Diabetes & Metabolism Journal

Original Articles

Lifestyle
Association between Healthy Lifestyle Factors and Metabolic Syndrome Risk: A Prospective Analysis of the Korean Genome and Epidemiology Study: Jialei Fu, Sangah Shin; Received July 28, 2024 Accepted December 12, 2024 Published online March 26, 2025; DOI: https://doi.org/10.4093/dmj.2024.0427 [Epub ahead of print]

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Abstract PDF Supplementary Material PubReader ePub: Background
To investigate the association of adherence to five modifiable lifestyle factors (limiting alcohol, physical activity, limiting smoking, favorable diet quality, and adequate sleep) with metabolic syndrome (MetS) risk in Korean adults.
Methods
Health Examinees Study data were used, and 41,368 participants aged 40 to 69 years were included. Cox proportional hazards regression analyses assessed the associations of individual and combined healthy lifestyle factors (32 and 16 lifestyle profiles in men and women.
Results
During a median 4.2-year follow-up, 6,213 participants were newly diagnosed with MetS. Adherence to more healthy lifestyle factors (4–5 vs. 0–1) could lower MetS risk by 28% and 12% in men and women (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.63 to 0.83 in men; HR, 0.88; 95% CI, 0.78 to 0.99 in women). Each additional healthy lifestyle could reduce the risk of MetS by 10% and 6% in men and women. The pooled analysis yielded similar results based on similar numbers of healthy lifestyle factors, the risk of MetS decreased as the number of healthy lifestyle factors increased.
Conclusion
Adherence to more healthy lifestyle factors was inversely associated with MetS risk. These findings highlight the importance of limiting drinking in managing MetS. Future research should consider the synergistic effects of emerging lifestyle factors, such as sleep duration, on chronic disease development, while focusing on the effects of traditional lifestyle factors.

Metabolic Risk/Epidemiology
Trends in Metabolically Unhealthy Obesity by Age, Sex, Race/Ethnicity, and Income among United States Adults, 1999 to 2018: Wen Zeng, Weijiao Zhou, Junlan Pu, Juan Li, Xiao Hu, Yuanrong Yao, Shaomei Shang; Diabetes Metab J. 2025;49(3):475-484. Published online February 25, 2025; DOI: https://doi.org/10.4093/dmj.2024.0364

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Background
This study aimed to estimate temporal trends in metabolically unhealthy obesity (MUO) among United States (US) adults by age, sex, race/ethnicity, and income from 1999 to 2018.
Methods
We included 17,230 non-pregnant adults from a nationally representative cross-sectional study, the National Health and Nutrition Examination Survey (NHANES). MUO was defined as body mass index ≥30 kg/m² with any metabolic disorders in blood pressure, blood glucose, and blood lipids. The age-adjusted percentage of MUO was calculated, and linear regression models estimated trends in MUO.
Results
The weighted mean age of adults was 47.28 years; 51.02% were male, 74.64% were non-Hispanic White. The age-adjusted percentage of MUO continuously increased in adults across all subgroups during 1999–2018, although with different magnitudes (all P<0.05 for linear trend). Adults aged 45 to 64 years consistently had higher percentages of MUO from 1999–2000 (34.25%; 95% confidence interval [CI], 25.85% to 42.66%) to 2017–2018 (42.03%; 95% CI, 35.09% to 48.97%) than the other two age subgroups (P<0.05 for group differences). The age-adjusted percentage of MUO was the highest among non-Hispanic Blacks while the lowest among non-Hispanic Whites in most cycles. Adults with high-income levels generally had lower MUO percentages from 1999–2000 (22.63%; 95% CI, 17.00% to 28.26%) to 2017–2018 (32.36%; 95% CI, 23.87% to 40.85%) compared with the other two subgroups.
Conclusion
This study detected a continuous linear increasing trend in MUO among US adults from 1999 to 2018. The persistence of disparities by age, race/ethnicity, and income is a cause for concern. This calls for implementing evidence-based, structural, and effective MUO prevention programs.

Citations

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Addressing the Persistent Increase and Inequities in Metabolically Unhealthy Obesity: Toward an Understanding of Clinical Obesity
Young Sang Lyu, Sang Yong Kim
Diabetes & Metabolism Journal.2025; 49(3): 405. CrossRef

Metabolic Risk/Epidemiology
Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study: Yu Meng Tian, Wei Sen Zhang, Chao Qiang Jiang, Feng Zhu, Ya Li Jin, Shiu Lun Au Yeung, Jiao Wang, Kar Keung Cheng, Tai Hing Lam, Lin Xu; Diabetes Metab J. 2025;49(1):60-79. Published online October 29, 2024; DOI: https://doi.org/10.4093/dmj.2024.0117

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Abstract PDF Supplementary Material PubReader ePub: Background
The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies.
Methods
MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function.
Results
Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores.
Conclusion
Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.

Metabolic Risk/Epidemiology
Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality: Rosa Oh, Seohyun Kim, So Hyun Cho, Jiyoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Gyuri Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(1):80-91. Published online August 28, 2024; DOI: https://doi.org/10.4093/dmj.2024.0042

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Background
Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities.
Methods
We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities.
Results
This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer-, and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD.
Conclusion
SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.

Citations

Citations to this article as recorded by

KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025
Won Sohn, Young-Sun Lee, Soon Sun Kim, Jung Hee Kim, Young-Joo Jin, Gi-Ae Kim, Pil Soo Sung, Jeong-Ju Yoo, Young Chang, Eun Joo Lee, Hye Won Lee, Miyoung Choi, Su Jong Yu, Young Kul Jung, Byoung Kuk Jang
Clinical and Molecular Hepatology.2025; 31(Suppl): S1. CrossRef
Diagnosis and Management of Early Stages of ALD
Jordi Gratacós-Ginès, Edilmar Alvarado-Tapias, David Martí-Aguado, Hugo López-Pelayo, Ramón Bataller, Elisa Pose
Seminars in Liver Disease.2025;[Epub] CrossRef
Refining Risk Estimates of Colorectal Cancer in Steatotic Liver Disease: Insights on Methodological Challenges
Wei-Chun Cheng, Ching-Nung Wu, Pin-Nan Cheng
Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Synergistic benefit of thiazolidinedione and sodium-glucose cotransporter 2 inhibitor for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: a 24-week, open-label, randomized controlled trial
Minyoung Lee, Sukchul Hong, Yongin Cho, Hyungjin Rhee, Min Heui Yu, Jaehyun Bae, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
BMC Medicine.2025;[Epub] CrossRef
High-Sensitivity C-Reactive Protein Levels in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), Metabolic Alcohol-Associated Liver Disease (MetALD), and Alcoholic Liver Disease (ALD) with Metabolic Dysfunction
Seong-Uk Baek, Jin-Ha Yoon
Biomolecules.2024; 14(11): 1468. CrossRef

Metabolic Risk/Epidemiology
Harnessing Metabolic Indices as a Predictive Tool for Cardiovascular Disease in a Korean Population without Known Major Cardiovascular Event: Hyun-Jin Kim, Byung Sik Kim, Yonggu Lee, Sang Bong Ahn, Dong Wook Kim, Jeong-Hun Shin; Diabetes Metab J. 2024;48(3):449-462. Published online February 1, 2024; DOI: https://doi.org/10.4093/dmj.2023.0197

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Background
This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults.
Methods
The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period.
Results
A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619.
Conclusion
The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes.

