Author: admin

  • Associations between atherogenic indexes, remnant cholesterol and gest

    Associations between atherogenic indexes, remnant cholesterol and gest

    Introduction

    Gestational diabetes mellitus (GDM) refers to any form of glucose intolerance with onset or first recognition in the perinatal period.1 Various studies have revealed that GDM could contribute to adverse pregnancy outcomes for both mothers and their offspring. For mothers, GDM patients are at higher risks of subsequent GDM, cardiovascular disease, dysglycemia, and type 2 diabetes.2–4 For their offspring, GDM could bring out neonatal macrosomia, childhood obesity and metabolic syndrome.5 Moreover, the majority of pregnant women who experience GDM are young, which could affect their life for a longer time.

    The prevalence of GDM is 1%−28% worldwide, with significant variations observed across different populations.6 These differences can be attributed to several factors, including geographic and ethnic predisposition, screening strategies and diagnostic criteria, as well as the varying risk factors.7 With improvements in living conditions and strengthened nutrition during pregnancy, the prevalence of GDM is increasing year by year.8 Although there are plenty of studies have explored the risk factors of GDM on genetic, lifestyle, diet, and other factors, the pathogenesis of GDM is still unclear. Current studies emphasized placental hormone-driven insulin resistance, β-cell dysfunction, and low-grade inflammation may collectively contribute to GDM development.9

    Population GDM risk is increasing with the high prevalence of obesity. To provide sufficient energy for fetal growth, blood lipid levels rise as pregnancy progresses.10 Lipid metabolism is closely related to glycometabolism, which is regulated by insulin. Therefore, dyslipidemia has the potential to induce insulin resistance and the occurrence of GDM. Previous studies have demonstrated the relationships between lipid biomarkers and the risk of GDM. A meta-analysis based on 292 studies interpreted that blood triglyceride (TG) concentrations were significantly different between mothers with GDM and mothers without GDM.11 A few studies showed that elevated serum TG levels and/or decreased high-density lipoprotein cholesterol (HDL−C) could contribute to the development of GDM.12–16 These studies prompted that TG/HDL−C could be potential indicators of GDM, which is one of the atherogenic indexes.17

    Currently, little information has been given to the risk of GDM derived from atherogenic indices,18 which were originally calculated to evaluate the risk of atherosclerosis.19 Notably, another indicator of dyslipidemia of remnant cholesterol, which refers to the cholesterol content within triglyceride-rich lipoprotein remnants (including very-low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], and chylomicron remnants), may relate to the occurrence GDM. The connection between remnant cholesterol and the risk of type 2 diabetes has been well-documented, but evidence regarding its role in GDM risk remains insufficient.20 While emerging studies have indicated a positive association between remnant cholesterol and GDM, none have specifically examined the predictive effect of remnant cholesterol on GDM risk.21–23 Moreover, although dyslipidemia is a potential indicator of GDM as mentioned above, GDM patients might have abnormal atherogenic indices and remnant cholesterol but normal serum lipids at the same time. Therefore, it is still necessary to apply atherogenic indices for the assessment of GDM risk. To fill this gap, this study aimed to investigate the predictive effects of atherogenic indices and remnant cholesterol on the risk of GDM.

    Materials and Methods

    Study Population

    This retrospective study was conducted at the Maternal and Child Health Hospital of Hubei Province, which is one of the largest tertiary hospitals focusing on maternal and child health care in Wuhan City, China. This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Maternal and Child Health Hospital of Hubei Province (2021IECXM005). First, the entire list of inpatients who delivered at this hospital from December 2020 to March 2022 was exported from the clinical information system. Second, patients whose outpatient examination data were complete were reviewed and selected. Complete data were defined as containing the essential independent variables of blood lipid indicators and the outcome variable of GDM diagnosis. There were a total of 6946 inpatients who underwent blood lipid examination in the 1st (0~13+6 weeks) or 2nd (14~27+6 weeks) trimester. Third, after removing missing maternal age (essential covariates, N = 26), missing family history of diabetes (essential covariates, N = 33), missing records of in vitro fertilization (IVF) (essential covariates, N = 4), missing body mass index (BMI) (essential covariates, N = 32), multiple pregnancies (have different risk of GDM compared to singleton pregnancies, N = 135), missing oral glucose tolerance test (OGTT) results (outcome measurement, N = 85), and type 1 or type 2 diabetes (pre-gestational dysglycemia confounders, N = 12), 6619 participants were included in this study.

    Data Collection

    Clinical data were exported from the Hospital’s electronic medical records from the clinical information system. General personal information was collected including maternal age, family history of diabetes (one or more clinically diagnosed diabetes patients within three generations), reproductive history, gestational weight gain, IVF, fasting plasma glucose (FPG) in the 1st trimester of pregnancy, and pre-pregnancy BMI (calculated by self-reported pre-pregnancy weight and height). Specifically, pre-pregnancy BMI was divided into four categories according to the Chinese standard of obesity: underweight (BMI < 18.5), healthy weight (18.5−23.9), overweight (24−27.9), and obese (≥28). Gestational weight gain was classified as insufficient, normal, or excessive according to the standard of recommendation for weight gain during pregnancy released by the Health Industry Standards of the People’s Republic of China.24

    Serum lipids, including TG, total cholesterol (TC), HDL−C, and low-density lipoprotein cholesterol (LDL−C) were obtained during the 1st or 2nd trimester of pregnancy. Atherogenic indices including TG/HDL−C, TC/HDL−C, and LDL−C/HDL−C, and remnant cholesterol were regarded as independent variables. All of the independent variables were classified by four interquartile ranges (IQRs).

    The dependent variable of GDM was diagnosed according to the recommendations of the International Association of the Diabetes and Pregnancy Study Groups Consensus Panel.25 A 75 g OGTT was performed at 24−28 weeks of gestation on the following criteria: fasting plasma glucose ≥5.1 mmol/L, and/or 1-hour plasma glucose ≥10.0 mmol/L, and/or 2-hour plasma glucose ≥8.5 mmol/L. GDM is diagnosed if one or more of the following glucose values is exceeded.

    Data Analysis

    The normality of continuous independent variables was examined by Shapiro–Wilk tests. Nonnormal continuous variables were classified into four categories by IQR or summarized as medium (P25, P75). The differences in the prevalence of GDM among subgroups of general personal variables and independent variables were examined by Chi-square tests for categorical variables and Wilcoxon–Mann–Whitney tests for continuous variables. Logistic regression analyses were performed to examine the associations between the independent variables and the risk of GDM. First, the risk of GDM was assessed by several unadjusted logistic regression models for the independent variables, including TC, TG, HDL−C, LDL−C, TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol. The corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were obtained. Second, based on unadjusted logistic regression analysis, the associations between serum lipids and GDM were further adjusted for general personal variables including maternal age, family history of diabetes, parity history, pre-pregnancy BMI, IVF, FPG, and gestational weight gain. To explore the causal relationship between atherogenic indices, remnant cholesterol, and the risk of GDM, stratified analysis of 1st trimester and 2nd trimester were conducted in this study. The normality examinations, Chi-square tests, Wilcoxon–Mann–Whitney tests, and logistic regression analysis were performed with SAS 9.4 (SAS Institute Inc., Cary, NC, USA). Furthermore, the risk of GDM was predicted by nomogram analysis and decision curve analysis (DCA) to gauge the net benefit of identifying high-risk patients that ought to have intervention and the net reduction of unnecessary interventions. The potential nonlinear relationships between the atherogenic indices, remnant cholesterol and the risk of GDM were examined by the restricted cubic splines (RCS). We adopted an RCS with 4 knots, and the media of the atherogenic indices and remnant cholesterols were used as references to obtain the ORs. Nomogram analysis, DCA, and RCS regression analysis were performed with R 4.2.1 (The R Foundation for Statistical Computing, Vienna, Austria). A two-sided P < 0.05 was regarded as statistically significant.

