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Search Results (1,529)

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23 pages, 888 KiB  
Article
Correlations Between Coffee Intake, Glycemic Control, Cardiovascular Risk, and Sleep in Type 2 Diabetes and Hypertension: A 12-Month Observational Study
by Tatiana Palotta Minari, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo and Luciana Pellegrini Pisani
Biomedicines 2025, 13(8), 1875; https://doi.org/10.3390/biomedicines13081875 - 1 Aug 2025
Viewed by 105
Abstract
Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension [...] Read more.
Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension over a 12-month period. Methods: An observational study was conducted with 40 participants with T2D and hypertension, comprising 20 females and 20 males. Participants were monitored for their daily coffee consumption over a 12-month period, being assessed every 3 months. Linear regression was utilized to assess interactions and relationships between variables, providing insights into potential predictive associations. Additionally, correlation analysis was performed using Pearson’s and Spearman’s tests to evaluate the strength and direction of linear and non-linear relationships. Statistical significance was set at p < 0.05. Results: Significant changes were observed in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index, sleep duration, nocturnal awakenings, and waist-to-hip ratio (p < 0.05) over the 12-month study in both sexes. No significant differences were noted in the remaining parameters (p > 0.05). The coffee consumed by the participants was of the “traditional type” and contained sugar (2g per cup) for 100% of the participants. An intake of 4.17 ± 0.360 cups per day was found at baseline and 5.41 ± 0.316 cups at 12 months (p > 0.05). Regarding correlation analysis, a higher coffee intake was significantly associated with shorter sleep duration in women (r = −0.731; p = 0.037). Conversely, greater coffee consumption correlated with lower LDL cholesterol (LDL-C) levels in women (r = −0.820; p = 0.044). Additionally, a longer sleep duration was linked to lower FBG (r = -0.841; p = 0.031), HbA1c (r = -0.831; p = 0.037), and LDL-C levels in women (r = -0.713; p = 0.050). No significant correlations were observed for the other parameters in both sexes (p > 0.05). Conclusions: In women, coffee consumption may negatively affect sleep duration while potentially offering beneficial effects on LDL-C levels, even when sweetened with sugar. Additionally, a longer sleep duration in women appears to be associated with improvements in FBG, HbA1c, and LDL-C. These correlations emphasize the importance of a balanced approach to coffee consumption, weighing both its potential health benefits and drawbacks in postmenopausal women. However, since this study does not establish causality, further randomized clinical trials are warranted to investigate the underlying mechanisms and long-term implications—particularly in the context of T2D and hypertension. Full article
(This article belongs to the Special Issue Diabetes: Comorbidities, Therapeutics and Insights (3rd Edition))
12 pages, 269 KiB  
Article
Exploring the Interplay Between Glycated Albumin, AGEs, and Inflammation in Old Patients with CKD
by Simone Vettoretti, Lara Caldiroli, Paolo Molinari, Amanda Villa, Massimiliano M. Corsi Romanelli, Elena Vianello, Elena Dozio and Simonetta Genovesi
Metabolites 2025, 15(8), 515; https://doi.org/10.3390/metabo15080515 (registering DOI) - 1 Aug 2025
Viewed by 132
Abstract
Introduction: Chronic kidney disease (CKD) increases cardiovascular risk through mechanisms such as oxidative stress and the accumulation of advanced glycation end products (AGEs). Glycated albumin (GA) is associated with cardiovascular risk in CKD patients, but its relationship with AGEs and systemic inflammation remains [...] Read more.
