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Burtscher J, Kopp M, Klimont J, Ulmer H, Strasser B, Burtscher M. Age- and sex-dependent associations between self-reported physical activity levels and self-reported cardiovascular risk factors: a population-based cross-sectional survey. BMC Public Health 2024; 24:2843. [PMID: 39415183 PMCID: PMC11481313 DOI: 10.1186/s12889-024-20351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 10/09/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND The amount of regular physical activity (PA) can modulate the prevalence of traditional risk factors for cardiovascular disease (CVD) such as obesity, systemic hypertension, hypercholesterolemia, and type 2 diabetes (T2D). However, how different PA levels either below (< 600 MET min/week), within (600-1200 MET min/week), or above (> 1200 MET min/week) the range of the minimal WHO recommendations impact the age- and sex-dependent prevalence of these risk factors remains to be elucidated. METHODS This cross-sectional study was performed to evaluate these relationships using population-based self-reported data collected in a central European country (Austria, 2019). The sample included a total of 15,461 persons (7166 males: 16-95 + years, BMI 26.6 ± 4.4; 8295 females: 16-95 + years, BMI 25.1 ± 5.0). Besides various lifestyle factors (e.g., dietary habits, smoking, and alcohol consumption), variables of particular interest were the age- and sex-dependent amount of weekly PA and prevalence of risk factors for CVD. Sex-specific logistic regression analyses were applied to estimate adjusted odds ratios (ORs) for the associations between self-reported PA and risk factor prevalence. RESULTS Relatively small beneficial effects were found regarding the prevalence of risk factors for CVD when achieving PA levels corresponding to 600-1200 MET min/week as compared to those who did not meet these recommendations. However, exceeding the WHO recommendations provided much more pronounced benefits, especially in younger and older age groups. Adjusted ORs revealed that high volumes of PA (> 1200 MET min/week) were associated with a 32-43% reduction in the prevalence of obesity and T2D compared to those who did not achieve the WHO recommendations (< 600 MET min/week), as well as with a lower prevalence of systemic hypertension only in women and a lower prevalence of hypercholesterolemia only in men. CONCLUSIONS Exceeding minimal WHO recommendations for PA promises large beneficial effects, particularly on the prevalence of obesity and T2D. Demonstrated sex differences in PA levels and their association with cardiovascular risk factors may provide an important basis for preventive health counseling.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, CH-1015, Switzerland
| | - Martin Kopp
- Institute of Sport Science, University of Innsbruck, Innsbruck, A-6020, Austria
| | - Jeannette Klimont
- Unit Demography and Health, Directorate Social Statistics, Vienna, 1110, Statistics Austria, Austria
| | - Hanno Ulmer
- Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, 6020, Austria
| | - Barbara Strasser
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, 1100, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, 1020, Austria
| | - Martin Burtscher
- Institute of Sport Science, University of Innsbruck, Innsbruck, A-6020, Austria.
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152
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Yu L, Liu Y, Wang Y, Wang G, Xiao X, Wang H, Wang H, Sun H, Wang G. Increased thyroid hormone sensitivity is correlated with visceral obesity in patients with type 2 diabetes. Lipids Health Dis 2024; 23:337. [PMID: 39415187 PMCID: PMC11481250 DOI: 10.1186/s12944-024-02320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 10/01/2024] [Indexed: 10/18/2024] Open
Abstract
OBJECTIVE The study aimed to assess whether thyroid hormone (TH) sensitivity is related to visceral fat area (VFA) and visceral obesity in euthyroid subjects with type 2 diabetes (T2D). METHODS 750 euthyroid patients with T2D were enrolled. A VFA of 80 cm2 or more was considered visceral obesity. Central TH sensitivity was conducted using thyrotrophic thyroxine resistance index (TT4RI), thyrotropin index (TSHI), and thyroid feedback quantile-based index (TFQI). Free triiodothyronine to free thyroxine (FT3/FT4) was utilized for assessing peripheral TH sensitivity. RESULTS The subjects had a mean age of 51.5 ± 11.1 years, and 540 (72.0%) of them were men. In multivariable regression analyses, there was a positive correlation of FT3/FT4 tertile with visceral obesity, after full adjustment for confounding variables (P < 0.05). The middle and highest FT3/FT4 tertiles were correlated with a 134% [95% CI (1.24, 4.44)] and 98% [95% CI (1.04, 3.78)] higher prevalence of visceral obesity than the lowest tertile, respectively. Conversely, elevated TFQI levels were linked to a decreased prevalence of visceral obesity. Stratified analysis revealed that these associations were particularly pronounced in participants who are neither overweight nor obese and those aged less than 60 years (all P < 0.05). CONCLUSIONS Higher TH sensitivity is correlated with visceral obesity and elevated VFA in euthyroid patients with T2D, particularly among those younger than 60 years and individuals who are neither overweight nor obese.