Citations

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Comparing non-alcoholic fatty liver disease indices in predicting the prevalence and incidence of metabolic syndrome in middle-aged adults
Byung Sik Kim, Hyun-Jin Kim, Seong Won Jeon, Kyung Hwan Kim, Dong Wook Kim, Jeong-Hun Shin
Heliyon.2025; 11(7): e43073. CrossRef
Association between mixed exposure to per- and polyfluoroalkyl substances and metabolic syndrome in Korean adults: Data from the Korean National environmental health survey cycle 4
Seung Min Chung, Kyun Hoo Kim, Jun Sung Moon, Kyu Chang Won
International Journal of Hygiene and Environmental Health.2024; 261: 114427. CrossRef
Estimated pulse wave velocity as a forefront indicator of developing metabolic syndrome in Korean adults
Hyun-Jin Kim, Byung Sik Kim, Dong Wook Kim, Jeong-Hun Shin
The Korean Journal of Internal Medicine.2024; 39(4): 612. CrossRef

Metabolic Risk/Epidemiology
Metabolic Dysfunction-Associated Fatty Liver Disease and Mortality: A Population-Based Cohort Study: Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park; Diabetes Metab J. 2023;47(2):220-231. Published online January 12, 2023; DOI: https://doi.org/10.4093/dmj.2021.0327

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Background
We investigated whether metabolic dysfunction-associated fatty liver disease (MAFLD) is associated with an elevated risk of all-cause and cardiovascular mortality using a large-scale health examination cohort.
Methods
A total of 394,835 subjects in the Kangbuk Samsung Health Study cohort were enrolled from 2002 to 2012. Participants were categorized by the presence of nonalcoholic fatty liver disease (NAFLD) and MAFLD as follows: normal subjects; patients with both NAFLD and MAFLD; patients with NAFLD only; and patients with MAFLD only. Cox proportional hazards models were used to analyze the risk of mortality.
Results
During a median 5.7 years of follow-up, 20.69% was patients with both NAFLD and MAFLD, 1.51% was patients with NAFLD only, and 4.29% was patients with MAFLD only. All-cause and cardiovascular death was higher in patients with MAFLD than those without MAFLD (P<0.001, respectively). In patients with MAFLD only, the hazard ratio (HR) of all-cause and cardiovascular death was 1.35 (95% confidence interval [CI], 1.13 to 1.60) and 1.90 (95% CI, 1.26 to 2.88) after adjusting for age, which lost its statistical significance by multivariable adjustments. Compared to patients with less than two components of metabolic dysfunction, patients with more than two components of metabolic dysfunction were a higher risk of cardiovascular death (HR, 2.05; 95% CI, 1.25 to 3.38) and only women with more than two components of metabolic dysfunction were a higher risk of all-cause death (HR, 1.44; 95% CI, 1.02 to 2.03).
Conclusion
MAFLD criteria could identify a high-risk group for all-cause and cardiovascular death.

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MAFLD but not MASLD increases risk of all-cause mortality in regional Australia, with components of metabolic syndrome exacerbating factors: 20 year longitudinal, cohort study
Karl Vaz, William Kemp, Ammar Majeed, John Lubel, Dianna J. Magliano, Kristen M. Glenister, Lisa Bourke, David Simmons, Stuart K. Roberts
Hepatology International.2025; 19(2): 384. CrossRef
Research Progress of the Relationship between Metabolic-Associated Fatty Liver Disease and Colorectal Neoplasia
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Mortality in metabolic dysfunction-associated steatotic liver disease: A nationwide population-based cohort study
Eugene Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Sang Hoon Ahn, Yong-ho Lee, Seung Up Kim
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Karl Vaz, William Kemp, Ammar Majeed, John Lubel, Dianna J. Magliano, Kristen M. Glenister, Lisa Bourke, David Simmons, Stuart K. Roberts
Hepatology International.2024; 18(4): 1135. CrossRef
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Grazia Pennisi, Giuseppe Infantino, Ciro Celsa, Gabriele Di Maria, Marco Enea, Marco Vaccaro, Roberto Cannella, Carlo Ciccioli, Claudia La Mantia, Alessandro Mantovani, Francesco Mercurio, Herbert Tilg, Giovanni Targher, Vito Di Marco, Calogero Cammà, Sal
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Racial and ethnic disparities in metabolic dysfunction-associated steatotic liver disease outcomes: A call for culturally sensitive interventions: Editorial on “Differences in liver and mortality outcomes of non-alcoholic fatty liver disease by race and e
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Clinical and Molecular Hepatology.2024; 30(4): 665. CrossRef
Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
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Comparison of Outcomes Between Metabolic Dysfunction-Associated Fatty Liver Disease and Non-alcoholic Fatty Liver Disease: A Meta-Analysis
Ghazala S Virk, Jaahnavi Vajje, Nausheen K Virk, Raam Mannam, Wajeeh Rehman, Naglaa G Ghobriel , Irfan-ud-din Mian, Muhammad Usama
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European Journal of Internal Medicine.2023; 110: 62. CrossRef
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Increased expression of sodium-glucose cotransporter 2 and O-GlcNAcylation in hepatocytes drives non-alcoholic steatohepatitis
Hye Jin Chun, Eun Ran Kim, Minyoung Lee, Da Hyun Choi, Soo Hyun Kim, Eugene Shin, Jin-Hong Kim, Jin Won Cho, Dai Hoon Han, Bong-Soo Cha, Yong-ho Lee
Metabolism.2023; 145: 155612. CrossRef
Current understanding and future perspectives on the impact of changing NAFLD to MAFLD on global epidemiology and clinical outcomes
Karl Vaz, Daniel Clayton-Chubb, Ammar Majeed, John Lubel, David Simmons, William Kemp, Stuart K. Roberts
Hepatology International.2023; 17(5): 1082. CrossRef
Mitochondrial Quality Control: Its Role in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
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Metabolic Risk/Epidemiology
Synergistic Interaction between Hyperuricemia and Abdominal Obesity as a Risk Factor for Metabolic Syndrome Components in Korean Population: Min Jin Lee, Ah Reum Khang, Yang Ho Kang, Mi Sook Yun, Dongwon Yi; Diabetes Metab J. 2022;46(5):756-766. Published online January 20, 2022; DOI: https://doi.org/10.4093/dmj.2021.0166

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Background
The present study investigated the role of synergistic interaction between hyperuricemia and abdominal obesity as a risk factor for the components of metabolic syndrome.
Methods
We performed a cross-sectional study using the data of 16,094 individuals from the seventh Korean National Health and Nutrition Examination Survey (2016 to 2018). The adjusted odds ratios of metabolic syndrome and its components were analyzed by multivariate logistic regression analysis. The presence of synergistic interaction between hyperuricemia and abdominal obesity was evaluated by calculating the additive scales—the relative excess risk due to interaction, attributable proportion due to interaction, and synergy index (SI).
Results
There was a synergistic interaction between hyperuricemia and abdominal obesity in hypertriglyceridemia (men: SI, 1.39; 95% confidence interval [CI], 1.01 to 1.98; women: SI, 1.61; 95% CI, 1.02 to 2.69), and low high-density lipoprotein cholesterol (HDL-C) (men: SI, 2.03; 95% CI, 1.41 to 2.91; women: SI, 1.70; 95% CI, 1.05 to 2.95). There was no significant synergistic interaction between hyperuricemia and abdominal obesity for the risk of high blood pressure (men: SI, 1.22; 95% CI, 0.85 to 1.77; women: SI, 1.53; 95% CI, 0.79 to 2.97), and hyperglycemia (men: SI, 1.03; 95% CI, 0.72 to 1.47; women: SI, 1.39; 95% CI, 0.75 to 2.57).
Conclusion
Hyperuricemia and abdominal obesity synergistically increased the risk of hypertriglyceridemia and low HDL-C in both sexes.

