Higher long-term variability of serum uric acid associated with diabetic retinopathy risk: Study

A new study published in the journal of Diabetes Research and Clinical Practice found that patients with type 1 and type 2 diabetes mellitus had a greater chance of developing diabetic retinopathy (DR) if their serum uric acid levels were variable.

With a projected global incidence of 12.2% in 2045, diabetes mellitus (DM), a metabolic condition marked by persistent hyperglycemia brought on by absolute or relative insulin insufficiency, has emerged as one of the most prevalent chronic illnesses. Diabetes-related hyperglycemia and other metabolic irregularities can have a significant impact on the body’s organs, resulting in retinopathy, nephropathy, and neuropathy, among other problems.

One significant ocular consequence of diabetes is DR, which affects 22.27 percent of people with diabetes. Additionally, 6.17 percent of people with diabetes have vision-threatening DR (VTDR), making DR the most common cause of visual impairment in people of working age.

Purine metabolism produces uric acid, and high blood uric acid levels are a frequent metabolic change seen in diabetic patients. Several clinical investigations have linked higher serum uric acid levels to diabetic retinopathy. Thus, this study assessed the relationship between the onset and/or severity of diabetic retinopathy (DR) in patients with Type 1 and Type 2 diabetes mellitus (DM) and the variability of serum uric acid (SUA).

At Shanghai General Hospital, 730 DM patients lacking proliferative diabetic retinopathy at baseline participated in a prospective trial. Every subject had several DR evaluations using fundus photography and SUA measures throughout the course of at least a year of follow-up. To evaluate SUA fluctuations, average real variability (ARV) was computed for every patient, taking into consideration different follow-up frequencies and visit counts.

With a Log-rank p-value of 0.0055, the Kaplan-Meier survival analysis revealed that the group with higher SUA ARV scores had a greater chance of developing and progressing DR.

The hazard ratios for DR deterioration in patients in the third and fourth quantiles of ARV are 2.2 (p = 0.008, 95 % CI: 1.2206∼3.8201) and 2.74 (p = 0.017, 95 % CI: 1.1339∼3.7255), respectively, as compared to patients in the first quantile, according to Cox regression with Backward Stepwise Selection of covariates.

Overall, in DM patients, high long-term variability is strongly linked to the onset and exacerbation of DR, indicating the significance of the advantages of ongoing serum uric acid management.

Source:

Zhu, Q., Wang, H., Qu, Y., Jiang, Y., Liu, X., Liu, X., Xiao, Y., Lv, K., Xing, X., Niu, T., & Liu, K. (2025). Association between long-term serum uric acid variability and diabetic retinopathy: A prospective study in patients with Type 1 and Type 2 diabetes. Diabetes Research and Clinical Practice, 226(112306), 112306. https://doi.org/10.1016/j.diabres.2025.112306

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High dietary fiber intake may reduce likelihood of stroke, death, reveals research

A recent study published in Stroke by Lai et al. (2025) highlights a significant association between high dietary fiber intake and reduced mortality from stroke. The research indicates that individuals consuming higher amounts of dietary fiber have a lower risk of dying from stroke compared to those with lower fiber intake. This finding aligns with previous studies that have demonstrated the protective effects of dietary fiber against cardiovascular diseases, including stroke.

The study emphasizes the importance of incorporating fiber-rich foods into the diet, such as fruits, vegetables, whole grains, and legumes. These foods not only provide essential nutrients but also contribute to overall cardiovascular health. The mechanisms by which dietary fiber exerts its protective effects include the reduction of blood pressure, improvement of lipid profiles, and enhancement of insulin sensitivity. In addition to the findings by Lai et al., a meta-analysis by Threapleton et al. (2013) supports the inverse relationship between dietary fiber intake and stroke risk. Their analysis concluded that greater dietary fiber consumption is significantly associated with a lower risk of first stroke, reinforcing the importance of dietary fiber in stroke prevention strategies. Given the substantial evidence linking dietary fiber intake to reduced stroke mortality, public health initiatives should focus on promoting diets rich in fiber. Such dietary modifications are a cost-effective and accessible means to improve cardiovascular health and reduce the burden of stroke-related deaths.
Keywords: dietary fiber, stroke mortality, cardiovascular health, whole grains, fruits, vegetables, stroke prevention
References:

Lai, S., et al. (2025). High dietary fiber intake may reduce likelihood of stroke death. Stroke. doi:10.1161/STROKEAHA.124.049093

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Low Vitamin D3 and High Prolactin Linked to Increased Uterine Fibroids in Premenopausal Women: Indian Study

India: A new study published in the Indian Journal of Medical Sciences sheds light on the hormonal imbalances potentially influencing the growth and progression of uterine fibroids (UFs) in premenopausal women. Conducted by Dr. Azaz Ahmad and colleagues from the Department of Reproductive Medicine, Indira IVF Hospital Pvt. Ltd., Udaipur, India, the research explored the correlation between serum vitamin D3 and prolactin (PRL) levels in women diagnosed with uterine fibroids.

“Indian study found that premenopausal women with uterine fibroids had much lower vitamin D3 levels (10.85 ng/mL) and higher prolactin levels (27.79 ng/mL) compared to healthy women (19.64 and 13.96 ng/mL, respectively). Lower vitamin D3 was linked to more fibroids, while higher prolactin levels were also associated with an increased number of fibroids, suggesting both may play a role in fibroid development,” the researchers reported.

Uterine fibroids, also known as leiomyomas, are non-cancerous tumors commonly seen in women of reproductive age, with prevalence rates nearing 70%. Despite being benign, these growths can lead to a range of reproductive and gynecological issues, including infertility, pelvic pain, and heavy menstrual bleeding. Emerging evidence points to the role of vitamin D deficiency and elevated prolactin levels in the development and exacerbation of these tumors.

In this cross-sectional study conducted between April and November 2022, researchers compared 80 premenopausal women with uterine fibroids (≥2 cm in size) with 80 healthy women. All participants were evaluated using transvaginal ultrasound and underwent blood tests to measure serum levels of vitamin D3 and prolactin.

Based on the study, researchers reported the following findings:

  • Women with fibroids had significantly lower serum vitamin D3 levels (10.85 ± 3.34 ng/mL) compared to healthy controls (19.64 ± 5.50 ng/mL).
  • Prolactin levels were significantly higher in the fibroid group (27.79 ± 8.19 ng/mL) than in the control group (13.96 ± 4.09 ng/mL).
  • Both differences in vitamin D3 and prolactin levels between groups were statistically significant.
  • Serum vitamin D3 levels showed a moderate negative correlation with the number of fibroids (r = −0.513), indicating that lower vitamin D3 levels were linked to a higher number of fibroids.
  • Serum prolactin levels exhibited a positive correlation with fibroid number (r = 0.453), suggesting that higher prolactin levels were associated with a greater fibroid burden.

These findings highlight the potential role of vitamin D3 deficiency and elevated prolactin as contributing factors in fibroid development. The authors suggest that monitoring these serum levels could aid in early detection and better management of uterine fibroids in premenopausal women.

“Given the clear associations observed, serum vitamin D3 and prolactin may serve as important biomarkers in the clinical evaluation of uterine fibroids,” the researchers noted.

The study adds to growing evidence supporting the importance of hormonal and nutritional assessment in women with fibroids. It paves the way for future interventions aimed at correcting these imbalances to slow disease progression.

Reference:

Ahmad A, Ahmad M, Bhoi NR, Kumar M. Correlation between serum vitamin D3 and prolactin levels in premenopausal women with uterine fibroids. Indian J Med Sci. doi: 10.25259/IJMS_246_2024

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Immunotherapy boosts chemotherapy in combating stage 3 colon cancer: Study

Colon cancer is the third most prevalent form of cancer in the U.S., and while screening has helped detect and prevent colon cancer from spreading, major advancements in treating colon cancer have lagged.

