Sustained poor survival rate in pancreatic ductal adenocarcinoma (PDAC) calls for an earlier diagnosis to assure curative treatment. New powerful biomarkers are necessary because the currently used CA19-9 is not sensitive enough to distinguish PDAC, especially from chronic pancreatitis (CP). Expressions of miRNA-21, -30 -192, -196, -200, and -423 were measured in 77 patients with PDAC, 26 patients with CP and 64 non-cancer/non-CP subjects (39 patients with type 2 diabetes mellitus and 25 control healthy persons). Eleven patients with PDAC had CP at the background. The expressions of all microRNAs were significantly 1.4-3.7 times higher in the PDAC group compared to non-cancer/non-CP subjects and 2.2-6.1 times higher compared to CP patients. No difference in miRNA expressions was found between diabetic and non-diabetic patients. CA19-9 did not distinguish CP from PDAC patients with the history of CP, whereas all six miRNAs were able to do it. Adding miR-196, -200 and -423 to current marker CA19-9 improved sensitivity by 7 % (to 93 %) and specificity by 8 % (to 89 %). MicroRNA-423 could significantly distinguish PDAC from CP with both sensitivity and specificity 96 %. Panel of six miRNAs could be used as reliable marker in differentiating PDAC from chronic pancreatitis with the most impressive difference in miR-196 and miR-423. Key words microRNA " Pancreatic ductal adenocarcinoma " Chronic pancreatitis " Biomarker " CA19-9.

Regarding cardiovascular (CV) risk, patients with type 1 diabetes mellitus (T1D) are a heterogeneous population with CV risk ranging from low to very high. For personalized prevention strategies, screening for subclinical atherosclerosis may be of clinical significance. However, more data is needed. Our study aimed to describe the prevalence of prognostically significant findings on invasive coronary artery examination in patients with subclinical atherosclerosis determined by non-invasive examination of the carotid and coronary arteries. Patients with T1D for at least 10 years, without a prior history of atherosclerotic CV disease or target organ damage, followed at a large tertiary hospital were enrolled. Non-invasive examinations included carotid ultrasound for carotid plaque detection and a CT for coronary artery calcium (CAC) score evaluation. Patients with the presence of >/=2 carotid plaques and/or CAC score of >/=400 were classified as very high risk (VHR). These VHR patients were subsequently evaluated using invasive coronary angiography (ICA) for the presence of obstructive coronary artery disease (CAD) and intracoronary optical coherence tomography (OCT) for the presence of thin-cap fibroatheroma (TCFA) and very high-risk plaque. Moreover, hemodynamic stenosis relevance was assessed by the vessel fraction flow ratio (vFFR). Sixty-two T1D patients aged 50.1+/-12.7 years, 53 % women were enrolled. The criteria of VHR were fulfilled in 12/62 (19.4 %) patients, of which 6 (50 % of VHR) had both CAC>/=400 and at least 2 atherosclerotic plaques in the carotid arteries, one patient (8 % of the VHR) fulfilled only the CAC criteria and 5 (42 % of VHR) only the carotid criteria. The median CAC score of the VHR group was 606.3 (175.3-1515) and the mean number of carotid plaques was 2.75+/-1.06. ICA showed obstructive CAD in 5/12 (41.7 %) patients, and 3/12 (25 %) had vFFR-positive lesions. Using OCT, TCFA was present in 7/12 (58.3 %) and a very high-risk plaque in 4/12 (33.3 %) patients. Among asymptomatic patients with T1D, the combination of coronary artery calcium score and carotid ultrasound identifies a very high-risk group, in which 58.3 % of patients had a thin-cap fibroatheroma and 33.3 % of patients had a very high-risk plaque. Patients identified by these non-invasive techniques may benefit from intensive risk factors management. Key words Type 1 diabetes mellitus " Coronary artery calcium score " Carotid ultrasound " Optical coherence tomography " Cardiovascular risk.

The global prevalence of cardio-renal-metabolic (CRM) conditions, including chronic kidney disease, heart failure, type 2 diabetes in interconnected pathophysiology, is rapidly increasing. This presents health/economic consequences for Asia-Pacific (APAC) countries experiencing substantial disease burden. We aimed to forecast the regional clinical/economic burden of comorbid CRM conditions and evaluate the potential impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on burden reduction, with empagliflozin as the modeled intervention.