Introduction: Chronic kidney disease (CKD) increases cardiovascular risk through mechanisms such as oxidative stress and the accumulation of advanced glycation end products (AGEs). Glycated albumin (GA) is associated with cardiovascular risk in CKD patients, but its relationship with AGEs and systemic inflammation remains unclear. This study investigated these associations in old patients with severe CKD, with and without diabetes. Methods: We conducted a cross-sectional analysis in 122 patients aged ≥ 65 years with CKD stages G3a–G5, including 67 diabetics and 55 non-diabetics. Patients with confounding comorbidities were excluded. We measured GA, AGEs, various AGEs receptors (RAGE) isoforms, and inflammatory cytokines (CRP, IL-6, TNFα, and MCP-1) using standardized assays. Statistical analyses included group comparisons, correlation coefficients, and multivariate regression. Results: Of 122 patients (mean age 77.7 ± 11.3 years), diabetics had higher GA percentages than non-diabetics (22.0 ± 7.1% vs. 17.5 ± 5.4%, p = 0.0001), while AGEs (2931 ± 763 vs. 3156 ± 809 AU; p = 0.118) and inflammatory markers (CRP 0.240[0.380] vs. 0.200[0.280] mg/dL; p = 0.142; IL-6 3.4[4.0] vs. 3.0[3.8] pg/mL; p = 0.238) were similar between groups. Overall, GA was inversely correlated with estimated glomerular filtration rate (eGFR) (ρ = −0.189, p = 0.037) and positively with glycated hemoglobin (HbA1c) (ρ = 0.525, p < 0.0001), but showed no significant correlation with AGEs, RAGE isoforms, or inflammatory cytokines. In multivariate analysis, only HbA1c remained independently associated with GA (β = 0.222, p = 0.005). Conclusions: In old patients with severe CKD, GA appears to be a more useful marker of glycemic control than glycation stress, the latter of which is the result of multiple factors, including impaired kidney function and systemic inflammation. Full article
16 pages, 661 KiB  
Article
Comparative Evaluation of ARB Monotherapy and SGLT2/ACE Inhibitor Combination Therapy in the Renal Function of Diabetes Mellitus Patients: A Retrospective, Longitudinal Cohort Study
by Andrew W. Ngai, Aqsa Baig, Muhammad Zia, Karen Arca-Contreras, Nadeem Ul Haque, Veronica Livetsky, Marcelina Rokicki and Shiryn D. Sukhram
Int. J. Mol. Sci. 2025, 26(15), 7412; https://doi.org/10.3390/ijms26157412 (registering DOI) - 1 Aug 2025
Viewed by 235
Abstract
Diabetic nephropathy affects approximately 30–40% of individuals with diabetes mellitus (DM) and is a major contributor to end-stage renal disease (ESRD). While angiotensin II receptor blockers (ARBs) have long served as a standard treatment, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have recently gained attention for [...] Read more.
Diabetic nephropathy affects approximately 30–40% of individuals with diabetes mellitus (DM) and is a major contributor to end-stage renal disease (ESRD). While angiotensin II receptor blockers (ARBs) have long served as a standard treatment, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have recently gained attention for their renal and cardiovascular benefits. However, comparative real-world data on their long-term renal effectiveness remain limited. We conducted a retrospective, longitudinal study over a 2-year period to compare the impact of ARB monotherapy versus SGLT2i and angiotensin-converting enzyme inhibitor (ACEi) combination therapy on the progression of chronic kidney disease (CKD) in patients with DM. A total of 126 patients were included and grouped based on treatment regimen. Renal biomarkers were analyzed using t-tests and ANOVA (p < 0.01). Albuminuria was qualitatively classified via urinalysis as negative, level 1 (+1), level 2 (+2), or level 3 (+3). The ARB group demonstrated higher estimated glomerular filtration rate (eGFR) and lower serum creatinine (sCr) levels than the combination therapy group, with glycated hemoglobin (HbA1c), potassium (K+), and blood pressure remaining within normal limits in both cohorts. Albuminuria remained stable over time, with 60.8% of ARB users and 73.1% of combination therapy users exhibiting persistently or on-average negative results. Despite the expected additive benefits of SGLT2i/ACEi therapy, ARB monotherapy was associated with slightly more favorable renal function markers and a lower incidence of severe albuminuria. These findings suggest a need for further controlled studies to clarify the comparative long-term renal effects of these treatment regimens. Full article
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21 pages, 1893 KiB  
Article
Relationship Between Body Composition and Biomarkers in Adult Females with Breast Cancer: 1-Year Follow-Up Prospective Study
by Angélica Larrad-Sáinz, María Gemma Hernández Núñez, Ana Barabash Bustelo, Inés Gil Prados, Johanna Valerio, José Luis Espadas Gil, María Eugenia Olivares Crespo, María Herrera de la Muela, Blanca Bernaldo Madrid, Irene Serrano García, Ignacio Cristóbal García, Miguel Ángel Rubio-Herrera, Alfonso Luis Calle-Pascual, Juana María Brenes Sánchez and Pilar Matía-Martín
Nutrients 2025, 17(15), 2487; https://doi.org/10.3390/nu17152487 - 30 Jul 2025
Viewed by 232
Abstract
Background/Objectives: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat [...] Read more.