    Results

    The results showed that the prevalence of GDM was 31.03% (Table 1). Nearly half of the participants were mothers aged 30−34 years (45.34%), and the median age of the participants was 31 years. The prevalence of GDM among the subgroups stratified by age was significantly different (P < 0.0001). Compared with mothers without a family history of diabetes, women with a family history of diabetes had a significantly higher prevalence of GDM (52.58% vs 29.91%, P < 0.0001). Compared with primiparous women, multiparas had a higher prevalence of GDM (34.06% vs 29.53%, P = 0.0002). The prevalence of GDM was higher among mothers who were fertilized by IVF (42.52% vs 30.57%, P < 0.0001). The higher the pre-pregnancy BMI of participants was, the greater the corresponding prevalence of GDM as well (P < 0.0001). Furthermore, the prevalence of GDM was higher among mothers with insufficient gestational weight gain than those with excessive gestational weight gain (52.00% vs 23.42%, P < 0.0001).

    Table 1 General Personal Characteristics Between Gestational Diabetes Mellitus and Control Group

    The serum atherogenic indices and remnant cholesterols were classified into four categories by IQR, and the differences in the continuity indicators were examined between the GDM group and the control group (Table 2). The prevalence of GDM among the Q4 group in terms of TG/HDL−C, TC/HDL−C, LDL-C/HDL−C, and remnant cholesterol was significantly higher than that among the Q1 group (42.25% vs 23.90%, P < 0.0001; 39.09% vs 23.65%, P < 0.0001; 38.37% vs 23.86%, P < 0.0001; 36.34% vs 24.62%, P < 0.0001; respectively). In line with the Chi-square analysis, the corresponding continuity indicators also showed significant differences between the GDM group and the control group. The results of the univariate analysis between the serum lipid indexes and GDM are provided in Table S1.

    Table 2 Atherogenic Indices and Remnant Cholesterol Between Gestational Diabetes Mellitus and Control Group

    Table 3 shows the effects of serum atherogenic indices and remnant cholesterol on the risk of GDM. Both adjusted and unadjusted logistic regression analyses presented that atherogenic indices and remnant cholesterol were significantly related to the risk of GDM. Compared to those of the lowest quartile, mothers in the highest quartile of TG/HDL−C had a 66% higher risk of GDM (adjusted OR = 1.66, 95% CI: 1.41, 1.96). Mothers in the highest quartile of TC/HDL−C, LDL-C/HDL−C, and remnant cholesterol demonstrated significantly elevated GDM risk compared to those in the lowest quartile, with adjusted ORs of 1.47 (95% CI: 1.24−1.73), 1.47 (95% CI: 1.24−1.73), and 1.39 (95% CI: 1.18−1.64), respectively. Moreover, Table S2 presented the results of multivariable analysis between serum lipid indexes and GDM stratified by stages of pregnancy. Groups in the highest quartiles of TG, TC, and LDL−C showed higher risks of GDM than did those in the lowest quartile. Furthermore, consistent with Table 3, all atherogenic indices and remnant cholesterol significantly predicted GDM risk stratified by pregnancy stage (Table S3).

    Table 3 Multivariable Analysis Between Atherogenic Indices, Remnant Cholesterol and Gestational Diabetes Mellitus

    To better visualize the predictive outcomes of TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol, the results of the monogram analyses are provided in Figure 1. The Hosmer and Lemeshow goodness of fit test results for the four groups showed that all of the prediction models were significant (P > 0.05). The AUCs for the TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol predictive models were 0.73 (95% CI: 0.71, 0.74), 0.73 (95% CI: 0.71, 0.74), 0.73 (95% CI: 0.71, 0.74), and 0.72 (95% CI: 0.71, 0.74), respectively. The result of DCA analysis showed that all indicators demonstrated high net benefit (approximately 0.22), excellent sensitivity (>97%), and good negative predictive value (>88%) at a threshold of 0.1 (Figure 2).

    Figure 1 The nomogram prediction of gestational diabetes mellitus by atherogenic indices and remnant cholesterol (A) the nomogram prediction of GDM by TG/HDL−C; (B) the nomogram prediction of GDM by TC/HDL−C; (C) the nomogram prediction of GDM by LDL−C/HDL−C; (D) the nomogram prediction of GDM by remnant cholesterol.

    Figure 2 The receiver operating characteristic curves and the decision curve analysis of the nomogram predictions (A) the receiver operating characteristic curves of the predictive outcomes of TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol; (B) the decision curve analysis of the predictive outcomes of TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol.

    The nonlinear associations between atherogenic indices, remnant cholesterol and GDM are presented in Figure 3. All of the atherogenic indices and remnant cholesterol exhibited unimodal distributions. A nonlinear relationship was detected between atherogenic indices, remnant cholesterol, and the risk of GDM (χ2= 30.91, P < 0.0001; χ2= 13.08, P = 0.0014; χ2= 6.95, P = 0.0309; χ2= 12.52, P = 0.0019; respectively). First, the risk of GDM showed an upward trend with the increasing of TG/HDL−C. But after TG/HDL−C reached 1.64, the risk of GDM started to decline. Similar nonlinear patterns were observed in the relationships between TC/HDL−C, remnant cholesterol, and GDM, with inflection points at 3.47 and 0.65, respectively. Although the LDL−C/HDL−C ratio showed a significant nonlinear relationship with GDM risk, the risk of GDM continued to rise with increasing levels of LDL−C/HDL−C. However, the rising pace decelerated once the ratio exceeded 1.54.

    Figure 3 The associations between atherogenic indices and gestational diabetes mellitus risk by RCS regression analysis (A) The associations between TG/HDL−C and GDM; (B) The associations between TC/HDL−C and GDM; (C) The associations between LDL−C /HDL−C and GDM; (D) The associations between remnant cholesterol and GDM. Adjusted for age, pre-pregnancy BMI, gestational weight gain, family history of diabetes, and parity history.

    Discussion

    The results of this study showed that atherogenic indexes and remnant cholesterol were closely related to the risk of GDM. Higher values of TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol were significantly associated with elevated risks of GDM, and the results of the nomogram analysis showed that these indicators exhibited similar predictive performance, suggesting that all of them may serve as strong predictors for GDM.

