Early identification of type 2 diabetes is vital for prevention. While the FINDRISC questionnaire offers a non-invasive screening method, machine learning models may offer alternative ways to analyze risk patterns. This study compares the predictive performance of the aggregate FINDRISC score and its individual components using both conventional and machine learning approaches in a population-based cohort. This prospective population-based cohort study evaluated the performance of the aggregate FINDRISC score and its individual items for predicting 6-year incident type 2 diabetes using logistic regression and four machine learning algorithms (decision tree, random forest, support vector machine, and artificial neural network). SMOTE was applied strictly within training folds during cross-validation. Model discrimination and calibration were evaluated using the AUC-ROC, decile-based calibration plots, and the Hosmer–Lemeshow test. Among 8,859 participants with complete 6-year follow-up, 525 incident cases occurred (6.0
Human papillomavirus (HPV) infection and associated diseases are a major global health burden, and the 9-valent HPV vaccine is widely used to reduce their incidence and mortality. This study reports the first documented case of arginine vasopressin (AVP) deficiency following 9-valent HPV vaccination, to highlight the need for clinical vigilance for potential post-vaccination adverse events. A 30-year-old Chinese woman developed symptoms after her first dose of the 9-valent HPV vaccine in July 2023. This report details her clinical data, laboratory results, MRI findings, treatment, and follow-up outcomes. One day after vaccination, the patient developed polyuria and severe thirst, with no prior history of head trauma, peripartum events, or endocrine disorders. Laboratory tests confirmed AVP deficiency, and brain MRI showed pituitary stalk thickening and absence of the posterior pituitary bright spot, consistent with infundibulo-neurohypophysitis. Following treatment with desmopressin, her polyuria and polydipsia were well controlled. At 30 months of follow-up, the desmopressin dose had been reduced to 0.025 mg twice daily without symptom recurrence, and repeat MRI showed normalized pituitary morphology. This is the first reported case of AVP deficiency possibly associated with 9-valent HPV vaccination. Although causality cannot be established from a single case, clinicians should be aware of new-onset polyuria and polydipsia after vaccination and consider AVP deficiency in the differential diagnosis.
The combined phenotype of residual inflammation and anemia on kidney function in diabetes remains unclear. Our study examined their joint association with impaired kidney function and kidney function decline in a nationally representative Chinese sample. Our study encompassed 2,363 diabetes patients from the China Health and Retirement Longitudinal Study (CHARLS) for cross-sectional analysis and a sub-cohort of 547 patients for longitudinal analysis (2011–2015). Exposures comprised residual inflammation (hs-CRP ≥ 2.0 mg/L) and WHO-defined anemia. Outcomes were prevalent impaired kidney function in the cross-sectional analysis and rapid kidney function decline (RKFD) in the longitudinal analysis. Logistic and linear regression, restricted cubic splines, and subgroup and sensitivity analyses were applied. Cross-sectionally, isolated residual inflammation or isolated anemia were each associated with impaired kidney function, while the combined phenotype showed the strongest association (OR = 3.61, 95
Patients with type 2 diabetes are prone to necrotizing soft tissue infections (NSTIs). The clinical outcomes of NSTIs are poor, with high mortality and morbidity. The association between the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and outcomes in these patients remains unclear. We conducted a retrospective database analysis including patients with type 2 diabetes (ICD-10 E11) who had used GLP-1RAs within six months before the diagnosis of NSTIs. Patients younger than 18 years and those with NSTI diagnoses more than 20 years earlier were excluded. Short- and mid-term outcomes including all-cause mortality, major adverse cardiovascular events, acute respiratory distress syndrome, acute kidney injury, need of blood transfusion, and amputation were compared after propensity score matching. A total of 16,792 patients were included. After propensity score matching, 1,099 patients remained in each group with balanced baseline characteristics. The use of GLP-1RAs was associated with lower mortality at three months (HR 0.49, 95
Cardiovascular risk associated with longitudinal adiposity change may not be fully captured by body mass index. We examined whether change in multidimensional anthropometric adiposity and newly recorded dysfunction were associated with incident cardiovascular disease (CVD). We analyzed 49,742 UK Biobank participants with anthropometric measurements at baseline and the first imaging assessment. A multidimensional adiposity index was constructed from body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio. The primary exposure was annualized change in this index. Newly recorded low-overlap dysfunction was assessed separately. Cox proportional hazards models estimated associations with incident CVD. During a median follow-up of 4.11 years, 1,971 CVD events occurred. Greater annualized adiposity change was modestly associated with higher CVD risk in the primary adjusted model (HR per 1-SD increase, 1.045; 95
