Emerging evidence suggested that liraglutide possessed the potential to improve the albumin-to-creatinine ratio (ACR) in patients with type 2 diabetes mellitus (T2DM). This study aimed to ascertain the impact of liraglutide on ACR in T2DM.

PubMed, Embase, the Cochrane Library, WanFang and CNKI were searched for randomized controlled trials (RCTs) from inception to November 30, 2024 (PROSPERO: CRD52025336785). The data were pooled using fixed- or random-effects models based on the heterogeneity. Sensitivity analyses and publication bias assessments were performed.

Seven RCTs involving 473 participants were included. Liraglutide significantly reduced ACR (WMD: - 11.76 mg/g, 95% CI, - 21.71 to - 1.81, I² = 75%, P = 0.02) compared to controls (placebo or active drugs). Subgroup analysis revealed significant ACR reductions in patients with HbA1c > 8.0%, follow-up > 12 weeks, and age < 60 years. Meta regression indicated that heterogeneity was not influenced by sample size, HbA1c, baseline ACR, treatment duration, or liraglutide dosage (P = 0.92; 95% CI, - 322.34 to 340.66). The results were stable based in sensitivity analysis, and no publication bias was detected (Begg's P = 0.46; Egger's P = 0.57).

Liraglutide significantly reduced ACR in T2DM, particularly in patients with poor glycemic control, longer treatment duration, and younger age. Future studies with extended follow-up are needed to confirm its renoprotective benefits.

Previous studies investigating the relationship of dietary fat intake with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) have yielded inconsistent findings. Therefore, the relationship between fat intake before and during pregnancy and risk of GDM and IGT was assessed.

A comprehensive search was conducted using electronic databases up to June 2024. Our selection criteria focused on observational studies that reported odds ratios (ORs)/ relative risks (RRs)/ hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between total, animal or plant fat intake and risks of GDM and IGT.

A total of 14 studies comprising 39,399 participants were included. Comparing the highest versus lowest intakes of total, animal, and plant fat revealed the summary RRs of 1.49 (95% CI: 1.20, 1.83), 1.56 (95% CI: 1.32, 1.85), and 1.26 (95% CI: 1.08, 1.47), respectively, indicating significant positive associations of total, animal and plant fat with GDM. Subgroup analysis indicated that total fat intake during pregnancy had a stronger association with GDM than pre-pregnancy intake. For animal and plant fat, significant associations were only observed for intake during pregnancy. Based on the linear dose-response analysis, each 5% energy increment in total dietary fat during pregnancy was associated with a 6% increased risk of GDM (RR = 1.06; 95% CI: 1.03, 1.10). The non-linear dose-response analysis indicated an increasing trend between total fat intake during pregnancy (23%-50% E) and the risk of GDM. However, there was no significant relationship between fat intake and IGT.

Higher total fat intake before and during pregnancy is directly and dose-dependently associated with increased GDM risk. The highest versus lowest values of animal and plant fat intakes during pregnancy were related to higher risk of GDM. No significant association was observed for IGT; however, the limited number of included studies especially on "pre-pregnancy" and the cross-sectional nature of several studies on "during pregnancy" prevent us from establishing causal relationships.

Antihyperglycemic medications can affect more than just glucose control; they may also influence mental health outcomes. This study aimed to investigate the relationships between various antidiabetic medications and psychiatric disorders, including depression, anxiety, and sleep disturbances, in individuals with type 2 diabetes (T2DM).

This cross-sectional study analyzed data from patients with T2DM, assessing psychiatric outcomes among these patients using various antidiabetic therapies. Sleep quality, anxiety, and depression were measured using validated scales, including the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), respectively.

