To examine the association between the lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) and metabolic dysfunction-associated steatotic liver disease (MASLD).

This study used data from the National Health and Nutrition Examination Survey (NHANES) database, including 3,863 adult participants. MASLD was diagnosed using current common criteria. We used multivariable logistic regression models to examine the association between LHR and MASLD risk, while restricted cubic spline (RCS) regression was used to look for nonlinear relationships. We found threshold effects using segmented linear regression, and subgroup differences were checked.

Multivariable logistic regression analysis showed that for each unit rise in LHR, the risk of MASLD went up 33% (OR=1.33, 95%CI: 1.18-1.50, P<0.001) after considering age, sex, race, socioeconomic factors, lifestyle, comorbidities, anthropometric indices, and liver enzyme/lipid profiles. RCS analysis showed a clear nonlinear link between LHR and MASLD risk (P=0.02), with the lowest risk seen at LHR=1.62. Threshold analysis found an inflection point at LHR=2.554. When LHR <2.554, each unit rise in LHR pushed up MASLD risk by 53.5% (OR=1.535, 95%CI: 1.270-1.856, P<0.001); but when LHR≥2.554, the link was not significant (OR=1.105, 95%CI: 0.718-1.700, P=0.650). Subgroup analysis showed that the link weakened and became non-significant in people with obesity (BMI≥30 kg/m²) or diabetes.

LHR has a nonlinear link with MASLD risk, which means it might work as a biomarker for checking MASLD risk, especially for people without severe metabolic dysfunction.

To evaluate the association between phase angle (PhA) and abdominal obesity and explore its clinical value as a screening tool for abdominal obesity.

A retrospective analysis was conducted on data from 1 802 adults (838 males, 964 females; age 18-84 years) who underwent health examinations at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between March 2019 and October 2021. Participants were stratified into tertiles based on PhA. Abdominal obesity was defined using combined diagnostic criteria: waist circumference (WC)>90 cm and visceral fat area (VFA)>100 cm² for males, and WC>85 cm and VFA>100 cm² for females. Multivariate logistic regression, smooth curve fitting, and piecewise regression models were used to analyze the associations.

The combined diagnostic criteria showed good consistency with WC and VFA criteria (Kappa=0.745 and 0.865, respectively). PhA was significantly associated with abdominal obesity defined by the combined criteria, with a threshold effect detected (P for nonlinearity=0.011). When PhA>5.6°, each 0.1° increment in PhA was associated with a 20.6% reduction in the risk of abdominal obesity (P<0.001); no significant change was observed when PhA≤5.6°.

PhA is an independent predictor of abdominal obesity under the combined diagnostic criteria, and the threshold of 5.6°may provide a reference for non-invasive and efficient clinical screening.

This study aims to explore the relationship between the severity of obstructive sleep apnea (OSA) and blood glucose management in patients with type 2 diabetes mellitus (T2DM). The goal is to provide insights for the comprehensive management of T2DM.

A total of 112 patients with T2DM were selected from Yan'an University Affiliated Hospital between February 2020 and February 2023. OSA was evaluated using polysomnography (PSG) and classified into two groups based on the AASM 2012 standard: a simple T2DM group (33 patients) and a T2DM+OSA group (79 patients). General information and biochemical indicators were collected, and continuous glucose monitoring (CGMS) was used to obtain mean blood glucose (MG), time in range (TIR), time above target range (TAR), time below target range (TBR), and the glucose management indicator (GMI).

The fasting blood glucose (FPG), glycated hemoglobin (HbA1c), MG, TAR, TBR, and GMI values were significantly higher in the T2DM+OSA group compared to the simple T2DM group, while TIR was lower (all P<0.05). Spearman correlation analysis indicated that the apnea-hypopnea index (AHI) was positively correlated with GMI (r=0.56) and TAR (r=0.49), and negatively correlated with TIR (r=-0.50) (all P<0.01). Multiple regression analysis demonstrated that an increase in AHI was independently correlated with a decrease in TIR (β=-0.37, P<0.01), an increase in MG (β=4.07, P<0.01), and an increase in GMI (β=7.29, P<0.01).

CGMS indicators, such as MG, TIR, and GMI, are closely related to the severity of OSA in patients with T2DM and can serve as valuable evaluation tools for this condition. This study provides a foundation for optimizing the comprehensive management of T2DM. Further exploration of the mechanisms linking OSA with diabetes and the clinical value of CGMS is warranted.

To discuss the related factors and effect of relationships of hyperuricemia (HUA) in premenopausal women, laying a theoretical foundation for evaluating the diagnostic criteria and prevention and treatment.

A cross-sectional study were adopted. 20 572 premenopausal women who underwent health check-up were selected. HUA was defined as those with fasting serum uric acid (SUA) >420 μmol/L. Univariate analysis and Logistic regression were used to screen the related factors. We used comprehensive attribution risk analysis to identify primary attributions. Correspondence analysis was used to display the order and aggregation between HUA and associated factors. Association paths were constructed for relevant factors and mediation effects were tested.

The prevalence of HUA in premenopausal women was 0.48%. The results of univariant analysis showed that the age, occupation, body mass index, systolic blood pressure, diastolic blood pressure, blood urea nitrogen, creatinine, estimated glomerular filtration rate (eGFR), total cholesterol, triacylglycerol (TG), high density lipoprotein cholesterol, low-density lipoprotein cholesterol, plasma viscosity were significantly related to HUA (P<0.001). Logistic regression showed that elevated TG, hypertension and decreased eGFR were independently related to HUA (P<0.001). The abnormal rates of abnormal blood uric acid corresponding to the three cut-off points of 420 μmol/L and 360 μmol/L, were 0.48% and 2.04% respectively. The mediation effect of TG- mean arterial pressure (MAP)-eGFR and MAP-eGFR-SUA was 9.42%, and 1.86%, respectively with statistical significance.

The prevalence of HUA in premenopausal women may be underestimated due to high diagnostic criteria. The reasonable cut-point for HUA might be slightly lower than 360 μmol/L. Elevated TG, hypertension, and decreased eGFR are independently associated with HUA and may develop along the path of "metabolism disorder-hypertension-renal injury" . Intervention measures should start with intervening in dietary habits firstly and comprehensively considering various associated factors. These measures are of great significance for premenopausal women in reducing metabolic diseases and protecting renal function.

Sleeve gastrectomy (SG), currently the most widely performed metabolic and bariatric surgery, demonstrates high safety and efficacy. However, the significant postoperative weight regain rate adversely affects patient prognosis. At present, the primary intervention for weight recurrence after SG is surgical revision, including procedures such as re-SG and Roux-en-Y gastric bypass (RYGB). Nevertheless, these surgical approaches are associated with considerable trauma, a higher incidence of complications, and the potential for recurrent weight regain. In contrast, minimally invasive non-surgical interventions offer distinct advantages in managing post-SG weight regain. Current non-surgical strategies include lifestyle modification, psychological intervention, pharmacotherapy, and endoscopic treatments. These methods exert their effects through multiple mechanisms, such as modulating metabolic adaptation, altering lifestyle behaviors, improving endocrine function, and maintaining gastric volume. Collectively, they provide safer and more effective options for postoperative weight management following SG.

The prevalence of gout in China is increasing year by year, and it shows a trend of youthfulness. Uric acid can not only be deposited in common joints, causing classic gout attacks, but also widely deposited in various parts of the body, showing atypical pathogenic manifestations. Many reasons, such as atypical clinical manifestations, special location, special population, lack of clinical understanding, and cover-up of comorbidity, have greatly increased the difficulty of clinical diagnosis and treatment, and the probability of clinical missed diagnosis and misdiagnosis is high, which deserves the attention of clinicians. Traditional imaging examination has limited diagnostic value. Dual-energy computed tomography (DECT) can specifically identify urate crystals, which is helpful for diagnosis. Through literature review, this paper summarizes the atypical clinical manifestations of uric acid deposition, and provides reference for clinical diagnosis and treatment.

Bariatric metabolic surgery (MBS) is an important therapeutic option for severe obesity and obesity-related metabolic disorders; however, its long-term effectiveness largely depends on postoperative adherence and the quality of longitudinal, comprehensive care. Postoperative adherence is multidimensional, encompassing follow-up adherence, dietary and medication adherence, and exercise adherence, and is influenced by a range of factors including sociodemographic characteristics, psychological and behavioral problems, family and social support, healthcare accessibility, and the design of follow-up workflows. Case management emphasizes patient-centered continuous assessment, multidisciplinary coordination, and structured follow-up support. The existing literature generally suggests that case management may improve weight maintenance and related clinical outcomes by increasing follow-up participation and strengthening self-monitoring and behavioral support; nevertheless, the evidence is limited by substantial heterogeneity in study designs and intervention components, non-uniform outcome measures, and insufficient basis for causal inference. Based on current evidence and clinical needs, a postoperative care pathway integrating stage-based, standardized, individualized, and digital approaches is recommended to establish a closed-loop system of "assessment-intervention-feedback and correction." Future high-quality prospective studies, grounded in unified core outcome sets and standardized management frameworks, are warranted to identify the active components and cost-effectiveness of case management and to provide robust evidence for its wider implementation.

To conduct a meta-analysis on the efficacy and safety of mazdutide in weight loss for both diabetic and non-diabetic obese individuals.

By searching domestic and international literature databases from the establishment of the database to January 2026, randomized controlled trials involving both diabetic and non-diabetic populations and using mazdutide intervention were included. A standardized process and a double-blind quality control system by two researchers were adopted to observe weight loss efficacy-related indicators and safety.

A total of 10 studies were included, involving 2,321 patients. Overall, mazdutide achieved greater weight loss compared to the control group, and a dose-response gradient was observed. Stratified meta-analysis by follow-up time showed that the weight loss effect generally increased with the extension of follow-up. It was confirmed that the weight loss benefit of mazdutide may be related to the follow-up duration (MD=-6.57%, 95%CI: -8.18%~-4.96%; I²=94%; Z=8.00, P<0.0001). In terms of safety outcomes, mazdutide significantly increased the risk of gastrointestinal adverse reactions. Regarding hypoglycemia, no statistically significant difference was found between the two groups (RR=1.64, 95%CI: 0.94~2.84; I²=0%; Z=1.75, P=0.08). Begg's test did not suggest publication bias (Z=-0.17, P=0.87), and Egger's regression intercept test also did not show statistical significance (P=0.27).

Mazdutide demonstrated statistically significant weight loss effects in both diabetic and non-diabetic obese individuals, with a dose-dependent trend. Given the high heterogeneity in some analyses and the limited follow-up duration, the extent of efficacy and long-term benefits still require further research for confirmation.

To systematically evaluate the efficacy and safety of berberine alone or combined with oral hypoglycemic agents in type 2 diabetes mellitus (T2DM), and explore whether baseline glycemic status affects treatment effect consistency.

We systematically searched PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases from inception to January 1, 2026. We included T2DM clinical studies using berberine alone or combined with standard glucose-lowering therapies. Outcomes included fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), 2-hour postprandial blood glucose (2hPBG), and safety (adverse events, hypoglycemia). Subgroup analyses were performed by baseline FPG/HbA1c; publication bias was assessed via funnel plots and Egger’s test.

Thirty-three studies (3,131 participants) were included, with intervention durations of 14 days to 6 months and berberine doses of 0.9-2.4 g/day. Compared with controls, berberine significantly reduced FPG (WMD=-0.78 mmol/L), HbA1c (WMD=-0.63%), and 2hPBG (MD=-1.11 mmol/L). Subgroup effects were directionally consistent; HbA1c reduction was greater in patients with baseline HbA1c≥9.0% (-0.79% vs -0.58%). Berberine was associated with lower risks of total adverse events (RR=0.73) and hypoglycemia (RR=0.59). No significant publication bias was detected.

Berberine as adjunctive therapy improves glycemic control in T2DM without increasing safety risk, and may reduce adverse events and hypoglycemia. Baseline glycemic status may affect effect magnitude. Further high-quality randomized controlled trials are needed to confirm optimal populations and clinical applications.

Portal-mesenteric venous thrombosis (PMVT) is a rare yet life-threatening complication following laparoscopic sleeve gastrectomy. Risk factors include obesity, metabolic disorders, intraoperative manipulation, and postoperative complications. However, its non-specific symptoms often lead to missed diagnosis. This article reports a case of PMVT after laparoscopic sleeve gastrectomy that was successfully treated with superior mesenteric artery catheter-directed thrombolysis combined with low-molecular-weight heparin anticoagulation. The purpose of this report is to enhance awareness among bariatric and metabolic surgeons regarding PMVT, emphasizing the importance of timely diagnosis and intervention to prevent severe consequences caused by delayed treatment.

In recent years, with the rapid development of novel anti-obesity medications such as glucagon-like peptide-1 receptor agonists (GLP-1RA), these agents have been extensively utilized in the treatment of obesity, type 2 diabetes mellitus (T2DM), and various metabolic disorders. Currently, only a limited number of published studies have reported an increased risk of intraoperative regurgitation and aspiration when GLP-1RA is administered in the perioperative period. This paper presents a case involving a patient who fasted for more than 18 hours prior to surgery, experienced regurgitation during tracheal intubation, and underwent laparoscopic sleeve gastrectomy (LSG) with preservation of the gastric fundus after intraoperative exploration revealed residual gastric contents. The aim of this report is to enhance the management of GLP-1RA in the perioperative period, reduce associated risks, and standardize the conduct of bariatric surgery.