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Objective: The study objective was to characterize subgroups of Asia‐Pacific patients with type 2 diabetes who achieved different glycated hemoglobin (HbA1c) targets on tirzepatide treatment. Methods: This was a post hoc analysis of the SURPASS AP‐Combo study. Baseline characteristics, changes in metabolic markers, and safety were compared between tirzepatide‐treated patients achieving HbA1c <7.0% (<53 mmol/mol) and those achieving ≥7.0% (≥53 mmol/mol) at week 40. Among patients achieving HbA1c <7.0% (<53 mmol/mol), further comparisons were conducted among subgroups achieving HbA1c <5.7% (<39 mmol/mol), 5.7% to 6.5% (39 to 48 mmol/mol), and >6.5% to <7.0% (>48 to <53 mmol/mol). Results: Five hundred ninety‐eight patients on tirzepatide treatment without rescue medication were included (56.9% male; mean age: 53.1 years; mean baseline HbA1c: 8.7% [71.6 mmol/mol]). Patients achieving HbA1c <7.0% (<53 mmol/mol) versus ≥7.0% (≥53 mmol/mol) were slightly younger with a shorter disease duration and lower HbA1c at baseline, and they had greater improvements in HbA1c, fasting serum glucose, body weight, BMI, waist circumference, waist‐height ratio, diastolic blood pressure, lipids, and self‐monitored blood glucose at week 40. Patients achieving HbA1c <5.7% (<39 mmol/mol) versus those achieving 5.7% to 6.5% (39 to 48 mmol/mol) and those achieving >6.5% to <7.0% (>48 to <53 mmol/mol) were much younger, had much lower HbA1c, and had further improvements in metabolic markers. Tirzepatide treatment was well tolerated irrespective of the HbA1c level achieved, with a low incidence of hypoglycemic events. Conclusions: These findings may help to inform clinical decisions in Asia‐Pacific patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the role of body fat percentage (BFP) changes in diabetes remission (DR) and the association between baseline body composition and its changes after bariatric surgery. Methods: We analyzed 203 patients with type 2 diabetes who underwent Roux‐en‐Y gastric bypass. Body composition was measured using a gold‐standard‐derived predictive equation and magnetic resonance imaging. Body composition changes were calculated as 100 × (baseline value – follow‐up value)/baseline value. We verified the results in a laparoscopic sleeve gastrectomy cohort with 311 patients. Results: Compared with non‐remission patients in the Roux‐en‐Y gastric bypass cohort, those who achieved DR showed a higher baseline fat‐free mass index (FFMI) and experienced the most significant changes in BFP (p < 0.001). In comparative analyses, BFP changes were significantly better than BMI changes in identifying short‐ and long‐term DR. Linear regression analysis identified FFMI as the most significant baseline variable correlated with BFP changes (p < 0.001). Baseline BMI was positively correlated with changes in BFP but negatively correlated with changes in FFMI. These findings were replicated in the laparoscopic sleeve gastrectomy cohort. Conclusions: BFP changes determine DR after bariatric surgery, and baseline FFMI is crucial for BFP changes. A low initial BMI is associated with a smaller BFP reduction and greater FFMI loss after bariatric surgery. [ABSTRACT FROM AUTHOR]

Multiple‐Input‐Multiple‐Output (MIMO) radar has the characteristic of multiple antenna channels, bringing on a big data volume for signal processing. Therefore, the trade‐off between detection ability and computational efficiency is always considered. In this article, an optimisation system is proposed to enhance the real‐time performance of frequency division MIMO radar without compromising accuracy. For the scenario of low‐altitude small target detection, a signal processing acceleration method is proposed and a MIMO radar optimisation system based on graphics processing unit (GPU) architecture is built. The signal model of frequency division MIMO radar is first established, improving the classical signal processing flow efficiency from the perspective of reducing fast Fourier transform (FFT) times and windowing operation times. To achieve an advanced acceleration, the parallel architecture of ArrayFire‐library in GPU is then employed. Distinct minimum parallel units are extracted by analysing the principle of digital beamforming (DBF), pulse compression, moving target detection (MTD), and constant false‐alarm rate (CFAR) algorithms. And the corresponding parallel algorithms are designed to constitute a parallel acceleration system of frequency division MIMO. Simulation results indicate that the proposed method significantly improves the efficiency of MIMO system with a maximum acceleration ratio of 65 times, meeting the real‐time processing requirements. [ABSTRACT FROM AUTHOR]

