本研究回顾性纳入2000至2022年孕前糖尿病(PDM)单胎妊娠孕妇,分析血糖、糖化血红蛋白(HbA1c)、血脂、动脉血pH、电解质及阴离子间隙等代谢指标,采用ROC曲线和logistic回归评估其预测糖尿病酮症酸中毒(DKA)及围产期死亡的价值。219例孕妇中21例(9.6%)发生DKA,其血糖(395.33 vs. 126.91 mg/dL)、HbA1c(8.45% vs. 6.73%)、LDL较高,HDL较低(均P<0.05)。围产期死亡6例(28.6%),与较低动脉血pH、较低碳酸氢盐、较宽阴离子间隙、较高HbA1c及高钾血症相关。联合代谢指标的ROC曲线下面积分别为0.99(DKA)和0.98(围产期死亡)。HbA1c升高、HDL降低及血糖升高为DKA的独立预测因素,碳酸氢盐降低与围产期死亡风险增加独立相关;碳酸氢盐<6.50 mEq/L与围产期死亡显著相关(P<0.001)。关键代谢指标有助于PDM孕妇DKA及围产期死亡的风险分层。
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical University, New Taipei City, Taiwan. Electronic address: f122481@mmh.org.tw.
The Francis Crick Institute, Midland Road, London NW1 1AT, UK; Department of Cell and Developmental Biology (CDB), University College London, Gower St., London WC1E 6BT, UK; The Gurdon Institute, University of Cambridge, Tennis Court Rd., Cambridge CB2 1QN, UK. Electronic address: j.cornwallscoones@ucl.ac.uk.
The Francis Crick Institute, Midland Road, London NW1 1AT, UK. Electronic address: james.briscoe@crick.ac.uk.
Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK. Electronic address: j.delas@ucl.ac.uk.
Srilaxmi Bearelly、Cassandra Areff、Matthew K Hoffman、Daniel Sunko、Andrew F Laine、Bin Choi、Hanna Rodriguez Coleman、Bianca Cordazzo Vargas、Chloe Y Li、Jennifer J Dawkins、Emily Amir、Sahar Paz、Lisa A Hark、Whitney A Booker、April A Jauhal、Justin S Brandt、Ronald J Wapner、Liat Shenhav
作者机构
Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA.
Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA.
Institute for Systems Genetics, NYU Grossman School of Medicine, New York University, New York, NY, USA.
Division of Obstetrics and Gynecology, ChristianaCare, Newark, DE, USA.
Department of Biomedical Engineering, Columbia University, New York, NY, USA.
Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA.
Center for Health Analytics, Data Science Institute, Columbia University, New York, NY, USA.
Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York University, New York, NY, USA.
Institute for Systems Genetics, NYU Grossman School of Medicine, New York University, New York, NY, USA. liat.shenhav@nyulangone.org.
Department of Microbiology, NYU Grossman School of Medicine, New York University, New York, NY, USA. liat.shenhav@nyulangone.org.
Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York University, New York, NY, USA. liat.shenhav@nyulangone.org.
Department of Computer Science, Courant Institute of Mathematical Sciences, New York University, New York, NY, USA. liat.shenhav@nyulangone.org.
利用深度学习从英国生物银行42059名及Mass General Brigham生物银行2745名参与者的腹部MRI中提取107个脾脏影像组学特征,其中10个特征与冠状动脉疾病相关。对这些特征的基因组关联分析识别出219个位点,包括9p21;该位点变异与脾脏连续纹理区域异质性等特征相关。研究MRI结果内部一致,但外部临床验证因成像方案差异和患者临床异质性面临转化挑战。研究结合深度学习与基因组学,揭示脾脏可能参与冠状动脉疾病,并强调研究与临床影像组学间的转化差距。
Philip M Croon、Bruno Batinica、Lovedeep S Dhingra、Ryan B Choi、Evangelos K Oikonomou、Sumukh V Shankar、Veer Sangha、Robert M A van der Boon、Michelle Michels、Maarten van Ettinger、Peter-Paul Zwetsloot、Sergio Teruya、Cesia Gallegos Kattan、Edward J Miller、Navid Noory、Oscar M Westin、Sie K Fensman、Steen Hvitfeldt Poulsen、Avneet Singh、Sudarshan Balla、Anouk Achten、Charalambos Vlachopoulos、Alexios S Antonopoulos、Nico Bruining、Julian D Gillmore、Mathew S Maurer、Frederick L Ruberg、Marianna Fontana、Rohan Khera
作者机构
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, Connecticut.
Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Thoraxcenter, Cardiovascular Institute, Erasmus Medical Center, Rotterdam, the Netherlands.
Division of Cardiology, Columbia University Irving Medical Center, New York, New York.
Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Cardiology, Northwell Health, New York, New York.
Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown.
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands.
National Amyloidosis Centre, University College London, Royal Free Hospital, London, United Kingdom.
Cardiogenetics Unit, First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Section of Cardiovascular Medicine and Amyloidosis Center, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Massachusetts.
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, Connecticut.
Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Shenzhi Chen、Vincent Loubiere、Ethan W Hollingsworth、Ken Murakami、Nikolaus Mandlburger、Sandra H Jacinto、Atrin Dizehchi、Jacob Schreiber、Evgeny Z Kvon、Alexander Stark
作者机构
Research Institute of Molecular Pathology (IMP), Vienna BioCenter (VBC), Vienna, Austria.
Vienna BioCenter PhD Program, Doctoral School of the University of Vienna and Medical University of Vienna, Vienna, Austria.
Department of Developmental and Cell Biology, University of California Irvine, Irvine, CA, USA.
Medical Scientist Training Program, University of California Irvine, Irvine, CA, USA.
Department of Genomics and Computational Biology, UMass Chan Medical School, Worcester, MA, USA.
Department of Systems Biology, University of California Irvine, Irvine, CA, USA.
Research Institute of Molecular Pathology (IMP), Vienna BioCenter (VBC), Vienna, Austria. stark@starklab.org.
Medical University of Vienna, Vienna BioCenter (VBC), Vienna, Austria. stark@starklab.org.
2026年美国心脏协会/美国心脏病学会/多学会血脂异常管理指南就动脉粥样硬化性心血管疾病(ASCVD)风险评估及他汀一级预防适用人群提出新推荐。本研究旨在评估该指南对他汀一级预防的人群健康影响,采用2017至2023年美国国家健康与营养调查中30至79岁、无已知ASCVD的非妊娠成人全国代表性横断面样本,比较2026年与2018年血脂指南下他汀一级预防资格的变化。加权样本包括4366名参与者,代表1.545亿美国成人。结果显示,依据2026年指南,约8750万(56.6%)成人符合他汀一级预防条件,其中2150万(13.9%)为新符合条件者;70至79岁成人中超过93%、60至69岁中85%符合条件,而30至39岁仅11%。新符合条件人群较既往推荐人群更年轻、风险更低(平均10年ASCVD估计风险3.1% vs 6.1%)。结论认为,2026年血脂指南大幅扩大了美国他汀一级预防推荐人群,且主要为较低风险个体。
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