Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND/OBJECTIVES

This systematic review and meta-analysis was performed to assess the effects of inulin-type fructans (ITF) on human blood lipids and glucose homeostasis associated with metabolic abnormalities, including dyslipidemia, overweight or obesity, and type-2 diabetes mellitus (T2DM).

SUBJECTS/METHODS

The MEDLINE, EMBASE and Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) before January 2016. Human trials that investigated the effects of ITF supplementation on the lipid profile, fasting glucose and insulin were included using Review Manager 5.3.

RESULTS

Twenty RCTs with 607 adult participants were included in this systematic review and meta-analysis. In the overall analysis, the supplementation of ITF reduced only the low density lipoprotein-cholesterol (LDL-c) (mean difference (MD): -0.15; 95% confidence interval (CI): -0.29, -0.02; P=0.03) without affecting the other endpoints. Within the T2DM subgroup analysis, ITF supplementation was positively associated with a decreased fasting insulin concentration (MD: -4.01; 95% CI: -5.92, -2.09; P<0.0001) and increased high density lipoprotein-cholesterol (HDL-c) (MD: 0.07; 95% CI: 0, 0.14; P=0.05). Moreover, a reduced fasting glucose tendency was identified only in the T2DM subgroup (MD: -0.42; 95% CI: -0.90, 0.06; P=0.09). There was a potential publication bias, and few trials were available for the T2DM subgroup analysis.

CONCLUSIONS

In summary, the use of ITF may have benefits for LDL-c reduction across all study populations, whereas HDL-c improvement and glucose control were demonstrated only in the T2DM subgroup. Thus, additional, well-powered, long-term, randomized clinical trials are required for a definitive conclusion. Overall, ITF supplementation may provide a novel direction for improving the lipid profile and glucose metabolism.

Developmental Responses of the Lateral Hypothalamus to Leptin in Neonatal Rats, and its Implications for the Development of Functional Connections with the Ventral Tegmental Area

Food intake is regulated by a close communication between the hypothalamus and the mesocorticolimbic pathways, which are still developing during the perinatal period in the rat, and are known targets for peripheral metabolic hormones such as leptin. A key region for this communication is the lateral hypothalamus (LH), although the onset of leptin responsiveness in the LH is unknown. We examined the activation of cellular signalling molecules in identified LH neurones on postnatal day (PND)10 and 16 and determined whether leptin directly targets orexin A (ORX-A) or neurotensin (NT) LH neurones through the detection of leptin receptors (ObRb) mRNA on these neurones. Next, using retrograde labelling in PND6 pups, we tested whether phenotypically identified neurones of the LH that respond to leptin project to ventral tegmental area (VTA) neurones. Leptin significantly induced phosphorylated extracellular signal-regulated kinase (pERK)1/2 and phosphorylated signal transducer activator of transcription (pSTAT)3 in the LH on PND16, whereas, on PND10, modest pERK1/2- and sparse pSTAT3-positive cells were identified. On PND16, most pERK1/2-activated neurones contain ORX-A and leptin-induced pSTAT3 was observed in other unidentified neurones. Afferents to the VTA were observed on PND6, including a large input from the LH, which contained both ORX-A-positive and non-ORX-A neurones, with some of these ORX-A neurones being activated by leptin treatment. Leptin receptor (ObRb) mRNA in the LH did not colocalise with ORX-A neurones on PND10, and only a few NT-positive neurones displayed ObRb mRNA expression. Thus, functional responsiveness to leptin in LH neurones is only partially achieved prior to the onset of independent feeding on PND16, and ORX-A neurones are indirectly activated by leptin. The presence of anatomical connections between the LH and the VTA in the first week of life, prior to the development of leptin responsiveness in both structures, suggests that tissue responsiveness to leptin, rather than the maturation of neuronal connections, critically regulates the onset of independent feeding.