    In line with this study, previous studies have showed the positive associations between atherogenic indexes and GDM, but little of them examined the predictive ability. A cross-sectional study conducted by Khosrowbeygi et al among Iranian reported that LDL−C/HDL−C, TG/HDL−C, and TC/HDL−C levels were significantly higher in the GDM group than in the control group.18 Wang et al analyzed data from 15 hospitals in Beijing, China demonstrated that elevated TG/HDL−C and LDL−C/HDL−C in the 1st trimester of pregnancy were related to increased risks of GDM.17 Pazhohan et al reported that mothers in Iran with the highest tertile of TG/HDL−C in the 1st trimester of pregnancy contributed to a 3.9-fold of the risk of GDM compared with the lowest tertile.26 Cross-sectional studies conducted by Barat et al and Wang et al also revealed that TG/HDL−C was sensitive to GDM diagnosis,14,27,28 and a retrospective cohort study with a TG/HDL−C ratio cutoff of 3 reported that higher pre-gestational TG/HDL−C was associated with higher rates of GDM (13.1% vs 5.2%).29 Zhang et al conducted a prospective cohort study in the Korean population and suggested that a log10 (TG/HDL) below 0.36 might be beneficial for GDM control.30 Besides, Yue et al investigated serum lipids during the 2nd trimester and found that TG/HDL−C was related to the risk of GDM, but no significant difference was detected for LDL−C/HDL−C.31 Liu et al reported that Beijing mothers in the top tertile of TG/HDL−C before 12 weeks’ gestation had a significantly greater risk of GDM (OR = 2.388), but this relationship was not observed in TC/HDL−C.32 Based on the above findings, it was reconfirmed that TG/HDL−C has a positive effect on the risk of GDM, but discrepancies were noted in the relationships between TC/HDL−C and LDL−C/HDL−C and GDM. These gaps could be explained by the different study designs, populations, and gestational weeks of lipid-data collection.

    The positive associations between atherogenic indexes and GDM could be explained by insulin resistance regulated by atherogenic indexes. Case-control studies conducted by Xiang et al and Kimm et al aimed to clarify the associations between atherogenic indexes and insulin resistance and revealed that all of the atherogenic indexes were significantly correlated with insulin resistance.33,34 Specifically, previous studies have confirmed that TG/HDL−C is a reliable biomarker of insulin resistance.35,36 Moreover, increased TC or decreased HDL−C concentrations could contribute to insulin resistance, glucose intolerance, and hyperinsulinemia,37 and these factors are leading hazards for GDM.

    Consistent with our findings, elevated remnant cholesterol levels were significantly associated with an increased risk of GDM. Our study further highlights the promising predictive effect of remnant cholesterol on the risk of GDM. A high concentration of remnant cholesterol was reported to have a higher risk of GDM, even among pregnancies with low TC.21 Another prospective cohort study conducted in Korea confirmed the independent association between remnant cholesterol and GDM.22 Su et al reported a significant dose-response relationship that the risk of GDM elevated along with the increasing of remnant cholesterol.23 Although the exact mechanistic link between remnant cholesterol and GDM remains to be fully elucidated, it was hypothesized that remnant cholesterol may contribute to GDM pathogenesis through dual pathways similar to those observed in type 2 diabetes: The direct effects of remnant cholesterol-induced insulin resistance or β-cell dysfunction,38 and the indirect effects of low-grade inflammation triggered by remnant cholesterol promote insulin resistance.39,40 Further studies are warranted to validate these mechanisms.

    The present study novelly revealed intuitive changes in GDM risk with respect to atherogenic indexes and remnant cholesterol and warned the elevated risk of GDM under high values of atherogenic indexes and remnant cholesterol. However, certain limitations should be addressed. First, the causal correlations between atherogenic indexes and remnant cholesterol and GDM in this study might be undermined. Second, this study obtained clinical data from a single hospital of Chinese population; caution should be taken when generalizing this study to other populations. Third, other confounding factors that might interfere with the relationship between atherogenic indexes and remnant cholesterol and GDM, such as insulin resistance, gestational weight gain before the diagnosis of GDM, liver function indexes, lifestyle behavior factors, and socioeconomic status et al were not considered in this study because they were not routine examined in the clinical practice. Fourth, this study included only one serum lipid data point per person, and the effects of dynamic changes in lipid ratios on the risk of GDM were failed to examine. Future studies focused on the dynamic changes in lipid indicators on the risk of GDM prediction are highly promoted.

    Conclusion

    Notably, our findings highlight the promising role of atherogenic indices and remnant cholesterol as potential predictive biomarkers for GDM risk assessment, which has not been fully explored in previous studies. Elevated levels of blood TG/HDL−C, TC/HDL−C, LDL−C/HDL−C, and remnant cholesterol are linked to a significant increase in the risk of developing GDM. Therefore, it is essential to maintain atherogenic indexes and remnant cholesterols at low levels in order to reduce the risk of GDM. Specially, the turning points (TG/HDL−C = 1.64, TC/HDL−C = 3.47, LDL−C/HDL−C = 1.54, and remnant cholesterol = 0.65) identified by the nonlinear relationships could serve as potential warning thresholds for clinical interventions to optimize GDM risk assessment. These findings underscore the potential of routine lipid testing as a cost-effective strategy for the early identification and management of GDM in clinical settings.

    Abbreviations

    GDM, gestational diabetes mellitus; TG, triglyceride; TC, total cholesterol; HDL−C, high-density lipoprotein cholesterol; LDL−C, low-density lipoprotein cholesterol.

    Data Sharing Statement

    The datasets used during the current study are available from the corresponding author on reasonable request, which should be approved by the Ethics Committee of Maternal and Child Health Hospital of Hubei Province.

    Ethics Approval and Informed Consent

    This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Maternal and Child Health Hospital of Hubei Province (2021IECXM005).

    Acknowledgments

    We would like to express our gratitude to all obstetric clinical workers in Maternal and Child Health Hospital of Hubei Province for their contributions to the sample accumulation of this paper.

    Funding

    This study was funded by the Maternal and Child Health Hospital of Hubei Province Research Project [grant No. 2021SFYM007] and Hubei Provincial Natural Science Foundation of China [grant No. 2025AFD690]. All these fundings were received by Dr. Yao Cheng. The funders had no role in the design, data collection, analyses, interpretation, manuscript writing, nor in the decision to publish the results.

    Disclosure

    The authors report no conflicts of interest in this work.

    References

    1. Petry CJ. Nutrients as risk factors and treatments for gestational diabetes. Nutrients. 2023;15(22):4716. doi:10.3390/nu15224716

    2. Liang X, Zheng W, Liu C, et al. Clinical characteristics, gestational weight gain and pregnancy outcomes in women with a history of gestational diabetes mellitus. Diabetol Metab Syndr. 2021;13(1):73. doi:10.1186/s13098-021-00694-9

    3. Chen LW, Soh SE, Tint MT, et al. Combined analysis of gestational diabetes and maternal weight status from pre-pregnancy through post-delivery in future development of type 2 diabetes. Sci Rep. 2021;11(1):5021. doi:10.1038/s41598-021-82789-x

    4. Retnakaran R, Shah BR. Mediating effect of vascular risk factors underlying the link between gestational diabetes and cardiovascular disease. BMC Med. 2022;20(1):389. doi:10.1186/s12916-022-02581-0

    5. Vohr BR, Boney CM. Gestational diabetes: the forerunner for the development of maternal and childhood obesity and metabolic syndrome? J Matern Fetal Neonatal Med. 2008;21(3):149–157. doi:10.1080/14767050801929430

    6. Dewi RS, Isfandiari MA, Martini S, Yi-Li C. Prevalence and risk factors of gestational diabetes mellitus in Asia: a review. J Public Health Afr. 2023;14(2):7.

