Diabetes, a chronic disorder, is showing a rapidly increasing trend globally. India holds the second position in the global diabetes epidemic. The present investigation is an assessment of different anthropometric measurements and their association with type 2 diabetes to determine their diagnostic potential for diabetes as well as its co-morbidities. In this cross-sectional study, we have measured anthropometric parameters and blood biomarkers in subjects with diabetes. We have presented the comparisons of cost- and time-effective anthropometric variable with costly and time-dependent biochemical variables in control and diabetic groups (n = 233/group). Correlations between anthropometric variables and biochemical measurements, as well as the diagnostic utility of anthropometric variables for diabetes, were evaluated. The diagnostic utility of anthropometric variables for diabetes was assessed through receiver operating characteristic (ROC) curves. Neck circumference, sagittal abdominal diameter (SAD), skinfold thickness, and body roundness index (BRI) displayed high specificity and diagnostic utility for diabetes, emphasizing their potential in predicting diabetes and the further development of metabolic syndrome. The study highlights the importance of cost- and time-effective anthropometric assessments in diabetes risk evaluation and calls for further research to elucidate this intricate relationship and develop personalized management strategies.

Metformin is a popular first-line glucose-lowering medication for type 2 diabetes mellitus (T2DM). Although metformin reduces the risks of various complications of diabetes, its potential to cause polyneuropathy by depleting vitamin B12 levels is concerning. This study investigated whether the adherence or discontinuation of metformin after adding-on a second-line antiglycemic agent increases the risk of polyneuropathy in patients with T2DM. Data from TriNetX were obtained, and patients with T2DM who were receiving second-line antiglycemic agents were divided into metformin-adherent and metformin-nonadherent groups based on prescription claims data. Neuropathy incidence was evaluated using diagnostic claims and nerve conduction examinations. For independent confirmation and external validation of the primary findings, we used data from the National Health Insurance Research Database (NHIRD) of Taiwan. After matching, 58,027 patients were included in each group. Compared with metformin adherent patients, metformin nonadherent patients had a higher risk of polyneuropathy (adjusted hazard ratios [aHR] 1.26; 95% confidence interval [CI] 1.23-1.29; P < 0.001). Risks of diabetic foot ulcer, amputation, neuropathy-related medication use, and bone fracture were also higher among nonadherent patients. Sensitivity analyses confirmed the robustness of findings. In the validation NHIRD cohort (31,384 matched pairs), metformin nonadherence remained associated with increased polyneuropathy risk (aHR 1.25; 95% CI 1.10-1.42; P < 0.001). Metformin adherence in patients with T2DM who require second-line treatment may reduce the risk of polyneuropathy; vitamin B supplementation may enhance this benefit.

Patients with severe mental disorders (SMD) are at substantially elevated risk for metabolic syndrome (MetS), contributing to excess cardiovascular morbidity and premature mortality. Adverse childhood experiences (ACEs) have been associated with dysregulation of metabolic pathways, yet their contribution to MetS risk in SMD remains poorly understood. This study aimed to investigate the association between ACEs and MetS in outpatients with bipolar disorder (BD) and schizophrenia (SZ) in clinical remission and to identify independent and incremental predictors of MetS using a hierarchical analytical framework. This cross-sectional study included 140 outpatients with SMD (96 with BD and 44 with SZ) in clinical remission, recruited from a university hospital in Eastern Turkey. MetS was defined according to NCEP-ATP III criteria, and ACEs were assessed using the Turkish version of the Adverse Childhood Experiences Scale (ACE-TR). Hierarchical and multivariable logistic regression analyses were performed to examine factors associated with MetS. MetS was highly prevalent in this sample (46.4%). ACE-TR total score was independently and consistently associated with MetS across all hierarchical models (odds ratio [OR] range: 1.68-1.77), with each one-unit increase conferring approximately 71% higher odds in the fully adjusted model (OR = 1.71; 95% confidence interval [CI] 1.26-2.32; P = 0.001). The number of hospitalizations was the only other independently associated variable (OR = 1.19; 95% CI 1.02-1.39). Sexual abuse (16.9% vs. 2.7%; P = 0.004), emotional neglect (63.1% vs. 30.7%; P < 0.001), and physical neglect (30.8% vs. 14.7%; P = 0.022) were significantly more prevalent in the MetS group. ACE-TR total score was positively correlated with waist circumference and triglyceride levels. The strong and consistent association between ACEs and MetS underscores the importance of trauma-informed care models in psychiatric practice, where metabolic comorbidity remains a leading cause of premature mortality.