This study involved 229 patients with a mean age ± standard deviation of 63.43 ± 10.38 years. The median body mass index (BMI) was 27.18 kg/m², with an interquartile range (IQR) of 24.55-30.10, and the median duration of diabetes was 11.00 years (IQR: 6.00-16.00). The use of sodium glucose cotransporter-2 (SGLT-2) inhibitors was significantly associated with poorer sleep quality, as indicated by a higher odds ratio (odds ratio [OR] = 2.076, 95% confidence interval [CI]: 1.016-4.242, P = 0.045). Insulin use was linked to increased anxiety, with an OR of 1.985 (95% CI: 1.007-3.913, P = 0.048). In contrast, sulfonylureas and glinides were associated with lower odds of depression, with an OR of 0.374 (95% CI: 0.182-0.768, P = 0.007). No significant associations were found between thiazolidinediones, metformin, or dipeptidyl peptidase-4 (DPP-4) inhibitors and any psychiatric outcomes.

The use of SGLT2 inhibitors may negatively impact sleep quality, whereas insulin therapy is associated with increased anxiety symptoms. Conversely, sulfonylureas and glinides appear to have a protective effect against depression. These findings underscore the importance of considering psychiatric outcomes when prescribing antidiabetic medications.

The hs-CRP/HDL-C ratio is a novel marker reflecting inflammation and lipid metabolism disorders, but systematic investigations regarding its association with prediabetes and diabetes are still lacking. This study aimed to explore the association between the hs-CRP/HDL-C ratio and the presence of prediabetes and diabetes, thereby providing a theoretical basis for identifying individuals with dysglycemia at an earlier stage.

A total of 18,472 eligible adult participants were included based on NHANES data from 2015 to 2023. The hs-CRP/HDL-C ratio was divided into quartiles, and its association with the odds of prediabetes and diabetes was evaluated using multivariable logistic regression and restricted cubic spline (RCS) analysis. Subgroup analyses were performed to explore the predictive value of the ratio across different population subgroups. All statistical analyses were weighted to enhance the representativeness of the findings.

A significant positive association was observed between the hs-CRP/HDL-C ratio and the odds of prediabetes and diabetes. Compared to individuals with normal glucose levels, those with prediabetes and diabetes had significantly elevated hs-CRP/HDL-C ratios (both p < 0.001). An increasing trend in the prevalence of prediabetes and diabetes was observed with rising hs-CRP/HDL-C ratio (28.72-44.10% and 4.38-17.34%, respectively). In Model 3, after full adjustment, each unit increase in the hs-CRP/HDL-C ratio was associated with a 13.3% higher odds of prediabetes (OR = 1.133, 95% CI: 1.082-1.184, p < 0.001) and a 26.9% higher odds of diabetes (OR = 1.269, 95% CI: 1.186-1.351, p < 0.001). The RCS analysis revealed a significant nonlinear association between the hs-CRP/HDL-C ratio and the risks of prediabetes and diabetes, with apparent inflection points near 0.614 and 1.168 (Model 3). Additionally, receiver operating characteristic (ROC) analysis showed that the hs-CRP/HDL-C ratio had better discriminatory performance than either hs-CRP or HDL-C alone in predicting prediabetes (AUC = 0.751) and diabetes (AUC = 0.857). Subgroup analyses further demonstrated notable heterogeneity in the predictive value of this indicator across various demographic and clinical strata.

Our findings suggest that the hs-CRP/HDL-C ratio is significantly associated with the presence of prediabetes and diabetes in a nonlinear dose-response pattern, indicating its potential as a marker associated with glycemic disorders.

Not applicable.

Inflammation has been recognized as a pivotal factor in the pathophysiology of diabetes. The aggregate index of systemic inflammation (AISI) has recently been proposed as a novel biomarker for evaluating inflammatory status and predicting clinical outcomes. However, evidence on the association between AISI and mortality in diabetic patients remains limited. To address this knowledge gap, we aimed to investigate the association between AISI and mortality risk from cardio-cerebrovascular disease (CCD) and malignant neoplasms in diabetic patients. We analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2001-2018). Multivariable-adjusted Cox models revealed strong associations between elevated AISI levels and CCD mortality (HR 1.18, 95% CI 1.11-1.26) as well as malignant neoplasm mortality (HR 1.20, 95% CI 1.10-1.30). Kaplan-Meier analysis showed that higher AISI was associated with lower survival in diabetic patients for both CCD and malignant neoplasms. Restricted cubic spline (RCS) analysis demonstrated an increased risk of mortality from CCD and malignant neoplasms in diabetic patients with elevated AISI levels. Subgroup and sensitivity analyses confirmed the robustness of these findings. In adults with diabetes, elevated AISI levels are strongly associated with an increased risk of mortality from CCD and malignant neoplasms.