    7. Sweeting A, Hannah W, Backman H, et al. Epidemiology and management of gestational diabetes. Lancet. 2024;404(10448):175–192. doi:10.1016/S0140-6736(24)00825-0

    8. Alwash SM, Huda MM, McIntyre HD, Mamun AA. Time trends and projections in the prevalence of gestational diabetes mellitus in Queensland, Australia, 2009-2030: evidence from the Queensland perinatal data collection. Aust N Z J Obstet Gynaecol. 2023;63(6):811–820. doi:10.1111/ajo.13734

    9. Modzelewski R, Stefanowicz-Rutkowska MM, Matuszewski W, Bandurska-Stankiewicz EM. Gestational diabetes mellitus-recent literature review. J Clin Med. 2022;11(19):5736. doi:10.3390/jcm11195736

    10. Jiang HQ, Chen H, Yang J. Characteristics of blood lipids levels and relevant factor analysis during pregnancy. Zhonghua yi xue za zhi. 2016;96(9):724–726. (). doi:10.3760/cma.j.issn.0376-2491.2016.09.013

    11. Hu J, Gillies CL, Lin S, et al. Association of maternal lipid profile and gestational diabetes mellitus: a systematic review and meta-analysis of 292 studies and 97,880 women. EClinicalMedicine. 2021;34:100830. doi:10.1016/j.eclinm.2021.100830

    12. Hu M, Gu X, Niu Y, et al. Elevated serum triglyceride levels at first prenatal visit is associated with the development of gestational diabetes mellitus. Diabetes Metab Res Rev. 2022;38(2):e3491. doi:10.1002/dmrr.3491

    13. Li G, Kong L, Zhang L, et al. Early pregnancy maternal lipid profiles and the risk of gestational diabetes mellitus stratified for body mass index. Reprod Sci. 2015;22(6):712–717. doi:10.1177/1933719114557896

    14. Wang J, Li Z, Lin L. Maternal lipid profiles in women with and without gestational diabetes mellitus. Medicine. 2019;98(16):e15320. doi:10.1097/MD.0000000000015320

    15. Enquobahrie DA, Williams MA, Qiu C, Luthy DA. Early pregnancy lipid concentrations and the risk of gestational diabetes mellitus. Diabetes Res Clin Pract. 2005;70(2):134–142. doi:10.1016/j.diabres.2005.03.022

    16. Koukkou E, Watts GF, Lowy C. Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study. J Clin Pathol. 1996;49(8):634–637. doi:10.1136/jcp.49.8.634

    17. Wang C, Zhu W, Wei Y, et al. The predictive effects of early pregnancy lipid profiles and fasting glucose on the risk of gestational diabetes mellitus stratified by body mass index. J Diabetes Res. 2016;2016:3013567. doi:10.1155/2016/3013567

    18. Khosrowbeygi A, Shiamizadeh N, Taghizadeh N. Maternal circulating levels of some metabolic syndrome biomarkers in gestational diabetes mellitus. Endocrine. 2016;51(2):245–255. doi:10.1007/s12020-015-0697-4

    19. Acay A, Ulu MS, Ahsen A, et al. Atherogenic index as a predictor of atherosclerosis in subjects with familial Mediterranean fever. Medicina. 2014;50(6):329–333. doi:10.1016/j.medici.2014.11.009

    20. Li B, Zhou X, Wang W, et al. Remnant cholesterol is independently associated with diabetes, even if the traditional lipid is at the appropriate level: a report from the REACTION study. J Diabetes. 2023;15(3):204–214. doi:10.1111/1753-0407.13362

    21. Wang W, Li N, Wang X, et al. Remnant cholesterol is associated with gestational diabetes mellitus: a cohort study. J Clin Endocrinol Metab. 2023;108(11):2924–2930. doi:10.1210/clinem/dgad262

    22. Gao Y, Hu Y, Xiang L. Remnant cholesterol, but not other cholesterol parameters, is associated with gestational diabetes mellitus in pregnant women: a prospective cohort study. J Transl Med. 2023;21(1):531. doi:10.1186/s12967-023-04322-0

    23. Su S, Zhang E, Gao S, et al. Associations of remnant cholesterol in early pregnancy with gestational diabetes mellitus risk: a prospective birth cohort study. Lipids Health Dis. 2024;23(1):243. doi:10.1186/s12944-024-02230-w

    24. National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention. Standard of recommendation for weight gain during pregnancy period. Available from: https://www.chinanutri.cn/yyjkzxpt/yyjkkpzx/hdjl/202208/t20220823_260929.html. Accessed August 23, 2022.

    25. Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–682. doi:10.2337/dc10-0719

    26. Pazhohan A, Rezaee Moradali M, Pazhohan N. Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn. J Matern Fetal Neonatal Med. 2019;32(7):1167–1175. doi:10.1080/14767058.2017.1402876

    27. Barat S, Ghanbarpour A, Bouzari Z, Batebi Z. Triglyceride to HDL cholesterol ratio and risk for gestational diabetes and birth of a large-for-gestational-age newborn. Caspian J Intern Med. 2018;9(4):368–375. doi:10.22088/cjim.9.4.368

    28. Wang D, Xu S, Chen H, Zhong L, Wang Z. The associations between triglyceride to high-density lipoprotein cholesterol ratios and the risks of gestational diabetes mellitus and large-for-gestational-age infant. Clin Endocrinol. 2015;83(4):490–497. doi:10.1111/cen.12742

    29. Arbib N, Pfeffer-Gik T, Sneh-Arbib O, Krispin E, Rosenblat O, Hadar E. The pre-gestational triglycerides and high-density lipoprotein cholesterol ratio is associated with adverse perinatal outcomes: a retrospective cohort analysis. Int J Gynaecol Obstet. 2020;148(3):375–380. doi:10.1002/ijgo.13078

    30. Zhang J, Suo Y, Wang L, et al. Association between atherogenic index of plasma and gestational diabetes mellitus: a prospective cohort study based on the Korean population. Cardiovasc Diabetol. 2024;23(1):237. doi:10.1186/s12933-024-02341-9

    31. Yue CY, Ying CM. Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI. J Clin Lab Anal. 2018;32(8):e22568. doi:10.1002/jcla.22568

    32. Liu PJ, Liu Y, Ma L, et al. The predictive ability of two triglyceride-associated indices for gestational diabetes mellitus and large for gestational age infant among Chinese pregnancies: a preliminary cohort study. Diabetes Metab Syndr Obes. 2020;13:2025–2035. doi:10.2147/DMSO.S251846

    33. Xiang SK, Hua F, Tang Y, Jiang XH, Zhuang Q, Qian FJ. Relationship between serum lipoprotein ratios and insulin resistance in polycystic ovary syndrome. Int J Endocrinol. 2012;2012:173281. doi:10.1155/2012/173281