A Markov model (10-year time horizon [2024-2033]; annual cycle length) was developed and adapted for selected Southeast Asian countries (Malaysia/the Philippines/Thailand/Vietnam/Singapore), Australia, and South Korea using published local epidemiological and economic data. Future CRM disease prevalence, as well as the modeled SGLT2 inhibitor empagliflozin's potential in reducing clinical burden (prevalence/mortality) and associated healthcare resource use (HCRU) costs, were estimated. Empagliflozin cost was excluded from HCRU calculations to isolate/evaluate the economic burden of CRM conditions.

Projecting the current disease trends (without SGLT2 inhibitors), the total number of patients with comorbid CRM conditions and deaths in Southeast Asia/Australia/South Korea would increase ∼3-fold from 19.0 million/968,000/2.6 million (2024) to 63.4 million/3.1 million/7.1 million (2033). Guideline-recommended use of SGLT2 inhibitor empagliflozin is estimated to prevent 925,000/19,100/105,000 patients from developing comorbid conditions and ∼1.9 million/50,000/174,000 deaths in Southeast Asia/Australia/South Korea by 2033. After excluding empagliflozin cost, these reductions translate to discounted cumulative cost savings for Southeast Asia (Malaysia: RM16.9 billion/the Philippines: ₱775.6 billion/Thailand: ฿973.7 billion/Vietnam: 148.0 trillion ₫/Singapore: S$1.1 billion), Australia (AU$23.2 billion), and South Korea (₩42.4 trillion). Varying the parameters of the deterministic sensitivity analysis resulted in upper and lower estimates of economic burden that differed by no more than 10% from the mean economic burden of each health state across the seven APAC countries.

Underreporting/variability in local epidemiological data potentially affected burden projection accuracy. Insufficient available data on comorbid CRM conditions across countries necessitated model input assumptions, which may have introduced uncertainties.

Substantial increases in comorbid CRM disease prevalence and associated healthcare resource strain in APAC are expected over the next decade. Guideline-directed SGLT2 inhibitor use, with empagliflozin as an example, may alleviate regional clinical and economic burden.

Type 1 diabetes mellitus (T1DM) is a common chronic disease in children and adolescents. Diabetic kidney disease (DKD) is one of its most serious microvascular complications. Serum uric acid (SUA) has been associated with an increased risk of DKD. The aim of this study was to evaluate the association between SUA levels and the presence of microalbuminuria, an important and early marker of DKD, in pediatric patients with T1DM. This retrospective study included 138 pediatric patients who were followed up with a diagnosis of T1DM for at least 1 year. Patients were divided into two groups, normoalbuminuric and microalbuminuric, according to the urine albumin/creatinine ratio (uACR) and were also divided into two groups according to SUA levels, < 3.98 mg/dL and ≥ 3.98 mg/ dL. The mean SUA level of 138 patients with T1DM was 3.85 ± 1.0 mg/dL. The mean SUA level was significantly higher in the microalbuminuria group compared to the normoalbuminuria group. ROC curve analysis revealed that mean SUA level at a cut-off of 3.98 mg/dL was associated with the presence of albuminuria, with an AUC of 0.66 (p: 0.008, 95% CI [0.56-0.76]) yielding 63% sensitivity and 65% specificity. The rate of microalbuminuria was found to be 3.06 times significantly higher among patients with SUA level of ≥ 3.98 mg/dL (p = 0.008, OR 3.06, 95% CI [1.31-7.13]).

The mean SUA level was significantly higher in the microalbuminuria group and the rate of microalbuminuria is higher in patients with T1DM when SUA was ≥ 3.98 mg/dL. These findings indicate a potential link between elevated SUA levels and early renal involvement in pediatric T1DM, though the proposed cut-off should be interpreted with caution.

• Serum uric acid levels have been associated with an increased risk of developing DKD and development of albuminuria has been linked to higher SUA levels in patients with diabetes.