The global burden of gout is substantial and expected to increase. We investigated the relationship between the triglyceride-glucose (TyG) index, a biomarker of insulin resistance, and gout risk in the general population over time. This study was conducted using data from the National Health Screening Cohort Database of South Korea (2002-2019) among 300,107 participants who had no history of gout and underwent more than three repeated TyG index measurements. During the median of 9.62 years (interquartile range 8.72-10.53), 14,116 individuals (4.72%) developed gout. In a multivariable time-dependent Cox proportional hazards model, a per-unit increase in the TyG index significantly increased gout risk (hazard ratio [HR] 1.150; 95% confidence interval [CI] 1.116-1.184). The multivariate Cox proportional hazards model for average TyG index quartiles was positively associated with the incidence risk of gout, accompanied by a significant trend (HR 1.326, 95% CI 1.260-1.397). This association followed a J-shaped pattern with increased risk. Our findings highlight a strong link between elevated TyG index and gout incidence in the general population, suggesting that the TyG index may serve as a valuable predictor of gout risk.

The aim of this study was to investigate the prognostic impact of sex on in- and out-of-hospital adverse events in troponin-positive patients with non-obstructive coronary artery disease (CAD). 24,775 patients who underwent coronary angiography from 2010 to 2021 were screened for this study. The final study population consisted of 373 troponin-positive patients with non-obstructive CAD with a follow-up period of 6.2 ± 3.1 years, with 185 males and 188 females. The primary study end point was a composite of in-hospital adverse events. Secondary endpoints covered out-of-hospital adverse events during follow-up. In-hospital adverse event rates revealed no significant sex differences (37.8% in males vs. 33.0% in females). Significantly more long-term adverse events occurred in women compared with men during follow-up (27.3% vs. 41.9%). All-cause mortality was significantly higher in women than in men (29.7% vs. 21.2%, p = 0.022). Cox analysis identified age ≥ 70 years, arterial hypertension, diabetes mellitus, supraventricular tachycardia, pulmonary disease, neurological disease, and kidney disease as predictors of out-of-hospital adverse events, whereas male sex was associated with a better long-term outcome. While sex differences were not significant in in-hospital adverse events, females demonstrated a higher incidence of out-of-hospital adverse events and increased mortality during long-term follow-up compared to males.

