{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T23:29:10Z","timestamp":1786404550882,"version":"build-2736575974"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In type 2 diabetes, hyperglycaemia usually clusters with atherogenic\n                    dyslipidaemia and low-grade inflammation; yet, these axes may dissociate in some\n                    patients. We aimed to estimate the prevalence of a normolipidemic dysglycemia\n                    phenotype in adults with type 2 diabetes and characterise its\n                    clinical\u2013biochemical profile within an analytical window free of lipid-lowering\n                    and chronic anti-inflammatory\/immunomodulatory therapy. In this retrospective,\n                    cross-sectional study, we analysed records of 1,046 adults aged 25\u201360 years with\n                    type 2 diabetes from a tertiary care hospital between 2020 and 2024. Individuals\n                    with other diabetes types, acute inflammatory conditions, malignancy, advanced\n                    organ failure and non-euthyroid status were excluded. Normolipidemic dysglycemia\n                    was defined as glycated hemoglobin\u226564 mmol\/mol with low-density lipoprotein\n                    cholesterol&lt;100 mg\/dL, triglycerides&lt;150 mg\/dL, high-density lipoprotein\n                    cholesterol\u226540 mg\/dL in men or\u226550 mg\/dL in women, and high-sensitivity\n                    C-reactive protein&lt;5 mg\/l in the absence of lipid-lowering or chronic\n                    anti-inflammatory\/immunomodulatory therapy. Comparative analyses were restricted\n                    to a hyperglycaemic subpopulation free of lipid-lowering and chronic\n                    anti-inflammatory\/immunomodulatory therapy (glycated hemoglobin\u226564 mmol\/mol;\n                        n=183), while glucose-lowering treatment status was recorded\n                    separately and evaluated as a potential confounder. Normolipidemic dysglycemia\n                    was identified in 47\/1,046 individuals (prevalence: 4.49%; 95% confidence\n                    interval: 3.40\u20135.92) and 47\/183 individuals (prevalence: 25.7%; 95% confidence\n                    interval: 19.9\u201332.5) within the analytical subpopulation. Compared with\n                    atherogenic dysglycemia, normolipidemic dysglycemia showed lower triglycerides,\n                    lower high-sensitivity C-reactive protein, higher high-density lipoprotein\n                    cholesterol, higher fasting plasma glucose and higher creatinine-based estimated\n                    glomerular filtration rates. In multivariable models, higher fasting plasma\n                    glucose, longer diabetes duration and higher creatinine-based estimated\n                    glomerular filtration rates remained associated with normolipidemic dysglycemia,\n                    whereas age, sex and body mass index were not independently associated with\n                    normolipidemic dysglycemia. These findings identify a clinically detectable\n                    subgroup in which marked hyperglycaemia coexists with relatively preserved lipid\n                    and inflammatory markers. The normolipidemic dysglycemia construct reflects\n                    metabolic heterogeneity rather than established prognostic distinction and\n                    requires prospective validation with cardiovascular and renal outcomes.<\/jats:p>","DOI":"10.1055\/a-2901-3276","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:53:47Z","timestamp":1783983227000},"page":"299-310","source":"Crossref","is-referenced-by-count":0,"title":["Normolipidemic Dysglycemia in Type 2 Diabetes: Clinical and\n                    Biochemical Characteristics of a Cohort Free of Lipid-Lowering and Chronic\n                    Anti-Inflammatory Therapy"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-075X","authenticated-orcid":false,"given":"Ali","family":"Zeynettin","sequence":"additional","affiliation":[{"name":"\u0130zmir Bozyaka Education and Research Hospital, T\u00fcrkiye","place":["\u0130zmir"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Balikci","sequence":"additional","affiliation":[{"name":"Ministry of Health \u0130zmir City Hospital, T\u00fcrkiye","place":["\u0130zmir"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130smail","family":"Demir","sequence":"additional","affiliation":[{"name":"Ministry of Health \u0130zmir City Hospital, T\u00fcrkiye","place":["\u0130zmir"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"issue":"17","key":"ref1","doi-asserted-by":"crossref","first-page":"6275","DOI":"10.3390\/ijms21176275","article-title":"Pathophysiology of type 2 diabetes mellitus","volume":"21","author":"U Galicia-Garcia","year":"2020","journal-title":"Int J Mol Sci"},{"issue":"12","key":"ref2","first-page":"1063","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for\n                    2030 and 2045: results from the International Diabetes Federation Diabetes\n                    Atlas, 9th edition","volume":"7","author":"P Saeedi","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"02","key":"ref3","first-page":"173","article-title":"Diabetes: advances in diagnosis and treatment","volume":"373","author":"D M Nathan","year":"2015","journal-title":"N Engl J Med"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"771","DOI":"10.5551\/jat.RV17023","article-title":"Pathophysiology of diabetic dyslipidemia","volume":"25","author":"T Hirano","year":"2018","journal-title":"J Atheroscler Thromb"},{"issue":"06","key":"ref5","first-page":"337","article-title":"Molecular mechanisms of atherogenic dyslipidaemia in type 2 diabetes","volume":"17","author":"M Adiels","year":"2021","journal-title":"Nat Rev Endocrinol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.immuni.2021.12.013","article-title":"Inflammation