Diabetes mellitus is strongly linked to a heightened risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is increasingly utilized as a surrogate marker of atherosclerosis and cardiovascular disease risk. This study aimed to evaluate CIMT through high-resolution ultrasonography in adults with Type 2 diabetes and assess its potential association with selected clinical factors within a native Black African population. An analytical cross-sectional study was conducted between November 2022 and February 2023 at the Diabetic Clinic of Mulago National Referral Hospital, Kampala, Uganda. One hundred normotensive adults with Type 2 diabetes were enrolled by consecutive sampling. CIMT was measured bilaterally at the common carotid artery using high-resolution Doppler ultrasonography. Clinical variables collected included age, sex, body mass index (BMI), glycated haemoglobin (HbA1c), fasting lipid profile, and diabetes duration. Multivariable Poisson regression with robust standard errors was used to estimate adjusted prevalence ratios (aPR). The mean age was 52.4 years (SD 11.2) and 62% of participants were female. The median diabetes duration was 10.0 years and the median HbA1c was 9.9% (IQR 7.8-10.9). Abnormal CIMT (> 0.9mm) was found in 61% (61/100) of participants. On multivariable analysis, independent predictors of abnormal CIMT included age > 45 years (aPR 1.17, 95% CI 1.08-1.28), high LDL cholesterol (aPR 1.20, 95% CI 1.07-1.36), poor or very poor glycemic control (HbA1c > 8%; aPR 1.16, 95% CI 1.01-1.32), and diabetes treatment duration > 9 years (aPR 1.11, 95% CI 1.01-1.21). Among normotensive Ugandan adults with Type 2 diabetes, 61% had increased CIMT. Independent predictors were older age, poor glycemic control, high LDL cholesterol, and longer disease duration. CIMT assessment offers a simple, non-invasive adjunct for identifying subclinical atherosclerosis and may improve cardiovascular risk stratification in this population.

To investigate the association between the cardiometabolic risk factors cluster (CRFC) and all-cause mortality in type 2 diabetes (T2D). Data from the Zhejiang Rural T2D Cohort (2016-2024) included 10,310 participants. Four cardiometabolic risk factors (CRFs) were evaluated: central obesity, elevated blood pressure, high triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C). After adjusting for confounders, multivariate Cox regression models were constructed to estimate hazard ratios (HRs). A Total CRFs Score (TCRFS), weighted by regression coefficients of individual CRFs, was stratified into four groups based on quartiles (<P25, P25-P50, P50-P75, and ≥P75). The TCRFS and TCRFS-based groupings were analyzed for associations with all-cause mortality, including age- and sex-stratified analyses. Participants had a mean age of 63.54 ± 9.77 years, with the most prevalent CRFs being elevated blood pressure (86.97%), followed by elevated TG (41.21%), low HDL-C (38.71%), and central obesity (32.96%). Over a mean 8.12 ± 1.71 years of follow-up, 1,770 deaths occurred (death density: 211.21/10,000 person-years). No single CRF, except for TG, showed a significant association with all-cause mortality, whereas the TCRFS was a significant predictor (HR = 2.719, 95%CI (1.360, 5.437), p = 0.005). Furthermore, participants in the highest TCRFS quartile (≥P75) had a significantly higher mortality risk compared to those in the lowest quartile (<P25) (HR = 1.155, 95% CI: 1.030-1.294, P = 0.013). CRFC is significantly associated with increased all-cause mortality risk in T2D patients. Early comprehensive assessment and intervention for cardiometabolic risk factors may reduce mortality in this population.

High-density lipoprotein cholesterol (HDL-C) has been inversely associated with atherosclerotic cardiovascular disease (ASCVD) risk. This relationship is the foundation of the "HDL hypothesis," which states that increasing plasma HDL-C levels would result in a decrease in cardiovascular events. The recent surge in clinical testing of cholesteryl ester transfer protein (CETP) inhibitors provides valuable data for this hypothesis. The CETP inhibitors increase plasma HDL-C along with variable effects on low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB). The clinical outcomes of randomized controlled trials were heterogeneous, with several studies showing either neutral or adverse clinical outcomes despite robust increases in HDL-C values. These observations along with Mendelian randomization studies suggest that low HDL-C is a risk marker, not a causal mediator of ASCVD. New evidence points to HDL functionality, specifically cholesterol efflux potential and particle composition, instead of HDL-C concentration as a more relevant determinant of ASCVD risk. The favorable clinical outcomes observed with certain CETP inhibitors are more consistently explained by reductions in apoB-containing lipoproteins (including LDL-C and non-HDL-C), rather than increases in HDL-C itself. This distinction reframes the HDL hypothesis where HDL-C is merely a biomarker of ASCVD while apoB-containing lipoproteins are the more plausible causal treatment pathway. These findings have shifted the focus of the HDL hypothesis from the "quantity" to the "quality" of HDL.

