Program of ipragliflozin for endothelial dysfunction in chronic kidney disease and type 2 diabetes: a multicenter, randomized-controlled, open-label trial - PROCEED

开始日期2020-03-26

申办/合作机构-

JPRN-jRCTs031190022

/ Completed临床4期IIT

Switching sitagliptin to ipragliflozin in obese patients with type 2 diabetes mellitus who have inadequate glycemic control with sitagliptin - IPRA-SWITCH

开始日期2019-06-24

申办/合作机构-

JPRN-UMIN000035555

/ RecruitingN/AIIT

Efficacy and Safety of SGLT2 Inhibitor Ipragliflozin in with Type 1 Diabetes patients using FGM - Efficacy and Safety of SGLT2 Inhibitor Ipragliflozin in with Type 1 Diabetes patients using FGM

开始日期2019-02-01

申办/合作机构-

100 项与伊格列净L-脯氨酸盐相关的临床结果

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100 项与伊格列净L-脯氨酸盐相关的转化医学

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100 项与伊格列净L-脯氨酸盐相关的专利（医药）

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项与伊格列净L-脯氨酸盐相关的文献（医药）

2025-11-01·AACE endocrinology and diabetes

Evaluating the Comparative Effectiveness of Sodium-Glucose Transporter 2 Inhibitors (SGLT-2i) on Liver Enzymes in Patients With Nonalcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Review

作者: Khalil, Ibrahim ; Hossain, Md Imran ; Akter, Mahmuda

Objective:

This study aimed to conduct the first network meta-analysis (NMA) comparing the effectiveness of sodium-glucose transporter 2 (SGLT-2) inhibitors-dapagliflozin, empagliflozin, and ipragliflozin-in improving liver-related and metabolic outcomes in patients with nonalcoholic fatty liver disease (NAFLD), utilizing a robust Bayesian NMA framework.

Methods:

We conducted a systematic review and Bayesian NMA of randomized controlled trials (RCTs) up to December 31, 2024, following Preferred Reporting Items for Systematic Reviews and Network Meta-Analyses guidelines. Databases (PubMed, Cochrane Library, Scopus, Embase) were searched for RCTs involving NAFLD patients (with or without type 2 diabetes) treated with SGLT-2 inhibitors versus placebo/standard treatments. Outcomes included alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, fibrosis-4 score, body weight, and fasting plasma glucose. A random-effects Bayesian NMA was performed using a Markov Chain Monte Carlo method, with treatments ranked via Surface Under the Cumulative Ranking Curve (SUCRA) scores.

Results:

Eleven RCTs (805 patients) were included. Dapagliflozin led in alanine aminotransferase (mean difference [MD]: -11.35 IU/L, 95% CrI: -18.39 to -4.19, SUCRA: 84.87%), aspartate aminotransferase (MD: -7.96 IU/L, 95% CrI: -15.69 to -0.18, SUCRA: 81.70%), and body weight reduction (MD: -3.60 kg, 95% CrI: -5.92 to -1.64, SUCRA: 88.88%). Ipragliflozin excelled in gamma-glutamyl transferase (MD: -15.19 IU/L, 95% CrI: -31.25 to -2.11, SUCRA: 81.35%) and fasting plasma glucose reduction (MD: -2.20 mmol/L, 95% CrI: -9.88 to 5.30, SUCRA: 59.79%). Empagliflozin topped fibrosis-4 score reduction (MD: -0.12, 95% CrI: -0.42 to 0.13, SUCRA: 73.27%).

Conclusion:

SGLT-2 inhibitors significantly improve liver and metabolic outcomes in NAFLD, with dapagliflozin, ipragliflozin, and empagliflozin offering distinct benefits, supporting personalized treatment strategies.

2025-11-01·Endocrinology, diabetes & metabolism

Effect of Oral Hypoglycaemic Agents on Carotid Artery Intima‐Media Thickness in Patients With Cardiovascular Disease and/or Diabetes—A Systematic Review

Review

作者: Shabu, Ali ; Hesari, Farshad ; Naqvi, Syed Mohammad ; Tawfick, Wael ; Naqvi, Syed Yaseen

ABSTRACT:

Introduction:

Atherosclerotic cardiovascular disease (ASCVD) is a global concern, with diabetes being a key risk factor. Preventive measures increasingly rely on surrogate markers, such as carotid artery intima‐media thickness (CIMT), a marker linked to ASCVD. Given the connection between dysglycaemia and ASCVD, the impact of oral hypoglycaemic agents (OHA) on CIMT is of interest. Despite the cardiovascular benefits of several OHAs, their effect on CIMT remains uncertain. This review aims to clarify the influence of OHAs on CIMT in patients with ASCVD and/or diabetes.

Objectives:

This systematic review aims to assess the effect of OHAs on CIMT in patients with ASCVD and/or diabetes mellitus (Type 1 or Type 2). We aim to provide evidence on the role of OHAs in reducing cardiovascular events in these high‐risk patients.

Methodology:

A systematic search of databases, including Cochrane, Embase, CINAHL, Scopus and PubMed, was conducted to identify relevant randomised controlled trials (RCTs). We analysed the efficacy and adverse effects of OHAs on CIMT in adults with diabetes and/or cardiovascular disease.

Results:

The initial search identified 629 studies, with 13 selected, involving 3849 participants. Pioglitazone showed effectiveness in slowing CIMT progression in two out of three studies. Repaglinide was effective in reducing CIMT and inflammation, while Rosiglitazone showed no significant effect. Metformin, Sitagliptin and Alogliptin studies yielded mixed results, with some showing reduced CIMT progression but increased gastrointestinal and hypoglycaemia risks. SGLT‐2 inhibitors Tofogliflozin and Ipragliflozin showed no significant CIMT reduction.

Conclusion:

The study suggests that prolonged use of Pioglitazone, Repaglinide and Alogliptin may significantly slow CIMT progression, improving cardiovascular risk management in patients with diabetes and/or cardiovascular disease. Further research is needed to understand the benefits and optimise oral hypoglycaemic treatment strategies for these patients.

2025-09-01·Annals of Medicine and Surgery

Comparative efficacy of sodium-glucose transporter 2 inhibitors on lipid profiles in nonalcoholic fatty liver disease (NAFLD): a comprehensive Bayesian network meta-analysis

Article

作者: Khalil, Ibrahim ; Al-Badri, Sajjad Ghanim ; Akter, Mahmuda ; Hossain, Md. Imran

Background::

Nonalcoholic fatty liver disease (NAFLD) is a global health concern associated with dyslipidemia, obesity, and type 2 diabetes mellitus (T2DM), necessitating effective therapeutic strategies. Sodium-glucose transporter 2 (SGLT-2) inhibitors have shown promise in improving metabolic parameters, but their comparative efficacy in NAFLD remains unclear.

Methods::

We systematically searched PubMed, Cochrane Library, Scopus, and Embase for randomized controlled trials (RCTs) up to 31 December 2024, involving NAFLD patients treated with SGLT-2 inhibitors versus placebo or standard treatments. Outcomes included changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, BMI, and HbA1c. A Bayesian NMA was performed using a random-effects model, with mean differences (MD) and 95% credible intervals (CrI) reported. Treatments were ranked using Surface Under the Cumulative Ranking Curve (SUCRA) scores.

Results::

We evaluated and compared the efficacy of SGLT-2 inhibitors in improving lipid profiles (LDL-C, HDL-C, total cholesterol, and triglycerides), BMI, and HbA1c in patients with NAFLD. Eleven RCTs involving 805 patients were included. Empagliflozin achieved the greatest LDL-C reduction (MD: −8.07 mg/dL, 95% CrI: −25.92 to 1.41; SUCRA: 95.38%), total cholesterol reduction (MD: −15.08 mg/dL, 95% CrI: −58.87 to 5.38; SUCRA: 94.32%), and HbA1c reduction (MD: −0.69%, 95% CrI: −1.52 to −0.06; SUCRA: 81.84%). Ipragliflozin non-significantly increased HDL-C (MD: 2.28 mg/dL, 95% CrI: −1.21 to 4.83; SUCRA: 85.11%) and significantly reduced triglyceride (MD: −22.39 mg/dL, 95% CrI: −39.25 to −7.27; SUCRA: 82.26%). Dapagliflozin resulted in significant BMI reduction (MD: −1.23 kg/m2, 95% CrI: −2.11 to −0.41; SUCRA: 73.28%).

Conclusion::

Empagliflozin and ipragliflozin demonstrated superior efficacy in improving lipid profiles, while dapagliflozin was most effective for BMI reduction in NAFLD patients. These findings align with their cardiovascular and metabolic benefits, offering a multifaceted approach to a complex disease. Further research is needed to confirm long-term effects and optimize treatment strategies for diverse NAFLD populations.

