Approximately 20-40% of patients with diabetes mellitus (DM) develop diabetic kidney disease (DKD), a major microvascular complication of the condition. This study aimed to explore the potential diagnostic value of hsa-miR-5585-3p for DKD, and its regulatory effects, by targeting CHUK, on inflammatory factor expression and NLRP3 activation in HK-2 cells induced by high glucose (HG). The expression profile of hsa-miR-5585-3p in the serum samples from patients with type 2 DM (T2DM) and DKD was analyzed by RT-qPCR. Correlation analysis between hsa-miR-5585-3p and UACR, eGFR, as well as inflammatory factors was investigated. Bioinformatics analysis predicted the downstream target genes of hsa-miR-5585-3p. The interaction between hsa-miR-5585-3p and CHUK was verified by dual luciferase reporter assay. An in vitro DKD model was established by exposing HK-2 cells to HG. The expression levels of inflammatory factors and the NLRP3 activation were detected by RT-qPCR, Western blot, or ELISA following modulation of the hsa-miR-5585-3p/CHUK axis. Hsa-miR-5585-3p was significantly downregulated in the serum of DKD patients and showed correlations with UACR, eGFR, and inflammatory factors. In HK-2 cells stimulated by HG, hsa-miR-5585-3p suppressed the expression of inflammatory factors as well as key molecules in the NLRP3 pathway. Data from the rescue experiment supported the partial role of CHUK overexpression in counteracting the inhibition mediated by hsa-miR-5585-3p. Hsa-miR-5585-3p may serve as a potential diagnostic biomarker for DKD, pending further validation. Moreover, hsa-miR-5585-3p regulated the inflammatory response and activation of the NLRP3 in HK-2 cells induced by HG through CHUK. Not applicable.

Lymph node metastasis (LNM) characterized by high thyroglobulin measurement through fine-needle aspiration (FNA-Tg) is correlated with elevated tumor burden in papillary thyroid carcinoma (PTC). However, the prognostic significance of FNA-Tg remains incompletely understood. The aim of this study was to determine the prognostic significance of FNA-Tg for stratification of patients at high risk of local recurrence following therapeutic lateral neck dissection (LND) in PTC. This study reviewed medical records of PTC patients with suspected lateral LNM, who underwent FNA-Tg and therapeutic LND. Logistic regression analyses were used to assess the relationships between clinical outcomes and FNA-Tg in lateral LNM. The prognostic value was evaluated using Cox regression and Kaplan-Meier survival curve analyses. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values. The median FNA-Tg levels of metastatic LNs were 500.00 ng/mL and 328.40 ng/mL in patients with and without recurrence, respectively. Multivariate analysis revealed that FNA-Tg > 397.00 ng/mL, multifocality, and lateral lymph nodes ratio (LLNR) > 0.161 as independent risk factors for local recurrence or persistence (p < 0.05). Notably, an FNA-Tg cut-off value of 397.00 ng/mL combined with multifocality and LLNR had a higher predictive value with an area under the ROC curve of 0.912. Additionally, all the three factors were associated with shorter recurrence-free survival (p < 0.05). As an independent preoperative risk factor for predicting local recurrence or persistence, FNA-Tg assisted in guiding the extent of therapeutic LND and identifying patients at high-risk of postoperative recurrence.

