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Aims Studies confirm that microalbuminuria (MAU) can not only predict diabetic kidney disease (DKD) but also indicate of systemic vascular endothelial injury. Thyroid hormones (TH) have been reported to be associated with various cardiovascular diseases and endothelial cell damage. Currently, few studies have reported the association between free thyroxine (FT4) to free triiodothyronine (FT3) ratio and MAU. The purpose of this study was to investigate the association between FT4/FT3 ratio and MAU in euthyroid patients with type 2 diabetes mellitus (T2DM). Methods This study enrolled a total of 1734 T2DM patients with euthyroid status. MAU was defined as 30 ≤ urinary albumin-to-creatinine ratio (UACR) < 300 mg/g. The participants were divided into MAU group and normal albuminuria group (NAU group). The relationship between FT4/FT3 ratio and MAU was analyzed. Results In this study, there were 367 patients with MAU. Compared with the NAU group, the MAU group had higher FT4/FT3 ratio (P < 0.001). In univariate analysis, the FT4/FT3 ratio was positively related to both UACR and MAU (both P < 0.001). In multivariate linear stepwise regression, the FT4/FT3 ratio is independently related to UACR (Standardized coefficients: 0.148, P < 0.001). In binary logistic regression analysis, the FT4/FT3 ratio emerges as an independent risk factor for MUA (odds ratio: 1.947, 95% confidence interval: 1.522–2.491). Conclusion The FT4/FT3 ratio was independently and positively correlated with MAU in euthyroid patients with T2DM. [ABSTRACT FROM AUTHOR]

Aim: Diabetes is an independent risk factor for thyroid nodules (TNs), however, the influencing factors of TNs have not been fully clarified under the condition of diabetes. Previous studies have shown a connection between pituitary-thyroid hormone (TH) functions and TNs in different populations. However, the potential link in euthyroid patients with diabetes is unclear. We aimed to explore the correlates of TNs in euthyroid type 2 diabetes (T2D) patients. Methods: This cross-sectional study included 1965 euthyroid adults with T2D. Clinical and biochemical data, including TH and relevant covariates were collected. TNs were evaluated using ultrasound. Univariate and multivariate logistic regression analyses were performed to identify factors associated with TNs, with analyses stratified by sex. Results: The overall prevalence of TNs was 51.9%. The prevalence of TNs was higher in females. Stratified by sex, the results from univariate and further logistic regression analyses showed that free triiodothyronine (FT3) (OR: 1.381; 95% CI: 1.066– 1.790) and thyroid-stimulating hormone index (TSHI) (OR: 0.740; 95% CI: 0.584– 0.937) were independently correlated with TNs only in females, while no TH-related indicators entered the regression model in males. Conclusion: The relationship between TH and related indices with TNs exhibited sex differences. Specifically, FT3 and TSHI were independently associated with TNs in females. These findings underscore the importance of evaluating TH and related indices for early monitoring and management of TNs, particularly in euthyroid female T2D patients. [ABSTRACT FROM AUTHOR]

Aim: Attenuated insulin-sensitivity (IS) is a characteristic of type 2 diabetes (T2D) and is closely linked to non-alcoholic fatty liver disease (NAFLD). In recent years, many surrogate markers of IS have emerged to predict NAFLD. A natural log transformation of the glucose disposal rate (loge GDR) has been proposed as a new model for IS in patients with T2D. Our aim is to explore the correlation between loge GDR and NAFLD in normoalbuminuric patients with T2D. Methods: A total of 1227 normoalbuminuric patients with T2D were involved in our study. NAFLD was evaluated by ultrasound. Biochemical and clinical data were collected, including parameters essential for calculating the loge GDR (triglycerides, urinary albumin-to-creatinine ratio, γ-glutamyl transferase and body mass index), as well as other relevant covariates required for adjustment. The relationship between the loge GDR and NAFLD was analyzed. Results: NAFLD patients showed lower loge GDR values than non-NAFLD (P < 0.001). As the loge GDR tertiles increased, the prevalence of NAFLD was decreased (P < 0.001). Multivariate analysis displayed that loge GDR was independently corrected with NAFLD (OR: 0.084; 95% CI: 0.040– 0.177). Furthermore, receiver operating characteristic (ROC) analysis showed that loge GDR (area under the curves: 0.797) was superior to other evaluation variables. Conclusion: The loge GDR was strongly associated with NAFLD and might be a useful predictor in normoalbuminuric patients with T2D. [ABSTRACT FROM AUTHOR]

