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Circulating metabolites, genetics and lifestyle factors in relation to future risk of type 2 diabetes

Nat Med. 2026 Jan 14. doi: 10.1038/s41591-025-04105-8. Online ahead of print.

ABSTRACT

The human metabolome reflects complex metabolic states affected by genetic and environmental factors. However, metabolites associated with type 2 diabetes (T2D) risk and their determinants remain insufficiently characterized. Here we integrated blood metabolomic, genomic and lifestyle data from up to 23,634 initially T2D-free participants from ten cohorts. Of 469 metabolites examined, 235 were associated with incident T2D during up to 26 years of follow-up, including 67 associations not previously reported across bile acid, lipid, carnitine, urea cycle and arginine/proline, glycine and histidine pathways. Further genetic analyses linked these metabolites to signaling pathways and clinical traits central to T2D pathophysiology, including insulin resistance, glucose/insulin response, ectopic fat deposition, energy/lipid regulation and liver function. Lifestyle factors-particularly physical activity, obesity and diet-explained greater variations in T2D-associated versus non-associated metabolites, with specific metabolites revealed as potential mediators. Finally, a 44-metabolite signature improved T2D risk prediction beyond conventional factors. These findings provide a foundation for understanding T2D mechanisms and may inform precision prevention targeting specific metabolic pathways.

PMID:41535386 | DOI:10.1038/s41591-025-04105-8

Chatbot To Help Patients Understand Their Health

arXiv:2509.05818v2 Announce Type: replace Abstract: Patients must possess the knowledge necessary to actively participate in their care. We present NoteAid-Chatbot, a conversational AI that promotes patient understanding via a novel 'learning as conversation' framework, built on a multi-agent large language model (LLM) and reinforcement learning (RL) setup without human-labeled data. NoteAid-Chatbot was built on a lightweight LLaMA 3.2 3B model trained in two stages: initial supervised fine-tuning on conversational data synthetically generated using medical conversation strategies, followed by RL with rewards derived from patient understanding assessments in simulated hospital discharge scenarios. Our evaluation, which includes comprehensive human-aligned assessments and case studies, demonstrates that NoteAid-Chatbot exhibits key emergent behaviors critical for patient education, such as clarity, relevance, and structured dialogue, even though it received no explicit supervision for these attributes. Our results show that even simple Proximal Policy Optimization (PPO)-based reward modeling can successfully train lightweight, domain-specific chatbots to handle multi-turn interactions, incorporate diverse educational strategies, and meet nuanced communication objectives. Our Turing test demonstrates that NoteAid-Chatbot surpasses non-expert human. Although our current focus is on healthcare, the framework we present illustrates the feasibility and promise of applying low-cost, PPO-based RL to realistic, open-ended conversational domains, broadening the applicability of RL-based alignment methods.

VaultGemma: A Differentially Private Gemma Model

arXiv:2510.15001v2 Announce Type: replace-cross Abstract: We introduce VaultGemma 1B, a 1 billion parameter model within the Gemma family, fully trained with differential privacy. Pretrained on the identical data mixture used for the Gemma 2 series, VaultGemma 1B represents a significant step forward in privacy-preserving large language models. We openly release this model to the community

A multi-omics and mediation-based genetic screening approach identifies STX4 as a key link between epigenetic regulation, immune cells, and childhood asthma

Childhood asthma presents a multifaceted immune-driven pathology shaped by genetic, epigenetic, and immune regulatory interactions. Despite extensive genome-wide analyses pinpointing multiple susceptibility lo...

Efficient discovery of robust prognostic biomarkers and signatures in solid tumors

Cancer Lett. 2025 Mar 31;613:217502. doi: 10.1016/j.canlet.2025.217502. Epub 2025 Jan 24.

ABSTRACT

Recent advancements in multi-omics and big-data technologies have facilitated the discovery of numerous cancer prognostic biomarkers and gene signatures. However, their clinical application remains limited due to poor reproducibility and insufficient independent validation. Despite the availability of high-quality datasets, achieving reliable biomarker identification across multiple cohorts continues to be a significant challenge. To address these issues, we developed a comprehensive platform, SurvivalML, designed to support the discovery and validation of prognostic biomarkers and gene signatures using large-scale and harmonized data from 21 cancer types. Through SurvivalML, we identified DCLRE1B as a novel prognostic biomarker for hepatocellular carcinoma, with experimental confirmation of its role in promoting tumor progression. Additionally, we developed the Chinese glioblastoma prognostic signature (CGPS) and its simplified version, SCGPS, a three-gene model. Both demonstrated superior predictive performance compared to other glioblastoma signatures in our in-house cohort and five independent Chinese datasets. The SCGPS model was further validated in 109 clinical samples using multiplex immunofluorescence, showing strong consistency with the original CGPS model. Overall, SurvivalML provides a robust platform for the identification and validation of prognostic biomarkers and gene signatures, offering a valuable resource for advancing cancer research and clinical application.

PMID:39864538 | DOI:10.1016/j.canlet.2025.217502

Tumour vasculature at single-cell resolution

Nature, Published online: 10 July 2024; doi:10.1038/s41586-024-07698-1

An atlas of tumour vasculature shows that tumour angiogenesis is initiated from venous endothelial cells and extended towards arterial endothelial cells.

Epigenetically regulated gene expression profiles decipher four molecular subtypes with prognostic and therapeutic implications in gastric cancer

Gastric cancer (GC) is one of the most common malignant tumors of the digestive tract which seriously endangers the health of human beings worldwide. Transcriptomic deregulation by epigenetic mechanisms plays ...
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