    34. Kimm H, Lee SW, Lee HS, et al. Associations between lipid measures and metabolic syndrome, insulin resistance and adiponectin. – Usefulness of lipid ratios in Korean men and women. Circ J. 2010;74(5):931–937. doi:10.1253/circj.CJ-09-0571

    35. Quispe R, Martin SS, Jones SR. Triglycerides to high-density lipoprotein-cholesterol ratio, glycemic control and cardiovascular risk in obese patients with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes. 2016;23(2):150–156. doi:10.1097/MED.0000000000000241

    36. Huhtala M, Rönnemaa T, Tertti K. Insulin resistance is associated with an unfavorable serum lipoprotein lipid profile in women with newly diagnosed gestational diabetes. Biomolecules. 2023;13(3):470. doi:10.3390/biom13030470

    37. Jeppesen J, Facchini FS, Reaven GM. Individuals with high total cholesterol/HDL cholesterol ratios are insulin resistant. J Intern Med. 1998;243(4):293–298. doi:10.1046/j.1365-2796.1998.00301.x

    38. Hao M, Head WS, Gunawardana SC, Hasty AH, Piston DW. Direct effect of cholesterol on insulin secretion: a novel mechanism for pancreatic beta-cell dysfunction. Diabetes. 2007;56(9):2328–2338. doi:10.2337/db07-0056

    39. Varbo A, Benn M, Tybjærg-Hansen A, Nordestgaard BG. Elevated remnant cholesterol causes both low-grade inflammation and ischemic heart disease, whereas elevated low-density lipoprotein cholesterol causes ischemic heart disease without inflammation. Circulation. 2013;128(12):1298–1309. doi:10.1161/CIRCULATIONAHA.113.003008

    40. Hu X, Liu Q, Guo X, et al. The role of remnant cholesterol beyond low-density lipoprotein cholesterol in diabetes mellitus. Cardiovasc Diabetol. 2022;21(1):117. doi:10.1186/s12933-022-01554-0

    Continue Reading

  • Club World Cup 2025: Al-Hilal ‘climb Everest’ but worries for Man City

    Club World Cup 2025: Al-Hilal ‘climb Everest’ but worries for Man City

    The revamped Club World Cup has not received universal acclaim but an unforgettable last-16 tie will be talked about in all corners of the globe.

    Al-Hilal clung on in the first half and were fortunate to only be 1-0 down thanks to goalkeeper Bono’s heroics but they recovered to go ahead in the second period.

    They were twice pegged back but Marcos Leonardo delivered the decisive blow and once the final whistle was blown, staff and substitutes poured on to the pitch to enjoy the moment with their players.

    The joyous Al-Hilal fans, a large cluster of whom were directly behind the dugout, waved the blue flags of the club and the green and white of the country.

    Exiting the Camping World Stadium, travelling supporters packed out the concourses, dancing and singing “ole, ole ole ole”, while Saudi journalists hugged and kissed each other in the post-match news conference room.

    One walked in with wide eyes and arms raised, screaming “Mabrook” in Arabic, translating as “congratulations”, almost in disbelief as to what he had witnessed.

    It was the first time an Asian club have defeated a side from Europe in an official Fifa tournament. European teams have won 18 of the previous 20 meetings, with two matches drawn.

    A journalist from the media outlet Arryadia called the result “one of the biggest in the history of Saudi football” – but added that the country’s shock 2-1 win over Argentina at the 2022 World Cup will “always be top”.

    A lot of money has been spent to try to grow the Saudi game’s profile – more than £700m has gone on bringing players to the Pro League, while Portugal great Cristiano Ronaldo’s arrival at Al-Nassr two and a half years ago was a significant signing.

    Saudi Arabia will also host the 2034 World Cup – a decision that has been defended by Fifa president Gianni Infantino amid significant criticism – with the human rights campaign group Amnesty International describing it as “reckless”.

    Infantino – the man behind the new 32-team Club World Cup format – has argued that staging the World Cup in the Gulf kingdom can be a catalyst for social improvements.

    Saudi Arabia has faced years of scrutiny over its human rights and environmental record. Its World Cup bid was backed by the Football Association in December after it received assurances that all fans would be welcome.

    The Saudi bid for the World Cup was unopposed, as Australia – the only other potential candidate – decided not to enter the running, hinting it was futile to do so after being given less than a month by Fifa to mount a challenge.

    Fifa stood by a fast-tracked process that critics argued lacked transparency. They suggested it effectively paved the way for the Saudis thanks to a decision that only bids from Asia and Oceania would be considered.

    Serbia midfielder Sergej Milinkovic-Savic, who joined Al-Hilal from Lazio in 2023, was asked about the disapproval players have received in leaving Europe for the riches of the Middle East.

    “Let’s see now if they will criticise us,” he said. “We showed them it’s not like they are speaking about the league.

    “We show against Real Madrid, Salzburg, Pachuca and tonight. I hope we will continue to show it.”

    Former Chelsea defender Kalidou Koulibaly, who scored in extra time, added: “We knew it would be difficult against one of the best in the world.

    “We wanted to show our talents. We are so happy because we wanted to show Al-Hilal had the talent to be here.”

    Continue Reading

  • How soil viruses impact carbon emissions and sequestration

    How soil viruses impact carbon emissions and sequestration

    Relationships between measured variables and keystone bacterial taxa with metal-bound organic C after 30-d incubation.

    FAYETTEVILLE, GA, UNITED STATES, July 1, 2025 /EINPresswire.com/ — Soil viruses play an influential but often overlooked role in soil carbon (C) dynamics, directly affecting both the release and sequestration of carbon. The research uncovers the significant role these viruses play in enhancing the accumulation of recalcitrant carbon, such as dissolved organic matter (DOM) and mineral-associated organic carbon, which are vital for carbon sequestration.

    Soil, a major global carbon sink, holds more than twice the amount of organic carbon found in vegetation biomass and the atmosphere. As climate change accelerates, understanding the dynamics of soil carbon has become increasingly important, particularly regarding microbial processes that control carbon emissions and storage. Viruses, which impact microbial communities, have been found to affect the mineralization and stabilization of organic carbon in soils. However, studies on how viruses influence both carbon loss and retention have been limited, necessitating further research to clarify these viral roles in soil carbon cycling.

    A recent study (DOI: 10.1016/j.pedsph.2025.03.008) published in Pedosphere examines the role of soil viruses in carbon dynamics. The team from Zhejiang University (China) and La Trobe University (Australia) analyzed the impact of viruses on microbial activities and soil carbon emissions, identifying complex interactions between viral lysis and carbon sequestration. This research provides new insights into how viruses might contribute to both the release of CO2 and the stabilization of carbon in soils.

    The study reveals that viruses can both stimulate and inhibit soil CO2 release, depending on the interplay between viral lysis and microbial recycling of lysates. The researchers found that, while viral activity led to variable carbon emissions across different soil types, it generally enhanced the accumulation of recalcitrant dissolved organic matter. This finding suggests that viruses may play a critical role in enhancing soil carbon sequestration, especially by facilitating the binding of carbon to soil minerals like iron and calcium. Interestingly, the study also found that soil viruses influence nitrogen cycling, highlighting the viral shuttle process that links carbon and nitrogen cycling in soil ecosystems.

