Cardio-renal-metabolic (CRM) multimorbidity, defined by the co-occurrence of cardiovascular disease (CVD), chronic kidney disease (CKD), and type 2 diabetes (T2DM), poses a growing burden for multimorbidity management. The atherogenic index of plasma (AIP), a lipid-based marker of insulin resistance, may help predict CRM progression, but its prognostic value remains unclear. We used data from 5805 adults free of CRM at baseline in the China Health and Retirement Longitudinal Study. AIP was calculated as log10[triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)]. CRM onset was defined as incident CVD, T2DM, or CKD. Multistate models captured transitions from no disease to single, dual, and triple CRM states. Cox regression and time-dependent receiver operating characteristic (ROC) curves were used to assess associations and predictive performance. AIP showed a clear dose-response relationship with CRM progression. Each 1-standard deviation (SD) increase in AIP was associated with higher risks of single (HR 1.17, 95% CI 1.13-1.22), dual (HR 1.31, 95% CI 1.21-1.41), and triple CRM (HR 1.57, 95% CI 1.27-1.94) diseases. Strong associations were observed for new-onset T2DM and stroke, but not CKD. AIP yielded the highest discrimination for triple CRM (5-year area under the curve [AUC] = 0.710). Multistate modeling showed each 1-SD increase in AIP raised the hazard of transitioning from single to dual CRM by 14% and from dual to triple by 31%. AIP is an independent, simple, and low-cost predictor of CRM onset and progression, with potential utility for early risk stratification and prevention.

To explore the associations of sarcopenia and sarcopenic obesity (SO) with memory. Data from the Guangzhou Biobank Cohort Study (GBCS) were used to conduct both cross-sectional (n = 6390) and longitudinal (n = 3979) analyses. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019, while obesity was defined by 20 obesity indicators. Memory was assessed by the Delayed Word Recall Test (DWRT). Linear regression was used to analyze these associations. Two-sample Mendelian randomization (2SMR) was used to investigate potential causal associations of sarcopenia-related traits with memory. Compared to participants without sarcopenia, those with sarcopenia had lower baseline and follow-up DWRT score, and greater decrease in mean annual change (MAC) and MAC rate of DWRT score, with adjusted βs (95% CIs) being -0.24 (-0.33 to -0.14), -0.10 (-0.20 to -0.004), -0.03 (-0.06 to -0.001) and -0.79 (-1.57 to -0.01), respectively. Among all the SO definitions, the associations of SO defined by waist-to-hip-to-height ratio (WHHR) appeared to be the strongest (-0.36 [-0.50 to -0.22], -0.31 [-0.45 to -0.17], -0.09 [-0.14 to -0.05] and -2.70 [-3.81 to -1.59]), and stronger than those with sarcopenia only or obesity only. In 2SMR, walking pace (one of the sarcopenia indicators) was positively associated with working memory (1.61 [0.59, 2.62]). Sarcopenia and SO were associated with faster memory decline. Using the central obesity indicator WHHR to define SO may better predict late-life memory.

Fat mass and obesity-related gene (FTO) has been associated with glucose homeostasis and insulin sensitivity in some populations. The aim of this study was to evaluate the association of FTO gene rs9939609 and rs17817449 polymorphisms with insulin resistance, some cardiometabolic parameters, and body mass index (BMI) in Turkish children with obesity. The cross-sectional observational study included 83 children with obesity genotyped for variants of the FTO gene (rs9939609 and rs17817449). Children were divided into two groups as control and insulin resistant according to the homeostatic model assessment of insulin resistance (HOMA-IR). The relationship between the genotypes of rs9939609 and rs17817449 polymorphisms and insulin resistance was determined using binary logistic regression analysis. In the control group and insulin-resistant obese group, the majority of the rs9939609 polymorphism was AT (69.2%) and AA (64%) genotypes, and the majority of the rs17817449 polymorphism was GT (65.4%) and TT (70%) genotypes, respectively. Fasting glucose and insulin values were lower, and quantitative insulin sensitivity calculation index (QUICKI) values were higher in the risk genotype (GG) of rs17817449 polymorphism (p < 0.05). Additionally, rs9939609 (AT genotype, OR = 0.063; 95% CI: 0.006-0.707, p = 0.025 and AA genotype, OR = 0.111; 95% CI: 0.021-0.576, p = 0.009) and rs17817449 (GT genotype, OR = 12.250; CI: 9.720-84.383, p < 0.001) polymorphisms were strongly associated with insulin resistance. Our study supports that FTO gene rs9939609 and rs17817449 polymorphisms are associated with insulin resistance independently of age, gender, and BMI.