Now, new research led by Mayo Clinic Comprehensive Cancer Center found that adding immunotherapy to chemotherapy after surgery for patients with stage 3 (node-positive) colon cancer-and with a specific genetic makeup called deficient DNA mismatch repair (dMMR)-was associated with a 50% reduction in cancer recurrence and death compared to chemotherapy alone. Approximately 15% of people diagnosed with colon cancer exhibit dMMR and, to date, these tumors appear less sensitive to chemotherapy. The results of the multi-center study were presented during a plenary session at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

“The findings from our study represent a major advance in the adjuvant treatment of dMMR stage 3 colon cancer and will now change the treatment for this type of cancer,” says oncologist Frank Sinicrope, M.D., who led the study. “It’s extremely rewarding to be able to offer our patients a new treatment regimen that can reduce the risk of recurrence and improve their chances of survival.”

Until now, the standard treatment after surgery for any stage 3 colon cancer has been chemotherapy. However, the researchers note that approximately 30% of patients experience cancer recurrence despite this treatment.

The clinical trial enrolled 712 patients with dMMR stage 3 colon cancer that had been surgically removed and who had cancer cells in their lymph nodes. The immunotherapy given in this study was an immune checkpoint inhibitor, known as atezolizumab, which activates one’s immune system to attack and kill cancer cells, which are responsible for cancer recurrence and spread. The patients-who lived in the U.S. and Germany-received chemotherapy for six months along with immunotherapy and then continued with immunotherapy alone for another six months.

Dr. Sinicrope and others previously studied patients with colon cancer whose cells are unable to repair errors during DNA replication that create a nucleotide mismatch, a condition called dMMR. They noted that these patients’ tumors showed a striking increase in inflammatory cells within the tumor, including those that express the target of immune checkpoint inhibitors. This sparked the idea of using immune checkpoint inhibitors to make the immune cells more effective in attacking and killing the cancer cells.

Based on the data from this study, Dr. Sinicrope recommends this combination of immunotherapy and chemotherapy treatment to be the new standard treatment for stage 3 deficient mismatch repair colon cancer. The research team plans to approach the National Comprehensive Cancer Network, a nonprofit organization consisting of 33 leading cancer centers, including Mayo Clinic, with this recommendation.

The study included patients with Lynch syndrome, the most common form of hereditary colon cancer, as these patients can have tumors that show deficient mismatch repair (dMMR).

“We’re changing the paradigm in colon cancer treatment. By using immunotherapy at earlier stages of disease, we are achieving meaningful benefits for our patients,” says Dr. Sinicrope.

Reference:

Immunotherapy boosts chemotherapy in combating stage 3 colon cancer, Mayo Clinic, Meeting: 2025 ASCO Annual Meeting.

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Increasing Antioxidant Intake May Help Preserve Gum Health and prevent periodontitis: Study

Elevated dietary antioxidant intake is associated with a diminished prevalence of periodontitis suggests a new study published in the BMC Oral Health.

The antioxidant system of periodontal tissue is unbalanced in periodontitis, and appropriate supplementation of antioxidants can effectively prevent or alleviate periodontal tissue damage. However, a dearth of research exists on the association between dietary antioxidant intake and the prevalence of periodontitis. Six dietary antioxidants (vitamins A, C, and E, zinc, selenium, and carotenoids) were extracted from two 24-h recall interviews utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The composite dietary antioxidant index (CDAI) made calculations using data on the intake of these six dietary antioxidants. Periodontitis severity was categorized into mild, moderate, and severe classifications based on established consensus criteria. Additionally, a restricted cubic spline (RCS) regression model was applied to evaluate the potential non-linear dose–response relationship between CDAI and periodontitis prevalence. Results: A total of 9,378 adults were included in this analysis, of which 4,755 had periodontitis. Individuals within the highest CDAI quartile demonstrated a diminished prevalence of total periodontitis compared to those in the lowest quartile (OR = 0.70 [0.53–0.93], Ptrend = 0.012). When moderate/severe periodontitis served as the outcome variable, those within the fourth CDAI quartile exhibited a 32% reduced prevalence compared to those in the first quartile (OR = 0.68 [0.52–0.88], Ptrend = 0.006). RCS regression showed that CDAI was linearly and negatively related to the prevalence of periodontitis (both total and moderate/severe periodontitis). In subgroup analysis by gender, a significant association between CDAI and total periodontitis was discerned solely among females (OR = 0.60 [0.42–0.85], Pinteraction = 0.015). Elevated dietary antioxidant intake is associated with a diminished prevalence of periodontitis. These findings underscore the potential role of antioxidants in periodontal health.