    The experiment involved introducing soil viruses into sterilized soils from different regions, including forest and cropland areas in China. The results demonstrated that viral lysis triggered a shift in the microbial biomass and nutrient cycling, with viral presence leading to increased microbial activity in some soil types, enhancing soil’s carbon storage capacity.

    Professor Jianming Xu from Zhejiang University, a leading expert in soil and environmental science, comments: “This study is the first to demonstrate how soil viruses not only influence carbon release but also help to stabilize carbon through mineral-binding processes. Our findings suggest a more complex role for viruses in soil ecosystems, one that could have significant implications for climate change mitigation strategies.”

    The findings from this study provide a novel perspective on the role of viruses in soil carbon cycling, emphasizing their potential impact on carbon sequestration. Understanding how viruses influence both microbial communities and soil carbon dynamics could inform future strategies for managing soil health and mitigating climate change. Furthermore, the research underscores the need for broader studies to explore the impacts of viral processes on various soil types, potentially leading to new methods for enhancing soil carbon sinks in agricultural and forested landscapes.

    References
    DOI
    10.1016/j.pedsph.2025.03.008

    Original Source URL
    https://doi.org/10.1016/j.pedsph.2025.03.008

    Funding Information
    This study was supported by the National Key R&D Program of China (No. 2024YFD1501801), the Science and Technology Program of Zhejiang Province (No. 2022C02046), 111 Project (No. B17039), and China Agriculture Research System (No. CARS-01).

    Lucy Wang
    BioDesign Research
    email us here

    Legal Disclaimer:

    EIN Presswire provides this news content “as is” without warranty of any kind. We do not accept any responsibility or liability
    for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this
    article. If you have any complaints or copyright issues related to this article, kindly contact the author above.

    You just read:


    EIN Presswire’s priority is author transparency. We do our best to weed out false and misleading content. The content above is
    the sole responsibility of the author who makes it available. If you have any complaints, kindly contact the author above.

    Continue Reading

  • JAK1 Inhibitor Shows Promise for Ankylosing Spondylitis

    JAK1 Inhibitor Shows Promise for Ankylosing Spondylitis

    TOPLINE:

    Ivarmacitinib, a highly selective Janus kinase 1 (JAK1) inhibitor, tamed ankylosing spondylitis with sustained efficacy through 24 weeks in a phase 2/3 trial.

    METHODOLOGY:

    • A phase 2/3 trial in China evaluated the efficacy and safety of ivarmacitinib in 504 adults with active ankylosing spondylitis who did not benefit from nonsteroidal anti-inflammatory drugs (NSAIDs).
    • In phase 2, patients were randomly assigned to receive ivarmacitinib (2 mg, 4 mg, or 8 mg) or placebo once daily for 12 weeks; 4 mg was selected as the recommended dose based on an interim analysis.
    • In phase 3, 373 patients (mean age, 33.8 years; 79.6% men) were randomly assigned to receive 4 mg ivarmacitinib (n = 187) or placebo (n = 186) once daily for 12 weeks, after which all patients received ivarmacitinib for 12 weeks.
    • The primary endpoint in both phases was the proportion of patients achieving an Assessment of Spondyloarthritis International Society (ASAS) 20 response at week 12.

    TAKEAWAY:

    • At week 12, 48.7% of patients who received 4 mg ivarmacitinib achieved an ASAS20 response compared with 29% of those who received placebo (P = .0001).
    • More patients on 4 mg ivarmacitinib vs placebo achieved an ASAS40 response (32.1% vs 18.3%; P = .0011) and an ASAS5/6 response (42.8% vs 15.6%; P < .0001) at week 12, with efficacy sustained at week 24.
    • After 12 weeks of treatment, patients receiving 4 mg ivarmacitinib had greater improvements in disease symptoms, physical function, spinal mobility, and quality of life.
    • During the first 12-week period, treatment-emergent adverse events occurred in 79.7% of patients in the ivarmacitinib group and 65.6% in the placebo group but caused few treatment discontinuations.

    IN PRACTICE:

    “Ivarmacitinib 4 mg once daily provided rapid, sustained, and clinically meaningful improvements in disease activity, signs and symptoms, function, and MRI-detected inflammation in patients with active AS [ankylosing spondylitis] who had an inadequate response to NSAIDs, with a manageable safety profile,” the authors wrote.

    SOURCE:

    This study was led by Xu Liu, MD, and Liling Xu, MD, of Peking University People’s Hospital in Beijing, China. It was published online on June 12, 2025, in Arthritis & Rheumatology.

    LIMITATIONS:

    The 24-week efficacy of ivarmacitinib may not reflect long-term outcomes. The absence of an active comparator limited the comparison of ivarmacitinib with other disease-modifying antirheumatic drugs used for active ankylosing spondylitis. These findings in Chinese patients with radiographic axial spondyloarthritis may not be generalizable to other populations.

    DISCLOSURES:

    Jiangsu Hengrui Pharmaceuticals Co. Ltd. sponsored and designed the trial. Two authors reported being employees of the sponsor company while the study was conducted. 

    This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

    Continue Reading

  • Is the ‘big, beautiful’ deal in trouble?

    Is the ‘big, beautiful’ deal in trouble?

    Is the “big, beautiful” India-US trade deal slipping out of reach?

    With just days to go before a 9 July deadline set by US President Donald Trump’s administration, hopes of clinching an interim trade pact between Delhi and Washington remain alive but increasingly entangled in hard bargaining.

    Despite White House Press Secretary Karoline Leavitt hinting that the deal was imminent, and Indian Finance Minister Nirmala Sitharaman’s upbeat assertion that Delhi would welcome “a big, good, beautiful” agreement – in response to Trump’s claim that a trade deal with Delhi is coming and would “open up” the Indian market – negotiators remain locked in tough discussions.

    Key sticking points persist, particularly over agricultural access, auto components and tariffs on Indian steel.

    Indian trade officials have extended their stay in Washington for another round of talks, even as Delhi signals “very big red lines” on farm and dairy protections, and the US presses for wider market openings. The tone remains optimistic – but the window to strike a deal appears to be narrowing.

    “The next seven days could determine whether India and the US settle for a limited ‘mini-deal’ or walk away from the negotiating table – at least for now,” says Ajay Srivastava, a former Indian trade official who runs Global Trade Research Initiative (GTRI), a Delhi-based think tank.

    That uncertainty hinges on a few key flashpoints – none more contentious than agriculture.

    “There are two real challenges to concluding an initial agreement. First on the list is US access to the Indian market for basic agriculture products. India will need to protect its basic agriculture sector for economic and political reasons,” Richard Rossow, who tracks India’s economy at Washington’s Center for Strategic and International Studies, told the BBC.

    For years, Washington has pushed for greater access to India’s farm sector, seeing it as a major untapped market. But India has fiercely protected it, citing food security, livelihoods and interests of millions of small farmers.

