Obesity: A Chronic Low-Grade Inflammation and Its Markers

Crosstalk between white adipose tissue and skin: Unraveling its role in psoriasis pathogenesis (Review)

Psoriasis is a chronic systemic inflammatory skin disorder characterized by hyperproliferation of keratinocytes and significant immune dysregulation. Obesity is markedly associated with psoriasis, acting as an independent risk factor that exacerbates disease severity and treatment failure, while weight‑reduction interventions can improve psoriatic lesions. However, the mechanisms by which obesity promotes the onset and progression of psoriatic lesions still require further elucidation. The present comprehensive narrative review highlighted the critical role of the crosstalk between white adipose tissue (WAT) and skin in the pathogenesis of psoriasis. The expansion of WAT contributes to inflammation, epidermal proliferation and angiogenesis in skin lesions through the release of adipokines, extracellular vesicles and free fatty acids. Conversely, psoriatic lesions induce dysregulation in the inflammation and function of WAT. These findings suggested that this bidirectional communication not only explains the high prevalence of obesity among patients with psoriasis, but also highlights the importance of addressing metabolic comorbidities in treatment strategies.

The dual challenge of diabesity: pathophysiology, management, and future directions

Diabesity, the concurrent occurrence of obesity and type-2 diabetes mellitus (T2DM), represents a pressing global health challenge characterized by intricate pathophysiological mechanisms and a wide range of associated comorbidities. Central to its development are insulin resistance, metabolic syndrome, and chronic low-grade inflammation mediated by dysregulated adipokine secretion and systemic metabolic dysfunction. These mechanisms underpin the progression of diabesity and its complications, including cardiovascular disease and hypertension. Management strategies encompass lifestyle interventions focusing on tailored dietary modifications and structured physical activity, pharmacological treatments targeting both glycemic control and weight loss, and surgical interventions such as bariatric surgery, which have demonstrated efficacy in achieving durable outcomes. Clinical trials and meta-analyses underscore the comparative advantages of different treatment modalities in terms of efficacy, safety, and sustainability. Moreover, long-term follow-up studies emphasize the critical need for sustained multidisciplinary interventions to prevent relapse and enhance patient outcomes. Future advancements in management include exploring precision medicine approaches that integrate individual metabolic profiles, lifestyle factors, and emerging therapeutic innovations. A multidisciplinary approach combining advanced therapeutic strategies and patient-centered care remains pivotal for optimizing management and improving prognoses for individuals with diabesity. This review highlights the complex interplay between obesity and T2DM, offering comprehensive insights into their pathophysiology, clinical presentation, and management paradigms.

Chronic inflammation in obesity and neurodegenerative diseases: exploring the link in disease onset and progression

Obesity, a worldwide health emergency, is defined by excessive fat accumulation and significantly impacts metabolic health. In addition to its recognized association with cardiovascular disease, diabetes, and other metabolic illnesses, recent studies have revealed the connection between obesity and neurodegeneration. The main reason for this link is inflammation caused by the growth of fat tissue, which activates harmful processes that affect how the brain works. Fat tissue, particularly the fat around the organs, produces various substances that cause inflammation, such as cytokines (TNF-α, IL-6), adipokines (leptin, resistin), and free fatty acids. These chemicals cause low-grade, persistent systemic inflammation, which is becoming more widely acknowledged as a major factor in peripheral metabolic dysfunction and pathology of the central nervous system (CNS). Inflammatory signals in the brain cause neuroinflammatory reactions that harm neuronal structures, change neuroplasticity, and disrupt synaptic function. When obesity-related inflammation is present, the brain's resident immune cells, known as microglia, become hyperactivated, which can lead to the production of neurotoxic chemicals, which can cause neuronal death. This neuroinflammation exacerbates the negative effects of obesity on brain health and is linked to cognitive decline, Alzheimer's disease, and other neurodegenerative disorders. Moreover, the blood-brain barrier (BBB) exhibits increased permeability during inflammatory states, facilitating the infiltration of peripheral immune cells and cytokines into the brain, hence exacerbating neurodegeneration. Adipose tissue is a source of chronic inflammatory mediators, which are examined in this review along with the molecular pathways that connect inflammation brought on by obesity to neurodegeneration. Additionally, it addresses various anti-inflammatory treatment approaches, including lifestyle modifications, anti-inflammatory medications, and gut microbiota modulation, to lessen the metabolic and neurological effects of obesity. Recognizing the link between obesity and inflammation opens up new opportunities for early intervention and the development of targeted treatments to prevent or alleviate neurodegenerative disorders.

Sex-specific Mendelian randomization phenome-wide association study of basal metabolic rate

Observationally, higher basal metabolic rate (BMR) is associated with metabolism-related disorders, cancer, aging, and mortality. In this Mendelian randomization (MR) phenome-wide association study, using two-sample MR methods, we systematically and comprehensively investigated the health effects of genetically predicted BMR across the phenome sex-specifically. We obtained sex-specific genetic variants strongly (p < 5 × 10- 8) and independently (r2 < 0.001) predicting BMR from the UK Biobank and applied them to over 1,000 phenotypes within the same study. We combined genetic variant-specific Wald estimates using inverse-variance weighting, supplemented by sensitivity analysis. We used a false-discovery rate correction to allow for multiple comparisons as well as multivariable MR adjusted for body mass index and testosterone to investigate the independent effects of BMR on phenotypes with significant univariable associations. We obtained 217/219 genetic variants predicting BMR and applied them to 1,150/1,242 phenotypes in men/women, respectively. BMR was associated with 190/270 phenotypes in univariable analysis and 122/123 phenotypes in multivariable analysis in men/women. Examples of robust associations in multivariable analysis included those with neoplasms, diseases of the circulatory system, and growth and reproductive investment. In conclusion, BMR might affect a wide range of health-related outcomes. The underlying mechanisms and interactions between phenotypes warrant further study, as BMR is modifiable.

Quantification of Modifiable Risk Factors in Monoclonal Gammopathy of Undetermined Significance Progression to Multiple Myeloma

PURPOSE

Multiple myeloma (MM) is the most common plasma cell dyscrasia in the United States with notably significant health disparities. MM is preceded by an asymptomatic precursor monoclonal gammopathy of undetermined significance (MGUS). Studies have identified several risk factors for the progression of MGUS to MM; however, the relative contributions of these remain unknown. Particularly, understanding the contribution among those modifiable factors may inform MM prevention.

METHODS

This study quantified these contributions by estimating the adjusted population attributable fractions (aPAF) of modifiable risk factors for MM among the Veteran population with MGUS.

RESULTS

Among all evaluated risk factors, excess body mass index (BMI ≥25 kg/m 2 ) was the leading factor (Black: aPAF=27.0%, 95% CI 19.3-33.9%; White: 27.1%, 95% CI 20.3-33.4%; All: aPAF=27.1%, 95% CI: 22.0-31.8%).

CONCLUSION

Our study highlights the potential for weight management as a key strategy in reducing the risk of progression to MM in Black and White patients diagnosed with MGUS.

Interruptins Extracted from Cyclosorus terminans Protect Gut Pathologies Induced by High-Fat Diet in Rats

BACKGROUND/OBJECTIVES

The fern "Cyclosorus terminans" (C. terminans) or "Maiden Fern" contains interruptin A and interruptin B. This plant could attenuate obesity, insulin resistance, and fatty liver in rats fed a high-fat/calorie diet. However, the benefits of C. terminans to the gut remain unknown. We investigated the protective effect of C. terminans extract against gut dysfunction in rats exposed to a high-fat/calorie diet.

METHODS

Male Wistar rats were assigned to receive either (1) a normal diet treated with vehicle, (2) a high-fat/calorie diet treated with vehicle, (3) a high-fat/calorie diet treated with 100 mg per kg per day (mg·kg-1·day-1) of C. terminans extract, or (4) a high-fat/calorie diet treated with 200 mg·kg-1·day-1 of C. terminans extract. The rats were euthanized after 12 weeks of treatment to enable feces and colon tissue collection.

RESULTS

Both 100 and 200 mg·kg-1·day-1 of C. terminans extract reduced body weight (-10.49%; p = 0.030 and -10.54%; p = 0.037, respectively) and ameliorated gut inflammation, gut barrier disruption, changes in short-chain fatty acid levels, and gut dysbiosis caused by high-fat/calorie diet.

CONCLUSIONS

C. terminans extract attenuated an increase in body weight and exerted prophylactic effects against gut pathologies induced by high-fat/calorie diet.

The Obesity Paradox in Patients Undergoing Surgical Repair of Degenerative Mitral Regurgitation

Background: The obesity paradox describes the beneficial influence of an elevated body mass index on health outcomes. Currently, few studies have evaluated BMI and its impact on survival following surgical repair of degenerative mitral regurgitation (MR). Methods: Between 2004 and 2021, 1214 patients underwent surgical mitral valve repair at our institution for MR due to myxomatous degeneration. Results: Patient age was 63.2 ± 12.3 years, 341 (28%) were female, and 678 (55%) were either overweight or obese (body mass index ≥ 25 kg/m2) preoperatively. Concomitant coronary revascularization was performed in 152 (13%). Clinical and echocardiographic follow-up averaged 4.5 years and was complete for all patients. Perioperative mortality occurred in 4 (0.3%). Ten-year survival, freedom from recurrent MR ≥ 2+, and freedom from recurrent MR ≥ 3+ was 75.1 ± 2.3%, 85.8 ± 2.1%, and 96.6 ± 1.0%, respectively. A higher body mass index was associated with better survival (hazard ratio 0.99, 95% CI 0.98-0.99, p = 0.02) after adjusting for age, sex, preoperative LV function, and preoperative LV size. Conclusions: A higher BMI was associated with better long-term survival independent of age, gender, LV function, and LV size. These data may provide nuanced risk prognostication in patients undergoing surgical mitral repair.

