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19 11月 2019

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Author : 伤口世界

医疗特长：大面积烧伤救治；特殊烧伤治疗，包括电烧伤、化学烧伤、放射性损伤等；瘢痕疙瘩、增生性瘢痕、浅表性瘢痕综合治疗；慢性溃疡修复，包括糖尿病溃疡、静脉性溃疡、褥疮、自身免疫性皮肤软组织溃疡等；各类色素性、血管性皮肤疾病激光治疗。

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Metabolic challenges in rheumatoid arthritis: a translational overview from pathogenesis to patient care 2026-04-30 00:00

Sara Ferrigno1 · Eneida Çela1 · Mauro Fatica1,2 · Benedetta Monosi1 · Arianna D’Antonio1 · Paola Conigliaro1 · Marina Cardellini3,4 · Susanna Longo3,4 · Massimo Federici3,4 · Maria Sole Chimenti1

Received: 20 February 2026 / Accepted: 26 March 2026 © The Author(s) 2026

Abstract

Rheumatoid arthritis (RA) is an inflammatory disease characterized by a higher burden of cardiovascular and metabolic diseases than in the general population. Altered lipid and glucose metabolic pathways are widely observed, primarily due to chronic inflammation. However, metabolic dysfunction may also affect RA pathogenesis, further enhancing immune cell activation and joint damage. Glucose and lipid alterations observed in RA help define the comorbidity burden of this disease, significantly affecting disease activity and prognosis. The aim of the present review is to describe the role of metabolic dysfunctions in RA and to examine how disease activity and treatments can influence these conditions. We also summarized the main management strategies based on current literature and developed a cardiometabolic monitoring algorithm across different clinical settings to support daily patient care of these patients.

Keywords Rheumatoid arthritis · Glucose metabolism · Lipid metabolism · Atherogenesis · Inflammation · Immune-metabolism · Cardiovascular risk

Sara Ferrigno and Eneida Çela contributed equally to this manuscript

Communicated by Salvatore Corrao, M.D

Sara Ferrigno

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1 Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

2 Academic Rheumatology Unit, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Giovanni Paolo II, C/da Tappino, Campobasso 86100, Italy

3 Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

4 Center for Atherosclerosis, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis 2026-04-29 00:00

Georgios Mavraganis1 · Dimitrios Bampatsias1,2 · Christina Konstantaki1 · Kamil Stankowski3,4 ·Stavros Athanasopoulos1 · Chrysoula Moustou1 · Alexandros Alexandropoulos1 · Stefano Figliozzi3,4 ·Angelos Soranides1 · Ioannis Petropoulos1 · Dimitrios Klettas5 · Kimon Stamatelopoulos1,6 ·Georgios Georgiopoulos1,7

Received: 12 December 2025 / Accepted: 15 March 2026 © The Author(s) 2026

Abstract

Introduction Diabetic cardiomyopathy (DCM) often evades diagnosis before manifestation of clinical symptoms. In this study we explored how cardiometabolic traits influence early cardiac structure and function in asymptomatic people living with diabetes (PwD), using advanced imaging.

Methods We conducted a cross-sectional study of 88 participants: 57 people living with type 2 diabetes (PwT2D), 16 people living with type 1 diabetes (PwT1D) and 15 controls. All subjects underwent transthoracic echocardiography and/or cardiac magnetic resonance (CMR) imaging. Strain analysis, perfusion indices, and tissue characterization (T1, T2, and extracellular volume) were assessed. Arterial stiffness via pulse wave velocity (PWV), ventricular-arterial coupling (VAC), circulating biomarkers and liver fibrosis indices were evaluated.