BackgroundTo compare the effects of different digitally and remotely deliveredexercise interventions on glycated hemoglobin (HbA1c) in adults with type 2diabetes mellitus (T2DM) using a network meta-analysis (NMA), and to clarifythe relative effectiveness of distinct delivery models.MethodsA systematic review and network meta-analysis of randomized controlledtrials was conducted following PRISMA-NMA guidelines and prospectivelyregistered in PROSPERO (CRD420261288210). Major databases were searched frominception to November 11, 2025. Exercise-centered digital and remoteinterventions were categorized as digital exercise interventions (DEX),structured exercise prescription (SEP), multi-behavior lifestyle interventions(MBLI), and tele-exercise/tele-rehabilitation (TEX). The primary outcome waschange in HbA1c.ResultsFifty-four RCTs were included. Compared with control, TEX demonstratedthe greatest reduction in HbA1c (MD −0.51%, 95% CrI −0.88 to −0.14), followedby MBLI (MD −0.32%, 95% CrI −0.51 to −0.13). SEP showed a non-significanttrend, and DEX did not significantly reduce HbA1c. SUCRA rankings favored TEX(0.87), followed by MBLI (0.66), SEP (0.62), and DEX (0.24). Subgroup analysessuggested that HbA1c reductions with TEX and MBLI were more evident among olderadults (≥60 years) and those with longer diabetes duration（>10 years）;however, network inconsistency was detected in these subgroups, and findingsshould be interpreted cautiously.ConclusionsDigitally and remotelydelivered exercise interventions differ in their effectiveness for HbA1ccontrol in T2DM. Interventions incorporating ongoing professional supervisionare associated with the most consistent glycemic benefits, whereas largelyautomated approaches show limited effects, highlighting the importance ofdelivery structure and supervision intensity.Supplementary informationThe online version contains supplementary material available at 10.1186/s12902-026-02267-1.

Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and obesity are associated with glucose metabolism dysregulation. This study aimed to investigate the individual and joint effects of MTHFR gene polymorphisms and pre-pregnancy body mass index (pre-BMI) status on postpartum abnormal glucose tolerance (PAGT) risk among women with gestational diabetes mellitus (GDM). This retrospective study enrolled 1181 women with GDM who underwent a postpartum oral glucose tolerance testing for 6-12 weeks in Guangzhou, China. The association between MTHFR gene polymorphism and pre-BMI status with PAGT risk was assessed using logistic regression models, followed by stratified analyses. Among the included women with GDM, the overall prevalence of PAGT was 28.96%, and the prevalence of pre-pregnancy obesity was 4.23%. Pre-pregnancy obesity and carriage of the MTHFR A1298C AC + CC genotype were independently associated with a significantly elevated risk of PAGT. Stratified analyses by MTHFR variants dominant models revealed that women with obesity carrying the MTHFR C677T CT + TT genotype had an elevated risk of PAGT (odds ratio [OR] = 3.99, 95% confidence interval [CI]: 1.21-13.18). Among A1298C AA genotype carriers, pre-pregnancy obesity was associated with a 4.85-fold higher risk of PAGT (95% CI 1.35-17.41), whereas pre-pregnancy underweight correlated with a significantly reduced PAGT risk (OR = 0.37, 95% CI 0.14-0.99). Furthermore, in the normal weight subgroup, women harboring the MTHFR A1298C AA genotype combined with the C677T CT + TT genotype had a significantly decreased risk of PAGT (OR = 0.59, 95% CI 0.35-0.98), compared with those carrying the MTHFR A1298C AC + CC genotype combined with the C677T CT genotype. Pre-pregnancy obesity is an independent risk factor for PAGT in women with GDM, and this association could be modified by MTHFR gene polymorphisms. Further large-scale prospective studies are warranted to evaluate whether genotype-guided folic acid supplementation can reduce PAGT risk in high-risk women with GDM, particularly those with pre-pregnancy obesity. Not applicable.