Effect of light-emitting diode (LED) vs. fluorescent (FL) lighting on laying hens in aviary hen houses: Part 2 - Egg quality, shelf-life and lipid composition

In this 60-wk study, egg quality, egg shelf-life, egg cholesterol content, total yolk lipids, and yolk fatty acid composition of eggs produced by Dekalb white laying hens in commercial aviary houses with either light-emitting diode (LED) or fluorescent (FL) lighting were compared. All parameters were measured at 27, 40, and 60 wk of age, except for egg shelf-life, which was compared at 50 wk of age. The results showed that, compared to the FL regimen, the LED regimen resulted in higher egg weight, albumen height, and albumen weight at 27 wk of age, thicker shells at 40 wk of age, but lower egg weight at 60 wk of age. Egg quality change was similar between the lighting regimens during the 62-d egg storage study, indicating that LED lighting did not influence egg shelf-life. Eggs from both lighting regimens had similar cholesterol content. However, cholesterol concentration of the yolk (15.9 to 21.0 mg cholesterol/g wet weight yolk) observed in this study was higher than that of United States Department of Agriculture (USDA) database (10.85 mg/g). No significant differences in total lipids or fatty acid composition of the yolks were detected between the two lighting regimens.

Effect of light-emitting diode vs. fluorescent lighting on laying hens in aviary hen houses: Part 1 - Operational characteristics of lights and production traits of hens

Light-emitting diode (LED) lights are becoming more affordable for agricultural applications. Despite many lab-scale studies concerning impact of LED on poultry, little research has been documented under field production conditions, especially for laying hens. This 15-month field study was carried out to evaluate the effects of LED vs. fluorescent (FL) lights on laying hens (Dekalb white breed) using 4 (2 pairs) aviary hen houses each at a nominal capacity of 50,000 hens. The evaluation was done regarding operational characteristics of the lights and hen production traits. The results show that spatial distribution of the LED light was less uniform than that of the FL light. Light intensity of the LED light decreased by 27% after 3,360 h use but remained quite steady from 3,360 to 5,760 h use. Eleven out of 762 (1.44%) LED lamps (new at onset of the study) in the 2 houses failed during the 15-month experiment period. The neck area of the LED lamp was hottest, presumably the primary reason for the lamp failure as cracks were noticed in the neck region of all failed LED lamps. No differences were observed in egg weight, hen-day egg production, feed use, and mortality rate between LED and FL regimens. However, hens under the FL had higher eggs per hen housed and better feed conversion than those under the LED during 20 to 70 wk production (P < 0.05). Hens under the LED tended to have less feather uniformity and insulation than those under the FL (P < 0.05). Moreover, hens under the LED showed a larger median avoidance distance than those under the FL at 36 wk age (P < 0.05), indicating that hens under the LED were more alert; but no difference at 60 wk age. More comparative research to quantify behavioral and production responses of different breeds of hens to LED vs. FL lighting seems warranted.

Long-term outcome of HLA-haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion based on an FBCA conditioning regimen for hematologic malignancies

Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an alternative for patients who need a transplant without having conventional donors. One hundred and five consecutive patients with hematologic malignancies who underwent G-CSF-primed peripheral blood haplo-HSCT without in vitro T-cell depletion in our single center were reported in this study. Patients were categorized into the intermediate-risk group (n=28) or high-risk group (n=77) according to the risk stratification. The conditioning regimen included fludarabine, busulfan, cyclophosphamide and anti-lymphocyte globulin. The cumulative incidence of grades II-IV acute GvHD (aGvHD) on day +100 was 21.9%, and that of grades III-IV aGvHD was 14.3%. The 2-year cumulative incidence of total chronic GvHD (cGvHD) was 24.1%, and that of extensive cGvHD was 5.6% in 83 eligible patients. The 3-year cumulative incidence rates of relapse and no relapse mortality were 21.9% and 30.5%, respectively. After a median follow-up of 35 months, the 3-year probabilities of overall and disease-free survival for the intermediate-risk and high-risk groups were 63.2% and 39.8% and 61.2% and 32.2%, respectively. In multivariate analysis, the outcome of survival (overall survival and disease-free survival) was associated with the risk stratification, disease status at transplant and dose of infused mononuclear cells. Our results suggest that unmanipulated peripheral blood stem cell allograft performed with fludarabine, busulfan, cyclophosphamide and anti-lymphocyte globulin conditioning regimen is feasible.