ABSTRACTAimsType 2 Diabetes Mellitus (T2DM) and depression are major public health challenges, with Mexico ranking among the countries with the highest prevalence of both. Research into the bidirectional relationship between the two conditions in Mexico is scarse. This study aims to investigate the prevalence of T2DM and depression, the co‐occurrence of these conditions, the strength of their association, and socio‐demographic, and geographical factors contributing to their prevalence in Mexico.MethodsWe used data from the 2022 National Health and Nutrition Survey. T2DM was self‐report. Depression was assessed using the Center for Epidemiological Studies Depression Scale. Descriptive statistics and multivariate logistic regression models were used to explore the bidirectional relationship and associated factors.ResultsA high prevalence of depressive symptoms (16.7%) and Type 2 Diabetes Mellitus (T2DM, 10.9%) was found in a representative sample for the Mexican population (n =11 913). Participants with T2DM had higher odds of depressive symptoms (OR:1.78, 95 95% CI: 1.48–2.14), and those with depressive symptoms were also more likely to have T2DM (OR:1.97, 95% CI:1.52–2.54) for ages 20–59, and for ages 60+ (OR: 1.63, 95% CI: 1.27–2.09). Women were more likely to report depression than men (OR:2.14, 95% CI:1.83–2.51), and older adults (60+) had over three times higher odds of depression compared to younger adults (OR:3.53, 95% CI:3.00–4.15). Higher education was protective against both conditions, with individuals having high school or higher education showing lower odds of depression (OR:0.41, 95% CI: 0.31–0.53) and T2DM (OR: 0.52, 95% CI: 0.37–0.74).ConclusionsIntegrated strategies to address the co‐occurrence of T2DM and depression are needed, particularly among vulnerable and older populations.

CAC-guided management framework for adults with diabetes.

Mechanisms of action and effects of GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists on multiple organ systems relevant to obstructive sleep apnea and cardiometabolic health.

ABSTRACTDiabetes mellitus (DM) is one of the most common chronic diseases worldwide, and diabetic cardiomyopathy (DCM) is one of the cardiovascular complications of DM, described as the development of abnormalities of myocardial structure/function associated with DM in the absence of coronary artery disease, hypertension, and valvular disease. The disease has an insidious onset and lacks effective treatment. Studies have shown that even with effective glycemic control, the progression of DCM cannot be prevented. Exploring the pathogenesis of DCM and identifying effective intervention targets is the focus and hotspot of current research. Silent message regulator 3 (Sirtuin3, SIRT3) is one of the members of the nicotinamide adenine dinucleotide (NAD+)‐dependent deacetylase family of sirtuins, and studies have confirmed that SIRT3 has a protective effect on cardiovascular disease and may become a new target for the treatment of cardiovascular diseases. Therefore, this paper emphasizes the role of SIRT3 in DCM, describes the mechanism of SIRT3 in DCM, and summarizes the methods to improve DCM by elevating the level of SIRT3, aiming to provide new perspectives for treating and delaying DCM.

ABSTRACTBackgroundLongitudinal evidence of the relationship between blood pressure (BP) variability and end‐stage kidney disease (ESKD) among individuals with type 2 diabetes is limited. Therefore, we evaluated the association between BP variability and ESKD in Korean adults with type 2 diabetes.MethodsThe study utilized data from the Korean National Health Insurance Service database, comprising health checkups conducted between 2004 and 2015. We enrolled 36 421 adults aged ≥ 19 years with type 2 diabetes who underwent at least two health checkups and were followed up until the end of 2017. BP variability was measured using the coefficient of variation, standard deviation, and variability independent of the mean. Hazard ratios (HRs) and 95% confidence intervals (CIs) for ESKD were determined using multivariate Cox proportional hazards regression analysis.ResultsDuring a median follow‐up of 8.05 years, 290 patients with ESKD were identified. The highest quartile of systolic or diastolic BP variability presented a higher risk of ESKD than did the lowest quartile of systolic or diastolic BP variability. The group with the highest systolic and diastolic BP variability had a 77% higher risk of ESKD than did those in the lowest three quartiles of both systolic and diastolic BP variability. These associations were present in younger individuals without comorbidities.ConclusionsAmong individuals with type 2 diabetes, increased BP variability was associated with an increased risk of ESKD. These associations were similarly observed in younger individuals without comorbidities. Maintaining a consistent BP seems to be important to prevent progression to ESKD in individuals with type 2 diabetes.