{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:47:10Z","timestamp":1792068430816,"version":"4.4.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Metabolic Syndrome and Related Disorders"],"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Overweight, obesity, and type 2 diabetes (T2DM) increase the risk of vascular complications, including retinal vascular alterations. Artificial intelligence (AI)\u2014based retinal screening enables early detection of microvascular damage, potentially contributing to appropriate cardiometabolic prevention strategies. We performed a realworld evidence observational study to assess cardiometabolic parameters as well as retinal vascular alterations using novel AI-based retinal imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      Between September and December 2025, we recruited 301 consecutive adults with overweight,obesity, or T2DM; cardiometabolic assessment was performed, and all participants also underwent retinal screening with the Aireen AI system, distinguishing those who resulted positive (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 42), negative (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 204), or undetermined (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 55) at the screening.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      All patients who resulted positive at the screening were confirmed with a diagnosis of retinal alterations by the ophthalmologists. The presence of positive retinal screening (RS+) progressively increased with worsening fasting glycemia, glycated hemoglobin (HbA1c) levels, carotid intima\u2013media thickness, and endothelial function (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for all). Multivariate logistic regression analysis revealed independent associations of RS+ with HbA1c [odds ratio (OR) 2.29,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001], carotid stenosis (OR 1.06,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), fasting glucose (OR 1.02,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and the triglyceride\/high-density lipoprotein cholesterol ratio (OR 2.19,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>These findings suggest that AIbased retinal screening with advanced tools can effectively identify early microvascular damage in individuals with overweight, obesity, or T2DM, with RS+ prevalence reflecting glycemic burden and vascular dysfunction. Therefore, integrating AI retinal assessment into cardiometabolic prevention programs may enable timely interventions to prevent progression to vision-threatening complications and support comprehensive cardiovascular risk management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15578518261496129","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:57:07Z","timestamp":1791806227000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiometabolic Assessment in Patients with Overweight, Obesity, or Type 2 Diabetes Undergoing Artificial Intelligence\u2013Based Retinal Screening: A Real-World Evidence Study"],"prefix":"10.1177","author":[{"given":"Elena","family":"Muratore","sequence":"first","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2211-8482","authenticated-orcid":false,"given":"Viviana","family":"Maggio","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Maria","family":"Patti","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfredi","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Unit of Ophthalmology, University Hospital of Palermo, Palermo, Italy."},{"name":"MePreCC Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Di Falco","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Manunta","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Geraci","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorina","family":"Ispas","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Ciaccio","sequence":"additional","affiliation":[{"name":"Unit of Laboratory Medicine, University Hospital of Palermo, Palermo, Italy."},{"name":"Bind Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Agnello","sequence":"additional","affiliation":[{"name":"Unit of Laboratory Medicine, University Hospital of Palermo, Palermo, Italy."},{"name":"Bind Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Skrha","sequence":"additional","affiliation":[{"name":"Third Department of Medicine, Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University, Prague, Czech Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Prazny","sequence":"additional","affiliation":[{"name":"Third Department of Medicine, Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University, Prague, Czech Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"MePreCC Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"Unit of Ophthalmology, University Hospital of Palermo, Palermo, Italy."},{"name":"Bind Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza Elena","family":"Bonfiglio","sequence":"additional","affiliation":[{"name":"Unit of Ophthalmology, University Hospital of Palermo, Palermo, Italy."},{"name":"Bind Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfredi","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, Palermo, Italy."},{"name":"Promise Department, School of Medicine, University of Palermo, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_3_3_2_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2025","unstructured":"1.International Diabetes Federation. 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