The effect of estrogen-related receptor α on the regulation of angiogenesis after spinal cord injury

Estrogen receptor-related receptor-α (ERRα) is an orphan member of the nuclear receptor superfamily that interacts with peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) to stimulate vascular endothelial growth factor (VEGF) expression and angiogenesis in a hypoxia-inducible factor-1α-independent pathway. Although it is not regulated by any natural ligand, the action of ERRα can be blocked by the synthetic molecule XCT790. In the present study, Sprague-Dawley rats were randomly allocated to a sham group, injury-saline group or injury-XCT90 group. A modified Allen's weight-drop method was applied to induce the acute traumatic spinal cord injury (SCI) model in these rats, and an injection of XCT790 was administered every 24h, starting half an hour after the SCI contusion. Histological analyses revealed that XCT790 significantly aggravated tissue damage and decreased the number of ERRα-positive cells at 1, 3 and 7 days after SCI. Western blot and quantitative real-time polymerase chain reaction (qRT-PCR) analyses also indicated that XCT790 dramatically repressed the expression of ERRα, thus reducing the expression of VEGF and angiopoietin-2 (Ang-2) throughout the duration of the experiment, but the expression of PGC-1α was not affected. Immunofluorescence analyses indicated that vascular density and endothelial cell proliferation were decreased in the injury-XCT90 group compared with the injury-saline group. These results suggest that ERRα is involved in mediating angiogenesis after SCI in the rat traumatic SCI model.

A novel multivariate scoring system for determining the prognosis of lymph node-negative esophageal squamous cell carcinoma following surgical therapy: an observational study

BACKGROUND

Identifying patients with esophageal squamous cell carcinoma (ESCC) with negative prognostic factors, which have an extremely low survival rate, has been problematic.

METHODS

We retrospectively collected clinical data for 648 patients with lymph node-negative ESCC who were treated at the Sun Yat-Sen University Cancer Center from 1990 to 2005. Survival difference was compared using Kaplan-Meier analysis and multivariate Cox regression analysis.

RESULTS

We identified advancing age, smoking history, alcohol consumption history, decreased forced expiratory volume in 1 s (FEV1), surgical procedure, tumor location, number of resected lymph nodes, poor tumor differentiation, and surgical stage as independent prognostic risk factors. Furthermore, based on the results of multivariate analysis, we constructed a novel scoring system that included the factors of age, smoking history, alcohol consumption history, number of resected lymph nodes, tumor differentiation, and surgical stage. Risk score (RS) was computed with the scoring system, and patients were divided into Class A (RS: 0-5) and Class B (RS: 6-10). P < 0.001 indicated statistical significance. A significant difference (p < 0.001) demonstrated that Class B was strongly related to a low survival rate and poor prognosis.

CONCLUSION

We developed a new simple flexible scoring system of high prognostic significance, which has the potential to guide postoperative therapeutic strategies and follow-up frequency and to provide better prognostic information for patients and their families.

Neonatal onset of leptin signalling in dopamine neurones of the ventral tegmental area in the rat