项与伊格列净L-脯氨酸盐相关的新闻（医药）

2026-01-26

·临床肝胆病杂志

指南推荐｜中国成人HIV感染合并代谢相关脂肪性肝病的管理专家共识

人类免疫缺陷病毒（HIV）感染及其导致的获得性免疫缺陷综合征（AIDS）是全球范围内严重威胁人类健康的重大公共卫生和社会问题。根据联合国艾滋病规划署（UNAIDS）的最新数据，截至2024年，全球约有4 080万HIV感染者，其中2024年新增感染人数约130万。随着联合抗逆转录病毒治疗（cART）的广泛应用，HIV/AIDS患者的生存期显著延长，慢性非艾滋病定义性疾病逐渐成为其主要健康负担。值得关注的是，肝病已成为HIV/AIDS患者的主要死因之一，在某些地区甚至超过心血管疾病。代谢相关脂肪性肝病（MASLD），过去称为非酒精性脂肪性肝病（NAFLD），已超越病毒性肝炎，成为HIV/AIDS患者中最常见的慢性肝病类型之一。MASLD不仅影响HIV/AIDS患者的肝脏健康，还显著增加心血管疾病、慢性肾病、恶性肿瘤及全因死亡的风险。近期，国内已更新MASLD的防治指南，为MASLD的诊疗提供了规范化依据。然而，现有指南主要面向一般人群，尚未充分考虑HIV/AIDS患者特有病理生理特征和治疗背景，在实际临床应用中存在一定局限性。具体而言，MASLD在HIV/AIDS患者中的临床认知仍显不足，相关的早期筛查、风险分层、评估工具与干预路径尚未形成标准化流程。此外，传统用于普通人群的无创诊断方法（如肝纤维化评分模型、瞬时弹性成像等），在HIV/AIDS患者人群中是否具有同等准确性和适用性，仍缺乏高质量证据支持。cART药物可能影响代谢状态与肝脂质积聚，进一步增加了MASLD在HIV/AIDS患者人群中表现的异质性和管理的复杂性。在此背景下，《中国成人人类免疫缺陷病毒（HIV）感染合并代谢相关脂肪性肝病的管理专家共识》（以下简称《共识》）聚焦HIV/AIDS患者合并MASLD的全程管理，旨在构建以循证医学为基础、兼顾HIV感染特殊性的诊疗框架。通过明确高危人群识别策略、规范多模态评估技术、制定个体化综合干预方案（涵盖cART方案调整、代谢共病管理及肝病靶向治疗），并推动感染科、肝病科、内分泌科等多学科协作，最终实现降低肝病进展风险、改善患者长期预后的核心目标。《共识》中提及的证据和推荐意见基本按照GRADE系统进行（表1）。 1相关术语脂肪性肝病（SLD）是指影像学表现为弥漫性脂肪肝，或病理学表现为以大泡或大泡为主的显著肝细胞脂肪变性为主要特征的、多因素复杂作用所致的高度异质性疾病。MASLD、酒精性肝病（ALD）、以及代谢与酒精相关性肝病（MetALD）是SLD最常见的病因。MASLD定义为肝脂肪变性（肝细胞内脂肪蓄积≥5%），同时合并至少1项代谢风险因素（表2），且排除其他明确致病因素。MASLD病谱包括以下4个逐渐进展的临床分型：（1）代谢相关脂肪肝（MASL）：MASLD的早期阶段，影像学或肝活检病理学证实肝脂肪变性累及≥5%的肝组织；（2）代谢相关脂肪性肝炎（MASH）：在肝脂肪变性基础上，病理学证实存在小叶内炎症和肝细胞气球样变性；（3）代谢相关脂肪性肝纤维化：MASLD患者出现F2～F3级肝纤维化；（4）代谢相关脂肪性肝硬化：MASLD患者进展至肝硬化阶段。 ALD是指长期饮酒导致的SLD，其诊断标准为女性每周酒精摄入量超过140 g，男性超过210 g。MetALD是新提出的临床亚型，指在满足MASLD诊断标准的基础上，酒精摄入量介于女性每日20～50 g、男性每日30～60 g之间，但尚未达到ALD的诊断标准。尽管MetALD与MASLD具有相似的心血管代谢风险因素患病率，但研究表明，MetALD患者的全因死亡风险更高，提示其为预后较差的独立疾病亚型。因此，MASLD的诊疗建议并不能直接适用于MetALD人群。除了ALD和MetALD，其他因素如某些药物（包括糖皮质激素、他莫昔芬和胺碘酮等）、基因3型HCV感染、肝豆状核变性、脂肪代谢紊乱（如cART药物引起的脂肪重分布）、妊娠及营养不良等，也可能导致脂肪肝的发生。值得注意的是，正如其他肝脏疾病一样，SLD的多重病因可同时存在于同一个体，且这些因素可能会影响病程的发展和治疗反应。特别是，MASLD可能加速ALD和慢性乙型肝炎患者肝病的进展，并协同诱导肝硬化或肝细胞癌的发生。 2流行病学流行病学调查数据显示，超过95%的NAFLD患者也符合MASLD诊断标准，因此关于NAFLD的流行病学数据亦适用于MASLD。营养过剩及运动过少导致肥胖、代谢综合征、以及2型糖尿病（T2DM），是MASLD的主要传统风险因素。一项荟萃分析结果表明，HIV/AIDS患者汇总的NAFLD患病率为33.9%，显著肝纤维化为12%。在有肝活检的研究中，非酒精性脂肪性肝炎（NASH）的患病率为 48.77%，显著肝纤维化的患病率为23.34%。美国一项横断面研究发现，约50%的HIV/AIDS患者合并脂肪肝，其中NAFLD占90%。不过，在该项研究中NAFLD更多的传统风险因素［如T2DM和体重指数（BMI）］有关，而与cART和CD4细胞计数无关。欧洲HIV/AIDS患者队列中，约2/3的HIV/AIDS患者合并NAFLD，约10%合并进展性肝纤维化。该队列共发现了高CD4细胞计数、低高密度脂蛋白以及高甘油三酯血症等7个NAFLD的风险因素。最近一项来自覆盖中、低收入国家的横断面研究发现脂肪肝和肝纤维化的患病率分别为28.4%和7.6%。该研究中脂肪肝的风险因素除了包括超重/肥胖、T2DM以及血脂异常等传统风险因素外，也包括cART药物如司他夫定的长期暴露。来自荷兰的HIV/AIDS患者队列数据表明，脂肪肝的总体患病率为37.7%，在“瘦人”和超重/肥胖的HIV/AIDS患者人群中的患病率分别为19.7%和54.0%；肝纤维化的总体患病率为9.0%，在“瘦人”和超重/肥胖的HIV/AIDS患者人群中的患病率分别为5.9%和12.0%。在“瘦人”中，脂肪肝主要与HIV相关因素（如CD4细胞和CD8细胞计数，具体的cART药物）有关，然而在超重/肥胖的HIV/AIDS患者中，未观察到这些关联。国内上海地区一项主要针对接受cART的HIV/AIDS患者的流行病学调查显示，该人群MASLD患病率达34.9%。主要风险因素包括：转氨酶水平升高、总胆固醇增高以及腰围-身高比超标等代谢指标异常。北京协和医院的HIV/AIDS患者队列中，MAFLD的患病率超过50%；高CD4细胞计数、转氨酶水平升高以及超重/肥胖与MAFLD相关。南京地区的一项流行病学调查研究发现，HIV感染初治人群MASLD的患病率为29.8%；甘油三酯升高、高密度脂蛋白胆固醇降低以及肝脂肪变性指数评分增加是MASLD主要风险因素。国内一项多中心前瞻性队列研究显示，未经抗病毒治疗的HIV感染者代谢综合征患病率为16.9%。研究发现合并代谢综合征的患者更易出现多器官代谢异常，主要表现为肝酶异常和肾功能损害等，这一结果不仅证实了HIV/AIDS患者人群代谢紊乱的高发生率，更揭示了代谢综合征与MASLD之间的密切关联，为临床综合管理提供了重要依据。推荐意见1：MASLD是HIV/AIDS患者常见的慢性进展性肝病，应加强筛查和防治（B1）。推荐意见2：HIV/AIDS患者合并MASLD的风险评估需同时关注肥胖、T2DM、代谢综合征组分等传统代谢因素和cART相关因素（B1）。推荐意见3：HIV/AIDS患者合并肥胖、T2DM、代谢综合征组分、转氨酶增高等高风险因素，需筛查MASLD（B1）。 3HIV/AIDS患者人群合并MASLD预后当前关于HIV/AIDS患者合并MASLD的预后数据有限，主要证据来源于非HIV感染者。MASLD与心血管代谢因素相互影响，共同促进全身多系统器官代谢相关疾病的发病。MASLD的预后主要与心血管事件和非肝恶性肿瘤有关，合并进展期纤维化时肝脏相关事件（肝失代偿、肝细胞癌、肝移植或肝脏相关病死）显著增多。MASLD患者的非致死性心血管疾病［风险比（HR）=1.40］、冠心病［比值比（OR）=1.33］、心力衰竭（OR=1.5）、慢性肾病（HR=1.43）、T2DM（HR=2.19）及其相关糖尿病周围多发性神经病变（HR=2.48）以及阻塞性睡眠呼吸暂停（HR=2.22）的发病风险显著升高。相反，存在多种心血管代谢风险因素会显著增加肝损伤进展和发生重大不良肝脏结局的风险。在未通过肝活检诊断的NAFLD队列中，全因死亡率为12.60/1 000人年［95%置信区间（95%CI）：6.68/1 000人年～23.67/1 000人年］；心脏原因特异性死亡率为4.20/1 000人年（95%CI：1.34/1 000人年～7.05/1 000人年）；肝外癌症特异性死亡率为2.83/1 000人年（95%CI：0.78/1 000人年～4.88/1 000人年）；肝脏特异性死亡率为0.92/1 000人年（95%CI：0.00/1 000人年～2.21/1 000人年）。当存在NASH时，肝脏相关死亡率和总体死亡率分别为15.44（11.72～20.34）/1 000人年和25.6（6.3～103.8）/1 000人年。推荐意见4：HIV/AIDS患者合并MASLD时，需要同时监测肝脏相关并发症（如进展性肝纤维化、肝硬化和肝细胞癌）以及代谢相关并发症（如T2DM、心血管疾病、以及慢性肾脏疾病等）的发生发展情况（C1）。 4诊断与评估诊断MASLD需要排除过量饮酒（每周乙醇摄入量男性≥210 g，女性≥140 g）、基因3型HCV感染、以及肝豆状核变性等其他原因导致的脂肪肝，且需要至少合并1项心血管代谢风险因素（表2）。肝脂肪变性可通过组织病理学或影像学方法进行诊断，其中病理学诊断标准为≥5%肝细胞呈现大泡性或大泡为主性脂肪变，若同时存在肝细胞气球样变及小叶炎症则定义为MASH。尽管肝活检仍是MAFLD诊断和分期的金标准，能够准确评估肝细胞脂肪变性、气球样变、炎症程度和纤维化分期等重要病理特征，但其临床应用受到侵入性操作风险、较高成本和资源限制等因素的影响。因此，肝活检主要适用于特定临床场景：一是MASLD新药研发和无创检测技术的临床验证研究；二是当多种无创检测结果不一致或与临床表现不符时的鉴别诊断；三是合并多种肝损伤因素或存在不典型表现（如自身抗体阳性、持续肝酶异常等）的疑难病例评估；四是减重代谢手术前的综合评估。临床实践中需谨慎权衡肝活检的风险与获益，合理选择适应证。目前已开发出多种影像学技术用于评估肝组织的脂肪变性，主要包括B超检查、基于振动控制瞬时弹性成像（TE）的受控衰减参数（CAP）（FibroScan检测系统）和磁共振技术质子密度脂肪分数（MRI-PDFF）。腹部B超检查因其成本低廉且普及性高，目前是诊断肝脂肪变性的一线影像学手段。尽管B超检查在临床实践中应用广泛，但其对轻度脂肪变性的敏感性不足（尤其合并肥胖症患者），且仅能对脂肪变性严重程度进行半定量主观评估。CAP可以作为一个连续性反映肝脂肪变性的参数来评估和监测肝脂肪变性程度，其诊断轻（S1）、中（S2）和重度（S3）肝脂肪变性的最佳界值分别为248 dB/m、268 dB/m和294 dB/m。FibroTouch系统的超声衰减参数（UAP）与FibroScan的CAP值相近，UAP诊断S1、S2和S3的界值分别为244 dB/m、269 dB/m和296 dB/m。MRI-PDFF诊断脂肪肝的敏感性高于B超和CAP，然而其检测成本高、可及性低等缺点限制其推广应用。对于诊断MASLD的患者，需要进一步评估纤维化的程度。用于评估肝纤维化程度的非侵入性方法主要基于血液成分的检测或影像学检查，而后者多反映的是组织的力学特性。相较于单一肝酶指标，将血液检测结果与人体测量学数据相结合，能更准确地预测肝纤维化的程度。目前已开发出多种无创非侵入性评分工具，例如FIB-4评分、NAFLD纤维化评分（NFS）、天冬氨酸氨基转移酶与血小板比值指数（APRI）等，其中FIB-4评分是被验证最多、应用最广泛的一种，在识别低风险晚期纤维化患者方面优于其他评分方法。根据FIB-4界值（<1.3；>2.67）可以初步评估NAFLD患者进展期纤维化的低、中、高风险。FIB-4风险等级的变化（如从低风险<1.3上升至中风险1.3～2.67，再进一步至高风险>2.67）也可用于动态评估疾病的临床进展。基于TE的肝硬度检测（LSM）准确性优于FIB-4评分，但易收到非空腹状态、重度肥胖、血清谷丙转氨酶显著升高等因素的影响，LSM<8.0可初步排除进展性肝纤维化。研究表明，LSM和FIB-4诊断进展期纤维化的受试者操作特征曲线下面积（AUC）分别为0.85和0.76。采用双重临界值的标志物序贯检测策略可减少肝活检的需求。采用FIB-4分界值（<1.3；≥2.67）联合LSM分界值（<8.0；≥10.0 kPa）以排除或确认进展性肝纤维化的策略，其敏感度和特异度分别为66%和86%，约有33%的患者仍需依赖肝活检以明确最终诊断。而采用FIB-4分界值（<1.3；≥3.48）联合LSM分界值（<8.0；≥20.0 kPa）用于排除进展性肝纤维化或诊断肝硬化时，敏感度为38%，特异度为90%，仅有19%的患者需行肝活检。目前国内外指南推荐基于FIB-4和LSM对MASLD进行分级管理（图1）。注： 1）FIB-4阈值适用于年龄≤65岁者（年龄>65岁：FIB-4下限值为2.0分）；2）例如生活方式干预、合并症治疗（如胰高血糖素样肽-1受体激动剂）、减重手术；3）例如磁共振弹性成像、剪切波弹性成像、增强肝纤维化检测。Ⓐ和Ⓑ为可选方案，具体选择取决于患者病史、临床背景及当地医疗资源。图1 进展性肝纤维化和肝脏结局风险的无创评估策略推荐意见5：诊断MASLD基于以下3个标准：（1）影像学诊断脂肪肝和／或肝活检发现至少5％肝细胞大泡性脂肪变性；（2）存在1项及以上心血管代谢风险因素；（3）排除过量饮酒、营养不良、肝豆状核变性等可能导致脂肪肝的其他原因（Bl）。推荐意见6：超声显像是影像学诊断脂肪肝的首选方法（Bl）。推荐意见7：基于TE的CAP/UAP和LSM可以用脂肪肝和肝纤维化的无创诊断与评估（Bl）。推荐意见8：推荐联合FIB-4和TE对MASLD进行分级管理。采用FIB-4指数进行初筛；若存在纤维化疑虑或判定为高风险人群，则建议进一步采用TE进一步明确纤维化分期（B1）。推荐意见9：FIB-4>2.67或LSM≥8.0 kPa的患者需要肝病专科和AIDS专科共同管理（B1）。 5治疗 AIDS合并MASLD的管理需强调多学科协作，有效的管理依赖于感染科、肝病科、内分泌科、心血管内科、营养科及临床药学等多学科团队的深度协作。理想治疗方案不仅需有效改善肝脂肪沉积及损伤，更应同步干预与MASLD密切关联的代谢紊乱和心血管风险，同时需特别关注cART的代谢安全性优化。基于此，以饮食结构调整、体重控制及科学设计的运动方案为核心的生活方式干预始终是疾病管理的基石，且需同步优化cART方案，避免加剧胰岛素抵抗或脂质代谢紊乱的药物。这种多靶点干预模式通过改善胰岛素抵抗、调控脂质代谢稳态、减轻全身性炎症反应及精准cART药物选择，对肝内病理进程、HIV控制与肝外代谢-心血管结局产生协同获益。 5.1 综合生活方式干预生活方式干预及减重能够以剂量依赖的方式减少肝脂肪含量、缓解脂肪性肝炎、逆转肝纤维化，并有效提高患者的生活质量，减重幅度越大，获益越显著。一项采用组织学终点的严格干预性研究表明，体重降低5%以上可有效减少肝脂肪含量；降低7%～10%可显著改善肝脏炎症；而要实现肝纤维化的逆转，则通常需要减重达到或超过10%。MASLD患者即使是BMI正常也需适当减重。一项随机对照试验表明，一半的非肥胖的MASLD患者体重降低3%～5%即可实现MAFLD的缓解。在瘦型MASLD患者中，体重减轻与脂肪肝缓解之间同样存在剂量依赖关系。 5.1.1 饮食目前已有多种饮食方式被证实可帮助减重并改善MASLD相关代谢异常。低碳水化合物饮食与低脂饮食均有利于减少肝脂肪含量及改善相关生化指标。荟萃分析发现低碳水化合物饮食在改善肝脂肪含量方面优于低脂饮食。能量限制程度与患者体重下降和肝功能改善之间有量效关系。每天减少500～1 000 kcal能量有助于体重的逐渐下降以及肝脂肪变性的改善。地中海饮食因富含多不饱和脂肪酸、膳食纤维及抗氧化物质，不仅有助于降低肝脂肪含量，同时对心血管代谢健康具有额外益处。时间限制饮食（又称间歇性禁食）是一种新兴饮食干预方式，强调在特定时间窗口内摄入全部日常热量。一项荟萃分析表明，间歇性禁食可降低MASLD患者的体重，并改善其转氨酶水平、肝脂肪变性和肝纤维化程度。为了便于实施和长期坚持，制定饮食干预策略时应充分考虑患者的个体偏好、临床情况、文化背景及经济条件。 5.1.2 运动干预久坐行为已被证实是MASLD的独立风险因素。即使不伴随饮食干预或明显体重减轻，单纯通过运动也可有效减少MASLD患者的肝脂肪堆积。尽管高强度间歇训练所需的时间和能量投入通常更少，其在减少肝脂肪方面的效果与中等强度持续性运动相当。研究发现，阻力训练相比有氧训练更有利于减轻肝脂肪含量，但最优方式可能为二者的结合。每周150 min快走持续3个月以上可使MASLD患者肝脂肪含量降低30%以上。 5.1.3 行为干预建议HIV/AIDS患者避免吸烟、饮酒、熬夜、不规律进食、夜间进餐以及久坐等不良生活习惯。鼓励适量饮用咖啡以降低进展期肝病及肝细胞癌风险。此外，建议借助心理咨询师、康复师和数字健康平台协助患者持续改善生活方式。推荐意见10：调整生活方式和降低体重是AIDS合并MASLD患者治疗的基石（B1）。推荐意见11：对于合并MASLD的HIV/AIDS患者，建议优先选择地中海饮食模式，严格限制超加工食品（如高糖、高脂食品）及含糖饮料的摄入（B1）。推荐意见12：AIDS合并MASLD患者，应避免吸烟、饮酒以及久坐等不良行为（C1）。推荐意见13：AIDS并MASLD患者，应该尽可能增加体力活动，建议每周进行150～200 min中等强度的有氧运动，分为3～5次完成。个性化运动处方可以增加体育锻炼的安全性和治疗效果（Bl）。 5.2 肝病的管理目前针对MASH的药物仍旧是非常有限的。Resmetirom是一种口服活性、肝脏靶向的甲状腺激素受体激动剂，对β1受体具有高度选择性。一项针对非肝硬化性MASH的注册性Ⅲ期临床试验的结果证实Resmetirom治疗52周后肝脏炎症和纤维化得到改善。美国食品药品监督管理局已批准Resmetirom治疗合并显著纤维化的NASH。维生素E是一种脂溶性维生素，具有抗氧化、抗炎和抗凋亡特性。补充维生素E的应用能够改善肝脏的生化指标和组织病理学指标，但长期补充维生素E的风险（比如前列腺癌）仍有待评估。熊去氧胆酸是一种天然胆汁酸，具有广泛的肝脏保护作用，但其缺乏改善组织学炎症的证据。奥贝胆酸是一种口服合成的鹅去氧胆酸类似物，其作为法尼醇X受体激动剂的效力强于天然胆汁酸。尽管在临床实验中证实奥贝胆酸可以逆转纤维化，但瘙痒等不良反应发生率偏高，限制其在临床中的推广应用。临床常用的肝脏保护药物（如多烯磷脂酰胆碱、甘草酸类制剂、水飞蓟素、双环醇及还原型谷胱甘肽等）在改善NAFLD患者血清转氨酶等生化指标方面显示出一定疗效，但都无肝组织学获益的足够证据。 5.3 合并症的管理 MASLD患者常合并多种全身性代谢紊乱和心血管并发症，需通过多学科团队协作综合管理体重、血压、血脂及血糖等风险因素。管理这些合并症时，可以优先选择有潜在肝脏获益的药物；其中，T2DM治疗药物在这一领域的疗效证据正在快速积累。无论是否合并T2DM，过氧化物酶体增殖物激活受体γ激动剂吡格列酮均可改善MASLD患者的胰岛素抵抗、肝生化和组织学指标，但目前仍缺乏大样本随机对照试验的循证支持。多项研究报道了达格列净、恩格列净和卡格列净等钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）在降低肝脂肪含量、改善血清转氨酶水平以及无创性纤维化评分方面的获益。然而，但此类药物对肝脏炎症和纤维化的组织学改善作用仍缺乏充分证据。伊格列净（ipragliflozin）与托格列净（tofogliflozin）能够改善MASLD的肝脏病理学表现。然而，由于受试者数量有限，这一结论的可靠性仍需更大规模研究验证。小样本和非对照临床研究提示二甲双胍可改善肝生化指标和胰岛素抵抗，目前仍旧缺乏二甲双胍直接改善MASH患者肝组织学指标的证据。回顾性研究发现二甲双胍的长期使用可降低MASLD患者的全因死亡以及肝细胞癌发生率。胰高血糖素样肽-1受体激动剂（GLP-1RA）类药物的问世是T2DM管理的重大突破。在降低血糖的同时，GLP-1RA（代表性药物司美格鲁肽、利拉鲁肽）可以降低心血管事件风险、慢性肾脏疾病进展、减轻体重以及改善胰岛素抵抗。一项Ⅱ期随机对照试验表明，司美格鲁肽可以缓解MASH患者的肝脏炎症，但不能改善肝纤维化。最近一项在HIV/AIDS患者中开展的小样本、单臂、开放标签的临床研究证实，司美格鲁肽具有良好疗效和耐受性，能有效减少肝脂肪含量并改善代谢指标。司美格鲁肽也能降低HIV/AIDS患者的炎症指标。替尔泊肽是一种新型葡萄糖依赖性促胰岛素分泌多肽（GIP）/GLP-1RA双重激动剂。在近期一项针对合并中度或重度肝纤维化的MASH患者开展的Ⅱ期临床试验中，52周的替尔泊肽治疗显著促进了MASH的缓解。双受体激动剂司伏鲁肽（survodutide）的2期临床试验中同样发现该类药物可以有效缓解MASH。最后，也可以通过手术来控制体重。减重与代谢手术的机制是通过缩小胃容积和/或缩短小肠有效长度，以达到限制摄食量和/或减少营养吸收，从而减轻体重，此类手术同时可有效改善甚至缓解肥胖症相关疾病。对于18～70周岁的成年人，国内肥胖症诊疗指南推荐的手术适应证包括：（1）BMI≥32.5 kg/m2，或者BMI≥27.5 kg/m2 合并T2DM（无f论T2DM 内科治疗是否有效）；（2）BMI≥27.5 kg/m2且<32.5 kg/m2，内科减重无效，或者合并肥胖症相关其他疾病，内科治疗无效；（3）BMI ≥25.0 kg/m2且<27.5 kg/m2，且合并T2DM，内科强化治疗血糖控制不能达标，如进行手术治疗探索，需经伦理委员会正式批准研究方案，并充分知情同意。最近一项开放标签、多中心、随机对照试验发现，减重与代谢手术在治疗NASH方面比生活方式干预和优化药物治疗更有效。需注意的是，手术导致的胃容积减小、胃酸改变、胃肠动力变化、肠肝循环重构及胆汁酸代谢异常等系列生理改变，可能影响cART药物的药代动力学参数。一项小样本回顾性队列研究提示，对于接受稳定cART的HIV/AIDS患者，减重及代谢手术是一种有效的体重管理和血脂控制策略，且未发现其与不良病毒学结局存在明确关联。推荐意见14：针对AIDS合并MASLD患者常见的并发症，包括肥胖症、2型糖尿病、血脂异常、高血压及心血管疾病，建议由相关专科医师或全科医师规范管理（C1）。推荐意见15：AIDS合并MASLD患者中，T2DM的治疗优先选择GLP-1RA（或GIP/GLP-1RA双重激动）、SGLT-2抑制剂、吡格列酮、以及二甲双胍等对肝脏有潜在获益的药物（B1）。推荐意见16：AIDS合并MASLD患者中，若生活方式干预后BMI仍≥24.0 kg/m2，可选择GLP-1RA（或GIP/GLP-1RA双重激动）来控制体重（B1）。推荐意见17：符合减重与代谢手术标准的AIDS合并MASLD患者可以考虑应用代谢手术治疗MASH和纤维化（B2）。 5.4 cART方案优化 AIDS合并MASLD患者的cART需兼顾病毒学抑制、肝脏安全性及代谢优化。第一代核苷类逆转录酶抑制剂（NRTI）如扎西他滨、去羟肌苷、司他夫定和齐多夫定因线粒体毒性已停用，这类药物可导致乳酸堆积、脂质氧化障碍并促进肝脂肪变性。拉米夫定和恩曲他滨代谢影响较小，而替诺福韦二吡呋酯（TDF）在血脂和体重控制方面可能优于替诺福韦艾拉酚胺（TAF），但需权衡骨肾安全性。第一代非核苷类逆转录酶抑制剂（NNRTI），如奈韦拉平和依非韦伦与肝损伤和代谢紊乱相关，其中依非韦伦可导致肝细胞脂质积累。临床研究显示，依非韦伦相关的体重增加幅度小于整合酶链转移抑制剂（INSTI），提示其对脂肪肝的影响较复杂。新一代NNRTI（利匹韦林、多拉韦林、艾诺韦林）代谢安全性更优。利匹韦林在实验研究中表现出抗炎和肝保护作用，临床上也显示其对血脂的不良影响小于依非韦伦。多拉韦林和艾诺韦林在随机对照研究中均证实能改善血脂谱，提示其在MASLD患者中的潜在优势。蛋白酶抑制剂类药物则普遍伴随血脂异常和脂肪沉积风险，虽新一代蛋白酶抑制剂类有所改善，但利托那韦仍显著增加代谢负担。临床数据表明，达芦那韦的代谢安全性优于洛匹那韦，但劣于新一代NNRTI。多项研究报道了使用INSTI（尤其是多替拉韦和比克替拉韦）和/或TAF后可能出现体重增加的现象。也有数据支撑，启动INSTI或TAF后的体重增加现象可能源于对TDF体重抑制效应的解除，而非药物直接作用。需要注意的是，新近研究提示INSTI相关的体重增长呈现性别差异。女性HIV/AIDS患者在接受含INSTI方案治疗后体重增幅显著高于男性，女性患者启动含INSTI的cART方案1年其脂肪肝的风险增加。此外，以INSTI为基础的治疗也增加T2DM的风险（即便校正了BMI和其他变量）。这些研究结果提示，虽然INSTI的代谢影响可能受到合并用药及既往cART方案的影响，临床医师仍需警惕该类药物治疗可能导致的体重增加、糖代谢异常及肝脂肪变性等不良反应。鉴于新一代INSTI具有较高的耐药屏障、良好的患者依从性和耐受性特征，但仅基于体重增加这一单一因素而更换为其他类型cART药物的临床依据尚不充分。尽管TDF在代谢参数和体重控制方面较TAF展现出一定优势，但临床决策时仍需审慎评估其潜在的骨密度降低和肾功能损害风险。然而，对于合并MASLD的患者，若经临床医师综合评估认为其肝脏疾病进展、心血管事件及代谢相关并发症风险较高时，可在充分权衡获益与风险的基础上，考虑转换为对体重及代谢影响更为优化的cART方案。以TDF联合新一代NNRTI（如多拉韦林、艾诺韦林）为基础的方案可作为这类患者的潜在治疗选择，但其确切的临床获益仍需通过严格的随机对照研究进一步验证。推荐意见18：对于HIV/AIDS合并MASLD患者，若BMI≥28 kg/m²或启动cART后体重增加超过10%，可考虑将方案调整为以TDF联合新一代NNRTI为基础的cART。调整后，需要定期监测TDF相关肾毒性和骨毒性（C2）。 6疗效评估和定期随访 MASLD的治疗目标不仅限于改善肝脏病变本身，更重要的是降低心血管疾病、代谢综合征、恶性肿瘤以及肝脏相关并发症的发生风险，同时提升患者的主观健康感受和生活质量。接受cART的HIV/AIDS患者，需要密切监测cART的有效性和不良反应。疗效的综合评估应包括：人体测量学指标（如体重、腰围）、血液生化参数（如肝酶、血脂、血糖）、CD4细胞计数、CD4/CD8比值、血浆HIV病毒载量、肝脂肪变性、炎症与纤维化的程度、药物依从性和不良反应的发生情况，以及患者对生活方式干预与整体治疗效果的满意度。通过多维度指标的动态评估，可为临床优化个体化治疗策略提供依据，从而实现持续提升治疗效果与患者生活质量的目标。尚无证据提示合并MASLD时，HIV/AIDS患者需要更改CD4细胞计数和血浆HIV病毒载量的监测频率。目前尚无关于如何最有效监测MASLD患者及其对药物治疗反应的统一共识，亚太肝病学会推荐根据患者的肝脏疾病的严重情况来调整监测的频率：（1）对于无肝纤维化的患者，若合并的代谢风险因素未见恶化，建议每2～3年进行1次随访监测；（2）对于存在肝纤维化或合并代谢风险因素未得到控制的患者，建议每年进行1次随访监测，尤其是在有新药出现的背景下更应加强管理；（3）对于部分具有肝纤维化进展高风险的患者，监测过程中可考虑进行基线肝穿刺活检评估；但如果患者已确诊为肝硬化，则应采用终末期肝病模型评分进行评估；（4）对于已发生肝硬化的患者，建议每6个月进行1次随访监测，其中应包括肝细胞癌筛查以及临床显著性门静脉高压的评估。国内MASLD防治指南提及临床实践中通常每3～6个月检查肝肾功能、血脂、血糖等生化指标，每6～12个月检查全血细胞计数以及上腹部和颈动脉超声显像。对于BMI正常的患者每年通过人体成分测定仪检测体脂和骨骼肌质量。此外，每年应至少评估1次FIB-4，且进行1次TE。FIB-4评分和LSM增加预示肝病进展及肝脏相关事件风险增加。然而，国内指南并未针对随访频率给出具体推荐意见。本共识参考国内外关于MASLD的指南要点，并结合HIV/AIDS患者接受cART后的随访管理需求，提出以下推荐意见。推荐意见19：AIDS合并MASLD患者应随访了解生活方式和体重变化，定期监测血液生化指标、脂肪肝和纤维化程度、心血管疾病等肝外并发症，以及CD4细胞计数和血浆HIV病毒载量指标（C1）。推荐意见20：HIV/AIDS患者在启动cART后，其CD4细胞计数和血浆HIV病毒载量的监测频率不因合并MASLD而调整（C1）。推荐意见21：AIDS合并MASLD患者需动态监测FIB-4评分和LSM。二者逐渐升高提示肝病可能进展，且肝脏相关不良事件的风险增加。（B1）。推荐意见22：AIDS合并MASLD患者，建议根据肝脏疾病的严重程度，合理调整肝生化指标及影像学检查的监测频率。若合并肝硬化，应至少每6个月监测1次，并同步评估门静脉高压及肝细胞癌风险（C1）。 7问题与展望 AIDS合并MASLD的研究领域面临多重挑战与机遇。首先，尽管HIV/AIDS患者因cART毒性、慢性炎症及代谢异常等因素，额外增加了MASLD患病风险，但其病理机制与自然史仍不明确。许多研究确实观察到使用INSTI和TAF体重增加，而TDF则表现出抑制体重效应，但具体药物对肝脂肪变性和纤维化的影响机制尚未完全阐明，尤其是不同cART方案组合的长期代谢效应仍需深入探索。其次，HIV/AIDS患者长期被排除在MASLD及其进展型MASH的临床试验之外，导致该群体缺乏针对性治疗证据。例如，非侵入性肝纤维化评估工具（如FIB-4评分、TE）在HIV/AIDS患者中的准确性尚未充分验证，且资源有限地区缺乏简易筛查手段，进一步加剧了诊断与管理的滞后。此外，社会健康决定因素如社会经济地位低下、医疗资源分配不均、系统性歧视及性别差异，不仅增加HIV/AIDS患者患MASLD的风险，还阻碍其获得早期筛查与规范治疗。未来研究需优先填补以下关键空白：其一，建立 HIV/AIDS患者专属的MASLD流行病学数据库，开展多中心前瞻性研究以识别疾病进展的关键预测因子（如cART方案、肠道菌群紊乱、慢性免疫激活），并据此构建适用于该人群的风险分层模型；同时推进以肝脏结局（脂肪变性、纤维化进展、肝相关事件）为核心终点的随机对照试验与前瞻性队列研究，评估不同cART方案对MASLD发生与进展的因果影响，为临床用药选择提供可操作的证据。其二，推动HIV/AIDS患者纳入MASLD/MASH临床试验，尤其是评估新型代谢调节药物（如GLP-1受体激动剂、SGLT2抑制剂）与ART的相互作用及疗效，同时探索针对慢性炎症和线粒体功能障碍的靶向治疗策略。其三，优化非侵入性诊断工具的适用性，并验证TE在不同HIV/AIDS患者中的诊断阈值。其四，深入解析社会健康决定因素对疾病负担的影响机制，例如通过政策干预改善食品不安全、减少酒精滥用及提升医疗可及性，从而打破HIV与MASLD的协同恶性循环。其五，制定跨学科管理指南，整合肝病、感染病及内分泌专科资源，建立从社区筛查到三级转诊的连贯照护体系，并纳入患者报告结局以全面评估治疗对生活质量的改善效果。实现上述目标需全球合作：学术界应主导针对HIV/AIDS合并MASLD的病理机制研究，药企需优先将HIV/AIDS患者纳入药物开发管线，公共卫生机构则需推动政策改革以减少健康不平等。最终，通过科学证据积累与多层面干预，有望显著降低HIV/AIDS患者MASLD发病率和死亡率，实现从“疾病管理”到“健康促进”的范式转变。与此同时，应积极推动多学科照护模式的建立与完善，整合感染、肝病、内分泌、心血管及营养等专科资源，为AIDS合并MASLD患者提供全病程、连续性的综合管理。需要强调的是，MASLD本质上是代谢综合征在肝脏的表现。HIV/AIDS患者常伴多种共病并长期接受多药治疗，在此背景下，cART药物的代谢不良反应及其与其他药物的相互作用，是该人群管理中不可忽视的专属性问题。执笔人：胡志亮（南京市第二医院感染科）、陆莲凤（南京市第二医院感染科）、魏洪霞（南京市第二医院感染科）编写成员（以姓氏笔画为序）：马萍（天津市第二人民医院感染二科）、龙海（贵阳市公共卫生救治中心）、成骢（南京市第二医院感染科）、池云（南京市第二医院感染科）、吕玮（中国医学科学院北京协和医学院北京协和医院感染内科）、刘水青（贵州医科大学附属医院感染科）、孙永涛（空军军医大学唐都医院感染科）、孙丽琴（深圳市第三人民医院感染与免疫科）、何云（深圳市第三人民医院感染与免疫科）、李侠（云南省传染病医院感染科）、李凌华（广州医科大学附属市八医院感染病中心）、陆兴（扬州市第三人民医院感染科）、陆莲凤（南京市第二医院感染科）、陈亚玲（南京市第二医院感染科）、陈晨（南京市第二医院感染科）、陈耀凯（重庆市公共卫生医疗救治中心感染科）、陈雅红（福建医科大学孟超肝胆医院感染科）、沈银忠［上海市（复旦大学附属）公共卫生临床中心感染与免疫科］、张彤（首都医科大学附属北京佑安医院感染性疾病临床研究中心）、邹美银（南通市第三人民医院感染科）、曹玮（中国医学科学院北京协和医学院北京协和医院感染内科）、赵红心（首都医科大学附属北京地坛医院艾滋病临床中心）、赵清霞［郑州大学附属传染病医院（河南省传染病医院）感染科］、胡志亮（南京市第二医院感染科）、顾青青（连云港第四人民医院感染二科）、程健（南京市第二医院感染科）、喻剑华（浙江中医药大学附属杭州西溪医院）、蔡卫平（广州医科大学附属市八医院感染病中心）、蔡仁田（南京市第二医院感染科）、魏洪霞（南京市第二医院感染科）审稿成员（以姓氏笔画为序）：丁明东（泰州市人民医院感染科）、马兴（扬州市第三人民医院感染科）、乔飞（江苏省中医院感染科）、成娟（盐城市第七人民医院感染科）、严友德（宿迁市第一人民医院感染病科）、严晓敏（南京市鼓楼医院感染科）、吴东刚（连云港第四人民医院感染二科）、吴翠松（镇江市第三医院感染科）、张艳（盐城市第一人民医院感染科）、张凤池（徐州市传染病医院感染科）、陈仁芳（无锡市第五人民医院感染科）、陈国春（常州市第三人民医院感染科）、李春杨（徐州医科大学附属医院感染科）、汪朝晖（中国人民解放军第八一医院传染科/全军肝病中心）、邱源旺（无锡市第五人民医院）、钱峰（苏州市第五人民医院感染一科）、郭春辉（江阴市人民医院感染科）、黄燕（苏州大学附属第一医院感染病科）、傅更锋（江苏省疾病控制中心性艾所）、董莉（江苏省人民医院感染科）、戴善梅（连云港市东方医院传染科）顾问：李太生（北京协和医院感染内科）、卢洪洲（深圳市第三人民医院）、张福杰（首都医科大学附属北京地坛医院感染性疾病诊疗中心）、吴昊（首都医科大学附属北京佑安医院感染科）、杨永峰（南京市第二医院肝病科）本文首次发表于［中国艾滋病性病，2025，31（10）:1135-1148］全文下载 PDF & HTML https://www.lcgdbzz.org/cn/article/doi/10.12449/JCH251206 引证本文 Citation 江苏省医学会感染病学分会艾滋病学组,南京市第二医院(南京中医药大学附属南京医院),中国性病艾滋病防治协会HIV合并肝病专业委员会. 中国成人人类免疫缺陷病毒(HIV)感染合并代谢相关脂肪性肝病的管理专家共识[J]. 临床肝胆病杂志, 2025, 41(12): 2474-2482 扩展阅读 Read more 指南推荐｜2025年欧洲肝病学会临床实践指南：经颈静脉肝内门体分流术指南推荐｜2025年亚太肝病学会临床实践指南：代谢相关脂肪性肝病的诊断和管理指南推荐｜2025年欧洲肝病学会/欧洲罕见病网络临床实践指南：肝豆状核变性指南推荐｜2025年美国肝病学会实践指导：肝细胞癌的预防、诊断和治疗（关键更新）指南推荐｜2025年欧洲肿瘤内科学会临床实践指南：胆道癌的管理（中期更新）关于本刊 About us ■ 中国首个肝胆病专业杂志 ■ 中国科技期刊卓越行动计划·中文领军期刊 ■ 百种中国杰出学术期刊 ■ 中国精品科技期刊 ■ 中国百佳高校科技期刊 ■ 《科技期刊世界影响力指数报告》收录期刊 ■ 北京大学图书馆中文核心期刊 ■ 中国科技论文统计源期刊 ■ RCCSE中国权威学术期刊（A+） ■ 国际医学期刊编辑委员会（ICMJE）规范期刊 ■ 国际管理与技术编辑学会（ISMTE）会员期刊 ■ Embase、Scopus等18种国际重要数据库收录 ■ 金色开放获取期刊（Golden OA）官方网站：lcgdbzz.org 官方微信：lcgdbzz1985 官方邮箱：lcgdb@vip.163.com 投稿咨询：0431-88782044 审稿咨询：0431-88783542