Background/Objectives: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat redistribution or muscle loss. The objective of this exploratory study was to assess the evolution of body composition and muscle strength after one year of treatment, and their relationship with metabolic biomarkers. Methods: Prospective observational study in newly diagnosed breast cancer patients. Body composition was assessed using bioelectrical impedance analysis (BIA) and ultrasound (US); muscle strength was measured by handgrip dynamometry. Biomarkers analyzed included glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), total cholesterol (and its fractions), triglycerides, C-reactive protein (CRP), 6-interleukin (IL-6), vitamin D, myostatin, and fibroblast growth factor 21 (FGF-21). Results: Sixty-one women (mean age 58 years) were included. After one year, fat mass and related parameters significantly increased, while skeletal muscle mass and muscle strength decreased. Sarcopenic obesity prevalence rose from 1.16% to 4.9%. No significant changes were found in biomarkers, but positive correlations were observed between fat parameters and insulin, HOMA-IR, and triglycerides, and negative correlations with HDL-cholesterol. Conclusions: BIA and US can detect unfavorable changes in body composition that are not reflected in conventional measurements. At one year post-diagnosis, women showed increased fat accumulation, muscle loss, and reduced strength, even without significant metabolic biomarker changes. Further research is warranted to elucidate the long-term clinical implications of these findings and the external validity in larger cohorts. Full article
(This article belongs to the Special Issue Body Composition and Nutritional Status in Cancer Patients)
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13 pages, 259 KiB  
Article
Excessive Daytime Sleepiness and Associated Cardiometabolic Factors in Latino Individuals of Mexican Ancestry at High Risk of Type 2 Diabetes: An El Banco Biobank Cross-Sectional Study
by Ludovica Verde, Dawn K. Coletta, Yann C. Klimentidis, Linsday N. Kohler, Lisa Soltani, Oscar D. Parra, Sairam Parthasarathy, Lawrence J. Mandarino and Giovanna Muscogiuri
Nutrients 2025, 17(15), 2476; https://doi.org/10.3390/nu17152476 - 29 Jul 2025
Viewed by 156
Abstract
Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic [...] Read more.
Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic control in this population. Methods: This cross-sectional study utilized data from the El Banco por Salud biobank, including 1685 participants (aged 52.6 ± 14.5 years, BMI: 32.4 ± 7.0 kg/m2) recruited from Federally Qualified Community Health Centers. Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale, while dietary information was obtained via the Brief Dietary Assessment Tool for Hispanics. Primary outcomes included cardiometabolic risk factors and glycated hemoglobin (HbA1c) levels. Results: Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 22.0% of participants and was associated with higher BMI (p < 0.001), larger waist circumference (p = 0.002), poorer diet quality, increased dyslipidemia (p = 0.036), and elevated HbA1c (p = 0.007). Linear regression analyses confirmed that excessive daytime sleepiness was significantly associated with higher HbA1c levels, both in unadjusted (R2 = 0.011; p < 0.001) and adjusted for demographic, anthropometric, and socioeconomic factors (R2 = 0.107; p = 0.004) models. Conclusions: Excessive daytime sleepiness among Latinos of Mexican ancestry is associated with unhealthy dietary patterns and poor glycemic control, highlighting the need for targeted interventions addressing sleep and dietary habits in this vulnerable population. Full article
(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)
10 pages, 269 KiB  
Article
Similarities and Differences Between Patients Diagnosed with ANCA-Associated Vasculitis Who Are Positive and Negative for ANCA: University Clinic Practice and Expertise
by Giedre Dereseviciene, Jolanta Dadoniene and Dalia Miltiniene
Medicina 2025, 61(8), 1369; https://doi.org/10.3390/medicina61081369 - 29 Jul 2025
Viewed by 115
Abstract
Background and objective. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affects small- to medium-sized vessels and is characterized by the production of ANCAs. The ANCA-negative term is used if the patient otherwise fulfills the definition for AAV but has negative results on serologic testing [...] Read more.
