Medical Bulletin 15/ February/ 2025 - Video

A new study published in Journal of the Society for Cardiovascular Angiography & Interventions has revealed a lower risk of cardiovascular events for patients with Type 1 diabetes compared to those with Type 2 diabetes.

For the study, researchers examined the Veradigm Metabolic Registry, which includes longitudinal records of 1.5 million individuals from over 700 facilities. The analysis identified nearly 6,000 people with Type 1 diabetes and compared their cardiovascular event rates to those of people with Type 2 diabetes. When controlling for confounders, the results showed that people with Type 1 diabetes had lower rates of myocardial infarction (MI), percutaneous coronary intervention (PCI), stroke, and limb ischemia compared to people with Type 2 diabetes. There was no significant difference in the rates of bypass surgery between the two groups.

“The study's findings suggest that the cardiovascular risk associated with Type 1 diabetes is lower than previously thought, which has important implications for managing these patients. Our findings indicate that Type 1 diabetes is associated with a significantly lower risk of cardiovascular events compared to Type 2 diabetes, even after adjusting for various confounders such as age, diabetes control, and kidney function,” said Andrew M. Goldsweig, MD, MSc, FSCAI, director of cardiovascular clinical research at Baystate Medical Center in Springfield, MA. “The power of big data amplifies the results: With the enormous population included in this analysis, we were able to identify a large number of people with Type 1 diabetes and compare them to those with Type 2 diabetes, providing a comprehensive understanding of the differences in cardiovascular risk."

Reference: Cardiovascular Event Prevalence in Type 1 Versus Type 2 Diabetes: Veradigm Metabolic Registry Insights, Goldsweig, Andrew M. et al., Journal of the Society for Cardiovascular Angiography & Interventions, Volume 0, Issue 0, 102502

The American Academy of Neurology (AAN) has developed a new systematic review to summarize for neurologists and other clinicians the evidence for epidural steroid injections and whether they reduce pain and disability for people with certain kinds of chronic back pain. The systematic review is published online in Neurology®.

With an epidural steroid injection, a steroid or corticosteroid medication is injected into a part of the spine called the epidural space. The goal is to help reduce certain kinds of back pain.

For the review, researchers analyzed all available studies over a 16-year period. A total of 90 studies were examined. The review focused on the use of epidural steroid injections to reduce pain for people with radiculopathy and spinal stenosis.

For people with radiculopathy, the review says studies show epidural steroid injections may be effective at modestly reducing pain and disability for up to three months after the procedure.

When compared to people not receiving the treatment, 24% more people receiving the treatment reported reduced pain, and 16% more reported reduced disability for up to 3 months. The treatment may also reduce disability for up to six months or more, with 11% more of those treated reporting reduced disability.

For people with spinal stenosis, studies show epidural steroid injections might modestly reduce disability for up to six months or more after the procedure.

When compared to people not receiving the treatment, 26% more people receiving the treatment reported reduced disability up to three months, and 12% more for up to six months or more. The treatment was not found to reduce pain for up to three months.

“Our review affirms the limited effectiveness of epidural steroid injections in the short term for some forms of chronic back pain,” said author Pushpa Narayanaswami, MD, of Beth Israel Deaconess Medical Center in Boston and a Fellow of the American Academy of Neurology. “We found no studies looking at whether repeated treatments are effective or examining the effect of treatment on daily living and returning to work. Future studies should address these gaps.”

Reference: https://www.aan.com/PressRoom/Home/PressRelease/5231

A new study led by investigators from Mass General Brigham finds that yogurt consumption over time may protect against colorectal cancer through changes in the gut microbiome. Using data from studies that have followed participants for decades, researchers found that long-term consumption of two or more servings per week of yogurt was tied to lower rates of proximal colorectal cancer positive for Bifidobacterium, a bacterial species found in yogurt. The study showed that the bacterial species was quite common: about 30 percent of patients with colorectal cancer had detectable Bifidobacterium in their tumor tissue. Their results are published in Gut Microbes.

To conduct their study, the researchers used data from two U.S.-wide prospective cohort studies known as the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). The studies have followed more than 100,000 female registered nurses and 51,000 male health professionals, respectively. Participants have been followed since 1976 for the NHS and 1986 for HFPS, answering repeated questionnaires about lifestyle factors and disease outcomes, including questions about average daily intake of plain and flavored yogurt, as well as other dairy products. The researchers also assessed tissue samples for participants with confirmed cases of colorectal cancer, measuring the amount of Bifidobacterium DNA in tumor tissue.

The researchers found 3,079 documented cases of colorectal cancer in the two study populations. Information on Bifidobacterium content was available in 1,121 colorectal cancer cases. Among those, 346 cases (31%) were Bifidobacterium-positive, and 775 cases (69%) were Bifidobacterium-negative. The researchers did not observe a significant association between long-term yogurt intake and overall colorectal cancer incidence, but they did see an association in Bifidobacterium-positive tumors, with a 20 percent lower rate of incidence for participants who consumed two or more servings of yogurt a week. This lower rate was driven by lower incidence of Bifidobacterium-positive proximal colon cancer—a type of colorectal cancer that occurs in the right side of the colon.

Reference: Ugai, S., Liu, L., Kosumi, K., Kawamura, H., Hamada, T., Mima, K., … Ugai, T. (2025). Long-term yogurt intake and colorectal cancer incidence subclassified by Bifidobacterium abundance in tumor. Gut Microbes, 17(1). https://doi.org/10.1080/19490976.2025.2452237

Loneliness and social isolation have been linked to an elevated risk of non-alcoholic fatty liver disease (NAFLD), according to a study published in Health Data Science. The study analyzed data from over 400,000 participants in the UK Biobank, shedding light on the far-reaching impacts of social factors on liver health.

Using detailed assessments of participants' social connections and emotional well-being, the study found that loneliness increased the risk of developing NAFLD by 22%, while social isolation raised the risk by 13%, independent of traditional risk factors such as obesity, diabetes, and lifestyle behaviors. Remarkably, the associations persisted after adjusting for mutual influences between loneliness and social isolation, highlighting their independent effects.

The study’s mediation analysis revealed that unhealthy lifestyle behaviors, depression, and inflammatory responses partially explained these associations. Specifically, lifestyle factors like obesity, smoking, and irregular physical activity accounted for up to 30% of the observed risk linked to loneliness, while depression contributed an additional 33%. These findings underscore the importance of addressing both psychological and behavioral factors to mitigate NAFLD risk.

“Our findings provide robust evidence that loneliness and social isolation are not just mental health issues but also critical factors in the development of metabolic diseases like NAFLD,” said Professor Huang, one of the authors of the study. “Interventions that target these social determinants, alongside promoting healthier lifestyles, could be transformative for public health.”

The researchers emphasize the need for further studies in diverse populations and longitudinal settings to confirm and expand these findings and also call for integrated prevention strategies.

Reference: Ya Miao, Xiaoke Kong, Bin Zhao, Fang Fang, Jin Chai, Jiaqi Huang. Loneliness and Social Isolation with Risk of Incident Non-alcoholic Fatty Liver Disease, UK Biobank 2006 to 2022. Health Data Sci. 2025;5:0220.DOI:10.34133/hds.0220