临床研究细胞疗法

2026-01-24

·CVDAILY

全球糖尿病速递（第024期）｜替尔泊肽、视网膜病变、虚拟助手、吸入胰岛素、肺癌

*本资料仅供医疗卫生专业人士参考，请勿向非医疗卫生专业人士发放截至01月24日15点59分，近期共有 456 本期刊发布了 871 篇文章，其中糖尿病相关的文章共 325 篇，覆盖 30 个领域的内容。中国专家参与发表的文章有 77 篇。今日，影响因子最高的文章刊登在 Journal of the American Medical Association (IF: 55.000) 期刊上。今日头条 Headlines 01 Ophthalmology IF: 09.500 替尔泊肽与降低糖尿病视网膜病变及相关并发症风险：一项美国多中心队列研究 Shah, Jaffer, Razavi, Peyman, Festok, Muhamad, Ahmed, Harris, Mahrous, M Abdallah, Kovacs, Kyle D, etc. 近日，一项发表于眼科权威期刊《Ophthalmology》的大型回顾性研究揭示了新型药物替尔泊肽（Tirzepatide）在糖尿病管理中可能带来的额外益处。该研究首次系统评估了替尔泊肽对糖尿病视网膜病变（DR）这一常见且严重的微血管并发症的长期影响。研究团队利用覆盖广泛的TriNetX美国协作医疗数据库，开展了一项基于人群的回顾性队列分析。研究聚焦于患有糖尿病且伴有超重或肥胖状况的患者群体，旨在探究起始使用替尔泊肽与仅接受生活方式干预，在预防和延缓糖尿病视网膜病变方面是否存在差异。研究设计严谨，为尽量减少混杂因素的影响，研究人员采用了倾向评分匹配的方法。他们将每位起始使用替尔泊肽的患者，与一位在人口统计学特征、代谢指标（如糖化血红蛋白、体重指数）以及系统性共病（如高血压、高血脂）等方面高度相似，但仅接受生活方式干预且未使用任何减重药物的患者进行配对。经过匹配，最终共有173,846名患者被纳入分析，平均年龄为56.9岁，其中女性占比52.0%，两组各包含86,923名患者，确保了比较的均衡性。研究的主要观察终点是糖尿病视网膜病变的发生、向更严重阶段（如从非增殖性发展为增殖性）的进展，以及因视网膜病变而需要接受特定眼科干预的情况，例如玻璃体内注射抗血管内皮生长因子（抗-VEGF）药物或进行全视网膜激光光凝术。经过为期12个月的随访，分析结果呈现出显著差异。与单纯依靠生活方式干预的对照组相比，使用替尔泊肽的患者发生各类糖尿病视网膜病变事件的风险普遍降低。具体数据显示，替尔泊肽组患者新发轻度非增殖性糖尿病视网膜病变的风险相对降低了约14%，进展为威胁视力的增殖性糖尿病视网膜病变的风险降低了约30%。替尔泊肽在降低糖尿病视网膜病变相关严重并发症风险方面表现出更为明显的优势。研究结果显示，使用替尔泊肽的患者，发生合并有视力损害风险的糖尿病性黄斑水肿的风险降低了约38%，发生玻璃体积血的风险降低了约39%，而发生可能导致永久性视力丧失的牵拉性视网膜脱离的风险更是大幅降低了约63%。这些风险的降低直接转化为临床干预需求的减少。数据分析表明，与对照组相比，替尔泊肽组患者在未来一年内需要接受玻璃体内抗-VEGF注射以治疗黄斑水肿或新生血管的风险降低了约52%，需要接受全视网膜激光光凝术以控制增殖性病变的风险降低了约39%。综上所述，这项基于大规模真实世界数据的研究表明，对于患有糖尿病且超重或肥胖的患者，使用替尔泊肽治疗，与仅采取生活方式干预相比，可能与更低的糖尿病视网膜病变新发及进展风险相关联。此外，替尔泊肽的使用还可能显著降低因视网膜病变导致严重并发症的发生率，并减少患者后续接受侵入性眼科治疗的需求。这一发现为临床医生在制定糖尿病综合管理方案，特别是对于有视网膜病变风险的患者选择治疗方案时，提供了新的重要参考依据。本文由牛祥编辑扫描二维码查看源文 Ophthalmology | Ahead of Print. 10.1016/j.ophtha.2026.01.013 02 JAMA Network Open IF: 09.700 互动虚拟助手对2型糖尿病老年患者健康促进的干预研究：IVAM-ED随机临床试验 Matzenbacher, Lucas S, da Costa, Frederico Ludwig, de Barros, Laura Gomes Boabaid, Gheno, Vicenzo, Maia, Isabela Semmelmann, Blank, Luiza Machado, etc. 一项最新发表的随机临床试验显示，一款基于智能音箱的互动虚拟助手，能够显著改善老年2型糖尿病患者的心理健康状况、生活质量、疾病自我管理行为以及血糖控制水平。该研究结果发表在JAMA Network Open期刊上。该研究旨在探究技术设备结合行为干预模型，在支持老年糖尿病患者健康管理方面的潜力。研究指出，老年糖尿病患者常面临较高的心理困扰，这可能使疾病管理复杂化，并对健康结局产生负面影响。该研究于2023年6月22日至2024年2月8日期间，在巴西的一家学术医疗中心开展。研究共纳入了112名年龄在65岁及以上、确诊为2型糖尿病的参与者，他们的平均年龄为72.5岁，平均糖化血红蛋白水平为7.9%。参与者被随机分为两组，干预组在家中使用了预编程的智能音箱设备（Amazon Echo Dot）12周，而对照组则继续接受常规医疗护理。研究人员在12周的干预期结束后，对参与者的多项指标进行了评估。主要结局是心理困扰程度，采用自评问卷进行测量。结果显示，与常规护理组相比，使用智能音箱的干预组参与者的心理困扰评分显著更低，两组间的调整后平均差值为-1.46分，具有统计学意义。这表明该干预有效减轻了患者的心理困扰。除了主要结局，研究还观察了一系列重要的次要结局。在生活质量方面，干预组比常规护理组有显著提升。在糖尿病自我护理行为的依从性上，干预组也表现出明显改善。更重要的是，在血糖控制的关键指标——糖化血红蛋白上，干预组比对照组平均降低了0.48%，达到了具有临床意义的改善水平。然而，在感知压力方面，两组之间未观察到显著差异。整个研究过程中，没有参与者因不良事件而退出试验。该研究的结论表明，这种通过智能设备提供的、易于实施的行为干预，能够为老年2型糖尿病患者带来多方面的健康获益。它不仅有助于缓解患者的心理痛苦，还能促进其积极进行自我管理，并最终实现更好的血糖控制效果。这为在社区和家庭环境中推广数字化健康管理工具提供了新的证据。本文由牛祥编辑扫描二维码查看源文 JAMA Network Open | Volume 9, Issue 1 10.1001/jamanetworkopen.2025.53508 03 Diabetes Technol Ther IF: 06.300 糖尿病吸入胰岛素应用者的肺癌与慢性阻塞性肺疾病真实世界发病率 Cowart, Kevin, Everich, Hannah, Flores, Francisco, Harris, Marisa, Randall, Daniel, Sammartano, Lauren, etc. 一项新近发表于《Diabetes technology & therapeutics》的研究，利用大规模真实世界数据，评估了吸入式胰岛素与速效胰岛素类似物在成年糖尿病患者中的肺部安全性，重点关注肺癌与慢性阻塞性肺疾病风险。该研究结果为临床决策提供了重要参考。研究团队利用TriNetX网络数据库，回顾性地纳入了患有1型或2型糖尿病的成年患者。这些患者被分为两组：一组曾处方吸入式胰岛素，另一组则处方速效胰岛素类似物。为减少混杂因素的影响，研究者对两组人群进行了倾向性评分匹配，最终使两组在基线特征上具有可比性。研究结果显示，在肺癌风险方面，两组患者未观察到统计学上的显著差异。具体而言，吸入式胰岛素组与速效胰岛素类似物组发生任何肺癌的风险比值为1，其95%置信区间为0.42至2.40，P值达到0.999，表明两组风险并无不同。然而，在慢性阻塞性肺疾病方面，吸入式胰岛素组发生慢性阻塞性肺疾病复合结局的风险，显著高于速效胰岛素类似物组。风险比值为3.45，意味着前者的风险是后者的约3.5倍，且该差异具有高度的统计学意义。不过，研究者也指出，两组患者的绝对风险均处于较低水平。基于这些发现，研究者得出结论：在这项真实世界研究中，未发现吸入式胰岛素的使用与肺癌风险增加之间存在关联。但同时，吸入式胰岛素与慢性阻塞性肺疾病风险的升高相关，尽管绝对风险较低。研究者强调，该关联的生物学合理性尚不明确，并非结论性的。研究者同时指出了本研究的局限性。作为一项回顾性观察性研究，其设计本身可能受到混杂因素及信息偏倚（如监测偏倚）的影响，因此难以做出确切的因果推断。尽管如此，这些发现强调了继续监测和评估吸入式胰岛素长期肺部安全性的必要性。本文由牛祥编辑扫描二维码查看源文 Diabetes Technol Ther | Ahead of Print. 10.1177/15209156251387102 中国发表（77） China BMC medicine IF: 08.300Ahead of Print.No.01Association of short-term exposure to ambient air pollutants with liver function and mediation by fasting insulin: evidence from a rural cohort in China短期暴露于环境空气污染物与肝功能的关联及空腹胰岛素的中介作用：来自中国农村队列的证据DOI: 10.1186/s12916-026-04645-x npj science of food IF: 07.800Ahead of Print.No.02Cooked meat-derived extracellular vesicles ssc-miR-1 induces metabolic disorders in the mice liver via PI3k/AKT pathway烹饪肉食来源的细胞外囊泡ssc-miR-1通过PI3K/AKT通路诱导小鼠肝脏代谢紊乱DOI: 10.1038/s41538-026-00709-7 Am J Vet Res IF: 01.400Ahead of Print.No.03Hydroxyacyl coenzyme A dehydrogenase trifunctional multienzyme complex subunit α depletion dysregulates hepatic energy and lipid metabolism in dairy cows hepatocytes: a multiomic integration analysis羟酰基辅酶A脱氢酶三功能多酶复合体α亚基缺失扰乱奶牛肝细胞的能量与脂质代谢：一项多组学整合分析DOI: 10.2460/ajvr.25.09.0336 BMC endocrine disorders IF: 03.300Ahead of Print.No.04Calcitonin-negative medullary thyroid carcinoma combined with multifocal papillary thyroid carcinoma: a case report and literature review降钙素阴性甲状腺髓样癌合并多灶性甲状腺乳头状癌：一例报告并文献复习DOI: 10.1186/s12902-026-02172-7 BMC microbiology IF: 04.200Ahead of Print.No.05Faecal microbiome and serum metabolomics: potential biomarkers for type 2 diabetes粪便微生物组与血清代谢组学：2型糖尿病的潜在生物标志物DOI: 10.1186/s12866-025-04571-7 Nature reviews. Nephrology IF: 39.800Ahead of Print.No.06Effects of social determinants of health on the landscape of kidney disease健康的社会决定因素影响肾脏疾病图景DOI: 10.1038/s41581-026-01052-6 Int J Biol Macromol IF: 08.500Ahead of Print.No.07Pro-angiogenic dual-crosslinked collagen bioinks for precise cell-laden DLP 3D printing and rapid vascularized diabetic wound repair用于精确负载细胞DLP 3D打印和快速血管化糖尿病伤口修复的促血管生成双交联胶原生物墨水DOI: 10.1016/j.ijbiomac.2026.150408 Experimental Eye Research IF: 02.700Ahead of Print.No.08Elevated Expression of Hsa_circ_0053004 in Peripheral Blood Mononuclear Cells Correlates with Endothelial Dysfunction in Diabetic Retinopathy外周血单个核细胞中hsa_circ_0053004的表达升高与糖尿病视网膜病变中的内皮功能障碍相关DOI: 10.1016/j.exer.2026.110880 Life sciences IF: 05.100Ahead of Print.No.09Exogenous hydrogen sulphide alleviates diabetes-associated cognitive decline by inhibiting ferroptosis through Nrf2/GPX4 signalling pathway外源性硫化氢通过激活Nrf2/GPX4信号通路抑制铁死亡，缓解糖尿病相关认知衰退DOI: 10.1016/j.lfs.2026.124220 Colloids Surf B Biointerfaces IF: 05.600Ahead of Print.No.10A self-adapting DNA-crosslinked hydrogel reprograms macrophage polarization and angiogenesis for synergistic repair of diabetic wounds一种自适性DNA交联水凝胶通过重编程巨噬细胞极化与血管生成协同修复糖尿病伤口DOI: 10.1016/j.colsurfb.2026.115465 International dental journal IF: 03.700Ahead of Print.No.11Exploration Novel Therapeutic Targets for Periodontitis via Stress Granules Biomarkers通过应激颗粒生物标志物探索牙周炎的新型治疗靶点DOI: 10.1016/j.identj.2025.109390 Biomaterials advances IF: 06.000Ahead of Print.No.12A novel ROS switcher potentiates the type-I photodynamic effect of sodium zinc chlorophyllin against Pseudomonas aeruginosa in diabetic wounds一种新型活性氧转换开关可增强锌叶绿酸钠对糖尿病伤口中铜绿假单胞菌的I型光动力效应DOI: 10.1016/j.bioadv.2026.214721 Biomaterials advances IF: 06.000Ahead of Print.No.13Multifunctional conductive hydrogel integrating exosome delivery and electrical stimulation for enhanced diabetic wound healing整合外泌子递送与电刺激的多功能导电水凝胶促进糖尿病伤口愈合DOI: 10.1016/j.bioadv.2026.214716 J Nutr Health Aging IF: 04.000Ahead of Print.No.14An atlas of associations between dietary nutrients and the risk of 36 major chronic diseases膳食营养素与36种主要慢性病风险关联图集DOI: 10.1016/j.jnha.2026.100785 Obesity surgery IF: 03.100Ahead of Print.No.15Global Trends in Bariatric Surgery for the Treatment of Metabolic Syndrome: A Bibliometric and Visualization Analysis代谢综合征治疗中减重手术的全球趋势：A Bibliometric and Visualization AnalysisDOI: 10.1007/s11695-026-08489-5 Communications biology IF: 05.100Ahead of Print.No.16Obesity impairs spermatogenesis via Leydig cell ferroptosis induced by liver-derived exosomal miR-122-5p肥胖通过肝脏来源外泌体miR-122-5p诱导Leydig细胞铁死亡进而损害精子发生DOI: 10.1038/s42003-026-09612-z npj science of food IF: 07.800Ahead of Print.No.17Computational-experimental study reveals direct target and bioactives of Ajania fruticulosa against NAFLD via TLR2/NF-κB/PPAR-γ signaling计算与实验研究揭示黄花蒿水提物通过TLR2/NF-κB/PPAR-γ信号通路对抗NAFLD的直接靶点与活性成分DOI: 10.1038/s41538-026-00722-w Journal of Genetics and Genomics IF: 07.100Ahead of Print.No.18Lipid metabolism and metabolites: emerging roles in systemic physiology and metabolic diseases脂质代谢与代谢物：系统生理学与代谢疾病中的新兴作用DOI: 10.1016/j.jgg.2026.01.006 Experimental gerontology IF: 04.300Ahead of Print.No.19Association between weight-adjusted waist index (WWI) and multimorbidity: Evidence from NHANES and prospective validation in CHARLS体重调整腰围指数（WWI）与多重共病的关联：基于NHANES的证据及CHARLS的前瞻性验证DOI: 10.1016/j.exger.2026.113044 Bioorganic chemistry IF: 04.700Ahead of Print.No.20Design, synthesis and biological evaluation of hydroxycinnamoylamides derivatives as potent glucosidase inhibitors羟基肉桂酰胺衍生物作为强效葡萄糖苷酶抑制剂的设计、合成与生物学评价DOI: 10.1016/j.bioorg.2025.109453 Cell reports IF: 06.900Ahead of Print.No.21Lysosome-localized IRTKS condensates promote mTORC1 activity leading to MASLD and HCC溶酶体定位的IRTKS凝聚体通过激活mTORC1导致MASLD和HCCDOI: 10.1016/j.celrep.2025.116893 Curr Opin Gastroenterol IF: 02.500Ahead of Print.No.22Mechanistic insights into pancreatic duct pressure: from basic physiology to translational implications胰腺导管压力：从基础生理到转化应用的机制新见解DOI: 10.1097/MOG.0000000000001147 JMIR research protocols IF: 01.500Volume 15, Issue No.23Traditional Chinese Medicine Syndrome Differentiation of Adult Patients With Type 2 Diabetes and Metabolic Syndrome: Protocol for a Cross-Sectional Study成人2型糖尿病合并代谢综合征患者的中医证型鉴别：一项横断面研究方案DOI: 10.2196/86217 Biomolecules & biomedicine IF: 02.200Ahead of Print.No.24Prediabetes and the risk of incident chronic kidney disease in adults: A systematic review and meta-analysis成人糖尿病前期与慢性肾脏病发病风险：一项系统综述和荟萃分析DOI: 10.17305/bb.2026.13524 Reproduction IF: 03.700Volume 171, Issue 1No.25Deficiency of the GnIH/GPR147 system induces asthenozoospermia via PI3K-mediated metabolic and apoptotic dysregulationGnIH/GPR147系统缺陷通过PI3K介导的代谢与凋亡失调诱导弱精子症DOI: 10.1093/reprod/xaaf017 Reproduction IF: 03.700Ahead of Print.No.26High dietary fructose induces the senescence of granulosa cells by enhancing O-GlcNAcylation高果糖饮食通过增强O-GlcNAc糖基化诱导颗粒细胞衰老DOI: 10.1093/reprod/xaag005 Int J Mol Med IF: 05.800Volume 57, Issue 3No.27Research progress on the effects of macrophage‑derived exosomes on muscle factors IGF‑1 and FGF‑2 mediating musculoskeletal crosstalk molecular signaling pathway on bone metabolism (Review)巨噬细胞来源外泌体通过调节肌肉因子IGF-1和FGF-2介导肌肉骨骼互作信号通路影响骨代谢的研究进展（综述）DOI: 10.3892/ijmm.2026.5738 Molecular Medicine Reports IF: 03.500Volume 33, Issue 3No.28PDX1 in human cancers: Molecular mechanisms, dual roles and clinical implications (Review)PDX1在人类癌症中的作用：分子机制、双重角色及临床意义（综述）DOI: 10.3892/mmr.2026.13806 Annals of biomedical engineering IF: 05.400Ahead of Print.No.29T(2) Mapping at 3 T of Cartilage and Menisci in Patients with Diabetes Mellitus3T磁共振T2映射评估糖尿病患者的软骨与半月板DOI: 10.1007/s10439-026-03990-5 Science China. Life Sciences IF: 09.500Ahead of Print.No.30Lung function impairment and risk of sepsis and sepsis-related mortality: a large cohort study with over 310,000 participants肺功能损伤与脓毒症发生及脓毒症相关死亡风险：一项涵盖超31万人的大型队列研究DOI: 10.1007/s11427-025-3140-8 Molecular biology reports IF: 02.800Volume 53, Issue 1No.31UFMylation in lipid metabolism disorders-associated diseasesUFMylation在脂质代谢紊乱相关疾病中的作用DOI: 10.1007/s11033-026-11452-3 The FASEB journal : IF: 04.200Volume 40, Issue 2No.32Maternal Fructose Intake During Pregnancy Induced the Hepatic Glucose Homeostasis Imbalance in the Offspring by Inhibiting Glucokinase孕期母体果糖摄入通过抑制葡萄糖激酶诱发子代肝脏葡萄糖稳态失衡DOI: 10.1096/fj.202503081R Biomaterials science IF: 05.700Ahead of Print.No.33A dual-network Bletilla striata polysaccharide hydrogel for PPAR-mediated macrophage polarization and accelerated diabetic wound healing一种基于PPAR介导的巨噬细胞极化加速糖尿病伤口愈合的双网络白及多糖水凝胶DOI: 10.1039/d5bm01617g Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.34Evaluating WHtR and WC cut-offs for abdominal obesity among children and adolescents: Insights from three National Surveys in China评估中国儿童青少年腹型肥胖的腰围身高比和腰围切点：基于三次全国学生体质与健康调研的启示DOI: 10.1111/dom.70488 Int J Mol Med IF: 05.800Volume 57, Issue 3No.35Mangiferin in human disease: Multifaceted mechanisms and applications (Review)芒果苷在人类疾病中的研究：多面机制与应用（综述）DOI: 10.3892/ijmm.2026.5736 Int J Mol Med IF: 05.800Volume 57, Issue 3No.36Epigenetic dysregulation of B‑cells in autoimmune diseases and lymphomas (Review)自身免疫性疾病和淋巴瘤中B细胞的表观遗传失调DOI: 10.3892/ijmm.2026.5739 Int J Mol Med IF: 05.800Volume 57, Issue 3No.37[Retracted] DDAH2 alleviates myocardial fibrosis in diabetic cardiomyopathy through activation of the DDAH/ADMA/NOS/NO pathway in ratsDDAH2通过激活DDAH/ADMA/NOS/NO通路减轻大鼠糖尿病心肌病的心肌纤维化DOI: 10.3892/ijmm.2026.5734 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.38Machine learning-based online prediction of nocturnal hypoglycemia in elderly patients with type 2 diabetes基于机器学习的老年2型糖尿病患者夜间低血糖在线预测DOI: 10.3389/fendo.2025.1685969 Int J Ophthalmol IF: 01.800Volume 19, Issue 2No.39Detecting altered spontaneous activities of different brain areas in diabetic vitreous hemorrhage patients: a magnetic resonance imaging study应用磁共振成像探测糖尿病玻璃体积血患者不同脑区的自发性活动改变DOI: 10.18240/ijo.2026.02.09 Journal of clinical ultrasound : IF: 01.400Ahead of Print.No.40Analysis of Risk Factors for Patency Rate After Ultrasound-Guided PTA for AVF Stenosis超声引导PTA治疗AVF狭窄后通畅率的风险因素分析DOI: 10.1002/jcu.70190 Advances in wound care IF: 05.600Ahead of Print.No.41Efficacy and Safety of Human Amniotic Membrane for Chronic Wounds: A Systematic Review and Meta-Analysis of Clinical Trials人羊膜治疗慢性伤口的有效性与安全性：一项临床试验的系统回顾与荟萃分析DOI: 10.1177/21621918251411808 Lipids in health and disease IF: 04.200Volume 25, Issue 1No.42Risk prediction of multiple cardiometabolic diseases in middle-aged and older adults using lipid metabolism biomarkers and derived composite measures based on machine learning: a prospective cohort study of CHARLS基于机器学习，利用脂质代谢标志物及其衍生复合指标预测中老年人心血管代谢共病的风险：CHARLS前瞻性队列研究DOI: 10.1186/s12944-025-02820-2 Frontiers in immunology IF: 05.900Volume 16, Issue No.43Correction: The role of immune cells-mediated memory in weight cycling, glucose disorders and insulin resistance更正：免疫细胞介导的记忆在体重循环、血糖紊乱及胰岛素抵抗中的作用DOI: 10.3389/fimmu.2025.1773368 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.44Cangfu Daotan decoction treats PCOS-IR through the IL6/JAK2/STAT3/FOXO4 signaling pathway苍附导痰汤通过IL6/JAK2/STAT3/FOXO4信号通路治疗多囊卵巢综合征胰岛素抵抗DOI: 10.3389/fendo.2025.1661000 Frontiers in nutrition IF: 05.100Volume 12, Issue No.45Assessing the potency of vitamin D augmentation on saccharometric indices in type 2 diabetes: a meta-analysis评估维生素D补充对2型糖尿病血糖指标的效能：一项Meta分析DOI: 10.3389/fnut.2025.1677686 Frontiers in nutrition IF: 05.100Volume 12, Issue No.46Metabolism, senescence, and natural products: new perspectives on wound healing in diabetes代谢、衰老与天然产物：糖尿病伤口愈合的新视角DOI: 10.3389/fnut.2025.1746827 Mini Rev Med Chem IF: 03.300Ahead of Print.No.47Bitter Compounds as Multifunctional Agents against Diabetes-associated Cognitive Dysfunction: Bridging Metabolic Regulation and Neuroprotection苦味化合物作为抗糖尿病相关认知功能障碍的多功能药物：连接代谢调控与神经保护DOI: 10.2174/0113895575414424251128113543 Can J Neurol Sci IF: 02.200Ahead of Print.No.48Peripheral Indicators of Alzheimer's Disease Pathology in Women With Polycystic Ovary Syndrome: A Case-Control Study多囊卵巢综合征女性阿尔茨海默病病理的外周指标：一项病例对照研究DOI: 10.1017/cjn.2025.10495 Front Mol Biosci IF: 04.000Volume 12, Issue No.49Research progress on oral glucagon-like peptide-1 receptor agonists in the treatment of diabetes mellitus type 2口服胰高血糖素样肽-1受体激动剂在2型糖尿病治疗中的研究进展DOI: 10.3389/fmolb.2025.1729904 FCVM IF: 02.900Volume 12, Issue No.50Machine learning-based prediction model for 30-day readmission risk in elderly patients with type 2 diabetes mellitus and heart failure: a retrospective cohort study with SHAP interpretability analysis基于机器学习的老年2型糖尿病合并心力衰竭患者30天再入院风险预测模型：一项结合SHAP可解释性分析的回顾性队列研究DOI: 10.3389/fcvm.2025.1673159 Frontiers in nutrition IF: 05.100Volume 12, Issue No.51Effect of preoperative oral isomaltulose on insulin resistance and glycemic variability in patients with type 2 diabetes mellitus: a randomized controlled trial术前口服异麦芽酮糖对2型糖尿病患者胰岛素抵抗及血糖变异性的影响：一项随机对照试验DOI: 10.3389/fnut.2025.1718843 Current diabetes reviews IF: 