Background and objective. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affects small- to medium-sized vessels and is characterized by the production of ANCAs. The ANCA-negative term is used if the patient otherwise fulfills the definition for AAV but has negative results on serologic testing for ANCAs. The objective of this study was to compare ANCA-positive and -negative vasculitis patients and to evaluate the main differences possibly related to the presence of ANCAs. Material and methods. A cross-sectional study of 73 patients treated at the tertiary Rheumatology Centre of University Hospital from the 1 January, 2001, to the 31August, 2023, with diagnoses of AAV was carried out. Clinical characteristics and laboratory data were collected at the onset or at the first year of the disease. Results. Forty-eight (65.8%) patients were ANCA-positive, while twenty-five (34.3%) were ANCA-negative. Distribution by gender was similar in both groups, with a female–male ratio of 2:1. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated for all AAV patients, but values were higher in the ANCA-positive patients’ group. The median hemoglobin was 106 g/L in the seropositive group and 127 g/L in the seronegative group. A higher prevalence of kidney involvement (60.4%) with elevated serum creatinine level (93.5 µmol/L) was observed in the ANCA-positive group compared with 24% and 70 µmol/l in the ANCA-negative group (p < 0.05). Neurological involvement was more frequently found in the ANCA-positive patient group, too: 29.2% compared to 20%. Among patients with ANCA-negative vasculitis, 88% had pulmonary; 92% ear, nose, throat (ENT); 48% joint; and 28% skin presentation. In comparison, involvement of these organs was less common in the ANCA-positive patients’ group, at 79.2%, 60.4%, 31.3%, and 25 %, respectively. Conclusions. ANCA-positive patients appear to be in a more difficult clinical situation in terms of organ involvement and laboratory changes. Full article
(This article belongs to the Special Issue Recent Advances in Autoimmune Rheumatic Diseases: 2nd Edition)
27 pages, 2593 KiB  
Review
Mobile Health Interventions for Individuals with Type 2 Diabetes and Overweight or Obesity—A Systematic Review and Meta-Analysis
by Carlos Gomez-Garcia, Carol A. Maher, Borja Sañudo and Jose Manuel Jurado-Castro
J. Funct. Morphol. Kinesiol. 2025, 10(3), 292; https://doi.org/10.3390/jfmk10030292 - 29 Jul 2025
Viewed by 364
Abstract
Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent [...] Read more.
Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent a promising strategy to address both conditions simultaneously. Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of mHealth-based interventions for the management of adults with T2D and overweight/obesity. Specifically, it assessed the quantitative impact of these interventions on glycosylated hemoglobin (HbA1c), body weight, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases from inception to 9 July 2025. The inclusion criteria focused on randomized controlled trials (RCTs) using mHealth interventions in adults with T2D and overweight/obesity, reporting HbA1c or weight as primary or secondary outcomes. The risk of bias was assessed using the Cochrane Risk of Bias tool 2. A total of 13 RCTs met the inclusion criteria. Results: Meta-analysis indicated significant improvements after 6–12 months of intervention in HbA1c (MD −0.23; 95% CI −0.36 to −0.10; p < 0.001; I2 = 72%), body weight (MD −2.47 kg; 95% CI −3.69 to −1.24; p < 0.001; I2 = 79%), total cholesterol (MD −0.23; 95% CI −0.39 to −0.07; p = 0.004; I2 = 0%), and LDL (MD −0.27; 95% CI −0.42 to −0.12; p < 0.001; I2 = 0%). Conclusions: mHealth interventions are effective and scalable for managing T2D and obesity, particularly when incorporating wearable technologies to improve adherence. Future research should focus on optimizing personalization, engagement strategies, and long-term implementation. Full article
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16 pages, 1920 KiB  
Review
Time-Restricted Eating Improves Glycemic Control in Patients with Type 2 Diabetes: A Meta-Analysis and Systematic Review
by Taegwang Nam, Hyeongbin Oh, Anna Kim and Yongtaek Oh
Int. J. Mol. Sci. 2025, 26(15), 7310; https://doi.org/10.3390/ijms26157310 - 29 Jul 2025
Viewed by 558
Abstract
Time-restricted eating (TRE), a dietary strategy that aligns food intake with circadian rhythms, has emerged as a promising non-pharmacological approach for improving glycemic control in patients with type 2 diabetes. This systematic review and meta-analysis evaluated the effects of TRE on glycemic outcomes [...] Read more.
Time-restricted eating (TRE), a dietary strategy that aligns food intake with circadian rhythms, has emerged as a promising non-pharmacological approach for improving glycemic control in patients with type 2 diabetes. This systematic review and meta-analysis evaluated the effects of TRE on glycemic outcomes by analyzing eight randomized controlled trials involving 312 participants with type 2 diabetes or impaired fasting glucose. Meta-analyses of six eligible studies demonstrated that TRE significantly reduced fasting glucose (mean difference [MD]: −0.74 mmol/L; 95% CI: −1.13 to −0.36) and glycated hemoglobin (ΔHbA1c) (MD: −0.11%; 95% CI: −0.15 to −0.07) and increased time in range (TIR) for blood glucose (MD: +10.51%; 95% CI: 6.81 to 14.21). Improvements in fasting glucose and HbA1c were modest but consistent, while the increase in TIR showed no between-study heterogeneity, suggesting a robust and reproducible benefit of TRE on glycemic stability. These findings support the clinical feasibility and effectiveness of TRE as a dietary intervention in diabetes management. However, further high-quality trials with standardized protocols and longer follow-up are needed to confirm long-term efficacy and inform guidelines. Full article
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14 pages, 839 KiB  
Article
Biochemical Profile Variations Among Type 2 Diabetic Patients Stratified by Hemoglobin A1c Levels in a Saudi Cohort: A Retrospective Study
by Abdulrahman Alshalani, Nada AlAhmari, Hajar A. Amin, Abdullah Aljedai and Hamood AlSudais
J. Clin. Med. 2025, 14(15), 5324; https://doi.org/10.3390/jcm14155324 - 28 Jul 2025
Viewed by 345
Abstract
Background: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories [...] Read more.
