BackgroundDiabetes mellitus (DM) is a significant global public health concern, with prediabetes serving as a critical stage between normoglycemia and DM. Without intervention, individuals with prediabetes face an increased risk of developing DM, underscoring the need for effective preventive measures. The Hemoglobin Glycation Index (HGI)—which measures the discrepancy between actual and predicted glycated hemoglobin (HbA1c) levels—has shown promise in predicting the onset of both microvascular and macrovascular complications associated with DM. However, its potential role in assessing the risk of developing DM or prediabetes remains to be fully established. This study aims to investigate the predictive capacity of HGI for both DM and prediabetes.MethodThis retrospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45 years and older who were assessed in 2011 and followed up in 2015. Univariate and multivariate logistic regression models were employed to analyze the relationship between HGI and the incidence of prediabetes and DM. Dose-response analyses were conducted using restricted cubic splines, and subgroup analyses were performed based on various demographic and health-related factors.ResultsAmong 3,963 participants, 187 individuals (4.72%) developed prediabetes within four years, and 107 individuals (2.70%) developed DM. HGI was independently associated with an increased risk of developing both DM and prediabetes, with adjusted odds ratios of 1.61 (95% confidence interval [CI]: 1.19–2.16, p = 0.001) and 2.03 (95% CI: 1.40–2.94, p < 0.001), respectively. A linear relationship was observed between HGI and both DM and prediabetes. An interaction effect was identified between age and HGI; specifically, the association between higher HGI and incident DM was more pronounced in individuals aged 45 to 60 years. Among this age group, the OR was 3.93 (95% CI: 2.19–7.05, p < 0.001).ConclusionHGI is identified as an independent risk factor for both DM and prediabetes, demonstrating its utility in predicting the likelihood of their development, particularly within the population aged 45 to 60. These findings highlight the potential of HGI as a valuable biomarker for the early identification of DM risk, thereby facilitating the formulation of targeted intervention strategies.Trial registrationNot applicable.

The pathogenesis of type 2 diabetes mellitus (type 2 DM) involves two major abnormalities: insulin resistance(IR) and impaired insulin secretion, both of which contribute to the inability to regulate blood glucose levels. Adiponectin, a hormone secreted by adipose tissue, plays a role in glucose metabolism and possesses insulin-sensitizing properties. Additionally, adiponectin may play a central role in protecting against atherosclerosis by reducing inflammation, lipid accumulation, and oxidative stress. It has also been reported to increase nitric oxide production in endothelial cells through the activation of nitric oxide synthase. The aim of this study was to investigate the association of serum adiponectin level with glycemic control and atherogenic lipid profile in Sudanese patients with type 2 DM. This was a case-control study. Patients with type 2 DM (n = 202) and healthy controls (n = 100) were consented and enrolled. Systolic and diastolic blood pressures (mm Hg), weight (kg), and height (m) were measured, and body mass index (kg/m²) was calculated. Blood samples were collected after an overnight fast. Fasting blood glucose (FBG), haemoglobin A1c (HbA1c), and lipid profile were measured using enzymatic methods. Adiponectin levels were determined using a sandwich ELISA. Multiple regression analysis was conducted to assess the correlation of adiponectin levels with HbA1c and lipid profile parameters. Adiponectin levels were significantly lower in patients with type 2 DM compared to healthy controls (p < 0.001). Adiponectin was inversely correlated with HbA1c (β = −0.200, p = 0.005), total cholesterol (TC) (β = −0.140, p = 0.044), and low- density lipoprotein cholesterol (LDL-C) (β = −0.162, p = 0.022), and positively correlated with high-density lipoprotein cholesterol (HDL-C) (β = 0.160, p = 0.030). No correlation was observed with triglyceride (TG) levels. Patients with type 2 DM also exhibited significantly higher systolic and diastolic blood pressure, body mass index (BMI), fasting blood glucose (FBG), HbA1c, total cholesterol, and LDL-C levels, along with significantly lower HDL-C levels compared to healthy controls (p < 0.05). Patients with type 2 DM had decreased serum adiponectin levels. The present study supports that adiponectin levels are associated with glycemic control and an atherogenic lipid profile. Adiponectin can be considered clinically relevant both as a potential dual biomarker and as a therapeutic target for glycemic control and atherogenic dyslipidemia in patients with type 2 DM.