The relationship between hepatic steatosis index and hypertension: NHANES 2011-2018

BACKGROUND

The Hepatic Steatosis Index (HSI) serves as a non-invasive indicator for assessing liver fat accumulation. Its potential association with hypertension has garnered increasing attention, as metabolic dysfunctions, including hepatic steatosis, may contribute to elevated blood pressure via mechanisms such as insulin resistance and chronic inflammation.

METHODS

Utilizing data from the NHANES database (2011-2018), the HSI was calculated on the basis of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and BMI.The association between HSI and hypertension was assessed by univariate analysis, weighted multivariate Logistic regression, and restricted cubic spline (RCS) models. Subgroup analyses were performed to increase the reliability of the data.

RESULTS

This cross-sectional study analysed data from 17,501 adults (NHANES 2011-2018) to assess the association between HSI and hypertension. Of these, 9,890 (56.51%) were diagnosed with hypertension.In the unadjusted model, HSI demonstrated a statistically significant correlation with hypertension, showing an odds ratio (OR) of 1.05 (95% confidence interval: 1.04-1.06).After adjustment for potential confounders, a higher prevalence of hypertension was observed in participants in the upper HSI quartiles (Q3 and Q4), with corresponding ORs of 2.29 (95% CI: 2.29-2.63) and 4.03 (95% CI: 3.42-4.74), respectively. RCS analysis revealed a U-shaped non-linear relationship between HSI and hypertension (P < 0.001), indicating that while hypertension risk primarily escalated with increasing HSI, a modest risk elevation was also detected at lower HSI levels. This suggests that both excessive liver fat accumulation (indicated by a high HSI) and underlying metabolic disorders (such as malnutrition or sarcopenia) may contribute to hypertension risk in individuals with unexpectedly low HSI. Subgroup analyses identified significant interactions in relation to education, cancer, and diabetes mellitus (p for interaction < 0.05), whereas no significant interactions were observed in other stratifications.

CONCLUSION

This study found a U-shaped relationship between the hepatic steatosis index (HSI) and the risk of hypertension. Although the HSI shows potential as a practical screening tool in primary care, further longitudinal studies are needed to establish causality and explore the complex bidirectional pathways involved.

CLINICAL TRIAL NUMBER

Not applicable.

Prognostic scoring system using inflammation- and nutrition-related biomarkers to predict prognosis in stage I-III colorectal cancer patients

BACKGROUND

Colorectal cancer (CRC) is a common malignancy that has become a global burden. The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.

AIM

To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.

METHODS

Patients were randomized at a 3:2 ratio into a training cohort (n = 282) or a validation cohort (n = 188). To identify the optimal prognostic factors for constructing the risk score (RS), LASSO Cox regression analysis was conducted. The association between the RS and overall survival (OS) was evaluated using receiver operating characteristic (ROC) curves and Kaplan-Meier (K-M) survival analysis. Independent risk factors were screened by multivariate Cox regression analysis. Nomograms were constructed and validated on the basis of these factors.

RESULTS

In the training cohort, univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value. A LASSO-Cox analysis included four biomarkers and constructed an RS. Through ROC analysis, the area under the prognostic curve was 0.795. K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group (P < 0.001). Multivariate analysis demonstrated that the degree of differentiation (P = 0.001), degree of nerve invasion (P = 0.022), and RS (P < 0.001) were independent risk factors. We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort. The calibration curve showed high accuracy. Additionally, decision curve analysis for 1-year, 3-year, and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.

CONCLUSION

This study developed a nomogram based on the RS to predict the OS of CRC patients. This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk, aiming to improve long-term prognosis.

A comprehensive review on the implications of Yogic/Sattvic diet in reducing inflammation in type 2 diabetes

Chronic inflammation in type 2 diabetes (T2D), characterized by constitutively activated immune cells and elevated pro-inflammatory mediators along with hyperglycaemia and increased free fatty acids and branched chain amino acid levels, significantly alters the immuno-metabolic axis. Over the years, dietary intervention has been explored as an effective strategy for managing T2D. Evidence from experimental and clinical studies indicates that various diets, including Mediterranean, Nordic, Palaeolithic and ketogenic diets, increase insulin sensitivity, decrease gluconeogenesis, and adiposity, and exert anti-inflammatory effects, thus preserving immuno-metabolic homeostasis in individuals with T2D. Indian dietary sources are categorized as Sattvic, Rajasic, and Tamasic, depending on their impact on health and behaviour. The Yogic diet, commonly recommended during yoga practice, is predominantly Sattvic, emphasizing plant-based whole foods while limiting processed and high-glycaemic-index items. Yogic diet is also recommended for Mitahara, emphasizing mindful eating, which is attributed to calorie restriction. Adopting a Yogic diet, featuring low-fat vegetarian principles, strongly reduces inflammatory mediator levels. This diet not only ameliorates insulin resistance and maintains a healthy body weight but also regulates immunomodulation, enhances gut microbiome diversity and provides essential phytonutrients, collectively preventing inflammation. Although, preliminary studies show aforementioned beneficial role of Yogic diet in improving diabetes associated metabolic and inflammatory changes, precise cellular and molecular mechanisms are not yet understood. Hence, further studies are warranted to decipher the mechanisms. This review summarizes the multiple roles of Yogic diet and related dietary components in mitigating inflammation and enhancing glycaemic control in T2D.

Predictors of Anemia Recovery in Patients with Pre-existing Anemia Undergoing Metabolic Bariatric Surgery: A Retrospective Cohort Study

BACKGROUND

Although studies have explored the development of postoperative anemia after metabolic bariatric surgery, little is known about the effect of metabolic bariatric surgery on anemia recovery in patients with pre-existing anemia. Therefore, the objective of this study was to determine the prevalence of anemia recovery six months after metabolic bariatric surgery and predictors associated with recovery.

METHODS

This was a retrospective cohort study of 1,664 patients with pre-existing anemia aged 18-80 years who received a primary metabolic bariatric procedure between January 2010 and June 2020. The primary outcome of interest was the percentage of patients who recovered from anemia as defined by the World Health Organization thresholds at six-months post-metabolic bariatric surgery.

RESULTS

Of the 1,664 patients identified with preoperative anemia, 952 (57.2%) recovered six-months post-metabolic bariatric surgery. Female sex (OR 1.93, 95% CI 1.42-2.61, p < 0.001), age between 45-54 years vs. under 35 years (OR 1.48, 95% CI 1.08-2.05, p < 0.05), and receiving sleeve gastrectomy vs. Roux-en-Y gastric bypass (OR 1.41, 95% CI 1.06-.86, p < 0.05) were associated with significantly higher odds of recovery. A preoperative hemoglobin of 11-20 g/L below normal as compared to 0-10 g/L below normal (OR 0.52, 95% CI 0.40-0.69, p < 0.001) was associated with significantly lower odds of recovering from anemia.

CONCLUSION

More than half of patients with preoperative anemia undergoing metabolic bariatric surgery recover from anemia after their procedure. Age, sex, preoperative hemoglobin, and surgery type all influence recovery. The total body weight lost after six-months post-surgery conferred no significant effect.

A Pilot 24-Week 'Bulk and Cut' Dietary Protocol Combined with Resistance Training Is Feasible and Improves Body Composition and TNF-α Concentrations in Untrained Adult Males

Background/Objectives: This study piloted a 24-week bodybuilding program combining resistance training (RT) with a dietary bulk-and-cut protocol in middle-aged adult males. Methods: Seven untrained males (33 ± 3.0 years; BMI = 35.0 ± 4.6 kg/m2; body fat = 36 ± 5%) completed a 24-week intervention combining RT with a dietary protocol consisting of 12-week cycles of caloric bulking (0-12 weeks) and cutting (12-24 weeks). The participant retention rate was 64%, while compliance with training was 96.7%, and adherence to dietary cycles was over 93%. To assess the preliminary efficacy of the intervention, venous blood samples and measurements of body composition (BodPod), muscle strength, and VO2max (cycle ergometer) were collected at baseline (week 0) and following the bulking (week 12) and cutting (week 24) cycles. Circulating lipids (triglycerides, total, low-density, and high-density cholesterol), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured in serum. Results: The training led to significant increases in muscle strength, especially in the deadlift (+46%, p < 0.001) and squat (+65%, p < 0.001). Improvements in body composition were characterized by an increase in fat-free mass and a decrease in body fat percentage over the 24-week intervention (+3% and -6%, respectively, p < 0.05). Lipids, CRP, IL-6, and IL-10 did not change significantly, but there was a notable reduction in TNF-α (time effect p = 0.05, pη2 = 0.39), with 15% lower concentrations at week 24 compared to baseline, indicating reduced inflammation. Conclusions: Overall, the pilot intervention achieved high compliance and adherence rates, leading to improvements in body composition and lower resting TNF-α concentrations in a group of middle-aged males with obesity.

