Diabetic Nephropathy and Diabetic Atherosclerosis

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 6162

Special Issue Editors


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Guest Editor
1. Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
2. Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
Interests: cardiovascular disease; diabetic nephropathy; atherosclerosis; inflammation; macrophage
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Guest Editor
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
Interests: immune microenvironment; cell-cell communication; inflammation and bioinformatics

Special Issue Information

Dear Colleagues,

In our Special Issue on "Diabetic Nephropathy and Diabetic Atherosclerosis", we aim to provide a comprehensive exploration of the interrelated pathophysiological mechanisms, clinical manifestations, and therapeutic strategies for these critical complications of diabetes. Recent research has highlighted the intricate molecular pathways linking hyperglycemia with renal and vascular damage, emphasizing the role of inflammation, oxidative stress, and endothelial dysfunction. For this Special Issue, we seek to gather cutting-edge studies that elucidate novel biomarkers to aid in early detection, innovative pharmacological and non-pharmacological interventions, and evaluations of the impact of genetics on disease progression. By bridging gaps in the current knowledge, this Special Issue will advance our understanding of basic science and clinical practices and improve patient outcomes in diabetic nephropathy and atherosclerosis, fostering a holistic approach to managing diabetes-related complications.

Dr. Satyesh K. Sinha
Dr. Yuchen Wang
Guest Editors

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Keywords

  • diabetic nephropathy
  • diabetic atherosclerosis
  • diabetes
  • inflammation
  • oxidative stress
  • renal and vascular cell dysfunction
  • basic science
  • clinical practice
  • patient outcomes

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Published Papers (5 papers)

