Objective To investigate the correlation between ferroptosis-related indicators and metabolic-associated fatty liver disease(MAFLD) in type 2 diabetes mellitus(T2 DM). Methods A total of 167 T2 DM patients admitted to the Department of Endocrinology of the Second Affiliated Hospital of Baotou Medical College from January 2023 to April 2024 were selected. Based on abdominal ultrasound results, they were divided into a T2 DM group(44 cases) and a T2 DM-MAFLD group(123 cases). According to the fatty liver index(FLI), T2 DM-MAFLD patients were further divided into a low-risk subgroup(37 cases, FLI < 30), a medium-risk subgroup(46 cases, 30 ≤ FLI < 60), and a high-risk subgroup(40 cases, FLI ≥60). Enzyme-linked immunosorbent assay was used to detect the levels of ferroptosis-related indicators including ferritin(FE),glutathione peroxidase 4(GPX4), reactive oxygen species(ROS), acyl-Co A synthase long-chain family member 4(ACSL4),glutathione(GSH), and superoxide dismutase(SOD). Pearson and Spearman correlation analyses were used to investigate the correlation between ferroptosis-related indicators and clinical parameters in T2 DM-MAFLD patients. Multivariate logistic regression analysis was performed to identify influencing factors for MAFLD in T2 DM patients. Results Serum levels of FE,ROS, and ACSL4 showed an increasing trend: T2 DM group < low-risk subgroup < medium-risk subgroup < high-risk subgroup(F/P = 112.240/<0.001, 42.118/<0.001, 22.607/<0.001). Serum levels of GPX4, GSH, and SOD showed a decreasing trend: T2 DM group > low-risk subgroup > medium-risk subgroup > high-risk subgroup(F/P = 40.784/<0.001, 11.040/<0.001,17.371/<0.001). BMI, FPG, HbA 1c, TG, TC, GGT, and HOMA-IR levels showed an increasing trend: T2 DM group < low-risk subgroup < medium-risk subgroup < high-risk subgroup(F/H/P = 5.904/0.001, 25.409/<0.001, 26.011/<0.001, 16.694/<0.001,6.633/<0.001, 91.146/<0.001, 44.600/<0.001). LDL-C levels showed: T2 DM group < low-risk subgroup < medium-risk subgroup(F/P = 7.215/<0.001). HDL-C levels showed: T2 DM group > low-risk subgroup > medium-risk subgroup > high-risk subgroup(F/P = 6.894/<0.001). Ferroptosis-related indicators FE, ROS, and ACSL4 were positively correlated with clinical indicators BMI, FPG, HbA 1c, TG, TC, CPS, HOMA-IR, and GGT in T2 DM-MAFLD patients(all P <0.05). FE and ROS were negatively correlated with HDL-C(r/P =-0.255/0.001,-0.160/0.039). GPX4, GSH, and SOD were negatively correlated with BMI, FPG, HbA 1c, TG, TC, CPS, HOMA-IR, and GGT(all P <0.05). Multivariate logistic regression analysis showed that high BMI, high FE, high ROS, high ACSL4, high FPG, high HbA 1c, high TG, high GGT, and high HOMA-IR were independent risk factors for MAFLD in T2 DM patients[OR(95%CI) = 1.182(1.003-1.392), 1.044(1.009-1.080), 1.552(1.512-1.592),1.008(1.002-1.014), 1.879(1.051-3.360), 1.760(1.114-2.782), 1.209(1.007-1.453), 1.072(1.025-1.121), 1.482(1.152-1.906)], while high GPX4 was an independent protective factor [OR(95%CI) = 0.951(0.912-0.993)]. Conclusion Ferroptosis is associated with the progression of metabolic-associated fatty liver disease in type 2 diabetes mellitus.