    Mr Rossow says the “second issue is India’s non-tariff barriers. Issues like India’s growing set of ‘Quality Control Orders’ (QCO) are significant obstacles to US market access and may prove tricky to meaningfully handle in a trade deal”.

    The US has raised concerns over what it calls India’s growing and burdensome import-quality rules. Over 700 QCOs – part of the “self-reliant India” push – aim to curb low-quality imports and promote domestic manufacturing. Suman Berry, a senior member of a government think tank Niti Aayog, has also called these rules a “malign intervention” that restrict imports and raise costs for domestic medium and small scale industries.

    The elephant in the room is farm exports. India-US farm trade remains modest at $8bn, with India exporting rice, shrimp and spices, and the US sending nuts, apples and lentils. But as trade talks progress, Washington is eyeing bigger farm exports – maize, soya bean, cotton and corn – to help narrow its $45bn trade deficit with India.

    Experts fear tariff concessions could pressure India to weaken its minimum support prices (MSP) and public procurement – key protections that shield farmers from price crashes by guaranteeing fair prices and stable crop purchases.

    “No tariff cuts are expected for dairy products or key food grains like rice and wheat, where farm livelihoods are at stake. These categories are politically and economically sensitive, affecting over 700 million people in India’s rural economy,” says Mr Srivastava.

    Curiously, a recent Niti Aayog paper recommends tariff cuts on US farm imports – including rice, dairy, poultry, corn, apples, almonds and GM soya – under a proposed India-US trade pact. It’s unclear, however, whether the proposal reflects official government thinking or remains a policy suggestion on paper.

    “If the US were to say ‘no deal’ if India does not include access on basic agriculture, then clearly American expectations were not set correctly. Any democratically-elected government will have political limits to commercial policy choices,” says Mr Rossow.

    So what could happen with the deal now?

    Experts like Mr Srivastava believe that the “more likely outcome is a limited trade pact” – styled after the US-UK mini trade deal announced on 8 May.

    Under the proposed deal, India may cut tariffs on a range of industrial goods – including automobiles, a long-standing US demand – and offer limited agricultural access via tariff cuts and quotas on select products like ethanol, almonds, walnuts, apples, raisins, avocados, olive oil, spirits and wine.

    Beyond tariff cuts, the US is likely to push India for large-scale commercial buys – from oil and LNG to Boeing aircraft, helicopters and nuclear reactors. Washington may also seek FDI easing in multi-brand retail, benefiting firms like Amazon and Walmart, and relaxed rules on re-manufactured goods.

    “This ‘mini-deal’, if concluded, would therefore focus on tariff reductions and strategic commitments, leaving broader FTA issues – including services trade, intellectual property (IP) rights and digital regulations – for a future negotiation,” says Mr Srivastava.

    At the start, the India-US trade talks appeared to be grounded in a clear and fair vision.

    “The two leaders [Trump and Modi] laid out a simple concept in their first summit this year. The US would focus on manufactured goods that are capital-intensive, while India would focus on items that are labour-intensive,” says Mr Rossow. But things appear to have changed since.

    If talks fail, Trump is unlikely to reinstate the 26% tariffs on India, experts believe.

    While 57 countries faced these levies in April, only the UK has secured a deal so far. Targeting India specifically could seem unfair. “Still, with Trump, surprises can’t be ruled out,” says Mr Srivastava.

    Continue Reading

  • Action Titles and RPGs Generate 75% of Revenue on Steam

    Action Titles and RPGs Generate 75% of Revenue on Steam

    Action was the highest-grossing genre on Steam, accounting for 58.37% of total platform revenue. Next came RPGs (17.11%), strategy games (13.97%), simulators (9.76%), and sports games (1%).

    Among action games, arena shooters made the most money – 18.99% of the genre’s revenue, or $9.52 billion. The second-highest subgenre is first-person shooters, with $6.67 billion in revenue.

    The report also named top-earning RPG subgenres, which are action RPGs (26.45% or $3.89 billion), MMORPGs ($3.69 billion), and CRPGs ($2.69 billion).

    Steam users also like strategy games – in particular, they prefer MOBAs (19.23% or $2.31 billion), RTS games ($1.84 billion), and grand strategy titles ($1.16 billion).

    The money makers in the simulator category are general simulators (44.57% or $3.74 billion), job simulators ($1.36 billion), and racing games ($942.89 million).

    Another thing: they attempted to define the highest average revenue per game. The results are as follows: arena shooters ($634.8 million), battle royales ($354.2 million), and hero shooters ($206.7 million). The subgenres making the least money are visual novels and roguelike deck builders, which generate $4.2 million and $3.4 million, respectively.

    Of course, the results cannot be trusted 100% as they are more like predictions, but the report is good for assessing different trends in the industry. The full breakdown is available here.

    Earlier today, Metacritic admitted that “veteran” gaming journalists have greater influence in determining a game’s final score.

    Don’t forget to join our 80 Level Talent platform and our new Discord server, follow us on Instagram, Twitter, LinkedIn, Telegram, TikTok, and Threads, where we share breakdowns, the latest news, awesome artworks, and more.


    Continue Reading

  • What Israel and the US didn’t achieve

    What Israel and the US didn’t achieve

     Smoke billows following missile attack from Iran on Israel, at Tel Aviv, Israel. — Reuters

    The 12-day war of aggression waged principally by Israel against Iran has been fascinating for its starkness on multiple fronts. Much like Israel’s genocide of the Palestinians, on open display yet unstoppable, the falsehood and illegality of both Israeli and American words and actions continued unabated throughout the war.

    It was, in every way, a no-holds-barred affair: the facts, the rhetoric, the deceit. And this wasn’t about domestic politics or some marginal policy issue. This was about taking nations to war. It was about planning to tear down a country, deploying weapons and unloading tonnes upon tonnes of missiles. 

    It was about flaunting cutting-edge technology, including 30,000-pound GBU-57 bunker buster bombs, to be dropped by the B-2 bombers – the most expensive planes ever built, worth $2.2 billion each. 

    The logistics story was made captivating, numbing the mind to more critical questions – such as what these 30,000-pounders could achieve when targeting material located more than a kilometre beneath the earth. 

    Reports were sent out dutifully about the unprecedented ‘heroic’ 37-hour-long missions of the B-2 bomber pilots, who would drop fourteen of these bombs, guaranteeing annihilation and destruction at three sites.

    The power-wielding architects of this dramatically worded bombing mission spread their ‘faith’ with conviction. The shrill messaging around this unprecedented, colossal task was delivered in fascistic simplicity: that the ‘noble’ objective was to rid the world of the ‘most dangerous threat’ to global security. 

    The mission, they claimed, would demolish Iran’s nuclear programme once and for all. Israel had been making the claim for over two decades – and was now seconded by US President Donald Trump – that Iran was just months away from producing nuclear weapons for what they called the world’s most dangerous and dreaded regime.

    Thus, the shrill rhetoric proliferated globally. Digital and legacy media buzzed with talk of the mission, of bombers and bombs, of Top Gun-style pilots in Tom Cruise mode who had rehearsed every step of ‘Mission Annihilate’. 