Background: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories to support early identification and better management of diabetes-related complications. Methods: A retrospective observational study at King Khalid University Hospital (KKUH), Riyadh, included 621 adult patients diagnosed with T2DM categorized into four HbA1c groups: normal (<5.7%), prediabetes (5.7–6.4%), controlled diabetes (6.5–7.9%), and uncontrolled diabetes (≥8.0%). Biochemical parameters included the liver profile: alkaline phosphatase (ALP) and bilirubin, renal profile: creatinine, blood urea nitrogen (BUN), glucose, sodium, and chloride, and lipid profile: cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. Regression models identified predictors of ALP, cholesterol, and LDL. Results: ALP was higher in uncontrolled diabetes (89.0 U/L, Q1–Q3: 106.3–72.0) than in the prediabetes group (75.0 U/L, Q1–Q3: 96.8–62.3). Sodium and chloride were lower in uncontrolled diabetes (Na: 138.3 mmol/L, Q1–Q3: 140.3–136.4; Cl: 101.1 mmol/L, Q1–Q3: 102.9–99.4) compared to the normal group (Na: 139.5 mmol/L, Q1–Q3: 142.4–136.9; Cl: 103.5 mmol/L, Q1–Q3: 106.1–101.7). LDL was lower in uncontrolled diabetes (2.1 mmol/L, Q1–Q3: 2.8–1.7) than in the normal group (2.8 mmol/L, Q1–Q3: 3.7–2.2), while triglycerides were higher in patients with uncontrolled diabetes compared to the normal group (1.45 mmol/L, Q1–Q3: 2.02–1.11 vs. 1.26 mmol/L, Q1–Q3: 1.44–0.94). Regression models showed low explanatory power (R2 = 2.1–7.3%), with weight, age, and sex as significant predictors of select biochemical markers. Conclusions: The study observed biochemical variations across HbA1c categories in T2DM patients, likely reflecting insulin resistance. Monitoring these markers in conjunction with HbA1c can enhance early detection and improve the management of complications. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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21 pages, 328 KiB  
Article
The Role of Metabolic Disorders and Laboratory Abnormalities in Wound Healing and Recovery in Geriatric and Non-Geriatric Orthopedic Patients in Poland—Prospective Research
by Robert Węgłowski, Bartosz Borowski, Anna Bronikowska, Piotr Piech, Grzegorz Staśkiewicz and Jaromir Jarecki
J. Clin. Med. 2025, 14(15), 5317; https://doi.org/10.3390/jcm14155317 - 28 Jul 2025
Viewed by 255
Abstract
Objectives: This study sought to assess the impact of diabetes and hypertension on wound healing and recovery in orthopedic patients, with an emphasis on laboratory correlations. Materials and Methods: This study included 67 orthopedic patients, divided into a geriatric group (n = 49, [...] Read more.
Objectives: This study sought to assess the impact of diabetes and hypertension on wound healing and recovery in orthopedic patients, with an emphasis on laboratory correlations. Materials and Methods: This study included 67 orthopedic patients, divided into a geriatric group (n = 49, ≥65 years) and a control group (n = 18). Clinical and laboratory assessments were performed at admission and discharge. Data were analyzed statistically. Results: Geriatric patients showed a higher triglyceride glucose-body mass index (TyG-BMI), glucose, cholesterol, C-reactive protein (CRP), interleukin-6 (IL-6), and leukocytes and lower hemoglobin and platelets (PLTs), with poorer healing and well-being. Elevated CRP, IL-6, and urea and decreased protein and hemoglobin persisted in this group. Diabetes improved outcomes in older adults, while hypertension worsened them in younger patients. Favorable outcomes correlated with higher triglycerides, fibrinogen, hemoglobin, and red blood cells (RBCs), while they did not correlate with elevated CRP, IL-6, leptin, urea, creatinine, and white blood cells (WBCs). Conclusions: Key predictors of healing and well-being included CRP, hemoglobin, RBC, and hematocrit in older patients and hypertension, CRP, hemoglobin, and leptin in younger individuals. Age-specific metabolic and inflammatory profiles influence recovery trajectories and may be used to predict problems in both recovery and patients’ well-being. Further research is required to better understand the correlations between these factors. Full article
(This article belongs to the Section Orthopedics)
19 pages, 316 KiB  
Article
Comparison of the Usefulness of Optical Coherence Tomography Angiography and Fluorescein Angiography in the Diagnosis of Diabetic Macular Edema
by Alfred Niewiem, Krzysztof Broniarek and Katarzyna Michalska-Małecka
Diagnostics 2025, 15(15), 1873; https://doi.org/10.3390/diagnostics15151873 - 25 Jul 2025
Viewed by 225
Abstract
Background/Objectives: Diabetic macular edema (DME) is the primary cause of vision loss in people with diabetes, and if untreated, it can result in irreversible macular damage. Both fluorescein angiography (FA), the gold standard, and optical coherence tomography angiography (OCTA) are used for evaluation [...] Read more.