Reference:

Chen, X., Han, R., Liu, X. et al. Association between composite dietary antioxidant index and the prevalence of periodontitis: results from NHANES 2009–2014. BMC Oral Health 25, 779 (2025). https://doi.org/10.1186/s12903-025-06151-7

Keywords:

BMC Oral Health, Chen, X., Han, R., Liu, X, Periodontitis, Antioxidants, Dietary intake, CDAI, NHANES

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Higher Vitamin D Levels Linked to Reduced Mortality and Cardiovascular Disease Risk in Psoriasis Patients: Study

Researchers have identified in a new study that increased serum 25-hydroxyvitamin D (25(OH)D) is linked with lower risks of all-cause mortality and cardiovascular disease (CVD) in psoriasis patients. The large cohort study, including 8,947 patients with psoriasis and 178,937 age- and sex-matched controls from the UK Biobank, was conducted to examine the protective effect of serum 25(OH)D against mortality and the risk of CVD in psoriasis patients. The study was published in the Journal of the American Academy of Dermatology by Kaiqing Lin and colleagues.

Psoriasis is a chronic inflammatory skin disease that has been associated with an elevated risk of systemic illnesses, including CVD. Vitamin D, with its immune-modulatory and cardiovascular functions, has been implicated in protection against diseases. Yet, there has been limited evidence demonstrating the effect of serum 25(OH)D levels on mortality and risk of CVD among psoriasis patients. This research sought to fill this gap in knowledge by examining the relationship between levels of serum 25(OH)D and these health outcomes.

This cohort study employed UK Biobank data comprising 8,947 patients with psoriasis and 178,937 controls matched to them. Baseline measurements of serum 25(OH)D were made, and the incidence of CVD and all-cause mortality was followed up. Multivariable-adjusted Cox proportional hazards regression analyses were employed to evaluate the associations of serum 25(OH)D concentrations with mortality risk and CVD.

Key Findings

  • Among patients with psoriasis, patients with the highest serum levels of 25(OH)D (≥50 nmol/L) had a 46% reduced risk of all-cause mortality (HR 0.54) and a 22% reduced risk of new-onset CVD (HR 0.78) relative to those with the lowest levels of vitamin D (<25 nmol/L).

  • Psoriasis patients who had serum 25(OH)D levels ≥50 nmol/L did not have an increased risk of mortality or new CVD events relative to matched controls.

Increased serum 25(OH)D concentrations were also linked with decreased risks for all-cause mortality and CVD in patients with psoriasis.These findings bring to light the importance of maintaining proper levels of vitamin D to promote better health in patients with such conditions. Further research is needed to determine why there is such a protective effect and whether supplementation with vitamin D would result in further improvement in patients with psoriasis.

Reference:

Lin, K., Miao, Y., Gan, L., Zhao, B., Fang, F., Wang, R., Chen, X., & Huang, J. (2025). Associations of serum 25-hydroxyvitamin D concentrations with risks of mortality and cardiovascular disease among individuals with psoriasis. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2025.05.1380

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High CRP-to-HDL Ratio Linked to Greater NAFLD and Liver Fibrosis Risk: Study Shows

China: A recent study published in Scientific Reports has spotlighted a novel biomarker combination that may aid in identifying individuals at risk for non-alcoholic fatty liver disease (NAFLD) and its complications. 

Conducted by Yanyan Xuan and colleagues from the Department of Hepatology, The First Affiliated Hospital of Ningbo University, China, the research explores the association between the ratio of high-sensitivity C-reactive protein (hs-CRP) to high-density lipoprotein cholesterol (HDL-C)—referred to as HCHR—and the likelihood of NAFLD, liver steatosis, and fibrosis.