    All the rest was drowned out. Questions about the impact on areas and people surrounding the nuclear sites of Isfahan, Fordow and Natanz – and above all, concerns about possible radiation from these bombed sites, where the world had been told Iran held several hundred kilograms of enriched uranium – surfaced only as outlier opinions. 

    The dominant mood in the power corridors of the US, most Western nations and India was one of rah-rah, let’s gun for Iran. Questions did emerge regularly, but they evaporated just as quickly. Often, this was because the lead decision-maker, President Donald Trump, would simply brush off all concerns, almost mocking any journalist who dared to raise them.

    This was a fantasy being spread, much like the ugly truth that was systematically concealed about a hundred years ago. It was the truth of how today’s aggressor, Israel, was born – and who actively midwifed its then-illegitimate birth. 

    That concealed truth was about how Palestinians were robbed of two-thirds of their land, and how Irgun and Haganah, the two terrorist Zionist organisations, killed, maimed and pushed out from Palestine its rightful owners, who were actively resisting the occupation of their land.

    Significantly, in the 12-day war of aggression, Israel and the US alone cannot be given credit for the major political, military and psychological setback it represented. Much of the West had politically and diplomatically partnered with the aggressors.

    The Israel–US duo’s determination to deny Iran nuclear weapons was shared by most European governments, as well as the EU.

    German Chancellor Friedrich Merz unabashedly stated that he was happy that “Israel is doing [this] for all of us. We’re also affected by this regime. This Mullah regime has brought death and destruction over the world. The dirty work that Israel did here – I can only say that I have the highest respect that the Israeli army was courageous enough, that the Israeli government was courageous enough to do this. Otherwise, we possibly would have seen this terror made by this regime for months and years, and possibly with a nuclear weapon in their hand”. 

    These deeply partisan, hate-ridden words in praise of the aggressor were, of course, spoken somewhat prematurely.

    Nato Secretary General Mark Rutte also sent a profusely congratulatory WhatsApp message to Trump, which Trump then posted on social media: “Thank you for your decisive action in Iran. That was truly extraordinary and something no one else dared to do. It makes us safer…” Rutte wrote. Again, prematurely.

    Only on Switzerland’s foreign ministry website did a post appear that cautioned against the aggressors’ complete disregard for legality. It read: “Switzerland emphasizes the importance of full respect for international law, including the UN Charter and international humanitarian law.”

    However, beyond all the bravado and chest-thumping by the self-declared winners of the 12-day war lay the uncomfortable reality: Not even one of the three objectives that Netanyahu and his team had bragged they were determined to achieve was fulfilled – no regime change, no destruction of Iran’s nuclear capability and no major disabling of Iran’s missile infrastructure. 

    Satellite imagery shows only limited irreversible damage to Iran’s storage and launch sites. Iran’s stockpiles of its most advanced ballistic missiles were largely left intact.

    The dramatic B-2 bombers and 30,000-pound bombs weren’t able to destroy Iran’s nuclear capability. The core components of Iran’s nuclear facilities were not destroyed – at best, their progress was delayed by only a few months.

    The first to report this was the US’s own Defense Intelligence Agency (DIA). CNN quoted their report, noting that no irreversible damage had been done and that more information was required from the actual nuclear sites to confirm the extent of the damage. Both the IAEA and DIA conceded that, without access to the sites, all estimates were merely “guesstimates”. Claims of “obliteration” or “significant damage” were baseless.

    Trump’s assertions that the 30,000-pound bombs had “obliterated” Iran’s programme at depths of over 800 meters beneath a mountain at the Fordow facility clashed with the IAEA’s conclusion that the programme had only been delayed by a few months, with all of Iran’s enriched uranium safely stashed away – unreachable to everyone but the Iranians. And the majority of the centrifuges had not been damaged.

    The IAEA’s own duplicity was unmistakable. Rafael Grossi, head of the UN nuclear watchdog, said on June 23 that the airstrikes had probably caused “very significant” damage to Fordow, a major uranium enrichment facility. Yet the IAEA subsequently veered toward the DIA’s more cautious assessment.

    As for what has long been deployed by Washington as a ‘legitimate’ policy tool – the removal of governments in foreign lands through force, sabotage and other means – that too failed. After all, Iran is neither Syria, Iraq, nor Libya, nor even the Iran of 1953. 

    This was not a regime that could be brushed aside easily. Iran’s revolution-hardened, four-decade-old government stood its ground. Paradoxically, for a regime already facing multiple domestic challenges, Israeli aggression somewhat boosted its political fortunes. Nationalist sentiment rose.

    After the war, despite mounting economic and security problems, Iran’s regime emerged more confident and self-assured, having successfully fought back and survived the much-hyped Israeli-US war machine.

    Amid the widespread chatter about what comes next, only two facts appear reliable. First, and fortunately, beyond all the litter of whimsical, flashy and fictional verbosity, there are signs of re-engagement between the two principal players: Iran and the US. 

    Trump has publicly criticised some of Israel’s recent actions, while in important circles in Tehran, there is recognition that indirect communication between Iranian and American officials continues. Some Iranians even see in Trump a potential president willing to pursue an ‘America First’, not ‘Israel First’, policy.

    The second important development appears to be a ceasefire in Gaza. But does this mean progress toward a definitive two-state solution or merely a deceptive lull, under the cover of which the ‘Greater Israel’ agenda advances? At present, with a disengaged Arab and Muslim world, Donald Trump remains – somewhat paradoxically – central to advancing a lasting and viable solution for Palestine. And that solution, clearly, is a two-state one.

    The writer is a senior journalist. She tweets at @nasimzehra and can be reached at: [email protected]

    Disclaimer: The viewpoints expressed in this piece are the writer’s own and don’t necessarily reflect Geo.tv’s editorial policy.



    Originally published in The News


    Continue Reading

  • Donald Trump suggests Doge should review subsidies to Elon Musk’s companies – Financial Times

    Donald Trump suggests Doge should review subsidies to Elon Musk’s companies – Financial Times

    1. Donald Trump suggests Doge should review subsidies to Elon Musk’s companies  Financial Times
    2. Trump threatens to set Doge on Musk as pair feud again over budget plan  BBC
    3. Musk vows to unseat lawmakers who support Trump’s ‘big, beautiful bill’  The Guardian
    4. Why is Musk calling for a new America Party over the Big Beautiful Bill?  Al Jazeera
    5. Trump escalates feud with Musk, threatens Tesla, SpaceX support  Reuters

    Continue Reading

  • Over half of sports fans are turning to AI or gen AI for more personalized content

    Over half of sports fans are turning to AI or gen AI for more personalized content





    Over half of sports fans are turning to AI or gen AI for more personalized content – Capgemini



























    Skip to Content

    Continue Reading

  • Prime Minister Paetongtarn Shinawatra Suspended Amid Cambodia Dispute – The New York Times

    1. Prime Minister Paetongtarn Shinawatra Suspended Amid Cambodia Dispute  The New York Times
    2. Thailand: PM Paetongtarn Shinawatra suspended over leaked phone call  BBC
    3. Court suspends Thailand’s PM pending case over leaked phone call  Al Jazeera
    4. Blow for Thailand’s government as court suspends PM from duty  Reuters
    5. Thousands demand Thai PM’s resignation  Dawn

    Continue Reading