BackgroundMetabolic syndrome (MetS) is highly prevalent among individuals with type 2 diabetes and is characterized by a combination of specific clinical parameters including abnormal blood lipid levels, impaired fasting glucose, elevated blood pressure, and excessive abdominal fat. This study aimed to investigate the trends in MetS prevalence and its components among patients with diabetes in Iran from 2015 to 2021 and explore its association with cardiovascular disease and diabetes complications.MethodsWe conducted a nationwide trend analysis using data from 313,939 patients with diabetes enrolled in the National Program for Prevention and Control of Diabetes (NPPCD). Annual trends of Mets according to age and gender, annual trends of MetS components and the association between MetS and CVD, diabetic foot, neuropathy, nephropathy, and retinopathy were analyzed using SPSS version 26.ResultsOverall, the prevalence of MetS in patients with diabetes increased from 60.3% in 2015 to 66.9% in 2021, with a total prevalence of 63.2%. Women (67.4%) and the 50–60 age group (66.0%) exhibited the highest rates. Among MetS components, fasting blood glucose > 100 mg/dL had the highest prevalence (89.5%), followed by low HDL (61.8%) and obesity (49.8%). AORs of association between MetS and cardiovascular disorder, diabetic foot, retinopathy, nephropathy, and neuropathy were 1.826 (1.670–1.998), 1.343 (1.145–1.576), 1.376 (1.263-1.500), 1.587 (1.434–1.757), 1.613 (1.499–1.736), respectively.ConclusionPrevalent cases of MetS among patients with diabetes in Iran and positive associations between MetS and cardiovascular disorder and diabetes complications highlights the need for targeted interventions focusing on glycemic control, obesity management, screening, health education, and better diabetic management, especially in high-risk groups. Future research should explore the impact of lifestyle modifications and policy-driven interventions in reducing MetS-related complications.Trial registrationNot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12902-025-02050-8.

Thyroid hemiagenesis (THA) is a rare congenital disorder in which one thyroid lobe fails to develop. A variety of pathological conditions can occur in the remaining thyroid tissue in association with this rare anomaly such as subacute thyroiditis, colloid nodules, Graves’ disease, simple goiter, Hashimoto thyroiditis, adenoma and thyroid carcinoma. The association of thyroid hemiagenesis with simple diffuse goiter is rare, and very few cases have been reported in the literature. A 30-year-old female patient presented at the thyroid clinic because of anterior neck swelling for approximately 2 years, thus raising the suspicion of a thyroid disorder. Physical examination revealed an approximately 5 × 5 cm anterior neck mass consistent with a goiter. The thyroid function test results were within normal limits. Ultrasonography of the anterior neck (thyroid gland) revealed thyroid hemiagenesis of the right lobe and a contralateral (left) diffusely enlarged thyroid gland, which had areas of tiny cystic components with a spongy appearance. Fine needle aspiration cytology demonstrated that the lesion was a colloid goiter and the patient was on regular follow up with thyroid function tests and ultrasound as the patient was without symptoms. Finally, the diagnosis of right thyroid hemiagenesis with a contralateral simple diffuse goiter was made which was a very rare association. Right sided thyroid hemiagenesis was also a very rare finding compared to left sided.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12902-025-02047-3.