Chromium and formoterol therapy for obesity-induced asthma in rats

The development of asthma is impacted by fat. Asthma is more common in obese persons. The purpose of the experimental study is to determine how chromium, formoterol, and their combination can improve the quality of life for obese people with lung anomalies. Thirty-six male Wistar rats were divided into six groups: control (C), obesity (CO), obese-asthma (COA), and obese-asthma groups treated with formoterol (OAF), chromium (OACR), or both (OACRF). Except for group C, all groups received a high-fat diet for 4 weeks. Subsequently, ovalbumin (OVA) was administered subcutaneously (s.c.) to all groups except C and CO to induce sensitization. Asthma was triggered via 1% OVA aerosol challenges on days 26-28. Over 5 days, OAF and OACRF received daily formoterol inhalations (50 μg/kg), while OACR and OACRF were given chromium (400 μg/kg). Treatments were timed to align with asthma induction protocols. Lipid profile and inflammatory indicators were examined at the end of the trial-Immunohistochemical analysis of lung tissue, Histopathological and lung tissue stained with Hematoxylin and Eosin. The combination therapy (OACRF) significantly reduced body weight (p < 0.05), lowered LDL and triglycerides, increased HDL, and normalized lung tissue architecture compared to controls. Immunohistochemistry revealed reduced IL-1β and IL-17α expression. The (OACRF) group demonstrated superior asthma control by reducing body weight, improving inflammatory indicators, and restoring lung tissue to its normal state by administering chromium and formoterol therapy. The most effective strategy for treating both obesity and asthma is to address their two connected conditions. These findings demonstrate that combined chromium and formoterol therapy effectively addresses metabolic and inflammatory components of obesity-induced asthma, offering a promising dual-target therapeutic strategy.

Glucocorticoids and HPA axis regulation in the stress-obesity connection: A comprehensive overview of biological, physiological and behavioural dimensions

Chronic stress, characterized by increased long-term exposure to the glucocorticoid hormone cortisol, is increasingly linked to obesity development. Still, various knowledge gaps persist, including on underlying pathophysiological mechanisms. The aim of the current review is to provide the latest insights on the connection between stress and obesity. We discuss three biological stress systems-the autonomic nervous system, the hypothalamus-pituitary-adrenal (HPA) axis and the immune system-and their link with obesity, with a particular focus on the HPA axis. The role of cortisol and its regulatory variations (including glucocorticoid rhythmicity and altered sensitivity) in adipose tissue biology and obesity development is discussed. Moreover, we highlight the physiological, affective, cognitive and behavioural dimensions of the stress response offering a deeper understanding of how stress contributes to obesity development and vice versa. Finally, stress as a treatment target for obesity is discussed. We conclude that the link between stress and obesity is complex and multifaceted, influenced by physiological, affective, cognitive and behavioural stress response mechanisms, which especially when chronically present, play a key role in the development of obesity and associated cardiometabolic diseases. This necessitates integrated approaches tailored to individual needs, including lifestyle modifications, behavioural interventions, psychosocial support and possible additional pharmacological interventions.

Weight-adjusted waist index and its relationship with systemic inflammatory Index and metabolic indices in overweight and obese individuals: A cross-sectional study

BackgroundObesity- characterized by excessive adiposity- is associated with various comorbidities, including metabolic, cardiovascular, and liver diseases. Chronic low-grade inflammation is a key factor in complications associated with obesity. This study aimed to investigate the associations between systemic inflammatory indices (SIIs) and weight-adjusted waist index (WWI), alongside metabolic and liver function biomarkers in overweight and obese individuals.MethodThis cross-sectional study included 350 overweight or obese participants (body mass index (BMI) ≥ 25 kg/m2) from both genders. Weight, height, waist, hip, and neck circumferences were measured and BMI, WWI, and the ratios of waist to height (WHtR) and hip (WHR) were estimated. Fasting blood samples were taken to assess SII as well as metabolic parameters.ResultsIn this study, males had significantly higher weight and WC compared to females, whereas the mean level of WWI (p < 0001) and WHtR (p = 0.01) in women were greater than in men. A significant correlation was observed between WWI and SII (r = 0.113, p = 0.039), and other associations were observed between HbA1c levels (r = -0.117, p = 0.033) and monocyte-to-lymphocyte ratio (MLR), and fasting blood sugar (FBS) and neutrophil-to-lymphocyte ratio NLR (r = 0.110, p = 0.041). SII quartiles showed significant differences in aspartate aminotransferase AST levels (p < 0.001), and significant variations in WHtR and MLR were also observed (r = -0.112, p = 0.043).ConclusionOur results reveal strong and significant correlations between systemic inflammatory markers, including SII, MLR, and PLR, and important obesity measures, as well as metabolic and liver function parameters in individuals with obesity.

Development of a quality eating index and its relationship with nutritional status in adults

Background

The implementation of Indonesia's food-based dietary guidelines (FBDG) through an index should be simulated to provide a concise overview of the diet quality of the Indonesian adult population. This study aimed to (1) develop a quality eating index to depict diet quality and (2) evaluate the performance of the instrument used to assess the association between diet quality and nutritional status among the Indonesian adult population.

Methods

The quality eating index was developed based on the FBDG. The index was developed through a multi-step workflow: (1) literature review and expert panel discussion, (2) pilot study, (3) final testing and score weighing, (4) cut-off score determination, and (5) construct and criterion validation for the body mass index (BMI) and biochemical parameters such as fasting blood glucose (FBG), total cholesterol, high- and low-density lipoprotein (HDL and LDL), and triglyceride. A total of 415 subjects were randomly recruited using proportional stratified random sampling in the urban and rural communities.

Results

The quality eating index was constructed of 12 food groups with a cut-off score of ≥60 indicating good and <60 showing poor/needing improvement. A low score on the quality eating index was associated with a 1.6-fold greater risk of overweight/obesity and tended to be associated with a 1.5-fold higher risk of dyslipidemia.

Conclusions

The development of the quality eating index was only significantly associated with BMI. The quality eating index could potentially be used for screening for diet quality and risk of overweight/obesity among adults in urban and rural areas.

The effect of peer victimisation on cognitive development in childhood: evidence for mediation via inflammation

PURPOSE

Peer victimisation, often a serious childhood stressor, has been associated with poor cognitive outcomes. The current study sought to uncover whether peer victimisation is associated with poor cognitive functioning in childhood via inflammation.

METHODS

Data from 4583 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. Path analysis was conducted to determine whether inflammation, measured using IL-6 and CRP levels (age 9), mediates the effects of peer victimisation (age 8), even after controlling for other stressors, on multiple cognitive outcomes, including working memory (age 10), reading (accuracy, speed, and comprehension) (age 9), spelling (age 9), response inhibition (age 10), attentional control (age 11), and selective attention (age 11).

RESULTS

IL-6 and CRP partially mediated the effects of peer victimisation on working memory, reading accuracy, and selective attention. IL-6 partially mediated the effect of peer victimisation on reading comprehension, while CRP partially mediated the effect of peer victimisation on reading speed. All effects were small. Inflammation did not mediate the effects of peer victimisation on spelling, response inhibition or attentional control.

CONCLUSION

Peer victimisation may impact on some aspects of children's cognitive functioning via inflammation. The cognitive outcome specificity observed warrants further research.

Insulin resistance and cancer: molecular links and clinical perspectives

The association between insulin resistance (IR), type 2 diabetes mellitus (T2DM), and cancer is increasingly recognized and poses an escalating global health challenge, as the incidence of these conditions continues to rise. Studies indicate that individuals with T2DM have a 10-20% increased risk of developing various solid tumors, including colorectal, breast, pancreatic, and liver cancers. The relative risk (RR) varies depending on cancer type, with pancreatic and liver cancers showing a particularly strong association (RR 2.0-2.5), while colorectal and breast cancers demonstrate a moderate increase (RR 1.2-1.5). Understanding these epidemiological trends is crucial for developing integrated management strategies. Given the global rise in T2DM and cancer cases, exploring the complex relationship between these conditions is critical. IR contributes to hyperglycemia, chronic inflammation, and altered lipid metabolism. Together, these factors create a pro-tumorigenic environment conducive to cancer development and progression. In individuals with IR, hyperinsulinemia triggers the insulin-insulin-like growth factor (IGF1R) signaling pathway, activating cancer-associated pathways such as mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PIK3CA), which promote cell proliferation and survival, thereby supporting tumor growth. Both IR and T2DM are linked to increased morbidity and mortality in patients with cancer. By providing an in-depth analysis of the molecular links between insulin resistance and cancer, this review offers valuable insights into the role of metabolic dysfunction in tumor progression. Addressing insulin resistance as a co-morbidity may open new avenues for risk assessment, early intervention, and the development of integrated treatment strategies to improve patient outcomes.

Proinflammatory diet is associated with higher pain, disease severity and biochemical parameters associated with inflammation in fibromyalgia

OBJECTIVE

Fibromyalgia, which is becoming increasingly common today, affects the quality of life of those affected. The aim of this study was to investigate the relationship between diet and pain, disease severity, and biochemical parameters in fibromyalgia.

DESIGN

Cross-sectional design using validated questionnaires.

SETTING

Fibroyalgia patients with Traditional and Complementary Medicine clinics.

SUBJECT

In total, 84 patients with fibromyalgia (FM), which was diagnosed by a rheumatologist.