Purpose: Substantial evidence has established a strong association between non-alcoholic fatty liver disease (NAFLD), type 2 diabetes mellitus (T2DM) and insulin resistance (IR). Insulin resistance metabolic score (METS-IR) is a new and more effective comprehensive indicator for measuring IR. Our aim was to investigate the relationship between METS-IR and NAFLD in T2DM population. Patients and methods: This cross-sectional study included 1097 adult patients with T2DM. Anthropometric measurements and biochemical indicators were collected, and the NAFLD was diagnosed by ultrasound. The METS-IR was calculated. Based on the presence of NAFLD, the population was divided into non-NAFLD and NAFLD groups. The relationship between METS-IR and NAFLD was evaluated. Results: Compared with the non-NAFLD group, the METS-IR was higher in the NAFLD group (P < 0.001). The incidence rate of NAFLD increased across the quartiles of the METS-IR (P < 0.001). Spearman correlation analysis showed that METS-IR was positively correlated with NAFLD (Correlation Coefficient: 0.441, P < 0.001). The binary logistic regression analysis indicated that METS-IR was independently associated with NAFLD (OR: 1.120, 95% CI 1.080– 1.161). Furthermore, the area under the receiver operating characteristic curve of the METS-IR was 0.781 (95% CI 0.746– 0.817) and relatively higher than other evaluation variables. Conclusion: In patients with T2DM, METS-IR is closely associated with NAFLD, and might be a valuable predictor of NAFLD. Further research is needed to verify this association. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The purpose of the present study was to observe the relationship between serum α‐klotho (KL) protein level and diabetic retinopathy (DR), and to further examine the effects of KL protein on apoptosis induced by palmitic acid (PA) in human retinal endothelial cells. Materials and Methods: A total of 17 healthy people and 60 type 2 diabetes patients were included. According to the results from fundus fluorescein angiography, the diabetes patients were divided into three subgroups: without DR, non‐proliferative DR and proliferative DR. Serum KL level was measured by enzyme‐linked immunosorbent assay. In vitro, human retinal endothelial cells were exposed to PA with or without KL protein. Apoptosis rates were analyzed by flow cytometry analysis. Apoptotic‐related protein expressions were detected by western blotting analysis. Results: Serum KL level was lower in diabetes patients than that in healthy participants (P = 0.007), and was gradually decreased among the without DR, non‐proliferative DR and proliferative DR subgroups (P = 0.045). A logistic regression analysis showed that after adjusting for the other confounding factors, serum KL level was independently and negatively related with DR (P = 0.049). Furthermore, the increased apoptosis rates induced by PA were inhibited with the addition of KL protein. Consistently, KL protein reversed the expression levels of the increased pro‐apoptotic protein Bax and the decreased anti‐apoptotic protein Bcl‐2 induced by PA. However, the anti‐apoptotic effect of KL protein was attenuated by LY294002 through the phosphatidylinositol 3 kinase‐serine∕threonine kinase pathway. Conclusions: The data suggested that KL protein was probably a potential protective factor against retinopathy in type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) and hypertension often coexist, and insulin resistance (IR) plays an important role in their pathological progression. An increasing number of studies have focused on the relationship between different IR indices and hypertension. A natural log transformation of the glucose disposal rate (log e GDR) has been proposed as a new model for insulin sensitivity in patients with T2D. The study aimed to explore the relationship between log e GDR and hypertension in T2D patients. This cross-sectional study included 1544 Chinese T2D patients. Clinical and biochemical characteristics were collected. The log e GDR