Objective To investigate the efficacy of serum acylated ghrelin(AG) and glycosylphosphatidylinositolanchored high-density lipoprotein-binding protein 1(GPIHBP1) levels in the evaluation of diabetic retinopathy(DR) and proliferative DR(PDR). Methods A total of 338 patients with type 2 diabetes mellitus(T2 DM) admitted to the Department of Endocrinology, 987 th Hospital of Joint Logistics Support Force from January 2022 to February 2025 were selected as the T2 DM group, and 60 healthy individuals during the same period were selected as the control group. Based on the occurrence and development of DR, T2 DM patients were divided into a PDR subgroup(62 cases), a non-proliferative DR(NPDR) subgroup(73 cases), and a non-DR(NDR) subgroup(203 cases). Serum AG and GPIHBP1 levels were detected by enzymelinked immunosorbent assay. Multivariate logistic regression analysis was used to analyze the relationship between serum AG and GPIHBP1 levels and the occurrence and development of DR and PDR. Receiver operating characteristic(ROC) curve analysis was used to evaluate the efficacy of serum AG and GPIHBP1 levels in the assessment of DR and PDR. Results Compared with the control group, serum AG levels were lower and GPIHBP1 levels were higher in the T2 DM group(t/P =-9.398/<0.001, 12.221/<0.001). Serum AG levels decreased sequentially, and GPIHBP1 levels increased sequentially,across the NDR, NPDR, and PDR subgroups(F/P = 58.552/<0.001, 75.813/<0.001). Multivariate logistic regression analysis showed that a longer duration of T2 DM, higher glycated hemoglobin, and higher GPIHBP1 levels were independent risk factors for the occurrence and development of DR and PDR [OR(95%CI) = 1.902(1.482-2.442), 1.741(1.361-2.228), 6.111(1.790-20.861), 2.842(1.012-7.979), 1.010(1.004-1.016), 1.007(1.002-1.012)], while higher AG levels were an independent protective factor [OR(95%CI) = 0.962(0.929-0.996), 0.965(0.936-0.995)].ROC curve analysis showed that the area under the curve(AUC) for serum AG, GPIHBP1 levels, and their combination in evaluating DR were 0.790, 0.816, and 0.897,respectively. The combined evaluation was superior to either marker alone(Z/P = 5.442/<0.001, 4.779/<0.001). The AUC for serum AG, GPIHBP1 levels, and their combination in evaluating PDR were 0.784, 0.796, and 0.865, respectively. The combined evaluation was superior to either marker alone(Z/P = 3.945/<0.001, 3.200/0.001). Conclusion Decreased serum AG levels and increased GPIHBP1 levels are closely associated with the occurrence and development of DR. The combination of serum AG and GPIHBP1 levels has high efficacy in evaluating the occurrence and development of DR.

Objective To investigate the relationship between the levels of serum sirtuin 1(Sirt1) and sirtuin 6(Sirt6) and diabetes in patients with diabetic cataract(DC) and its diagnostic value. Methods A total of 113 patients with DC admitted to the Ophthalmology Department of Shunyi District Maternal and Child Health Hospital, Beijing, from January 2024 to June 2025 were prospectively enrolled(DC group). In addition, 113 patients with type 2 diabetes mellitus(T2 DM group)and 113 healthy individuals(control group) matched at a 1:1 ratio were included. Serum Sirt1 and Sirt6 levels were measured using enzyme-linked immunosorbent assay. According to the stage of cataract, DC patients were divided into early(n = 34),middle(n = 43), and late(n = 36) subgroups. Spearman correlation analysis was used to assess the association between serum Sirt1, Sirt6 levels and DC stage. Multivariate logistic regression was performed to identify factors influencing DC occurrence.Receiver operating characteristic(ROC) and decision curve analyses were used to evaluate the diagnostic performance and clinical benefit of serum Sirt1 and Sirt6 levels. Results Serum Sirt1 and Sirt6 levels decreased progressively across the control, T2 DM, and DC groups(F/P = 312.468/<0.001; 257.992/<0.001), and further declined with advancing DC stage(F/P =240.406/<0.001; 158.124/<0.001). Serum Sirt1 and Sirt6 levels were negatively correlated with DC stage(r s/P =-0.653/<0.001;-0.680/<0.001). Longer T2 DM duration and higher Hb A 1cwere independent risk factors for DC, while increased Sirt1 and Sirt6 levels were independent protective factors [OR(95%CI) = 1.741(1.329-2.282), 2.217(1.241-3.960), 0.692(0.606-0.791), 0.720(0.636-0.815)]. The areas under the ROC curve for serum Sirt1, Sirt6, and their combination in diagnosing DC were 0.808, 0.796, and 0.901, respectively. The combined diagnostic model performed better than either marker alone(Z/P =3.692/<0.001; 4.428/<0.001). Decision curve analysis showed that within a threshold probability range of 0.15-0.95, the combined model yielded greater net clinical benefit than individual Sirt1 or Sirt6 levels. Conclusion Serum Sirt1 and Sirt6 levels are significantly decreased in DC patients and are associated with disease occurrence and progression. The combined detection of Sirt1 and Sirt6 provides superior diagnostic performance and clinical benefit, suggesting potential value for early diagnosis and risk assessment of diabetic cataract.