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Affiliation(s)
- Lu Yu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
- Department of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Yujia Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yingxuan Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
| | - Gang Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
| | - Xianchao Xiao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
| | - Huan Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China
| | - Hanyu Wang
- Department of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Hui Sun
- Department of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China.
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, 130021, China.
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153
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Pellegrini V, La Grotta R, Carreras F, Giuliani A, Sabbatinelli J, Olivieri F, Berra CC, Ceriello A, Prattichizzo F. Inflammatory Trajectory of Type 2 Diabetes: Novel Opportunities for Early and Late Treatment. Cells 2024; 13:1662. [PMID: 39404426 PMCID: PMC11476093 DOI: 10.3390/cells13191662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/24/2024] [Accepted: 10/07/2024] [Indexed: 10/19/2024] Open
Abstract
Low-grade inflammation (LGI) represents a key driver of type 2 diabetes (T2D) and its associated cardiovascular diseases (CVDs). Indeed, inflammatory markers such as hs-CRP and IL-6 predict the development of T2D and its complications, suggesting that LGI already increases before T2D diagnosis and remains elevated even after treatment. Overnutrition, unhealthy diets, physical inactivity, obesity, and aging are all recognized triggers of LGI, promoting insulin resistance and sustaining the pathogenesis of T2D. Once developed, and even before frank appearance, people with T2D undergo a pathological metabolic remodeling, with an alteration of multiple CVD risk factors, i.e., glycemia, lipids, blood pressure, and renal function. In turn, such variables foster a range of inflammatory pathways and mechanisms, e.g., immune cell stimulation, the accrual of senescent cells, long-lasting epigenetic changes, and trained immunity, which are held to chronically fuel LGI at the systemic and tissue levels. Targeting of CVD risk factors partially ameliorates LGI. However, some long-lasting inflammatory pathways are unaffected by common therapies, and LGI burden is still increased in many T2D patients, a phenomenon possibly underlying the residual inflammatory risk (i.e., having hs-CRP > 2 mg/dL despite optimal LDL cholesterol control). On the other hand, selected disease-modifying drugs, e.g., GLP-1RA, seem to also act on the pathogenesis of T2D, curbing the inflammatory trajectory of the disease and possibly preventing it if introduced early. In addition, selected trials demonstrated the potential of canonical anti-inflammatory therapies in reducing the rate of CVDs in patients with this condition or at high risk for it, many of whom had T2D. Since colchicine, an inhibitor of immune cell activation, is now approved for the prevention of CVDs, it might be worth exploring a possible therapeutic paradigm to identify subjects with T2D and an increased LGI burden to treat them with this drug. Upcoming studies will reveal whether disease-modifying drugs reverse early T2D by suppressing sources of LGI and whether colchicine has a broad benefit in people with this condition.
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Affiliation(s)
- Valeria Pellegrini
- IRCCS MultiMedica, Via Fantoli 16/15, 20138 Milan, Italy; (V.P.); (R.L.G.)
| | - Rosalba La Grotta
- IRCCS MultiMedica, Via Fantoli 16/15, 20138 Milan, Italy; (V.P.); (R.L.G.)
| | - Francesca Carreras
- IRCCS MultiMedica, Via Fantoli 16/15, 20138 Milan, Italy; (V.P.); (R.L.G.)
| | - Angelica Giuliani
- Cardiac Rehabilitation Unit of Bari Institute, Istituti Clinici Scientifici Maugeri IRCCS, 70124 Bari, Italy
| | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences (DISCLIMO), Università Politecnica delle Marche, 60127 Ancona, Italy; (J.S.); (F.O.)
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, 60127 Ancona, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences (DISCLIMO), Università Politecnica delle Marche, 60127 Ancona, Italy; (J.S.); (F.O.)
- Advanced Technology Center for Aging Research, IRCCS INRCA, 60127 Ancona, Italy
| | | | - Antonio Ceriello
- IRCCS MultiMedica, Via Fantoli 16/15, 20138 Milan, Italy; (V.P.); (R.L.G.)