“A higher high-sensitivity CRP to HDL-C ratio (HCHR) was linked to an increased risk of NAFLD, liver fibrosis, and fat buildup in the liver. People with NAFLD had a much higher median HCHR (2.47) compared to those without the condition (0.99),” the researchers reported. “The risk was especially high in women, adults under 40, and those with a BMI between 25 and 30 kg/m². As HCHR levels rose, liver fat and fibrosis worsened, with a 21% higher risk of cirrhosis seen at elevated HCHR levels.”

Using data from the 2017–2018 US National Health and Nutrition Examination Survey (NHANES), the researchers analyzed information from 4,039 adults.

The study revealed the following findings:

  • Individuals with higher HCHR levels were significantly more likely to have non-alcoholic fatty liver disease (NAFLD).
  • The median HCHR was 2.47 in those with NAFLD, compared to 0.99 in those without the condition.
  • Multivariable regression analysis confirmed a strong, independent link between increased HCHR and NAFLD risk, even after adjusting for confounding factors.
  • The risk of NAFLD was particularly elevated in women, individuals under 40 years of age, and those with a BMI between 25 and 30 kg/m².
  • Higher HCHR levels were associated with greater severity of hepatic steatosis and an increased risk of liver fibrosis.
  • Individuals with elevated HCHR had a 21% higher odds of developing cirrhosis.
  • A nonlinear relationship was observed between HCHR and NAFLD, with a threshold ratio of 2.598 identified.
  • Beyond this threshold, the risk of NAFLD increased more sharply, suggesting HCHR as a potential marker for liver disease severity.

The study provides valuable insights into the utility of HCHR as a simple, non-invasive marker for assessing liver disease risk in clinical settings. Given the rising global burden of NAFLD, such tools are urgently needed to support early detection and preventive strategies.

However, the researchers caution that due to the cross-sectional design of the study, a causal relationship cannot be definitively established. Additionally, as the data were predominantly drawn from a non-Hispanic white US population, further validation is needed in more diverse groups through prospective, multi-center studies.

“The findings open new avenues for early identification of at-risk individuals and underscore the relevance of inflammation-lipid profiles in liver disease progression,” the researchers concluded.

Reference:

Xuan, Y., Wang, B., Xie, B., Cen, Y., Yu, S., & Yao, Q. (2025). Nonlinear relationship between serum high sensitivity C reactive protein to high-density lipoprotein cholesterol ratio with non-alcoholic fatty liver disease. Scientific Reports, 15(1), 1-14. https://doi.org/10.1038/s41598-025-03528-0

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Maternal and Perinatal Outcomes: Study gives Closer Look at Prolonged Second Stage of Labour in Rural setting

Recent study aimed to analyze the incidence, management, and outcomes of prolonged second stage of labor in a rural hospital in Malawi. Prolonged second stage labor can lead to maternal and perinatal complications, and the options for management include oxytocin augmentation, instrumental vaginal birth, or second-stage cesarean section. The study assessed a dataset of 3,426 births over a two-year period in St Luke’s Hospital in Malawi. About 9% of women experienced a prolonged second stage, with interventions including oxytocin augmentation (7.2%), vacuum extraction (10.1%), or cesarean section (20.8%). The majority of women (69.1%) had spontaneous vaginal births.

Challenges and Outcomes

The study revealed that a considerable proportion of women arrived at the hospital already in the second stage of labor, which posed challenges in monitoring and timely intervention. Despite this, outcomes for these women were generally good without significant differences in maternal and neonatal complications compared to women admitted in earlier stages of labor. Women who were admitted during the second stage had higher parity, older age, and fewer antenatal care consultations. However, they had lower rates of previous cesarean sections.

Documentation and Interventions

Among the women admitted in the second stage, only a small percentage had a documented prolonged second stage on the partograph. Women in this subgroup experienced higher rates of instrumental vaginal births, cesarean sections, and complications. The study emphasized the need to enhance the use of vacuum extraction as an alternative to second-stage cesarean sections, which have higher risks. Training on instrumental vaginal birth, like vacuum extraction, was identified as crucial for clinicians to improve the quality of care and reduce complications associated with prolonged labor.

