The close relationship between inflammation and insulin resistance: a comparative perspective from a new angle

Xiaoyan Wang1  · Run Yang1  · Jingxiang Li1  · Yongqi Liang2  · Chenxi Jin1  · Yining Xu1  · Xianbo Wu2  · Mengchen Zou1

Received: 4 July 2025 / Accepted: 30 September 2025 / Published online: 15 October 2025 © The Author(s) 2025

Abstract

    Background Excess weight is a progressive metabolic epidemic, and inflammation plays an important role in the progres-sion of disease. Insulin resistance (IR) is an important feature of obesity, but it does not reflect systemic inflammation. Cur-rently, there is a lack of effective clinical tools for early risk stratification and intervention in physically active people.

    Methods This was a prospective cohort of 72,262 overweight but physically active persons in the UK Biobank. The TyG was combined with hsCRP, waist circumference (WC), or body mass index (BMI) as indices of IR. Adjusted Cox regression, interaction tests, restricted cubic splines (RCS) analysis, Kaplan-Meier analysis, and Harrell’s C-index were used to examine the relations and time-dependent predictive power.

    Results During 12.7 years of follow-up, 1,477 participants developed metabolic dysfunction-associated fatty liver disease (MAFLD). RCS analysis suggested TyG-hsCRP had a nonlinear positive correlations with all-cause mortality. Compared to the lowest quartile group, the corrected hazard ratio (HR) (95% confidence interval [CI]) of new-onset MAFLD in maximum quartile groups for TyG-hsCRP was 1.94(1.62–2.32), for TyG-WC was 1.78(1.44–2.18), for TyG-BMI was 1.36(1.12–1.65), and for TyG was 1.41(1.15–1.72). The relation between C-index of TyG-hsCRP and MAFLD was higher than that of other TyG indices. Similar results were observed in all-cause mortality.

    Conclusion TyG-hsCRP is superior to other indices for identifying risk of MAFLD and all-cause mortality in overweight but physically active people. Our findings suggest the importance of inflammatory metabolism and provide evidence for effectively early anti-inflammatory treatments.

    Keywords Excess weight · Inflammation · Insulin resistance · Physically active

Communicated by Salvatore Corrao, M.D

    Mengchen Zou

    该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

    Xianbo Wu

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1 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road North, Guangzhou 510515, China

2 Department of Occupational Health and Medicine, School of Public Health, Southern Medical University, Guangzhou, China

How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective

Chunhai Tao1 , Xi Chen2*, Wenji Zheng1*, Zehao Zhang1 , Ruoyan Tao3 , Rui Deng1 and Qizhe Xiong1

1School of Statistics, Jiangxi University of Finance and Economics, Nanchang, China, 2School of Economics and Management, Nanchang University, Nanchang, China, 3School of Liberal Arts, Macau University of Science and Technology, Taipa, Macau SAR, China

OPEN ACCESS

EDITED BY

Kui Yi, East China Jiaotong University, China

REVIEWED BY

Yong Wang, Dongbei University of Finance and Economics, China Gang Peng, Southwestern University of Finance and Economics, China

*CORRESPONDENCE

Xi Chen 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Wenji Zheng 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

SPECIALTY SECTION

This article was submitted to Organizational Psychology, a section of the journal Frontiers in Psychology

RECEIVED 27 October 2022 ACCEPTED 05 December 2022 PUBLISHED 05 January 2023

CITATION

Tao C, Chen X, Zheng W, Zhang Z, Tao R, Deng R and Xiong Q (2023) How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective Frint Psychol. 13:1081562.

doi: 10.3389/fpsyg.2022.1081562

COPYRIGHT

© 2023 Tao, Chen, Zheng, Zhang, Tao, Deng and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the  origina publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