Aims: Clusterin (encoded by CLU) is a novel adipokine. Serum clusterin levels were elevated in populations with obesity and diabetes. Adipose tissue insulin resistance (Adipo‐IR) is proposed as an early metabolic defect that precedes systemic insulin resistance. Herein, we aimed to investigate the relationship between serum clusterin levels and Adipo‐IR. CLU expression in human abdominal adipose tissues and clusterin secretion in human adipocytes was also explored. Materials and Methods: A total of 201 participants (aged 18–62 years, 139 of whom were obese) were recruited. Enzyme‐linked immunosorbent assay was used to measure serum clusterin levels. Adipo‐IR was calculated from the product of fasting free fatty acids and fasting insulin levels. Transcriptome sequencing of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) was performed. Human adipocytes were used to detect the secretion of clusterin. Results: Serum clusterin levels were independently associated with Adipo‐IR after adjusting for several confounding factors (standardised β = 0.165, p = 0.021). CLU expression in VAT and SAT was associated with obesity‐related metabolic risk factors. Higher CLU expression in VAT was accompanied by an increase in collagen accumulation. Clusterin secretion in differentiated human adipocytes was stimulated by insulin and inhibited by rosiglitazone. Conclusions: Clusterin is strongly associated with Adipo‐IR. Serum clusterin may function as an effective indicator of adipose tissue insulin resistance. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between a new composite metric, glycaemia risk index (GRI), and incident diabetic retinopathy (DR). Methods: A total of 1204 adults with type 2 diabetes without DR at baseline were included between 2005 and 2019 from a single centre in Shanghai, China. GRI was obtained from continuous glucose monitoring data at baseline. Cox proportion hazard regression analysis was used to assess the association between GRI and the risk of incident DR. Results: During a median follow‐up of 8.4 years, 301 patients developed DR. The multivariable‐adjusted hazard ratios (HRs) for incident DR across ascending GRI quartiles (≤14 [reference], 15 ~ 28, 29 ~ 47 and > 47) were 1.00, 1.05 (95% CI 0.74‐1.48), 1.33 (95% confidence interval [CI] 0.96‐1.84) and 1.53 (95% CI 1.11‐2.11), respectively. For each 1‐SD increase in GRI, the risk of DR was increased by 20% (HR 1.20, 95% CI 1.07‐1.33) after adjustment for confounders. Conclusions: In patients with type 2 diabetes, higher GRI is associated with an increased risk of incident DR. GRI has the potential to be a valuable clinical measure, which needs to be further explored in future studies. [ABSTRACT FROM AUTHOR]

Aims: Diabetic retinopathy (DR) can occur even in well‐controlled type 2 diabetes, suggesting residual risks of DR in this population. In particular, we investigated the combined effect of thyroid function and glycaemic control assessed by an emerging metric, time in range (TIR) with DR. Materials and Methods: In this cross‐sectional study, a total of 2740 euthyroid patients with type 2 diabetes were included. Thyroid indicators, including thyroid‐stimulating hormone (TSH), free triiodothyronine, free thyroxine, thyroid peroxidase antibody and thyroglobulin antibody, were measured. TIR was measured using continuous glucose monitoring data. Results: Overall, the multivariable‐adjusted odds ratios (ORs) for DR across ascending tertiles of TSH were 1.00 (reference), 1.06 (95% confidence interval [CI] 0.85–1.32), and 1.48 (95% CI 1.19–1.85). Even in well‐controlled participants who achieved a TIR target of >70% (n = 1449), the prevalence of DR was 23.8%, which was significantly related to TSH (OR = 1.54, 95% CI 1.12–2.12, highest vs. lowest TSH tertile). Participants were then classified into 6 groups by the joint categories of TIR (>70%, ≤70%) and TSH (tertiles), and the multivariable‐adjusted ORs for DR were highest in TIR ≤70% and the highest TSH tertile group (OR = 1.96, 95% CI 1.41–2.71) when compared with the TIR >70% and the lowest TSH tertile group. Conclusions: In type 2 diabetic patients with well‐controlled glycaemic status, higher TSH within the normal range was associated with an increased risk of DR. The combination of suboptimal TSH and TIR further increased the risk of DR. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to compare measures of weight regain (WR) and their association with the glucose metabolism deterioration within 3 years following bariatric surgery among Chinese patients with obesity and type 2 diabetes mellitus (T2DM). Methods: Among a retrospective cohort of 249 patients with obesity and T2DM who underwent bariatric surgery and were followed up to 3 years, WR was assessed by weight changes, BMI changes, percentage of presurgery weight, percentage of nadir weight, and percentage of maximum weight lost (%MWL). Glucose metabolism deterioration was defined as a change from an absence of antidiabetic medication use to use, or absence of insulin use to use, or an increase in glycated hemoglobin by at least 0.5% to 5.7% or greater. Results: A comparison of C‐index of glucose metabolism deterioration indicated %MWL had better discriminatory ability versus weight change, BMI change, percentage of presurgery weight, or percentage of nadir weight (all p < 0.01). The %MWL also had the highest prediction accuracy. The optimal %MWL cutoff point was 20%. Conclusions: Among Chinese patients with obesity and T2DM who underwent bariatric surgery, WR quantified as %MWL predicted 3‐year postoperative glucose metabolism deterioration better than the alternatives; 20% MWL was the optimal cutoff point. [ABSTRACT FROM AUTHOR]

