BackgroundThis study aimed to investigate the association between serum uric acid level in the before 20 weeks of gestation and gestational diabetes mellitus (GDM).MethodsA retrospective cohort study was conducted involving 44,609 singleton pregnant women from three medical centers from January 2018 to June 2024. The primary exposure was serum uric acid levels measured prior to 20 weeks of gestation. The main outcome of interest was GDM, with secondary outcomes including GDM requiring insulin therapy (GDMA2) and GDM complicated by pre-eclampsia (GDM&PE). Statistical methods such as smooth curve fitting, threshold effects, multivariate logistic regression, and subgroup analysis were employed to examine the relationship between uric acid and GDM. Additionally, a two-sample Mendelian randomization (MR) study was performed using genetic data from Genome-Wide Association Studies (GWAS) of serum uric acid and GDM.ResultsThe cohort study revealed a nonlinear relationship between uric acid level and GDM risk, with a turning point of 240 μmol/L. After adjusting for confounders, the odds ratio for GDM was 1.47(95% CI: 1.37-1.58) for uric acid level between 240 ~ 360 μmol/L compared to level below 240 μmol/L, the odds ratio for GDM was 2.60 (95% CI: 1.94-3.47) for uric acid levels ≥ 360 μmol/L. Similar positive associations were observed between uric acid level and GDMA2 and GDM & PE, which were consistent across subgroup analyses. The MR analysis indicated a causal relationship between uric acid and GDM (OR = 1.122, 95% CI: 1.016-1.239, p = 0.023).ConclusionElevated serum uric acid levels in the before 20 weeks of gestation are associated with an increased risk of GDM. Monitoring serum uric acid in early pregnancy helps in risk stratification for the management of individuals at high risk of GDM.

Background:Insulin resistance (IR) has been shown to be associated with hypertension. The triglyceride-glucose body mass index (TyG-BMI) has emerged as a novel surrogate marker for assessing IR. This study aimed to investigate the association between the TyG-BMI index and hypertension among adults in rural southwest China using a cross-sectional study. Method:We recruited 2,998 people between the ages of 30 and 79 from Rongchang, Chongqing municipality, southwest China, as part of The China Multi-Ethnic Cohort Study, considered the largest cohort study in southwest China. Logistic regression model, restricted cubic spline (RCS) model and receiver operating characteristic (ROC) were applied to estimate the association between the TyG-BMI index and hypertension. Moreover, subgroup and sensitivity analyses were undertaken to check the consistency of the outcomes. Results:A total of 2,998 participants were included in the present study, with a hypertension prevalence of 39.93%. After adjusting for confounding factors, the ORs of hypertension in Q2, Q3, Q4 were 1.641 (1.277-2.109), 1.768 (1.371-2.281), 2.463 (1.794-3.382) compared with the lowest quartile (Q1), respectively. RCS indicated that the TyG-BMI index was nonlinearly associated with hypertension (P for overall < 0.001, P for nonlinear  = 0.046). The ROC analysis indicated that the TyG-BMI index had a 64.1% (AUC: 0.641, 95% CI: 0.621-0.661) ability to distinguish hypertension. Subgroup analysis in participants without diabetes, dyslipidemia, hyperuricemia and central obesity as well as sensitivity analyses also demonstrated the similar relationship between the TyG-BMI index and hypertension. Conclusion:The current study demonstrates that the TyG-BMI index is associated with higher risk of hypertension among rural adults in southwest China. Lifestyle modifications, including weight control, vigorous physical activity and healthy dietary pattern can help improve IR and prevent hypertension.

Inflammation is a key contributor to cardiovascular disease (CVD), yet existing risk models such as Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) and Pooled Cohort Equations (PCE) inadequately identify individuals at intermediate risk. We investigated whether incorporating the inflammatory chemokine CCL17 could improve cardiovascular risk prediction. In two prospective cohorts—the Shunyi Cohort (n = 706, China) and the UK Biobank (n = 36,097, UK)—baseline CCL17 levels were quantified, and major adverse cardiovascular events (MACEs) were tracked over follow-up. Elevated CCL17 levels were independently associated with increased risk of MACEs. Integrating CCL17 into existing models significantly improved discrimination and reclassification, particularly among intermediate-risk individuals (e.g., NRI: 15.1

Although environmental exposure to toxic metals and metalloids is linked with the risk of cardiovascular diseases, the evidence is limited in the elderly. We evaluated the associations between 12 plasma metal levels including aluminum (Al), titanium (Ti), strontium (Sr), lead (Pb), vanadium (V), chromium (Cr), cobalt (Co), nickel (Ni), cuprum (Cu), zinc (Zn), arsenic (As), and selenium (Se) with prevalence of hypertension in the elderly Chinese population. In this study, stratified cluster sampling was conducted among elderly residents in three communities in Gansu province from June to July 2023, with a total of 330 participants included. The concentrations of metals in whole plasma were measured using inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression and restricted cubic spline analyses were used to evaluate the dose–response relationship between plasma metal levels and hypertension, with all metal concentrations log-transformed. We applied quantile g-computation (QG-comp) and Bayesian kernel machine regression (BKMR) models to examine the associations of both individual metals and metal mixtures with hypertension. After multivariable adjustments, the odds ratios (ORs) and 95

BACKGROUND:The weight-adjusted waist index (WWI) is a novel obesity measure standardizing waist circumference by body weight. While linked to cardiometabolic disorders, its association with hypertension (HTN) and the mediating role of systemic inflammation remain unclear. This study investigated the WWI-HTN relationship and the mediating effects of C-reactive protein-albumin-lymphocyte ratio (CALLY), C-reactive protein-albumin ratio (CAR), and lymphocyte-C-reactive protein ratio (LCR). METHODS:We analyzed data from 10,869 adults (≥20 years) in NHANES 1999-2010. Associations of WWI with HTN and inflammatory markers were examined using multivariable regression, restricted cubic splines (RCS), and generalized additive models (GAM). Mediation was evaluated through bootstrap analysis. RESULTS:Higher WWI was strongly associated with HTN risk (OR = 1.79; 95% CI: 1.66-1.93; P < 0.001). Participants in the highest quartile had nearly fourfold greater risk than those in the lowest (OR = 3.79; 95% CI: 3.04-4.72). The relationship remained robust after adjusting for inflammatory markers (OR = 1.62; 95% CI: 1.49-1.75). Elevated log-CALLY and log-LCR were protective, whereas higher log-CAR increased HTN risk. Mediation analyses showed CALLY, LCR, and CAR explained 12.81%, 12.54%, and 15.89% of the association, respectively, with a combined effect of 13.91%. Subgroup analyses confirmed WWI as a consistent risk factor, and RCS/GAM demonstrated a nonlinear positive association with a threshold at WWI = 11.70. CONCLUSION:WWI is independently and nonlinearly associated with hypertension risk, particularly when WWI ≤11.70. Systemic inflammation partially mediates this association, underscoring its role in obesity-related hypertension.

This study aimed to analyze and compare the proportion of patients with different types of inflammatory arthritis and investigate the clinical characteristics, including symptoms and signs, medication choices, and disease activity, in the daily clinical practice of China. Patients with inflammatory arthritis were recruited from 16 Grade-A tertiary hospitals between August 2021 and April 2022. The medical profiles, encompassing sociodemographic characteristics, clinical and laboratory date, were collected. This study included 2,693 patients with arthritis, with rheumatoid arthritis (RA) accounting for the highest proportion (50.50

Aims:To evaluate the spatial-temporal changes in the incidence of type 2 diabetes related chronic kidney disease (CKD-T2DM) from 1990 to 2019, categorized by age and sex in 21 regions with different socio-demographic indexes (SDI), and to predict the incidence rate between 2020 and 2030. Methods:Data on the burden of CKD-T2DM were obtained from the Global Burden of Disease Study 2019. Age-standardized incidence rates (ASIR) were estimated by sex, age, region, SDI, and specifically in China. The trends of ASIR were assessed using Joinpoint model to calculate the average annual percentage changes (AAPCs) and their 95% confidence intervals. Prediction was conducted using the Bayesian age-period-cohort (BAPC) model. Result:In 2019, the ASIR of global CKD-T2DM increased with age in both sexes, and was highest in the older 75 age group. The ASIR of CKD-T2DM in males was higher than those in females. Overall, the global ASIR of CKD-T2DM increased from 1990 to 2019 in both sexes and all age groups. The most significant increase was observed in the 15-49 age group [males: AAPC=1.42, 95%CI:(1.35-1.49); females: AAPC=1.18,95%CI:(1.13-1.23)]. Besides, the upward trends in ASIR of CKD-T2DM were observed in most SDI regions and GBD regions. The changing trends in ASIR of CKD-T2DM in China were similar to the global trends. Finally, the predicted ASIR was also found to be increased globally and also in China in both sex from 2020 to 2030. Conclusion:The global CKD-T2DM incidence rates increased from 1990 to 2019 in both sexes, most regions and in China., and also increased globally between 2020 and 2030. Therefore, it is important to input more medical resources and establish prevention strategies for the increasing trends of CKD-T2DM.

AIMS:The objective of this prospective cohort study on the incidence of metabolic diseases and risk factors in Shunde (Speed-Shunde cohort) was to evaluate the incidence of cardiovascular-kidney-metabolic (CKM) syndrome and metabolic-associated multimorbidity, such as diabetes, hypertension, dyslipidaemia, and metabolic dysfunction-associated steatotic liver disease in Shunde, Foshan, Guangdong, China. Additionally, the study sought to identify the potential determinants that may impact the development of these conditions and the potential consequences that may result. METHODS AND RESULTS:In the Speed-Shunde cohort, data were gathered via questionnaires, physical measurements, and laboratory analyses encompassing demographic data, behavioural tendencies, anthropometric assessments, controlled attenuation parameters, and liver stiffness measurement utilizing vibration-controlled transient elastography, as well as serum and urine detection (such as oral 75 g glucose tolerance tests, haemoglobin A1c levels, lipid profiles, liver and renal function tests, urinary microalbumin, and creatinine levels). The baseline data were gathered from October 2021 to September 2022 from over 10 000 Chinese community-based adults and the follow-up surveys would be conducted every 2 or 3 years. Blood and urine samples were obtained and stored for future omics data acquisition. Initial analyses revealed the prevalence and risk factors associated with metabolic-associated multimorbidity. CONCLUSIONS:The Speed-Shunde cohort study is a longitudinal community-based cohort with comprehensive CKM health and metabolic-associated multimorbidity assessment. It will provide valuable insights into these conditions' development, progression, and interrelationships, potentially informing future prevention and treatment strategies.

Environmental exposure to heavy metals may adversely affect lung function particularly in the elderly. However, limited data are available directly evaluating the relationship of heavy metal exposures with lung function in Chinese elderly. We aimed to investigate the associations between plasma metals and lung function among Chinese elderly residents. We conducted a cross-sectional study of 308 elderly residents in an industrial area and a non-industrial area in northwest China and estimated the single and combined effects of plasma metals and their interactions with lung functions (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC). We analyzed 12 plasma metals and identified 4 metals by lasso regression and BKMR model for further analysis. Bayesian kernel machine regression (BKMR) and quantile-g computation (QG-comp) models estimated four metals that had greater importance in lung function indicators, namely strontium (Sr), chromium (Cr), cobalt (Co) and nickel (Ni). Subgroup analyses were performed based on the resident areas. Both BKMR and QG-comp models showed metal mixtures was positively associated with FEV1/FVC (0.046 [0.017,0.075]) among all participants but of negative association with FVC, and similar results were found among participants in non-industrial area. The subgroup analysis by region showed higher heavy metal levels in industrial areas than non-industrial area. Sr concentrations were lower in non-industrial area, but they had a negative effect on FVC. In conclusion, plasma Sr, Cr, Co, and Ni levels are significant associated with lung function particularly with restrictive ventilatory dysfunction among the Chinese elderly population.

Asthma is a prevalent inflammatory condition of the lower respiratory tract, affecting over 272 million people worldwide. Although prevalence and mortality rates have declined, asthma continues to burden healthcare systems, particularly in low-income regions. Metabolic diseases significantly influence the development and progression of asthma. This study aimed to evaluate global, regional, national, and temporal trends in asthma burden attributable to metabolic diseases from 1990 to 2021 and to project changes through 2040. The GBD (Global Burden of Disease) 2021 dataset was used to analyze key epidemiological variables, focusing on disability survival, years of life lost, and disability-adjusted life years (DALYs). Descriptive analyses and trend evaluations illustrated the burden of asthma due to metabolic diseases (MAS) over the last 30 years, while decomposition analyses quantified the impacts of population growth, aging, and epidemiological changes. In 2021, deaths totaled 62,363, with DALYs reaching over 3.28 million. High socio-demographic index (SDI) quintiles reported the highest age-standardized rates of DALYs and years of disability (YLDs), while low-middle SDI quintiles had the highest death rates. South Asia experienced the highest number of MAS-related deaths, years of life lost (YLLs), and DALYs. From 1990 to 2020, rates of deaths, DALYs, YLLs, and YLDs declined, with the most significant decrease occurring from 1993 to 2000. The analysis indicated that females bore a greater burden than males, with changes in DALYs more influenced by population growth. Inequalities associated with SDI decreased significantly, with a notable reduction in the health concentration index. Despite progress in prevention and treatment, the number of MAS cases is expected to continue rising until 2040, highlighting the need for effective public health strategies and ongoing research.

ObjectiveWe conducted this study to investigate the relationship between serum uric acid (SUA) levels and the risk of upper gastrointestinal cancer.MethodsWe conducted a prospective cohort study with 475659 cancer-free participants from the UK Biobank. All subjects were grouped into quartiles, and we used a Cox proportional hazards model to analyze the association between SUA levels and the risk of upper gastrointestinal cancer and explore the potential sex-specific relationship.ResultsOf the 475659 participants, 883 eventually developed upper gastrointestinal cancers over a median follow-up period of 6.7 years. We observed that SUA level was positively correlated with the risk of female oral cancer (hazard ratio Quartile 4 vs Quartile 1 (95% CI): 2.05(1.03,4.06)) and negatively associated with the risk of esophageal cancer in the general population (hazard ratio Quartile 3 vs Quartile 1 (95% CI): 0.65(0.45,0.93)). The risk of gastric cancer in males showed a U-shaped trend, decreasing and then increasing as SUA levels increased (hazard ratio Quartile 3 vs Quartile 1 (95% CI): 0.51(0.32,0.81)). The risk of small intestine cancer in females showed a trend of increasing and then decreasing with increasing SUA levels (hazard ratio Quartile 3 vs Quartile 1 (95% CI): 3.34(1.10,10.13)). Interaction analysis indicated that various factors, such as age, sex, smoking and drinking status, family history of cancer and BMI might play an important role in the relationship between SUA and cancer.ConclusionSUA levels are positively associated with the risk of oral cancer risk in females and negatively associated with the risk of esophageal cancer in the general population. Both low and high SUA levels were associated with increased risk of gastric cancer, supporting a U-shaped association.

Long-term exposure to lead is associated with an increased risk of diabetic kidney disease (DKD). However, limited data exist on global trends in DKD burden attributable to lead exposure, especially across diverse regions categorized by socioeconomic level. We aimed to assess the spatiotemporal changes in DKD burden attributable to lead exposure from 1990 to 2019 across 204 countries and regions with varying socio-demographic index (SDI) metrics. This retrospective analysis utilized data from the Global Burden of Disease Study 2019 (GBD2019) database. We estimated the burden of DKD attributable to lead exposure using the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR), accounting for sex, age, nationality, and SDI. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated using the Joinpoint model to evaluate trends in the ASMR and ASDR attributable to lead exposure from 1990 to 2019. Gaussian process regression was used to model the relationship between the SDI and ASMR/ASDR. Globally, the burden of DKD attributable to lead exposure has significantly increased since 1990, especially among elderly men and in regions such as Asia, Central Latin America, North Africa, the Middle East, and low-SDI regions. In 2019, the ASMR and ASDR of DKD attributable to lead exposure were 0.68 (95% CI: 0.40, 0.98) per 100,000 people and 15.02 (95% CI: 8.68, 22.26) per 100,000 people, respectively. From 1990 to 2019, the global ASMR and ASDR attributable to lead-associated DKD changed by 15.45% and -1.78%, respectively. The global AAPCs of the ASMR and ASDR were 0.55 (95% CI: 0.45, 0.65) and -0.01 (95% CI: -0.12, 0.1), respectively. Significant declining trends were observed in the high-income Asia Pacific region, eastern sub-Saharan Africa, North Africa, the Middle East, and other regions with high SDIs. Over this 30-year study period, the global burden of DKD attributable to lead exposure has increased, particularly in regions with low SDI. Lead exposure remains a significant concern in the global burden of diabetic kidney disease.

The effects of metal exposure on kidney function have been reported in previous literature. There is limited and inconsistent information on the associations between individual and combined exposures to metals and kidney function among the middle-aged and older population. The aim of this study was to clarify the associations of exposure to individual metals with kidney function while accounting for potential coexposure to metal mixtures and to evaluate the joint and interactive associations of blood metals with kidney function. A total of 1669 adults aged 40 years and older were enrolled in the present cross-sectional study using the 2015–2016 National Health and Nutrition Examination Survey (NHANES). Single-metal and multimetal multivariable logistic regression models, quantile G-computation, and Bayesian kernel machine regression models (BKMR) were fitted to explore the individual and joint associations of whole blood metals [lead (Pb), cadmium (Cd), mercury (Hg), cobalt (Co), manganese (Mn), and selenium (Se)] with the odds of decreased estimated glomerular filtration rate (eGFR) and albuminuria. A decreased eGFR was defined as an eGFR ≤ 60 mL/min per 1.73 m2, and albuminuria was categorized as a urinary albumin-creatinine ratio (UACR) of ≥ 30.0 mg/g. The results from quantile G-computation and BKMR indicated positive associations between exposure to the metal mixture and the prevalence of decreased eGFR and albuminuria (all P values < 0.05). These positive associations were mainly driven by blood Co, Cd, and Pb. Furthermore, blood Mn was identified as an influential element contributing to an inverse correlation with kidney dysfunction within metal mixtures. Increasing blood Se levels were negatively associated with the prevalence of decreased eGFR and positively associated with albuminuria. In addition, a potential pairwise interaction between Mn-Co on decreased eGFR was identified by BKMR analysis. Findings from our study suggested a positive association between exposure to the whole blood metal mixture and decreased kidney function, with blood Co, Pb, and Cd being the main contributors to this association, while Mn demonstrated an inverse relationship with renal dysfunction. However, as our study was cross-sectional in nature, further prospective studies are warranted to better understand the individual and combined effects of metals on kidney function. • Exposure to metal mixtures of cadmium (Cd), lead (Pb), mercury (Hg), manganese (Mn), cobalt (Co), and selenium (Se) positively associated with kidney dysfunction. • Co, Cd, Pb positively associated with kidney function impairment, Mn negatively associated with kidney function impairment. • A potential pairwise interaction between blood Mn-Co on decreased eGFR may exist.

Although numerous evidences suggest that zinc may have a beneficial impact on preventing and treating diabetes, findings from the population studies are inconclusive. To address this gap, we conducted a nested case-control study, employing restricted cubic splines and a conditional logistic regression model to explore the association between serum zinc levels and the risk of diabetes. We also assessed potential effect modifications through stratified analyses and examined the mediating effects of metabolic indicators using a multiclass mediation effect model. We measured baseline serum zinc concentrations using Inductively Coupled Plasma Mass Spectrometry in a cohort of 2156 participants, including 1078 individuals with diabetes and 1078 matched controls. Our findings revealed a 51 % increased risk of diabetes when comparing the highest quartile (Q4) to the lowest quartile (Q1) of serum zinc levels (Odds Ratio [95 % Confidence Interval]: 1.51 [1.09, 2.09]). There was a positive linear dose-response relationship between serum zinc and diabetes risk (P overall ≤0.01, P nonlinear = 0.20). Effect modifications were evident between serum zinc and factors such as educational attainment, body mass index, alcohol index, family history of diabetes, history of hypertension, coronary heart disease, and stroke, all of which influenced the risk of diabetes (all P-interaction <0.05). Moreover, our study identified significant indirect effects of triglycerides levels on diabetes risk for participants in the third (Q3) and fourth (Q4) quartiles of serum zinc, with mediation proportions of 19.23 % and 19.28 %, respectively. A significant indirect effect of alanine aminotransferase on diabetes risk was found for those in the Q4 of serum zinc, with a mediation proportion of 12.05 %. Considering these findings, it is advisable to conduct testing for serum zinc level and exercise caution when considering zinc supplementation. Furthermore, our results emphasized the necessity for additional validation through large-sample prospective population studies and experimental research.