METHODS

The cross-sectional study was conducted with 84 fibromyalgia patients in Turkey. The Dietary Inflammatory Index (DII) was calculated by a 24-hour diet recall. Self-reported pain levels and disease severity were evaluated by the Visual Analog Scale (VAS) and a Revised Fibromyalgia Impact Questionnaire (FIQR), respectively. Antropometric measures and biochemical parameters associated with inflammation were also evaluated.

RESULTS

Linear regression analysis revealed that the VAS pain score [β (95% confidence interval [CI])=1.72 (0.90-2.55), P < .001], FIQ-R [β (95% CI)=5.62 (0.14-11.09), P < .001] and uric acid/creatinine ratio [β (95% CI)=0.21 (-0.10 to 0.52), P < .001] were positively associated with the DII after adjustments for body mass index (BMI), body fat, fat free mass, cholesterol, fiber, caroten, iron, magnesium, vitamine C reported by the patients with FM.

CONCLUSIONS

A pro-inflammatory diet was associated with higher pain, disease severity and uric acid/creatinine ratio in patients with FM.

The Relationship and Mechanisms Between Body Mass Index and Autoimmune Hypothyroidism: Insights from Mendelian Randomization

BACKGROUND

Obesity is increasingly prevalent worldwide and has been linked to various health conditions, including hypothyroidism.

METHODS

Summary-level GWAS data from the UK Biobank and the FinnGen Biobank were used for Mendelian randomization analysis. The impact of BMI on autoimmune hypothyroidism through putative mediators was assessed through a four-step analytical process. Statistical analyses, including the inverse-variance-weighted (IVW) method, weighted median (WM), and MR-Egger methods, were employed to evaluate causal relationships and detect horizontal pleiotropy. Mediation analysis was performed using a two-step method to assess the causal relationships between BMI, putative mediators, and autoimmune hypothyroidism.

RESULTS

Higher BMI was associated with an increased risk of autoimmune hypothyroidism. Mean corpuscular volume, eosinophil count, and cystatin C levels were found to mediate this association.

CONCLUSIONS

BMI positively correlates with autoimmune hypothyroidism, with mean corpuscular volume, eosinophil count, and cystatin C levels mediating this relationship. Further research is needed to confirm these findings and explore causal relationships across diverse populations.

Plasmonic Graphene-Gold Nanostar Heterojunction for Red-Light Photoelectrochemical Immunosensing of C-Reactive Protein

The development of red-light photoelectrochemical (PEC) nanoimmunosensors offers new avenues for detecting clinically relevant biomarkers with high sensitivity and specificity. Herein, the first PEC nanoimmunosensor based on a plasmonic graphene and gold nanostar (AuNS) heterojunction excited with 765 nm red light is presented for label-free detection of C-reactive protein (CRP), a key biomarker of inflammation. This platform leverages the unique localized surface plasmon resonance effect of AuNSs in combination with in situ generated graphene to enhance photoelectrical conversion efficiency under 765 nm monochromatic light. This wavelength minimizes photodamage and interference from biological samples. By optimizing the nanoarchitecture and utilizing a bifunctional photoactive transduction platform, a linear detection range of 25-800 pg/mL is achieved, with a limit of detection as low as 13.3 pg/mL. The low-energy red-light activation, effective electron-hole pair separation, and signal amplification allow CRP's rapid, selective, and sensitive detection in real clinical samples from patients with low-grade chronic inflammation. The nanoimmunosensor demonstrated consistent analytical performance across multiple samples, showing potential for accurate biomarker monitoring in inflammatory disorders. This work highlights plasmonic nanomaterials to develop robust PEC immunosensors that provide scalable, noninvasive, automated, low-background noise as a highly sensitive alternative for clinical diagnostics.

Olea europaea L. cv. Nepal Leaf Extract Alleviates Dyslipidemia and Inflammation Related to Obesity in Rabbits: A Network Pharmacology Approach Revealing Effective Antihyperlipidemic Bioactive Compounds

The current study investigated the effects of Olea europaea L. cv. Nepal (OEN) leaf extract on obesity-related disorders in rabbits. OEN extract, in dose 100 mg/kg body weight, significantly reduced cholesterol (TC), triglycerides (TAG), and inflammatory markers (MCP-1, VCAM-1, IL-6, IL-1β, TNFα, NF-κB) in both preventative and treatment groups. In addition, heart tissue displayed near-normal collagen fiber distribution. LC-HRESIMS analysis tentatively identified 20 metabolites (1-20) in OEN, including lignans, secoiridoids, and triterpenoids. Network pharmacology analysis suggested 8-hydroxy-p-menth-1-en-7-oic-acid (13), 6,7-dihydroxy-2H-1-benzopyran-2-one 6-O-d-glucopyranoside (5), and 3-hydroxy-12-oleanen-28-oic-acid (20) as key antihyperlipidemic compounds, potentially targeting pathways involved in hyperlipidemia regulation. Furthermore, in silico studies revealed that lignans (compounds 1, 2, and 16) from OEN may bind and inhibit HMG-CoA reductase, a crucial enzyme in cholesterol metabolism. These results indicate the potential of using OEN leaf extract as a therapeutic strategy for managing hyperlipidemia and inflammation associated with obesity. More investigation is necessary to confirm and validate these results and explore the extract's full therapeutic potential.

Distinct Morning and Evening Fatigue Profiles in Patients With Gynecologic Cancers Receiving Chemotherapy

OBJECTIVES

To identify distinct morning and evening fatigue profiles in patients with gynecologic cancers and evaluate for differences in demographic and clinical characteristics, common symptoms, and quality-of-life outcomes.

SAMPLE & SETTING

Outpatients with gynecologic cancers (N = 233) were recruited before their second or third cycles of chemotherapy at four cancer centers in San Francisco Bay and New York.

METHODS & VARIABLES

The Lee Fatigue Scale was completed six times over two cycles of chemotherapy in the morning and in the evening. Latent profile analysis was used to identify distinct morning and evening fatigue profiles.

RESULTS

Four distinct morning and two distinct evening fatigue classes were identified. Common risk factors for morning and evening fatigue included younger age, higher body mass index, lower functional status, and higher comorbidity burden. Patients in the worst morning and evening fatigue classes reported higher levels of anxiety, depression, and sleep disturbance; lower levels of energy and cognitive function; and poorer quality of life.

IMPLICATIONS FOR NURSING

Clinicians can use this information to identify higher-risk patients and develop individualized interventions for morning and evening fatigue.

Investigation of calonysterone and 20-hydroxyecdysone effects in high-fat, high-sugar diet-induced obesity rat model

Globally, the incidence of obesity among adults has significantly risen since 1990, with a more than twofold rise in prevalence. Similarly, the incidence of obesity among adolescents has increased fourfold. Overweight constitutes a significant health and social issue in developed nations globally. Conventional therapies such as lifestyle modification (nutrition and physical activity) have limited weight reduction. Drug therapy is often not possible or cannot be afforded due to poor patient compliance or therapeutic side effects. 20-hydroxyecdysone (20E) is a worldwide used 'green anabolic' dietary supplement that has beneficial effects in some animal models of metabolic diseases. Our ongoing research examines the impacts of 20E and calonysterone (CAL) in an animal model with a diet high in fats and sugars (HFHSD). Glucose tolerance tests assessed prediabetic status and RT-PCR and Western blot analysis determined interleukin-6 (IL6) expression. The concertations of superoxide dismutase, catalase, adiponectin, leptin, and IL-6 were quantified by ELISA. Total antioxidant capacity was assessed using a colorimetric assay kit, and global DNA methylation was also measured. CAL entirely prevented HFHSD-induced obesity and decreased the inflammatory cytokine (IL6) level and antioxidant activity in our model. Both 20E and CAL normalized the changed plasma concentration of adiponectin and leptin after the HFHS diet. The administration of CAL and 20E in obese rats significantly increased the percent of total DNA methylation. This is the first in vivo study on this natural ecdysteroid, which may offer new alternatives for treating metabolic diseases. Based on our findings, we are supposed to show new preventive possibilities for overweight-induced chronic progressive diseases.

Screening for coronary artery disease among cancer survivors: rationale and design of the REDEEM-CAD study

BACKGROUND

Cancer survivors are reported to be at a heightened risk of coronary artery disease (CAD) due to shared risk factors, potentially cardiotoxic cancer treatments and premature aging in survivors. Early identification of those who are at greater risk, followed by protective treatment, can prevent CAD progression. However, to date there was a relative paucity of prospective data to optimally guide management of atherosclerotic coronary risk among cancer survivors.

METHODS

The REDEEM-CAD (Risk-guidEd DisEasE Management plan to prevent CAD in patients with previous cancer) study is a prospective cohort study conducted in Victoria and Tasmania, Australia aiming to evaluate the efficacy of a comprehensive CAD screening strategy. Cancer survivors aged ≥ 40 years with cancer treatment ≥ 5 years prior are eligible for the study. Consented participants will be stratified into low, intermediate or high risk of major atherosclerotic adverse events based on clinical assessment and biochemistry tests. Subsequently, those within the intermediate risk will be referred for coronary artery calcium (CAC) scoring, with computed tomography coronary angiography (CTCA) completed where CAC > 0 and < 400. Participants with high risk or CAC > 400 will be informed about strategies (including lipid-lowering therapy) to manage asymptomatic CAD. Those with low clinical risk or CAC = 0 will conclude their participation while those with CTCA imaged at baseline will be referred for a follow-up CTCA 2-year post-baseline. The primary endpoint is to identify the prevalence of CAD, identified via CAC scoring, among cancer survivors classified as intermediate risk. Secondary endpoint includes the absolute change in total coronary plaque volume over 24 months among those imaged at baseline and follow-up. The REDEEM-CAD study will be the first study to systematically evaluate risk of CAD in cancer survivors, and subsequent responsiveness to coronary risk reduction. This will offer valuable insights into the efficacy of the CAD screening strategies among cancer survivors and the impact of treatment on managing plaque progression.