To investigate associations between prepregnancy cardiometabolic risk factors and early childhood weight status, independent of genetic susceptibility. The ancillary study of the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) included 227 dyads consisting of Hispanic/Latina mothers who had singleton live births between baseline and visit 2 and their children, aged 3-9 years. Child outcomes included body mass index (BMI) z-scores, and weight status categories. Maternal prepregnancy biomarkers included fasting triglycerides, high-density lipoprotein cholesterol (HDL-C), glucose, insulin, blood pressure, BMI, and waist circumference. Child DNA was used to calculate a polygenic risk score for obesity. Linear and logistic regression models adjusted for confounders and child genetic risk. On average, 10.9 years elapsed between maternal baseline assessment and child anthropometry. At baseline, 4.8% of women reported having diabetes or hypertension, one-third had obesity (BMI 30 or higher), and more than half had elevated waist circumference or low HDL-C. Among children (mean age 7.5 years), 17.2% were categorized as having overweight and 27.8% were categorized as having obesity. Higher maternal BMI, larger waist circumference, and higher fasting insulin and diastolic blood pressure were significantly associated with higher child BMI z-scores. A 1-SD increase in maternal BMI (6.1 units) or waist circumference (13.3 cm) was linked to greater odds of child overweight or obesity. Elevated maternal insulin was associated with having a child with overweight status, and higher diastolic blood pressure with having a child in the obesity category in minimally adjusted models. Prepregnancy cardiometabolic risk factors in Hispanic/Latina women are associated with higher BMI and obesity risk in their children, independent of genetic predisposition. These findings highlight the prepregnancy period as a critical window for interventions to improve intergenerational health outcomes.

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder with a risk of progression to multiple myeloma. Metabolic syndrome (MetS) is implicated in cancer development, yet its association with MGUS remains unclear. We examined MetS as a risk factor for MGUS in a large Korean cohort. In a retrospective cohort study using the National Health Information Database, we analyzed 4,453,504 adults undergoing health checkups in 2012, followed through up to 2022. MetS was defined by NCEP-ATP III criteria. Over a median 9.3-year follow-up, 1,241 MGUS cases were identified. MetS was associated with a 28% increased MGUS risk (hazard ratio [HR]=1.28; 95% confidence interval [CI]: 1.14- 1.44). Risk escalated with more MetS components, peaking at 76% for five components (HR=1.76; 95% CI: 1.35-2.30). Low high-density lipoprotein cholesterol, hypertension, and central obesity were key risk factors, with higher risks in males and younger adults (range, 20-39 years). Longitudinal analysis showed MetS onset (HR=1.25; 95% CI: 1.06-1.47) or persistence (HR=1.25; 95% CI: 1.06-1.48) increased MGUS risk compared to persistent MetS absence, whereas MetS resolution showed no significant risk increase over persistent MetS absence. MetS increases MGUS risk, particularly in males and younger individuals. Resolving MetS may mitigate MGUS risk, supporting targeted metabolic interventions.

Inverse association between circulating hexosylceramides and cardiometabolic risk factors in adult women with overweight-obesity.

