Background The relationship between sarcopenia and type 2 diabetes mellitus (T2DM) among those with prediabetes is largely inconclusive given the heterogeneous findings of previous studies. We aimed to clarify the association between sarcopenia and prediabetes progression to T2DM in adult participants. Methods Participants with baseline prediabetes from the UK Biobank cohort were included in this study. Sarcopenia was classified as present or absent based on the criteria from the 2019 European Working Group of Sarcopenia in Older People (EWGSOP2 criteria) including handgrip strength, muscle mass and walking pace. The primary outcome was incident T2DM during follow-up. Multivariable Cox regression model adjusting for sociodemographic factors, lifestyles, comorbidities, and laboratory measures, was used to assess the association between sarcopenia and risk of T2DM. Results We included 60,325 participants (mean age: 59.6 years, 54.5% females) with baseline prediabetes for analysis, among whom 9,305 (15.4%) had incident T2DM during a mean follow up of 11.4 years. There were 7,139 (11.8%) participants categorized as having sarcopenia. Those with sarcopenia had a higher cumulative incidence of T2DM than those without (19.3% vs. 14.9%, P < 0.001). Sarcopenia was associated with a 22% increased risk of T2DM when compared with no sarcopenia (hazard ratio [HR] = 1.22, 95% confidence interval [CI]: 1.15–1.30) in the fully adjusted model. This association was more evident in participants with a waist to hip ratio < 0.9 (P-value for interaction < 0.05). Conclusions Sarcopenia was associated with increased risk of T2DM in adults with prediabetes. Sarcopenia appears to be a marker for risk of T2DM in people with prediabetes and interventions targeted at preserving and improving muscle health might be another novel potential approach to effectively decelerating prediabetes progression to T2DM.

The European Society of Cardiology (ESC) Council on Stroke (CoS) is a multidisciplinary body for cooperation, education, and research on primary and second

Cardiovascular, kidney, and metabolic (CKM) conditions frequently coexist with atrial fibrillation (AF), but their impact in AF population remains poo…

LJMU is supporting individuals and communities, both in the city and internationally to look after their hearts.

Background Atrial fibrillation (AF) confers a high risk of thromboembolism and cardiovascular events, which persists despite optimal oral anticoagulation (OAC). The non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) integrates pro- and anti-atherogenic lipid fractions and has been linked to adverse outcomes in high-risk patient populations. The prognostic value of NHHR in anticoagulated AF patients is uncertain. We aimed to evaluate NHHR as a marker of residual thromboembolic and cardiovascular risk in this population. Methods Consecutive AF outpatients initiating OAC between January 2016 and November 2021 were enrolled in this prospective cohort study. NHHR was calculated from baseline non-HDL-C and HDL-C levels, and patients were stratified into two groups. Primary outcomes were thromboembolic events (i.e., composite of ischaemic stroke (IS), transient ischaemic attack (TIA), or systemic embolism) and major adverse cardiovascular events (MACE), comprising myocardial infarction, IS, TIA, or cardiovascular death. Secondary outcomes included cardiovascular and all-cause death. Restricted cubic spline (RCS) models assessed non-linear associations, and multivariable Cox models evaluated associations between NHHR and outcomes. Results 1694 patients (52.8% female; age 76 years [IQR 69–82]; follow-up 1.86 years [SD 0.4]) were included. During follow-up, 97 (5.7%) experienced a thromboembolic event and 126 (7.4%) experienced MACE. RCS analysis showed significant linear associations between continuous NHHR and primary outcomes (p-overall < 0.001). High NHHR was independently associated with increased risk of thromboembolic events (adjusted Hazard Ratio [aHR] 2.15; 95% CI 1.41–3.29; p < 0.001) and MACE (aHR 1.69; 95% CI 1.15–2.48; p = 0.007), compared to the low NHHR group. No significant associations were observed for secondary outcomes. Conclusions In anticoagulated AF patients, high NHHR was independently associated with increased residual thromboembolic and cardiovascular risk. NHHR may improve cardiovascular risk stratification in patients with AF, although external validation in more ethnically diverse cohorts is warranted. Graphical abstract

AbstractBackground. New-onset atrial fibrillation (AF) in the setting of acute myocardial infarction (AMI) is associated with higher risks of stroke and mo

AbstractBackground and Aims. In the Edoxaban Low-Dose for Elder Care Atrial Fibrillation Patients (ELDERCARE-AF) trial, very low-dose edoxaban (15 mg once

AbstractIntroduction. Although moderate-to-vigorous physical activity (MVPA) is linked to a lower risk of atrial fibrillation (AF), the influence of its ti

Aims Diabetes is characterized by clinical heterogeneity. This study aimed to identify different clinical phenotypes of real-world people with diabetes and to assess their associations with major ad...

Background Given the modest performance of available predictive models in estimating the risk of atrial fibrillation (AF) in patients with atrial high-rate episodes (AHREs) detected by cardiac impla.....