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Research

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14 pages, 230 KiB  
Article
Investigation of the Potential Association Between Atherosclerotic Cardiovascular Disease Risk Score and Diabetic Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study
by Chrysa Agapitou, Theodoros N. Sergentanis, Effie G. Papageorgiou, Panagiotis Theodossiadis, Ignatios Ikonomidis, Vaia Lambadiari and Irini Chatziralli
Biomedicines 2025, 13(3), 633; https://doi.org/10.3390/biomedicines13030633 - 5 Mar 2025
Viewed by 541
Abstract
Purpose: To examine the association between diabetic retinopathy (DR) and the atherosclerotic cardiovascular disease (ASCVD) risk score using the “ASCVD Risk Estimator Plus” tool in patients with type 2 diabetes mellitus (DM) and to assess risk factors potentially associated with DR. Methods [...] Read more.
Purpose: To examine the association between diabetic retinopathy (DR) and the atherosclerotic cardiovascular disease (ASCVD) risk score using the “ASCVD Risk Estimator Plus” tool in patients with type 2 diabetes mellitus (DM) and to assess risk factors potentially associated with DR. Methods: Participants in the study included 181 patients with type 2 DM who underwent a thorough ophthalmic examination, including a best-corrected visual acuity (BCVA) measurement, a dilated fundoscopy, fundus photography, an optical coherence tomography (OCT), and an OCT-angiography (OCT-A). DR was graded as no apparent retinopathy (NDR), mild non-proliferative (NPDR), moderate NPDR, severe NPDR, or proliferative DR (PDR). In addition, a detailed medical history of patients was recorded, while the “ASCVD Risk Estimator Plus” tool by the American College of Cardiology was used to calculate the ASCVD risk. Results: The ASCVD score, derived by the “ASCVD Risk Estimator Plus”, was not found to be significantly correlated with DR (p = 0.191). Multivariable logistic regression analysis showed that factors associated with DR independently included DM duration (multivariable OR = 3.16, 95% CI: 1.55–6.44, p = 0.002), HbA1c levels (multivariable OR = 2.94, 95% CI: 1.37–6.32, p = 0.006), and the presence of neuropathy (multivariable OR = 3.59, 95% CI: 1.43–9.05, p = 0.007). In the multivariable multinomial logistic regression analysis, NPDR development was associated with duration of DM (multivariable RR = 3.31, 95% CI: 1.57–6.97, p = 0.002), HbA1c levels (multivariable RR = 2.24, 95% CI: 1.00–5.02, p = 0.050), and neuropathy (multivariable RR: 3.94, 95% CI: 1.54–10.11, p = 0.004), while PDR development was only associated with HbA1c levels (multivariable RR = 6.88, 95% CI: 2.19–21.63, p = 0.001). Conclusions: The ASCVD score, as it was calculated using the “ASCVD Risk Estimator Plus” tool, was not found to be significantly associated with DR. Factors significantly associated with DR were DM duration, HbA1c levels, and the presence of neuropathy. Full article
(This article belongs to the Special Issue Diabetic Nephropathy and Diabetic Atherosclerosis)
14 pages, 829 KiB  
Article
The Asia-Pacific Body Mass Index Classification and New-Onset Chronic Kidney Disease in Non-Diabetic Japanese Adults: A Community-Based Longitudinal Study from 1998 to 2023
by Yukari Okawa, Toshiharu Mitsuhashi and Toshihide Tsuda
Biomedicines 2025, 13(2), 373; https://doi.org/10.3390/biomedicines13020373 - 5 Feb 2025
Cited by 2 | Viewed by 1767
Abstract
Background/Objectives: Obesity is a risk factor for chronic kidney disease (CKD) in Asians. The Asia-Pacific body mass index (BMI) classification sets lower obesity cutoffs than the conventional BMI classification for all races, generally reflecting the lower BMIs in Asians. This longitudinal study [...] Read more.
Background/Objectives: Obesity is a risk factor for chronic kidney disease (CKD) in Asians. The Asia-Pacific body mass index (BMI) classification sets lower obesity cutoffs than the conventional BMI classification for all races, generally reflecting the lower BMIs in Asians. This longitudinal study evaluated the association between BMI, as classified by the Asia-Pacific BMI system, and CKD development in non-diabetic Asian adults. Methods: A population-based longitudinal study (1998–2023) was conducted in non-diabetic Japanese adults (hemoglobin A1c < 6.5%) in Zentsuji City (Kagawa Prefecture, Japan). The generalized gamma model was used to assess the relationship between time-varying BMI categories and CKD development, stratified by sex. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2. BMI was calculated as weight (kg) divided by the square of height (m2) and categorized per the Asia-Pacific classification as overweight (23.0–24.9 kg/m2), obesity class I (25.0–29.9 kg/m2), and obesity class II (≥30.0 kg/m2). Results: CKD developed in 34.2% of 3098 men and 34.8% of 4391 women. The mean follow-up times were 7.41 years for men and 8.25 years for women. During follow-up, the BMI distributions for men were 5.0% underweight, 43.3% normal weight, 25.6% overweight, 24.1% obesity class I, and 2.0% obesity class II; those for women were 7.7%, 50.5%, 20.5%, 18.3%, and 2.9%, respectively. Compared with normal weight, obesity class I was associated with a 6% (95% confidence interval [CI]: 2–10%) shorter time to CKD onset in men and 5% (95% CI: 2–7%) in women. In both sexes, obesity class II showed shorter survival times than normal weight by point estimates, although all 95% CIs crossed the null value. Conclusions: Obesity, as classified by the Asia-Pacific BMI system, shortened the time to CKD onset in non-diabetic Asians. The conventional BMI cutoff for obesity (≥30.0 kg/m2) may be too high to identify CKD risk in this population. The findings of this study may be useful for public health professionals in designing interventions to prevent CKD. Full article
(This article belongs to the Special Issue Diabetic Nephropathy and Diabetic Atherosclerosis)
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8 pages, 211 KiB  
Article
Serum Carnosinase 1 Is Not Associated with Insulin Resistance or Glucose Metabolism in a Type 1 Diabetes Cohort
by Jiedong Qiu, Benito A. Yard, Bernhard K. Krämer, Harry van Goor, Peter R. van Dijk and Aimo Kannt
Biomedicines 2025, 13(2), 366; https://doi.org/10.3390/biomedicines13020366 - 5 Feb 2025
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Abstract
Background/Objectives: Preclinical studies suggest that the deleterious effect of a high serum carnosinase 1 (CN1) concentration is attributed to its adverse effects on insulin sensitivity and glucose metabolism. However, there is little evidence for a modulating role of CN1 in glucose metabolism [...] Read more.
Background/Objectives: Preclinical studies suggest that the deleterious effect of a high serum carnosinase 1 (CN1) concentration is attributed to its adverse effects on insulin sensitivity and glucose metabolism. However, there is little evidence for a modulating role of CN1 in glucose metabolism in humans. Methods: We measured serum CN1 concentration in an observational type 1 diabetes cohort of 172 patients in whom glucose variability (MAGE, MODD, SD of individual blood glucose, mean, and CV) was recorded by blinded continuous glucose monitoring for 5–7 days. Furthermore, insulin dose per kg body weight was compared. Results: Insulin sensitivity (insulin dosage) and glucose variability parameters did not differ between different CN1 tertiles (p > 0.05). Conclusions: There was no association of serum CN1 with indices of glucose variability in this type 1 diabetes cohort. Full article
(This article belongs to the Special Issue Diabetic Nephropathy and Diabetic Atherosclerosis)
11 pages, 1589 KiB  
Article
Lower Free Thyroxine Levels Are Associated with Diabetic Kidney Disease in Males with Type 2 Diabetes Mellitus: An Observational Cross-Sectional Study
by Jianan Shang, Yixuan Zheng, Meng Zhang, Meng Li, Wei Qiang, Jing Sui, Hui Guo, Bingyin Shi and Mingqian He
Biomedicines 2024, 12(10), 2370; https://doi.org/10.3390/biomedicines12102370 - 17 Oct 2024
Viewed by 1178
Abstract
Objectives: We aimed to explore the correlation between thyroid function and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 7516 T2DM patients were enrolled and grouped according to DKD status. Clinical parameters, including [...] Read more.
Objectives: We aimed to explore the correlation between thyroid function and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 7516 T2DM patients were enrolled and grouped according to DKD status. Clinical parameters, including blood glucose parameters, thyroid function, and indicators of renal impairment, were collected and compared between the DKD and Non-DKD groups. Correlation analysis and univariate/multivariate logistic regression analyses were performed. Results: Age, T2DM duration, the use of insulin and lipid-lowering drugs, systolic and diastolic blood pressure, body mass index, and fasting blood glucose levels were greater in the DKD group than in the Non-DKD group (p < 0.001). Notably, compared with those in the Non-DKD group, patients in the DKD group had lower triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), and free thyroxine (FT4) levels and higher thyrotropin levels (p < 0.001). Univariate logistic regression analysis revealed that T3, T4, FT3, and FT4 levels were negatively correlated with the risk of DKD. Spearman correlation analysis confirmed that T3, T4, FT3, and FT4 levels were negatively correlated with blood urea nitrogen levels, blood creatinine levels, and the urinary albumin-to-creatinine ratio (p < 0.05). Multivariate logistic regression analysis revealed that a greater FT4 level was a protective factor against DKD in T2DM patients, especially in males, with a cut-off value of 13.35 pmol/L (area under the curve = 0.604). Conclusions: Thyroid hormone levels, especially FT4 levels, were significantly negatively correlated with DKD in T2DM patients. Full article
(This article belongs to the Special Issue Diabetic Nephropathy and Diabetic Atherosclerosis)
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Review