Obesity has reached epidemic proportions globally, with its prevalence nearly tripling since 1975. It is now recognized as a chronic, relapsing disease associated with increased morbidity and mortality due to its strong relationship with several cardio-renal-metabolic conditions. This narrative review aims to explore the major obesity-related complications - namely obstructive sleep apnea syndrome (OSAS), metabolic dysfunction-associated steatotic liver disease (MASLD), dyslipidemia, and chronic kidney disease (CKD) - highlighting their pathophysiological mechanisms, clinical consequences, and current therapeutic strategies. Obesity contributes to OSAS by increasing upper airway collapsibility and to MASLD through ectopic fat accumulation, insulin resistance, and inflammatory responses. Dyslipidemia in obesity is characterized by elevated triglycerides, small dense LDL particles, and low HDL-C, driven by chronic inflammation and insulin resistance. CKD progression, particularly obesity-related glomerulopathy (ORG), is also mediated by metabolic and hemodynamic derangements, including renin-angiotensin-aldosterone system activation and glomerular hyperfiltration. Therapeutic interventions such as lifestyle modification, pharmacological therapy - including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is) - and bariatric surgery have shown efficacy not only in promoting weight loss but also in improving the clinical course of these obesity-related conditions. In particular, Very Low Energy Ketogenic Therapy (VLEKT) is emerging as a promising approach in improving metabolic parameters, hepatic steatosis, and cardiovascular risk factors. A comprehensive and multidisciplinary approach to obesity is essential, focusing not only on weight loss but also on mitigating associated complications. Effective management can significantly improve patients' quality of life and reduce the long-term burden of obesity on healthcare systems.

Objectives. To examine associations of ultraprocessed foods (UPFs, defined by Nova) with cardiometabolic risk factors, prevalent conditions, and mortality, before and after comprehensively adjusting for nutritional quality. Methods. We analyzed data from 47 999 adults in the National Health and Nutrition Examination Survey (NHANES)1999-2018. Survey-weighted, multivariable adjusted linear or logistic regression evaluated cross-sectional associations with risk factors and disease prevalence, and Cox models evaluated prospective associations with all-cause mortality. Models were compared before and after adjustment for each individual's Food Compass Score (i.FCS) to test independence from nutritional quality. Results. Every 10% of energy supplied from UPFs was associated with higher body mass index, HbA1c, diastolic blood pressure, total-to-high-density lipoprotein cholesterol (HDL-C); lower HDL-C and low-density lipoprotein cholesterol (LDL-C); greater prevalence of metabolic syndrome (odds ratio [OR] = 1.07; 95% confidence interval [CI] = 1.05, 1.09), diabetes (OR = 1.03; 95% CI = 1.00, 1.07), and cancer (OR = 1.05; 95% CI = 1.02, 1.08); and higher risk of all-cause mortality (hazard ratio = 1.04; 95% CI = 1.02, 1.07). When we adjusted for i.FCS, associations were only partly attenuated, remaining significant. By comparison, adjustment for saturated fat, added sugar, or sodium had little effect. Findings were consistent in population subgroups, except for stronger associations among lower-income adults. Conclusions. UPF consumption is associated with adverse risk factors, disease conditions, and all-cause mortality, only partly explained by nutritional quality. (Am J Public Health. 2026;116(7):1015-1024. https://doi.org/10.2105/AJPH.2026.308499).

High LDL-cholesterol in children and adolescents with type 1 diabetes: the impact of body adiposity and sex.

Abdominal obesity, measured by waist-to-hip ratio, is an independent, potent risk factor for Ischemic Stroke. Risk of stroke can be minimized through primordial prevention. The study was conducted to assess the high waist hip ratio as a risk factor for Ischemic Stroke. A case control study was conducted with IRB approval in the department of Medicine and Neurology, Mymensingh Medical College Hospital for a period of six months with 100 admitted Ischaemic Stroke cases selected purposively following inclusion and exclusion criteria with equal number of age-sex matched pair controls from patients' relatives, hospital staffs and admitted patients other than Ischaemic Stroke. Waist-hip ratio was calculated by dividing the waist circumference with the hip circumference. Socio-demographic, clinical, biochemical and haematological data were collected as well. Informed written consent was obtained from the participants or their guardians/attendants for interview, physical measurements and taking blood samples for biochemical examinations. Data were collected by principal investigator using case record form and interview schedule. All the relevant ethical issues and measures for data quality were taken into consideration. Data were analyzed by using SPSS version-17.0, and presented in tables and figures. Mean age of the cases and controls was 63.4±2.0 years with a male-female ratio of 3:2. Of cases, 35(35.0%) were house-wives and 32(32.0%) were Farmers, while of controls, 40(40.0%) were house-wives and 23(23.0%) were farmers. Left hemisphere 58(58.0%), and cerebral cortex 48(48.0%) were commonly involved areas of the brain. Hemiplegia (57.0%) and hemi-paresis (31.0%) were commonplace with exacerbated ankle jerk (60.0%) and extension planter response (55.0%). As many as 12(12.0%) cases and 16(16.0%) controls were diabetic (p>0.05) with 7(7.0%) cases and 1(1.0%) control had past history of Ischemic Heart Disease (p<0.05). 59(59.0%) cases and 33(33.0%) controls had Systolic Hypertension (p<0.001), while 48(48.0%) cases and 21(21.0%) controls had Diastolic Hypertension (p<0.0001). Seventy-five (75.0%) cases and 30(30.0%) controls had high waist-hip ratio (p<0.001). At least 39(39.0%) cases and 37(37.0%) controls had high total cholesterol level (p>0.05), whereas 52(52.0%) cases and 30(30.0%) controls had low HDL cholesterol level (p<0.0001), 54(54.0%) cases and 46(46.0%) controls had high LDL cholesterol level (p>0.05) and 63(63.0%) cases and 37(37.0%) controls had high triglyceride level (p>0.05). Waist-hip ratio is high among cases with high statistical significance. A significant number of cases and controls are with total cholesterol and high LDL, low HDL and high TG levels.