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Association between novel adiposity parameters and hyperuricemia: a cross-sectional study
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A predictive model for hyperuricemia among type 2 diabetes mellitus patients in Urumqi, China
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Review

Pathophysiology
Insulin Resistance: From Mechanisms to Therapeutic Strategies: Shin-Hae Lee, Shi-Young Park, Cheol Soo Choi; Diabetes Metab J. 2022;46(1):15-37. Published online December 30, 2021; DOI: https://doi.org/10.4093/dmj.2021.0280

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Insulin resistance is the pivotal pathogenic component of many metabolic diseases, including type 2 diabetes mellitus, and is defined as a state of reduced responsiveness of insulin-targeting tissues to physiological levels of insulin. Although the underlying mechanism of insulin resistance is not fully understood, several credible theories have been proposed. In this review, we summarize the functions of insulin in glucose metabolism in typical metabolic tissues and describe the mechanisms proposed to underlie insulin resistance, that is, ectopic lipid accumulation in liver and skeletal muscle, endoplasmic reticulum stress, and inflammation. In addition, we suggest potential therapeutic strategies for addressing insulin resistance.

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Original Articles

COVID-19
Association of Metabolic Syndrome with COVID-19 in the Republic of Korea: Woo-Hwi Jeon, Jeong-Yeon Seon, So-Youn Park, In-Hwan Oh; Diabetes Metab J. 2022;46(3):427-438. Published online November 26, 2021; DOI: https://doi.org/10.4093/dmj.2021.0105

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Background
Metabolic syndrome (MetS) is reportedly a crucial risk factor for coronavirus disease 2019 (COVID-19). Since the epidemiological studies that examine this association are few and include small samples, we investigated the relationship between MetS and COVID-19 severity and death using a larger sample in the Republic of Korea.
Methods
We analyzed 66,321 patients, 4,066 of whom had COVID-19. We used chi-square tests to examine patients’ characteristics. We performed logistic regression analysis to analyze differences in COVID-19 infection and clinical outcomes according to the presence of MetS.
Results
Although MetS was not significantly associated with COVID-19 risk, acquiring MetS was significantly associated with the risk of severe COVID-19 outcomes (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.34 to 2.91; P=0.001). The mortality risk was significantly higher in COVID-19 patients with MetS (OR, 1.74; 95% CI, 1.17 to 2.59; P=0.006). Patients with abnormal waist circumference were approximately 2.07 times more likely to develop severe COVID-19 (P<0.001), and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with COVID-19; the mortality risk due to COVID-19 was 1.74 times higher in men with an HDL-C level of <40 mg/dL and in women with an HDL-C level of <50 mg/dL (P=0.012).
Conclusion
COVID-19 is likely associated with severity and death in patients with MetS or in patients with MetS risk factors. Therefore, patients with MetS or those with abnormal waist circumference and HDL-C levels need to be treated with caution.

Citations

Citations to this article as recorded by

Heterogeneity in familial clustering of metabolic syndrome components in the multiethnic GENNID study
Jia Y. Wan, Deborah Goodman, Sukh Makhnoon, Trina M. Norden‐Krichmar, Baolin Wu, Karen L. Edwards
Obesity.2024; 32(1): 176. CrossRef
Identification of shared genetic risks underlying metabolic syndrome and its related traits in the Korean population
Jun Young Kim, Yoon Shin Cho
Frontiers in Genetics.2024;[Epub] CrossRef
Metabolic health is more strongly associated with the severity and mortality of coronavirus disease 2019 than obesity
Hye Yeon Koo, Jae-Ryun Lee, Jin Yong Lee, Hyejin Lee
Archives of Public Health.2024;[Epub] CrossRef
Associated Factors with Changes of Metabolic Abnormalities among General Population in COVID-19 Pandemic
Eunjoo Kwon, Eun-Hee Nah, Suyoung Kim, Seon Cho, Hyeran Park
Korean Journal of Health Promotion.2023; 23(2): 55. CrossRef
Association between metabolic syndrome and mortality in patients with COVID-19: A nationwide cohort study
Hyo Jin Park, Jin-Hyung Jung, Kyungdo Han, Jean Shin, Yoojeong Lee, Yujin Chang, Kyeyeung Park, Yoon Jeong Cho, Youn Seon Choi, Seon Mee Kim, Ga Eun Nam
Obesity Research & Clinical Practice.2022; 16(6): 484. CrossRef

Type 1 Diabetes
Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus: Qianwen Huang, Daizhi Yang, Hongrong Deng, Hua Liang, Xueying Zheng, Jinhua Yan, Wen Xu, Xiangwen Liu, Bin Yao, Sihui Luo, Jianping Weng; Diabetes Metab J. 2022;46(1):93-103. Published online August 31, 2021; DOI: https://doi.org/10.4093/dmj.2020.0240

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Background
Both type 1 diabetes mellitus (T1DM) and metabolic syndrome (MetS) are associated with an elevated risk of morbidity and mortality yet with increasing heterogeneity. This study primarily aimed to evaluate the prevalence of MetS among adult patients with T1DM in China and investigate its associated risk factors, and relationship with microvascular complications.
Methods
We included adult patients who had been enrolled in the Guangdong T1DM Translational Medicine Study conducted from June 2010 to June 2015. MetS was defined according to the updated National Cholesterol Education Program criterion. Logistic regression models were used to estimate the odds ratio (OR) for the association between MetS and the risk of diabetic kidney disease (DKD) and diabetic retinopathy (DR).
Results
Among the 569 eligible patients enrolled, the prevalence of MetS was 15.1%. While female gender, longer diabetes duration, higher body mass index, and glycosylated hemoglobin A1c (HbA1c) were risk factors associated with MetS (OR, 2.86, 1.04, 1.14, and 1.23, respectively), received nutrition therapy education was a protective factor (OR, 0.46). After adjustment for gender, age, diabetes duration, HbA1c, socioeconomic and lifestyle variables, MetS status was associated with an increased risk of DKD and DR (OR, 2.14 and 3.72, respectively; both P<0.05).
Conclusion
Although the prevalence of MetS in adult patients with T1DM in China was relatively low, patients with MetS were more likely to have DKD and DR. A comprehensive management including lifestyle modification might reduce their risk of microvascular complications in adults with T1DM.