TRIAL REGISTRATION

NCT05366153.

Dietary, metabolic and gut microbiota influences on primary ovarian failure: a two-sample Mendelian randomization study

BACKGROUND AND OBJECTIVES

Previous studies have reported there were associations between ovarian function and dietary factors, metabolic factors and gut microbiota. However, it is unclear whether causal associations exist. We aimed to explore the causal relationship of these factors with risk of primary ovarian failure (POF).

METHODS AND STUDY DESIGN

Two-sample Mendelian randomization (MR) analysis was performed to genetically predict the causal effects of dietary and metabolic factors and gut microbiota on POF. The inverse variance weighted (IVW) method was used as the primary statistical method. A series of sensitivity analyses, including weighted median, MR-Egger, simple mode, weighted mode methods, and leave-one-out analysis, were conducted to assess the robustness of the MR analysis results.

RESULTS

IVW analysis revealed that cigarettes smoked per day, coffee intake and cooked vegetable intake were not causally correlated with POF at the genetic level. However, POF were associated with fresh fruit intake, BMI, Eubacterium (hallii group), Eubacterium (ventriosum group), Adlercreutzia, Intestinibacter, Lachnospiraceae (UCG008), and Terrisporobacter. These findings were robust according to extensive sensitivity analyses.

CONCLUSIONS

This study identified several dietary factors, metabolic factors and gut microbiota taxa that may be causally implicated in POF, potentially offering new therapeutic targets.

Exploring the mechanisms and relationship between body mass index and asthma: findings from Mendelian randomization

BACKGROUND

The mechanism linking BMI and asthma remains unclear.

METHOD

Mendelian Randomization (MR) analysis was conducted using summary-level GWAS data from the FinnGen Biobank and the Open GWAS project. The analysis considering potential variables as mediators, including blood cell counts, blood pressure, and blood biomarkers. Three commonly used MR methods-the inverse-variance-weighted (IVW) method, weighted median (WM) method, and MR-Egger method-were employed to infer causal links. A two-step approach was used in mediation analysis to evaluate the causal links among BMI, candidate mediators, and asthma.

RESULT

Elevated BMI demonstrated a substantial correlation with increased asthma risk. Thirteen biomarkers mediated the relationship between BMI and asthma, mainly including leukocyte count (5.070%), apolipoprotein A levels (7.395%), cystatin C levels (5.345%), urate levels (9.057%), diastolic blood pressure (7.365%), and albumin levels (10.888%). These factors collectively explained over 50% of the increased asthma risk associated with BMI elevation. Additionally, eosinophil count and C-reactive protein were also identified as important mediators using the WM method.

CONCLUSION

This study highlights the complex relationship between obesity, blood biomarkers, and asthma risk. Additional studies are required to validate these results and investigate causal relationships in various populations.

Predictive Value of Complete Blood Count (CBC)-Derived Indices-C-Reactive-Protein-Albumin-Lymphocyte index (CALLY), Glucose-to-Lymphocyte Ratio (GLR), Prognostic Nutritional Index (PNI), Hemoglobin, Albumin, Lymphocyte, Platelet (HALP), and Controlling Nutritional Status (COUNT)-on Body Composition Changes After Bariatric Surgery

BACKGROUND/OBJECTIVE

Obesity is linked to increased risks of cardiovascular disease, diabetes, and certain cancers. Bariatric surgery (BS) aids in weight management, significantly altering body composition. This study evaluates the predictive value of five complete blood count (CBC)-derived indices [C-reactive-protein-albumin-lymphocyte (CALLY), glucose-to-lymphocyte ratio (GLR), prognostic nutritional index (PNI), hemoglobin, albumin, lymphocyte, platelet (HALP), and controlling nutritional status (COUNT)] on body composition changes post-BS.

METHOD

A retrospective study was conducted on 240 patients undergoing BS at Sina Hospital, Tehran, Iran. Indices were calculated using routine laboratory tests, and body composition changes were measured using bioelectrical impedance analysis at 3 and 6 months post-surgery.  RESULTS: Higher pre-surgical GLR values positively correlated with increased fat-free mass (FFM) (p = 0.005 1, p = 0.003 2), muscle mass (MM) (p = 0.011 1, p = 0.008 2), and total body water (TBW) (p = 0.005 1, p = 0.005 2) post-surgery. In contrast, higher PNI was negatively associated with changes in FM (p = 0.029 1, p = 0.015 2), FFM (p = 0.002 1, p = 0.018 2), TBW (p = 0.002 1, p = 0.015 2) and MM (p = 0.003 2), particularly after laparoscopic sleeve gastrectomy (LSG). Furthermore, there was a significant correlation between pre-surgical HALP score and changes in FFM (p = 0.002 1, p = 0.042 2), TBW (p = 0.002 1) and MM (p = 0.011 1, p = 0.041 2). In addition, the modified HALP score showed a more significant correlation compared to the HALP score to predict the changes FM (p = 0.002 1, p = 0.002 2), FFM (p = 0.001 1, p = 0.006 2), TBW (p = 0.001 1, p = 0.003 2) and MM (p = 0.001 1, p = 0.023 2) particularly, after 6 months.

CONCLUSION

Our findings suggest that pre-surgical assessment of GLR, PNI, and HALP indices may provide valuable insights into predicting changes in body composition after bariatric surgery. Specifically, these indices could serve as tools for tailoring preoperative nutritional strategies and post-surgical interventions. However, as this study is retrospective, further prospective research with longer follow-ups is required to validate these findings and evaluate their utility in clinical practice. 1 3 months after metabolic bariatric surgery. 2 6 months after metabolic bariatric surgery.

Immunometabolic Changes Following Gastric Bypass and Sleeve Gastrectomy: A Comparative Study

BACKGROUND

Immunometabolism is the interaction between immune system and nutrient metabolism. Severe obesity is considered a state of meta-inflammation associated with obesity that influences the development of chronic-degenerative diseases.

OBJECTIVE

We aimed to establish the immunometabolic differences in bariatric patients and to determine whether cellular immunity is associated with metabolic changes.

METHODOLOGY

We conducted an observational study in patients who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB). We explored the differences in the immunometabolic profile before and after surgery in the study group, by surgical technique, and we evaluated the changes in immunological variables as a function of metabolic variables with correlation analysis.

RESULTS

The follow-up rate was 88.7%. After the intervention, there were changes in cellular immunity, with a decrease in effector T lymphocytes (CD8+CD28-) and an increase in B lymphocytes, memory helper T cells, and cytotoxic T lymphocytes. LSG resulted in a greater decrease in (CD4+CD62-) T lymphocytes compared with LRYGB. Patients who underwent surgery with LRYGB presented greater clinical and metabolic improvements, as well as improvement of obesity-associated medical problems. Women who underwent LRYGB showed a greater reduction in fat-free mass compared with women who underwent LSG.

CONCLUSION

Bariatric surgery, mainly LRYGB, leads to immunometabolic changes and improves associated medical problems.

Comparative assessment of phenotypic markers in patients with chronic inflammation: Differences on Bifidobacterium concerning liver status

BACKGROUND

The relationship between systemic lupus erythematosus (SLE) and low-grade metabolic inflammation (MI) with the microbiota is crucial for understanding the pathogenesis of these diseases and developing effective therapeutic interventions. In this context, it has been observed that the gut microbiota plays a key role in the immune regulation and inflammation contributing to the exacerbation through inflammatory mediators. This research aimed to describe similarities/differences in anthropometric, biochemical, inflammatory, and hepatic markers as well as to examine the putative role of gut microbiota concerning two inflammatory conditions: SLE and MI.

METHODS

Data were obtained from a cohort comprising adults with SLE and MI. Faecal samples were determined by 16S technique. Statistical analyses compared anthropometric and clinical variables, and LEfSe and MetagenomeSeq were used for metagenomic data. An interaction analysis was fitted to investigate associations of microbiota with fatty liver index (FLI) depending on the inflammatory condition.

RESULTS

Participants with low-grade MI showed worse values in anthropometry and biochemicals compared with patients with SLE. The liver profile of patients with MI was unhealthier, while no relevant differences were found in most of the inflammatory markers between groups. LEfSe analysis revealed an overrepresentation of Bifidobacteriaceae family in SLE group. An interactive association between gut Bifidobacterium abundance and type of disease was identified for FLI values, suggesting an effect modification of the gut microbiota concerning liver markers depending on the inflammatory condition.

CONCLUSION

This study found phenotypical and microbial similarities and disparities between these two inflammatory conditions, evidenced in clinical and hepatic markers, and showed the interactive interplay between gut Bifidobacterium and liver health (measured by FLI) that occur in a different manner depending on the type of inflammatory disease. These results underscore the importance of personalized approaches and individual microbiota in the screening of different inflammatory situations, considering unique hepatic and microbiota profiles.