01.900Ahead of Print.No.52Chain Mediating Role of Illness Perception and Fear of Hypoglycemia in Impaired Hypoglycemic Awareness and Mild Cognitive Impairment in Patients with Type 2 Diabetes Mellitus疾病感知和低血糖恐惧在2型糖尿病患者低血糖感知受损与轻度认知障碍间的链式中介作用DOI: 10.2174/0115733998418191251127053922 Current diabetes reviews IF: 01.900Ahead of Print.No.53Targeting the Gut Microbiota in the Treatment of Type 2 Diabetes: Dietary Interventions, Microbial Preparations, and Fecal Transplantation靶向调控肠道菌群治疗2型糖尿病：饮食干预、微生物制剂与粪菌移植DOI: 10.2174/0115733998411102251127094217 Endocr Metab Immune Disord Drug Targets IF: 02.000Ahead of Print.No.54Gamma-Glutamyl Transferase and Male Reproductive Hormone Levels in Men with Type 2 Diabetes: A Cross-Sectional Studyγ-谷氨酰转移酶与2型糖尿病男性患者的生殖激素水平：一项横断面研究DOI: 10.2174/0118715303392699251016073511 Frontiers in nutrition IF: 05.100Volume 12, Issue No.55Mapping the evolution of botanical interventions for diabetic neuropathy: a two-database bibliometric landscape from 2005 to mid-2025映射植物干预糖尿病神经病变的演进：一项2005年至2025年中期的双数据库文献计量学图景DOI: 10.3389/fnut.2025.1727582 Andrology IF: 03.400Ahead of Print.No.56Comprehensive Quantification of Oligoasthenozoospermia Induced by Obesity, Reproductive Toxicants, and Their Combination in Rat Models大鼠模型中肥胖、生殖毒物及其组合诱导的少弱精子症的综合量化研究DOI: 10.1111/andr.70171 Journal of food science IF: 03.400Volume 91, Issue 1No.57Study on Anti-Obesity Activities of Three Individual Black Soybean Meal-Derived Insoluble Dietary Fibers via Modulating Intestinal Microbiota and Their Metabolites通过调节肠道微生物群及其代谢物研究三种黑豆粕不溶性膳食纤维的抗肥胖活性DOI: 10.1111/1750-3841.70778 Frontiers in immunology IF: 05.900Volume 16, Issue No.58Bioactives and exercise synergize to modulate AMPK and inflammation生物活性物质与运动协同调节AMPK及炎症DOI: 10.3389/fimmu.2025.1670379 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.59Impact of BMI on basal LH in premenarcheal girls with idiopathic central precocious puberty体重指数对月经初潮前特发性中枢性性早熟女童基础促黄体生成素的影响DOI: 10.3389/fendo.2025.1740527 Current pharmaceutical design IF: 02.800Ahead of Print.No.60Nuciferine Prevents Obesity by Inhibiting Macrophage Inflammation Involving LGALS3, CTSB, and RBP4 Genes Based on an Integrative Analysis of Adipose Tissue Transcriptomics and Network Pharmacology基于脂肪组织转录组学与网络药理学整合分析发现荷叶碱通过靶向LGALS3、CTSB和RBP4基因抑制巨噬细胞炎症进而预防肥胖DOI: 10.2174/0113816128400528251121074807 FCVM IF: 02.900Volume 12, Issue No.61Combining triglyceride glucose-body mass index and high-sensitivity C-reactive protein to predict cardiovascular disease: results from a national cohort and a clinical verified cohort联合甘油三酯葡萄糖-体重指数和高敏C反应蛋白预测心血管疾病：来自一项全国队列和一项临床验证队列的结果DOI: 10.3389/fcvm.2025.1726615 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.62Comparison of the efficacy of antidiabetic agents in type 2 diabetes with MASLD: a network meta-analysis降糖药物治疗2型糖尿病合并代谢功能障碍相关脂肪性肝病有效性的网络Meta分析比较DOI: 10.3389/fendo.2025.1659740 Medical acupuncture IF: 00.800Volume 37, Issue 5No.63Efficacy of Abdominal Acupoints Catgut Embedding Combined with Auricular Acupressure Therapy for Abdominal Obesity: A Single-Blind Randomized Control Trial腹部穴位埋线联合耳穴压豆疗法治疗腹型肥胖的有效性：一项单盲随机对照试验DOI: 10.1089/acu.2024.0014 Diabetes Technol Ther IF: 06.300Ahead of Print.No.64Performance of the Fifth Generation of a 16-Day Continuous Glucose Monitoring System in Adults with Diabetes第五代16天连续葡萄糖监测系统在成人糖尿病患者中的性能表现DOI: 10.1177/15209156261416870 CNS Neurol Disord Drug Targets IF: 03.000Ahead of Print.No.65The Use of Benzodiazepines and Risk of Incident Type 2 Diabetes in the General Population with Insomnia在患有失眠症的普通人群中使用苯二氮䓬类药物与2型糖尿病风险的研究DOI: 10.2174/0118715273430289251128102145 Frontiers in medicine IF: 03.000Volume 12, Issue No.66Solving the diagnostic dilemma in bone infections: metagenomic next generation sequencing enhances pathogen identification accuracy破解骨感染诊断困境：宏基因组二代测序提升病原体识别准确性DOI: 10.3389/fmed.2025.1699607 Front Clin Diabetes Healthc IF: 02.200Volume 6, Issue No.67Electrical stimulation: a novel adjunct therapy for diabetic foot ulcers电刺激：糖尿病足溃疡的新型辅助疗法DOI: 10.3389/fcdhc.2025.1682871 Frontiers in public health IF: 03.400Volume 13, Issue No.68Knowledge of diabetes among nurses of primary healthcare facilities in China: a cross-sectional survey study中国基层医疗机构护士糖尿病知识水平：一项横断面调查研究DOI: 10.3389/fpubh.2025.1717127 Front Mol Biosci IF: 04.000Volume 12, Issue No.69Effect of treatment duration on the associations between three modern antidiabetic drugs and survival outcomes of lung cancer in China三类新型抗糖尿病药物治疗时长对中国肺癌患者生存结局的影响DOI: 10.3389/fmolb.2025.1701515 Frontiers in surgery IF: 01.800Volume 12, Issue No.70Risk factors for sacrococcygeal pilonidal sinus: a systematic review and meta-analysis supplemented by genetic causal assessment骶尾部藏毛窦的风险因素：系统回顾、荟萃分析及遗传因果评估补充DOI: 10.3389/fsurg.2025.1718589 Journal of diabetes research IF: 03.400Volume 2026, Issue No.71Yixiao Formula Suppresses Myocardial Fibrosis Through UpregulatingmiR-133a and Downregulating TGF-β/Smads Signal Molecules益消方通过上调miR-133a和下调TGF-β/Smads信号分子抑制心肌纤维化DOI: 10.1155/jdr/5533249 Hematology IF: 01.600Volume 31, Issue 1No.72Effect of autoimmune diseases on aplastic anemia: a bidirectional two-sample Mendelian randomization study自身免疫性疾病对再生障碍性贫血的影响：一项双向两样本孟德尔随机化研究DOI: 10.1080/16078454.2026.2617680 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.73Deep exploration and precise identification of key risk factors for diabetic peripheral neuropathy using the random forest algorithm运用随机森林算法深入探索并精准识别糖尿病周围神经病变的关键风险因素DOI: 10.3389/fendo.2025.1740545 International journal of surgery IF: 10.100Volume 112, Issue 1No.74The C-reactive protein-triglyceride glucose index (CTI) predicts mortality in cardiovascular-kidney-metabolic syndrome: a dual-cohort study with machine learning validationC反应蛋白-甘油三酯-葡萄糖指数 (CTI) 预测心血管-肾脏-代谢综合征死亡率：一项结合机器学习验证的双队列研究DOI: 10.1097/JS9.0000000000003560 Frontiers in immunology IF: 05.900Volume 16, Issue No.75Multi-omics analysis of the potential association between metabolic features of hypothyroidism in the first half of pregnancy and Th17/Treg balance基于多组学分析探讨妊娠前半期甲状腺功能减退的代谢特征与Th17/Treg平衡的潜在关联DOI: 10.3389/fimmu.2025.1656946 Endocr Metab Immune Disord Drug Targets IF: 02.000Ahead of Print.No.76Association of Fibrinogen-Like Protein 1 with Metabolic Disorders and Pregnancy Outcomes: A Case-Control Study纤维蛋白原样蛋白1与代谢紊乱及妊娠结局的关联：一项病例对照研究DOI: 10.2174/0118715303416614251106110927 J Cachexia Sarcopenia Muscle IF: 09.100Volume 17, Issue 1No.77Multi-Omics Revealed the Effects of Intrauterine Hyperglycemia Exposure on the Development of Skeletal Muscle in Offspring多组学揭示宫内高血糖暴露对子代骨骼肌发育的影响DOI: 10.1002/jcsm.70177 其他发布内容（245） More Published Articles ?eská a slovenská farmacieVolume 73, Issue E2No.01Pharmaceutical care of patients with metabolic syndrome in Slovakia - questionnaire斯洛伐克代谢综合征患者的药学服务：一项问卷调查DOI: 10.36290/csf.2024.020 Physiology & behavior IF: 02.500Volume 306, Issue No.02Moderating effects of physical activity intensity and sedentary break patterns on the association between sedentary time and cardiometabolic risk in older adults体力活动强度与久坐中断模式对老年人久坐时间与心脏代谢风险关联的调节作用DOI: 10.1016/j.physbeh.2025.115214 ?eská a slovenská farmacieVolume 73, Issue E3No.03Pharmaceutical company Norgine in Ústí nad Labem (Aussig)位于拉贝河畔乌斯季（奥西希）的Norgine制药公司DOI: 10.36290/csf.2024.034 J Chem Inf Model IF: 05.300Ahead of Print.No.04HelixSide: A Comprehensive Method for Local and Global Orientational Analysis of ProteinsHelixSide：一种用于蛋白质局部与全局取向分析的综合性方法DOI: 10.1021/acs.jcim.5c02426 J Gen Intern Med IF: 04.200Ahead of Print.No.05Engaging in Advocacy to Promote Policy Change: Incorporating Advocacy-Informed Research and Applying the PRISM Implementation Science Model参与倡导以促进政策变革：融入倡导知证研究与应用PRISM实施科学模型DOI: 10.1007/s11606-026-10169-0 Ophthalmology and therapy IF: 03.200Ahead of Print.No.06A Phase III Randomized Trial Comparing Efficacy, Safety, and Immunogenicity of ZRC-3285 vs. Eylea(®) in Patients with Wet Age-Related Macular Degeneration一项在湿性年龄相关性黄斑变性患者中比较ZRC-3285与Eylea®的有效性、安全性和免疫原性的III期随机试验DOI: 10.1007/s40123-025-01299-5 Diabetologia IF: 10.200Ahead of Print.No.07Glycaemic, appetite and circadian benefits of a dairy-enriched diet with high-protein breakfast and early daytime-restricted carbohydrate intake in type 2 diabetes: a randomised crossover trial富含奶制品的饮食搭配高蛋白早餐和日间早期限制碳水化合物摄入为2型糖尿病带来血糖、食欲和昼夜节律获益：一项随机交叉试验DOI: 10.1007/s00125-025-06658-2 British dental journal IF: 02.300Volume 240, Issue 2No.08Non-sugar sweeteners - too sweet to be true?非糖甜味剂——真的甜到好处吗？DOI: 10.1038/s41415-025-9252-8 Clinical therapeutics IF: 03.600Ahead of Print.No.09Study of Insulin Treatment Modalities in Adults With Cystic Fibrosis-Related Diabetes After Elexacaftor-Tezacaftor-Ivacaftor TherapyElexacaftor-Tezacaftor-Ivacaftor治疗后成人囊性纤维化相关糖尿病患者胰岛素治疗模式研究DOI: 10.1016/j.clinthera.2025.12.016 Pathology IF: 03.000Ahead of Print.No.10Screening for multiple myeloma has low yield as part of a secondary osteoporosis screen作为继发性骨质疏松症筛查的一部分，多发性骨髓瘤筛查的检出率较低DOI: 10.1016/j.pathol.2025.11.004 Evidence-based nursingAhead of Print.No.11Tailored, resource-aware implementation is crucial for sustainable diabetes prevention in primary care初级保健中可持续糖尿病预防的关键在于定制化且资源意识强的实施DOI: 10.1136/ebnurs-2025-104430 Advances in geneticsVolume 115, Issue No.12The JAK-STAT signaling pathway in inflammatory and autoimmune diseases: Its potential role as a therapeutic targetJAK-STAT信号通路在炎症与自身免疫性疾病中的作用及其作为治疗靶点的潜力DOI: 10.1016/bs.adgen.2025.11.008 Endocrinol Diabetes Nutr (Engl Ed) IF: 01.800Volume 73, Issue 1No.13Recent advances in pituitary tumors following the 2022 WHO classification2022年WHO分类发布后的垂体肿瘤研究新进展DOI: 10.1016/j.endien.2026.501747 Endocrinol Diabetes Nutr (Engl Ed) IF: 01.800Volume 73, Issue 1No.14Radioactive iodine-induced esophagitis: A rare complication放射性碘诱发的食管炎：一种罕见并发症DOI: 10.1016/j.endien.2025.501656 Endocrinol Diabetes Nutr (Engl Ed) IF: 01.800Volume 73, Issue 1No.15Vitamin K in home parenteral nutrition: Is it really necessary?家庭肠外营养中的维生素K：真的必要吗？DOI: 10.1016/j.endien.2025.501655 Endocrinol Diabetes Nutr (Engl Ed) IF: 01.800Volume 73, Issue 1No.16Enhancing levothyroxine dosing accuracy post-total thyroidectomy using body fat percentage利用体脂百分比提高全甲状腺切除术后左甲状腺素剂量准确性DOI: 10.1016/j.endien.2025.501645 J Stroke Cerebrovasc Dis IF: 01.800Ahead of Print.No.17Early Insights from a Multi-Centre National Stroke Surveillance Initiative in Tanzania坦桑尼亚多中心国家卒中监测倡议的早期发现DOI: 10.1016/j.jstrokecerebrovasdis.2026.108571 Toxicol Appl Pharmacol IF: 03.400Ahead of Print.No.18Sustained cadmium exposure and hyperglycemia additively drives mitochondrial dysfunction in hepatic cells: Implications for MASLD etiopathogenesis持续镉暴露与高血糖协同加剧肝细胞线粒体功能障碍：对MASLD发病机制的启示DOI: 10.1016/j.taap.2026.117729 Am J Clin Nutr IF: 06.900Ahead of Print.No.19Metabolome contribution to sex differences in the link between alcohol consumption and type 2 diabetes: a prospective analysis in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)代谢组对饮酒与2型糖尿病关联中性别差异的贡献：一项基于 Hispanic Community Health Study/Study of Latinos (HCHS/SOL)的前瞻性分析DOI: 10.1016/j.ajcnut.2026.101203 Clinical nutrition ESPEN IF: 02.600Ahead of Print.No.20Reply - Letter to the editor: Impact of fish oil-enriched high protein peptide-based formula on free fatty acid profiles and metabolomic changes in home enterally fed patients: A pilot study回复—致编辑的信：富含鱼油的高蛋白肽基配方对居家肠内营养患者游离脂肪酸谱及代谢组学变化的影响：一项初步研究DOI: 10.1016/j.clnesp.2026.102923 Clin Gastroenterol Hepatol IF: 12.000Ahead of Print.No.21Reply to : "Is baseline MASH fibrosis the key determinant for survival after bariatric surgery ?"回应：“基线MASH纤维化是减重手术后生存预后的关键决定因素吗？”DOI: 10.1016/j.cgh.2026.01.006 J Foot Ankle Surg IF: 01.300Ahead of Print.No.22Two-Dimensional vs Three-Dimensional Analysis of Weightbearing Charcot Neuropathy Deformities负重夏科氏神经关节病畸形的二维与三维分析对比DOI: 10.1053/j.jfas.2026.01.010 Environment international IF: 09.700Ahead of Print.No.23Longitudinal associations of long-term exposure to ambient air pollution, residential greenness, and air temperature with type 2 diabetes subphenotypes: Results from the KORA cohort study长期环境空气污染、住宅绿化及气温暴露与2型糖尿病亚型纵向关联研究：来自KORA队列研究的结果DOI: 10.1016/j.envint.2025.110043 Hormones and behavior IF: 02.400Ahead of Print.No.24Early androgens and development of social personality traits: Evidence from classical congenital adrenal hyperplasia早期雄激素与社交人格特质发展：来自经典先天性肾上腺增生症的证据DOI: 10.1016/j.yhbeh.2025.105875 Journal of pediatric nursing IF: 02.300Ahead of Print.No.25Adolescents' experiences of hypoglycemic episodes in type 1 diabetes青少年1型糖尿病患者的低血糖发作体验DOI: 10.1016/j.pedn.2026.01.023 Pediatric neurology IF: 02.100Ahead of Print.No.26The Relationship of Serum Uric Acid With Neurocognitive Functions in Children and Adolescents With Mild to Moderate Chronic Kidney Disease血清尿酸水平与轻度至中度慢性肾脏病儿童及青少年神经认知功能的关系DOI: 10.1016/j.pediatrneurol.2025.12.024 British journal of anaesthesia IF: 09.200Ahead of Print.No.27Perioperative management of patients taking glucagon-like peptide-1 receptor agonists: implementation of complex fasting recommendations. Response to Br J Anaesth 2025; 136: 375-6围手术期管理使用胰高血糖素样肽-1受体激动剂的患者：实施复杂禁食建议——对 Br J Anaesth 2025; 136: 375-6 的回应DOI: 10.1016/j.bja.2025.12.022 Fertility and sterility IF: 07.000Ahead of Print.No.28The Reproductive Tract Microbiome and Female Fertility: Dysbiosis, Disease Links, and Emerging Therapeutic Strategies生殖道微生物群与女性生育力：菌群失调、疾病关联及新兴治疗策略DOI: 10.1016/j.fertnstert.2026.01.010 Wiener klinische Wochenschrift IF: 02.100Ahead of Print.No.29Determination of the relationship between mothers' carbohydrate counting knowledge and glycemic control in children with type 1 diabetes母亲碳水化合物计数知识与儿童1型糖尿病血糖控制关系的研究DOI: 10.1007/s00508-025-02696-3 Placenta IF: 02.500Ahead of Print.No.30Structural alterations in the placental villous tree in well-controlled gestational diabetes mellitus控制良好的妊娠期糖尿病中胎盘绒毛树的结构改变DOI: 10.1016/j.placenta.2026.01.010 Comput Biol Chem IF: 03.100Ahead of Print.No.31Tailored pyrrole-based imidazothiazole scaffolds: Synthetic elaboration, enzyme kinetic profiling and DFT-guided molecular docking toward Antidiabetic therapeutics设计合成的吡咯基咪唑并噻二唑骨架：合成拓展、酶动力学分析及基于DFT的分子对接用于抗糖尿病治疗DOI: 10.1016/j.compbiolchem.2026.108920 Am J Vet Res IF: 01.400Ahead of Print.No.32Oral gabapentin reduces respiratory rate and resistance scores in adult domestic pigeons (Columba livia domestica) during and after handling口服加巴喷丁降低成年家鸽（Columba livia domestica）在操作期间及操作后的呼吸频率与抵抗评分DOI: 10.2460/ajvr.25.11.0401 J Gen Intern Med IF: 04.200Ahead of Print.No.33Gender Differences in Statin Discontinuation and Adherence Among Privately Insured People with HIV in the USA美国有私人保险的HIV感染者中他汀类药物停用与依从性的性别差异DOI: 10.1007/s11606-025-10164-x Res Social Adm Pharm IF: 02.800Ahead of Print.No.34Assessing the impact of frailty on statin prescriptions among older stroke survivors with and without diabetes评估虚弱对老年卒中幸存者他汀类处方的影响：糖尿病与非糖尿病患者的比较DOI: 10.1016/j.sapharm.2026.01.004 J Gen Intern Med IF: 04.200Ahead of Print.No.35Subtle Laboratory and Clinical Precursors of Celiac Disease in Young Adults: A Large-Scale Retrospective Cohort Study年轻成人乳糜泻的细微实验室与临床先兆：一项大规模回顾性队列研究DOI: 10.1007/s11606-026-10187-y BMC public health IF: 03.600Ahead of Print.No.36Evaluation of the experience of people referred under the NHS enhanced service incentive for obesity to the NHS digital weight management programme: a mixed method study对经NHS肥胖管理增强服务激励计划转诊至NHS数字体重管理项目者的体验评估：一项混合方法研究DOI: 10.1186/s12889-026-26203-z Canadian journal of anaesthesia IF: 03.300Ahead of Print.No.37Characteristics of the epidural electrical stimulation test and pressure waveform test to confirm epidural catheter placement in patients who are pregnant and have a body mass index higher than 50 kg·m(-2)体重指数高于50 kg·m(-2)孕妇中硬膜外电刺激测试与压力波形测试确认硬膜外导管放置的特征DOI: 10.1007/s12630-025-03062-7 The AAPS journal IF: 03.700Volume 28, Issue 2No.38Pharmacokinetics of Inhibitors of Succinyl-CoA:3-Ketoacid CoA Transferase in Sprague-Dawley Rats, and the Effect of a High-Fat DietSprague-Dawley大鼠中琥珀酰辅酶A：3-酮酸辅酶A转移酶抑制剂的药代动力学及高脂饮食的影响DOI: 10.1208/s12248-026-01208-z European journal of pediatrics IF: 02.600Volume 185, Issue 2No.39Influence of weight perception on the evolution of body composition of adolescents under obesity