  Due to the disorderly access to medical care and inefficient use of health resources, the advancement of the hierarchical diagnosis and treatment is more valued in promoting health system reform. Hence, this article integrates prospect theory into an evolutionary game model of the local government health departments, the medical institutions, and the patients in the system promotion of the hierarchical diagnosis and treatment. The simulation shows the specific influencing mechanism of the psychological perceived value of game subjects. Then by introducing the stochastic evolutionary game model, the system promotion under different medical cultures is also discussed in detail. The results indicate that for local government health departments, the amount and duration of financial subsidies are the key factors influencing the game system’s evolution. For medical institutions, participating in the hierarchical diagnosis and treatment system is relatively beneficial. For patients, the recovery rate in primary hospitals matters more than the cost of treatment. Changes in the risk sensitivity coefficient will cause the equilibrium of the game system to change. However, changes in the loss avoidance factor do not change the equilibrium and only have an impact on the speed of convergence. With the health departments’ intervention, patients in rural medical culture are more inclined to support the hierarchical diagnosis and treatment system than those in urban or town medical culture. Therefore, in order to promote the hierarchical diagnosis and treatment system, this article recommends that more attention should be paid to the regulatory role of health departments and the participation improvement of medical institutions and patients.

KEYWORDS

hierarchical diagnosis and treatment, evolutionary game theory, prospect theory, stochastic disturbance, medical cultures

Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases

Esra Küpeli Akkol 1 *, Irem Tatlı Çankaya2 , Gökçe S¸ eker Karatoprak 3 , Elif Carpar 4 , Eduardo Sobarzo-Sánchez 5,6 and Raffaele Capasso7

  Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara, Turkey, 2 Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey, 3 Department of Pharmacognosy, Faculty of Pharmacy, Erciyes University, Kayseri, Turkey, 4 Department of Psychiatry, Private French La Paix Hospital, Istanbul, Turkey, 5 Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile, 6 Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain, 7 Department of Agricultural Sciences, University of Naples Federico II, Potici, Italy

OPEN ACCESS

Edited by:Anca Oana Docea, University of Medicine and Pharmacy of Craiova, Romania

Reviewed by: Luigia Trabace, University of Foggia, Italy Vasileios Siokas, University of Thessaly, Greece

*Correspondence: Esra Küpeli Akkol 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Specialty section: This article was submitted to Neuropharmacology, a section of the journal Frontiers in Pharmacolog

Received: 22 February 2021

Accepted: 16 April 2021

Published: 13 May 2021

Citation: Küpeli Akkol E, Tatlı Çankaya I, S¸ eker Karatoprak Gç, Carpar E, Sobarzo-Sánchez E and Capasso R (2021) Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases. Front. Pharmacol. 12:669638. doi: 10.3389/fphar.2021.669638

  Psychiatric disorders are frequently encountered in many neurological disorders, such as Alzheimer’s and Parkinson diseases along with epilepsy, migraine, essential tremors, and stroke. The most common comorbid diagnoses in neurological diseases are depression and anxiety disorders along with cognitive impairment. Whether the underlying reason is due to common neurochemical mechanisms or loss of previous functioning level, comorbidities are often overlooked. Various treatment options are available, such as pharmacological treatments, cognitive-behavioral therapy, somatic interventions, or electroconvulsive therapy. However oral antidepressant therapy may have some disadvantages, such as interaction with other medications, low tolerability due to side effects, and low efficiency. Natural compounds of plant origin are extensively researched to find a better and safer alternative treatment. Experimental studies have shown that phytochemicals such as alkaloids, terpenes, flavonoids, phenolic acids as well as lipids have significant potential in in vitro and in vivo models of psychiatric disorders. In this review, various efficacy of natural products in in vitro and in vivo studies on neuroprotective and their roles in psychiatric disorders are examined and their neuro-therapeutic potentials are shed light.

Keywords: Alzheimer’s diseases, anxiety, depression, Parkinson’s disease, natural compound

Diabetes and tumor risk: a 23-year Danish national cohort study

Katja F. Skovbjerg1 *† , Julie C. Antvorskov1 *† , Lonny M. Stokholm2,3, Tine D. Bille1 , Nis Andersen 4 , Jens Andresen 4 , Toke Bek 5 , Javad Hajar 6 , Ryo Kawasaki 2,7, Caroline S. Laugesen 8 , Sören Möller 2,3, Frederik N. Pedersen2,9, Katja C. Schielke10, Anne S. Thykjær Petersen2,9,11 12, Flemming Pociot 1,13, Jakob Grauslund2,9,11 and Steffen Heegaard14,15,16