Citations

Citations to this article as recorded by

Link Between Metabolic Syndrome, Inflammation, and Eye Diseases
Kamila Pieńczykowska, Anna Bryl, Małgorzata Mrugacz
International Journal of Molecular Sciences.2025; 26(5): 2174. CrossRef
Metabolic syndrome in type 1 diabetes: higher time above range and glycemic variability revealed by continuous glucose monitoring (CGM)
Yayu Fang, Wei Liu, Xiaoling Cai, Yu Zhu, Mingxia Zhang, Siqian Gong, Xiangqing Wang, Chu Lin, Rui Zhang, Sai Yin, Juan Li, Yongran Huo, Xiaodan Hu, Xiaoqi Xie, Linong Ji
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Current status, trend changes, and future predictions of the disease burden of type 1 diabetes kidney disease in global and China
Qinghua Yang, Li Jin, Mingwei Luo, Shiwei Xie
Frontiers in Endocrinology.2025;[Epub] CrossRef
Metabolic syndrome in type 1 diabetes mellitus in adults
R. I. Malievskaya, D. S. Avzaletdinova, I. G. Nasretdinova, I. Z. Urmanova, D. F. Iksanova
FOCUS. Endocrinology.2025; 6(1): 6. CrossRef
Dynamic Changes in Metabolic Status Are Associated With Risk of Ocular Motor Cranial Nerve Palsies
Daye Diana Choi, Kyung-Ah Park, Kyungdo Han, Sei Yeul Oh
Journal of Neuro-Ophthalmology.2024; 44(3): 386. CrossRef
Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus
Asad Riaz, Shoaib Asghar, Salman Shahid, Haider Tanvir, Muhammad Hamza Ejaz, Mamuna Akram
Cureus.2024;[Epub] CrossRef
Simplified integration of optimal self-management behaviors is associated with improved HbA1c in patients with type 1 diabetes
C. Deng, Y. Xie, F. Liu, X. Tang, L. Fan, X. Yang, Y. Chen, Z. Zhou, X. Li
Journal of Endocrinological Investigation.2024; 47(11): 2691. CrossRef
Correlation between triglyceride-glucose index and diabetic kidney disease risk in adults with type 1 diabetes mellitus
Mengyun Lei, Ping Ling, Yongwen Zhou, Jing Lv, Ying Ni, Hongrong Deng, Chaofan Wang, Daizhi Yang, Xubin Yang, Wen Xu, Jinhua Yan
Diabetology & Metabolic Syndrome.2024;[Epub] CrossRef
Development and validation of an age-sex-ethnicity-specific metabolic syndrome score in the Chinese adults
Shujuan Yang, Bin Yu, Wanqi Yu, Shaoqing Dai, Chuanteng Feng, Ying Shao, Xing Zhao, Xiaoqing Li, Tianjing He, Peng Jia
Nature Communications.2023;[Epub] CrossRef
Association of Endotoxemia with Low-Grade Inflammation, Metabolic Syndrome and Distinct Response to Lipopolysaccharide in Type 1 Diabetes
Aleksejs Fedulovs, Leonora Pahirko, Kaspars Jekabsons, Liga Kunrade, Jānis Valeinis, Una Riekstina, Valdis Pīrāgs, Jelizaveta Sokolovska
Biomedicines.2023; 11(12): 3269. CrossRef
Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus (Diabetes Metab J 2022;46:93-103)
Qianwen Huang, Sihui Luo
Diabetes & Metabolism Journal.2022; 46(3): 515. CrossRef
Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus (Diabetes Metab J 2022;46:93-103)
Gyuri Kim
Diabetes & Metabolism Journal.2022; 46(3): 512. CrossRef
Metabolic syndrome associated with higher glycemic variability in type 1 diabetes: A multicenter cross-sectional study in china
Keyu Guo, Liyin Zhang, Jianan Ye, Xiaohong Niu, Hongwei Jiang, Shenglian Gan, Jian Zhou, Lin Yang, Zhiguang Zhou
Frontiers in Endocrinology.2022;[Epub] CrossRef

Metabolic Risk/Epidemiology
Trends and Risk Factors of Metabolic Syndrome among Korean Adolescents, 2007 to 2018: Jiun Chae, Moon Young Seo, Shin-Hye Kim, Mi Jung Park; Diabetes Metab J. 2021;45(6):880-889. Published online July 6, 2021; DOI: https://doi.org/10.4093/dmj.2020.0185

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Background
There is a lack of recent research on the changes in risk factors for metabolic syndrome (MetS) in the Asian pediatric population. We aimed to determine the 12-year trends in the prevalence of MetS and relevant lifestyle factors such as smoking, exercise, and calorie intake among Korean adolescents.
Methods
We investigated trends in MetS and lifestyle factors among 6,308 adolescents aged 12 to 18 years from the Korea National Health and Nutrition Examination Survey, 2007 to 2018.
Results
The prevalence of MetS was stable from 2007 to 2018 (1.7% to 2.2%). There were significant increases in the prevalence of central obesity (from 8.1% to 11.2%, P=0.012) and hyperglycemia (from 5.3% to 10.4%, P<0.001) and decreases in hypo-high-density lipoprotein (HDL)-cholesterolemia (from 22.4% to 14.8%, P<0.001). Total calorie intake and calorie intake from fat significantly increased (P<0.001), whereas calorie intake from carbohydrates significantly decreased (P<0.001) during the study period. The proportions of tobacco smokers and regular walkers significantly decreased from 2007 to 2018. After controlling for all covariates, total calorie intake was positively correlated with waist circumference (P<0.05). HDL-cholesterol was negatively associated with carbohydrate consumption (P<0.01) and positively associated with fat consumption (P<0.001). Regular walking and regular strength training were associated with lower waist circumference (P<0.05). Smoking was associated with lower fasting glucose levels (P<0.01).
Conclusion
Although the prevalence rate of MetS is stable among Korean adolescents, the prevalence of central obesity and hyperglycemia has increased greatly in the recent decade. Public education on proper dietary intake and lifestyle modification is required.

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Metabolic Risk/Epidemiology
Longitudinal Change in Myocardial Function and Clinical Parameters in Middle-Aged Subjects: A 3-Year Follow-up Study: Dong-Hyuk Cho, Hyung Joon Joo, Mi-Na Kim, Hee-Dong Kim, Do-Sun Lim, Seong-Mi Park; Diabetes Metab J. 2021;45(5):719-729. Published online June 15, 2021; DOI: https://doi.org/10.4093/dmj.2020.0132

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Background
Metabolic syndrome (MetS) is closely associated with the aging process. However, changes in metabolic conditions and cardiac function that occur in middle aged population remain unclear. We evaluated longitudinal changes in metabolic parameters and cardiac function during a 3-year period in subjects with suspected MetS.
Methods
We studied 191 participants with suspected MetS at baseline and after 3 years. Anthropometric parameters, including waist circumference (WC), and metabolic parameters, including fasting blood glucose and lipid profile were measured. Conventional echocardiography with two-dimensional speckle tracking was performed.
Results
Mean age was 56.2±4.4 years, and there were 97 women (50.8%). Men had increased WC and triglycerides (TG) (WC 91.2±6.8 cm vs. 84.0±8.0 cm, P<0.001; TG 184.4±116.3 mg/dL vs. 128.2±53.6 mg/dL, P<0.001), and reduced global longitudinal strain (GLS) (–15.4%±2.1% vs. –17.1%±2.0%, P<0.001) compared to women. After 3.4 years, values of WC and TG did not change in men but increased in women (all P<0.05). The absolute value of left ventricular (LV) GLS did not change in men but was reduced in women (P=0.011). Change in TG was independently associated with worsening of LV GLS only in women (standardized β, –0.309; 95% confidence interval, –0.130 to –0.009; P=0.025).
Conclusion
In middle aged population, a vulnerable period for metabolic disturbance, cardiac remodeling tended to progress, which was prominent in women. Progression of adiposity and dyslipidemia after menopause may accelerate subclinical cardiac remodeling in middle-aged women. Lifestyle modification and medical interventions may help prevent further cardiac dysfunction in these subjects.

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Review

Pathophysiology
Hyperinsulinemia in Obesity, Inflammation, and Cancer: Anni M.Y. Zhang, Elizabeth A. Wellberg, Janel L. Kopp, James D. Johnson; Diabetes Metab J. 2021;45(3):285-311. Published online March 29, 2021; DOI: https://doi.org/10.4093/dmj.2020.0250; Correction in: Diabetes Metab J 2021;45(4):622

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The relative insufficiency of insulin secretion and/or insulin action causes diabetes. However, obesity and type 2 diabetes mellitus can be associated with an absolute increase in circulating insulin, a state known as hyperinsulinemia. Studies are beginning to elucidate the cause-effect relationships between hyperinsulinemia and numerous consequences of metabolic dysfunctions. Here, we review recent evidence demonstrating that hyperinsulinemia may play a role in inflammation, aging and development of cancers. In this review, we will focus on the consequences and mechanisms of excess insulin production and action, placing recent findings that have challenged dogma in the context of the existing body of literature. Where relevant, we elaborate on the role of specific signal transduction components in the actions of insulin and consequences of chronic hyperinsulinemia. By discussing the involvement of hyperinsulinemia in various metabolic and other chronic diseases, we may identify more effective therapeutics or lifestyle interventions for preventing or treating obesity, diabetes and cancer. We also seek to identify pertinent questions that are ripe for future investigation.