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Zhu Z, Yu M, Xu M, Ji X, Zong X, Zhang Z, Shang W, Zhang L, Fang P. Baicalin suppresses macrophage JNK-mediated adipose tissue inflammation to mitigate insulin resistance in obesity. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118355. [PMID: 38762213 DOI: 10.1016/j.jep.2024.118355] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/05/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Radix scutellariae (the root of Scutellaria baicalensis Georgi) is a traditional Chinese medicine (TCM) used to treat a wide range of inflammation-related diseases, such as obesity, diabetes, diabetic kidney disease, and COVID-19-associated inflammatory states in the lung and kidney. Baicalin is the major anti-inflammatory component of Radix scutellariae and has shown the potential to inhibit inflammation in metabolic disorders. In this study, we explored the ability and underlying mechanisms of baicalin to modulate the macrophage to mitigate insulin resistance in obesity. MATERIALS AND METHODS Obese mice were administered baicalin (50 mg/kg/day) intraperitoneally for 3 weeks. RAW264.7 and BMDM cells were stimulated with LPS and treated with baicalin for 24 h, while 3T3-L1 and primary white adipocytes were treated with the supernatants from baicalin-treated RAW264.7 cells for 24 h. RESULTS The results showed that baicalin significantly improved glucose and insulin tolerance as well as decreased fat and adipose tissue macrophage levels in obese mice. Besides, baicalin significantly reduced serum and adipose tissue IL-1β, TNF-α and IL-6 levels in obese mice, as well as suppressed LPS-induced IL-1β, TNF-α and IL-6 expression and release in macrophages. Furthermore, treatment with the supernatant from baicalin-treated RAW264.7 cells increased the levels of PGC-1α, SIRT1, p-IRS-1 and p-AKT in adipocytes. Moreover, baicalin treatment dramatically downregulated macrophage p-p38, p-JNK, and Ac-p65Lys310 levels while increasing SIRT1 both in vivo and in vitro. Importantly, JNK inhibitor SP600125 blocked most of the effects of baicalin on SIRT1, Ac-p65Lys310 and pro-inflammatory factors in macrophages. CONCLUSION Therefore, these results demonstrated for the first time that baicalin exerts its anti-inflammatory effects in obese adipose tissue macrophages mainly through suppressing JNK/SIRT1/p65 signaling. These findings amplified the mechanisms of baicalin and its potential to attenuate insulin resistance.
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Affiliation(s)
- Ziyue Zhu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Mei Yu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Mengfan Xu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xin Ji
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, 225001, China
| | - Xicui Zong
- Hanlin College, Nanjing University of Chinese Medicine, Taizhou, 225300, China
| | - Zhenwen Zhang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, 225001, China.
| | - Wenbin Shang
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Li Zhang
- Hanlin College, Nanjing University of Chinese Medicine, Taizhou, 225300, China.
| | - Penghua Fang
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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155
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Pinho ACO, Barbosa P, Lazaro A, Tralhão JG, Pereira MJ, Paiva A, Laranjeira P, Carvalho E. Identification and characterization of circulating and adipose tissue infiltrated CD20 +T cells from subjects with obesity that undergo bariatric surgery. Immunol Lett 2024; 269:106911. [PMID: 39147242 DOI: 10.1016/j.imlet.2024.106911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
T cells play critical roles in adipose tissue (AT) inflammation. The role of CD20+T cell in AT dysfunction and their contributing to insulin resistance (IR) and type 2 diabetes progression, is not known. The aim was to characterize CD20+T cells in omental (OAT), subcutaneous (SAT) and peripheral blood (PB) from subjects with obesity (OB, n = 42), by flow cytometry. Eight subjects were evaluated before (T1) and 12 months post (T2) bariatric/metabolic surgery (BMS). PB from subjects without obesity (nOB, n = 12) was also collected. Higher percentage of CD20+T cells was observed in OAT, compared to PB or SAT, in OB-T1. CD20 expression by PB CD4+T cells was inversely correlated with adiposity markers, while follicular-like CD20+T cells were positively correlated with impaired glucose tolerance (increased HbA1c). Notably, among OB-T1, IR establishment was marked by a lower percentage and absolute number of PB CD20+T cells, compared nOB. Obesity was associated with higher percentage of activated CD20+T cells; however, OAT-infiltrated CD20+T cells from OB-T1 with diabetes displayed the lowest activation. CD20+T cells infiltrating OAT from OB-T1 displayed a phenotype towards IFN-γ-producing Th1 and Tc1 cells. After BMS, the percentage of PB CD4+CD20+T cells increased, with reduced Th1 and increased Th17 phenotype. Whereas in OAT the percentage of CD20+T cells with Th1/17 and Tc1/17 phenotypes increased. Interestingly, OAT from OB pre/post BMS maintained higher frequency of effector memory CD20+T cells. In conclusion, CD20+T cells may play a prominent role in obesity-related AT inflammation.
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Affiliation(s)
- Aryane Cruz Oliveira Pinho
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal; CIBB - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504, Coimbra, Portugal; Department of Life Sciences, Faculty of Science and Technology, University of Coimbra, 3000-456, Coimbra, Portugal
| | - Pedro Barbosa
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal; CIBB - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504, Coimbra, Portugal; Institute for Interdisciplinary Research, University of Coimbra, 3030-789, Coimbra, Portugal
| | - André Lazaro
- General Surgery Unit, Centro Hospitalar e Universitário de Coimbra University of Coimbra, 3000-075, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - José G Tralhão
- General Surgery Unit, Centro Hospitalar e Universitário de Coimbra University of Coimbra, 3000-075, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Maria João Pereira
- Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
| | - Artur Paiva
- CIBB - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504, Coimbra, Portugal; Flow Cytometry Unit, Clinical Pathology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, 3000-076, Coimbra, Portugal; Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências Biomédicas Laboratoriais, 3046-854, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Group of Environmental Genetics of Oncobiology (CIMAGO), Faculty of Medicine (FMUC), University of Coimbra, 3000-548, Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), 3000-061, Coimbra, Portugal
| | - Paula Laranjeira
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal; CIBB - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504, Coimbra, Portugal; Flow Cytometry Unit, Clinical Pathology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, 3000-076, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Group of Environmental Genetics of Oncobiology (CIMAGO), Faculty of Medicine (FMUC), University of Coimbra, 3000-548, Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), 3000-061, Coimbra, Portugal.