was calculated based on triglycerides, urinary albumin to creatinine ratio, gamma-glutamyl transferase, and body mass index. Patients were categorized into hypertension and nonhypertension groups stratified by gender. Among both females and males, compared with the nonhypertension group, the level of log e GDR was significantly decreased in the hypertension group (both p < 0.001). As the log e GDR increased, the levels of systolic and diastolic blood pressure, and the prevalence of hypertension were obviously increased (all p < 0.001). Univariate analysis displayed that log e GDR was negatively related to hypertension (correlation coefficient: -0.243, p < 0.001 in females; correlation coefficient: -0.181, p < 0.001 in males). Furthermore, the logistic regression analysis showed that log e GDR was independently associated with hypertension (OR: 0.456; 95% CI: 0.224-0.927 in females; OR: 0.544; 95% CI: 0.314-0.941 in males). This study revealed that log e GDR was closely related to hypertension, which might help monitor and manage hypertension in T2D patients., (© 2025 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Aim: Attenuated insulin-sensitivity (IS) is a characteristic of type 2 diabetes (T2D) and is closely linked to non-alcoholic fatty liver disease (NAFLD). In recent years, many surrogate markers of IS have emerged to predict NAFLD. A natural log transformation of the glucose disposal rate (log e GDR) has been proposed as a new model for IS in patients with T2D. Our aim is to explore the correlation between log e GDR and NAFLD in normoalbuminuric patients with T2D., Methods: A total of 1227 normoalbuminuric patients with T2D were involved in our study. NAFLD was evaluated by ultrasound. Biochemical and clinical data were collected, including parameters essential for calculating the log e GDR (triglycerides, urinary albumin-to-creatinine ratio, γ-glutamyl transferase and body mass index), as well as other relevant covariates required for adjustment. The relationship between the log e GDR and NAFLD was analyzed., Results: NAFLD patients showed lower log e GDR values than non-NAFLD (P < 0.001). As the log e GDR tertiles increased, the prevalence of NAFLD was decreased (P < 0.001). Multivariate analysis displayed that log e GDR was independently corrected with NAFLD (OR: 0.084; 95% CI: 0.040-0.177). Furthermore, receiver operating characteristic (ROC) analysis showed that log e GDR (area under the curves: 0.797) was superior to other evaluation variables., Conclusion: The log e GDR was strongly associated with NAFLD and might be a useful predictor in normoalbuminuric patients with T2D., Competing Interests: All authors declare that they have no competing interests in this study., (© 2025 Ji et al.)

Scope: Diabetic cardiomyopathy is one of the most important cardiac complications associated with diabetes. However, the mechanisms underlying diabetic cardiomyopathy remain unclear. The PARP1, SIRT1, and mTOR pathways have been implicated in cardiac diseases, and they are also associated with diabetes. 1,25(OH) 2 D 3 was recently recognized as a potential PARP1inhibitor in a macrophage cell line. The aim of our study was to investigate whether 1,25(OH) 2 D 3 can improve diabetic cardiomyopathy through a vitamin D receptor (VDR)-dependent mechanism associated with the PARP1/SIRT1/mTOR pathway., Methods and Results: 1,25(OH) 2 D 3 -treated diabetic rats displayed improved left ventricular wall thickness and end-diastolic/systolic diameter, end-diastolic/systolic volume, left ventricular ejection fraction, fractional shortening, atrial natriuretic peptide, and brain natriuretic peptide gene expression, and interstitial fibrosis compared with untreated diabetic rats, while silencing the VDR gene in DM rats blocked the above results. 1,25(OH) 2 D 3 treatment also decreased PARP1 and increased SIRT1 expression levels and repressed the phosphorylation of mTOR. Treating neonatal cardiomyocytes with 1,25(OH) 2 D 3 and a PARP1 inhibitor decreased PARP1 and increased SIRT1 protein expression., Conclusion: The present study demonstrates that 1,25(OH) 2 D 3 treatment has the potential to improve diabetic cardiomyopathy in rats and suggests that VD-VDR signaling induces this protective effect against diabetic cardiomyopathy might partly through the PARP1/SIRT1/mTOR pathway., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)