Cross-country inequalities in disease burden and care quality of chronic kidney disease due to type 2 diabetes mellitus, 1990-2021: Findings from the global burden of disease study 2021

Global Trends in Childhood Acute Lymphoblastic Leukemia Burden and Quality of Care Inequalities Across Regions, 1990 to 2021: A Systematic Analysis Using Global Burden of Disease Study 2021 Data

OBJECTIVE

To reveal the global trends in the burden and quality of care for childhood ALL from 1990 to 2021, along with inequalities in quality of care across regions, thus identifying regions requiring targeted interventions for optimizing health care resource allocation.

METHODS

Utilizing Global Burden of Disease Study 2021 data, this research analyzed the temporal trends in the global burden of childhood ALL from 1990 to 2021. The quality of care index (QCI) was used to quantify care quality, and the gender disparity ratio (GDR) was used to assess gender disparities. Trend analyses were conducted using the estimated annual percentage change (EAPC), and the associations between QCI, GDR, and the sociodemographic index (SDI) were explored. Inequalities in QCI and GDR across regions were evaluated using the slope index of inequality (SII) and health inequality concentration index.

RESULTS

From 1990 to 2021, the incidence and death rates, as well as disability-adjusted life years (DALYs) and years of life lost (YLLs) due to childhood ALL, significantly decreased. However, the number of prevalence and prevalence crude rate increased by 66.818% and 37.923%, respectively. Global care quality continued to improve, with an EAPC of 2.566 (95% CI: 2.488-2.645). In 2021, regions with high QCI were concentrated in high-income areas like Western Europe, while low QCI regions were primarily in low-income areas like sub-Saharan Africa and Oceania. Although the health inequality concentration index of global quality of care decreased from 0.550 in 1990 to 0.395 in 2021, the SII increased from 35.396 to 87.141. Care quality was consistently higher in females than in males, particularly in low and low-middle SDI regions, while the disparities in high and middle SDI regions were gradually narrowing.

CONCLUSION

Despite the gradual decrease in the burden of childhood ALL globally and the steady improvement in quality of care, absolute inequalities remain a significant challenge. Future efforts should focus on increasing health care resource allocation in low SDI regions, enhancing international cooperation, improving the quality and accessibility of care in priority regions, and promoting global health equity.

Exploring the role of NLRP3 infalmmasome in diabetes: a literature review and bibliometric analysis

Background

Diabetes has emerged as the foremost public health challenge of the 21st century, with a notable shift towards managing it through an inflammatory lens. This study seeks to investigate the role of NLRP3 infalmmasome in diabetes over the past ten years, leveraging bibliometric analysis to pinpoint prevailing trends, underscore critical focal points, and establish a roadmap for subsequent research endeavors.

Method

A literature search was conducted based on the SCI-E database, and all recorded results were downloaded in plain text format for subsequent analysis. The analysis was carried out using Vosviewer1.6.18, citespace6.3R1, and Microsoft Excel 2021 software, focusing on the following terms: country, institution, author, journal, references, and keywords.

Results

From January 1, 2014, to December 31, 2023, a total of 1373 articles were retrieved, with China, the United States, and Italy contributing the majority of records. Harbin Medical University, Nanjing Medical University, and Central South University stand as the top three most productive institutions. "International Journal of Molecular Sciences" leads the way with the highest number of publications, closely followed by "Frontiers in Immunology" and "Frontiers in Pharmacology." Authors Wang Wei boast the most publications, closely followed by Li Xiang and Wang Yan. Within the superimposed keyword network, four primary clusters emerge: (1) exploring the link between NLRP3 infalmmasome and inflammatory diseases like diabetes; (2) investigating the cellular-level pathogenesis of diabetes-related conditions; (3) examining diabetes characteristics and associated suppression techniques; (4) studying cell morphology alterations, including pyroptosis. Over the past five years, key topics in this field have revolved around the "heart", "damage", "caspase 1 activation", "NLRP3", and "diabetic kidney disease".

Conclusion

This paper has identified the hot spots and trends concerning the role of NLRP3 infalmmasome in diabetes, thereby providing a valuable reference for future research. Furthermore, it is anticipated that pyroptosis and diabetes-related diseases will become frontier research topics that may garner significant attention in the coming years.

Identification of metabolic reprogramming-related genes as potential diagnostic biomarkers for diabetic nephropathy based on bioinformatics

BACKGROUND

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, marked by progressive renal damage. Recent evidence indicates that metabolic reprogramming is crucial to DN pathogenesis, yet its underlying mechanisms are not well understood. This study aimed to examine how metabolic reprogramming-related genes (MRRGs) are differentially expressed and to explore their potential mechanisms in the development of DN.

METHODS

We analyzed the datasets GSE30528 and GSE96804 from the Gene Expression Omnibus (GEO), comprising 50 DN samples and 33 controls. MRRGs were sourced from GeneCards and PubMed. Data preprocessing included batch effect correction using the R package sva, followed by normalization and differential expression analysis with limma (|logFC|> 0.5, adj.p < 0.05). Functional enrichment analyses (GO, KEGG, GSEA) were performed using clusterProfiler. Protein-protein interaction (PPI) networks were constructed via STRING, identifying hub genes through CytoHubba. Regulatory networks (mRNA-TF, mRNA-miRNA) were derived from ChIPBase and StarBase. Validation of hub genes and ROC analysis assessed diagnostic performance. ssGSEA quantified immune cell infiltration.

RESULTS

Our analysis identified 708 differentially expressed genes (DEGs), including 119 metabolic reprogramming-related DEGs (MRRDEGs). Enrichment analyses revealed significant roles for MRRDEGs in processes such as wound healing and pathways like MAPK signaling. The PPI network identified nine hub genes: FN1, CD44, KDR, EGF, HSPG2, HGF, FGF9, IGF1, and ALB, which exhibited high diagnostic accuracy (AUC 0.7 to 0.9). Notably, FN1 and CD44 showed significant association with renal fibrosis and could serve as potential biomarkers for early diagnosis and therapeutic targets in DN. Immune infiltration analysis showed notable differences in immune cell composition between DN and control samples.

CONCLUSION

This study identifies hub genes such as FN1 and CD44, with potential diagnostic value in DN. It also reveals immune cell infiltration differences between DN patients and controls, offering insights into disease progression and potential therapeutic targets.