• The mean SUA level demonstrated a moderate discriminative ability for microalbuminuria, with an AUC of 0.66 (p = 0.008, 95% CI [0.56-0.76]), providing 63% sensitivity and 65% specificity at a cut-off value of 3.98 mg/dL. • The rate of microalbuminuria is 3.06 times higher in pediatric patients with T1DM when SUA is ≥ 3.98 mg/dL. • Considering the ongoing debate regarding the definition of elevated SUA levels even in healthy individuals, the proposed cut-off may serve as a preliminary reference for future studies exploring risk assessment and follow-up in this population.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder associated with many comorbidities, including obesity, diabetes, cardiovascular risk factors, mental health issues, and many more disorders. Current treatments including biologics, topicals, and surgical interventions often fall short in terms of patient satisfaction, demonstrating a need for additional innovative approaches that address HS-related comorbidities.

This review explores the novel application of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in HS treatment, particularly for patients with comorbid conditions such as metabolic syndrome, diabetes, and obesity. Emphasis is placed on combination therapy and the potential for GLP-1RAs to address both HS symptoms and associated comorbidities, with careful consideration of patient selection.

A review of emerging evidence and existing literature on GLP-1RAs and their applications for weight loss, metabolic regulation, and anti-inflammatory effects was conducted.

GLP-1RAs offer dual benefits for HS patients by modulating inflammatory pathways and addressing associated comorbid conditions. Case studies and preliminary data suggest that GLP-1RAs may reduce lesion severity, systemic inflammation, and morbidity, either as monotherapy or in conjunction with existing treatments. However, high-quality randomized controlled trials are indicated to confirm these findings.

GLP-1RAs represent a promising adjunctive or standalone treatment choice for those with HS and its related comorbidities. Further research is needed to establish their safety and efficacy in HS treatment. &nbsp.

Recognizing the risk of atherosclerotic cardiovascular disease (ASCVD) in patients is crucial in clinical practice. Recent studies suggest an association between inflammatory skin diseases and ASCVD. This study evaluates ASCVD risk in inflammatory skin disease patients using a standardized assessment model.

We used the TriNetX platform to analyze 10-year ASCVD risk in inflammatory skin conditions. Propensity score-matched (PSM) cohorts adjusted for confounders. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression.

Inflammatory skin diseases were associated with elevated ASCVD risk. Hidradenitis suppurativa showed the strongest association (HR 1.32; 95% CI: 1.17-1.48). Elevated risks were also noted for psoriasis (HR 1.21; 95% CI: 1.14-1.28) and atopic dermatitis (HR 1.15; 95% CI: 1.04&ndash;1.26). These risks were lower than in diabetes mellitus (HR 2.57; 95% CI: 2.52-2.63).

Patients with hidradenitis suppurativa, psoriasis, and atopic dermatitis exhibit increased ASCVD risk. While lower than in diabetes mellitus, findings highlight the role of dermatologists in ASCVD risk identification and management. &nbsp.

Postpartum glucose intolerance significantly increases the risk of developing type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM). This study assessed the prevalence and identified clinical predictors of postpartum glucose intolerance among Malaysian women.

This retrospective cohort study included 600 women with previous GDM attending postpartum oral glucose tolerance testing (OGTT) at 16 primary health clinics in Terengganu, Malaysia. Data collected encompassed sociodemographic details, antenatal clinical characteristics, and postpartum OGTT outcomes. Multivariable logistic regression analyses identified significant predictors.

The overall prevalence of postpartum glucose intolerance was 19%, with impaired glucose tolerance (IGT) predominant (76%). Significant predictors included family history of diabetes (aOR=2.110; 95% CI: 1.324-3.365), previous GDM history (aOR=1.874; 95% CI: 1.137-3.090), primiparity (aOR=1.804; 95% CI: 1.122-2.898), elevated fasting plasma glucose at GDM diagnosis (aOR=1.636; 95% CI: 1.196-2.238), and elevated 2-hour plasma glucose at GDM diagnosis (aOR=1.452; 95% CI: 1.267-1.663).

The study highlights a substantial prevalence of postpartum glucose intolerance among Malaysian women with prior GDM. Identifying high-risk individuals based on family history, parity, and antenatal glucose levels may enable targeted preventive strategies to reduce the risk of progressing to T2DM.

Urine cast analysis is a rapid, cost-effective test that may reflect changes in renal function. In the current study, we evaluated urine cast as a risk factor of the occurrence and severity of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

Hospitalised T2DM patients were classified into DKD (n = 299) and Non-DKD (n = 301) groups. Data on urinalysis (including casts), demographics, and biochemical parameters were compared, followed by correlation analysis using logistic regression. Receiver operating characteristic (ROC) curve was constructed to assess the diagnostic potential of urine casts for DKD.