treatment体重感知对接受肥胖治疗的青少年身体成分演变的影响DOI: 10.1007/s00431-025-06737-x Surg Obes Relat Dis IF: 03.800Ahead of Print.No.40Left ventricular assist devices triple the risk of serious complications and longer hospital stay following bariatric surgery: a national analysis of 180,544 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program cases左心室辅助装置使减重术后严重并发症风险增加三倍，并延长住院时间：基于180,544例MBSAQIP病例的国家数据分析DOI: 10.1016/j.soard.2025.12.003 Endocrinol Diabetes Nutr (Engl Ed) IF: 01.800Volume 73, Issue 1No.41Beyond vectorial bioelectrical impedance: Assessing body composition changes with novel electrical parameters in obese osteoarthritis patients on a meal-replacement diet超越矢量生物电阻抗：利用新型电学参数评估肥胖骨关节炎患者进行代餐饮食后的身体成分变化DOI: 10.1016/j.endien.2025.501644 BMJ open IF: 02.300Volume 16, Issue 1No.42Evaluation of an innovative family-centred care and prevention intervention for children with overweight and obesity: a mixed-methods study protocol of the randomised controlled fruehstArt study in Germany德国fruehstArt随机对照研究：一项针对超重和肥胖儿童的创新性以家庭为中心的照护与预防干预的评估——一项混合方法研究方案DOI: 10.1136/bmjopen-2025-111373 Biochim Biophys Acta Gene Regul Mech IF: 03.100Ahead of Print.No.43Tet2-mediated Pref-1 activation delays adipocyte differentiationTet2介导的Pref-1激活延迟脂肪细胞分化DOI: 10.1016/j.bbagrm.2026.195137 Contraception IF: 02.300Ahead of Print.No.44Evaluating Graduating OBGYN Residents' Training in Postpartum Permanent Contraceptive Procedures评估即将毕业的妇产科住院医师产后永久避孕手术的培训情况DOI: 10.1016/j.contraception.2026.111372 Revista cli?nica espan?olaAhead of Print.No.45Position statement of the spanish society of internal medicine (SEMI) and the portuguese society of internal medicine (SPMI)西班牙内科医学会与葡萄牙内科医学会立场声明DOI: 10.1016/j.rceng.2026.502468 World neurosurgery IF: 02.100Ahead of Print.No.46Body Mass Index as A risk Factor for Recurrence and Frequency of Re-surgery After Lumbar Spine Surgery体重指数作为腰椎手术后复发及再手术频率的风险因素DOI: 10.1016/j.wneu.2026.124824 Journal of nutrition IF: 03.800Ahead of Print.No.47Integrative Nutrigenomics Approach in Polycystic Ovarian Syndrome: Targeting Gene-Diet Interactions for Personalized Nutraceutical Interventions多囊卵巢综合征的整合营养基因组学方法：靶向基因-饮食相互作用实现个性化营养干预DOI: 10.1016/j.tjnut.2026.101371 Journal of nutrition IF: 03.800Ahead of Print.No.48Chemical Analysis of Controlled Diets High in and Free of Ultra-processed Foods (UPF) and Proof-of-Concept Findings: Reducing UPF Consumption May Lower Diabetes Risk in Mid-life Adults高含量与零含量超加工食品的控制饮食化学分析及概念验证发现：减少超加工食品摄入或可降低中年成人糖尿病风险DOI: 10.1016/j.tjnut.2026.101370 Molecular metabolism IF: 06.600Ahead of Print.No.49α-Parvin Promotes Glucose Uptake and Metabolism in Skeletal Muscle with Minimal Influence on Hepatic Insulin Sensitivityα-Parvin促进骨骼肌葡萄糖摄取与代谢，对肝脏胰岛素敏感性影响甚微DOI: 10.1016/j.molmet.2026.102322 Cell reports IF: 06.900Ahead of Print.No.50Integrative multi-omics analysis reveals oral microbiome-metabolome signatures of obesity整合多组学分析揭示肥胖的口腔微生物组-代谢组特征DOI: 10.1016/j.celrep.2025.116819 Cell reports medicine IF: 10.600Ahead of Print.No.51Gut microbiome and obesity care: Bridging dietary, surgical, and pharmacological interventions肠道微生物组与肥胖管理：连接饮食、手术及药物干预DOI: 10.1016/j.xcrm.2025.102573 Gait & posture IF: 02.400Ahead of Print.No.52Cognitive decline outweighs adiposity in influencing lower limb gait kinematics in older adults在影响老年人下肢步态运动学方面，认知功能下降重于肥胖水平DOI: 10.1016/j.gaitpost.2026.110104 J Psychosom Res IF: 03.300Ahead of Print.No.53The association between sleep trajectories throughout pregnancy and postpartum pain in individuals with overweight or obesity: A prospective cohort study超重或肥胖个体孕期睡眠轨迹与产后疼痛的关联：一项前瞻性队列研究DOI: 10.1016/j.jpsychores.2026.112535 Geriatric nursing IF: 02.400Ahead of Print.No.54Association of routine clinical indicators for metabolic and cardiovascular health with weight loss in non-obese older adults: A case-control study using annual health screening data in Japan常规代谢与心血管健康指标与非肥胖老年人体重减轻的关联：基于日本年度健康筛查数据的病例对照研究DOI: 10.1016/j.gerinurse.2026.103889 BMC endocrine disorders IF: 03.300Ahead of Print.No.55Incidence and risk factors for osteoporosis in people with type 2 diabetes mellitus in Thailand泰国2型糖尿病患者骨质疏松症的发病率和危险因素DOI: 10.1186/s12902-026-02165-6 ?eská gynekologie IF: 00.500Volume 90, Issue 6No.56Status of a lipid accumulation product, triglycerides/ glucose index and visceral adiposity index on cardiometabolic risk factors in young polycystic ovary syndrome patients脂质蓄积产物、甘油三酯/葡萄糖指数与内脏肥胖指数在年轻多囊卵巢综合征患者心血管代谢风险因素中的状态评估DOI: 10.48095/cccg2025457 International dental journal IF: 03.700Ahead of Print.No.57Oral Health of Children With Severe or Complex Obesity and Association of Markers of Glucose Metabolism With Gingivitis重度或复杂性肥胖儿童的口腔健康及血糖代谢标志物与牙龈炎的相关性研究DOI: 10.1016/j.identj.2025.109383 Nature communications IF: 15.700Ahead of Print.No.58Epigenome-wide analysis identifies DNA methylation mediators of treatment-related cardiometabolic risk in survivors of childhood cancer表观基因组分析识别儿童癌症幸存者中治疗相关心血管代谢风险的DNA甲基化介导因子DOI: 10.1038/s41467-026-68689-6 Annals of hepatology IF: 04.400Ahead of Print.No.59Twofold increased risk of coronary artery disease after liver transplantation: A nationwide Swedish cohort of 2925 patients肝移植后冠心病风险增加两倍：瑞典全国性队列研究纳入2925例患者DOI: 10.1016/j.aohep.2025.102172 Value in health regional issues IF: 01.500Ahead of Print.No.60Retail Sales of Drugs for Diabetes, Dyslipidemia, and Hypertension in Chile Under 2 Health Policies2种健康政策下智利糖尿病、血脂异常和高血压药物的零售销售DOI: 10.1016/j.vhri.2025.101577 Neurochemical research IF: 03.800Volume 51, Issue 1No.61Metformin Ameliorates Cognitive Deficits and Neuroinflammation in a Mouse Model of Familial Hypercholesterolemia二甲双胍改善家族性高胆固醇血症小鼠模型的认知缺陷和神经炎症DOI: 10.1007/s11064-025-04658-7 European neuropsychopharmacology IF: 06.700Ahead of Print.No.62Antipsychotic plasma concentration as predictor of movement disorders and cardiometabolic side-effects: A comparison with prescription dose抗精神病药物血浆浓度作为运动障碍和心血管代谢副作用的预测因子：与处方剂量的比较DOI: 10.1016/j.euroneuro.2026.112769 Journal of clinical neuroscience IF: 01.800Ahead of Print.No.63Neuromuscular ultrasound and nerve conduction studies as complementary tools for screening of diabetic peripheral neuropathy神经肌肉超声与神经传导研究作为糖尿病周围神经病变筛查的互补工具DOI: 10.1016/j.jocn.2026.111876 CPT Pharmacometrics Syst Pharmacol IF: 03.000Volume 15, Issue 2No.64Preclinical Modeling and Simulation to Explore the Tissue/Plasma Exposure and Pharmacodynamic Effect of Vildagliptin in Diabetes Treatment临床前建模与模拟探索维格列汀在糖尿病治疗中的组织/血浆暴露及药效学效应DOI: 10.1002/psp4.70165 British journal of pharmacology IF: 07.700Ahead of Print.No.65Glucagon-like peptide-1 receptor agonists and muscle strength changes in older adults: Risks beyond muscle mass reductions胰高血糖素样肽-1受体激动剂与老年人肌力变化：超越肌肉量减少的风险DOI: 10.1111/bph.70355 Journal of neurosurgery. Spine IF: 03.100Ahead of Print.No.66The comparative impact of body mass index on outcomes following minimally invasive versus open surgery for grade 1 spondylolisthesis: 2-year follow-up from the Quality Outcomes Database体重指数对微创与开放手术治疗1级腰椎滑脱疗效的比较性影响：基于质量结局数据库的2年随访DOI: 10.3171/2025.9.SPINE25552 Lab on a chip IF: 05.400Ahead of Print.No.67Online affinity micro free-flow electrophoresis for the continuous monitoring of insulin via a competitive immunoassay基于竞争性免疫分析的在线亲和微自由流电泳技术用于胰岛素连续监测DOI: 10.1039/d5lc00745c PloS one IF: 02.600Volume 21, Issue 1No.68Evaluation of rat pancreatic islets damage after siRNA microporationsiRNA微穿孔后大鼠胰腺胰岛的损伤评估DOI: 10.1371/journal.pone.0340066 Biomaterials IF: 12.900Ahead of Print.No.69Smart multifunctional ROS-responsive supramolecular hydrogel for simultaneously regulating oxidative stress, immune dysregulation, and bacterial infection in diabetic wound healing智能多功能ROS响应性超分子水凝胶同步调控糖尿病伤口愈合中的氧化应激、免疫失调和细菌感染DOI: 10.1016/j.biomaterials.2026.124006 Journal of neurosurgery IF: 03.600Ahead of Print.No.70Association of standard postoperative day 1 discharge following endonasal surgery for pituitary adenoma with lower complication rates and unplanned medical care垂体腺瘤经鼻手术后标准术后第1天出院与较低并发症率及未计划医疗照护相关DOI: 10.3171/2025.9.JNS25752 Journal of clinical oncology : IF: 41.900Ahead of Print.No.71Threshold Dose-Response Association Between Alcohol Consumption and Risk of Young-Onset Pancreatic Cancer: A Nationwide Korean Cohort Study of Young Adults Age 20-39 Years酒精消费与年轻发病胰腺癌风险的阈值剂量反应关联：一项针对韩国20-39岁年轻成人的全国性队列研究DOI: 10.1200/JCO-25-01169 Science advances IF: 12.500Volume 12, Issue 4No.72Neuronal GPR75 deficiency protects against diet-induced obesity in a humanized mouse model在人源化小鼠模型中，神经元GPR75缺陷可预防饮食诱导的肥胖DOI: 10.1126/sciadv.ady7993 Science advances IF: 12.500Volume 12, Issue 4No.73CD318 expression defines a novel subset of human CD8(+) regulatory T cellsCD318的表达定义了人类CD8(+)调节性T细胞的一个新亚群DOI: 10.1126/sciadv.adz4203 Science advances IF: 12.500Volume 12, Issue 4No.74TDRD3, a Tudor domain-containing protein, regulates Klf2-dependent T(reg) differentiation and function to modulate immune tolerance含有Tudor结构域的蛋白TDRD3通过调控Klf2依赖性Treg分化与功能调节免疫耐受DOI: 10.1126/sciadv.aea3960 PloS one IF: 02.600Volume 21, Issue 1No.75The role of obesity and Type 2 diabetes in lung health: A systematic review (2024)肥胖与2型糖尿病在肺健康中的作用：一项系统综述DOI: 10.1371/journal.pone.0340692 PloS one IF: 02.600Volume 21, Issue 1No.76Cardiovascular risk among middle-aged Japanese adults with atopic dermatitis: A nested case-control study日本中年特应性皮炎患者的心血管风险：一项巢式病例对照研究DOI: 10.1371/journal.pone.0341337 PloS one IF: 02.600Volume 21, Issue 1No.77Stress hyperglycemia ratio predicts adverse outcomes in emergency department patients with upper gastrointestinal bleeding应激性高血糖比值预测急诊上消化道出血患者不良结局DOI: 10.1371/journal.pone.0340450 PloS one IF: 02.600Volume 21, Issue 1No.78Pharmacological evaluation of mangrove plant Rhizophora mucronata (Lam.) grown in the coastal area of Sundarbans对生长在孙德尔本斯沿海地区的红树植物红茄苳（Rhizophora mucronata (Lam.)）的药理评价DOI: 10.1371/journal.pone.0340646 PloS one IF: 02.600Volume 21, Issue 1No.79Impact of cardiometabolic risk factors on hepatocellular carcinoma incidence in patients with chronic hepatitis B: A retrospective cohort study心脏代谢风险因素对慢性乙型肝炎患者肝细胞癌发病的影响：一项回顾性队列研究DOI: 10.1371/journal.pone.0341366 PloS one IF: 02.600Volume 21, Issue 1No.80Developing count regression techniques for predicting the number of new type 2 diabetes cases in Saudi Arabia开发计数回归技术预测沙特阿拉伯2型糖尿病新发病例数DOI: 10.1371/journal.pone.0341436 JMIR research protocols IF: 01.500Volume 15, Issue No.81Developing a Culturally Adapted Digital Health Application for Older Hispanic Adults With Type 2 Diabetes: Protocol for a Qualitative and Pilot Study为患有2型糖尿病的老年西班牙裔成年人开发文化适应性数字健康应用程序：一项定性和试点研究方案DOI: 10.2196/76294 Med Lett Drugs Ther IF: 01.400Volume 67, Issue 1743No.82Comparison chart: Some available insulins for type 2 diabetes对比图表：2型糖尿病部分可用胰岛素DOI: 10.58347/tml.2025.1743d Med Lett Drugs Ther IF: 01.400Volume 67, Issue 1743No.83Insulins for type 2 diabetes2型糖尿病胰岛素疗法概览DOI: 10.58347/tml.2025.1743c Med Lett Drugs Ther IF: 01.400Volume 67, Issue 1743No.84A cardiovascular indication for oral semaglutide (Rybelsus)口服司美格鲁肽(Rybelsus)的心血管适应症DOI: 10.58347/tml.2025.1743b PloS one IF: 02.600Volume 21, Issue 1No.85HbA1c underperforms in identifying abnormal glucose tolerance in the presence of G6PD deficiency: Insight from the Africans in America study在G6PD缺乏症背景下，HbA1c识别糖耐量异常的效能降低：来自“美国非洲裔人群”研究的见解DOI: 10.1371/journal.pone.0334634 Med Lett Drugs Ther IF: 01.400Volume 68, Issue 1747No.86Risks of tramadol and gabapentin use for pain曲马多与加巴喷丁用于疼痛的风险DOI: 10.58347/tml.2026.1747d Appl Biochem Biotechnol IF: 03.300Ahead of Print.No.87Modulatory Role of Moringa Oleifera-Loaded Silver Nanoparticles on UCP1 and PPARGC1A Genes Expression in an Obesity Rat Model辣木负载银纳米颗粒在肥胖大鼠模型中对UCP1和PPARGC1A基因表达的调节作用DOI: 10.1007/s12010-025-05511-x Pediatric nephrology IF: 02.600Ahead of Print.No.88Beyond genetics: how environmental stressors drive pediatric hypertension risk超越遗传学：环境压力因素如何驱动儿童高血压风险DOI: 10.1007/s00467-025-07145-x J Nutr Educ Behav IF: 02.300Ahead of Print.No.89Stakeholder Perspectives on Remote Delivery of a Group-Based Child Obesity Prevention Program for Latino Families With Low Income利益相关者对拉丁裔低收入家庭基于群体的儿童肥胖预防项目远程实施的看法DOI: 10.1016/j.jneb.2025.12.004 Immunological reviews IF: 08.300Volume 338, Issue 1No.90Sex Differences in the Impact of Obesity on Immunity肥胖对免疫影响中的性别差异DOI: 10.1111/imr.70101 Cancer science IF: 04.300Ahead of Print.No.91Effect Modification by Cofactors in the Impact of Body Mass Index Change on the Risk of Lung Cancer体重指数变化对肺癌风险的影响：多种因素的效应修饰作用DOI: 10.1111/cas.70332 Die Chirurgie IF: 00.600Ahead of Print.No.92[Oral intake of 25 mg semaglutide in adults with overweight or obesity]超重或肥胖成人中口服25毫克司美格鲁肽DOI: 10.1007/s00104-026-02452-x Clin Transl Oncol IF: 02.500Ahead of Print.No.93IRS2 as a driver and therapeutic target in brain metastases from colorectal cancer: a systematic review of mechanistic and translational evidenceIRS2作为结直肠癌脑转移的驱动因子和治疗靶点：机制与转化证据的系统综述DOI: 10.1007/s12094-025-04212-5 Arch Gynecol Obstet IF: 02.500Volume 313, Issue 1No.94Impact of hormones on lipedema development: a systematic literature review激素对脂肪水肿发展的影响：一项系统性文献综述DOI: 10.1007/s00404-026-08318-1 Macromolecular bioscience IF: 04.100Volume 26, Issue 1No.95Identification of Novel Growth Factor Conjugated Nanofibers for Stimulation of Neuronal Growth鉴定用于刺激神经元生长的生长因子共轭纳米纤维DOI: 10.1002/mabi.202500585 J Int Med Res IF: 01.500Volume 54, Issue 1No.96Relationship of body composition with cortisol and dehydroepiandrosterone sulfate levels in Korean men and women韩国成年男女身体成分与皮质醇及脱氢表雄酮硫酸盐水平的关系DOI: 10.1177/03000605251413389 Med Lett Drugs Ther IF: 01.400Volume 68, Issue 1747No.97Oral semaglutide (Wegovy) for weight loss口服司美格鲁肽（Wegovy）用于减重DOI: 10.58347/tml.2026.1747a La Revue du praticienVolume 75, Issue 9No.98[Why and how should the renal risk of patients with type 2 diabetes be assessed ?]为何及如何评估2型糖尿病患者的肾脏风险https://pubmed.ncbi.nlm.nih.gov/41575136 Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.99SGLT2 inhibitors and mortality in older adults with diabetic kidney disease: A target trial emulation studySGLT2抑制剂与老年糖尿病肾病患者死亡率：一项靶向试验仿真研究DOI: 10.1111/dom.70502 JAMA IF: 55.000Ahead of Print.No.100Higher Food Preservative Intake Linked With Type 2 Diabetes食物防腐剂摄入量增加与2型糖尿病相关DOI: 10.1001/jama.2025.23033 JAMA Network Open IF: 09.700Volume 9, Issue 1No.101Voice Assistant for Older Adults With Type 2 Diabetes面向2型糖尿病老年患者的语音助手DOI: 10.1001/jamanetworkopen.2025.53483 Eur J Clin Microbiol Infect Dis IF: 03.000Ahead of Print.No.102Epidemiological profile and clinical outcomes of patients with mucormycosis: the multicenter retromucor study from Türkiye (2004-2024)毛霉菌病患者的流行病学特征与临床结局：土耳其多中心retromucor研究（2004-2024）DOI: 10.1007/s10096-025-05397-x Current obesity reports IF: 11.000Volume 15, Issue 1No.103Gut Peptide Alterations in Type 2 Diabetes and Obesity: A Narrative Review肠道肽在2型糖尿病与肥胖中的改变：叙事综述DOI: 10.1007/s13679-026-00687-7 J Physiol Biochem IF: 04.300Volume 82, Issue 1No.104Procyanidin B2 and an autochthonous apple pulp extract modulate oxidative stress and PPARγ expression on an in vitro model of lipid steatosis in HepG2 cells原花青素B2与一种本土苹果果肉提取物在HepG2细胞脂质变性体外模型中调节氧化应激与PPARγ表达DOI: 10.1007/s13105-026-01151-9 Diabetes Technol Ther IF: 06.300Ahead of Print.No.105Safety of Inhaled Insulin in Adults with Diabetes吸入胰岛素在成人糖尿病患者中的安全性DOI: 10.1177/15209156251390830 Kidney360 IF: 03.000Ahead of Print.No.106Clinical Characteristics and Disease Progression Among Non-Diabetic APOL1-Mediated Kidney Disease Patients and Patients with Other CKD非糖尿病APOL1介导的肾脏病患者与其他慢性肾脏病患者的临床特征及疾病进展比较DOI: 10.34067/KID.0000001097 JACC: Clinical Electrophysiology IF: 07.700Ahead of Print.No.107Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Device Leads: The TRIPLACE Registry在伴心脏植入式电子装置导线的患者中行经导管三尖瓣置换术：TRIPLACE注册研究DOI: 10.1016/j.jacep.2025.12.027 Diabetes care IF: 16.600Ahead of Print.No.108The Look AHEAD Research Program: A 25-Year Retrospective From the Perspective of GeroscienceLook AHEAD研究项目：基于老年科学视角的25年回顾DOI: 10.2337/dci25-0126 Diabetes care IF: 16.600Ahead of Print.No.109Interlaboratory Evaluation of Multiplex Autoantibody Assay Performance in the Islet Autoantibody Standardization Program 2024 Workshop胰岛自身抗体标准化程序2024研讨会：多重自身抗体检测性能的室间评估DOI: 10.2337/dc25-1326 Reproduction IF: 03.700Ahead of Print.No.110Curating Fertility-Proteomic Remodelling of Sperm During Epididymal Transit塑造生育力：精子在附睾转运中的蛋白质组重塑DOI: 10.1093/reprod/xaag012 Organic letters IF: 05.000Ahead of Print.No.111Total Synthesis of Okeaniamide AOkeaniamide A的全合成DOI: 10.1021/acs.orglett.5c05432 Annals of African medicine IF: 00.600Ahead of Print.No.112Management of Chronic Pancreatitis with Pancreatic Duct Calculi伴有胰管结石的慢性胰腺炎的治疗DOI: 10.4103/aam.aam_654_25 La Revue du praticienVolume 75, Issue 9No.113[What are the key takeaways from the HAS recommendations regarding special populations (elderly populations and pregnancy or planning to become pregnant) ?]