Implications for Maternal Health

The implications of the study suggest that timely attention, proper monitoring of labor progress, and the availability of instrumental birth methods can help prevent prolonged labor and its adverse outcomes. Enhancing the use of vacuum extraction, alongside appropriate training, can lead to significant improvements in maternal and neonatal health outcomes. This study provides valuable insights into clinical practices in low-resource settings and highlights the importance of tailored interventions to address the challenges associated with prolonged second stage labor in rural areas of Malawi.

Key Points

– The study focused on analyzing the incidence, management, and outcomes of prolonged second stage of labor in a rural hospital in Malawi, where 9% of women experienced this condition. Interventions for prolonged second stage labor included oxytocin augmentation, vacuum extraction, or cesarean section, with the majority (69.1%) having spontaneous vaginal births.

– A notable challenge identified was that a significant number of women arrived at the hospital already in the second stage of labor, which hindered monitoring and timely intervention. However, women admitted during the second stage did not show significant differences in maternal and neonatal complications compared to those admitted earlier, despite having higher parity, older age, and fewer antenatal care consultations.

– Documented cases of prolonged second stage on the partograph among women admitted in the second stage were minimal. This subgroup experienced more instrumental vaginal births, cesarean sections, and complications, highlighting the importance of improving documentation and considering vacuum extraction as an alternative to cesarean sections in such cases.

– The study underscored the necessity of training healthcare providers in instrumental vaginal birth techniques like vacuum extraction to enhance the quality of care and decrease complications related to prolonged labor. This training can potentially reduce the risks associated with second-stage cesarean sections and improve maternal and neonatal health outcomes.

– Timely attention, proper monitoring of labor progression, and the availability of instrumental birth methods were suggested as key factors in preventing prolonged labor and its adverse effects. Enhancing the use of vacuum extraction, coupled with appropriate training, has the potential to significantly enhance maternal and neonatal health outcomes, especially in low-resource settings such as rural areas of Malawi.

– The study provides valuable insights into clinical practices in low-resource settings, emphasizing the importance of tailored interventions to tackle the challenges associated with prolonged second stage labor. By addressing issues related to management and interventions, healthcare systems can improve outcomes for women experiencing prolonged labor, thus benefiting maternal and neonatal health in such regions.

Reference –

Wouter Bakker et al. (2025). Incidence, Management And Outcomes Of Prolonged Second Stage Of Labour In A Rural Setting In Malawi: A Retrospective Cohort Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07392-8.

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Both Low and High HGI Levels Linked to Elevated Risk of Diabetic Nephropathy: Study Finds

China: A recent retrospective cohort study published in Diabetes, Metabolic Syndrome and Obesity has revealed a significant U-shaped relationship between the hemoglobin glycation index (HGI) and the risk of developing diabetic nephropathy (DN) in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

The research, led by Dr. Weiyi Zhou from the Department of Nephrology at the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, analyzed data from 1,050 patients with T2DM who had normal kidney function at the study’s outset. Patients were categorized into quartiles based on their HGI values, and the DN incidence was monitored over time.

The HGI reflects the discrepancy between a patient’s actual HbA1c level and the value predicted from their fasting plasma glucose (FPG), offering insight into individual variations in hemoglobin glycation. Unlike FPG or HbA1c alone, which showed no significant association with DN risk in this study, HGI emerged as a more informative marker.

The key findings of the study were as follows:

  • Both very low and very high Hemoglobin Glycation Index (HGI) values were associated with an increased risk of developing diabetic nephropathy (DN).
  • The lowest risk of DN was observed at an HGI value of −0.648.
  • Patients in the highest HGI quartile had a 54% higher risk of DN (OR: 1.54).
  • Those in the lowest HGI quartile showed a 40% increased risk of DN (OR: 1.40), although this was not statistically significant.
  • Fasting plasma glucose and HbA1c were not independently associated with DN risk.
  • HGI appeared to be a more sensitive indicator for assessing DN risk compared to traditional glycemic markers.
  • Subgroup and sensitivity analyses confirmed the consistency of the U-shaped association across different patient groups.
  • Inflammation was identified as a potential mechanism in the HGI-DN link, with C-reactive protein (CRP) mediating 11.1% of the association.
  • These findings suggest a role for low-grade inflammation in the progression of DN among T2DM patients.