| | - Eugenia Carvalho
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal; CIBB - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504, Coimbra, Portugal; Institute for Interdisciplinary Research, University of Coimbra, 3030-789, Coimbra, Portugal; APDP-Portuguese Diabetes Association, Lisbon, Portugal.
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156
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Armidie TA, Bandera EV, Johnson CE, Peres LC, Haller K, Terry P, Akonde M, Peters ES, Cote ML, Hastert TA, Collin LJ, Epstein M, Marks J, Bondy M, Lawson AB, Alberg AJ, Schildkraut JM, Qin B. Diet and Survival in Black Women With Epithelial Ovarian Cancer. JAMA Netw Open 2024; 7:e2440279. [PMID: 39422908 PMCID: PMC11581655 DOI: 10.1001/jamanetworkopen.2024.40279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 08/27/2024] [Indexed: 10/19/2024] Open
Abstract
Importance Ovarian cancer survival among Black women is the lowest across all racial and ethnic groups. Poor dietary quality also disproportionately affects Black populations, but its association with ovarian cancer survival in this population remains largely unknown. Objective To examine associations between dietary patterns and survival among Black women diagnosed with epithelial ovarian cancer (EOC). Design, Setting, and Participants This prospective cohort study was conducted among self-identified Black women aged 20 to 79 years newly diagnosed with histologically confirmed EOC in the African American Cancer Epidemiology Study (AACES) between December 2010 and December 2015, with follow-up until October 2022. AACES is a population-based study of ovarian cancer risk and survival among Black women in 11 US regions. Data were analyzed from March 2023 to June 2024. Exposures Dietary patterns were assessed by the Healthy Eating Index-2020 (HEI-2020) and Alternative Healthy Eating Index-2010 (AHEI-2010), with scores calculated based on dietary intake in the year prior to diagnosis and collected via the validated Block 2005 Food Frequency Questionnaire. Higher scores indicate better dietary quality. Main outcomes and measures Hazard ratios (HRs) and 95% CIs were estimated from multivariable Cox models for the association between adherence to dietary recommendations and overall mortality among all participants and those with high-grade serous ovarian cancer (HGSOC). Results Among 483 Black women with EOC (mean [SD] age, 58.1 [10.5] years), 310 deaths were recorded during a median (IQR) follow-up of 4.3 (2.0-8.2) years. No association of dietary patterns with mortality was found among women with EOC overall. However, among 325 women with HGSOC, better adherence to HEI-2020 was associated with decreased mortality in later quartiles compared with the first quartile (HR, 0.63; 95% CI, 0.44-0.92 for quartile 2; HR, 0.67; 95% CI, 0.46-0.97 for quartile 3; HR, 0.63; 95% CI, 0.44-0.91 for quartile 4 ). Similar results were observed with AHEI-2010 among women with HGSOC for the second (HR, 0.62; 95% CI, 0.43-0.89) and fourth (HR, 0.67; 95% CI, 0.45-0.98) quartiles compared with quartile 1. Conclusions and relevance In this study, women with moderate and high prediagnosis dietary quality had significantly lower mortality rates from HGSOC compared with women with the lowest prediagnosis dietary quality. These findings suggest that even moderate adherence to dietary guidelines prior to diagnosis may be associated with improved survival among Black women with HGSOC, the most lethal form of ovarian cancer.
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Affiliation(s)
- Tsion A. Armidie
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Elisa V. Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute, New Brunswick, New Jersey
| | - Courtney E. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lauren C. Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kristin Haller
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Paul Terry
- Department of Medicine, University of Tennessee Medical Center-Knoxville
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia
| | - Edward S. Peters
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha
| | - Michele L. Cote
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis
| | - Theresa A. Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Lindsay J. Collin
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Michael Epstein
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffrey Marks
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Melissa Bondy
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
| | - Andrew B. Lawson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
- Usher Institute, Centre for Population Health Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Anthony J. Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia
| | - Joellen M. Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute, New Brunswick, New Jersey
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157
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Wu G, Liu S, Wang Z, Wang X. Structural characteristics of neutral polysaccharides purified from coix seed and its anti-insulin resistance effects on HepG2 cells. Food Sci Nutr 2024; 12:8419-8431. [PMID: 39479660 PMCID: PMC11521644 DOI: 10.1002/fsn3.4402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 11/02/2024] Open
Abstract
Coix seed is recognized as a functional medicinal food due to its valuable biological activities, with polysaccharides being the primary active compounds. In this study, an ultrasonic-assisted enzymatic extraction technique was employed, and response surface methodology was used to optimize the yield of polysaccharides to 9.55 ± 0.26%. A novel neutral polysaccharide, CSPsN-1, was purified with a molecular weight of 7.75 kDa. CSPsN-1 was composed of arabinose, galactose, glucose, xylose, and mannose in molar ratios of 0.48: 7.92: 86.39: 2.42: 2.79. Its backbone composed of →4)-α-D-Glcp-(1→ and →3,4)-α-D-Glcp-(1→ units, with terminal residues of α-D-Glcp. In vitro experiments, CSPsN-1 enhanced glucose consumption in insulin-resistant HepG2 cells and upregulated GLUT4 expression by activating the PI3K/AKT signaling pathway. These findings suggest that CSPsN-1 holds significant promise as a functional ingredient for treating insulin resistance and related metabolic disorders.