关于特殊人群（老年人群、孕产妇或备孕者），法国国家卫生管理局（HAS）建议的要点是什么？https://pubmed.ncbi.nlm.nih.gov/41575137 La Revue du praticienVolume 75, Issue 9No.114[Lifestyle modifications in type 2 diabetes: yes, but how ?]2型糖尿病的生活方式干预：方向明确，如何落实？https://pubmed.ncbi.nlm.nih.gov/41575134 La Revue du praticienVolume 75, Issue 9No.115[From glycemic control to comprehensive management of patients living with type 2 diabetes: a paradigm shift ?]从血糖控制到2型糖尿病患者的综合管理：一场范式转变https://pubmed.ncbi.nlm.nih.gov/41575132 MS. Me?decine sciences IF: 00.400Volume 42, Issue 1No.116[Intestinal microbiota biodiversity and the modern diet: consequences for human health]肠道微生物群多样性与现代饮食：对人类健康的影响DOI: 10.1051/medsci/2025253 Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.117Efficacy and safety of once-weekly insulins in type 2 diabetes: A systematic review and meta-analysis一周一次胰岛素在2型糖尿病中的有效性与安全性：一项系统评价与Meta分析DOI: 10.1111/dom.70497 Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.118Lorcaserin induces abdominal fat loss with associated improvements of the circulating metabolome/lipidome and no changes in the myostatin-activin-follistatin-IGF-1 axes: A 6-month long randomized placebo-controlled clinical trial氯卡色林通过改善循环代谢组/脂质组谱诱导腹部脂肪减少，且不改变肌肉生长抑制素-激活素-卵泡抑素-IGF-1轴：一项为期6个月的随机安慰剂对照临床试验DOI: 10.1111/dom.70496 Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.119Methylglyoxal-derived hydroimidazolone (MG-H1) is a novel marker of insulin resistance in Japanese individuals, disturbing insulin signalling via mTORC2 in cultured myocytes甲基乙二醛衍生的氢咪唑酮(MG-H1)是日本人群胰岛素抵抗的新标志物，通过mTORC2干扰培养肌细胞的胰岛素信号DOI: 10.1111/dom.70489 Health promotion practice IF: 01.200Ahead of Print.No.120Evaluation of a Prediabetes Media Campaign for Black and Hispanic Men to Increase Awareness of Diabetes Prevention and Address Health Inequity一项针对黑人和西班牙裔男性的糖尿病前期媒体运动评估：旨在提高糖尿病预防意识并解决健康不平等问题DOI: 10.1177/15248399251414653 Acta Cardiologica IF: 02.500Ahead of Print.No.121Incidence, risk factors and prognostic impact of cerebrovascular events after transcatheter aortic valve implantation经导管主动脉瓣植入术后脑血管事件的发生率、风险因素及预后影响DOI: 10.1080/00015385.2026.2617492 American journal of epidemiology IF: 04.800Ahead of Print.No.122Thyroid autoimmunity and the subsequent development of islet and celiac autoimmunity in the TEDDY study甲状腺自身免疫与后续胰岛及乳糜泻自身免疫的发展：TEDDY研究DOI: 10.1093/aje/kwag016 Annals of African medicine IF: 00.600Ahead of Print.No.123Stem Cell Therapy as a Regenerative Strategy in Hereditary Pancreatitis Postpancreatectomy干细胞疗法作为遗传性胰腺炎胰腺切除术后的再生策略DOI: 10.4103/aam.aam_509_25 J Diabetes Investig IF: 03.000Ahead of Print.No.124Erythrocyte deformability correlates with microvascular ischemia and disease severity in diabetic retinopathy红细胞变形能力与糖尿病视网膜病变的微血管缺血和疾病严重程度相关DOI: 10.1111/jdi.70247 J Diabetes Investig IF: 03.000Ahead of Print.No.125A pitfall in diagnosing type B insulin resistance syndrome: Suspected antibody interference in a patient with insulin allergy诊断B型胰岛素抵抗综合征的一个陷阱：胰岛素过敏患者中的疑似抗体干扰DOI: 10.1111/jdi.70235 J Diabetes Investig IF: 03.000Ahead of Print.No.126Increased C-reactive protein is associated with corneal nerve loss and painful neuropathic symptoms in Type 2 diabetes mellitusC反应蛋白升高与2型糖尿病患者角膜神经损失及疼痛性神经病变症状相关DOI: 10.1111/jdi.70246 Eur J Neurosci IF: 02.400Volume 63, Issue 2No.127Electrical Synapses Contribute to Sleep-Dependent Declarative Memory Retention电突触促进睡眠依赖性陈述性记忆保留DOI: 10.1111/ejn.70401 Pol Arch Intern Med IF: 04.700Ahead of Print.No.128Determining the association between preeclampsia and the thyroid hormone status in pregnant women with type 1 diabetes探究1型糖尿病孕妇先兆子痫与甲状腺激素状态的关联性DOI: 10.20452/pamw.17199 International wound journal IF: 02.500Volume 23, Issue 1No.129A Prospective Randomised Clinical Study Comparing Polygalacturonic and Caprylic Acid Ointment to Medical-Grade Honey in the Management of Chronic Wounds比较聚半乳糖醛酸-辛酸软膏与医用级蜂蜜治疗慢性伤口的前瞻性随机临床研究DOI: 10.1111/iwj.70815 JCI insight IF: 06.100Volume 11, Issue 2No.130Anti-CD3 mAb treatment reshapes infiltrating T and β cells in the islets in autoimmune diabetes抗CD3单抗治疗重塑自身免疫性糖尿病胰岛中的浸润性T细胞与β细胞DOI: 10.1172/jci.insight.192755 La Revue du praticienVolume 75, Issue 8No.131[Management of neuropathic pain: Don't lose hope!]神经病理性疼痛的管理：不要失去希望https://pubmed.ncbi.nlm.nih.gov/41575077 La Revue du praticienVolume 75, Issue 9No.132[Pharmacological management of non-insulin-treated type 2 diabetes: practical implementation of HAS guidelines]非胰岛素治疗的2型糖尿病的药物治疗：法国国家卫生管理局指南的实践实施https://pubmed.ncbi.nlm.nih.gov/41575133 Science progress IF: 02.900Volume 109, Issue 1No.133Retraction: Potassium bromate-induced nephrotoxicity and potential curative role of metformin loaded on gold nanoparticles撤稿：溴酸钾诱导的肾毒性及负载于金纳米颗粒的甲福明潜在治疗作用DOI: 10.1177/00368504261417035 Annals of African medicine IF: 00.600Ahead of Print.No.134Evaluating Antenatal Depression in Women with Gestational Diabetes Mellitus: A Hospital-based Observational Study妊娠期糖尿病女性产前抑郁评估：一项医院为基础的观察性研究DOI: 10.4103/aam.aam_700_25 La Revue du praticienVolume 75, Issue 9No.135[Why and how should the cardiovascular risk of patients with type 2 diabetes be assessed ?]为何以及如何评估2型糖尿病患者的心血管风险？https://pubmed.ncbi.nlm.nih.gov/41575135 Cancer Epidemiol Biomarkers Prev IF: 03.400Ahead of Print.No.136The Potential Impact of Histamine-2 Receptor Antagonists on Gynecologic Cancer Risk: A Population-Based Study of 23 Million IndividualsH2受体拮抗剂对妇科癌症风险的潜在影响：一项基于2300万人的群体研究DOI: 10.1158/1055-9965.EPI-25-1306 JACC: AdvancesVolume 5, Issue 2No.137FDA Cardiovascular Indication Expansion and Dispensing of Semaglutide/Tirzepatide in CVD Patients With Overweight/ObesityFDA心血管适应症扩展及司美格鲁肽/替尔泊肽在心血管疾病合并超重/肥胖患者中的处方情况DOI: 10.1016/j.jacadv.2025.102575 JACC: AdvancesVolume 5, Issue 2No.138Wireless Movement Activity and Cardiometabolic Disease Risk in Historical Redlined Areas历史红线划定区域内的无线移动活动与心血管代谢疾病风险DOI: 10.1016/j.jacadv.2025.102528 EBioMedicine IF: 10.800Volume 124, Issue No.139Endocrine and metabolic determinants of cardiometabolic risk in mild autonomous cortisol secretion轻度自主皮质醇分泌患者心脏代谢风险的内分泌和代谢决定因素DOI: 10.1016/j.ebiom.2026.106126 CNS Neurol Disord Drug Targets IF: 03.000Ahead of Print.No.140Investigation of the Antiepileptic and Anti-inflammatory Effects of Empagliflozin on Penicillin-induced Epileptiform Activity in Rats恩格列净对青霉素诱发大鼠癫痫样活动的抗癫痫及抗炎作用研究DOI: 10.2174/0118715273423680251125073602 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.141Diabetes and tumor risk: a 23-year Danish national cohort study糖尿病与肿瘤风险：一项为期23年的丹麦全国队列研究DOI: 10.3389/fendo.2025.1725065 Frontiers in nutrition IF: 05.100Volume 12, Issue No.142Editorial: The role of vitamin D in metabolic and cardiovascular health, volume II社论：维生素D在代谢和心血管健康中的作用（第二卷）DOI: 10.3389/fnut.2025.1759053 Diabetes Technol Ther IF: 06.300Ahead of Print.No.143Response to Comment on: "Nocturnal Hypoglycemia: Characterization with Continuous Glucose Monitoring in a Real-World Setting"对“夜间低血糖：真实世界环境中连续葡萄糖监测特征分析”评论的回应DOI: 10.1177/15209156251412814 Diabetes Technol Ther IF: 06.300Ahead of Print.No.144Hybrid Closed-Loop Disconnection Reduces the Risk of Hypoglycemia in Active Children and Adolescents with Type 1 Diabetes: A Randomized Controlled Pilot Study混合闭环系统断开可降低活跃1型糖尿病儿童及青少年的低血糖风险：一项随机对照试验DOI: 10.1177/15209156251390825 Eur J Endocrinol IF: 05.200Ahead of Print.No.145Long-Term Cardiac Effects of Adrenalectomy Versus Surveillance in Mild Cortisol Excess: 5-Year Results from the prospective ITACA Study轻度皮质醇过量中肾上腺切除术与监测的长期心脏效应：前瞻性ITACA研究的5年结果DOI: 10.1093/ejendo/lvag018 Current medicinal chemistry IF: 03.500Ahead of Print.No.146Differences of Plasma Metabolites in Sarcopenia Among Individuals with Type 2 Diabetes: A Cross-Sectional Study2型糖尿病患者肌少症的血浆代谢物差异：一项横断面研究DOI: 10.2174/0109298673417152251129140654 Endocrinol Diabetes Metab IF: 02.600Volume 9, Issue 1No.147Socioeconomic Inequalities and Type 2 Diabetes Comorbidities: A Systematic Review and Meta-Analysis on Observational Studies社会经济不平等与2型糖尿病合并症：一项基于观察性研究的系统评价与Meta分析DOI: 10.1002/edm2.70160 Sociology of health & illness IF: 02.700Volume 48, Issue 2No.148Transformations in Diabetes Care: Lessons From Commons-Based, Peer-Produced Citizen Science糖尿病护理的变革：来自基于公地、同伴生产的公民科学的启示DOI: 10.1111/1467-9566.70140 Med Sci Sports Exerc IF: 03.900Ahead of Print.No.149Stem Cell Transplant Patients' Activity Decline, Outpatient Resumption and Intervention Effectiveness Identified by Wearable Activity Monitoring通过可穿戴活动监测识别干细胞移植患者的活动下降、门诊恢复及干预效果DOI: 10.1249/MSS.0000000000003941 Transplantation IF: 05.000Ahead of Print.No.150Improving Bone Health in Type 1 Diabetes and Chronic Kidney Disease: The Overlooked Benefit of Simultaneous Pancreas-Kidney Transplantation改善1型糖尿病和慢性肾脏病中的骨骼健康：同步胰肾移植的被忽视的益处DOI: 10.1097/TP.0000000000005631 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.151Editorial: Applications of optical coherence tomography angiography (OCTA) in ocular complications of diabetes mellitus光学相干断层扫描血管成像（OCTA）在糖尿病眼部并发症中的应用DOI: 10.3389/fendo.2025.1743554 Drug delivery IF: 08.100Volume 33, Issue 1No.152Advancements and challenges in ophthalmic microneedles to treat eye diseases眼科微针在治疗眼部疾病中的进展与挑战DOI: 10.1080/10717544.2026.2617688 Molecular pharmaceutics IF: 04.500Ahead of Print.No.153Molecular Mechanisms of Liraglutide Aggregation Induced by Dual Air-Water and Silicone-Oil-Water Interfacial Stress空气-水与硅油-水双重界面应力诱导利拉鲁肽聚集的分子机制DOI: 10.1021/acs.molpharmaceut.5c01837 Bioeng Transl Med IF: 05.700Volume 11, Issue 1No.154Injectable hyaluronic acid-metformin conjugate gel for sustained intra-articular delivery and prevention of post-traumatic osteoarthritis可注射透明质酸-二甲双胍共轭凝胶用于关节内持续给药及创伤后骨关节炎的预防DOI: 10.1002/btm2.70100 Frontiers in psychiatry IF: 03.200Volume 16, Issue No.155Case Report: Persistent delusional memories after postoperative delirium in a woman with complex cardiac surgical history病例报告：一例具有复杂心脏手术史女性术后谵妄后的持久妄想性记忆DOI: 10.3389/fpsyt.2025.1743329 bioRxivVolume 2026, Issue No.156Lifespan-extending downregulation of insulin signalling reduces germline mutation load延长寿命的胰岛素信号下调可降低生殖细胞突变负荷DOI: 10.64898/2025.12.05.692572 bioRxivVolume 2026, Issue No.157A Fourfold Male-Specific Lifespan Extension via Canonical Insulin/IGF-1 Signaling经由经典胰岛素/IGF-1信号通路实现的雄性特异性四倍寿命延长DOI: 10.64898/2025.12.02.691904 bioRxivVolume 2026, Issue No.158AKT signaling in hepatocytes rapidly increases glucose phosphorylation and contribution to glycogen without affecting metabolite pool sizes or glycogen breakdown肝细胞中AKT信号快速增加葡萄糖磷酸化及向糖原的贡献，而不影响代谢物池大小或糖原分解DOI: 10.64898/2025.12.01.691331 bioRxivVolume 2026, Issue No.159Insular cortex predictions regulate glucose homeostasis岛叶皮层的预测调控葡萄糖稳态DOI: 10.64898/2025.12.09.693191 Curēus IF: 01.300Volume 17, Issue 12No.160Atypical Presentation and Unexpected Resolution: The Role of Serial Cerebrospinal Fluid Analysis in Differentiating Bacterial and Viral Meningitis After Pituitary Surgery垂体术后脑膜炎的不典型表现与转归：系列脑脊液分析在鉴别细菌性与病毒性感染中的关键作用DOI: 10.7759/cureus.99802 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.161Stc2a inhibits IGF-stimulated somatic growth in favor of organismal survival under hypoxic stressStc2a在低氧应激下抑制IGF介导的体细胞生长以利于机体存活DOI: 10.3389/fendo.2025.1729649 Pediatric diabetes IF: 05.600Volume 2026, Issue No.162Maternal Autoimmune Disease and Childhood-Onset Type 1 Diabetes: A Nationwide Population-Based Nested Case-Control Study母体自身免疫病与儿童期发病的1型糖尿病：一项全国性人群巢式病例对照研究DOI: 10.1155/pedi/3418021 Mol Nutr Food Res IF: 04.200Volume 70, Issue 2No.163A Comparative Study on the Effect of Omega-3 Fatty Acids on Lactationω-3脂肪酸对哺乳期影响的比较研究DOI: 10.1002/mnfr.70393 Epigenomics IF: 02.600Ahead of Print.No.164Paternal preconception exercise and sperm epigenetic mechanisms: a systematic review on offspring health父亲孕前运动与精子表观遗传机制：关于后代健康的系统综述DOI: 10.1080/17501911.2026.2620390 Current pharmaceutical design IF: 02.800Ahead of Print.No.165Gut Microbiota in the Hepato-Cardiorenal Axis: Microbial Metabolites, Inflammation, and Emerging Therapeutic Targets肝心肾轴中的肠道微生物群：微生物代谢产物、炎症与新兴治疗靶点DOI: 10.2174/0113816128413464251209115653 Cell transplantation IF: 03.200Volume 35, Issue No.166Editorial: Cellular replacement therapy for diabetes社论：糖尿病细胞替代疗法DOI: 10.1177/09636897251392313 Diabetes, obesity & metabolism IF: 05.700Ahead of Print.No.167CGM-derived efficacy and overall safety of once-weekly insulin efsitora alfa (efsitora) relative to day of administration in adults with type 2 diabetes连续血糖监测评估的每周一次胰岛素efsitora alfa（efsitora）在2型糖尿病成人患者中的有效性和总体安全性：与给药日相关DOI: 10.1111/dom.70419 Molecular pharmaceutics IF: 04.500Ahead of Print.No.168Soluble Antigen Array Displaying Proinsulin(F25D) Selectively Targets Anti-insulin B Cells without Hormonal Effects展示前胰岛素(F25D)突变体的可溶性抗原阵列选择性靶向抗胰岛素B细胞且无激素效应DOI: 10.1021/acs.molpharmaceut.5c01428 Med Sci Sports Exerc IF: 03.900Ahead of Print.No.169Metabolic Effects of Isoenergetic High Intensity Interval Training and Moderate Intensity Continuous Training in Adults with Type I Diabetes等能量高强度间歇训练与中等强度持续训练对1型糖尿病成人的代谢影响DOI: 10.1249/MSS.0000000000003939 FCVM IF: 02.900Volume 12, Issue No.170Effects of fasting on endothelial function in type 2 diabetes mellitus patients: cohort study斋月禁食对2型糖尿病患者内皮功能的影响：一项队列研究DOI: 10.3389/fcvm.2025.1646786 Curēus IF: 01.300Volume 17, Issue 12No.171Unilateral Ptosis and Bulbar Symptoms as the Initial Presentation of Late-Onset Acetylcholine Receptor Antibody-Positive Myasthenia Gravis Mimicking Acute Ischemic Stroke in an 82-Year-Old Man单侧眼睑下垂与球部症状：一例82岁男性晚发性乙酰胆碱受体抗体阳性重症肌无力模仿急性缺血性卒中的初始表现DOI: 10.7759/cureus.99832 Current diabetes reviews IF: 01.900Ahead of Print.No.172The Beneficial Effects of Combination Therapy With SGLT-2 Inhibitors and GLP-1 Receptor Agonists in Type 2 Diabetes MellitusSGLT-2抑制剂与GLP-1受体激动剂联合治疗对2型糖尿病的有益效应DOI: 10.2174/0115733998419380251126073540 Endocr Metab Immune Disord Drug Targets IF: 02.000Ahead of Print.No.173Insight into Molecular Mechanisms and Pathways Related to the Association of Periodontal Disease and Type 2 Diabetes Mellitus牙周病与2型糖尿病关联的分子机制与通路研究进展DOI: 10.2174/0118715303415067251124044844 Scand J Rheumatol IF: 02.100Ahead of Print.No.174Organ-specific autoimmunity in primary Sjögren's disease原发性干燥综合征中的器官特异性自身免疫DOI: 10.1080/03009742.2025.2598989 Current pharmaceutical design IF: 02.800Ahead of Print.No.175Histone Acetylation Retards the Adipogenic Differentiation of Human Umbilical Cord - Mesenchymal Stem Cells: A Clue for Anti-obesity Approach?组蛋白乙酰化延缓人脐带间充质干细胞的成脂分化：抗肥胖方法的一条线索？