eon Kim
- Department of Physical Education, Sejong University, Seoul, Korea
- Pulse LAB, Seoul, Korea
| | - Jong-Ho Park
- Department of Physical Education, Sejong University, Seoul, Korea
- Pulse LAB, Seoul, Korea
| | - Seung-Taek Lim
- College of General Education, Kookmin University, Seoul, Korea
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
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Bernstorff M, Hansen L, Enevoldsen K, Damgaard J, Hæstrup F, Perfalk E, Danielsen AA, Østergaard SD. Development and validation of a machine learning model for prediction of type 2 diabetes in patients with mental illness. Acta Psychiatr Scand 2025; 151:245-258. [PMID: 38575118 PMCID: PMC11787919 DOI: 10.1111/acps.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/08/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Type 2 diabetes (T2D) is approximately twice as common among individuals with mental illness compared with the background population, but may be prevented by early intervention on lifestyle, diet, or pharmacologically. Such prevention relies on identification of those at elevated risk (prediction). The aim of this study was to develop and validate a machine learning model for prediction of T2D among patients with mental illness. METHODS The study was based on routine clinical data from electronic health records from the psychiatric services of the Central Denmark Region. A total of 74,880 patients with 1.59 million psychiatric service contacts were included in the analyses. We created 1343 potential predictors from 51 source variables, covering patient-level information on demographics, diagnoses, pharmacological treatment, and laboratory results. T2D was operationalised as HbA1c ≥48 mmol/mol, fasting plasma glucose ≥7.0 mmol/mol, oral glucose tolerance test ≥11.1 mmol/mol or random plasma glucose ≥11.1 mmol/mol. Two machine learning models (XGBoost and regularised logistic regression) were trained to predict T2D based on 85% of the included contacts. The predictive performance of the best performing model was tested on the remaining 15% of the contacts. RESULTS The XGBoost model detected patients at high risk 2.7 years before T2D, achieving an area under the receiver operating characteristic curve of 0.84. Of the 996 patients developing T2D in the test set, the model issued at least one positive prediction for 305 (31%). CONCLUSION A machine learning model can accurately predict development of T2D among patients with mental illness based on routine clinical data from electronic health records. A decision support system based on such a model may inform measures to prevent development of T2D in this high-risk population.
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