Results PwD had lower cardiac index than controls. Global longitudinal strain (GLS) and global radial strain were lower in both diabetes mellitus (DM) groups, while left atrial strain was most impaired in PwT2D (β-coefficient= − 11.77, P=0.003). DM duration≥10 years was associated with worse GLS (β-coefficient= − 2.18, P=0.033) and right VAC (β-coefficient= − 0.27, P=0.027) after multivariable analysis. While tissue characterization and perfusion indices showed no significant group differences, tight glycemic control in PwD correlated with improved myocardial strain parameters. PwT2D exhib-ited greater arterial stiffness (β-coefficient=1.52, P=0.003). In PwD, elevated non-alcoholic fatty liver disease score cor-related with increased left ventricular mass (β-coefficient=6,195, P=0.022) and decreased left ventricular ejection fraction (LVEF) (β-coefficient= − 3.12, P=0.017). Higher growth differentiation factor levels were associated with reduced LVEF (β-coefficient= − 0.005, P=0.029).

Conclusion This multimodal imaging study highlights myocardial and vascular changes in asymptomatic PwD. Early com-prehensive cardiovascular assessment may help identify dysfunction before overt heart failure develops.

Keywords Diabetic cardiomyopathy · Cardiac magnetic resonance · Echocardiography · Arterial stiffness · Ventricular-arterial coupling · Liver fibrosis
Role of automated insulin delivery (AID) systems in glucose control in patients with diabetes mellitus undergoing dialysis in Calabria: AID-DIAL-CAL 2026-04-28 00:00

Elena Succurro1,2 · Giuseppe Cersosimo3 · Paola Sarnelli4 · Francesco Brisinda1 · Ilaria Gattuso1 · Valeria Mazza1 ·Giuseppe Fabiano1 · Fiorella Iorio3 · Roberta Arena3 · Giovanni Mazzitello5 · Ramona Nicotera5 · Maria Capria1 ·Gianluigi Zaza6 · Michele Andreucci1 · Raffaele Mancini5 · Francesco Andreozzi1,2

Received: 22 December 2025 / Accepted: 16 March 2026© The Author(s) 2026

Abstract

Aims To describe the main glycemic outcomes and the Quality of Life (QOL) observed in a cohort of people with type 1(T1D) or type 2 (T2D) insulin-treated diabetes under dialysis who started an Automated Insulin Delivery (AID) system.

Methods This is a longitudinal retrospective pilot real-world analysis of 14 individuals with T1D and T2D undergoingdialysis who began using an AID system to optimize glycemic control. All subjects used the MiniMed™ 780G system. Glu-cose metrics were collected at baseline, 3, 6, and 12 months after initiating the SmartGuard™ feature. The WHOQoL-Bref questionnaire was administered at the last follow-up to evaluate the QOL.

Results Out of the 14 people, 8 reached 1-year follow-up. Time in Range (TIR) increased from 63% at baseline to 69% at 12 months, Time Below Range <70 mg/dL (TBR70) decreased from 0.3% to 0%, and Time Above Range >250 mg/dL (TAR250) decreased from 6.7% to 3.9%. Seven out of eight subjects who reached a 12-month follow-up achieved all three glycemic targets for this fragile population (TIR>50%, TBR70<1% and TAR250<10%). At the last follow-up, 58.3% of the users were satisfied or very satisfied with their health status, versus only 25% with the previous treatment, and 81.7% had a good or very good QOL, whereas only 8.3% had a good QOL, and no one had a very good QOL with the previous

Conclusion This pilot real-world study showed how the use of an AID system is safe and can help to improve the glycemic outcomes and the QOL of people with diabetes in dialysis.

Keywords Automated insulin delivery system · End-stage kidney disease · Dialysis · Time in range · Diabetes mellitus · Quality of Life

Communicated by Salvatore Corrao, M.D

Elena Succurro

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1 Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro 88100, Italy

2 Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro, Italy

3 Azienda Ospedaliera Annunziata Cosenza, Cosenza, Italy

4 ASL Viterbo, Viterbo, Italy

5 ASP Catanzaro, Catanzaro, Italy

6 Department of Civil Engineering, University of Calabria, Rende, Italy

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

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