The Amazonian diet and its association with metabolic syndrome in adolescents: Insights from the ERICA study.

Evidence linking serum ferritin (SF) with metabolic syndrome (MetS) remains inconsistent by sex. Data from Latin American populations are lacking, and adults free of cardiometabolic disease remain understudied. We examined whether SF was independently associated with MetS (harmonized definition) in adults from Cali, Colombia. In this cross-sectional study of 245 adults (123 women) without type 2 diabetes or cardiovascular disease, SF was the exposure, and outcomes included categorical MetS, a continuous MetS z-score, individual MetS components, and total and LDL cholesterol (LDL-C). Sex-stratified logistic and linear regressions were performed, unadjusted and progressively adjusted for age, lifestyle factors, C-reactive protein, and BMI. MetS prevalence was 24.6% in men and 12.2% in women; overweight/obesity prevalence was 64.1% (men 68.9%, women 59.3%). In men, each 1-SD increase in SF was associated with a higher MetS z-score across models (β [95% CI] 0.82 [0.39–1.26]; p < 0.001), whereas the association with categorical MetS was attenuated after adjustment for C-reactive protein and BMI. In women, SF was not independently associated with MetS. By components, higher SF related to higher fasting glucose and triglycerides in men, and to lower HDL-C in both sexes. SF was associated with LDL-C only in women. In men, SF increased with the number of MetS components, including one or two versus none (p = 0.043). In conclusion, in this Latin American sample free of cardiometabolic disease, SF was positively associated with MetS score in men, but not in women, among whom SF was consistently linked to LDL-C.

The incidence of colorectal cancer (CRC) continues to rise, with colorectal adenoma(CRA) being its primary precancerous lesion. Recent studies suggest that hyperlipidemia may promote adenoma development by influencing cell membrane structure, cholesterol metabolism, and inflammatory responses. However, its independent role in the adenoma stage remains unclear. To investigate the association between hyperlipidemia and colorectal adenoma(CRA) risk and to evaluate the dose-response relationship based on lipoprotein profile stratification. This single-center retrospective case-control study included 180 patients with colorectal adenoma(CRA) and 80 colonoscopy-negative controls. An additional 80 patients with pathologically confirmed colorectal adenocarcinoma (CRAC) were included as a secondary exploratory comparison group. Demographic characteristics and lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), were collected. Univariate and multivariable unconditional logistic regression analyses were performed to evaluate associations between lipid abnormalities and colorectal adenoma, with adjustment for age, sex, BMI, smoking, alcohol consumption, and family history of colorectal cancer. Variance inflation factors were calculated to assess multicollinearity. Quartile stratification and restricted cubic spline models were used to explore dose-response patterns, and E-value analysis was performed to assess the potential impact of unmeasured confounding. High TC, high TG, high LDL-C, and low HDL-C were significantly associated with the overall presence of CRA in univariate analysis. After adjustment for potential confounders, these associations remained statistically significant. Quartile stratification showed that higher levels of TC, TG, and LDL-C were associated with progressively higher odds of colorectal adenoma, whereas HDL-C showed an inverse association. The RCS models suggested steeper increases in adenoma odds at higher TC and LDL-C levels, while HDL-C showed an approximately linear inverse association. Although high TG was associated with overall adenoma occurrence, TG levels did not differ significantly across adenoma histological subtypes. Subgroup analyses suggested that smoking, obesity, and family history may modify the associations between dyslipidemia and colorectal adenoma. Hyperlipidemia was independently associated with CRA in this retrospective case-control study. A comprehensive dyslipidemic pattern, characterized by elevated TC, TG, and LDL-C and reduced HDL-C, was observed among patients with CRA. Lipoprotein profiles may serve as accessible clinical indicators for colorectal adenoma risk stratification. However, because of the retrospective case-control design, causal inference and temporal relationships cannot be established, and the possibility of reverse causality should be considered.