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Affiliation(s)
- Guozhen Wu
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanP.R. China
- Key Laboratory for Applied Technology of Sophisticated Analytical Instruments of Shandong Province, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
| | - Shuang Liu
- Key Laboratory for Applied Technology of Sophisticated Analytical Instruments of Shandong Province, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
- Key Laboratory for Natural Active Pharmaceutical Constituents Research in Universities of Shandong Province, School of Pharmaceutical SciencesQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
| | - Zhenqiang Wang
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanP.R. China
- Key Laboratory for Applied Technology of Sophisticated Analytical Instruments of Shandong Province, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
| | - Xiao Wang
- Key Laboratory for Applied Technology of Sophisticated Analytical Instruments of Shandong Province, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
- Key Laboratory for Natural Active Pharmaceutical Constituents Research in Universities of Shandong Province, School of Pharmaceutical SciencesQilu University of Technology (Shandong Academy of Sciences)JinanP.R. China
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158
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Quehenberger O, Armando AM, Cedeno TH, Loomba R, Sanyal AJ, Dennis EA. Novel eicosanoid signature in plasma provides diagnostic for metabolic dysfunction-associated steatotic liver disease. J Lipid Res 2024; 65:100647. [PMID: 39303979 PMCID: PMC11526069 DOI: 10.1016/j.jlr.2024.100647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 09/12/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024] Open
Abstract
There is a clinical need for a simple test implementable at the primary point of care to identify individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) in the population. Blood plasma samples from adult patients with varying phenotypes of MASLD were used to identify a minimal set of lipid analytes reflective of underlying histologically confirmed MASLD. Samples were obtained from the NIDDK Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) NAFLD Database prospective cohort study (MASLD group; N = 301). Samples of control subjects were obtained from cohort studies at the University of California San Diego (control group; N = 48). Plasma samples were utilized for targeted quantitation of circulating eicosanoids, related bioactive metabolites, and polyunsaturated fatty acids by ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS) lipidomics analysis. Bioinformatic approaches were used to discover a panel of bioactive lipids that can be used as a diagnostic tool to identify MASLD. The final panel of fifteen lipid metabolites consists of 12 eicosanoid metabolites and 3 free fatty acids that were identified to be predictive for MASLD by multivariate area under the receiver operating characteristics curve (AUROC) analysis. The panel was highly predictive for MASLD with an AUROC of 0.999 (95% CI = 0.986-1.0) with only one control misclassified. A validation study confirmed the resulting MASLD LIPIDOMICS SCORE, which may require a larger-scale prospective study to optimize. This predictive model should guide the development of a non-invasive "point-of-care" test to identify MASLD patients requiring further evaluation for the presence of metabolic dysfunction-associated steatohepatitis.
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Affiliation(s)
- Oswald Quehenberger
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA.
| | - Aaron M Armando
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Tiffany H Cedeno
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Rohit Loomba
- MASLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Arun J Sanyal
- Division of Gastroenterology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Edward A Dennis
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA; Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA, USA.
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159
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Dong DB, Qiao XL, Chen CW, Bao W, Chen CW, Yuan X, Zhang Y. The predictive value of estimated pulse wave velocity (ePWV) combined with BMI for newly diagnosed diabetes. Rev Clin Esp 2024; 224:503-509. [PMID: 38972634 DOI: 10.1016/j.rceng.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
PURPOSE Estimated pulse wave velocity (ePWV) and body mass index (BMI) are significant predictors of new-onset diabetes. This study aims to evaluate the impact and predictive value of combining ePWV and BMI on the incidence of new-onset diabetes. METHODS A secondary analysis was conducted on a cohort study by Rich Healthcare (China), involving 211,833 eligible participants. Logistic regression analysis identified factors influencing diabetes occurrence, while ROC curve analysis assessed the predictive value of ePWV, BMI, and their combination for new-onset diabetes. RESULTS Over a mean follow-up period of 3.12 years, 3,000 men (1.41%) and 1,174 women (0.55%) were diagnosed with diabetes. Logistic regression revealed that BMI, triglycerides, alanine aminotransferase, blood urea nitrogen, creatinine clearance rate, ePWV, and family history of diabetes are high-risk factors for new-onset diabetes. The combination of ePWV and BMI provided a higher area under the ROC curve (0.822) compared to ePWV or BMI alone. CONCLUSION Elevated levels of ePWV and BMI are independent risk factors for new-onset diabetes. Combining these measures enhances predictive accuracy compared to using either indicator alone.
