Nationwide Japanese claims studies have documented regional variation in quantitative urinary albumin or protein testing, but it is unclear whether geographic ordering persists over time or depends on the denominator used. We evaluated the persistence of prefectural ordering in billed urinary albumin quantification and examined its robustness using a population-based denominator. This ecological provider-location study used National Database Open Data for 47 prefectures. FY2015-FY2022 was the primary historical interval; FY2023-FY2024 was a scope-aligned extension. The primary metric was urinary albumin quantification billing counts per 1,000 HbA1c billing counts. A sensitivity analysis used counts per 100,000 total population. Equal-weight dispersion, endpoint Spearman correlations, Kendall’s W across annual ranks, and cross-metric rank correspondence were calculated. During FY2015-FY2022, the national primary metric increased from 26.20 to 33.54 (+ 28.0
The influence of baseline depressive-symptom severity on psychological trajectories during incretin receptor agonists (glucose-dependent insulinotropic polypeptide [GIP] and/or glucagon-like peptide-1 receptor agonists [GLP-1RA]) therapy remains unclear. We evaluated short-term changes in binge-eating tendency and depressive symptoms during GIP/GLP-1RA therapy, stratified by baseline severity. Fifteen adults with type 2 diabetes or obesity (mean age 55.6 years; body weight 89.9 kg) initiating or switching GIP/GLP-1RA therapy completed daily ecological momentary assessment (EMA) of binge-eating tendency for 85 days and weekly Patient Health Questionnaire-9 (PHQ-9) assessments. Longitudinal changes were analysed using linear mixed-effects models, stratified by baseline PHQ-9 severity (low: <10; high: ≥10). Body weight and binge-eating tendency decreased significantly (both p < 0.001). A significant Week × Group interaction for depressive symptoms (p < 0.001) indicated divergent trajectories: scores decreased in the low baseline group (p = 0.026) but increased in the high baseline group (p = 0.001). In this exploratory study, baseline depressive-symptom severity was associated with divergent depressive-symptom trajectories during incretin receptor agonist therapy, whereas reductions in body weight and binge-eating tendency appeared independent of baseline mood.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in type 2 diabetes. We investigated the association between monocyte mRNA expression of sodium-glucose cotransporter 2 (SGLT2), the molecular target of luseogliflozin, and changes in the fibrosis-4 (FIB-4) index during treatment with this agent. This single-center retrospective observational study used prospectively collected peripheral blood monocyte samples from 82 participants with type 2 diabetes and MASLD who had received luseogliflozin for at least 6 months. Baseline monocyte SGLT2 mRNA expression was measured using quantitative real-time polymerase chain reaction. Clinical and laboratory parameters, including FIB-4 index, were evaluated at baseline and 6 months after luseogliflozin initiation. Changes were calculated as the 6-month value minus the baseline value; therefore, negative values indicated reductions. After 6 months, waist circumference, hemoglobin A1c, liver enzyme levels, high-sensitivity C-reactive protein, and the FIB-4 index decreased significantly. Baseline monocyte SGLT2 mRNA expression was negatively correlated with the change in the FIB-4 index, indicating that higher baseline expression was associated with a greater reduction. In multiple regression analyses, natural-log-transformed baseline monocyte SGLT2 mRNA expression remained associated with the change in the FIB-4 index after adjustment for baseline clinical variables. Higher baseline monocyte SGLT2 mRNA expression was associated with a greater reduction in the FIB-4 index after luseogliflozin treatment. This finding should be interpreted as an exploratory association between a cell-specific transcriptomic feature and changes in a fibrosis-related index, rather than as evidence of functional SGLT2 signaling in monocytes or histological fibrosis regression.
Tirzepatide improves body weight and glycemic control in patients with type 2 diabetes, but factors associated with inter-individual differences after switching remain unclear. We examined whether baseline monocyte glucose-dependent insulinotropic polypeptide receptor (GIPR) mRNA expression was associated with changes in body weight and the fibrosis-4 (FIB-4) index after switching from glucagon-like peptide−1 receptor agonists (GLP-1RAs) to tirzepatide. This single-center retrospective study included 90 patients with type 2 diabetes who had received a GLP-1RA for at least 6 months before switching. Baseline monocyte GIPR mRNA expression was measured by quantitative real-time polymerase chain reaction. Associations with percentage body-weight change and FIB-4 index change during the 6 months after tirzepatide initiation were assessed by correlation and multivariable regression. Exploratory ex vivo assays were performed to assess monocyte responses to native GIP. Higher baseline monocyte GIPR mRNA expression was associated with greater reductions in body weight and the FIB-4 index and remained significant in multivariable models. The association with the FIB-4 index remained significant after additional adjustment for percentage body-weight change at 6 months after tirzepatide initiation. GIPR mRNA expression was not associated with body-weight change during the preceding 6 months of GLP-1RA therapy. Native GIP suppressed lipopolysaccharide-induced interleukin-6 and tumor necrosis factor-alpha responses in monocytes. Baseline monocyte GIPR mRNA expression was associated with body-weight and FIB-4 index reductions after switching to tirzepatide. It may represent an exploratory marker of clinical changes, but treatment specificity, causal GIPR-dependent mechanisms, and structural liver fibrosis regression were not established. Summary of the study design and main finding. Baseline GIPR mRNA expression in peripheral blood monocytes was associated with reductions in body weight and the FIB-4 index after switching to tirzepatide in patients with type 2 diabetes. In exploratory ex vivo assays, native GIP suppressed LPS-induced inflammatory responses, supporting monocyte GIPR expression as a candidate exploratory marker requiring further validation.
Glycated hemoglobin (HbA1c) is widely used for diabetes diagnosis and long-term monitoring. Although high-performance liquid chromatography (HPLC) is the accepted method, its requirement for specialized instrumentation and infrastructure can limit its accessibility in some settings. Rapid point-of-care platforms based on fluorescence immunoassay (FIA) technology enable more accessible alternative. This study evaluated the analytical agreement between the TRUSTlight HbA1c fluorescence immunoassay and the HPLC comparator method. A total of 200 anonymized residual samples collected from a diagnostic laboratory in Chennai, India, between January and February 2026 were included. HbA1c levels were measured using the ion-exchange HPLC method and compared with the TRUSTlight Glycosylated Hemoglobin Test Kit. Method agreement was assessed using Bland–Altman analysis and Passing–Bablok regression. Classification agreement at the 6.5