BackgroundDiabetic Ketoacidosis (DKA) is a critical and potentially fatal complication predominantly seen in individuals diagnosed with Type 1 Diabetes Mellitus (T1DM), though it may also arise in those with Type 2 Diabetes Mellitus (T2DM) under specific circumstances. Although DKA is preventable through effective diabetes management strategies, the consequences can be severe if the condition is not addressed promptly. The timely recognition of DKA, coupled with suitable medical treatment, is essential to enhance patient outcomes and mitigate the risk of enduring complications related to this condition. The objective of this research was to identify the risk factors of DKA in diabetic patients receiving care at public hospitals in the East Gojjam Zone of Northwestern Ethiopia.MethodsAn unmatched case-control study was carried out in selected public hospitals located in the East Gojjam Zone between April 10 and July 30, 2023. Five public hospitals were randomly selected, and a systematic random sampling technique was employed to recruit 408 study participants. Logistic regression analysis was performed to identify variables significantly associated with the outcomes, using a significance level of P < 0.05 and a 95% confidence interval.ResultsThe study included 102 cases and 306 controls. Several key risk factors for DKA were identified, including the absence of regular follow-up [AOR = 2.21, 95% CI (1.31–3.71)], not being a member of health insurance [AOR = 3.30, 95% CI (1.75–6.24)], distance from a health facility greater than 5 km [AOR = 1.85, 95% CI (1.09–3.14)], infection [AOR = 2.15, 95% CI (1.12–3.89)], and reduction in insulin dosage [AOR = 2.13, 95% CI (1.19–3.83)].ConclusionsThe findings declared that lack of regular follow-up, living more than five kilometers from a healthcare facility, reducing insulin doses without adequate medical guidance, lack of community-based health insurance, and the presence of infections significantly increase the likelihood of DKA. Therefore, healthcare providers should intervene on the identified risk factors for DKA to prevent the occurrence of DKA.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12902-025-02023-x.

BackgroundType 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia, represents a growing global health burden. Natural menopause in women is defined as continuous cessation of menstruation for more than twelve consecutive months, and it is an important determinant of their future health. The average age at natural menopause is around 51 years. Early menopause is defined as the onset of menopause between the ages of 40 and 45 years, while genetic and environmental factors influence menopause timing, evidence suggests T2DM may accelerate ovarian aging. The aim of this study is to explore the existence of a relationship between T2DM and the natural age of menopause in Syrian women—a population with unique genetic and lifestyle factors underrepresented in existing literature.MethodsA cross-sectional study was conducted at Al-Mouwasat and National University Hospitals in Damascus, from 2022 to 2024. 175 naturally postmenopausal women aged over 45 years were included in the study, with participants stratified by T2DM status, which was confirmed either by an HbA1c level of ≥ 6.5% or a physician’s diagnosis. The age at menopause was ascertained based on self-reported cessation of menses for at least 12 months, exclusion of surgical or iatrogenic menopause cases, and validation against medical records. Data were analyzed using SPSS 25.0 with multivariable linear regression (α = 0.05).ResultsThe mean age at natural menopause did not differ significantly between women with and without T2DM (p = 0.099); key differences emerged in subgroup analyses. Women with T2DM demonstrated a 2.3-fold higher prevalence of early menopause (< 45 years) compared to non-diabetic counterparts (20.2% vs. 10.5%; p = 0.023). Notably, those with long-standing diabetes (> 10 years duration) experienced menopause ~ 2 years earlier than controls (p = 0.040). Furthermore, women with T2DM microvascular complications– specifically retinopathy (p = 0.044) and nephropathy (p = 0.000) – showed significantly earlier menopause compared to diabetes-free women.ConclusionsT2DM itself was not associated with a significantly earlier average age at natural menopause in Syrian women, but specific aspects of T2DM were significantly linked to earlier menopause, which are longer disease duration (> 10 years), and presence of microvascular complications (retinopathy or nephropathy). Critically, women with T2DM had a significantly higher prevalence of early menopause, indicating a doubled risk compared to non-diabetic women.

