{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:12:49Z","timestamp":1754143969157,"version":"3.41.2"},"reference-count":49,"publisher":"Baishideng Publishing Group Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Diabetes"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>The existing semi-quantitative ultrasound grading system inadequately evaluates synovial hypertrophy at the dorsal recess of the first metatarsophalangeal joint (MTPJ). Vitamin D deficiency is prevalent in type 2 diabetes mellitus (T2DM) and may influence joint inflammation. This study hypothesizes that serum 25-hydroxyvitamin D [25(OH)D] levels are inversely associated with synovial hypertrophy severity of the first MTPJ in patients with T2DM.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To refine ultrasound grading for the first MTPJ synovial hypertrophy and investigate its association with vitamin D in T2DM.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>This cross-sectional study included 56 patients (112 MTPJs) with T2DM from Shenzhen Traditional Chinese Medicine Hospital. Synovial hypertrophy was evaluated using a refined semi-quantitative ultrasound grading system focusing on the dorsal recess overlying the metatarsal bone. Serum 25(OH)D levels were measured. Logistic regression and threshold analyses assessed associations between vitamin D status and hypertrophy severity.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Of 112 joints assessed, 98 exhibited synovial hypertrophy (grade 1: 40; grade 2: 50; grade 3: 8). The refined grading system demonstrated strong intra- and inter-observer reliability (intraclass correlation coefficients = 0.79 and 0.73, respectively). Lower serum 25(OH)D (&lt; 24.3 ng\/mL) was independently associated with moderate-to-severe hypertrophy [odds ratio (OR) = 0.83; P  = 0.0163]. Vitamin D deficiency significantly increased the likelihood of moderate-to-severe hypertrophy compared with non-deficiency (OR = 3.86; P  = 0.0422). Threshold analysis identified 23.8 ng\/mL as a critical serum 25(OH)D level, below which each increment reduced moderate-to-severe hypertrophy risk by 21% (OR = 0.79; P  = 0.0078).<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>The refined ultrasound grading system demonstrated strong reliability. Serum 25(OH)D may serve as a protective factor against the severity of synovial hypertrophy in T2DM patients with lower 25(OH)D levels.<\/jats:p>","DOI":"10.4239\/wjd.v16.i7.107019","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T02:08:26Z","timestamp":1752545306000},"source":"Crossref","is-referenced-by-count":0,"title":["First metatarsophalangeal joint synovial hypertrophy associated with vitamin D status in type 2 diabetes mellitus: An ultrasound-graded study"],"prefix":"10.4239","volume":"16","author":[{"given":"Qing-Shan","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Hui","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Ying","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Peng","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping-Xiang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2023.101836"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-08122-5"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203804"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21729"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glt048"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbagen.2012.12.017"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/bs.acc.2020.04.002"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00127-X"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa912"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab009"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.bioorg.2024.107760"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105285"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2012.02.012"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.111755"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23083"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/t3mejo"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1477384"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00749-9"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2023.101981"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/nu16142329"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.38952"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S358170"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.04.038"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.reth.2020.07.007"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2005.01.005"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac261"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000428"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203158"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24734"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181095"},{"key":"B31","doi-asserted-by":"crossref","unstructured":"Jacobson JA.   Fundamentals of Musculoskeletal Ultrasound [Musculoskeletal Ultrasound Essentials]. 2012","DOI":"10.1016\/B978-1-4557-3818-2.00003-3"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00163-7"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10143178"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-023-00301-9"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1002\/art.10877"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/jfa2.12002"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000427"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2017.02.804"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202831"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac087"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2016.05.020"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v11.i10.418"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev032"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007568"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003739"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2020.12.001"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.02.016"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1142416"}],"container-title":["World Journal of Diabetes"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/1948-9358\/full\/v16\/i7\/107019.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/1948-9358\/full\/v16\/i7\/107019.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T02:09:04Z","timestamp":1752545344000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/1948-9358\/full\/v16\/i7\/107019.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":49,"journal-issue":{"issue":"7"},"alternative-id":["107019"],"URL":"https:\/\/doi.org\/10.4239\/wjd.v16.i7.107019","relation":{},"ISSN":["1948-9358"],"issn-type":[{"type":"print","value":"1948-9358"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}