Objective To investigate the correlation between the expression of Serum Slit protein 2(Slit-2) and fibroblast growth factor 4(FGF4) levels with blood lipids and neonatal outcomes in patients with gestational diabetes mellitus(GDM). Methods Clinical data of 100 GDM patients who visited the Department of Obstetrics of the Third Affiliated Hospital of Zhengzhou University from February 2021 to March 2022 were collected. Based on the condition of pregnant women and newborns during follow-up, GDM patients were separated into the good neonatal outcome subgroup(n = 72) and the adverse neonatal outcome subgroup(n = 28). Another 100 healthy pregnant women who underwent prenatal checkups and childbirth at same hospital during the same period were as the control group. The general clinical data and blood lipid indicators of all study subjects were collected. ELISA kits were applied to detect the levels of Slit-2 and FGF4 in serum. Pearson correlation was applied to analyze the correlation between serum Slit-2, FGF4 levels with blood lipid indicators. Multivariate logistic regression was applied to analyze the factors that affected the occurrence of GDM. ROC survival curve was applied to analyze the predictive effect of serum Slit-2 and FGF4 levels on adverse neonatal outcomes of GDM.Results Compared with the control group, the GDM group showed a prominent increase in C-reactive protein, total cholesterol, triglycerides, low-density lipoprotein, and the Slit-2 and FGF4 levels, and a great decrease in high-density lipoprotein(t/P = 12.341/<0.001, 7.628/<0.001,27.419/<0.001, 13.745/<0.001, 5.155/<0.001, 5.053/<0.001, 3.288/<0.001). Pearson correlation analysis showed that serum Slit-2 was positively correlated with triglyceride and C-reactive protein in GDM pregnant women(r/P = 0.418/<0.001, 0.621/<0.001), and FGF4 was positively correlated with triglyceride and C-reactive protein(r/P = 0.412/<0.001, 0.586/<0.001). High levels of CRP, serum Slit-2 and FGF4 were independent risk factors for GDM in pregnant women [OR(95%CI) = 1.753(1.090-2.817), 1.320(1.074-1.622), 1.852(1.450-2.366)]. The AUC values of serum Slit-2, FGF4, and their combination in predicting adverse neonatal outcomes were 0.805, 0.843, and 0.907, respectively, in addition, the combination of the two was superior to their individual predictive values(Z = 2.420, 1.959,P = 0.016, 0.047). Conclusion The levels of Slit-2 and FGF4 in the serum of GDM pregnant women are greatly increased, and they are positively correlated with serum triglyceride in pregnant women. The combined detection of serum Slit-2 and FGF4 levels in pregnant women has predictive value for poor neonatal prognosis.

Objective To investigate the impact of nicorandil on coronary microcirculation dysfunction and myocardial perfusion reserve in patients with obstructive coronary heart disease(OCHD).Methods A total of 178 patients with OCHD admitted to our hospital from January 2022 to December 2024 were selected and divided into two groups, with 89 cases in each group. The control group received conventional basic treatment, while the study group received nicorandil in addition to the treatment given to the control group. The differences in clinical efficacy, coronary microcirculation dysfunction, myocardial perfusion reserve, cardiac function, and adverse reactions between the two groups were compared.Results The clinical efficacy of the study group was significantly higher than that of the control group(χ 2= 4.773,P <0.05). Repeated-measures analysis revealed significant time, between-group, and interaction effects for distal coronary pressure(Pd), index of microcirculatory resistance(IMR), myocardial blood flow, blood flow velocity, transmural myocardial perfusion reserve index(transmural MPRI), peak myocardial signal intensity, maximum upslope rate of first-pass perfusion, N-terminal pro-B-type natriuretic peptide(NT-pro BNP), creatine kinase-MB(CK-MB), and cardiac troponin I(cTnI) in both groups(P <0.05). For the time to peak of first-pass perfusion, significant time and interaction effects were observed in both groups(P <0.05). After the intervention,the time to peak of first-pass perfusion, Pd, IMR, NT-pro BNP, CK-MB, and c Tn I were significantly reduced, while the transmural MPRI, peak myocardial signal intensity, maximum upslope rate of first-pass perfusion, myocardial blood flow, and blood flow velocity were significantly increased. The magnitude of these changes was greater in the study group than in the control group(t = 12.968, 26.790, 108.735, 91.296, 146.835, 426.022, 42.097, 121.478, 36.722, 56.127, 14.070, respectively;P <0.05). No statistically significant difference was observed in the incidence of adverse reactions between the two groups(χ 2=0.097, P >0.05).Conclusion Nicorandil has a significant therapeutic effect on patients with OCHD. It can effectively improve coronary microcirculation dysfunction, enhance myocardial perfusion reserve, reduce the levels of myocardial injury markers,and does not increase the incidence of adverse reactions during the treatment process, demonstrating good safety.