Sarcopenia often coexists with metabolic and renal dysfunction and may increase cardiovascular disease (CVD) risk. Insulin resistance (IR) is a key mechanism linking sarcopenia and cardiometabolic disorders. However, evidence on IR-related indices and CVD risk among individuals with sarcopenia across cardiovascular-kidney-metabolic (CKM) stages remains limited. This study aimed to examine associations between multiple IR-related indices and incident CVD, and to evaluate their predictive and mediating roles across CKM stages 1-3 and sarcopenia status. We analysed 5,965 adults with CKM stages 1-3 from the China Health and Retirement Longitudinal Study (CHARLS), categorised as no sarcopenia, possible sarcopenia, or sarcopenia. We assessed associations between sarcopenia, eight IR-related indices-including triglyceride-glucose index-body mass index (TyG-BMI) and estimated glucose disposal rate (eGDR)-and incident CVD using Cox and the Fine-Gray competing risks model. Missing data were handled by multiple imputation. Dose-response relationships were evaluated with restricted cubic splines, and predictive performance was assessed with the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Mediation and sensitivity analyses explored potential pathways and the robustness of the results. 63.8% of participants had possible sarcopenia or sarcopenia and were at higher risk of incident CVD and all-cause mortality. Mean follow-up was approximately 9 years. TyG-BMI was positively associated with CVD risk (HR = 3.58, 95% CI 2.50-5.14), whereas eGDR was inversely associated (HR = 0.36, 95% CI 0.28-0.47). The combined TyG-BMI and eGDR model improved CVD risk discrimination (AUC = 0.614, 95% CI 0.595-0.634), with gains in NRI (0.117, 95% CI 0.058-0.161) and IDI (0.013, 95% CI 0.007-0.023). IR-related indices accounted for 20%-46% of the association between CKM stage 3 (vs. stage 1) and CVD. Possible sarcopenia and sarcopenia were associated with increased CVD risk, particularly in CKM stage 3. IR-related indices, especially TyG-BMI and eGDR, were strongly associated with CVD risk and improved prediction, suggesting that IR may partially mediate the impact of CKM progression and sarcopenia on CVD outcomes.

The incidence of type 2 diabetes (T2D) in children is rising rapidly, yet many cases remain undetected. Conventional diagnostic tools, including fasting glucose, HbA1c, and the gold-standard oral glucose tolerance test (OGTT), have limitations and often show low compliance in pediatric populations. This study aimed to evaluate a simplified OGTT (s-OGTT) with adjusted capillary glucose cut-off values as a novel approach for screening and diagnosing T2D in children and adolescents. A total of 468 children from four clinical centers in China underwent s-OGTT with capillary glucose testing. Capillary glucose values were compared with venous glucose levels using Bland-Altman analysis. Sensitivity and specificity for diagnosing diabetes and prediabetes were assessed using receiver operating characteristic (ROC) curves. Capillary glucose levels showed a strong correlation with venous measurements. Based on gold-standard criteria, 37 children were diagnosed with diabetes, 41 with impaired fasting glucose (IFG), and 74 with impaired glucose tolerance (IGT). Using optimized capillary cut-offs tailored for point-of-care testing, the s-OGTT demonstrated excellent diagnostic performance and improved specificity compared with applying conventional venous-based thresholds directly: for diabetes based on fasting glucose (sensitivity 97.56%, specificity 98.40%), diabetes based on 2h postload glucose (sensitivity 100.00%, specificity 99.67%), IFG (sensitivity 97.60%, specificity 98.30%), and IGT (sensitivity 88.89%, specificity 92.04%). Validation analyses confirmed high agreement between s-OGTT and venous results. The s-OGTT provides a reliable, accurate, and child-friendly approach for diagnosing diabetes and abnormal glucose tolerance. These optimized thresholds enhance diagnostic specificity and support its use for large-scale pediatric screening.

Biochemical, inflammatory, and immunological markers may provide insight into systemic alterations in individuals with or without thyroid dysfunction. This study compared a comprehensive biomarker profile between adults without thyroid disease and those with thyroid dysfunction, and examined gender differences, correlations, and predictive markers. In this case-control study, 120 adults without thyroid disease (cases) and 120 adults with thyroid dysfunction (controls) were enrolled. Demographics, anthropometry, and biochemical parameters-including thyroid hormones, micronutrients, lipid profiles, inflammatory markers, and Epstein-Barr virus PCR-were assessed. Between-group differences were analyzed using the Mann-Whitney U test and the χ² test. Spearman's rho was used to determine correlations, and multivariable linear regression was used to identify predictors of group status. Cases and controls were similar in age (60 ± 12 vs. 60 ± 10.5 years) and body mass index (BMI) (24.85 ± 3.69 vs. 25.58 ± 3.39kg/m²). Compared with controls, cases had significantly lower zinc (97.98 vs. 143.03µg/dL), vitamin D₃ (88.24 vs. 152.76 nmol/L), and HDL (88.75 vs. 152.25mg/dL), but higher serum cholesterol (159.56 vs. 81.44mg/dL), triglycerides (TG) (171.08 vs. 69.92mg/dL), LDL (136.06 vs. 104.94mg/dL), and CRP (140.05 vs. 100.95mg/L) (all p < 0.001). In controls, TSH correlated positively with the Urea Breath Test (UBT) (rho = 0.334) and negatively with LDL (rho=-0.255). In cases, T3 showed a strong correlation with UBT (rho = 0.625) and a moderate correlation with PCR-EBV (rho = 0.417), while TSH correlated with UBT (rho = 0.434) and CRP (rho = 0.264). Regression analysis identified serum TG (β = 76.806, R²=0.462) and cholesterol (β = 64.834, R²=0.337) as the strongest predictors of case-control status. Adults without thyroid disease exhibit distinct biochemical and inflammatory profiles compared with those with thyroid dysfunction, highlighting lipid, micronutrient, and inflammatory markers as potential targets for risk stratification and clinical monitoring. Not applicable.