Mango Consumption Is Associated with Increased Insulin Sensitivity in Participants with Overweight/Obesity and Chronic Low-Grade Inflammation

Background/Objectives: Chronic low-grade inflammation is associated with insulin resistance and poor glycemic control, leading to the development of type 2 diabetes mellitus (T2DM). The present study investigated the effect of regular mango intake on inflammation and insulin sensitivity in participants with overweight or obesity and chronic low-grade inflammation. Methods: A human clinical study was performed using a randomized, controlled, two-arm, parallel design with a 2 h oral glucose tolerance test (OGTT) administered before and after 4 weeks (4 W) of mango or control product intake (1 cup/twice a day). Fasting and time course blood sampling for 2 h post-OGTT were analyzed for effects on plasma metabolic and inflammation endpoints using analysis of covariance and repeated-measure approaches (SAS 9.4). Results: Forty-eight adults (37.6 ± 2.8 years, 30.5 ± 4.1 BMI kg/m2) completed the study. Markers of inflammation (IL-6, TNFα, hs-CRP) were not different at the end of 4 W (p > 0.05). The intervention did not significantly influence fasting glucose concentrations; however, insulin was significantly lowered with the mango compared to the control intervention (8.2 ± 1.2 vs. 15.3 ± 1.2 µIU/mL respectively, p = 0.05). Furthermore, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), along with the disposition index (DI), was significantly improved in the mango compared to the control interventions (HOMA-IR, 2.28 ± 1.19 vs. 4.67 ± 1.21, p = 0.03; DI, 2.76 ± 1.02 vs. 5.37 ± 1.03, p = 0.04). Mean insulin concentrations were also significantly lower at W4 compared to W0 after the OGTT in the mango vs. control intervention (intervention × week effect, p = 0.04). Relative expression of nuclear factor erythroid 2-related factor 2 (Nrf-2), a gene regulating endogenous antioxidant defense, was non-significantly increased twofold in the mango intervention (W4 vs. W0). Conclusions: Collectively, the data suggest that mango intake increased insulin sensitivity in individuals with chronic low-grade inflammation, possibly through activating Nrf-2 genes and increasing cellular antioxidant status. The data warrant further research on consuming mango fruit as part of a dietary pattern to address insulin resistance and the mechanisms underpinning the actions of mango intake.

Asthma and obesity increase inflammatory markers in children

Background

Asthma and obesity are both characterized by inflammation. However, the combined impact of these conditions on inflammatory mechanisms in children has not been studied extensively. To address this gap, we investigated the interaction effects of asthma and obesity on inflammation in children.

Methods

The multiplex and singleplex assays were used to measure the levels of circulating cytokines, including IL-2, IL-5, IL-10, IL-13, IL-17A, IL-22, IL-33, IFN-γ, TNF-α, and the adipokine leptin, in plasma. The study included 97 children with normal weight and asthma (NW-A), 100 children with overweight/obesity and asthma (OO-A), 100 with overweight/obesity and no asthma (OO), and 67 normal weight children and no asthma (NW). The independent effects of asthma, obesity, and their interaction effect on these inflammatory markers were assessed using multiple regression analysis.

Results

Asthma was associated with the increased expression of pro-inflammatory cytokines, including IL-2, IL-5, IL-13, IL-17A, IL-22, IL-33, and TNF-α, and reduced levels of anti-inflammatory cytokine, IL-10 and adipokine, leptin in the circulation. Overweight/obesity was also linked to increased plasma levels of IL-5, IL-17A, IL-22, IL-33, TNF-α, and leptin and decreased levels of IL-10. In addition, obesity and asthma showed a significant interaction effect on the plasma levels of IL-5, IL-10, IL-17A, IL-33, TNF-α, and leptin. However, the interaction did not result in a synergistic or additive impact on cytokines, indicating a moderating effect of obesity on inflammation in pediatric asthma.

Conclusion

Both asthma and overweight/obesity were independently associated with increased expression of pro-inflammatory cytokines and decreased expression of anti-inflammatory cytokine in children. While the concurrent presence of asthma and obesity altered the inflammatory profile, it did not synergistically amplify the inflammation. These findings challenge the previous view that obesity enhances inflammation in individuals with asthma and highlight the importance of considering both conditions while treating obesity-associated asthma in children. Future studies are necessary to further explore the mechanisms that link obesity and asthma in the pediatric population.

Sperm-borne small non-coding RNAs: potential functions and mechanisms as epigenetic carriers

Over the past two decades, the study of sperm-borne small non-coding RNAs (sncRNAs) has garnered substantial growth. Once considered mere byproducts during germ cell maturation, these sncRNAs have now been recognized as crucial carriers of epigenetic information, playing a significant role in transmitting acquired traits from paternal to offspring, particularly under environmental influences. A growing body of evidence highlights the pivotal role of these sncRNAs in facilitating epigenetic inheritance across generations. However, the exact mechanisms through which these paternally supplied epigenetic carriers operate remain unclear and are under hot debate. This concise review presents the most extensive evidence to date on environmentally-responsive sperm-borne sncRNAs, encompassing brief summary of their origin, dynamics, compartmentalization, characteristics, as well as in-depth elaboration of their functional roles in epigenetic and transgenerational inheritance. Additionally, the review delves into the potential mechanisms by which sperm-delivered sncRNAs may acquire and transmit paternally acquired traits to offspring, modulating zygotic gene expression and influencing early embryonic development.

Associations between body mass index, high-sensitivity C-reactive protein, and depressive symptoms: NHANES 2015-2016

Objective

Studies have shown associations between Body Mass Index (BMI), High-Sensitivity C-reactive protein (HSCRP), and depressive symptoms(DP). However, the complex relationship between them remains uncertain. The objective of this research is to examine the correlation between them in a substantial sample that is representative of the national level.

Methods

Our analysis was based on the 2015-2016National Health and Nutrition Examination Survey (NHANES).DP was measured by the Patient Health Questionnaire-9 (PHQ-9). Using multivariable logistic regression analysis and stratified analysis, we examined the relationship between BMI, HSCRP, and DP. We applied generalized additive models to explore the non-linear relationships among variables.

Results

This study included a total of 4834 participants. The results revealed that BMI (P=0.002) and HSCRP (P=0.008) were risk factors for DP. The relationship between BMI and DP (P=0.035), BMI and HSCRP (P<0.001) were non-linear. The nonlinear association between HSCRP and DP (P=0.031), BMI and DP (P=9e-04) is significant in females when stratified by gender. No nonlinear association was found between BMI and DP (P =0.677) and between HSCRP and DP (P =0.439) in males. The results of the interaction test reveal a significant interaction between HSCRP and gender.

Conclusions

Research has found both BMI and HSCRP are risk factors for DP and the relationship between them was non-linear. The nonlinear associations between BMI and DP, as well as between HSCRP and DP, are gender-dependent.

Weight cycling exacerbates glucose intolerance and hepatic triglyceride storage in mice with a history of chronic high fat diet exposure

BACKGROUND

Obese subjects undergoing weight loss often fear the Yoyo dieting effect, which involves regaining or even surpassing their initial weight. To date, our understanding of such long-term obesity and weight cycling effects is still limited and often based on only short-term murine weight gain and loss studies. This study aimed to investigate the long-term impacts of weight cycling on glycemic control and metabolic health, focusing on adipose tissue, liver, and hypothalamus.

METHODS

Chow-fed mice and mice subjected to prolonged high-fat diet (HFD) consumption for 20 weeks, followed by 24 weeks of dietary interventions to either induce weight gain, weight loss, or weight cycling were monitored for perturbations in feeding efficiency and glucose homeostasis. Post-mortem analyses included qPCR, Western Blotting, biochemical and microscopical assessments for hepatic steatosis and insulin resistance, hypothalamic and adipose tissue inflammation, and circulating lipid, leptin and IL-6 levels.

RESULTS

Weight cycling led to hyperphagia and rapid weight regain, matching the weights of mice continuously on HFD. Despite weight loss, adipose tissue inflammation persisted with elevated pro-inflammatory markers, macrophage infiltration, and impaired Glut4 expression. HFD-induced dysregulation in hypothalamic expression of orexigenic peptides and synaptic plasticity markers persisted also after weight normalization suggesting long-lasting neural alterations. Weight-cycled mice exhibited higher circulating IL-6 and leptin levels, increased hepatic lipid storage, and dysregulated glucose metabolism compared to those with consistent diets, indicating worsened metabolic effects by Yoyo dieting.

CONCLUSION

In sum, our study highlights significant metabolic risks associated with weight cycling, particularly following prolonged obesity. Persistent adipose tissue inflammation, perturbed neural peptide and plasticity markers and impaired glucose tolerance emphasize the need for effective and sustainable weight loss strategies to mitigate the adverse outcomes of weight regain and improve long-term metabolic health.

Interplay of calcium pyrophosphate crystals, oxidative stress, and clinical features on knee osteoarthritis severity

BACKGROUND

Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).

OBJECTIVES

To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.

METHODS

Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H2O2 levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.

RESULTS

Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r =  - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r =  - 0.431, P = 0.011), WBC with H2O2 (r = 0.454, P = 0.007), and ROS with H2O2 (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H2O2 and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).

CONCLUSION

ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.