Patients with thyroid cancer experience a range of symptoms during surgical treatment. Identifying their core symptoms and understanding their dynamic changes can help improve the efficiency of clinical symptom management. A longitudinal observational study design was used, and convenience sampling method was applied to select thyroid cancer patients who attended the Department of Thyroid and Breast Surgery in a tertiary hospital in Suzhou City from October 2024 to April 2025. A general information questionnaire and the Chinese version of the Memory Symptom Assessment Scale were used to assess the patients 1 day before surgery (T1), 1-2 days after surgery (T2) and 2 weeks after surgery (T3). The symptom severity bias correlation network was constructed through R language, and the core symptoms of T1, T2 and T3 were identified. This study finally included 248 patients with thyroid cancer. The results showed that the three symptoms with the highest strength centrality in the T1 network were lack of appetite (rs=1.536), worrying (rs=1.442), and feeling nervous (rs=1.439). The three symptoms with the highest strength centrality in the T2 network were numbness/tingling in hands/feet (rs=1.613), lack of appetite (rs=1.433), and nausea (rs=1.294). The three symptoms with the highest strength centrality in the T3 network were difficulty swallowing (rs=1.778), feeling nervous (rs=1.681), and neck discomfort (rs=1.520). Neck discomfort (rs2=1.281, rs3=1.520) was the core symptom that was more stable postoperatively. In the test of network structural invariance, there were significant differences between T1 and T2 (M=0.78, P<0.001), T1 and T3 (M=0.45, P=0.009), and T2 and T3 (M=0.66, P<0.001). In terms of overall network connectivity strength, there were significant differences between T1 (GS=6.86) and T3 (GS=4.12), T2 (GS=7.66) and T3 (P<0.05), while there was no significant difference between T1 and T2 (P=0.65). The study identified the core symptoms present at each stage of the perioperative period in patients with thyroid cancer, suggesting that clinical practitioners can develop efficient, targeted and precise management strategies based on the core symptoms at different times, with a view to improving the perioperative symptom experience of patients and increasing the efficiency of symptom management. Not applicable.

BackgroundCardiovascular disease (CVD) remains a major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), particularly when complicated by hypertension. This study explored markers of glycaemic control, systemic inflammation, and lipid-related atherogenicity, and their relationship with CVD risk among a population of Nigerian patients with T2DM and co-morbid hypertension.MethodThis hospital-based cross-sectional analytical study was conducted over a period of 13 months among patients with T2DM, including those with co-morbid hypertension. The 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart validated for Western sub-Saharan Africa, while glycated haemoglobin (HbA1c), atherogenic index of plasma (AIP), and high-sensitivity C-reactive protein (hsCRP) were assessed as markers of glycaemic control, atherogenicity, and inflammation, respectively. Statistical analyses, including binary logistic regression, were conducted using SPSS version 25, with significance set at p < 0.05.ResultsHypertensive patients with T2DM had significantly higher hsCRP (2.57 mg/L, IQR: 2.63 vs. 0.86 mg/L, IQR: 1.72; p < 0.001) and AIP (0.071, IQR: 0.39 vs. 0.002, IQR: 0.34; p = 0.015). They also had significantly higher mean WHO CVD risk scores (11.3 ± 4.7 vs. 7.2 ± 4.1; p < 0.001), with 60.0% (n = 75) classified as moderate-to-high risk. However, after adjusting for potential confounders in the multivariable analysis, HbA1c (OR = 0.82, p = 0.062), hsCRP (OR = 1.01, p = 0.905), and AIP (OR = 2.22, p = 0.293) did not emerge as significant predictors.ConclusionAlthough hsCRP and AIP levels were elevated in higher CVD risk categories, they did not independently predict risk among patients with T2DM and hypertension. This highlights the limited utility of traditional biochemical markers in this group and the need for early risk assessment and aggressive blood pressure control. Further multicentre studies are needed to validate these results and inform targeted interventions in resource-limited settings.