Metabolic dysfunction-associatedsteatotic liver disease (MASLD) has become the most prevalent chronic liver disease worldwide. Its incidence continues to rise with a marked trend toward younger age groups, posing dual challenges for early screening and standardized diagnosis and treatment. There is an urgent clinical need for simple-to-operate, highly sensitive serological markers to enable early disease identification. This study aims to investigate the correlation between serum uric acid (SUA) and serum uric acid to creatinine ratio (SUA/Cr) levels in young adults and MASLD and its components. A retrospective analysis was conducted on 5,224 individuals aged 20–45 years who underwent physical examinations at Northern Jiangsu People’s Hospital in 2019. Measured the patient’s body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting blood glucose(FBG), creatinine(Cr), triglycerides(TG), total cholesterol(TC), serum uric acid(SUA), high-density lipoprotein(HDL-c) and other indicators. Logistic regression analysis was employed to investigate the correlations among SUA, SUA/Cr, and the components of MASLD in the young adults while adjusting for confounding factors. The receiver operating characteristic (ROC) curve analysis was performed to evaluate discriminatory ability. The levels of SUA and SUA/Cr in the MASLD cohort were significantly higher than those in the non-MASLD cohort. Elevated SUA and SUA/Cr levels were associated with components for MASLD. Both SUA (OR: 1.014, 95% CI: 1.013–1.015) and SUA/Cr (OR: 2.570, 95% CI: 2.368–2.788) were significantly associated with MASLD (P < 0.001). The Area Under Curve(AUC) values were 0.807 and 0.724, respectively. SUA and SUA/Cr levels are significantly associated with MASLD and its components in young adults. Not applicable.

A risk prediction model was developed to predict the risk of major amputation in patients with diabetic foot ulcer (DFU) on admission, and instruct patients to prevent and control early, and guide doctors to make clinical decisions. We used data from the Electronic Medical Record (EMR) database of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from February 2014 to July 2020. DFU patients were divided into major amputation group and non-major amputation group, and nested case-control study method was used to identify case group and control group. The results of the first laboratory tests, imaging examinations, complications and other information of DFU patients at admission were collected, and initial predictive variables were selected. Logistic regression and LASSO regression in R software were used to develop a clinical prediction model for DFU patients with major amputation, which was displayed in the form of nomographs, and the model was evaluated by internal validation. A total of 3654 patients were diagnosed as DFU, 695 patients were included in the study on the development of risk prediction model of DFU major amputation, 139 patients in the case group and 556 patients in the control group. 9 variables (WBC, Hb, ALB, Wagner grade, amputation history, smoking, ABI < 0.4, ulcer duration > 1 month, HbA1c) screened by logistic regression and LASSO regression were used as predictors of major amputation in DFU patients. The internal validation showed that the C index adjusted by Bootstrap method was 0.91 (95% CI, 0.894–0.943), the average absolute error of the prediction model for drawing the calibration curve was 0.01, and the brier score was 0.08. The clinical risk prediction model of major amputation in DFU patients developed in this study has good discrimination and calibration, can accurately predict the outcome events, can be used as an effective tool to guide doctors to make clinical decisions, and enrich and improve the content of DFU prevention and control work, but the promotion and use of the model still needs further verification of external data. Not applicable.