The relationship between remnant cholesterol and diabetes is a critical issue in the fields of health and public health. Currently, the relationship between remnant cholesterol (RC) and diabetes is a highly researched and trending topic. The aim of this study was to investigate association between RC and diabetes in US individuals. The secondary objective of this study was to explore the potential dose-response relationship between the exposure RC and diabetes. Our study utilized all available continuous data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Multivariable logistic regression models were used to investigate the association between RC and diabetes. The association between RC and diabetes was assessed using smoothing splines generated by generalized additive models. Additionally, a threshold effect analysis of the relationship between RC and diabetes was conducted. Analysis of 6,875 eligible adults (derived from an initial cohort of 7,780 after exclusions for missing diabetes/cholesterol data) revealed a significant threshold effect at 19 mg/dLof remnant cholesterol (RC) for diabetes prevalence. Participants with RC < 19 mg/dL exhibited substantially elevated diabetes odds in both unadjusted (OR = 1.80, 95% CI: 1.57-2.06; P < 0.001) and fully adjusted models (OR = 1.46, 95% CI: 1.30-1.64; P < 0.001), whereas RC ≥ 19 mg/dL demonstrated no significant association (adjusted OR = 0.99, 95% CI: 0.88-1.25; P = 0.96). Quartile analysis confirmed a robust dose-dependent relationship: compared to Quartile 1 (RC ≤ 12 mg/dL; reference), diabetes odds progressively increased to OR = 1.72 (95% CI: 1.37-2.16)​for Quartile 2 (13-18 mg/dL), OR = 2.32 (95% CI: 1.86-2.91) for Quartile 3 (19-26 mg/dL), and OR = 3.42 (95% CI: 2.77-4.21)​for Quartile 4 (27-80 mg/dL), with significant trend persistence after multivariable adjustment (P < 0.001). These associations remained significant despite substantial demographic variations across RC quartiles, including differences in age (P < 0.001), sex distribution (P < 0.001), and racial/ethnic composition (P < 0.001). This cross-sectional analysis observed that elevated RC levels were significantly associated with higher prevalence of diabetes in adults aged 20-80 years, with a threshold value of 19 mg/dL for increased association strength. The findings support RC as a metabolic marker associated with prevalent diabetes with a threshold value of 19 mg/dL for strengthened association.

To investigate the association between various obesity indices and the risk of developing microvascular complications in adult patients with Type 2 diabetes(T2DM), using cohort data derived from Yinzhou District Health Big Data Platform of China.

This study included adult patients with type 2 diabetes(T2DM) who were enrolled between January 1, 2008, and December 31, 2013, in Yinzhou District, Ningbo, and did not have any microvascular complications at baseline. Data collection encompassed demographic characteristics, lifestyle behaviors, laboratory test result, and physical examination findings, obtained at both baseline and during follow-up periods through structured epidemiological surveys and clinical assessments. Various obesity indices were calculated, including body mass index(BMI), waist-to-height ratio(WHtR), a body shape index(ABSI) and body roundness index(BRI). We also computed the coefficients of variation for these obesity indices during the follow-up period. A Cox proportional hazards regression model was used to analyze the association between obesity indices at baseline and follow-up, and the risk of developing microvascular complications. Additionally, receiver operating characteristic(ROC) curves were used to analyze the predictive efficacy of the coefficients of variation for BMI, WHtR, ABSI and BRI in relation to microvascular complications, and the areas under the curve(AUCs) were calculated.

A total of 27 635 patients with type 2 diabetes(T2DM) were included, contributing to 153 717 person-years of follow-up. During this period, 12 969 new cases of microvascular complications were identified, resultsing in an incidence rate of 84.37 cases per 1000 person-years. Patients were categorized into two groups based on the occurrence of complications: those with microvascular complications and those without. There was no significant difference in blood glucose levels between the two groups at baseline. After adjusting for sociodemographic characteristics, laboratory indicators, and potential confounders such as a history of hypertension and hyperlipidemia, it was found that only the WHtR(HR=1.027, 95%CI 1.008-1.046), ABSI(HR=1.035, 95%CI 1.018-1.053) and BRI(HR=1.030, 95%CI 1.011-1.049) were independently associated with the risk of microvascular complications at baseline, while waist circumference(HR=1.010, 95%CI 0.992-1.029) and BMI(HR=0.985, 95%CI 0.967-1.002) were not significantly related(P&gt;0.05). During the follow-up period, the coefficients of variation for all obesity indices were independently associated with an increased risk of microvascular complications. Among them, abdominal obesity indices, such as waist circumference(HR=0.063, 95%CI 1.057-1.069), WHtR(HR=1.060, 95%CI 1.054-1.066), and ABSI(HR=1.062, 95%CI 1.058-1.066), were most strongly linked to the risk of microvascular complications. Further stratified analysis based on baseline BMI revealed that the variability in abdominal obesity indices was more strongly associated with microvascular complications in patients with normal and overweight BMI compared to those with obesity. Specifically, the following result were observed: waist circumference(HR_(normal BMI)=1.074, HR_(overweight)=1.059, HR_(obesity)=1.041; P&lt;0.01), WHtR(HR_(normal BMI)=1.069, HR_(overweight)=1.059, HR_(obesity)=1.037; P&lt;0.01), ABSI(HR_(normal BMI)=1.065, HR_(overweight)=1.067, HR_(obesity)=1.038; P&lt;0.01), BRI(HR_(normal BMI)=1.023, HR_(overweight)=1.020, HR_(obesity)=1.011; P&lt;0.01). Additionally, to further explore the predictive value of various obesity indices for microvascular complications in type 2 diabetes mellitus(T2DM), we conducted stratified analyses based on sex and age(using 60 years as the cutoff). WHtR showed similar predictive performance between men(AUC = 0.794) and women(AUC=0.789). However, WHtR demonstrated stronger predictive ability in individuals over 60 years old(AUC = 0.803) compared to those aged 60 years or younger(AUC = 0.777). ABSI exhibited a higher predictive value in men(AUC = 0.752) than in women(AUC = 0.730), and again, the index performed better in the older population(AUC = 0.761) than in the younger group(AUC = 0.725). Similarly, BRI demonstrated comparable performance between sexes [men(AUC = 0.796) and women(AUC = 0.791)] with the highest predictive accuracy seen in participants over 60 years(AUC = 0.806). By contrast, BMI showed relatively lower predictive power across all subgroups. Specifically, the AUC values for BMI were 0.744 in men and 0.714 in women, 0.714 in those aged 60 years or below and 0.748 in those above 60 years.