Background/Objectives: Diabetic macular edema (DME) is the primary cause of vision loss in people with diabetes, and if untreated, it can result in irreversible macular damage. Both fluorescein angiography (FA), the gold standard, and optical coherence tomography angiography (OCTA) are used for evaluation of this disease. The objective of this study was to compare the diagnostic value of both. Methods: We conducted a comparative analysis of 98 patients aged 18–80 years with significant DME and best-corrected visual acuity ≥0.1 according to the Snellen chart. Participants underwent glycated hemoglobin blood test (HbA1c) and ophthalmological examinations, including OCTA and FA. OCTA 3 × 3 mm scans of superficial (SCP) and deep capillary plexus (DCP) along with FA scans were exported to the Gimp computer program. Size of the foveal avascular zone (FAZ), the number of visible microaneurysms (MAs), and ETDRS report number 11 classification of the images were assessed. Results: FAZ size differed significantly in superficial plexus (0.41 mm2), deep plexus (0.43 mm2) OCTA, and FA (0.38 mm2) (p < 0.001). FAZ size in DCP OCTA closely correlated with that of FA (τ = 0.79, p < 0.001). The total number of MAs visualized in the OCTA was significantly lower than in FA (p < 0.001). ETDRS classification of scans revealed that the level of consistency between the examinations was moderate to very strong. Conclusions: OCTA may be useful in evaluating macular ischemia. It is less sensitive in detecting MAs in DME eyes. FAZ has sharper boundaries and is larger when measured in OCTA. Poor glycemic control results in higher incidence of MAs in macula. Full article
(This article belongs to the Section Biomedical Optics)
10 pages, 217 KiB  
Article
Systemic Effects of Enzymatic Necrosectomy in Minor Burn Wounds Using NexoBrid®
by David Breidung, Moritz Billner, Felix Ortner, Philipp von Imhoff, Simonas Lapinskas, Konrad Karcz, Sarina Delavari and Denis Ehrl
J. Pers. Med. 2025, 15(8), 330; https://doi.org/10.3390/jpm15080330 - 25 Jul 2025
Viewed by 242
Abstract
Background/Objectives: Enzymatic debridement with NexoBrid® is an effective alternative to surgical debridement in burn care, but its potential systemic effects remain unclear. In the context of personalized burn care, understanding individual patient responses to topical agents is essential to optimize outcomes and [...] Read more.
Background/Objectives: Enzymatic debridement with NexoBrid® is an effective alternative to surgical debridement in burn care, but its potential systemic effects remain unclear. In the context of personalized burn care, understanding individual patient responses to topical agents is essential to optimize outcomes and minimize risks. This study aimed to characterize laboratory and clinical parameter changes following NexoBrid® application in patients with small burn injuries (≤10% TBSA). Methods: We retrospectively analyzed 75 burn patients treated with NexoBrid® to evaluate changes in systemic inflammatory markers, coagulation parameters, and clinical parameters before and after enzymatic debridement. Results: Statistically significant increases in body temperature (p = 0.018), decreases in hemoglobin (p < 0.001), and increases in C-reactive protein (CRP) levels (p < 0.001) were observed, suggesting mild systemic inflammatory changes. However, leukocyte counts did not change significantly (p = 0.927), and body temperature remained within the normothermic range, indicating that these changes were not clinically significant. A significant decrease in the prothrombin time ratio (% of normal; p = 0.002) was also observed, suggesting potential impacts on coagulation. Importantly, while body temperature was slightly higher in patients with a higher degree of BSA exposure within the ≤10% TBSA cohort (p = 0.036), the extent of NexoBrid® application did not correlate with other inflammatory markers. Conclusions: These findings suggest that measurable systemic changes can occur following NexoBrid® application in small burns, particularly affecting inflammatory and coagulation parameters. These observations contribute to the understanding of treatment-related responses and may help inform clinical decision-making. Full article
(This article belongs to the Special Issue Plastic Surgery: New Perspectives and Innovative Techniques)
39 pages, 2934 KiB  
Review
Phytocannabinoids as Novel SGLT2 Modulators for Renal Glucose Reabsorption in Type 2 Diabetes Management
by Raymond Rubianto Tjandrawinata, Dante Saksono Harbuwono, Sidartawan Soegondo, Nurpudji Astuti Taslim and Fahrul Nurkolis
Pharmaceuticals 2025, 18(8), 1101; https://doi.org/10.3390/ph18081101 - 24 Jul 2025
Viewed by 442
Abstract
Background: Sodium–glucose cotransporter 2 (SGLT2) inhibitors have transformed type 2 diabetes mellitus (T2DM) management by promoting glucosuria, lowering glycated hemoglobin (HbA1c), blood pressure, and weight; however, their use is limited by genitourinary infections and ketoacidosis. Phytocannabinoids—bioactive compounds from Cannabis sativa—exhibit multi-target [...] Read more.