Since orthogonal frequency division multiplexing (OFDM) signals are sensitive to Doppler shift, OFDM signals with cyclic prefix (CP) not only reduce the communication rate but also result in symmetric pseudo peaks in the ambiguity function of the radar, which eventually lead to the degradation of the performance of the joint radar communication system (JRCS). In this study, a novel JRCS is proposed based on the filter bank multicarrier (FBMC) waveform for the inverse synthetic aperture radar (ISAR) imaging and communication system. On the one hand, FBMC waveforms are capable of low orthogonality between subcarriers, which can counter Doppler and multipath effects. On the other hand, FBMC waveforms do not require CP, so the false targets can be avoided and spectral efficiency can be improved. The influence of multipath effect and Doppler shift on FBMC waveform in an integrated system is analysed in detail, and a Doppler compensation algorithm suitable for FBMC‐integrated waveform is proposed. The phase error caused by target motion can be iteratively compensated to obtain a well‐focussed ISAR image. Finally, considering the ISAR image entropy after motion compensation as the evaluation metric, extensive simulation experiments verify the noise robustness and effectiveness of the proposed algorithm. Compared with the conventional OFDM and CP‐OFDM schemes, the simulation verifies that the proposed waveform design and processing method has better performance in the ISAR imaging and communication integrated system. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the expression of follistatin‐like 3 (FSTL3) in adipose tissue in individuals with overweight or obesity and to explore the role of FSTL3 in human adipocytes, as well as the relationship between serum FSTL3 levels and fat distribution and inflammation. Methods: This study enrolled 236 individuals (171 with overweight or obesity; aged 18–67 years). Bulk transcriptome sequencing was performed on subcutaneous and visceral adipose tissue. The function of FSTL3 was studied in human adipocytes. Serum FSTL3 levels were measured using enzyme‐linked immunosorbent assay. Results: Adipose FTSL3 expression was higher in individuals with overweight or obesity than in individuals with normal weight. FSTL3 was mainly expressed in mature adipocytes and stimulated by tumor necrosis factor alpha (TNFα). FSTL3 suppressed inflammatory responses in human adipocytes, whereas FSTL3 knockdown promoted inflammatory responses. Serum FSTL3 levels were correlated with adipose FTSL3 expression and obesity‐related indicators (all p < 0.05). Multiple linear regression analysis showed that serum FSTL3 levels were independently associated with the visceral fat area and serum TNFα levels (both p < 0.05). Conclusions: FSTL3 was highly expressed in adipose tissue in individuals with overweight or obesity and could suppress adipocyte inflammation. Serum FSTL3 levels might be considered as a biomarker of visceral obesity and inflammation. [ABSTRACT FROM AUTHOR]

Glucose monitoring is an important component of diabetes management. The Chinese Diabetes Society (CDS) has been producing evidence‐based guidelines on the optimal use of glucose monitoring since 2011. In recent years, new technologies in glucose monitoring and more clinical evidence, especially those derived from Chinese populations, have emerged. In this context, the CDS organised experts to revise the Clinical application guidelines for blood glucose monitoring in China in 2021. In this guideline, we focus on four methods of glucose monitoring that are commonly used in clinical practice, including capillary glucose monitoring, glycated haemoglobin A1c, glycated albumin, and continuous glucose monitoring. We describe the definitions and technical characteristics of these methods, the factor that may interfere with the measurement, the advantages and caveats in clinical practice, the interpretation of glucose metrics, and the relevant supporting evidence. The recommendations for the use of these methods are also provided. The various methods of glucose monitoring have their strengths and limitations and cannot be replaced by one another. We hope that these guidelines could aid in the optimal application of common methods of glucose monitoring in clinical practice for better diabetes care. [ABSTRACT FROM AUTHOR]

Aims/introduction: We proposed a novel continuous glucose monitoring (CGM)‐based metric, area under the curve in range (AucIR), for integrating both the amplitude and duration of dysglycemia, and further compared AucIR with the emerging key CGM‐derived metric, time in range (TIR). Materials and methods: A total of 2,030 adult patients with type 2 diabetes were enrolled during May 2020 to October 2021. AucIR and TIR were measured with 7‐day CGM data. Logistic regression analysis and the C‐statistic was carried out to assess the association of AucIR and TIR with diabetic retinopathy (DR). Results: Both AucIR (r = −0.89) and TIR (r = −0.95) were strongly correlated with mean glucose levels. Compared with TIR, AucIR showed a tighter relationship with parameters of glycemic variability, including the coefficient of variation (r = −0.56), standard deviation (r = −0.89) and mean amplitude of glycemic excursions (r = −0.70). For each absolute 10% decrease in AucIR, the risk of DR was increased by 7% (95% confidence interval 1.02–1.13) after adjustment for confounders. With respect to TIR, each absolute 10% decrease was associated with an 8% (95% confidence interval 1.03–1.14) increased risk of DR. The model discrimination for DR, as measured by C‐statistic, did not differ significantly between the two metrics (P > 0.05). Conclusions: AucIR did not provide added benefit over TIR in the assessment of DR risk among patients with type 2 diabetes. The potential value of AucIR needs to be explored in future studies. [ABSTRACT FROM AUTHOR]