To investigate the clinical characteristics, related risk factors and outcomes of thyroid immune-related adverse events (irAEs) in patients with malignant solid tumor treated with programmed cell death-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) inhibitors in a large tertiary Chinese center. We retrospectively analyzed the clinical data of 1151 patients with malignant solid tumors who received PD-1 or PD-L1 inhibitors treatment and underwent thyroid function evaluation in a large 3A hospital of Beijing from September 2019 to December 2023. According to the thyroid status after receiving PD-1/PD-L1 inhibitors treatment, patients were divided into normal thyroid group and thyroid irAEs group. The clinical characteristics, including age, gender, tumor type, previous anti-cancer treatment history and thyroid function status were evaluated. After the occurrence of thyroid irAEs, thyroid function evaluation, onset time, and survival outcomes were analyzed. Risk factors that may contribute to the thyroid irAEs were further explored by logistic regression. Out of 1151 patients treated with a PD-1/PD-L1 inhibitor, 257 (22.3%) developed new thyroid irAEs, with the vast majority (98.0%) being hypothyroidism (193/257, 75.1%) and Grade1-2 (252/257, 98.0%), including 252 Hashimoto's thyroiditis (98.0%), 3 subacute thyroiditis (1.17%) and 2 Graves' disease (0.78%). There was a significant difference in the number of treatment cycles of PD-1/PD-L1 inhibitors between the two groups (P = 0.001). In multivariate analysis, gastrointestinal cancer, radiotherapy history, targeted therapy history, positive TgAb and TPOAb at baseline were associated with thyroid irAEs caused by PD-1/PD-L1 inhibitors. Absence of thyroid irAEs predicted increased mortality overall (HR = 2.935, P = 0.024) and particularly in gastrointestinal cancers (HR = 9.453, P = 0.007), despite comparable crude mortality (5.84% vs. 5.82%, P = 0.228). No association was observed in lung/other tumors. Thyroid function recovery occurred in 36.2% of patients, and treatment interruption due to thyroid irAEs was rare (3.5%). In our group, 22.3% patients treated with PD-1/PD-L1 inhibitors developed thyroid irAEs. The main subtype of thyroid irAEs was hypothyroidism (75.1%). Patients with gastrointestinal cancer, previous radiotherapy, history of targeted therapy, and baseline TgAb or TPOAb positivity may increase the risk of thyroid irAEs. Thyroid irAEs was associated with a trend for a survival benefit in patients with gastrointestinal cancer.

AimsResearch suggested that fibrinogen is associated with diabetic peripheral neuropathy (DPN). Our previous study unveiled that fibrinogen function indices, namely the k value and angle α, have the potential to serve as early diagnostic indicators for DPN. However, it has yet to be reported whether these factors influence the development of DPN. Here, type 2 diabetes were followed up for two years to investigate whether k value and angle α impact the onset of DPN.MethodsType 2 diabetes without neuropathy were recruited for this prospective observational clinical study and were followed up for two years. Participants were categorized into three groups based on progression to DPN: diabetes without neuropathy, subclinical DPN, and confirmed DPN. Differences in baseline parameters were compared, and independent risk factors were analysed.ResultsParticipants who progressed to DPN (both subclinical DPN and confirmed DPN) had higher baseline levels of HbA1c than in those who did not (P = 0.015; P = 0.040). The baseline angle α was also greater (P < 0.001; P < 0.001), while the k value was lower in participants who progressed to DPN than in those who did not (P < 0.001; P < 0.001). The associations of the angle α and k value with DPN were independent of HbA1c, duration, fibrinogen (Fib) and other potential confounders affecting the angle α and k value (e.g., vitamin B12, retinopathy, and renal status). ROC curve indicated that the predictive value of the angle α and k value were 0.759 and 0.804.ConclusionsFibrinogen function indices could potentially be utilized as predictive indicators for evaluating the likelihood of DPN in diabetes.