Key Players in the Complex Pathophysiology of Obesity: A Cross-Talk Between the Obesogenic Genes and Unraveling the Metabolic Pathway of Action of Capsaicin and Orange Peel

Obesity is a widespread prevailing health concern with multifactorial causes. Among the various defined molecular targets associated with obesity, peroxisome proliferator activated receptor gamma, leptin, ghrelin, and adiponectin play crucial roles in fundamental processes including energy balance, adipose tissue biology, and metabolic health, making them particularly significant in the study of obesity.Capsaicin and orange peel exhibit promising anti-obesity properties through their thermogenic, metabolic, and anti-inflammatory effects. Potential pathways for therapeutic approaches in the management of obesity are provided by these targets. The lipid-lowering and anti-obesity benefits of specific plant species have been highlighted in Asian medicine. Due to the potential anti-obesity qualities, capsaicin, which is derived from chilli peppers, and orange peel extract has been focused in this review. Capsaicin causes apoptosis in preadipocytes and adipocytes and suppresses adipogenesis. Citrus fruits are a significant source of bioactive substances, primarily flavonoids. Due to their ability to reduce adipocyte development and cellular lipid content, citrus polyphenols are helpful in the control of obesity. This extensive analysis offers insights into new treatment approaches for the prevention and management of obesity and metabolic syndrome by examining the interactions of molecular variables in obesity as well as the possible anti-obesity advantages of capsaicin and orange peel extract.

The Effect of Anthocyanin Supplementation on Pro-Inflammatory Biomarkers in Patients With Metabolic Disorders: A Grade-Assessed Systematic Review and Meta-Analysis

Introduction and Aim

Patients with metabolic disorders benefit from using anthocyanins. Nevertheless, the findings drawn from extant trials remain contentious. Thus, this meta-analysis evaluated anthocyanin's effect on inflammatory biomarkers in patients with metabolic disorders.

Materials and Methods

We comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and CENTRAL, from their inception to June 14, 2024.

Findings

A total of 11 randomized controlled clinical trials with 14 arms were analyzed. There was no significant effect of anthocyanin supplementation on interleukin (IL)-1β levels (standardized mean difference [SMD] = -0.01, 95% CI: -0.33, 0.31; P = 0.941, I 2 = 62.4%, P = 0.031), tumor necrosis factor-α (TNF-α) (SMD = -0.49, 95% CI: -1.07, 0.09; P = 0.098, I 2 = 94.0%, P < 0.001) and IL-6 (SMD = -0.69, 95% CI: -1.45, 0.06; P = 0.073, I 2 = 95.2%, P < 0.001), respectively. A significant between-study heterogeneity was identified, which was reduced when subgrouping by sample size, dosage, and study population. However, subgroup analysis showed that it might decrease TNF-α and IL-6 in patients with hypertension, and if the intervention lasted less than 12 weeks.

Conclusions

There was no significant impact of anthocyanin supplementation on IL-1β, TNF-α, and IL-6; however, it should be noted that the intervention has a decreasing impact on individuals with hypertension. Our observed effect sizes on IL-1β, TNF-α, and IL-6 are not clinically important.

Trained innate immunity as a potential link between preeclampsia and future cardiovascular disease

Preeclampsia (PE) is a complex pregnancy syndrome characterized by hypertension with or without proteinuria, affecting 2-6% of pregnancies globally. PE is characterized by excessive release of damage-associated molecular patterns (DAMPs) into the maternal circulation. This DAMP-rich milieu acts on innate immune cells, inducing a proinflammatory state characterized by elevated cytokines such as IL-1β and IL-18. This proinflammatory state in the mother and placenta results in the endothelial dysfunction strongly associated with cardiovascular disorders. While the immediate maternal and fetal risks of PE are well-documented, accumulating evidence indicates that PE also confers long-term cardiovascular risks to the mother, including hypertension, coronary heart disease, stroke, and heart failure. The underlying mechanisms connecting PE to these chronic cardiovascular conditions remain unclear. This article explores the potential role of trained innate immunity (TRIM) as a mechanistic link between PE and increased long-term cardiovascular risk. We propose that the persistent exposure to DAMPs during PE may epigenetically reprogram maternal innate immune cells and their progenitors, leading to TRIM. This reprogramming enhances the inflammatory response to subsequent stimuli, potentially contributing to endothelial dysfunction and chronic inflammation that predispose women to cardiovascular diseases later in life. Understanding the role of TRIM in PE could provide novel insights into the pathophysiology of PE-related cardiovascular complications and identify potential targets for therapeutic intervention. Further research is warranted to investigate the epigenetic and metabolic alterations in innate immune cells induced by PE and to determine how these changes may influence long-term maternal cardiovascular health.

Machine Learning-Driven Metabolic Syndrome Prediction: An International Cohort Validation Study

Background/Objectives: This study aimed to develop and validate a machine learning (ML)-based metabolic syndrome (MetS) risk prediction model. Methods: We examined data from 6155 participants of the China Health and Retirement Longitudinal Study (CHARLS) in 2011. The LASSO regression feature selection identified the best MetS predictors. Nine ML-based algorithms were adopted to build predictive models. The model performance was validated using cohort data from the Korea National Health and Nutrition Examination Survey (KNHANES) (n = 5297), the United Kingdom (UK) Biobank (n = 218,781), and the National Health and Nutrition Examination Survey (NHANES) (n = 2549). Results: The multilayer perceptron (MLP)-based model performed best in the CHARLS cohort (AUC = 0.8908; PRAUC = 0.8073), the logistic model in the KNHANES cohort (AUC = 0.9101, PRAUC = 0.8116), the xgboost model in the UK Biobank cohort (AUC = 0.8556, PRAUC = 0.6246), and the MLP model in the NHANES cohort (AUC = 0.9055, PRAUC = 0.8264). Conclusions: Our MLP-based model has the potential to serve as a clinical application for detecting MetS in different populations.

Gout and Hyperuricemia: A Narrative Review of Their Comorbidities and Clinical Implications

Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate crystals in the joints due to elevated serum uric acid levels. Its prevalence and associated healthcare burden have been rising in recent decades, a trend expected to continue. It is crucial to recognize that gout and hyperuricemia are not merely causes of painful joint flares, but systemic metabolic disorders linked to a broad spectrum of comorbidities such as cardiovascular diseases, chronic kidney disease, diabetes, insulin resistance, steatotic liver disease, osteoarthritis, and respiratory and eye diseases. Numerous risk factors for gout and hyperuricemia have been identified, with recent research uncovering further associations with other conditions. To optimize patient outcomes, gout and hyperuricemia must be addressed through a holistic approach that accounts for these risk factors while providing comprehensive management of related comorbidities affecting various organ systems. This review summarizes the current knowledge on the risk factors, comorbidities, and clinical implications of gout and hyperuricemia. Future research should focus on improving patient outcomes by tailoring treatments individually and addressing the underlying metabolic comorbidities of gout with multimodal treatment.

The Interplay of Uterine Health and Obesity: A Comprehensive Review

Uterine physiology encompasses the intricate processes governing the structure, function, and regulation of the uterus, a pivotal organ within the female reproductive system. The escalating prevalence of obesity has emerged as a significant global health issue, profoundly impacting various facets of well-being, including female reproductive health. These effects extend to uterine structure and function, influencing reproductive health outcomes in women. They encompass alterations in uterine morphology, disruptions in hormonal signaling, and inflammatory processes. Insulin and leptin, pivotal hormones regulating metabolism, energy balance, and reproductive function, play crucial roles in this context. Insulin chiefly governs glucose metabolism and storage, while leptin regulates appetite and energy expenditure. However, in obesity, resistance to both insulin and leptin can develop, impacting uterine function. Inflammation and oxidative stress further exacerbate the development of uterine dysfunction in obesity. Chronic low-grade inflammation and heightened oxidative stress, characteristic of obesity, contribute to metabolic disruptions and tissue damage, including within the uterus. Obesity significantly disrupts menstrual cycles, fertility, and pregnancy outcomes in women. The accumulation of excess adipose tissue disrupts hormonal equilibrium, disturbs ovarian function, and fosters metabolic irregularities, all of which detrimentally impact reproductive health.

Ziziphus jujuba (Jujube) in Metabolic Syndrome: From Traditional Medicine to Scientific Validation

PURPOSE OF REVIEW

This review evaluates the therapeutic potential of Ziziphus jujuba and its main components in managing complications of metabolic syndrome, including diabetes, dyslipidemia, obesity, and hypertension.

RECENT FINDINGS

The reviewed studies provide evidence supporting the use of Z. jujuba and its main components (lupeol and betulinic acid) as natural treatments for complications of metabolic syndrome. These substances enhance glucose uptake through the activation of signaling pathways such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt), reduce hepatic glucose synthesis, and increase glucose uptake by adipocytes and skeletal muscle cells. They also improve insulin sensitivity by modulating AMP-activated protein kinase (AMPK) activity and regulating insulin signaling proteins and glucose transporters. In the field of dyslipidemia, they inhibit triglyceride synthesis, lipid accumulation, and adipogenic enzymes, while influencing key signaling pathways involved in adipogenesis. Z. jujuba and its constituents demonstrate anti-adipogenic effects, inhibiting lipid accumulation and modulating adipogenic enzymes and transcription factors. They also exhibit positive effects on endothelial function and vascular health by enhancing endothelial nitric oxide synthase (eNOS) expression, NO production, and antioxidant enzyme activity. Z. jujuba, lupeol, and betulinic acid hold promise as natural treatments for complications of metabolic syndrome. They improve glucose metabolism, insulin sensitivity, and lipid profiles while exerting anti-adipogenic effects and enhancing endothelial function. However, further research is needed to elucidate the mechanisms and confirm their efficacy in clinical trials. These natural compounds offer potential as alternative therapies for metabolic disorders and contribute to the growing body of evidence supporting the use of natural medicines in their management.