Increased baseline abdominal obesity indices(WHtR, ABSI and BRI) and higher variability in obesity indices during follow-up are strongly associated with increased risks of microvascular complications in T2DM patients. In individuals with normal BMI, higher variability in abdominal obesity indices is positively correlated with the risk of microvascular complications. Furthermore, the variability in abdominal obesity indices(WHtR, ABSI and BRI) provides better predictive ability for microvascular complications compared to general obesity indices(BMI), especially in male patients and those aged over 60.

To investigate the association between the triglyceride-glucose(TyG) index and the risk of diabetes among Chinese adults with normal fasting serum glucose levels.

A total of 2161 participants were selected from China Nutrition and Health Surveillance(2010-2012) and China Nutrition and Health Follow-up Study(2021), who were not diabetes patients and fasting serum glucose&lt;6.1 mmol/L at baseline. Information on socioeconomic status, lifestyle habits, physical examination, and laboratory examination was collected. TyG index was calculated by fasting serum triglyceride and glucose. Participants were categorized into quartiles based on their baseline TyG index(2010-2012). Multiple adjusted logistic regression analysis was used to explore the association between TyG index and the risk of new-onset type 2 diabetes. Subgroup analysis was conducted among participants stratified by sex, age group, and body mass index(BMI).

In 2161 participants, there were significant differences in age, BMI, household income, systolic and diastolic blood pressure, fasting serum total cholesterol, and high-density lipoprotein cholesterol across quartiles of the TyG index. After adjusting for potential confounders such as age, sex, BMI, living area, education level, marital status, household income, current smoking, excessive drinking, leisure physical activity level, family history of diabetes, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, and high-density lipoprotein cholesterol, compared with the lowest quartile(Q1), the highest(Q4) showed a 2.82-fold increase in type 2 diabetes risk(95%CI=1.65-4.84, P_(trend)=0.007). Considering TyG index as continuous variable, the risk for diabetes will be 2.22-fold higher with the per unit increase of TyG index(95%CI=1.61-3.06, P&lt;0.001). Subgroup analysis showed that the association remained robust among participants over 45 years old, in males and females alike, and in people with different BMI. And the result showed to be more pronounced among those were over 60 years old, female, and BMI&lt;24. No significant interactions between subgroups and TyG index were observed.

Among Chinese adults with normal fasting serum glucose, the TyG index was positively associated with the risk of new onset type 2 diabetes.