Background: Sodium–glucose cotransporter 2 (SGLT2) inhibitors have transformed type 2 diabetes mellitus (T2DM) management by promoting glucosuria, lowering glycated hemoglobin (HbA1c), blood pressure, and weight; however, their use is limited by genitourinary infections and ketoacidosis. Phytocannabinoids—bioactive compounds from Cannabis sativa—exhibit multi-target pharmacology, including interactions with cannabinoid receptors, Peroxisome Proliferator-Activated Receptors (PPARs), Transient Receptor Potential (TRP) channels, and potentially SGLT2. Objective: To evaluate the potential of phytocannabinoids as novel modulators of renal glucose reabsorption via SGLT2 and to compare their efficacy, safety, and pharmacological profiles with synthetic SGLT2 inhibitors. Methods: We performed a narrative review encompassing the following: (1) the molecular and physiological roles of SGLT2; (2) chemical classification, natural sources, and pharmacokinetics/pharmacodynamics of major phytocannabinoids (Δ9-Tetrahydrocannabinol or Δ9-THC, Cannabidiol or CBD, Cannabigerol or CBG, Cannabichromene or CBC, Tetrahydrocannabivarin or THCV, and β-caryophyllene); (3) in silico docking and drug-likeness assessments; (4) in vitro assays of receptor binding, TRP channel modulation, and glucose transport; (5) in vivo rodent models evaluating glycemic control, weight change, and organ protection; (6) pilot clinical studies of THCV and case reports of CBD/BCP; (7) comparative analysis with established synthetic inhibitors. Results: In silico studies identify high-affinity binding of several phytocannabinoids within the SGLT2 substrate pocket. In vitro, CBG and THCV modulate SGLT2-related pathways indirectly via TRP channels and CB receptors; direct IC50 values for SGLT2 remain to be determined. In vivo, THCV and CBD demonstrate glucose-lowering, insulin-sensitizing, weight-reducing, anti-inflammatory, and organ-protective effects. Pilot clinical data (n = 62) show that THCV decreases fasting glucose, enhances β-cell function, and lacks psychoactive side effects. Compared to synthetic inhibitors, phytocannabinoids offer pleiotropic benefits but face challenges of low oral bioavailability, polypharmacology, inter-individual variability, and limited large-scale trials. Discussion: While preclinical and early clinical data highlight phytocannabinoids’ potential in SGLT2 modulation and broader metabolic improvement, their translation is impeded by significant challenges. These include low oral bioavailability, inconsistent pharmacokinetic profiles, and the absence of standardized formulations, necessitating advanced delivery system development. Furthermore, the inherent polypharmacology of these compounds, while beneficial, demands comprehensive safety assessments for potential off-target effects and drug interactions. The scarcity of large-scale, well-controlled clinical trials and the need for clear regulatory frameworks remain critical hurdles. Addressing these aspects is paramount to fully realize the therapeutic utility of phytocannabinoids as a comprehensive approach to T2DM management. Conclusion: Phytocannabinoids represent promising multi-target agents for T2DM through potential SGLT2 modulation and complementary metabolic effects. Future work should focus on pharmacokinetic optimization, precise quantification of SGLT2 inhibition, and robust clinical trials to establish efficacy and safety profiles relative to synthetic inhibitors. Full article
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18 pages, 3248 KiB  
Article
Electrochemical Nanostructured Aptasensor for Direct Detection of Glycated Hemoglobin
by Luminita Fritea, Cosmin-Mihai Cotrut, Iulian Antoniac, Simona Daniela Cavalu, Luciana Dobjanschi, Angela Antonescu, Liviu Moldovan, Maria Domuta and Florin Banica
Int. J. Mol. Sci. 2025, 26(15), 7140; https://doi.org/10.3390/ijms26157140 - 24 Jul 2025
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Abstract
Glycated hemoglobin (HbA1c) is an important biomarker applied for the diagnosis, evaluation, and management of diabetes; therefore, its accurate determination is crucial. In this study, an innovative nanoplatform was developed, integrating carbon nanotubes (CNTs) with enhanced hydrophilicity achieved through cyclodextrin (CD) functionalization, and [...] Read more.