1Department of Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark, 2Department of Clinical Research, University of Southern Denmark, Odense, Denmark, 3Open Patient

Data Explorative Network, Odense University Hospital, Odense, Denmark, 4Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark, 5Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark, 6Department of Ophthalmology, Rigshospitalet Glostrup, Glostrup, Denmark, 7 Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University Hospital, Osaka, Japan, 8Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark, 9Department of Ophthalmology, Odense University Hospital, Odense, Denmark, 10Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark, 11Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark, 12 Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark, 13Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 14Department of Pathology, Rigshospitalet, Copenhagen, Denmark, 15Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark, 16Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Introduction: Diabetes mellitus is a recognized risk factor for cancer, yet the relationship between diabetes type and tumor risk remains unclear. This study aimed to estimate the overall tumor burden, including benign, premalignant, and malignant tumors, in individuals with type 1 and type 2 diabete

Methods: In this nationwide cohort study spanning 23 years (1999–2022), data on diabetes diagnosis, tumor development, and potential confounding variables were retrieved from multiple Danish national health registries. The cohort included more than 6.5 million individuals and 128,647 tumor events among individuals with diabetes. Crude and adjusted hazard ratios (HRs) were estimated using Cox regression.

Results: For individuals with type 1 diabetes, adjusted HRs indicated no association for overall tumor development compared to individuals without diabetes. For individuals with type 2 diabetes, adjusted HRs suggested a slightly decreased hazard for overall tumor development compared to individuals without diabetes. When excluding tumors in the skin, the association between type 1 and type 2 diabetes and overall tumor development, suggested an increased hazard compared with individuals without diabetes. Our exploratory sub-analyses were stratified by tumor topography based on Systematized Nomenclature of Medicine (SNOMED) codes. Among individuals with type 1 diabetes, eight of 28 tumor groups showed reduced hazard, including the pancreas, bile ducts, and kidney. For type 2 diabetes, one group showed reduced hazard, while 22 groups, including the heart, blood vessels, and liver, showed increased hazard. Estimates from exploratory analyses should be interpreted with caution.

Discussion: Our findings provide population-level evidence that advances our understanding of the possible complex metabolic links between diabetes and tumor development. Further exploration of SNOMED-based tumor classifications in future studies may provide valuable knowledge on pathological differences and refine future tumor and cancer surveillance strategies in individuals with diabetes

KEYWORDS

cancer, diabetes, diabetes mellitus, neoplasm, pathology, T1DM, T2DM, tumor

OPEN ACCESS

EDITED BY Weijun Peng, Central South University, China

REVIEWED BY E´ va Csajbo´ k, University of Szeged, Hungary Abdullah Al Marzan, Dhaka Medical College and Hospital, Bangladesh

*CORRESPONDENCE Katja F. Skovbjerg 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Julie C. Antvorskov 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 †

These authors have contributed equally to this work and share first authorship

RECEIVED 14 October 2025

REVISED 02 December 2025

ACCEPTED 09 December 2025

PUBLISHED 07 January 2026

CITATION

Skovbjerg KF, Antvorskov JC, Stokholm LM, Bille TD, Andersen N, Andresen J, Bek T, Hajar J, Kawasaki R, Laugesen CS, Möller S, Pedersen FN, Schielke KC, Thykjær Petersen AS, Pociot F, Grauslund J and Heegaard S (2026) Diabetes and tumor risk: a 23-year Danish national cohort study. Front. Endocrinol. 16:1725065. doi: 10.3389/fendo.2025.1725065

COPYRIGHT

© 2026 Skovbjerg, Antvorskov, Stokholm, Bille, Andersen, Andresen, Bek, Hajar, Kawasaki, Laugesen, Möller, Pedersen, Schielke, Thykjær Petersen, Pociot, Grauslund and Heegaard. Thisis an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction, is permitted which does not comply with these terms.