Coronary artery calcium (CAC) score is a predictor of ischemic heart disease and closely linked to metabolic syndrome (MS). This study investigates the relationship between CAC and benign hepato-pancreaticobiliary disorders. A retrospective, cross-sectional, observational study was conducted on individuals who underwent cardiac computed tomography scans between 2015 and 2022 at a tertiary medical center. Multivariate logistic regression explored the association between CAC and potential confounders. Additionally, a logistic regression model was applied to determine whether CAC independently predicts benign hepato-pancreaticobiliary disorders [steatotic liver disease (SLD), fatty pancreas, gallstones, choledocholithiasis, pancreatic calcifications, and pancreatic duct stones]. Among 2422 individuals, 725 met inclusion. Univariate regression analysis indicated CAC was significantly linked to SLD, older age, male sex, and MS. Both SLD and fatty pancreas showed an association with CAC in individuals with and without MS (P < 0.001). Multivariate analysis demonstrated that CAC was independently associated with increasing age [OR: 1.18 (95% CI: 1.15-1.62), P < 0.001], male sex [OR: 3.12 (95% CI: 2.52-4.26), P < 0.001], MS [OR: 1.29 (95% CI: 1.25-2.45), P < 0.001], SLD [OR: 1.26 (95% CI: 1.12-2.42), P < 0.001], fatty pancreas [OR: 1.79 (95% CI: 1.19-1.98), P < 0.001], gallstones [OR: 1.82 (95% CI: 1.64-2.05), P < 0.001], choledocholithiasis [OR: 1.21 (95% CI: 1.19-2.62), P < 0.001], and pancreatic calcifications [OR: 1.74 (95% CI: 1.12-2.32), P < 0.001], regardless of MS. The CAC score is correlated with an increased prevalence of SLD, fatty pancreas, and other benign pancreaticobiliary conditions, independent of MS.

Traditional biomarkers like creatinine and estimated glomerular filtration rate (eGFR) often fail to detect early diabetic nephropathy. Proenkephalin A (PENK-A), a stable, kidney-specific peptide, has emerged as a potential alternative biomarker. This study aimed to evaluate serum PENK-A levels in diabetic nephropathy and their association with renal and clinical parameters. In this prospective cross-sectional study, PENK-A levels were compared between patients with type 2 diabetes and healthy controls. Biochemical variables were assessed, and receiver operating characteristic (ROC) analysis was used to determine diagnostic performance. Binary logistic regression was conducted to identify independent predictors of elevated PENK-A levels. A total of 120 participants (90 patients, 30 controls) were included. PENK-A levels were significantly higher in patients and correlated with lower eGFR, higher urea, and microalbuminuria. At a cut-off value of 2.25 pmol/L, PENK-A demonstrated moderate diagnostic accuracy (AUC = 0.702, p = 0.001), with high specificity (83.3%) and positive predictive value (90.6%). Logistic regression revealed an independent inverse association between PENK-A and HbA1c, while eGFR showed a borderline relationship. Serum PENK-A may serve as a supportive biomarker for renal dysfunction in diabetic nephropathy. Its relationship with HbA1c suggests possible links to metabolic stress. PENK-A could complement traditional markers, particularly in early detection or high-risk patients. Further longitudinal studies are warranted to confirm its prognostic value.

To investigate sex-specific associations between depot-specific adipose tissue distribution and prediabetes among U.S. adults. This cross-sectional analysis included 2993 adults from the 2011-2016 National Health and Nutrition Examination Survey. Android and gynoid fat percentages were measured using dual-energy X-ray absorptiometry. Sex-stratified multivariable logistic regression models were employed to assess these associations, adjusting for demographic, lifestyle, and metabolic covariates. Individuals with prediabetes had significantly higher android and gynoid fat percentages than normoglycemic controls in both sexes. After full adjustment, higher android fat was consistently associated with increased odds of prediabetes in both men [odds ratio (OR) = 1.044, 95% confidence interval (CI): 1.013-1.077] and women (OR = 1.052, 95% CI: 1.023-1.083). In contrast, higher gynoid fat was associated with reduced odds of prediabetes in women only (OR = 0.940, 95% CI: 0.910-0.972), with no significant association observed in men (OR = 0.965, 95% CI: 0.930-1.001). The association between regional adiposity and prediabetes is fundamentally modified by sex. While android fat is a uniform risk factor, gynoid fat appears to be protective, specifically in women. These findings underscore the necessity of sex-specific assessment of body fat distribution for early cardiometabolic risk stratification.