Leptin inhibits feeding by acting on hypothalamic and mesolimbic dopamine (DA) pathways involved in the homeostatic and hedonic control of energy balance. In the rodent, the neonatal period is characterised by high circulating leptin concentrations and an insensitivity to the anorectic effects of this hormone, suggesting that the modulation of these circuits by leptin is reduced during this period. The present study aimed to examine the onset of the functional ventral tegmental area (VTA) response to leptin during the neonatal period and to characterise the phenotype of leptin-responsive VTA neurones. On postnatal day (PND) 10 in pups insensitive to the anorectic effects of leptin and exclusively dependent on their mother for feeding, leptin administration failed to increase phosphorylated signal transducer of activation and transcription 3 (pSTAT3) and phosphorylated extracellular signal-regulated kinase (pERK)1/2 immunoreactivity in the midbrain. At the onset of independent feeding on PND16, leptin stimulated pSTAT3 production in the lateral parabrachial pigmented area of the midbrain, with a subset of these pSTAT3-positive neurones co-localising with tyrosine hydroxylase, a marker of DA neurones. Leptin did not increase pERK1/2 immunoreactivity in DA neurones on PND16. These results suggest that the insensitivity of PND10 pups to the anorectic effects of leptin might be mediated, at least in part, by a lack of signalling through the Janus kinase/STAT signalling pathway in VTA DA neurones in response to leptin before the onset of independent feeding.

Genetic relationship between lodging and lodging components in barley (Hordeum vulgare) based on unconditional and conditional quantitative trait locus analyses

Lodging (LD) is a major constraint limiting the yield and forage quality of barley. Detailed analyses of LD component (LDC) traits were conducted using 246 F2 plants generated from a cross between cultivars ZQ320 and 1277. Genetic relationships between LD and LDC were evaluated by unconditional and conditional quantitative trait locus (QTL) mapping with 117 simple sequence repeat markers. Ultimately, 53 unconditional QTL related to LD were identified on seven barley chromosomes. Up to 15 QTL accounted for over 10% of the phenotypic variation, and up to 20 QTL for culm strength were detected. Six QTL with pleiotropic effects showing significant negative correlations with LD were found between markers Bmag353 and GBM1482 on chromosome 4H. These alleles and alleles of QTL for wall thickness, culm strength, plant height, and plant weight originated from ZQ320. Conditional mapping identified 96 additional QTL for LD. Conditional QTL analysis demonstrated that plant height, plant height center of gravity, and length of the sixth internode had the greatest contribution to LD, whereas culm strength and length of the fourth internode, and culm strength of the second internode were the key factors for LD-resistant. Therefore, lodging resistance in barley can be improved based on selection of alleles affecting culm strength, wall thickness, plant height, and plant weight. The conditional QTL mapping method can be used to evaluate possible genetic relationships between LD and LDC while efficiently and precisely determining counteracting QTL, which will help in understanding the genetic basis of LD in barley.

HLA-B*13:01 and the dapsone hypersensitivity syndrome

BACKGROUND

Dapsone is used in the treatment of infections and inflammatory diseases. The dapsone hypersensitivity syndrome, which is associated with a reported mortality of 9.9%, develops in about 0.5 to 3.6% of persons treated with the drug. Currently, no tests are available to predict the risk of the dapsone hypersensitivity syndrome.

METHODS

We performed a genomewide association study involving 872 participants who had received dapsone as part of multidrug therapy for leprosy (39 participants with the dapsone hypersensitivity syndrome and 833 controls), using log-additive tests of single-nucleotide polymorphisms (SNPs) and imputed HLA molecules. For a replication analysis, we genotyped 24 SNPs in an additional 31 participants with the dapsone hypersensitivity syndrome and 1089 controls and performed next-generation sequencing for HLA-B and HLA-C typing at four-digit resolution in an independent series of 37 participants with the dapsone hypersensitivity syndrome and 201 controls.

RESULTS

Genomewide association analysis showed that SNP rs2844573, located between the HLA-B and MICA loci, was significantly associated with the dapsone hypersensitivity syndrome among patients with leprosy (odds ratio, 6.18; P=3.84×10(-13)). HLA-B*13:01 was confirmed to be a risk factor for the dapsone hypersensitivity syndrome (odds ratio, 20.53; P=6.84×10(-25)). The presence of HLA-B*13:01 had a sensitivity of 85.5% and a specificity of 85.7% as a predictor of the dapsone hypersensitivity syndrome, and its absence was associated with a reduction in risk by a factor of 7 (from 1.4% to 0.2%). HLA-B*13:01 is present in about 2 to 20% of Chinese persons, 1.5% of Japanese persons, 1 to 12% of Indians, and 2 to 4% of Southeast Asians but is largely absent in Europeans and Africans.