Beyond low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C) is a residual risk factor for atherosclerotic cardiovascular disease. However, whether sdLDL-C levels can predict the development of chronic kidney disease remains unclear. We investigated the association between the sdLDL-C level calculated using Sampson's equation and the progression of renal impairment in 16,814 Japanese individuals (10,806 men, 6,008 women; mean age: 47 years) who underwent annual health checkups. Participants were divided into 4 groups according to high (H) or low (L) sdLDL-C and LDL-C levels. Over a 10-year follow-up period, 2,533 participants progressed renal impairment, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2or positive for urine protein. Cox proportional hazards model with a restricted cubic spline after adjustment for confounders showed a gradual increase in the hazard ratio (HR) for renal impairment with high levels of sdLDL-C. Compared with the L-sdLDL-C/L-LDL-C group (reference) the adjusted HRs for renal impairment were significantly higher in the H-sdLDL-C/H-LDL-C and H-sdLDL-C/L-LDL-C groups (1.13 [95% confidence interval 1.03-1.25] and 1.15 [95% confidence interval 1.03-1.29], respectively). The addition of a high sdLDL-C level (≥35.7 mg/dL) to traditional risk factors significantly improved the discriminatory capacity for renal impairment. A high calculated sdLDL-C level was an independent predictor for the progression of renal impairment regardless of LDL-C level in a general Japanese population.

Ultra-processed food intake and its associations with atherogenic dyslipidemia, glycemic control, and gut microbiome features in adults with type 1 diabetes from Southern Italy.

Niemann-Pick disease type C (NPC) is a lysosomal lipid trafficking disorder characterized by impaired intracellular cholesterol transport, resulting in progressive neurovisceral involvement. While neurological progression has been extensively described, metabolic biomarkers and lipid abnormalities may provide earlier diagnostic clues, particularly in high-consanguinity populations. We retrospectively evaluated 14 genetically confirmed NPC patients followed at a tertiary pediatric metabolic center between 2018 and 2025. Clinical presentation, biochemical parameters including HDL cholesterol and lysosphingolipids (LysoSM, LysoSM-509), neuroimaging findings, and molecular genetic results were systematically reviewed. The cohort (eight males, six females; age range: 9days-24 years) demonstrated marked phenotypic heterogeneity, including neonatal cholestasis (29 %), pulmonary-dominant disease (29 %), juvenile neurodegeneration (64 %), psychiatric-onset presentation (14 %), and inflammatory bowel disease-like colitis. Low HDL cholesterol was observed in 86 % of patients. LysoSM-509 was elevated in all cases, irrespective of phenotype, supporting its diagnostic robustness. Eleven patients carried NPC1 variants and three carried NPC2 variants, including several novel truncating pathogenic variants. Marked intrafamilial variability was observed among siblings with identical genotypes. Miglustat treatment appeared to be associated with clinical stabilization in some patients, particularly when initiated at earlier stages of neurological involvement; however, given the limited sample size, no definitive conclusions can bedrawn. NPC should be considered across a broad clinical spectrum, ranging from prenatal presentations such as non-immune hydrops fetalis to adult-onset psychiatric manifestations, as well as neurological involvement at all ages. It should also be suspected in patients presenting with cholestasis, hepatosplenomegaly, developmental delay, interstitial lung disease, or treatment-refractory IBD-like colitis. LysoSM-509 is a highly sensitive biomarker across phenotypes. High consanguinity facilitates early cascade screening but also reveals substantial genotype-phenotype variability. Early biomarker-driven testing remains critical for timely diagnosis and management.