While the findings are compelling, the authors acknowledged several limitations. Being a single-center, retrospective study, it cannot establish causality. The reliance on baseline HGI values alone limited the ability to examine how changes over time might affect DN risk. Additionally, the absence of inflammatory markers beyond CRP and the lack of glycemic variability data, such as MAGE and CONGA, restricted deeper mechanistic insights.

Despite these limitations, the research provides the first evidence of a nonlinear, U-shaped association between HGI and diabetic nephropathy risk in newly diagnosed T2DM patients. According to the authors, incorporating HGI into clinical evaluations may enhance risk prediction and pave the way for more personalized interventions.

“Further multicenter prospective studies, incorporating inflammatory and glycemic variability markers, are needed to validate these findings and assess whether modifying HGI can improve renal outcomes in T2DM,” the authors concluded.

Reference:

Zhou W, Zhang L, Liu T. Association Between the Hemoglobin Glycation Index (HGI) and Risk of Diabetic Nephropathy: A Retrospective Cohort Study. Diabetes Metab Syndr Obes. 2025;18:1859-1872. https://doi.org/10.2147/DMSO.S523442

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Simvastatin fails to provide Added Antidepressant Effect in MDD with Obesity: JAMA

A new study published in the Journal of American Medical Association showed that simvastatin did not provide additional antidepressant benefits when combined with escitalopram in patients with major depressive disorder (MDD) and obesity, although it did improve cardiovascular risk factors.

Obesity and major depressive disorder are prevalent noncommunicable diseases with significant disease burdens that commonly co-occur. Interestingly, a biological connection between obesity, metabolic syndrome, and depression has been proposed by convergent lines of evidence from genetic and observational research as well as animal models.

The antidepressant potential of statins has been suggested by a number of modest randomized clinical studies (RCTs). Thus, to determine if simvastatin added to escitalopram is more effective than a placebo at reducing depressive symptoms, this trial was carried out.

This investigation included adults with MDD and concomitant obesity from nine German tertiary care settings. Analysis of the data took place between July and October of 2024. In addition to escitalopram (10 mg during the first two weeks, then raised to 20 mg until the completion of the research), simvastatin (40 mg daily) or a placebo was administered in a double-blind manner for 12 weeks. The Montgomery-Åsberg Depression Rating Scale (MADRS) score change from baseline (week 0) to week 12 was the main result.

The intention-to-treat analysis comprised 160 of the 161 patients who were recruited at 9 locations in Germany between August 21, 2020, and June 06, 2024 (mean [SD] age, 39.0 [11.0] years; 126 female [79%]; placebo: n = 79, simvastatin: n = 81). Blinding was successfully maintained throughout the experiment, and retention was outstanding (95.6%).

Four severe adverse events occurred, and there was no difference between the groups. Simvastatin addition did not significantly affect MADRS scores in the intention-to-treat population, according to primary endpoint analysis (mixed models for repeated measures least squares mean difference, 0.47 points; 95% CI, -2.08 to 3.02; P =.71).

Simvastatin substantially decreased LDL cholesterol (-40.37 mg/dL), total cholesterol (-39.07 mg/dL), and C-reactive protein (-1.04 mg/L) when compared to a placebo (all P <.01), but it had no effect on secondary outcomes relating to mental health. Overall, the study showed that even while simvastatin improved the cardiovascular risk profile, it had no extra antidepressant benefits when used with escitalopram in individuals who had both obesity and concomitant MDD.

Source:

Otte, C., Chae, W. R., Dogan, D. Y., Piber, D., Roepke, S., Cho, A. B., Trumm, S., Kaczmarczyk, M., Brasanac, J., Wingenfeld, K., Koglin, S., Wieditz, J., Junghanns, K., Lucht, M., Prvulovic, D., Krüger, T. H. C., Terock, J., Haaf, M., Hofmann, T., … Gold, S. M. (2025). Simvastatin as add-on treatment to escitalopram in patients with major depression and obesity: A randomized clinical trial. JAMA Psychiatry (Chicago, Ill.). https://doi.org/10.1001/jamapsychiatry.2025.0801

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