10-Gingerol reduces cytoplasmic lipid droplets and induces lipolysis in 3T3-L1 adipocytes

Obesity is a globally prevalent metabolic disorder characterized by an increased number of adipose cells and excessive fat in adipocytes. Herbal medicines, such as ginger, have shown potential in treating obesity by inhibiting adipogenesis and reducing adipocyte hypertrophy. Ginger contains bioactive compounds, particularly gingerols, which have demonstrated anti-adipogenic and/or lipolytic effects. However, research on the effects of 10-gingerol on adipose tissue remains limited. This study aimed to evaluate the effect of 10-gingerol on lipid content, lipolysis markers, and the expression of genes related to lipid metabolism in 3T3-L1 adipocytes. Three groups were analyzed: a negative control (preadipocytes), a positive control (mature adipocytes), and a group treated with 10-gingerol (10-G). Results showed that 10-G reduced lipid accumulation by 42.16% in mature adipocytes compared to the control, without affecting cell viability. Additionally, 10-G increased glycerol release and downregulated lipogenic genes such as Pparγ, Acaca, Fabp4, and Mtor, while upregulating genes related to fatty acid oxidation, including Cebpα, Cpt1a, Lipe, and Prkaa1. In conclusion, 10-gingerol reduces lipid content in mature adipocytes by downregulating lipogenesis, increasing lipolysis, and enhancing fatty acid oxidation.

Palmitic acid and eicosapentaenoic acid supplementation in 3T3 adipocytes: impact on lipid storage and oxidative stress

OBJECTIVES

Obesity is a worldwide public health problem, predisposing individuals to serious cardiovascular and metabolic complications such as type 2 diabetes mellitus. White adipose tissue serves as an important regulator of energy balance, and its expansion in obesity can trigger inflammatory reactions and oxidative stress, which can also lead to insulin resistance. Adipocytes, with a key role in regulating metabolic homeostasis, respond to increased calorie intake and altered fatty acid composition with hypertrophy or hyperplasia. Of particular interest are saturated fatty acids such as palmitic acid and omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA), which have differential effects on adipocyte function and inflammation.

METHODS

Using 3T3-L1 cells as a model for adipocytes, we evaluated the effects of PA and EPA on lipid accumulation, droplet size, and oxidative stress markers.

RESULTS

We were able to show that EPA supplementation in 3T3 adipocytes does not lead to excessive lipid accumulation, but rather reduces the size of lipid droplets and also induces redox changes due to the unsaturated nature of EPA.

DISCUSSION

These results emphasize the contrasting roles of PA and EPA and the importance of fatty acid composition in the regulation of adipocyte function.

Long-term real-world evidence of SB5 (adalimumab biosimilar) treatment in patients with moderate-to-severe psoriasis from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR)

BACKGROUND

SB5 (adalimumab-bwwd) is an adalimumab biosimilar targeting tumor necrosis factor (TNF) for the treatment of chronic inflammatory diseases, including moderate-to-severe chronic plaque psoriasis.

OBJECTIVES

To assess the four-year persistence associated with the effectiveness and safety of SB5 in patients with psoriasis in the UK and Ireland.

METHODS

This prospective study included 1195 SB5-treated patients using British Association of Dermatologists' Biologic Interventions Register (BADBIR) between 01 June 2018 and 31 August 2022. Persistence was defined as the time from biologic therapy initiation to discontinuation and Kaplan-Meier analysis was used to evaluate SB5 discontinuation rates. Cox regression was used to investigate the effect of covariates on the time-to-first-discontinuation of SB5 with the potential covariates.

RESULTS

SB5 one-, two-, three-, and four-year discontinuation rates were 26.5%, 37.2%, 41.9%, and 43.3%, respectively. Tested covariates such as switching, age, sex, body mass index (BMI), and duration of psoriasis did not significantly affect the discontinuation rate of SB5.

CONCLUSIONS

Median persistence of SB5 in predominantly bio-naïve psoriasis patients was about 2.5 years in clinical practice. The results suggest that SB5 can be confidently used for patients with psoriasis, offering comparable outcomes to reference adalimumab.

Overlapping and Distinct Physical and Biological Phenotypes in Pure Frailty and Obese Frailty

BACKGROUND

Pure frailty and obese frailty are common types of frailty syndrome. However, the overlapping and distinct characteristics between pure frailty and obese frailty remain unclear. This study aims to reveal the overlapping/distinct physical and biological phenotypes of pure frailty and obese frailty, providing theoretical support for their prevention, diagnosis, and treatment.

METHOD

Mice were fed either a normal or high-fat diet and assessed at 20 months of age. They were assigned to one of the four groups: control, obesity, pure frailty, and obese frailty. Grip strength, walking speed, physical activity, endurance, and body weight were measured to determine pure frailty and obese frailty. Physical and biological phenotypes were assessed.

RESULTS

Distinct physical phenotypes were observed between pure frailty and obese frailty in terms of body weight, lean mass, fat mass, fat mass in tissue, grip strength, endurance, and physical activity, while walking speed overlapped. In biological phenotypes, levels of Smad2/3, FoxO3a, P62, LAMP-2, and cathepsin L expression were distinct, while AKT, p-AKT, mTOR, p-mTOR, p-Smad2/3, p-FoxO3a, Beclin-1, ATG7, and LC3 overlapped.

CONCLUSION

Distinct physical phenotypes observed in obese frailty are primarily attributable to the effect of obesity, with further impairment of muscle function resulting from the combined effects of frailty syndromes and obesity. Pure frailty and obese frailty share overlapping biological phenotypes, particularly in the regulation of muscle protein synthesis. Moreover, the interaction between obesity and frailty syndromes gives rise to both overlapping and distinct biological phenotypes, especially in the regulation of specific degradation signaling proteins.

Body mass index and fat influences the role of Bifidobacterium genus in lupus patients concerning fibrinogen levels

Introduction

Metabolic disorders and autoimmune diseases elicit distinct yet interconnected manifestations of inflammation, which may be boosted by an excess of body adiposity. The purpose of this investigation was to analyze anthropometric, biochemical, and inflammatory/coagulation variables concerning patients diagnosed with systemic lupus erythematosus (SLE) exploiting low-grade metabolic inflammation (MI), as reference.

Methods

A population stratification by body mass index (BMI), allowed to assess the impact of adiposity on the putative role of gut microbiota composition on coagulation markers. A total of 127 participants with MI and SLE were categorized into two main groups based on their BMI, following WHO criteria: a low BMI group (<30 kg/m2) and a high BMI group (≥30 kg/m2). Each group included recorded data on demographics, comorbidities, and key clinical markers. Anthropometric and body composition variables, clinical features, and inflammatory/coagulation markers were measured while fecal 16S rRNA sequencing was examined at the genus Bifidobacterium. Regression models were fitted to evaluate the relationship between gut microbiota, inflammatory/coagulation markers, and body weight in these types of diseases.

Results

The study revealed worse clinical outcomes in anthropometric, body composition, and clinical markers in low-grade MI conditions as compared to SLE. However, inflammatory and coagulation markers such as C-reactive protein (CRP) and fibrinogen were significantly more elevated in patients with SLE, which was exacerbated by high BMI/ body fat as compared to the other screened groups. An interaction analysis revealed that fibrinogen levels showed different trends when Bifidobacterium was increased depending on BMI/adiposity, which evidenced an effect modification by this microorganism in patients with SLE.

Discussion

These findings underline that gut microbiota composition, particularly the presence of Bifidobacterium, may play a crucial role in modulating inflammation and coagulation processes in patients with SLE and high fat. These insights highlight the potential of targeting gut microbiota as a therapeutic strategy to mitigate inflammation and improve clinical outcomes in SLE patients.

The Action of Colchicine in Patients with Metabolic Syndrome and Obesity: Perspectives and Challenges

Colchicine is an alkaloid traditionally used to treat inflammatory conditions such as gout and familial Mediterranean fever. Currently, there are proposals for the use of this drug in several other situations, such as cardiovascular and liver diseases and diabetes. In this study, the current literature on the potential of colchicine in the treatment of obesity and metabolic syndrome (MS) was evaluated. The inhibitory action of the NLRP3 inflammasome and other processes, such as reductions in the migration and activation of immune system cells, are effects observed in both in vitro studies and animal models related to colchicine, as well as the promotion of mechanisms of the intensification of lipid metabolism, the reduction of tissue fibrosis, and the reduction of serum glucose and triglycerides. These factors are associated with changes in the prognoses of patients with MS, which, together with obesity, has a high association with inflammatory mechanisms for its maintenance and secondary impairments to homeostasis. In humans, clinical research has rarely addressed the use of colchicine in obesity and MS, with only one pilot randomized clinical trial having been conducted, which identified a beneficial anti-inflammatory effect on endothelial function and the process of insulin resistance in this population. However, it is not yet possible to extrapolate its findings and apply its results to a broader context. Given the potential of this "ancient drug" in various pathological contexts and its good tolerability, it is important that its properties continue to be investigated and that more clinical studies be conducted to expand the therapeutic applications of this low-cost substance in patients with obesity and MS.