Glycated hemoglobin (HbA1c) is an important biomarker applied for the diagnosis, evaluation, and management of diabetes; therefore, its accurate determination is crucial. In this study, an innovative nanoplatform was developed, integrating carbon nanotubes (CNTs) with enhanced hydrophilicity achieved through cyclodextrin (CD) functionalization, and combined with gold nanoparticles (AuNPs) electrochemically deposited onto a screen-printed carbon electrode. The nanomaterials significantly improved the analytical performance of the sensor due to their increased surface area and high electrical conductivity. This nanoplatform was employed as a substrate for the covalent attachment of thiolated ferrocene-labeled HbA1c specific aptamer through Au-S binding. The electrochemical signal of ferrocene was covered by a stronger oxidation peak of Fe2+ from the HbA1c structure, leading to the elaboration of a nanostructured aptasensor capable of the direct detection of HbA1c. The electrochemical aptasensor presented a very wide linear range (0.688–11.5%), an acceptable limit of detection (0.098%), and good selectivity and stability, being successfully applied on real samples. This miniaturized, simple, easy-to-use, and fast-responding aptasensor, requiring only a small sample volume, can be considered as a promising candidate for the efficient on-site determination of HbA1c. Full article
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12 pages, 1044 KiB  
Article
Serum 25-Hydroxyvitamin D Is Decreased with Metabolic Syndrome Following Anterior Cruciate Ligament Reconstruction
by Sonu Bae, Anthony Mantor, Hayden Price, Christopher C. Kaeding, Robert A. Magnussen, David C. Flanigan and Tyler Barker
Nutrients 2025, 17(15), 2410; https://doi.org/10.3390/nu17152410 - 24 Jul 2025
Viewed by 285
Abstract
Background/Objectives: Serum 25-hydroxyvitamin D (25(OH)D) concentrations are decreased with metabolic syndrome (MetSy), and low serum 25(OH)D concentrations are associated with poor outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR). It is unknown whether serum 25(OH)D concentrations are decreased in patients with MetSy [...] Read more.
Background/Objectives: Serum 25-hydroxyvitamin D (25(OH)D) concentrations are decreased with metabolic syndrome (MetSy), and low serum 25(OH)D concentrations are associated with poor outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR). It is unknown whether serum 25(OH)D concentrations are decreased in patients with MetSy following ACLR. The purpose of this study was to investigate whether serum 25(OH)D concentrations are decreased with MetSy following ACLR. Methods: This retrospective case–control study consisted of patients (≥18 years) who underwent ACLR. MetSy was defined as meeting any three of the five criteria (cases): (1) body mass index ≥ 30 kg/m2, (2) triglycerides ≥ 150 mg/dL, (3) HDL < 40 mg/dL in men and <50 mg/dL in women, (4) systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 85 mmHg, or (5) estimated (from hemoglobin A1c% [HbA1c]) fasting glucose ≥ 100 mg/dL. Participants without MetSy (meeting <3 criteria) served as controls. The first blood lipid, HbA1c, and 25(OH)D assessed ≥90 d after ACLR were included in this study. Results: The final analysis consisted of 219 patients (cases (with MetSy), n = 84; controls (without MetSy), n = 135). Serum 25(OH)D was significantly (p < 0.01) decreased (15.8%) in cases (mean [SD]; 25.1 [11.3] ng/mL) compared to controls (29.8 [14.8] ng/mL). An increasing number of MetSy components was associated with a decreased prevalence of vitamin D sufficiency (p < 0.01). Conclusions: We conclude that serum 25(OH)D concentrations are significantly lower with MetSy. These preliminary findings could provide justification for assessing serum 25(OH)D following ACLR in patients with MetSy and assist with risk stratification. Full article
(This article belongs to the Special Issue Vitamins and Human Health: 3rd Edition)
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