in obesity, diabetes, and related disorders","volume":"55","author":"T V Rohm","year":"2022","journal-title":"Immunity"},{"issue":"11","key":"ref7","first-page":"820","article-title":"Metabolic resilience and insulin resistance in humans","volume":"31","author":"N S Schultz","year":"2020","journal-title":"Trends Endocrinol Metab"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1038\/s41591-022-01790-7","article-title":"Heterogeneity in phenotype, disease progression and drug response in type 2\n                    diabetes","volume":"28","author":"AT N Nair","year":"2022","journal-title":"Nat Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1038\/s41586-024-07019-6","article-title":"Genetic drivers of heterogeneity in type 2 diabetes pathophysiology","volume":"627","author":"K Suzuki","year":"2024","journal-title":"Nature"},{"issue":"19","key":"ref10","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"L A Inker","year":"2021","journal-title":"N Engl J Med"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1161\/01.CIR.0000052939.59093.45","article-title":"Markers of inflammation and cardiovascular disease: application to clinical and\n                    public health practice","volume":"107","author":"T A Pearson","year":"2003","journal-title":"Circulation"},{"issue":"11","key":"ref12","first-page":"e596","article-title":"ACC\/AHA guideline on the primary prevention of cardiovascular disease: a report\n                    of the American College of Cardiology\/American Heart Association Task Force on\n                    Clinical Practice Guidelines","volume":"140","author":"D K Arnett","year":"2019","journal-title":"Circulation"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"S216","DOI":"10.2337\/dc26-S010","article-title":"Cardiovascular disease and risk management: standards of care in\n                    diabetes-2026","volume":"49","author":"American Diabetes Association Professional Practice\n                            Committee","year":"2026","journal-title":"Diabetes Care"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to\n                    reduce cardiovascular risk","volume":"41","author":"F Mach","year":"2019","journal-title":"Eur Heart J"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary\n                    data","volume":"159","author":"G Zou","year":"2004","journal-title":"Am J Epidemiol"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1093\/aje\/kwg074","article-title":"Estimating the relative risk in cohort studies and clinical trials of common\n                    outcomes","volume":"157","author":"L A McNutt","year":"2003","journal-title":"Am J Epidemiol"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The STROBE statement: guidelines for reporting observational studies","volume":"61","author":"E von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying\n                    insulin resistance in apparently healthy subjects","volume":"6","author":"L E Simental-Mendia","year":"2008","journal-title":"Metab Syndr Relat Disord"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1530\/EJE-17-0883","article-title":"METS-IR, a novel score to evaluate insulin sensitivity, is predictive of\n                    visceral adiposity and incident type 2 diabetes","volume":"178","author":"O Y Bello-Chavolla","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1681\/ASN.2016060666","article-title":"Glomerular hyperfiltration in diabetes: mechanisms, clinical significance, and\n                    treatment","volume":"28","author":"L Tonneijck","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of\n                    chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work\n                            Group","year":"2024","journal-title":"Kidney Int"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1038\/s41392-022-01073-0","article-title":"Trends in insulin resistance: insights into mechanisms and therapy","volume":"7","author":"M Li","year":"2022","journal-title":"Signal Transduct Target Ther"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1161\/CIRCULATIONAHA.118.035083","article-title":"Pathways to cardiorenal complications in type 2 diabetes mellitus","volume":"138","author":"N Sattar","year":"2018","journal-title":"Circulation"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"531","DOI":"10.2337\/dci23-0041","article-title":"Cardiovascular and kidney risks in individuals with type 2 diabetes:\n                    contemporary understanding with greater emphasis on excess adiposity","volume":"47","author":"N Sattar","year":"2024","journal-title":"Diabetes Care"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1093\/aje\/kwk052","article-title":"Relaxing the rule of ten events per variable in logistic and Cox regression","volume":"165","author":"E Vittinghoff","year":"2007","journal-title":"Am J Epidemiol"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S2213-8587(18)30051-2","article-title":"Novel subgroups of adult-onset diabetes and their association with outcomes: a\n                    data-driven cluster analysis","volume":"6","author":"E Ahlqvist","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1038\/s41575-021-00448-y","article-title":"The complex link between NAFLD and type 2 diabetes mellitus\u2014mechanisms and\n                    treatments","volume":"18","author":"G Targher","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2901-3276.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T22:59:52Z","timestamp":1786402792000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2901-3276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":27,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2026,8,10]]},"published-print":{"date-parts":[[2026,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2901-3276","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}