Metabolic dysfunction is an important contributor to stroke burden and may also help identify individuals at higher future risk of stroke. However, the population-level burden attributable to major metabolic risks and the individual-level predictive value of lipid-glucose metabolic biomarkers have not been well characterized within a complementary analytical framework. This study assessed temporal trends in stroke burden attributable to high FPG and high LDL-C in China and compared the prognostic performance of lipid-glucose metabolic biomarkers for incident stroke. GBD 2023 estimates were used to evaluate stroke burden attributable to high FPG and high LDL-C in China from 1990 to 2023. Individual-level analyses were conducted in CHARLS (2011-2020) as the discovery cohort and HRS (2016-2022) as an external-validation cohort. Network and correlation analyses were used to describe interrelationships among predictors. Cox proportional hazards models were applied to assess associations between biomarkers and incident stroke, with component-aware covariate adjustment and FDR correction. Machine-learning models with SHAP interpretation were used to evaluate predictor contribution. The incremental predictive value of eGDR was further assessed by adding it to conventional clinical risk models, with evaluation of discrimination, calibration, and decision-curve performance. From 1990 to 2023, age-standardized mortality and DALY rates for stroke attributable to high FPG and high LDL-C declined in China, whereas the absolute burden remained substantial. In 2023, high FPG accounted for 216.80 thousand stroke deaths and 4,378.51 thousand DALYs, while high LDL-C accounted for 233.09 thousand deaths and 5,642.72 thousand DALYs. In CHARLS, eGDR showed a consistent inverse association with stroke risk and ranked as the leading predictor in SHAP analyses. Similar patterns were observed in HRS. Adding eGDR to conventional clinical risk models modestly improved discrimination and reclassification in both cohorts, with AUC improvements of 0.017-0.025 in CHARLS and 0.009-0.013 in HRS. Age-standardized stroke burden attributable to high FPG and high LDL-C in China has declined, but the absolute burden remains substantial. eGDR showed consistent associations with incident stroke and modest incremental predictive value across CHARLS and HRS, supporting its potential relevance for future stroke risk-stratification research.

BACKGROUND Lupus nephritis (LN) is a significant cause of kidney morbidity in patients with systemic lupus erythematosus. While glomerular lesions are the primary focus of current classifications, tubulointerstitial involvement may significantly influence renal outcomes. There is limited data on tubulointerstitial inflammation (TII) and tubulointerstitial damage (TID) in Middle Eastern populations. AIM To examine the clinical, pathological, and prognostic significance of coexisting TII and TID in patients with biopsy-proven LN from Saudi Arabia. METHODS We retrospectively analyzed 100 patients with biopsy-confirmed LN. Patients were stratified into those with TII + TID (n = 48) and those without (n = 52). Baseline demographics, clinical features, laboratory and immunological data, and histopathological findings, including modified National Institutes of Health (NIH) activity and chronicity scores, were collected. Multivariable logistic regression identified predictors of TII + TID. Renal response during follow-up was evaluated using Kaplan-Meier analysis, and predictors of adverse composite outcomes were assessed using Cox regression. RESULTS Patients with TII + TID had lower baseline estimated glomerular filtration rate (77.7 ± 37.4 mL/minute/1.73 m2 vs 98.2 ± 52.7 mL/minute/1.73 m2; P = 0.028) and higher low-density lipoprotein cholesterol (LDL-C; 3.01 ± 1.88 mmol/L vs 1.78 ± 1.82 mmol/L; P = 0.006). They also had higher modified NIH activity (6.17 ± 3.90 vs 3.13 ± 3.18; P &lt; 0.001) and chronicity scores (4.21 ± 1.74 vs 1.85 ± 2.44; P &lt; 0.001). Proliferative classes, especially class III (35.4% vs 15.4%) and class IV + V (20.8% vs 15.4%; P = 0.024), were more common in this group. Independent predictors of TII + TID included class III (OR = 150.42; P = 0.006), class IV + V (OR = 44.11; P = 0.03), LDL-C (OR = 2.26; P = 0.004), fibrinoid necrosis [Exp(B) = 2.29; P = 0.041], and interstitial inflammation [Exp(B) = 73.29; P &lt; 0.001]. Patients with TII + TID had slower and reduced rates of achieving renal remission. Higher baseline serum creatinine, older age, elevated C-reactive protein (CRP), and the presence of hyaline deposits were associated with worse composite renal outcomes. In contrast, total glomerulosclerosis showed an inverse association in the subgroup but not in the overall cohort. CONCLUSION TII and damage are common in LN and are closely associated with proliferative glomerular lesions, fibrinoid necrosis, and adverse renal outcomes. The presence of TII + TID, along with baseline creatinine, CRP, and hyaline deposits, identifies patients at higher risk for poor renal prognosis. These findings highlight the importance of evaluating the tubulointerstitial compartment for risk stratification and tailored management in LN, particularly in the Saudi Arabian population.