CONCLUSIONS

HLA-B*13:01 was associated with the development of the dapsone hypersensitivity syndrome among patients with leprosy. (Funded by the National Natural Science Foundation of China and others.).

Coronectomy vs. total removal for third molar extraction: a systematic review

The objective of this systematic review was to compare the outcomes between coronectomy and total removal for third molar extractions with high risk of nerve injury and to help practitioners make prudent decisions on whether and how third molars should be removed. PubMed, Embase, Web of Science, CENTRAL, and SIGLE were searched from January 1990 to October 2011 for randomized or non-randomized controlled trials. Four studies met our inclusion criteria. The pooled risk ratio (coronectomy vs. total removal) was 0.11 (95% CI = 0.03-0.36), 1.03 (95% CI = 0.54-1.98), 0.55 (95% CI = 0.28-1.05), and 1.14 (95% CI = 0.57-2.30) for inferior alveolar nerve injury, post-operative infection, dry socket, and pain at 1 wk after surgery, respectively. A relatively high rate of failed coronectomy in one study (38.3%, compared with 2.3%-9.4% in others) may be attributed to a higher proportion of narrowing roots and vertical impactions. Although root migration rate was high (13.2%-85.29%), the migration distances were short (3.06 ± 1.67 mm), and the directions were away from the nerves. Moreover, the rates of re-operation and root exposure were low. Therefore, coronectomy appears superior to total removal for reducing inferior alveolar nerve damage and could be used in clinical practice for third molar extractions with high risk of nerve injury.

Diagnosing gestational diabetes: can expert opinions replace scientific evidence?

Preventive medical interventions should be based on the highest level of scientific evidence. Actual criteria for diagnosing gestational diabetes mellitus (GDM) are neither uniform nor based on pregnancy outcomes. An expert panel from the International Association of Diabetes in Pregnancy Study Groups recently proposed that all pregnant women undergo a one-step 75 g OGTT, and defined new lower cut-off points to diagnose GDM (Metzger BE et al. Diabetes Care 33: 676-682). These criteria will double the prevalence of GDM, as 18% of all pregnant women will be labelled as abnormal. A recent article in Diabetologia (Ryan EA 54:480-486) claimed that maternal glucose is a weak predictor of big babies, that a single OGTT is poorly reproducible, and that expected benefits from intervention would be, at best, modest. This Commentary discusses other objections and argues that guidelines on any new GDM diagnostic strategy should be based on the results of randomised controlled trials rather than on disputable expert opinions.

Molecular characterization of novel low-molecular-weight glutenin genes in Aegilops longissima

Extensive genetic variations of low-molecular-weight glutenin subunits (LMW-GS) and their coding genes were found in the wild diploid A- and D-genome donors of common wheat. In this study, we reported the isolation and characterization of 8 novel LMW-GS genes from Ae.longissima Schweinf. & Muschl., a species of the section Sitopsis of the genus Aegilops, which is closely related to the B genome of common wheat. Based on the N-terminal domain sequences, the 8 genes were divided into 3 groups. A consensus alignment of the extremely conserved domains with known gene groups and the subsequent cluster analysis showed that 2 out of the 3 groups of LMW-GS genes were closely related to those from the B genome, and the remaining was related to those from A and D genomes of wheat and Ae. tauschii. Using 3 sets of gene-group-specific primers, PCRs in diploid, tetraploid and hexaploid wheats and Ae. tauschii failed to obtain the expected products, indicating that the 3 groups of LMW-GS genes obtained in this study were new members of LMW-GS multi-gene families. These results suggested that the Sitopsis species of the genus Aegilops with novel gene variations could be used as valuable gene resources of LMW-GS. The 3 sets of group-specific primers could be utilized as molecular markers to investigate the introgression of novel alien LMW-GS genes from Ae. longissima into wheat.