In comparison to Non-DKD patients, DKD patients showed significantly higher detection rates of granular casts (19.7% vs. 1.0%). Additionally, the DKD patients had significantly higher average counts of granular casts (0.55 ± 1.68 vs. 0.01 ± 0.10). Granular cast was an independent risk factor for coincident occurrence of DKD in T2DM patients (OR = 4.696, 95% CI: 1.094-20.168) after multivariate adjustment. ROC analysis showed 19.7% sensitivity and 99.0% specificity (accuracy) at a cutoff of 0.5 using granular cast to diagnose DKD. Furthermore, Non-DKD patients with the presence of granular casts had a higher incidence of developing new-onset DKD than those without in 1 year follow-up (66.7% vs. 12.05%).

Granular cast is an independent risk factor for the occurrence and is positively associated with disease severity of DKD in patients with T2DM. The presence of granular casts also indicates an increased risk of the future development of DKD in T2DM patients.

This study aimed to explore the distribution, trends, and clinical characteristics of various types of childhood diabetes, including type 1 diabetes (T1DM), type 2 diabetes (T2DM), and maturity-onset diabetes of the young (MODY) in a tertiary health center.

We conducted a comprehensive review of medical records of individuals aged 0-18 years who were diagnosed with diabetes between January 1996 and December 2023. Clinical and laboratory characteristics at the time of diagnosis, along with the specific diabetes type, were meticulously documented.

A total of 1219 patients were included in the study, of whom 48.4% were female, with a mean age at diagnosis of 9.1 ± 4.3 years. T1DM was diagnosed in 85.8% of patients, T2DM in 6.3%, clinical MODY in 5.2%, and rare forms of diabetes in 2.6%. An increasing trend in T2DM and MODY cases has been observed since 2007. Diabetic ketoacidosis (DKA) was most prevalent in T1DM (47.1%), followed by T2DM (5.2%) and MODY (1.6%). Mean C-peptide levels at diagnosis were 0.57 ± 0.5 ng/mL in T1DM, 3.2 ± 1.3 ng/mL in T2DM, and 1.4 ± 0.9 ng/mL in MODY. Antibody positivity was observed in 78.8% of T1DM, 6.5% of T2DM, and 15.9% of MODY cases. Among the MODY group, genetic analysis was performed in 48 (75%) patients, with GCK gene mutations identified as the most common genetic abnormality in 27 (56.2%) of these patients.

This study demonstrates that T1DM is still the most commonly diagnosed type of diabetes in childhood, while T2DM and MODY are less frequent. However, a temporal increase in the incidence of MODY and T2DM subtypes was observed. The incidence of DKA at diagnosis was significantly higher in T1DM patients compared with those diagnosed with MODY or T2DM.

The purpose of this study was to collect qualitative feedback from key stakeholders as to their recommendations for developing a behavior-change-focused social media toolkit for American Indian and Alaska Native (AI/AN) female youth who are at risk for gestational diabetes mellitus (GDM). AI/AN women experience a higher rate of GDM than women from most other racial and ethnic groups. The Stopping Gestational Diabetes in Daughters and Mothers (SGDM) program is designed to reduce GDM risk for AI/AN females.

Individual interviews were conducted with content experts (health care providers/educators, researchers, and social media experts) who serve AI/AN communities (n = 20), and focus group interviews were conducted with female AI/AN youth ages 12 to 21 (n = 20) and AI/AN mothers (n = 20). Interviews were conducted via teleconference by an experienced AI/AN moderator, and transcripts were analyzed using thematic analysis. Participants completed a survey assessing personal characteristics and technology use.

All youth and mothers (100%) reported using social media daily; 60% of content experts reported daily social media use. Overarching themes included (1) negative aspects of social media use should be balanced with health-promoting messaging; (2) female AI/AN youth need positive AI/AN female role models, support, and connection to be healthy; (3) engage female AI/AN youth on social media through use of videos, humor, strengths-based messaging, and codevelopment of content.

Understanding the perspectives of content experts and members of the priority audience is a key first step in developing an AI/AN culturally relevant and community-engaged social media toolkit.