近红外二区荧光导航手术在足踝外科中的应用初探

樊潇霄a,b,# , 杨杰c,# , 倪沪桅b,# , 夏启铭a , 刘孝龙a , 吴天翔b , 李霖c , Paras N. Prasad d , 刘超c, * , 林辉a,e,f, * , 钱骏a,b, *

a Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

b Centre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China

c Department of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

d Institute for Lasers, Photonics, and Biophotonics, Department of Chemistry, State University of New York, Buffalo, NY 14260-3000, USA

e Zhejiang Engineering Research Center of Cognitive Healthcare, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

f College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China

摘要 近红外二区（NIR-II; 900~1880 nm）窗口的光学成像，是目前生物医学成像领域的热门研究课题。本研究 旨在探索 NIR-II荧光成像在足踝外科手术中的应用价值。我们开发了一套实验室自建的NIR-II荧光手 术导航系统，并将其用于足踝外科手术导航。相比于近红外一区（NIR-I）荧光图像，该系统获得的NIR-II 荧光图像，拥有更高空间频率的信息以及更高的信号背景比（SBR）。本文的研究结果表明，NIR-II成像 可为外科医生提供对比度更高、探测深度更大的图像。本研究纳入了三种临床应用场景（糖尿病足、跟骨 骨折以及下肢创伤）。利用NIR-II荧光成像技术，我们在糖尿病足出现形态学改变前就观察到了缺血区 域，精准定位了手术切口中缺血区域的边界，并全面评估了皮瓣的血供情况。NIR-II荧光成像能够帮助 外科医生精确判断手术切缘，提早发现缺血性病变，并动态追踪灌注过程。我们认为，便携且可靠的 NIR-II荧光成像设备以及更多功能性荧光探针，可在精准手术中发挥关键作用。 © 2024 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

关键词  近红外二区荧光成像  足踝外科手术  吲哚菁绿  影像引导手术

A R T I C L E I N F O

Article history: Received 19 January 2024 Revised 11 April 2024 Accepted 14 April 2024 Available online 26 April 2024

分子显像在糖尿病及其并发症中的应用研究进展

李军1 刘兴党2

1北京大学深圳医院核医学科，深圳 518036；2 复旦大学附属华山医院核医学科，上海市核医学质量控制中心，上海 200040

通信作者：刘兴党，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【摘要】 糖尿病是一种慢性代谢性疾病，全球有超过 4 亿的糖尿病患者。1 型糖尿病和 2 型糖尿病的发病机制与胰岛 β 细胞的减少和功能受损相关。糖尿病患者若长时间高血糖，则会导致心血管疾病、神经病变、糖尿病足及其他并发症。笔者就不同种类的 PET 或 SPECT 分子显像在糖尿病患者的胰岛 β 细胞的功能监测以及冠状动脉病变、心肌病、自主神经病变、大脑异常和糖尿病足的早期精准诊断中的应用研究进展进行综述。

【关键词】 糖尿病；糖尿病并发症；分子显像；正电子发射断层显像术；体层摄影术，发射型计算机，单光子

DOI：10.3760/cma.j.cn121381−202007026−00159

Li Jun1 , Liu Xingdang2

1 Department of Nuclear Medicine, Peking University Shenzhen Hospital, Shenzhen 518036, China;

2 Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai Nuclear Medicine Quality Control Center, Shanghai 200040, China

Corresponding author: Liu Xingdang, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【Abstract】 Diabetes mellitus is a chronic and metabolic disease affecting more than 400 million people in the world. The pathogenesis of type 1 and type 2 diabetes mellitus is associated with the decrease or functional impairment of pancreatic β cells. With long-term hyperglycemia, diabetic patients will develop cardiovascular disease, neuropathy, diabetic foot and other complications. This paper reviews the application research progress of different types of PET and SPECT molecular imaging in the function monitoring of pancreatic β cells, and early diagnosis of diabetic complications such as coronary artery disease, cardiomyopathy, autonomic neuropathy, brain abnormalities and diabetic foot in diabetic patients.

【Key words】 Diabetes mellitus; Diabetes complications; Molecular imaging; Positron emission tomography; Tomography, emission-computed, single-photon

DOI：10.3760/cma.j.cn121381−202007026−00159