Cardiovascular autonomic neuropathy (CAN) is often overlooked in type 2 diabetes, and reduced vagally mediated heart rate variability (HRV) may reflect earlier autonomic dysfunction. We compared four triglyceride-related metabolic surrogate indices in relation to vagal HRV and confirmed CAN. This cross-sectional study included 1,501 adults with type 2 diabetes. We examined the triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), C-reactive protein-triglyceride-glucose index (CTI), and waist circumference-adjusted TyG index (TyG-WC) in relation to log-transformed root mean square of successive differences (log-RMSSD), log-transformed high-frequency power (log-HF), and confirmed CAN. Confirmed CAN required at least two abnormal results among three complete cardiovascular autonomic reflex tests, classified using Hansen age- and sex-specific lower fifth-percentile reference equations. Associations were estimated with multivariable linear and logistic regression, and discrimination was described with receiver operating characteristic curves. Among the 1,501 eligible participants, 1,461 had complete results for all three cardiovascular autonomic reflex tests and could therefore be classified for CAN; 398 (27.2
To investigate whether systemic inflammation, measured by the neutrophil-to-lymphocyte ratio (NLR), modifies the cross‑sectional association between insulin resistance (IR, assessed by HOMA-IR) and overall cancer history in a nationally representative population. We conducted a cross-sectional analysis utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), which employs a complex, multistage probability sampling design. All analyses accounted for the complex survey design and sampling weights to ensure national representativeness. Weighted multivariable logistic regression was used to assess the cross‑sectional association, with an interaction term between HOMA-IR and NLR. Among 3,746 adults, after adjusting for age, sex, and BMI, HOMA-IR was not independently associated with cancer history (OR = 1.00, 95
Estimated glucose disposal rate (eGDR) summarizes waist circumference, hypertension, and glycated hemoglobin, whereas lipoprotein(a) [Lp(a)] reflects a largely inherited atherogenic pathway. We investigated their joint associations with cardiovascular disease (CVD) and examined whether either marker improves prediction beyond established risk factors. We followed 286,025 UK Biobank participants without baseline CVD. Low eGDR was defined as ≤ 6.28 mg/kg/min and high Lp(a) as ≥ 125 nmol/L. Multivariable Cox models estimated individual and joint associations. Interaction was evaluated on relative hazard and competing-risk-adjusted 10-year absolute-risk scales, and prediction was assessed using fivefold cross-validation. During a median follow-up of 14.1 years, 34,921 participants developed CVD. The adjusted HRs were 1.37 (95
To examine associations of biological age acceleration with incident arrhythmias in adults with type 2 diabetes and explore proteomic signatures and candidate mediators. We included 19,313 UK Biobank participants with type 2 diabetes and no recorded history of arrhythmia at baseline (mean age, 59.46 years; 60.49
Physical activity reduces cardiovascular risk in type 2 diabetes mellitus (T2DM), yet the intensity-specific metabolic mechanisms underlying this protection remain poorly characterized. Using the UK Biobank prospective cohort, we included 6,887 T2DM patients with complete physical activity and plasma NMR metabolomics data. Three intensity-specific metabolic signature scores (walking, moderate-, and vigorous-intensity) were constructed via elastic net regression. Restricted cubic spline Cox regression was used to model dose–response relationships between total physical activity and major adverse cardiovascular events (MACE). Multi-level mediation analyses quantified the proportion of the exercise–MACE association statistically accounted for by each intensity-specific metabolic pathway. Over a median follow-up of 15.17 years, 974 MACE events occurred. Total physical activity was inversely associated with MACE risk in a dose–response manner (P overall = 0.007), plateauing at approximately 3,500–4,000 MET-min/week. Compared with the low activity group, moderately active and highly active groups showed 17