IntroductionAlthough waist-to-height ratio (WHtR) has established association with cardiometabolic disease, the trend of changes in elevated WHtR among general population have not been examined adequately.MethodsThis study examined the prevalence of elevated WHtR and waist circumference (WC) and their trends over time using Joinpoint regression models among adults who participated in the United States National Health and Nutrition Examination Survey (U.S. NHANES) 1999–2018. We performed weighted logistic regression to identify the association between central obesity subtypes and the prevalence of comorbidities, including diabetes, chronic kidney disease, hypertension, cardiovascular disease, and cancer.ResultsThe prevalence of elevated WHtR has increased from 74.8% in 1999–2000 to 82.7% in 2017–2018 while elevated WC also increased from 46.9% in 1999–2000 to 60.3% in 2017–2018. Men, older adults, former smokers, and people with lower education levels were more likely to have elevated WHtR. A total of 25.5% of American adults had normal WC but elevated WHtR, and they had a significantly higher chance of suffering from diabetes (odds ratio [OR] = 2.06 [1.66, 2.55]), hypertension (OR = 1.75 [1.58, 1.93]) and CVD (OR = 1.32 [1.11, 1.57]).DiscussionIn conclusion, the burden of elevated WHtR and WC have been increasing among U.S. adults throughout the years, and the changes have been more significant across most subgroups. It is also notable that approximately a quarter of the population had normal WC but elevated WHtR, which had increased likelihood of having cardiometabolic diseases, especially diabetes. Future clinical practices should pay more attention to this subgroup of the population with overlooked health risks.

Background: The risk of hepatocellular carcinoma (HCC) is associated with a variety of factors. However, the possible association between the abnormal metabolism of fasting plasma glucose (FPG) and alanine aminotransferase (ALT) and the risk of HCC has not been widely studied. We examined this relationship based on a prospective cohort study.Methods: 162 first-attack HCC cases during three follow-up periods (2014-2020) were selected as the case group. A control group of 648 participants was obtained by 1:4 matching of age (+/- 2 years) and sex with noncancer participants in the same period. Conditional logistic regression models, restricted cubic spline models, additive interaction models, and generalized additive models were used to explore the effects of FPG and ALT on the risk of HCC.Results: After correction for confounding factors, we found that abnormal FPG and elevated ALT increased the risk of HCC, respectively. Compared with the normal FPG group, the risk of HCC was significantly increased in the impaired fasting glucose (IFG) (OR = 1.91, 95 %CI: 1.04, 3.50) and diabetes groups (OR = 2.12, 95 %CI: 1.24, 3.63). Compared with the lowest quartile of ALT, subjects in the fourth quartile had an 84 % increased risk of HCC (OR = 1.84, 95 %CI: 1.05-3.21). Moreover, there was an interaction between FPG and ALT on the risk of HCC, and 74 % of the HCC risk could be attributed to their synergistic effect (AP = 0.74, 95 %CI: 0.56-0.92).Conclusion: Abnormal FPG and elevated ALT are independent risk factors for HCC, and they have a synergistic effect on the risk of HCC. Therefore, serum FPG and ALT levels should be monitored to prevent the development of HCC.

Abstract Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self‐management remains the gold standard of care for diabetes. Improving patients' self‐management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID‐19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM. Methods A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis. Results The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference −0.24%; 95% confidence interval [CI]: −0.44, −0.05; p = 0.01), postprandial blood glucose (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010), but not on low‐density lipoprotein cholesterol (−0.06 mmol/L; 95% CI: −0.14, 0.02; p = 0.170), high‐density lipoprotein cholesterol (0.05 mmol/L; 95% CI: −0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure −0.82 mm Hg; 95% CI: −4.65, 3.00; p = 0.670; diastolic blood pressure −1.71 mmHg; 95% CI: −3.71, 0.29; p = 0.090). Conclusions Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.