Inflammation at the crossroads: A bibliometric and integrative review of metabolic-cardiac links in diabetic cardiomyopathy (2004–2024)

BACKGROUND: Diabetic cardiomyopathy (DCM) is a significant diabetes complication, primarily due to persistently high blood sugar and metabolic issues. Chronic low-grade inflammation plays a key role in its development and is closely associated with cardiomyocyte damage and the progression of heart failure. With diabetes being widespread, DCM greatly raises cardiovascular mortality risk. There's increasing interest in targeting inflammation-related metabolic immune dysregulation to treat DCM. However, current bibliometric analyses are outdated and need updating. This study aims to provide a comprehensive review of recent developments and trends in inflammation's role in DCM, enhancing researchers' understanding and guiding future research. METHODS: Searched the core Web of Science databases. EndNote 21, Microsoft Excel 365, CiteSpace, VOSviewer, and SCImago Graphica were used to explore current research trends and shifts in hotspots. RESULTS: From 2004 to 2024, 818 publications were analyzed. Annual publications surged significantly after 2016, peaking in 2024 (n > 100). China (n = 508) and the USA (n = 135) were the most productive countries. Wenzhou Medical University was the leading institution. Keyword analysis identified "DCM," "oxidative stress," "inflammation," "heart failure," and "mechanisms" as core themes, with recent emphasis on pathways linking metabolic dysfunction, inflammation, and structural/functional cardiac abnormalities. "Preserved ejection fraction" emerged as a recent burst keyword. CONCLUSION: This bibliometric analysis of inflammation in DCM highlights a rapidly expanding field, primarily led by China and the US. Key insights include the central role of oxidative stress-inflammation and metabolic dysregulation, with a new emphasis on HFpEF since 2021. Researchers should focus on multi-organ inflammatory networks and targeted anti-inflammatory treatments, while clinicians should adopt personalized strategies to prevent disease progression. This study addresses crucial gaps to lessen the cardiovascular impact of diabetes.