DOI: 10.2174/0113816128396945251127151448 Mol Nutr Food Res IF: 04.200Volume 70, Issue 2No.176Wheat Flour Intake Promotes Weight Gain and Metabolic Changes in Mice小麦粉摄入促进小鼠体重增加和代谢变化DOI: 10.1002/mnfr.70394 Acta Biochimica Polonica IF: 01.700Volume 72, Issue No.177Prevalence of vitamin D deficiency and related factors among adults in Tokat province, Türkiye: a community-based cross-sectional study土耳其托卡特省成人维生素D缺乏患病率及相关因素：一项基于社区的横断面研究DOI: 10.3389/abp.2025.15459 Health Psychol Behav Med IF: 02.200Volume 14, Issue 1No.178Developing a theory and evidence-based intervention for black African women using the COM-B model and behaviour change wheel: BALANCED programme运用COM-B模型与行为改变轮，为非裔黑人女性构建理论与循证干预：BALANCED项目DOI: 10.1080/21642850.2026.2616929 J Exp Orthop IF: 02.700Volume 13, Issue 1No.179Outcomes of total hip arthroplasty in obese patients with and without preoperative weight loss: A systematic review and meta-analysis肥胖患者全髋关节置换术结局：术前减重与未减重的系统评价与荟萃分析DOI: 10.1002/jeo2.70651 Frontiers in physiology IF: 03.400Volume 16, Issue No.180The role of impaired adipogenesis in insulin resistance among non-obese individuals脂肪生成障碍在非肥胖个体胰岛素抵抗中的作用DOI: 10.3389/fphys.2025.1739215 Journal of wrist surgery IF: 00.600Volume 15, Issue 1No.181Comparative Analysis of Comorbidities and Outcomes in Endoscopic versus Open Treatment of Carpal Tunnel Release in Patients with Rheumatoid Arthritis类风湿关节炎患者内镜与开放式腕管松解术比较分析DOI: 10.1055/s-0044-1791266 Front Clin Diabetes Healthc IF: 02.200Volume 6, Issue No.182Reduction of insulin resistance in 14-15-year-old students after the COVID-19 pandemic: a prospective study from Tsunan, JapanCOVID-19大流行后日本津南町14-15岁学生胰岛素抵抗的减少：一项前瞻性研究DOI: 10.3389/fcdhc.2025.1687294 Annals of neurosciences IF: 02.400Ahead of Print.No.183Association of Heart Rate Variability and NeuroCognitive Performance Among Metabolically Healthy Obese Adults: Cardio-psychological Based Approach心率变异性与神经认知功能的关联：针对代谢健康肥胖成年人的心脏心理学方法DOI: 10.1177/09727531251409528 J Educ Health Promot IF: 01.300Volume 14, Issue No.184Exploring the interplay between stress level, sleep quality, and body composition among university students: A cross-sectional study探究大学生压力水平、睡眠质量与身体成分之间的相互作用：一项横断面研究DOI: 10.4103/jehp.jehp_1947_24 J Educ Health Promot IF: 01.300Volume 14, Issue No.185Impact of sleep quality and physical activity on hypertension in adults: Findings from rural eastern India睡眠质量与体力活动对成人高血压的影响：来自印度东部农村地区的发现DOI: 10.4103/jehp.jehp_2133_24 bioRxivVolume 2026, Issue No.186Ovarian Hormones and Obesity Drive Th17-mediated Airway Inflammation through Estrogen Receptor Signaling卵巢激素与肥胖通过雌激素受体信号驱动Th17介导的气道炎症DOI: 10.64898/2025.12.02.691857 bioRxivVolume 2026, Issue No.187High-Fat Diet Induces Epigenetic and Metabolic Changes in Kisspeptin Neurons in Association with Obesity and Male Secondary Hypogonadism高脂饮食诱导Kisspeptin神经元的表观遗传和代谢改变，与肥胖及男性继发性性腺功能减退相关DOI: 10.64898/2025.11.30.691258 Sisli Etfal Hastan T?p Bul IF: 01.000Volume 59, Issue 3No.188Evaluation of Our Paediatric Patients Hospitalised with Covid-19 Diagnosis: Single Centre Experience我们因COVID-19诊断住院的儿科患者的评估：单中心经验DOI: 10.14744/SEMB.2025.73483 Curēus IF: 01.300Volume 17, Issue 12No.189Neurological Outcomes Following Surgical Resection of Intradural Extramedullary Spinal Tumors: A Retrospective Analysis Using the American Spinal Injury Association (ASIA) Impairment Scale使用美国脊髓损伤协会(ASIA)损伤量表评估硬膜内髓外脊髓肿瘤手术切除后的神经功能预后：一项回顾性分析DOI: 10.7759/cureus.99857 Curēus IF: 01.300Volume 17, Issue 12No.190Beyond Snoring: Unexpected Presentation of Obstructive Sleep Apnea不只是打鼾：阻塞性睡眠呼吸暂停的非典型表现DOI: 10.7759/cureus.99866 Curēus IF: 01.300Volume 17, Issue 12No.191Healthy Lifestyle Interventions for Non-communicable Disease Prevention in Saudi Arabia: A Scoping Review沙特阿拉伯非传染性疾病预防的生活方式干预：一项范围综述DOI: 10.7759/cureus.99800 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.192Effects of stress on bone health in children压力对儿童骨骼健康的影响DOI: 10.3389/fendo.2025.1715779 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.193Deciphering obesity: a conceptual overview and synthesis解码肥胖：概念性概览与综合DOI: 10.3389/fendo.2025.1738147 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.194Abdominal versus femoral subcutaneous fat gene expression in non-obese insulin resistant individuals非肥胖胰岛素抵抗个体腹部与大腿皮下脂肪基因表达对比DOI: 10.3389/fendo.2025.1684761 Obesity science & practice IF: 01.900Volume 12, Issue 1No.195Recent Insights Into Circulating Adipokines in Obesity: Systematic Review and Meta-Analysis肥胖中循环脂肪因子最新见解：系统综述与荟萃分析DOI: 10.1002/osp4.70113 Frontiers in nutrition IF: 05.100Volume 12, Issue No.196The excess body fat is a potential mediator between consumption of ultra-processed foods and cardiometabolic risk in normal-weight Brazilian children超重是超加工食品消费与巴西正常体重儿童心脏代谢风险之间潜在的中介因素DOI: 10.3389/fnut.2025.1726016 Public health nutrition IF: 03.000Ahead of Print.No.197Nutrition Inequities in the Deaf Community: A Call for Inclusive Public Health Action听障社区的营养不平等：呼吁包容性公共卫生行动DOI: 10.1017/S1368980026101864 Endocr Metab Immune Disord Drug Targets IF: 02.000Ahead of Print.No.198Effects of Swimming Exercise and L-Carnitine Administration on Insulin Resistance in Juvenile Obese Rats with Type 2 Diabetes游泳运动与L-肉碱干预对青少年肥胖2型糖尿病大鼠胰岛素抵抗的影响DOI: 10.2174/0118715303413143251031170236 J Dev Orig Health Dis IF: 01.500Volume 17, Issue No.199Mild fructose diet during periadolescent development increases emotionality, but not metabolic consequences of early life adversity in rats围青春期轻度果糖饮食增加大鼠的情绪性，但不加剧早期生活逆境的代谢后果DOI: 10.1017/S2040174425100433 Statistics in medicine IF: 01.800Volume 45, Issue 1-2No.200A Functional Approach to Testing Overall Effect of Interaction Between DNA Methylation and SNPs一种测试DNA甲基化与SNPs相互作用总体效应的功能方法DOI: 10.1002/sim.70364 Lupus IF: 01.900Ahead of Print.No.201Serum BAFF levels in pregnant patients with systemic lupus erythematosus系统性红斑狼疮孕妇患者的血清BAFF水平DOI: 10.1177/09612033261419984 Obesity reviews IF: 07.400Ahead of Print.No.202Effect of Citrus bergamia Supplementation on Body Composition in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials香柠檬补充剂对人体体成分影响的系统评价与荟萃分析：随机对照试验研究DOI: 10.1111/obr.70094 Childhood obesity IF: 01.400Ahead of Print.No.203Pragmatic Pilot Study of the Healthy Living Program: An Obesity Prevention and Treatment Program for Low-Income Hispanic Families Delivered Through Clinic-Community Partnership《健康生活计划》实用试点研究：一项通过诊所-社区合作为低收入西班牙裔家庭提供的肥胖预防与治疗计划DOI: 10.1177/21532176251410314 Asian J Endosc Surg IF: 00.900Volume 19, Issue 1No.204Short-Term Operative Outcomes of Loop Reconstruction for Duodenojejunal Bypass With Sleeve Gastrectomy: A Retrospective Study From a Single Japanese Academic Hospital十二指肠空肠旁路联合袖状胃切除术的环状重建的短期手术效果：一项来自日本单一学术医院的回顾性研究DOI: 10.1111/ases.70245 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.205Cardiometabolic implications of triglyceride-glucose index, remnant cholesterol, and vitamin D in normoglycemic Arab adolescents: a cross-sectional study甘油三酯-葡萄糖指数、残余胆固醇与维生素D对血糖正常阿拉伯青少年代谢心血管的意义：一项横断面研究DOI: 10.3389/fendo.2025.1674706 Curr Pharm Biotechnol IF: 02.600Ahead of Print.No.206Protective Role of Glibenclamide and Magnesium Sulfate in Fructoseinduced Type 2 Diabetes Mellitus格列本脲与硫酸镁在果糖诱导的2型糖尿病中的保护作用DOI: 10.2174/0113892010396082251107094426 Endocrinol Diabetes Metab IF: 02.600Volume 9, Issue 1No.207Association Between the Triglycerides-to-High-Density Lipoprotein-Cholesterol (TG/HDL-C) Ratio and Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）与慢性肾脏病关联性的系统综述与荟萃分析DOI: 10.1002/edm2.70161 Curēus IF: 01.300Volume 17, Issue 12No.208Unanticipated Residual Gastric Contents in an Appropriately Fasted Pediatric Patient on Glucagon-Like Peptide-1 Receptor Agonist Therapy: A Case Report and Review of Perioperative ConsiderationsGLP-1受体激动剂治疗儿科患者中未预期的胃内容物残留：病例报告及围术期考量DOI: 10.7759/cureus.99731 Curēus IF: 01.300Volume 17, Issue 12No.209Safety and Synergy of Capmatinib Plus Stereotactic Radiotherapy in MET Exon 14-Mutated Non-Small Cell Lung Cancer: A Case Report卡马替尼联合立体定向放疗治疗MET外显子14突变非小细胞肺癌的安全性及协同作用：病例报告DOI: 10.7759/cureus.99838 Circulation IF: 38.600Ahead of Print.No.210Association of Statin Discontinuation in Pregnancy With Maternal Cardiovascular Health and Birth Outcomes: A Nationwide Cohort Study妊娠期停用他汀类药物与孕产妇心血管健康及出生结局的关联：一项全国队列研究DOI: 10.1161/CIRCULATIONAHA.125.078919 Frontiers in health services IF: 02.700Volume 5, Issue No.211Factors influencing cardiovascular disease screening uptake and implementation strategies to enhance cardiovascular disease screening uptake in Singapore adults: a multi-method study protocol影响新加坡成人心血管疾病筛查参与度的因素及提升筛查参与度的实施策略：一项多方法研究方案DOI: 10.3389/frhs.2025.1677666 Diabetes Technol Ther IF: 06.300Ahead of Print.No.212Association of Continuous Glucose Monitoring Metrics with Incident Diabetic Retinopathy: A Real-World Long-Term Study连续葡萄糖监测指标与新发糖尿病视网膜病变的关联：一项长期真实世界研究DOI: 10.1177/15209156261416922 Diabetes Technol Ther IF: 06.300Ahead of Print.No.213Diagnostic Accuracy of Artificial Intelligence-Enabled Retinal Biomarkers for Detecting Type 2 Diabetes and Prediabetes Among Asian Indians [DART Study]人工智能视网膜生物标志物检测亚洲印度人2型糖尿病与前驱糖尿病的诊断准确性[DART研究]DOI: 10.1177/15209156261417296 Diabetes Technol Ther IF: 06.300Ahead of Print.No.214Accuracy of Dexcom One+ in Patients with Diabetes or Stress Hyperglycemia Hospitalized in Cardiac Intensive Care UnitDexcom One+在心脏重症监护室糖尿病或应激性高血糖患者中的准确性DOI: 10.1177/15209156251407717 Diabetes Technol Ther IF: 06.300Ahead of Print.No.215Automated Insulin Delivery Associated with Superior Glycemic Outcomes in Type 1 Diabetes: A Swedish National Registry Analysis自动化胰岛素输注与1型糖尿病更优血糖结局相关：一项瑞典国家注册研究分析DOI: 10.1177/15209156251414976 Diabetes Technol Ther IF: 06.300Ahead of Print.No.216Consistent Benefit of Control-IQ+ Automated Insulin Delivery Across a Range of Characteristics of Adults with Type 2 DiabetesControl-IQ+自动化胰岛素输注对2型糖尿病成人患者不同特征的一致益处DOI: 10.1177/15209156261416920 Diabetes Technol Ther IF: 06.300Ahead of Print.No.217The Effect of Automated Insulin Delivery Systems on Sleep Quality and Quantity in Type 1 Diabetes: A Systematic Review and Meta-Analysis自动化胰岛素输送系统对1型糖尿病患者睡眠质量与时间的影响：一项系统综述与荟萃分析DOI: 10.1177/15209156251411925 Diabetes Technol Ther IF: 06.300Ahead of Print.No.218Overcoming Closed-Loop System Limits: Diluted Insulin Improves Glycemic Control and Reduces Nighttime Hypoglycemia in Toddlers with Low Insulin Requirements克服闭环系统局限：稀释胰岛素改善低胰岛素需求幼儿的血糖控制并减少夜间低血糖DOI: 10.1177/15209156251414981 Diabetes Technol Ther IF: 06.300Ahead of Print.No.219Outcomes in United States Veterans on Insulin Pumps Following Rapid Deployment of Telehealth Care快速部署远程医疗护理后美国退伍军人胰岛素泵使用者的结局DOI: 10.1177/15209156251403561 Diabetes Technol Ther IF: 06.300Ahead of Print.No.220Clinical Impact of Continuous Glucose Monitoring in Noninsulin Treated Type 2 Diabetes: A Review连续葡萄糖监测在非胰岛素治疗2型糖尿病中的临床影响：一篇综述DOI: 10.1177/15209156251414980 Health education & behavior IF: 02.100Ahead of Print.No.221Eating Behavior Traits and Success in Dietary Changes in Men with Prediabetes - the T2D-GENE Intervention饮食行为特征与糖尿病前期男性饮食改变成功的关系——T2D-GENE干预研究DOI: 10.1177/10901981251411226 Wound repair and regeneration IF: 03.400Volume 34, Issue 1No.222Plain Radiography for Diagnosing and Monitoring Foot Osteomyelitis in Persons With Diabetes: Accuracy, Limitations and Clinical Utility平片放射学在诊断和监测糖尿病患者足部骨髓炎中的应用：准确性、局限性与临床效用DOI: 10.1111/wrr.70128 J Comp Eff Res IF: 02.500Ahead of Print.No.223Reshaping the cardiovascular continuum in the management of arterial and venous cardiovascular disease: a narrative review重塑心血管连续谱：动脉与静脉心血管疾病管理的叙事性综述DOI: 10.57264/cer-2025-0162 BMJ medicine IF: 10.000Volume 5, Issue 1No.224Physical activity types, variety, and mortality: results from two prospective cohort studies体力活动类型、多样性与死亡率：两项前瞻性队列研究结果DOI: 10.1136/bmjmed-2025-001513 Transgender health IF: 01.800Volume 10, Issue 6No.225The Role of Body Composition Assessment in Tailoring Gender-Affirming Treatment for Transgender/Gender Diverse Youth身体成分评估在定制跨性别/性别多元化青少年性别肯定治疗中的作用DOI: 10.1089/trgh.2022.0218 North Clin Istanb IF: 00.900Volume 12, Issue 6No.226Evaluation of sociodemographic and clinical characteristics of dermatochalasis patients: A retrospective epidemiologic study in a tertiary care eye clinic皮肤病患者的流行病学研究：一项三级眼科诊所的回顾性研究DOI: 10.14744/nci.2025.25936 Front Clin Diabetes Healthc IF: 02.200Volume 6, Issue No.227Improving self-care, HbA1c control, and quality of life in type 2 diabetes: a self-regulation intervention based on the individual and family self-management theory改善2型糖尿病自我护理、HbA1c控制及生活质量：一项基于个体和家庭自我管理理论的自律干预DOI: 10.3389/fcdhc.2025.1712334 MedComm IF: 10.700Volume 7, Issue 2No.228The Gut Microbiota as a Mediator in the Relationship Between Dietary Patterns and Depression肠道菌群作为膳食模式与抑郁症关系的中介DOI: 10.1002/mco2.70562 bioRxivVolume 2026, Issue No.229Harmine Selectively Drives Human Beta Cell Differentiation and Function Via Protein Kinase A PathwaysHarmine通过蛋白激酶A通路选择性驱动人类β细胞分化与功能DOI: 10.64898/2025.12.07.692818 Jornal Vascular Brasileiro IF: 01.000Volume 24, Issue No.230Incidence and risk factors for contrast-induced nephropathy after angioplasty: an observational retrospective study血管成形术后造影剂肾病的发生率与危险因素：一项回顾性观察研究DOI: 10.1590/1677-5449.202500282 Frontiers in oncology IF: 03.300Volume 15, Issue No.231KEAP1 mutations activate the NRF2 pathway to drive cell growth and migration, and attenuate drug response in thyroid cancerKEAP1突变激活NRF2通路驱动甲状腺癌细胞生长与迁移并减弱药物反应DOI: 10.3389/fonc.2025.1685379 Case Reports in Dentistry IF: 00.900Volume 2026, Issue No.232Refractory Gingival Enlargement: A Critical Oral Clue to Early-Stage Granulomatosis With Polyangiitis-A Case Report and Literature Review难治性牙龈肥大：早期肉芽肿性多血管炎的一个关键口腔线索——病例报告与文献回顾DOI: 10.1155/crid/8443058 FCVM IF: 02.900Volume 12, Issue No.233Clinical outcomes of aortic stenosis patients undergoing Impella-supported high-risk percutaneous coronary intervention主动脉瓣狭窄患者接受Impella支持的高风险经皮冠状动脉介入治疗的临床结果DOI: 10.3389/fcvm.2025.1638259 Curēus IF: 01.300Volume 17, Issue 12No.234A Literature Review of the Renal Manifestations in Pediatric Celiac Disease and Its Associated Clinical Implications儿童乳糜泻肾损伤表现及其临床意义的文献综述DOI: 10.7759/cureus.99773 Curēus IF: 01.300Volume 17, Issue 12No.235Hypertension and Risk of Stroke: A Systematic Review and Meta-Analysis高血压与卒中风险：一项系统性回顾与荟萃分析DOI: 10.7759/cureus.99863 Curēus IF: 01.300Volume 17, Issue 12No.236Exploring the Potential Observations Between Geomagnetic Activity and Cardiovascular Events: A Scoping Review探索地磁活动与心血管事件间的潜在关联：一项范围综述DOI: 10.7759/cureus.99851 Ther Adv Ophthalmol IF: 02.300Volume 18, Issue No.237Exploring hyperbaric oxygen therapy for central retinal artery occlusion beyond 24 h: case report探索高压氧疗法治疗超过24小时的中心视网膜动脉阻塞：病例报告DOI: 10.1177/25158414251405382 JIMD reports IF: 01.800Volume 67, Issue 1No.238Identification of Additional Cases of Severe Neonatal GABA-Transaminase Deficiency严重新生儿期GABA转氨酶缺乏症额外病例的识别DOI: 10.1002/jmd2.70069 Bioeng Transl Med IF: 05.700Volume 11, Issue 1No.239Vitrification and rapid rewarming of precision-cut liver slices for pharmacological and biomedical research用于药理学和生物医学研究的精密肝切片的玻璃化冷冻与快速复温DOI: 10.1002/btm2.70045 J Diabetes Metab Disord IF: 01.600Volume 25, Issue 1No.240AMPK as a central regulator of metabolic memory: mechanisms and therapeutic opportunitiesAMPK：代谢记忆的核心调节器——作用机制与治疗前景DOI: 10.1007/s40200-026-01859-x Curēus IF: 01.300Volume 17, Issue 12No.241Spectrum of Cardiac Complications in Diabetic Patients in Rural Uttar Pradesh, India: A Hospital-Based Study印度北方邦农村糖尿病患者心脏并发症谱系：一项医院为基础的研究DOI: 10.7759/cureus.99734 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.242Case report: Takotsubo cardiomyopathy and cardiac arrest in a 9-year-old girl with new-onset diabetes presenting with diabetic ketoacidosis: the chicken or the egg?病例报告：新发糖尿病伴酮症酸中毒的9岁女孩发生Takotsubo心肌病与心脏骤停：孰因孰果？DOI: 10.3389/fendo.2025.1723428 Curēus IF: 01.300Volume 17, Issue 12No.243Ectopic Acromegaly Caused by Peripheral Ectopic Growth Hormone Hypersecretion: A Case Report and Literature Review异位肢端肥大症：一例外周异位生长激素过度分泌病例报告与文献回顾DOI: 10.7759/cureus.99840 Frontiers in endocrinology IF: 04.600Volume 16, Issue No.244Prolonged alpha-blockade and doxazosin are associated with hypertensive crisis in pheochromocytoma surgery嗜铬细胞瘤手术中，延长α受体阻滞及使用多沙唑嗪与高血压危象相关DOI: 10.3389/fendo.2025.1682912 J Educ Health Promot IF: 01.300Volume 14, Issue No.245Maternal-physiological parameters and prenatal mindfulness interventions - A scoping review母体生理参数与产前正念干预——范围综述DOI: 10.4103/jehp.jehp_2061_24 217 Diabetes Mellitus(DM) 糖尿病 95 Obesity 肥胖症 87 Insulin 胰岛素 23 Type 2 diabetes mellitus(T2DM) 2型糖尿病 12 Metformin 二甲双胍 12 Metabolic Syndrome 代谢综合征 7 Semaglutide 司美格鲁肽 7 Diabetic Retinopathy 糖尿病视网膜病 6 Glucagon-Like Peptide-1 Receptor Agonists(GLP-1RA) 胰高血糖素样肽-1受体激动剂 6 Gestational Diabetes Mellitus(GDM) 妊娠糖尿病 5 Hypoglycemic Agents 降糖药 5 Diabetic Foot 糖尿病足 4 Liraglutide 利拉鲁肽 4 Type 1 diabetes mellitus(T1DM) 1型糖尿病 4 Tirzepatide 替尔泊肽 3 Diabetic Cardiomyopathies 糖尿病心肌病 3 Gabapentin 加巴喷丁 3 Pregabalin 普瑞巴林 3 Diabetic Peripheral Neuropathy(PDN) 糖尿病周围神经病变 2 Diabetic Neuropathies 糖尿病性神经病变 2 Diabetic Kidney Disease(DKD) 糖尿病肾脏病 2 Dipeptidyl-Peptidase IV Inhibitors(DPP-4i) 二肽基肽酶-4抑制剂 1 Vildagliptin 维格列汀 1 Dulaglutide 度拉糖肽 1 Sodium-Glucose Transporter 2 Inhibitors(SGLT-2i) 钠-葡萄糖协同转运蛋白2抑制剂 1 Empagliflozin 恩格列净 1 Ertugliflozin 艾托格列净 1 Ipragliflozin 依格列净 1 Diabetes Complications 糖尿病并发症 1 Diabetic acidosis 糖尿病性酸中毒编辑：牛祥审校：牛祥