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Affiliation(s)
- Da Bao Dong
- Department of Nephrology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiao Li Qiao
- Department of Critical Care Medicine, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Cheng Wen Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Bao
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chun Wei Chen
- Department of Cardiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Xiang Yuan
- Department of Emergency Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ying Zhang
- Department of Nephrology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
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160
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Arbee S, Himeno T, Miura-Yura E, Kato M, Islam S, Jahan N, Kamiya H, Watanabe H. Versican maintains the homeostasis of adipose tissues and regulates energy metabolism. Biochem Biophys Res Commun 2024; 727:150309. [PMID: 38936224 DOI: 10.1016/j.bbrc.2024.150309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Abstract
Versican is a large chondroitin sulfate proteoglycan in the extracellular matrix. It plays a pivotal role in the formation of the provisional matrix. S100a4, previously known as fibroblast-specific protein, functions as a calcium channel-binding protein. To investigate the role of versican expressed in fibroblasts, we generated conditional knockout mice in which versican expression is deleted in cells expressing S100a4. We found that S100a4 is expressed in adipose tissues, and these mice exhibit obesity under a normal diet, which becomes apparent as early as five months. The white adipose tissues of these mice exhibited decreased expression levels of S100a4 and versican and hypertrophy of adipocytes. qRT-PCR showed a reduced level of UCP1 in their white adipose tissues, indicating that the basic energy metabolism is diminished. These results suggest that versican in adipose tissues maintains the homeostasis of adipose tissues and regulates energy metabolism.
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Affiliation(s)
- Shahida Arbee
- Insitute for Molecular Science of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Tatsuhito Himeno
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Emiri Miura-Yura
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Makoto Kato
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Shamima Islam
- Insitute for Molecular Science of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Nushrat Jahan
- Insitute for Molecular Science of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hideki Kamiya
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hideto Watanabe
- Insitute for Molecular Science of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
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161
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Huo J, Molkentin JD. MCU genetically altered mice suggest how mitochondrial Ca 2+ regulates metabolism. Trends Endocrinol Metab 2024; 35:918-928. [PMID: 38688781 PMCID: PMC11490413 DOI: 10.1016/j.tem.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024]
Abstract
Skeletal muscle has a major impact on total body metabolism and obesity, and is characterized by dynamic regulation of substrate utilization. While it is accepted that acute increases in mitochondrial matrix Ca2+ increase carbohydrate usage to augment ATP production, recent studies in mice with deleted genes for components of the mitochondrial Ca2+ uniporter (MCU) complex have suggested a more complicated regulatory scenario. Indeed, mice with a deleted Mcu gene in muscle, which lack acute mitochondrial Ca2+ uptake, have greater fatty acid oxidation (FAO) and less adiposity. By contrast, mice deleted for the inhibitory Mcub gene in skeletal muscle, which have greater acute mitochondrial Ca2+ uptake, antithetically display reduced FAO and progressive obesity. In this review we discuss the emerging concept that dynamic fluxing of mitochondrial matrix Ca2+ regulates metabolism.
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Affiliation(s)
- Jiuzhou Huo
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Jeffery D Molkentin
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA.
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162
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Mashhadi Z, Yin L, Dosoky NS, Chen W, Davies SS. Plaat1l1 controls feeding induced NAPE biosynthesis and contributes to energy balance regulation in zebrafish. Prostaglandins Other Lipid Mediat 2024; 174:106869. [PMID: 38977258 DOI: 10.1016/j.prostaglandins.2024.106869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/17/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024]
Abstract
Dysregulation of energy balance leading to obesity is a significant risk factor for cardiometabolic diseases such as diabetes, non-alcoholic fatty liver disease and atherosclerosis. In rodents and several other vertebrates, feeding has been shown to induce a rapid rise in the intestinal levels of N-acyl-ethanolamines (NAEs) and the chronic consumption of a high fat diet abolishes this rise. Administering NAEs to rodents consuming a high fat diet reduces their adiposity, in part by reducing food intake and enhancing fat oxidation, so that feeding-induced intestinal NAE biosynthesis appears to be critical to appropriate regulation of energy balance. However, the contribution of feeding-induced intestinal NAE biosynthesis to appropriate energy balance remains poorly understood in part because there are multiple enzymes that can contribute to NAE biosynthesis and the specific enzyme(s) that are responsible for feeding-induced intestinal NAE biosynthesis have not been identified. The rate-limiting step in the intestinal biosynthesis of NAEs is formation of their immediate precursors, the N-acyl-phosphatidylethanolamines (NAPEs), by phosphatidylethanolamine N-acyltransferases (NATs). At least six NATs are found in humans and multiple homologs of these NATs are found in most vertebrate species. In recent years, the fecundity and small size of zebrafish (Danio rerio), as well as their similarities in feeding behavior and energy balance regulation with mammals, have led to their use to model key features of cardiometabolic disease. We therefore searched the Danio rerio genome to identify all NAT homologs and found two additional NAT homologs besides the previously reported plaat1, rarres3, and rarres3l, and used CRISPR/cas9 to delete these two NAT homologs (plaat1l1 and plaat1l2). While wild-type fish markedly increased their intestinal NAPE levels in response to a meal after fasting, this response was completely ablated in plaat1l1-/-fish. Furthermore, plaat1l1-/- fish fed a standard flake diet had increased weight gain and glucose intolerance compared to wild-type fish. The results support a critical role for feeding-induced NAPE and NAE biosynthesis in regulating energy balance and suggest that restoring this response in obese animals could potentially be used to treat obesity and cardiometabolic disease.