Investigation of dietary patterns provides an integrative model for examining the role of diet in chronic diseases. In this context, this study evaluated dietary patterns and their association with metabolic syndrome (MetS) and its components among quilombola women. A population-based cross-sectional study was conducted with women aged 19 to 59 years living in quilombola communities in Alagoas, Brazil. Socioeconomic, demographic, anthropometric, clinical, and dietary intake data were collected using a 24-hour dietary recall. Metabolic syndrome was defined according to the Joint Interim Statement criteria (abdominal obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, and hyperglycemia assessed by HbA1c instead of fasting plasma glucose). Dietary patterns were identified by factor analysis and classified into quartiles. Associations were estimated using prevalence ratios obtained by Poisson regression with robust variance. The sample included 895 women (mean age: 38.9 ± 11.0 years), of whom 48.3% had MetS. Seven dietary patterns were identified, none of which were associated with MetS. Moderate adherence to the "meat and beans" pattern was associated with a lower prevalence of hypertriglyceridemia (PR = 0.76; 95% CI: 0.58-0.99). The "dairy and soups" pattern was associated with a lower prevalence of hyperglycemia (PR = 0.68; 95% CI: 0.49-0.93) and low HDL cholesterol (PR = 0.89; 95% CI: 0.80-0.99). Higher adherence to the "cereals/roots, oils, and infusions" pattern (PR = 1.10; 95% CI: 1.01-1.19) and higher adherence to the "fruits" pattern in the second quartile (Q2) (PR = 1.10; 95% CI: 1.02-1.20) were associated with abdominal obesity. No dietary pattern was directly associated with metabolic syndrome; however, relevant associations were observed with specific metabolic components - particularly hypertriglyceridemia, hyperglycemia, low HDL cholesterol, and abdominal obesity -, highlighting the importance of dietary profiles in the metabolic health of quilombola women.

Poor glycemic control in type 2 diabetes mellitus (T2DM) is frequently associated with adverse lipid profiles, including elevated triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C). Lipid ratios, including TG/HDL-C (triglycerides/high-density lipoprotein cholesterol) and LDL-C/HDL-C (low-density/ high-density lipoprotein cholesterol), may serve as simple markers of insulin resistance and cardiometabolic risk. This study aimed to investigate the association between glycemic control and lipid parameters, including TG, HDL-C, and lipid ratios, in a Libyan cohort of T2DM patients. In this retrospective cross-sectional study, 363 T2DM patients (140 males, 223 females) aged 18 to 80 years attending a diabetic polyclinic in Benghazi between January 2022 and January 2024 were included. Clinical and biochemical data, including fasting lipid profiles and glycated hemoglobin (HbA1c), were extracted from patient records. Participants were classified according to glycemic control (HbA1c < 7% vs ≥7%). Associations between lipid parameters, lipid ratios, and glycemic control were assessed using multivariable logistic regression adjusted for age, sex, BMI, duration of diabetes, and statin use. Patients with uncontrolled HbA1c (≥7%) had significantly higher TG/HDL-C ratios (3.79 ± 2.52 vs 2.92 ± 2.42; P = .007) and LDL-C/HDL-C ratios (2.55 ± 1.30 vs 1.95 ± 1.05; P < .001) compared with those with controlled HbA1c. In multivariable logistic regression analysis, higher low-density lipoprotein cholesterol (LDL-C) levels were significantly associated with uncontrolled HbA1c (OR = 1.02; 95% CI: 1.01–1.03; P < .001). When lipid ratios were evaluated, the LDL-C/HDL-C ratio remained significantly associated with uncontrolled HbA1c (OR = 1.05; 95% CI: 1.02–1.09; P = .003). Lipid ratios, particularly LDL-C/HDL-C, were associated with poor glycemic control in type 2 diabetes mellitus; however, their clinical utility requires further validation in prospective studies. Integrated management of dyslipidemia and glycemic control is essential to reduce cardiovascular complications in this population.