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42 pages, 1369 KiB  
Review
Targeting Diabetic Atherosclerosis: The Role of GLP-1 Receptor Agonists, SGLT2 Inhibitors, and Nonsteroidal Mineralocorticoid Receptor Antagonists in Vascular Protection and Disease Modulation
by Merita Rroji, Nereida Spahia, Andreja Figurek and Goce Spasovski
Biomedicines 2025, 13(3), 728; https://doi.org/10.3390/biomedicines13030728 - 17 Mar 2025
Viewed by 1365
Abstract
Atherosclerosis is a closely related complication of diabetes mellitus (DM), driven by endothelial dysfunction, inflammation, and oxidative stress. The progression of atherosclerosis is accelerated by hyperglycemia, insulin resistance, and hyperlipidemia. Novel antidiabetic agents, SGLT2 inhibitors, and GLP-1 agonists improve glycemic control and offer [...] Read more.
Atherosclerosis is a closely related complication of diabetes mellitus (DM), driven by endothelial dysfunction, inflammation, and oxidative stress. The progression of atherosclerosis is accelerated by hyperglycemia, insulin resistance, and hyperlipidemia. Novel antidiabetic agents, SGLT2 inhibitors, and GLP-1 agonists improve glycemic control and offer cardiovascular protection, reducing the risk of major adverse cardiovascular events (MACEs) and heart failure hospitalization. These agents, along with nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), promise to mitigate metabolic disorders and their impact on endothelial function, oxidative stress, and inflammation. This review explores the potential molecular mechanisms through which these drugs may prevent the development of atherosclerosis and cardiovascular disease (CVD), supported by a summary of preclinical and clinical evidence. Full article
(This article belongs to the Special Issue Diabetic Nephropathy and Diabetic Atherosclerosis)
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