Publication Name	World Journal of Diabetes
Manuscript ID	107019
Country	China

Category	Endocrinology & Metabolism
Manuscript Type	Retrospective Study
Article Title	First metatarsophalangeal joint synovial hypertrophy associated with vitamin D status in type 2 diabetes mellitus: An ultrasound-graded study
Manuscript Source	Unsolicited Manuscript
All Author List	Qing-Shan Li, Xiao-Hui Xiao, Yu-Ying Cai, Xiao-Peng Xiao, Ping-Xiang Hu and Hong Li
Funding Agency and Grant Number
Corresponding Author	Hong Li, MD, Department of Ultrasound, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), No. 1 Fuhua Road, Futian District, Shenzhen 518000, Guangdong Province, China. lihong_echo@163.com
Key Words	Vitamin D; Synovial hypertrophy; Type 2 diabetes mellitus; Metatarsophalangeal joint; Serum 25-hydroxyvitamin D
Core Tip	This study refines a semi-quantitative ultrasound grading system for first metatarsophalangeal joint synovial hypertrophy by introducing a novel subtype that specifically classifies cases of dorsal recess overlying the metatarsal bone, demonstrating high reliability (intra-observer ICC = 0.79; inter-observer ICC = 0.73). We identified a significant inverse, non-linear correlation between serum 25-hydroxyvitamin D levels and synovial hypertrophy severity, with a threshold effect at 23.8 ng/mL. These findings suggest that vitamin D deficiency may contribute to synovial inflammation in T2DM patients and that targeted screening and supplementation could help mitigate joint complications.
Citation	Li QS, Xiao XH, Cai YY, Xiao XP, Hu PX, Li H. Ultrasound grading of first metatarsophalangeal joint synovial hypertrophy associated with vitamin D in type 2 diabetes mellitus. World J Diabetes 2025; In press

Received	2025-03-17 03:43
Peer-Review Started	2025-03-18 00:21
To Make the First Decision
Return for Revision	2025-04-03 04:00
Revised	2025-04-26 05:11
Second Decision	2025-06-11 03:28
Accepted by Journal Editor-in-Chief	2025-06-15 14:18
Accepted by Executive Editor-in-Chief	2025-06-19 07:56
Articles in Press	2025-06-19 07:56
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ISSN	1948-9358 (online)
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