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Metabolism.2024; 160: 156004. CrossRef
Uncovering the Links Between Dietary Sugar and Cancer: A Narrative Review Exploring the Impact of Dietary Sugar and Fasting on Cancer Risk and Prevention
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European Journal of Cancer Prevention.2024;[Epub] CrossRef
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Frontiers in Endocrinology.2024;[Epub] CrossRef
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Nutrients.2024; 16(18): 3106. CrossRef
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Nutrients.2024; 16(19): 3243. CrossRef
Intestinal ABC transporters: Influence on the metronomic cyclophosphamide-induced toxic effect in an obese mouse mammary cancer model
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Toxicology and Applied Pharmacology.2024; 492: 117130. CrossRef
Association between different patterns of obesity and the short-term outcomes of gastric cancer surgery
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European Journal of Cancer Prevention.2024;[Epub] CrossRef
Association Between Physical Activity and Pancreatic Cancer Risk and Mortality: A Systematic Review and Meta-Analysis
Mylena D. Bos, Jelmer E. Oor, Lucas Goense, N. Helge Meyer, Maximilian Bockhorn, Frederik J. H. Hoogwater, Joost M. Klaase, Maarten W. Nijkamp
Cancers.2024; 16(21): 3594. CrossRef
The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
Justinas Jonusas, Mingailė Drevinskaitė, Donata Linkeviciute-Ulinskiene, Adomas Ladukas, Aušvydas Patašius, Lina Zabulienė, Giedrė Smailytė
Open Medicine.2024;[Epub] CrossRef
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Sandesh Parajuli, Riccardo Tamburrini, Fahad Aziz, Ban Dodin, Brad C. Astor, Didier Mandelbrot, Dixon Kaufman, Jon Odorico
Transplantation Direct.2024; 10(11): e1720. CrossRef
Transitions in metabolic syndrome and metabolic obesity status over time and risk of urologic cancer: A prospective cohort study
Xia Wang, Runxue Jiang, Jianglun Shen, Shuohua Chen, Shouling Wu, Hailong Hu, Haifeng Cai, Yuki Arita
PLOS ONE.2024; 19(10): e0311492. CrossRef
Probiotic, Postbiotic, and Paraprobiotic Effects of Lactobacillus rhamnosus as a Modulator of Obesity-Associated Factors
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Foods.2024; 13(22): 3529. CrossRef
Impact of high body mass index on gallbladder and biliary tract cancer burden in China: a comprehensive analysis of trends from 1990 to 2021
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World Journal of Surgical Oncology.2024;[Epub] CrossRef
The Emerging Scenario of Ferroptosis in Pancreatic Cancer Tumorigenesis and Treatment
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International Journal of Molecular Sciences.2024; 25(24): 13334. CrossRef
Association Between Polycystic Ovary Syndrome and Pancreatic Cancer in a Retrospective Case‐Control Study
Pei-Ying Chung, Kuan-Fu Liao, Yu-Hung Kuo, Shih-Wei Lai, Bing Niu
International Journal of Clinical Practice.2024;[Epub] CrossRef
Anti-Diabetic Therapies and Cancer: From Bench to Bedside
Dimitris Kounatidis, Natalia G. Vallianou, Irene Karampela, Eleni Rebelos, Marina Kouveletsou, Vasileios Dalopoulos, Petros Koufopoulos, Evanthia Diakoumopoulou, Nikolaos Tentolouris, Maria Dalamaga
Biomolecules.2024; 14(11): 1479. CrossRef
Advances in “adiponcosis”: Insights in the inner mechanisms at the base of adipose and tumour tissues interplay
Cristina Pagano, Erika di Zazzo, Giorgio Avilia, Beatrice Savarese, Giovanna Navarra, Maria Chiara Proto, Donatella Fiore, Monica Rienzo, Patrizia Gazzerro, Chiara Laezza, Maurizio Bifulco
International Journal of Cancer.2023; 152(12): 2464. CrossRef
Influence of antidiabetic drugs on glucose metabolism and immune response in patients with metastatic pancreatic ductal adenocarcinoma receiving gemcitabine plus nab-paclitaxel as first-line treatment
Andrea Pretta, Pina Ziranu, Riccardo Giampieri, Clelia Donisi, Erika Cimbro, Dario Spanu, Eleonora Lai, Federica Pecci, Francesca Balconi, Alessio Lupi, Marta Pozzari, Mara Persano, Sara Murgia, Valeria Pusceddu, Marco Puzzoni, Rossana Berardi, Mario Scar
Digestive and Liver Disease.2023; 55(5): 655. CrossRef
Islet amyloid polypeptide does not suppress pancreatic cancer
Austin J. Taylor, Evgeniy Panzhinskiy, Paul C. Orban, Francis C. Lynn, David F. Schaeffer, James D. Johnson, Janel L. Kopp, C. Bruce Verchere
Molecular Metabolism.2023; 68: 101667. CrossRef
Pathophysiology of obesity and its associated diseases
Xin Jin, Tingting Qiu, Li Li, Rilei Yu, Xiguang Chen, Changgui Li, Christopher G. Proud, Tao Jiang
Acta Pharmaceutica Sinica B.2023; 13(6): 2403. CrossRef
Metabolic syndrome as a risk factor for oncogenesis
M.A. Osadchuk, I.N. Vasilieva, V.V. Kozlov, O.I. Mitrokhina
Russian Journal of Preventive Medicine.2023; 26(1): 70. CrossRef
Polycystic ovary syndrome: Causes, symptoms, pathophysiology, and remedies
Ananya Chaudhuri
Obesity Medicine.2023; 39: 100480. CrossRef
Metformin and long non-coding RNAs in breast cancer
Morteza Gholami, Zeynab Nickhah Klashami, Pirooz Ebrahimi, Amir Ali Mahboobipour, Amir Salehi Farid, Aida Vahidi, Marziyeh Zoughi, Mojgan Asadi, Mahsa M. Amoli
Journal of Translational Medicine.2023;[Epub] CrossRef
Host-Related Factors in the Interplay among Inflammation, Immunity and Dormancy in Breast Cancer Recurrence and Prognosis: An Overview for Clinicians
Lorenzo Ruggieri, Anna Moretti, Rossana Berardi, Maria Silvia Cona, Davide Dalu, Cecilia Villa, Davide Chizzoniti, Sheila Piva, Anna Gambaro, Nicla La Verde
International Journal of Molecular Sciences.2023; 24(5): 4974. CrossRef
Degree of obesity and gastrointestinal adverse reactions influence the weight loss effect of liraglutide in overweight or obese patients with type 2 diabetes
Fang Zhou, Lu Jiang, Jiamei Guo, Yuting Fan, Qin Pan, Tianlian Li, Xiaoshi Sun, Ping Li
Therapeutic Advances in Chronic Disease.2023;[Epub] CrossRef
Both early and late maternal age at childbirth is associated with increasing odds of central obesity in offspring
Hongyun Chen, Yinhua Feng, Changying Chen, Songcheng Yu
American Journal of Human Biology.2023;[Epub] CrossRef
Integrated Physiology of the Exocrine and Endocrine Compartments in Pancreatic Diseases: Workshop Proceedings
Teresa L. Mastracci, Minoti Apte, Laufey T. Amundadottir, Alexandra Alvarsson, Steven Artandi, Melena D. Bellin, Ernesto Bernal-Mizrachi, Alejandro Caicedo, Martha Campbell-Thompson, Zobeida Cruz-Monserrate, Abdelfattah El Ouaamari, Kyle J. Gaulton, Andre
Diabetes.2023; 72(4): 433. CrossRef
Obesity-induced changes in cancer cells and their microenvironment: Mechanisms and therapeutic perspectives to manage dysregulated lipid metabolism
Miriam Lee-Rueckert, Marina Canyelles, Mireia Tondo, Noemi Rotllan, Petri T. Kovanen, Vicenta Llorente-Cortes, Joan Carles Escolà-Gil
Seminars in Cancer Biology.2023; 93: 36. CrossRef
PIK3CA mutation in endometriotic epithelial cells promotes viperin-dependent inflammatory response to insulin
Mike R. Wilson, Shannon Harkins, Jake J. Reske, Rebecca A. Siwicki, Marie Adams, Victoria L. Bae-Jump, Jose M. Teixeira, Ronald L. Chandler
Reproductive Biology and Endocrinology.2023;[Epub] CrossRef
Gut microbiome modified by bariatric surgery improves insulin sensitivity and correlates with increased brown fat activity and energy expenditure
Jitender Yadav, Tao Liang, Tairan Qin, Nayanan Nathan, Katherine J.P. Schwenger, Lauren Pickel, Li Xie, Helena Lei, Daniel A. Winer, Heather Maughan, Susan J. Robertson, Minna Woo, Wendy Lou, Kate Banks, Timothy Jackson, Allan Okrainec, Susy S. Hota, Susa
Cell Reports Medicine.2023; 4(5): 101051. CrossRef
Prevalence of Type 2 Diabetes, Impaired Fasting Glucose, and Diabetes Risk in an Adult and Older North-Eastern Portuguese Population
Pedro M. Magalhães, José E. Teixeira, João P. Bragada, Carlos M. Duarte, José A. Bragada
Healthcare.2023; 11(12): 1712. CrossRef
Hyperinsulinemia Influences the Short-Term Efficiency of Laparoscopic Sleeve Gastrectomy for Patients with Obesity and Insulin Resistance
Zilong Yue, Long Qian, Yan Jin, Yabin Xia, Hui Sha, Qin Wu, Kaifeng Hu
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 1745. CrossRef
Acetyl-11-Keto-Beta-Boswellic Acid Has Therapeutic Benefits for NAFLD Rat Models That Were Given a High Fructose Diet by Ameliorating Hepatic Inflammation and Lipid Metabolism
Reza Ataei Kachouei, Alireza Doagoo, Maral Jalilzadeh, Seyyed Hossein Khatami, Shima Rajaei, Ali Jahanbazi Jahan-Abad, Farzaneh Salmani, Roya Pakrad, Somayeh Mahmoodi Baram, Mitra Nourbakhsh, Mohammad-Amin Abdollahifar, Hojjat Allah Abbaszadeh, Shokoofeh
Inflammation.2023; 46(5): 1966. CrossRef
Cancer Risk and its Association With Diabetes Mellitus in Patients With Acromegaly: A Two Center-based Study
Zhe-Hao Xiao, Cheng Wang, Yong Wang, Shang-Kun Yuan, Cheng Huang, Ren-Fang Chen, Yong Li
Endocrine Practice.2023; 29(9): 699. CrossRef
Obesity, diabetes, and cancer: epidemiology, pathophysiology, and potential interventions
Leonardo de Andrade Mesquita, Laura Fink Wayerbacher, Gilberto Schwartsmann, Fernando Gerchman
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef
Insulin Stimulates IL-23 Expression in Human Adipocytes: A Possible Explanation for the Higher Prevalence of Psoriasis in Obesity
Angelo Di Vincenzo, Marnie Granzotto, Marika Crescenzi, Camilla Costa, Stefano Piaserico, Vincenzo Vindigni, Roberto Vettor, Marco Rossato
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 1885. CrossRef
Immunometabolic aspects of chronic nonspecific inflammation in obesity
O. V. Skvortsova, N. B. Migacheva, E. G. Mikhailova
Meditsinskiy sovet = Medical Council.2023; (12): 75. CrossRef
The Reponic Classification of Insulin
Joshua Moen
Canadian Journal of Diabetes.2023; 47(8): 680. CrossRef
Dietary Acid Load and Cancer Risk: A Review of the Uruguayan Experience
Alvaro Luis Ronco, Maximilian Andreas Storz
Nutrients.2023; 15(14): 3098. CrossRef
Non-alcoholic fatty liver disease and diabetes mellitus as growing aetiologies of hepatocellular carcinoma
Stephanie Talamantes, Michela Lisjak, Eduardo H. Gilglioni, Camilo J. Llamoza-Torres, Bruno Ramos-Molina, Esteban N. Gurzov
JHEP Reports.2023; 5(9): 100811. CrossRef
Alteration of Metabolic Syndrome Is Associated with the Decreased Risk of Colorectal Cancer
Eun Hyo Jin, Yoon Jin Choi, Joo Hyun Lim, Cheol Min Shin, Kyungdo Han, Dong Ho Lee
Journal of Clinical Medicine.2023; 12(15): 4889. CrossRef
Dietary interventions improve diabetic kidney disease, but not peripheral neuropathy, in a db/db mouse model of type 2 diabetes
Stephanie A. Eid, Phillipe D. O'Brien, Katharina H. Kretzler, Dae‐Gyu Jang, Faye E. Mendelson, John M. Hayes, Andrew Carter, Hongyu Zhang, Subramaniam Pennathur, Frank C. Brosius, Emily J. Koubek, Eva L. Feldman
The FASEB Journal.2023;[Epub] CrossRef
Decoding the role of leptin and adiponectin in obesity-related gastrointestinal cancer
Vanda Marques, Fabiola Arella, Marta B. Afonso, André A. Santos, Cecília M.P. Rodrigues
Clinical Science.2023; 137(15): 1095. CrossRef
Metformin Can Attenuate Beta-Cell Hypersecretion—Implications for Treatment of Children with Obesity
Quan Wen, Rasmus Stenlid, Azazul Islam Chowdhury, Iris Ciba, Banu Aydin, Sara Y. Cerenius, Hannes Manell, Anders Forslund, Peter Bergsten
Metabolites.2023; 13(8): 917. CrossRef
The Effectiveness of a Low Glycemic Index/Load Diet on Cardiometabolic, Glucometabolic, and Anthropometric Indices in Children with Overweight or Obesity: A Systematic Review and Meta-Analysis
Ioustini Kalaitzopoulou, Xenophon Theodoridis, Evangelia Kotzakioulafi, Kleo Evripidou, Michail Chourdakis
Children.2023; 10(9): 1481. CrossRef
Characteristics of Children and Adolescents with Hyperinsulinemia Undergoing Oral Glucose Tolerance Test: A Single-Center Retrospective Observational Study
Clelia Cipolla, Ilaria Lazzareschi, Antonietta Curatola, Claudia Lasorella, Lucia Celeste Pane, Linda Sessa, Giulia Rotunno, Donato Rigante, Giorgio Sodero
Diseases.2023; 11(3): 110. CrossRef
Hyperinsulinemia acts via acinar insulin receptors to initiate pancreatic cancer by increasing digestive enzyme production and inflammation
Anni M.Y. Zhang, Yi Han Xia, Jeffrey S.H. Lin, Ken H. Chu, Wei Chuan K. Wang, Titine J.J. Ruiter, Jenny C.C. Yang, Nan Chen, Justin Chhuor, Shilpa Patil, Haoning Howard Cen, Elizabeth J. Rideout, Vincent R. Richard, David F. Schaeffer, Rene P. Zahedi, Chr
Cell Metabolism.2023; 35(12): 2119. CrossRef
Dairy Intake Modifies the Level of the Bile Acid Precursor and Its Correlation with Serum Proteins Associated with Cholesterol Clearance in Subjects with Hyperinsulinemia
Atena Mahdavi, Jocelyn Trottier, Olivier Barbier, Michel Lebel, Iwona Rudkowska
Nutrients.2023; 15(22): 4707. CrossRef
Trapa Bispinosa Roxb. Inhibits the Insulin-Dependent AKT/WNK1 Pathway to Induce Autophagy in Mice with Type 2 Diabetes
Takahiro Suzuki, Takehito Sato, Kaori Masuhara, Mizuki Tokusanai, Hisako Akatsuka, Tomohiro Kashikawa, Yasuyuki Suzuki
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 3095. CrossRef
Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer
Giovanna Flore, Andrea Deledda, Mauro Lombardo, Andrea Armani, Fernanda Velluzzi
Antioxidants.2023; 12(10): 1845. CrossRef
A systematic review exploring the mechanisms by which citrus bioflavonoid supplementation benefits blood glucose levels and metabolic complications in type 2 diabetes mellitus
Ankit Gupta, Abdulsatar Jamal, Dina A. Jamil, Hayder A. Al-Aubaidy
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(11): 102884. CrossRef
Diabetes Mellitus and Gastric Cancer: Correlation and Potential Mechanisms
Li Wang, Zhe Zhang, Eusebio Chiefari
Journal of Diabetes Research.2023; 2023: 1. CrossRef
EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL
Silvana Barbosa SANTIAGO, Gabriela Rodrigues de SOUSA, Amanda Ferreira Paes Landim RAMOS, Gisele Aparecida FERNANDES, Maria Paula CURADO, Mônica Santiago BARBOSA
Arquivos de Gastroenterologia.2023; 60(4): 419. CrossRef
Risk of cancer in acromegaly patients: An updated meta-analysis and systematic review
Zhehao Xiao, Pingping Xiao, Yong Wang, Chen Fang, Yong Li, Alvaro Galli
PLOS ONE.2023; 18(11): e0285335. CrossRef
Long Follow-Up Times Weaken Observational Diet–Cancer Study Outcomes: Evidence from Studies of Meat and Cancer Risk
William B. Grant
Nutrients.2023; 16(1): 26. CrossRef
Serum Lipid Profiles and Cholesterol-Lowering Medication Use in Relation to Subsequent Risk of Colorectal Cancer in the UK Biobank Cohort
Fangcheng Yuan, Wanqing Wen, Guochong Jia, Jirong Long, Xiao-Ou Shu, Wei Zheng
Cancer Epidemiology, Biomarkers & Prevention.2023; 32(4): 524. CrossRef
Prevalence of diabetes mellitus among 80,193 gastrointestinal cancer patients in five European and three Asian countries
Christoph Roderburg, Sven H. Loosen, Laura Hoyer, Tom Luedde, Karel Kostev
Journal of Cancer Research and Clinical Oncology.2022; 148(5): 1057. CrossRef
The Intricate Crosstalk Between Insulin and Pancreatic Ductal Adenocarcinoma: A Review From Clinical to Molecular
Junyuan Deng, Yujie Guo, Jiali Du, Jichun Gu, Lei Kong, Boan Tao, Ji Li, Deliang Fu
Frontiers in Cell and Developmental Biology.2022;[Epub] CrossRef
Effects of hyperinsulinemia on pancreatic cancer development and the immune microenvironment revealed through single-cell transcriptomics
Anni M. Y. Zhang, Ken H. Chu, Brian F. Daly, Titine Ruiter, Yan Dou, Jenny C. C. Yang, Twan J. J. de Winter, Justin Chhuor, Su Wang, Stephane Flibotte, Yiwei Bernie Zhao, Xiaoke Hu, Hong Li, Elizabeth J. Rideout, David F. Schaeffer, James D. Johnson, Jane
Cancer & Metabolism.2022;[Epub] CrossRef
Ghrelin and Cancer: Examining the Roles of the Ghrelin Axis in Tumor Growth and Progression
Anuhya S. Kotta, Abigail S. Kelling, Karen A. Corleto, Yuxiang Sun, Erin D. Giles
Biomolecules.2022; 12(4): 483. CrossRef
Influence of obesity on reproductive health before andduring pregnancy
A. Konwisser, O. Korytko
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2022; 18(8): 446. CrossRef
Research Status of the Correlation between Type 2 Diabetes Mellitus and the Occurrence and Development of Breast Cancer
聪李
Advances in Clinical Medicine.2022; 12(04): 3010. CrossRef
Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hype
Jong Han Choi, Yoon Jeong Cho, Hyun-Jin Kim, Seung-Hyun Ko, Suk Chon, Jee-Hyun Kang, Kyoung-Kon Kim, Eun Mi Kim, Hyun Jung Kim, Kee-Ho Song, Ga Eun Nam, Kwang Il Kim
Diabetes & Metabolism Journal.2022; 46(3): 355. CrossRef
Obesity and Pancreatic Cancer: Recent Progress in Epidemiology, Mechanisms and Bariatric Surgery
Shuhei Shinoda, Naohiko Nakamura, Brett Roach, David A. Bernlohr, Sayeed Ikramuddin, Masato Yamamoto
Biomedicines.2022; 10(6): 1284. CrossRef
Effect of carbohydrate-restricted diets and intermittent fasting on obesity, type 2 diabetes mellitus, and hypertension management: consensus statement of the Korean Society for the Study of obesity, Korean Diabetes Association, and Korean Society of Hype
Jong Han Choi, Yoon Jeong Cho, Hyun-Jin Kim, Seung-Hyun Ko, Suk Chon, Jee-Hyun Kang, Kyoung-Kon Kim, Eun Mi Kim, Hyun Jung Kim, Kee-Ho Song, Ga Eun Nam, Kwang Il Kim
Clinical Hypertension.2022;[Epub] CrossRef
Vitamin D and Risk of Obesity-Related Cancers: Results from the SUN (‘Seguimiento Universidad de Navarra’) Project
Rodrigo Sánchez-Bayona, Maira Bes-Rastrollo, Cesar I. Fernández-Lázaro, Maite Bastyr, Ainhoa Madariaga, Juan J. Pons, Miguel A. Martínez-González, Estefanía Toledo
Nutrients.2022; 14(13): 2561. CrossRef
Metabolically Defined Body Size Phenotypes and Risk of Endometrial Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Nathalie Kliemann, Romain Ould Ammar, Carine Biessy, Audrey Gicquiau, Verena Katzke, Rudolf Kaaks, Anne Tjønneland, Anja Olsen, Maria-Jose Sánchez, Marta Crous-Bou, Fabrizio Pasanisi, Sandar Tin Tin, Aurora Perez-Cornago, Dagfinn Aune, Sofia Christakoudi,
Cancer Epidemiology, Biomarkers & Prevention.2022; 31(7): 1359. CrossRef
Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hype
Jong Han Choi, Yoon Jeong Cho, Hyun-Jin Kim, Seung-Hyun Ko, Suk Chon, Jee-Hyun Kang, Kyoung-Kon Kim, Eun Mi Kim, Hyun Jung Kim, Kee-Ho Song, Ga Eun Nam, Kwang Il Kim
Journal of Obesity & Metabolic Syndrome.2022; 31(2): 100. CrossRef
Detangling the interrelations between MAFLD, insulin resistance, and key hormones
Shreya C. Pal, Mohammed Eslam, Nahum Mendez-Sanchez
Hormones.2022; 21(4): 573. CrossRef
Obesity, cancer risk, and time-restricted eating
Manasi Das, Nicholas J. G. Webster
Cancer and Metastasis Reviews.2022; 41(3): 697. CrossRef
Associations between early-life growth pattern and body size and follicular lymphoma risk and survival: a family-based case-control study
Michael K. Odutola, Marina T. van Leeuwen, Jennifer Turner, Fiona Bruinsma, John F. Seymour, H. Miles Prince, Samuel T. Milliken, Mark Hertzberg, Judith Trotman, Stephen S. Opat, Robert Lindeman, Fernando Roncolato, Emma Verner, Michael Harvey, Campbell T
Cancer Epidemiology.2022; 80: 102241. CrossRef
Differential expression of Ago2‐mediated microRNA signaling in adipose tissue is associated with food‐induced obesity
Hansi Zhang, Liang Qiao, Xiaoxuan Liu, Xiaojing Han, Jing Kang, Yanli Liu, Juntang Lin, Xin Yan
FEBS Open Bio.2022; 12(10): 1828. CrossRef
Proposal for standardizing normal insulin ranges in Brazilian patients and a new classification of metabolic syndrome
Pedro Renato Chocair, Precil Diego Miranda de Menezes Neves, Victor Augusto Hamamoto Sato, Sara Mohrbacher, Érico Souza Oliveira, Leonardo Victor Barbosa Pereira, Alessandra Martins Bales, Fagner Pereira da Silva, John A. Duley, Américo Lourenço Cuvello-N
Frontiers in Medicine.2022;[Epub] CrossRef
Two models of insulin resistance development and the strategy to combat age-related diseases: literature review
A. V. Martyushev-Poklad, D. S. Yankevich, M. V. Petrova, N. G. Savitskaya
Problems of Endocrinology.2022; 68(4): 59. CrossRef
In Vitro Mimicking of Obesity-Induced Biochemical Environment to Study Obesity Impacts on Cells and Tissues
Abdelaziz Ghanemi, Mayumi Yoshioka, Jonny St-Amand
Diseases.2022; 10(4): 76. CrossRef
Long‐term survival analysis of patients with stage IIIB‐IV non‐small cell lung cancer complicated by type 2 diabetes mellitus: A retrospective propensity score matching analysis
Xuejiao Li, Haiyan Fang, Dongwei Zhang, Liming Xia, Xiang Wang, Jingping Yang, Shaohu Zhang, Ya Su, Yongfu Zhu
Thoracic Cancer.2022; 13(23): 3268. CrossRef
Diabetes and skin cancers: Risk factors, molecular mechanisms and impact on prognosis
Elena-Codruta Dobrică, Madalina Laura Banciu, Vincent Kipkorir, Mohammad Amin Khazeei Tabari, Madeleine Jemima Cox, L V Simhachalam Kutikuppala, Mihnea-Alexandru Găman
World Journal of Clinical Cases.2022; 10(31): 11214. CrossRef
The role of the mTOR pathway in diabetic retinopathy
Fabio Casciano, Enrico Zauli, Erika Rimondi, Marco Mura, Maurizio Previati, Massimo Busin, Giorgio Zauli
Frontiers in Medicine.2022;[Epub] CrossRef
Hyperinsulinemia-induced microglial mitochondrial dynamic and metabolic alterations lead to neuroinflammation in vivo and in vitro
Xiaohan Yang, Yuan Xu, Wenting Gao, Li Wang, Xinnan Zhao, Gang Liu, Kai Fan, Shuang Liu, Huimin Hao, Siyan Qu, Renhou Dong, Xiaokai Ma, Jianmei Ma
Frontiers in Neuroscience.2022;[Epub] CrossRef
Integrated Physiology of the Exocrine and Endocrine Compartments in Pancreatic Diseases
Teresa L. Mastracci, Minoti Apte, Laufey T. Amundadottir, Alexandra Alvarsson, Steven Artandi, Melena D. Bellin, Ernesto Bernal-Mizrachi, Alejandro Caicedo, Martha Campbell-Thompson, Zobeida Cruz-Monserrate, Abdelfattah El Ouaamari, Kyle J. Gaulton, Andre
Pancreas.2022; 51(9): 1061. CrossRef
Intestinal Microbiome Modified by Bariatric Surgery Improves Insulin Sensitivity and Correlates with Increased Brown Fat Activity and Energy Expenditure
jitender Yadav, Tao Liang, Tairan Qin, Nayanan N. Nathan, Katherine J.P Schwenger, Lauren Pickel, Li Xie, Helena Lei, Daniel A. Winer, Heather Maughan, Susan J. Robertson, Minna Woo, Wendy Y. W. Lou, Kate Banks, Timothy Jackson, Allan Okrainec, Susy S. Ho
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Severe hyperglycemia and insulin resistance in patients with SARS-CoV-2 infection: a report of two cases
Alison H. Affinati, Amisha Wallia, Roma Y. Gianchandani
Clinical Diabetes and Endocrinology.2021;[Epub] CrossRef
Promises and pitfalls of beta cell–replacement therapies
Jelena Kolic, James D. Johnson
Nature Metabolism.2021; 3(8): 1036. CrossRef
Hiding unhealthy heart outcomes in a low-fat diet trial: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial finds that postmenopausal women with established coronary heart disease were at increased risk of an adverse outcome if
Timothy David Noakes
Open Heart.2021; 8(2): e001680. CrossRef
On the causal relationships between hyperinsulinaemia, insulin resistance, obesity and dysglycaemia in type 2 diabetes
James D. Johnson
Diabetologia.2021; 64(10): 2138. CrossRef
Diabetes mellitus and cancer: a system of insulin-like growth factors
E. M. Frantsiyants, E. I. Surikova, I. V. Kaplieva, V. A. Bandovkina, I. V. Neskubina, E. A. Sheiko, M. I. Morozova, I. M. Kotieva
Problems of Endocrinology.2021; 67(5): 34. CrossRef

Original Articles

Cardiovascular Risk/Epidemiology
Metabolic Syndrome Severity Score for Predicting Cardiovascular Events: A Nationwide Population-Based Study from Korea: Yo Nam Jang, Jun Hyeok Lee, Jin Sil Moon, Dae Ryong Kang, Seong Yong Park, Jerim Cho, Jang-Young Kim, Ji Hye Huh; Diabetes Metab J. 2021;45(4):569-577. Published online January 30, 2021; DOI: https://doi.org/10.4093/dmj.2020.0103

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Background
Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population.
Methods
From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve.
Results
Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III.
Conclusion
The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.

Citations

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Pathophysiology
Relationships between Islet-Specific Autoantibody Titers and the Clinical Characteristics of Patients with Diabetes Mellitus: Yiqian Zhang, Tong Yin, Xinlei Wang, Rongping Zhang, Jie Yuan, Yi Sun, Jing Zong, Shiwei Cui, Yunjuan Gu; Diabetes Metab J. 2021;45(3):404-416. Published online July 21, 2020; DOI: https://doi.org/10.4093/dmj.2019.0239

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Background

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

Methods

A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.

Results

Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUC_CP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUC_CP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.

Conclusion

Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

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