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Affiliation(s)
- Zahra Mashhadi
- Division of Clinical Pharmacology, Vanderbilt University, Nashville, TN, United States; Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Linlin Yin
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Noura S Dosoky
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Wenbiao Chen
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Sean S Davies
- Division of Clinical Pharmacology, Vanderbilt University, Nashville, TN, United States; Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Vanderbilt Institute for Chemical Biology, Vanderbilt University, Nashville, TN, United States.
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163
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Bilal A, Bilal M, Hathaf A, Usman D, Haboubi N. The Weight on Sight: Exploring the Links Between Obesity and Ocular Diseases. Cureus 2024; 16:e72742. [PMID: 39483584 PMCID: PMC11525091 DOI: 10.7759/cureus.72742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2024] [Indexed: 11/03/2024] Open
Abstract
Obesity is a significant public health concern with escalating levels worldwide creating a variety of socioeconomic challenges and imposing a serious risk factor for a range of complications which include diabetes, hypertension, cardiovascular disease, and stroke, all of which are primary causes of early death. Furthermore, there is growing evidence connecting obesity to the development of several ocular disorders. Excessive weight is a common denominator in the aetiology of many ocular pathologies such as diabetic retinopathy, idiopathic intracranial hypertension, cataract, high intraocular pressures, age-related macular degeneration, and retinal vascular diseases through the association with diabetes, hypertension, and dyslipidemia. This review highlights the risks weight gain and a sedentary lifestyle imposes on patients' ocular health and aims to inform the public and raise awareness about the consequences obesity has on sight. This review explores articles available on Ovid-MEDLINE (Medical Literature Analysis and Retrieval System Online) and PubMed regarding the impact of obesity on ocular health and the pathogenesis of obesity-linked ocular diseases.
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Affiliation(s)
- Ahmed Bilal
- Ophthalmology, University Hospital of Wales, Cardiff, GBR
| | - Muslim Bilal
- School of Medicine, Cardiff University, Cardiff, GBR
| | - Alia Hathaf
- School of Optometry, Cardiff University, Cardiff, GBR
| | - Danyal Usman
- Internal Medicine, University Hospital of Wales, Cardiff, GBR
| | - Nadim Haboubi
- Gastroenterology, Nevill Hall Hospital, Abergavenny, GBR
- Clinical Nutrition and Obesity, University of South Wales, Pontypridd, GBR
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164
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Wang SS, Cui M, Li JY, Zhang HM, Liu XY, Han J. Ameliorated lipid distribution in prediabetes - Effects of 12 weeks traditional Chinese YiJinJing exercise plus TheraBand: A randomized controlled trial. J Exerc Sci Fit 2024; 22:438-444. [PMID: 40276582 PMCID: PMC12020919 DOI: 10.1016/j.jesf.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 09/25/2024] [Accepted: 09/25/2024] [Indexed: 04/26/2025] Open
Abstract
Background/Objective Lipid distribution plays a crucial role in glucose metabolism, and this study aimed to investigate the effects of 12 weeks traditional Chinese YiJinJing exercise on specific lipid distributions in patients with prediabetes. Methods Sixty participants with prediabetes were randomly allocated to either a control group (Con, n = 30) or an exercise group (Ex, n = 30). The Ex group underwent YiJinJing exercise plus Theraband, engaging in 1-h sessions, 3 times per week, over a total period of 12 weeks. Dual-energy X-ray absorptiometry (DEXA) and magnetic resonance imaging (MRI) were used to measure lipid distribution in different body segments and organs. Additionally, a body composition analyser was employed to measure visceral fat, and laboratory tests were conducted to measure indicators related to glycolipid metabolism. Results Following a 12-week intervention with Exercise, 37 % of prediabetic patients in the Ex group achieved normal blood glucose levels. Significant reductions were observed in upper limb fat (ULF), trunk fat (TrF) and liver fat (LF) values in the Ex group compared to the Con group. Additionally, within the Ex group, there were notable decreases in triglyceride (TG) levels, body mass index (BMI), waist-hip ratio (WHR), android fat (AF), ULF, thigh fat (ThF), renal sinus fat (RSF), and LF compared to baseline. Conclusions Traditional Chinese YiJinJing plus TheraBand exercise can significantly reduce blood glucose levels through improved lipid distribution and metabolism in prediabetic patients. Hence, YiJinJing can serve as a crucial intervention for individuals with prediabetes.