临床结果临床研究

2026-01-15

·国际糖尿病idiabetes

年度盘点｜SGLT2i治疗常染色体显性多囊肾病（ADPKD）的作用机制与研究进展

点击“蓝字”关注我们常染色体显性多囊肾病（ADPKD）是全球最常见的遗传性肾脏疾病，也是终末期肾病（ESKD）的主要诱因之一，全球受累人群超1200万。目前，托伐普坦是唯一获美国食品药品监督管理局（FDA）批准的疾病修饰治疗药物，但其水排泄相关不良反应、耐受性局限及全球可及性不足等问题，促使临床亟需新的治疗方案。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）最初用于血糖控制，后被证实对糖尿病及非糖尿病慢性肾脏病（CKD）具有显著的肾脏和心血管保护作用，其作用机制与ADPKD病理生理存在多重交集。然而，因担忧其引发的渗透性利尿和血管加压素激活，ADPKD患者被排除于早期SGLT2i关键临床试验之外，2025年改善全球肾脏病预后组织（KDIGO）ADPKD指南甚至明确不建议将其用于延缓肾功能下降。本文结合最新研究，系统剖析SGLT2i与ADPKD的机制关联、临床证据及未来研究方向，为其精准应用提供参考。 SGLT2i的核心作用机制及与ADPKD病理的交集（图1）（一）血流动力学调节：改善肾小球高滤过与高血压 SGLT2i对肾脏的保护作用首先体现在血流动力学层面。其通过抑制近端肾小管对钠-葡萄糖的重吸收，增加致密斑处氯化钠的递送，激活管-球反馈（TGF），促使腺苷释放并激活入球小动脉A1受体，引发入球小动脉收缩，同时可能通过前列腺素、一氧化氮等途径介导出球小动脉舒张，最终降低肾小球内压力，缓解肾小球高滤过损伤。这种调节可在不影响肾灌注的前提下，减少肾小球滤过率（GFR）的过度消耗，对ADPKD患者尤为关键。图1. SGLT2i在ADPKD中的作用机制 ADPKD早期即存在肾小球高滤过，伴随肾内血流灌注紊乱：囊肿扩张压迫肾内小动脉，引发肾素-血管紧张素-醛固酮系统（RAAS）过度激活、交感神经张力升高及内皮功能障碍，约70%患者30岁前出现高血压，而高血压又会加速肾囊肿进展与肾功能衰退。SGLT2i可通过温和的利钠利尿作用降低血容量，且不会引发反射性心动过速或醛固酮水平异常；同时其能抑制夜间交感神经活性、改善内皮功能，在糖尿病及非糖尿病人群中可实现收缩压平均降低2.5 mmHg、舒张压降低1.5 mmHg，为ADPKD患者的血压控制提供了新路径。（二）代谢重编程：逆转Warburg效应与调控酮体生成 ADPKD囊肿上皮细胞存在典型的Warburg样代谢重塑，即有氧条件下优先进行糖酵解以满足快速增殖的生物合成需求，这一过程加剧了细胞内代谢应激。SGLT2i可通过降低胰岛素水平、升高胰高血糖素，诱导肝脏酮体生成，模拟热量限制状态，为肾脏、心脏等器官提供替代能量底物，同时抑制合成代谢信号，重塑细胞能量平衡。此外，SGLT2i可激活腺苷酸活化蛋白激酶（AMPK），上调过氧化物酶体增殖物激活受体γ共激活因子1α（PGC1α），改善线粒体功能、减少氧化应激，并促进底物从葡萄糖向脂质的转换，增强脂肪酸氧化。这一代谢切换不仅能纠正囊肿上皮细胞的糖酵解依赖，还可通过减少糖酵解中间产物的积累，限制囊肿的增殖与扩张。同时，SGLT2i可抑制肾小管尿酸转运体URAT1，降低血清尿酸水平，缓解ADPKD患者常见的高尿酸血症及其介导的RAAS激活、血管炎症与纤维化。（三）抑制囊肿增殖与液体分泌 ADPKD的囊肿扩张依赖上皮细胞异常增殖与氯离子驱动的液体分泌。前者与哺乳动物雷帕霉素靶蛋白复合物1（mTORC1）通路过度激活密切相关，而AMPK是mTORC1的负向调控因子。SGLT2i诱导的轻度能量缺乏状态可激活AMPK，进而抑制mTORC1通路，减少囊肿上皮细胞增殖。在液体分泌方面，囊肿纤维化跨膜电导调节因子（CFTR）是核心效应蛋白，AMPK可通过转录和翻译后修饰抑制CFTR功能，减少氯离子及相关液体的分泌，从而延缓囊肿体积增大。（四）改善肾内缺氧与免疫微环境囊肿扩张会压迫周围肾单位及肾小管毛细血管，导致局部缺血缺氧，激活缺氧诱导因子-1α（HIF-1α），进而促进血管生成、细胞外基质重塑与上皮增殖，加速肾间质纤维化。SGLT2i可降低近端肾小管转运负荷，减少氧耗，改善肾组织氧合，并通过上调HIF-2α促进促红细胞生成素合成，提升血红细胞比容，增强整体氧输送能力。在免疫层面，ADPKD肾脏内巨噬细胞呈现“先促炎后促纤维化”的表型转换：早期M1型巨噬细胞释放肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）等促炎因子，损伤肾小管；后期M2型巨噬细胞分泌转化生长因子β（TGF-β），驱动间质纤维化。SGLT2i可抑制M1型巨噬细胞活化，并限制M2型巨噬细胞向纤维化亚型转化，同时通过抑制Toll样受体4（TLR4）和核因子κB（NF-κB）通路，减少炎症因子释放，改善肾脏免疫微环境。 SGLT2i治疗ADPKD的临床证据（一）临床前研究：模型依赖性的疗效差异动物实验为SGLT2i的应用提供了初步依据，但结果存在模型特异性（表1）。在携带ANKS6突变的Han:SPRD大鼠（近端肾小管囊肿模型）中，达格列净可改善肾功能、降低尿白蛋白，但对囊肿负荷无显著影响；而双靶点SGLT1/2抑制剂根皮苷则能显著降低囊肿体积密度和肾脏重量，其疗效优于选择性SGLT2i，推测与SGLT1对致密斑葡萄糖感知的调节有关。与之相反，在常染色体隐性多囊肾病PCK大鼠（远端肾小管囊肿模型）中，达格列净反而增加了囊肿体积和尿白蛋白，可能是渗透性应激对远端肾小管囊肿的特异性影响。表1. SGLT2i治疗PKD的动物实验需注意的是，SGLT2i可能激活血管加压素通路：在糖尿病大鼠模型中，伊格列净治疗可使尿血管加压素水平升高，肾内V2受体和磷酸化水通道蛋白2表达上调，而血管加压素的激活可能加速ADPKD囊肿进展，这也是其临床应用的主要顾虑。（二）临床研究：初步探索与矛盾结果受限于入组限制，ADPKD患者的SGLT2i临床数据多来自回顾性研究和小样本试验。一项针对20例ADPKD患者的回顾性研究显示，达格列净治疗3.5个月后，患者GFR从47.9 ml/min/1.73m²降至40.8 ml/min/1.73m²，身高校正肾脏总体积（htTKV）从599 ml/m增至617 ml/m，提示存在短期血流动力学影响；但血红蛋白水平从13.1 g/dl升至14.0 g/dl，符合SGLT2i的促红细胞生成效应。在接受托伐普坦治疗的ADPKD患者中，联合达格列净的小样本随机试验显示出积极信号：6个月后，联合治疗组eGFR下降斜率从-3.66 ml/min/1.73m²/年改善至1.03 ml/min/1.73m2/年，htTKV增长率从5.04%降至-0.44%，尽管患者血浆血管加压素水平有所升高，但未出现明显安全事件。此外，美国退伍军人队列研究发现，SGLT2i初始治疗3个月内eGFR下降速度快于二肽基肽酶4抑制剂（DPP4i），但3-12个月时eGFR斜率更稳定，提示其对肾功能的长期影响或呈“先降后稳”的特征。（三）正在进行的关键临床试验目前两项大型Ⅲ期临床试验（DAPA-PKD和STOP-PKD）正在推进，旨在明确SGLT2i的疗效与安全性。DAPA-PKD计划纳入400例18~75岁ADPKD患者，以24个月MRI检测的TKV变化为主要终点，同时评估eGFR斜率和心血管结局；STOP-PKD则纳入420例高进展风险患者（携带PKD1截断突变或eGFR年下降＞3 ml/min/1.73m²），以36个月eGFR斜率为核心终点。两项试验均排除托伐普坦使用者，以避免联合治疗的容量紊乱风险，其结果将为SGLT2i的临床定位提供高级别证据。目前已开展的SGLT2i治疗PKD的临床研究见表2。表2. SGLT2i治疗PKD患者的临床研究概览 SGLT2i应用于ADPKD的挑战与未来方向（一）遗传异质性的精准分层 ADPKD存在显著遗传异质性，约78%患者为PKD1突变、15%为PKD2突变，其余7%为DNAJB11、ALG8、ALG9等罕见基因型。现有临床试验多富集于PKD1/2快速进展型患者，而DNAJB11等基因型常伴随更严重的肾间质纤维化，其对SGLT2i的应答可能与经典型不同。例如，SGLT2i的抗纤维化作用可能对间质纤维化为主的亚型更有益，但相关数据尚未见报道。未来需按基因型、疾病进展风险及合并症进行分层，实现SGLT2i的精准应用。（二）安全性争议的澄清血管加压素激活和容量紊乱是SGLT2i用于ADPKD的核心安全顾虑。一方面，SGLT2i引发的渗透性利尿可能升高血浆渗透压，刺激血管加压素释放，而血管加压素V2受体是托伐普坦的作用靶点，其激活会通过环磷酸腺苷（cAMP）通路促进囊肿分泌；另一方面，ADPKD患者本身存在肾脏浓缩功能异常，联合SGLT2i可能增加脱水风险。已有病例报告显示，1例ADPKD患者接受达格列净1年，TKV增加40%、eGFR显著下降，但停药后指标部分逆转，提示需警惕个体差异。未来研究需明确SGLT2i对血管加压素通路的影响阈值，以及与托伐普坦联用的安全性。（三）联合治疗的探索托伐普坦作为唯一获批药物，与SGLT2i的联合应用是潜在方向。二者机制互补：托伐普坦抑制血管加压素V2受体以减少囊肿液体分泌，SGLT2i则改善血流动力学和代谢紊乱。日本一项小型交叉试验已证实，托伐普坦联合达格列净可改善eGFR斜率并抑制TKV增长，但样本量小、随访短的局限性明显。未来需开展大样本长期研究，明确联合方案的获益-风险比。结语 ADPKD是累及肾脏和心血管系统的复杂性疾病，托伐普坦的局限性凸显了治疗方案的迫切需求。SGLT2i通过血流动力学调节、代谢重编程、免疫调控等多重机制，与ADPKD病理生理形成精准契合，尽管早期临床证据存在矛盾，但小样本试验已显示出延缓囊肿进展和保护肾功能的潜力。正在开展的Ⅲ期临床试验将为其疗效和安全性提供关键数据，而基于基因型的分层研究、联合治疗探索及长期安全性监测，将是推动SGLT2i成为ADPKD辅助或一线治疗方案的核心方向。2025年KDIGO指南的谨慎态度提示，在获得确证性证据前，SGLT2i的应用需严格遵循临床试验框架，同时关注患者个体差异，平衡获益与风险。参考文献1.Bou Antoun MT, et al. J Am Soc Nephrol . 2025 Nov 10. doi: 10.1681/ASN.0000000943. Online ahead of print.2.Mülle BL, et al. Nephrol Dial Transplant. 2025; 40: 2231-2238. 声明：本文仅供医疗卫生专业人士了解最新医药资讯参考使用，不代表本平台观点。该等信息不能以任何方式取代专业的医疗指导，也不应被视为诊疗建议，如果该信息被用于资讯以外的目的，本站及作者不承担相关责任。最新《国际糖尿病》读者专属微信交流群建好了，快快加入吧！扫描左边《国际糖尿病》小助手二维码（微信号：guojitnb），回复“国际糖尿病读者”，ta会尽快拉您入群滴！（来源：《肾医线》编辑部）

临床2期临床结果抗体药物偶联物

100 项与伊格列净L-脯氨酸盐相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D10200	伊格列净L-脯氨酸盐	A10BK05	DB11698

研发状态

批准上市

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适应症	国家/地区	公司	日期
1型糖尿病	日本	-	2014-01-17
2型糖尿病	日本	-	2014-01-17

未上市

10 条进展最快的记录,

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适应症	最高研发状态	国家/地区	公司	日期
肝功能不全	临床1期	美国	Astellas Pharma, Inc.	2010-05-01

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


JPRN-UMIN000015170 (EASD2022)	N/A	HbA1c \| BMI \| visceral fat area ... 更多	103	Ipragliflozin 50 mg	遞選襯廠觸艱衊鑰繭遞(廠顧選糧顧簾膚製壓糧) = 顧獵膚廠餘艱製繭憲網願繭艱鏇選壓鑰積醖網 (糧壓築製膚糧簾衊簾膚 )	积极	2022-09-20
				Metformin 1000 mg	遞選襯廠觸艱衊鑰繭遞(廠顧選糧顧簾膚製壓糧) = 觸鹹醖壓繭襯鹽願艱範願繭艱鏇選壓鑰積醖網 (糧壓築製膚糧簾衊簾膚 )
NCT02479399 (STELLA-LONG TERM, Pubmed \| Diabetol Int)	N/A	2型糖尿病一线	11,412	ipragliflozin (Treatment-naïve patients)	艱鬱蓋窪壓膚蓋蓋願憲(壓製顧築衊鬱淵醖壓夢) = 夢衊獵範壓壓範窪憲艱願鹹範簾鬱構膚蓋選繭 (衊艱艱憲醖鹹鬱網積蓋 ) 更多	-	2021-10-01
				ipragliflozin (Non-naïve patients)	艱鬱蓋窪壓膚蓋蓋願憲(壓製顧築衊鬱淵醖壓夢) = 範夢網築糧憲獵齋簾鑰願鹹範簾鬱構膚蓋選繭 (衊艱艱憲醖鹹鬱網積蓋 ) 更多
NCT02577003 \| NCT02564211 (Pubmed \| Diabetes Obes Metab)	临床3期	2型糖尿病	-	Ipragliflozin 50 mg	鹽餘襯窪蓋鏇觸艱鬱築(蓋獵鑰製獵鑰構簾壓壓) = 選鬱淵糧衊觸膚鏇壓鏇鬱顧選築餘構膚糧繭觸 (衊壓獵襯觸鏇選淵簾蓋 )	-	2021-05-25
NCT02479399 (STELLA-LONG TERM, Pubmed \| Diabetes Ther)	N/A	2型糖尿病	11,412	Ipragliflozin in patients aged <65 years	夢醖鏇鹽構醖顧鬱艱醖(淵顧簾夢積積憲憲鬱窪) = 積構餘積夢醖鑰獵鏇壓鹹選膚範鹽壓願蓋範膚 (繭窪窪襯鏇糧憲簾壓簾 ) 更多	-	2021-03-17
				Ipragliflozin in patients aged ≥65 years	夢醖鏇鹽構醖顧鬱艱醖(淵顧簾夢積積憲憲鬱窪) = 壓簾齋構廠廠夢艱製壓鹹選膚範鹽壓願蓋範膚 (繭窪窪襯鏇糧憲簾壓簾 ) 更多
JPRN-jRCTs031180205 (ADA2020)	临床4期	2型糖尿病二线	-	Ipragliflozin	糧鹽膚鹹製憲構窪構觸(齋製蓋鹹範蓋衊顧餘蓋) = 觸鹽顧構廠餘築獵簾顧鬱顧蓋鏇鑰糧夢艱積糧 (顧網糧衊獵艱鹹膚窪製 ) 更多	-	2020-06-01
				Sitagliptin	糧鹽膚鹹製憲構窪構觸(齋製蓋鹹範蓋衊顧餘蓋) = 鏇鬱鏇糧網構積衊醖窪鬱顧蓋鏇鑰糧夢艱積糧 (顧網糧衊獵艱鹹膚窪製 ) 更多
NCT01225081 \| NCT01071850 \| NCT01117584 \| NCT01057628 \| NCT00621868 \| NCT01316094 \| NCT01135433 \| NCT02452632 \| NCT01242215 \| NCT01505426 \| NCT02175784 \| NCT02794792 (Pubmed \| Diabetes Ther)	N/A	2型糖尿病	-	Ipragliflozin 50 mg	鹽選蓋鹽淵醖範膚鬱鏇(廠膚選齋築願遞衊醖鑰) = 餘網憲蓋壓選選齋糧構窪積糧顧壓襯廠鹹壓壓 (糧獵齋鏇簾鹹繭襯願範 ) 更多	-	2019-12-01
				Placebo	鹽選蓋鹽淵醖範膚鬱鏇(廠膚選齋築願遞衊醖鑰) = 襯獵鏇淵顧鑰積衊構積窪積糧顧壓襯廠鹹壓壓 (糧獵齋鏇簾鹹繭襯願範 ) 更多
NCT02479399 (STELLA-LONG TERM, Pubmed \| Curr Med Res Opin)	N/A	2型糖尿病	11,412	ipragliflozin (Non-elderly patients)	構築簾顧艱製壓糧築廠(鬱窪鹽製憲築製醖鏇鹽) = 齋鑰艱膚衊醖鏇觸襯廠製窪鹹艱齋簾鑰鏇醖製 (蓋積壓壓簾選齋夢觸餘 ) 更多	-	2019-11-01
				ipragliflozin (Elderly patients)	構築簾顧艱製壓糧築廠(鬱窪鹽製憲築製醖鏇鹽) = 簾構鬱餘淵遞窪製糧壓製窪鹹艱齋簾鑰鏇醖製 (蓋積壓壓簾選齋夢觸餘 ) 更多
NCT02897219 (Pubmed) 人工标引	临床3期	1型糖尿病	175	insulin+ipragliflozin	窪壓觸醖膚醖簾餘鑰製(網繭憲餘構獵製網積廠): difference = -3.8 (95% CI, -6.2 ~ -1.5) 更多	积极	2019-10-01
				insulin+Placebo
JPRN-UMIN000015170 (EASD2019)	N/A	insulin \| α1microglobulin (α1MG) \| glutamic pyruvic transaminase (GPT)	103	Ipragliflozin	蓋膚選齋餘糧製齋壓膚(製鹽繭餘積窪窪選願餘) = 蓋築遞廠製鹹構網遞窪製願蓋觸齋鏇築膚願襯 (遞襯醖襯鬱糧遞網醖窪 ) 更多	积极	2019-09-17
				Metformin	蓋膚選齋餘糧製齋壓膚(製鹽繭餘積窪窪選願餘) = 鬱繭構簾願廠鏇顧遞簾製願蓋觸齋鏇築膚願襯 (遞襯醖襯鬱糧遞網醖窪 ) 更多
JPRN-UMIN000015170 (EASD2018)	N/A	2型糖尿病一线 visceral fat area \| bone-specific alkaline phosphatase (BAP) \| tartrate-resistant acid phosphatase-5b (TRACP-5b)	103	Ipragliflozin 50 mg/day	鹽憲範夢鏇遞選築淵壓(構鏇齋鹽壓廠願構夢網) = 襯憲淵蓋構築願餘醖鹹鑰鏇憲膚簾衊鑰艱製廠 (醖築窪遞繭廠築蓋製簾 ) 更多	不佳	2018-10-05
				Metformin 1000-1500 mg/day	鹽憲範夢鏇遞選築淵壓(構鏇齋鹽壓廠願構夢網) = 製餘窪積範繭鑰淵膚夢鑰鏇憲膚簾衊鑰艱製廠 (醖築窪遞繭廠築蓋製簾 ) 更多