Pregnancy in teenagers and emerging adults is associated with an increased risk of adverse outcomes. Similarly, pregnancies complicated by pregestational and gestational diabetes mellitus (GDM) carry a higher risk of complications. However, limited data exist on the intersection of these two high-risk conditions. Our objective was to establish the prevalence of teenage and emerging adult pregnancies complicated by diabetes in a population-based cohort and compare outcomes to pregnancies uncomplicated by diabetes, noting a background prevalence of GDM of 8.1% and pregestational diabetes of 1.2% across all age groups in the United States. This is a retrospective cohort study conducted in Olmsted County, Minnesota, USA. It includes female residents aged ≤21 years with a pregnancy ICD-10 code between January 1, 2013, and December 31, 2022. The main outcome measures assessed include maternal characteristics and maternal and fetal pregnancy outcomes. A total of 1491 pregnancies in 1379 individuals were identified and included. In total, 68 (4.6%) pregnancies were complicated by diabetes: 51 (3.4%) with GDM and 17 (1.1%) with pregestational diabetes. In this study, pregnancies with diabetes had higher rates of adverse outcomes including cesarean delivery (GDM 29.4% vs. pregestational 60.0% vs. no diabetes 17.0%, P < 0.001), preeclampsia (GDM 15.7% vs. pregestational 40.0% vs. no diabetes 7.3%, P < 0.001), large-for-gestational-age neonates (GDM 13.7% vs. pre-existing 50.0% vs. no diabetes 5.8%, P < 0.001), and neonatal hypoglycemia (GDM 42.6% vs. pregestational 60.0% vs. no diabetes 13.3%, P < 0.001). The prevalence of pregestational diabetes in our teenage and emerging adult population is similar to that of the general pregnancy population; however, the prevalence of GDM is significantly lower. Overall, diabetes in teenage pregnancy is associated with an elevated risk of adverse maternal and neonatal outcomes. Future research should evaluate interventions aimed at reducing adverse pregnancy outcomes in this vulnerable population.

Metabolic syndrome (MetS) is a growing public health problem characterized by clustering of cardiometabolic risk factors and a chronic low-grade inflammatory state. Biomarkers such as Fetuin-A, YKL-40, and high-sensitivity C-reactive protein (hsCRP) have been implicated in insulin resistance, obesity, and atherosclerosis. Identifying accessible and cost-effective biomarkers that reflect the presence and severity of MetS may provide clinically relevant insight into metabolic burden. Therefore, this study aimed to evaluate whether inflammatory biomarkers are associated with the presence and dynamic severity of MetS. Forty-seven patients diagnosed with MetS according to National Cholesterol Education Program Adult Treatment Panel III criteria (≥3 components) and 23 healthy controls were included. Serum hsCRP, Fetuin-A, and YKL-40 levels were measured at baseline and after a 3-month follow-up. No pharmacological treatment was initiated; participants received standardized lifestyle modification advice. Associations between biomarker levels and MetS severity scores (range 3-5) were assessed using correlation analyses. Baseline serum Fetuin-A, YKL-40, and hsCRP levels were significantly higher in patients with MetS compared to controls (all P < 0.001). During follow-up, changes in MetS severity were positively correlated with changes in hsCRP (r = 0.844, P < 0.001), Fetuin-A (r = 0.918, P < 0.001), and YKL-40 (r = 0.913, P < 0.001). Sensitivity analysis using Kendall's tau-b confirmed robust monotonic associations (τ = 0.716-0.808, all P < 0.001). Fetuin-A and YKL-40 levels are strongly associated with both the presence and short-term changes in MetS severity. hsCRP appears to reflect longitudinal changes in metabolic burden. These findings suggest that selected inflammatory biomarkers may provide additional insight into the inflammatory and metabolic dynamics of MetS.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of global liver morbidity. Genetic variants, particularly in the patatin-like phospholipase domain-containing 3 (PNPLA3) gene, are critical determinants of metabolic traits and disease progression. This study presents the first meta-analysis to clarify the association between the PNPLA3 rs2896019 polymorphism and MASLD susceptibility and severity. We systematically searched PubMed, Embase, Web of Science, and Google Scholar for relevant articles published up to February 12, 2026. Data were extracted, and summary estimates of the association between PNPLA3 rs2896019 and MASLD were assessed. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to measure the effect. Ten eligible case-control cohorts involving 15,028 participants (3118 cases and 11,910 controls) were included. Our results demonstrated that the G allele is significantly associated with a 51% increased risk of MASLD (OR: 1.5, CI: 1.23-1.85, P < 0.0001). A clear gene-dose effect was observed, with risks escalating in the homozygous model (OR: 2.32, 95% CI: 1.53-3.53, P < 0.0001). Subgroup analysis revealed that diagnostic modality was the primary source of heterogeneity, whereby restricting the analysis to biopsy-proven cohorts eliminated heterogeneity (I2 = 0%) and strengthened the association (OR = 1.91). Furthermore, the G allele significantly increased the risk of severe MASLD/MASH (OR = 2.06) compared to mild steatosis (OR = 1.40). In conclusion, the PNPLA3 rs2896019 G allele is a robust, dose-dependent risk factor for both the development and severe progression of MASLD.