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Affiliation(s)
- Sha-sha Wang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Science, Shanghai, China
| | - Mu Cui
- Faculty of Education, University of Melbourne, Melbourne, Australia
| | - Jing-yuan Li
- Zhijiang College of Zhejiang University of Technology, Shaoxing, Zhejiang, China
| | - Huai-ming Zhang
- Prevetion and Control Department, Shanghai Yangpu District Mental Health Center, Shanghai, China
| | - Xiang-yun Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Science, Shanghai, China
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165
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Fang P, She Y, Yu M, Yan J, Yu X, Zhao J, Jin Y, Min W, Shang W, Zhang Z. Novel hypothalamic pathways for metabolic effects of spexin. Pharmacol Res 2024; 208:107399. [PMID: 39245191 DOI: 10.1016/j.phrs.2024.107399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/22/2024] [Accepted: 09/03/2024] [Indexed: 09/10/2024]
Abstract
One of the main underlying etiologies of type 2 diabetes (T2DM) is insulin resistance, which is most frequently caused by obesity. Notably, the deregulation of adipokine secretion from visceral adiposity has been identified as a crucial characteristic of type 2 diabetes and obesity. Spexin is an adipokine that is released by many different tissues, including white adipocytes and the glandular stomach, and is negatively connected with the state of energy storage. This peptide acts through GALR2/3 receptors to control a wide range of metabolic processes, including inflammation, browning, lipolysis, energy expenditure, and eating behavior. Specifically, spexin can enter the hypothalamus and regulate the hypothalamic melanocortin system, which in turn balances energy expenditure and food intake. This review examines recent advances and the underlying mechanisms of spexin in obesity and T2DM. In particular, we address a range of topics from basic research to clinical findings, such as an analysis of the possible function of spexin in the hypothalamic melanocortin response, which involves reducing energy intake and increasing energy expenditure while also enhancing insulin sensitivity and glucose tolerance. Gaining more insight into the mechanisms that underlie the spexin system's control over energy metabolism and homeostasis may facilitate the development of innovative treatment approaches that focus on combating obesity and diabetes.
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Affiliation(s)
- Penghua Fang
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Yuqing She
- Department of Endocrinology, Nanjing Pukou People's Hospital, Nanjing 211899, China
| | - Mei Yu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jing Yan
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xizhong Yu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Juan Zhao
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Yu Jin
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Wen Min
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Wenbin Shang
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Zhenwen Zhang
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou 225001, China.
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166
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Nakajima S, Hanzawa F, Ikeda S, Oda H. Physical inactivity and breakfast skipping caused visceral fat accumulation in rats. Sci Rep 2024; 14:22644. [PMID: 39349485 PMCID: PMC11442645 DOI: 10.1038/s41598-024-68058-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/19/2024] [Indexed: 10/02/2024] Open
Abstract
Physical inactivity as well as breakfast skipping is known as risk factor for various metabolic diseases, such as obesity and type 2 diabetes. We have previously reported that a breakfast skipping model, in which the timing of feeding is delayed, induces abnormal lipid metabolism by altering the circadian rhythm of lipid metabolism-related genes in rats. The purpose of this study was to elucidate the synergistic effect of physical inactivity and breakfast skipping on lipid metabolism. We adopted sciatic neurectomized rats as physically inactive models, because we confirmed that the rats mildly decreased their spontaneous locomotor activity compared to sham-operated rats. And then the physically inactive model rats were fed a mild high-fat diet during zeitgeber time (ZT) 12-0 in the control group and ZT16-0 in the breakfast skipping group for 11 days. Body weight gain and total food intake were similar in both groups. Breakfast skipping induced a significant visceral fat accumulation, which was not observed in our previous breakfast skipping or physically inactive studies. The mRNA levels of clock and lipogenesis-related genes were altered by breakfast skipping in the liver and epididymal adipose tissue, and serum insulin level was altered by breakfast skipping. These results suggest that physical inactivity and breakfast skipping synergistically induces drastic visceral fat accumulation due to the alteration of circadian clock and lipid metabolism in the liver and adipose tissue. Therefore, regular feeding timing plays an important role in the health of a sedentary modern society.
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Affiliation(s)
- Syunsuke Nakajima
- Laboratory of Nutritional Biochemistry, Department of Applied Molecular Biosciences, Nagoya University, Furo-Cho, Chikusa-Ku, Nagoya, 464-8601, