ABSTRACTIntroductionThyroglobulin (Tg) is a sensitive and specific marker for differentiated thyroid carcinoma (DTC). The presence of thyroglobulin autoantibodies (TgAb) can interfere with Tg measurement in commonly used immunoassays, often resulting in falsely low or undetectable Tg levels. However, data on the prognostic significance of TgAb or its potential utility as a surrogate marker for DTC are limited, leaving its role in the clinical management of DTC uncertain. The aim of this study was the evaluation of the prognostic significance of TgAb in a clinical cohort of patients with DTC.MethodsWe included n = 289 patients with DTC who presented to our clinic for radioiodine treatment. Clinical data and follow‐up outcomes were retrospectively analysed. The TgAb status at initial treatment and during follow‐up was assessed, and its association with disease remission, persistence or recurrence was evaluated.ResultsRoughly 25% of DTC patients in our cohort showed positive TgAb post‐surgery. There were no significant differences between TgAb‐positive and TgAb‐negative patients in histology, tumour size, metastasis, therapeutic regimen or risk stratification.ConclusionThe presence of TgAb did not influence the outcome regarding overall and disease‐free survival. Results implicate that the initial appearance of TgAb does not influence the outcome of patients with DTC. Patients with positive TgAb should be monitored closely during follow‐up as Tg measurement is unreliable, while overtreatment should be avoided.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular (CV) outcomes in patients with heart failure (HF) and type 2 diabetes. Their effect in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS), however, remains unclear. This study evaluated whether SGLT2 inhibitors reduce all-cause mortality and HF hospitalisations after TAVR. A systematic search of PubMed, ScienceDirect, Cochrane (CENTRAL), Scopus and Embase was performed through April 2025 for studies comparing post-TAVR outcomes between SGLT2 inhibitor users and non-users. Outcomes of interest included a composite of all-cause mortality or heart failure (HF) hospitalisation, along with the individual components of all-cause mortality and HF hospitalisation. All outcomes were extracted at 1 year. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was quantified using I2 statistics. Analyses were conducted in R (version 4.4.2). Three studies (1 RCT, 2 Observational) comprising 3187 patients met inclusion criteria. SGLT2 inhibitor use was associated with a reduced risk of the composite outcome (HR: 0.75; 95% CI: 0.65, 0.86; p < 0.01). Individually, therapy lowered all-cause mortality (HR: 0.72; 95% CI: 0.53, 0.96; p = 0.03) and HF hospitalisations (HR: 0.74; 95% CI: 0.61, 0.90; p < 0.01). In patients with severe AS undergoing TAVR, SGLT2 inhibitors were associated with significant reductions in all-cause mortality and HF hospitalisations. These findings suggest a promising role for SGLT2 inhibitors in improving post-TAVR outcomes. However, given the limited data, larger randomised clinical trials are necessary to consolidate these findings. CRD420251132729.

Low medication adherence is prevalent in diabetes, and many adherence factors found are non-modifiable by interventions. Adherence interventions have limited effectiveness due to a lack of tailoring and understanding of common modifiable factors. Hence, this study aimed to identify common and distinctive factors associated with medication adherence and glycaemic levels among people with type 2 diabetes in Singapore and the United Kingdom (UK) using cross-sectional and longitudinal analyses of standardised measures. Medication adherence, medication beliefs, illness perceptions, mood, and glycaemic level were assessed using validated questionnaires and glycated haemoglobin (HbA1c) among 550 participants. Regressions and multilevel models investigated factors associated with baseline and 3-6-month adherence and HbA1c. Overall, participants with greater resistance to illness (β = -0.084, p = 0.031), medication concern (β = -0.069, p = 0.026) and reduced understanding of diabetes (β = 0.105, p = 0.053) had lower baseline adherence. Participants with greater adherence (β = -0.088, p = 0.006), personal control (β = -0.154, p < 0.001) and reduced emotional impact (β = 0.076, p = 0.008) had lower baseline HbA1c. Perceived treatment control was associated with follow-up adherence (β = 0.140, p = 0.051), while personal control was associated with follow-up HbA1c (β = -0.092, p = 0.009). In Singapore, resistance to illness (β = -0.110, p = 0.011) and medication concern (β = -0.101, p = 0.006) were significant adherence factors. Participants with greater testing treatment tendency (β = 0.146, p = 0.028) and lower personal control (β = -0.132, p = 0.006) had higher HbA1c. In the UK, sensitivity to medication was related to adherence (β = -0.262, p = 0.019), while adherence (β = -1.020, p = 0.040) and personal control (β = -1.803, p = 0.001) were linked to HbA1c. Common factors, such as resistance to illness and perceived personal control, may affect medication adherence or glycaemic level. Distinctive factors associated with medication adherence or glycaemic level include perceived sensitivity to medication and testing treatment. The common and distinctive factors identified could be used to support broadly applicable and locally relevant personalised intervention development.

Fatty liver disease is common among obese individuals and is closely linked to chronic low-grade inflammation. This study examines the relationship between dietary inflammatory index (DII) and serum inflammatory markers in obese individuals with and without non-alcoholic fatty liver disease (NAFLD). In this case-control study, 85 obese adults (BMI ≥ 30), aged 20-70 years, were recruited from two outpatient clinics in Urmia, Iran. NAFLD diagnosis was based on sonography by an endocrinologist. Serum C-reactive protein (CRP) levels were measured using a high-sensitivity immunoturbidimetric assay to assess systemic inflammation. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). The Dietary Inflammatory Index (DII) was calculated to evaluate the inflammatory potential of the diet. Serum CRP levels were significantly higher in the NAFLD group (12.2 mg/L; 95% CI: 9.7-14.7) than controls (8.5 mg/L; 95% CI: 6.0-11.0; p = 0.04). DII scores did not differ significantly between groups (p = 0.2). CRP was positively associated with NAFLD (OR = 2.89; 95% CI: 1.1-7.2), while DII showed no significant association (OR = 0.50; 95% CI: 0.2-1.2). Our findings underscore the role of inflammation in the pathophysiology of fatty liver disease among obese individuals. Elevated CRP levels highlight potential targets for intervention. Although no significant differences in DII were observed, further serum investigation into the relationship between diet, inflammation and fatty liver is warranted.

There is still a lack of enough evidence about Nogo-B levels and vascular complications in patients with type 2 diabetes. Our first aim was to assess the levels of Nogo-B in type 2 diabetes mellitus (T2DM) patients with or without vascular complications (VC). Our second aim was to determine the mechanism by which Nogo-B may protect vasculature using a hyperglycemic HUVEC model. Sera or samples of patients with T2DM and subjects without diabetes were collected from the First or Second Affiliated Hospital of Chongqing Medical University. Human umbilical endothelial cells (HUVECs) were purchased and treated with high glucose (HG) and/or cholesterol (C) before and after Nogo-B knockdown or overexpression. Graphpad and SPSS version 27 software were used for statistical analyses. T2DM patients with vascular complications (DM + VC) displayed significantly lower levels of Nogo-B when compared with T2DM patients without VC (DM) or subjects without diabetes (NC) (p < 0.001). In addition, lower levels of Nogo-B were independently associated with diabetes and/or VC in T2DM patients. Nogo-B overexpression reduced the expression of mesenchymal markers (α-SMA and Collagen-1), TGF-β1 and P-smad2/3, while increasing the expression of endothelial markers (CD31, eNOS and VWF) in HUVECs treated with HG and/or C. Our study has proved that lower levels of Nogo-B are independently associated with VC in T2DM patients. In an invitro model, Nogo-B alleviates endothelial cell injury by affecting TGF-β signalling. Further studies are still needed to support or verify our findings.

This multicenter cross-sectional study was designed to verify whether patient empowerment mediates the relationship between psychosocial factors and diabetes self-management behaviours and HbA1c. Patient empowerment is a key factor improving diabetes management. The mechanism underneath is less clear. We conducted a multicenter cross-sectional study of 2005 type 2 diabetes from five university hospitals across diverse Chinese regions between December 2022 and May 2023. Demographic and lab values came from electronic medical record systems (EMS) while psychological factors were assessed via self-administered digital scales on a WeChat mini-program. The study examined patient empowerment's mediating role between psychological factors (Type D personality, DD, attitudes, subjective norms, perceived control, behaviour change intentions) and diabetes outcomes using mediation and chain mediation analyses. Patients with lower empowerment scores had shorter disease duration, poorer glycemic control, a higher prevalence of dyslipidemia and multiple complications, and greater socioeconomic disadvantage. Type D personality (OR = 2.201, p < 0.001) and diabetes distress (DD, OR = 1.053, p < 0.001) were identified as independent risk factors for low empowerment. Moreover, patient empowerment significantly mediated the associations between psychosocial factors and both self-management behaviours and HbA1c. Mediation analyses showed significant indirect effects of Type D personality (γ = -0.794, p < 0.001), DD (γ = -0.050, p = 0.024), attitude toward behaviour change (γ = 0.470, p < 0.001), subjective norm (γ = 0.287, p < 0.001), perceived behavioural control (γ = 0.489, p < 0.001) and behavioural intention (γ = 0.458, p < 0.001) on self-management behaviours through empowerment. Patient empowerment functions as a critical mediator linking psychosocial factors to self-management behaviours and glycemic control in individuals with type 2 diabetes. Type D personality and DD represent important risk factors for low empowerment. These findings suggest that patient empowerment-focused interventions may enhance diabetes self-management and glycemic control.

Body composition, particularly the interplay between skeletal muscle mass and adiposity, has gained attention for its potential impact on cardiovascular health. This study aimed to examine the relationship between body composition and carotid artery intima-media thickness (cIMT) as an indicator of early atherosclerosis. This cross-sectional study was conducted in the Tehran Lipid and Glucose Study (TLGS) cohort, focusing on young adults. Anthropometric measurements, laboratory tests and cIMT assessments were performed. Body composition was assessed using bioelectrical impedance analysis (BIA). The association between skeletal muscle mass index (SMMI) and skeletal muscle mass (SMM) with cIMT was analysed using linear and logistic regression models, adjusted for relevant covariates. A total of 795 participants (361 women, 434 men) were included in the study. Higher SMMI and SMM quartiles were associated with increased cIMT and a higher risk of high cIMT (above the 75th percentile). For instance, in the age-adjusted model, the highest quartile (Q4) of SMMI was associated with high cIMT with an OR of 1.80 (95% CI, 1.02-3.20) in men and an OR of 2.17 (95% CI, 1.14-4.13) in women. While these associations were significant after adjustment for age, further adjustment for cardiovascular risk factors attenuated some associations, particularly for SMMI quartiles. However, SMMI and SMM as continuous variables remained positively and significantly associated with cIMT in both sexes (e.g., for fully-adjusted continuous SMMI: β = 0.010 in men, β = 0.013 in women), indicating a persistent linear relationship independent of major confounders. In young adults, higher skeletal muscle mass was independently associated with greater cIMT, suggesting it may signal early vascular changes rather than protection, especially when coinciding with higher adiposity. This underscores the need to assess overall body composition and for future longitudinal studies to determine causality.

Curcumin and turmeric are widely studied for their potential renoprotective effects, but evidence regarding their impact on kidney function in individuals with diabetes remains inconsistent. To systematically evaluate the effects of curcumin/turmeric supplementation on kidney function parameters in subjects with diabetes. PubMed, Web of Science and Scopus were searched from inception until August 2025. Randomised controlled trials (RCTs) assessing the effects of curcumin/turmeric on serum creatinine, blood urea nitrogen (BUN), uric acid, urea and albumin in diabetic populations were included. Data were pooled using random-effects models and reported as weighted mean differences (WMDs) with 95% confidence intervals (CIs). Subgroup, sensitivity, and meta-regression analyses were conducted. Risk of bias was assessed using the Cochrane RoB 2 tool, and evidence certainty was evaluated via GRADE. Twelve RCTs (n = 1303 participants) were included. Curcumin/turmeric supplementation did not significantly affect creatinine (WMD: -0.01 mg/dL, 95% CI: -0.03 to 0.01, p = 0.519) or BUN (WMD: -0.41 mg/dL, 95% CI: -3.15 to 2.33, p = 0.769). A trend toward reduction in uric acid was observed (WMD: -1.46 mg/dL, 95% CI: -2.93 to 0.02, p = 0.053). However, urea levels were significantly reduced (WMD: -2.53 mg/dL, 95% CI: -4.09 to -0.96, p = 0.002). No significant change was found in albumin (WMD: 0.07 g/dL, 95% CI: -0.02 to 0.17, p = 0.133). Subgroup analyses showed no significant moderating effects. Publication bias was detected for creatinine (Egger's p = 0.028). The certainty of evidence was moderate for creatinine, urea, and albumin, and low for BUN and uric acid. Curcumin/turmeric supplementation significantly reduces urea levels but does not significantly affect creatinine, BUN, uric acid or albumin in individuals with diabetes. Further high-quality, long-term RCTs are needed to clarify its renoprotective potential and optimal dosing.

A main challenge identified by youth during exercise and sport is the lack of knowledge and awareness around type 1 diabetes (T1D) particularly in community sport settings. Working with youth living with T1D, parents and community sport coaches, our team has developed resources for the T1D and sporting community. This study was to evaluate the acceptability and usability of the resources. Participants completed an online evaluation survey consisting of a T1D quiz and ratings of subjective knowledge and confidence perception. The quiz on exercise and T1D management knowledge consisted of questions developed from the content of the resources and included: an understanding of T1D; signs and symptoms associated with T1D; identification and management of hypoglycaemic episodes. Participants were then provided access to the resources over a 4-week exposure period. After 4 weeks, participants completed the same online survey. Participants were interviewed to collect qualitative information relating to the usability and acceptability of the resources, which included concepts around confidence, trust, and frequency of use. 24 coaches, mean age of 38 years, participated in the study. After the 4-week exposure period, coaches' scores significantly better (p < 0.001) on the standardised T1D quiz from 67.3% to 81.8%. Similarly, coaches' self-perceived ratings of knowledge and confidence increased significantly (p < 0.001) after the 4-week period by an average of 1.6 Likert-scale rating points across all four components. In interviews, coaches indicated high trust and perceived usefulness of the resources, and provided recommendations regarding further tailoring of information, language, and design of resources to enable wide community engagement. The resources developed were found to be informative, trustworthy, acceptable, and easy to use. Following minor amendments, the resources will be implemented into community sport settings through a nationwide launch.

Evidence showed that microbial dysbiosis may lead to poor fertility outcomes. Today, therapy with probiotics, especially when using assisted reproductive technologies, is considered a potential method to improve outcomes. This study aimed to evaluate the effectiveness of probiotic consumption on reproductive outcomes in women with polycystic ovary syndrome (PCOS) who are candidates for Intrauterine Insemination (IUI). In this randomized, double-blind clinical trial, 100 women aged 19 to 37 years with PCOS who were candidates for IUI were studied in two groups (1:1): intervention and placebo. After ovulation induction and IUI, the study outcomes including chemical and clinical pregnancy rates, number of dominant follicles, and endometrial thickness were examined and compared in the two groups. No difference was observed between the intervention and control groups in terms of basic demographic findings and paraclinical evaluation (p > 0.05). The chemical pregnancy rate in the intervention group was higher than in the placebo group, but no statistically significant difference was observed (16% vs. 12%; p = 0.564). The clinical pregnancy rate in the intervention group was higher than in the placebo group (14% vs. 4%; p = 0.081). The mean endometrial thickness in intervention groups was significantly higher than placebo group (p = 0.028), while the mean dominant follicle between the two groups was almost the same (p > 0.05). The regression model showed that only the probiotic supplementation had a significant positive effect on endometrial thickness in the intervention than the placebo groups (β = 0.618, 95% CI: 0.167-1.069, p = 0.008). Probiotic supplementation for 8 weeks in women with PCOS who were candidates for IUI was associated with higher endometrial thickness, indicating a potential role in improving endometrial receptivity.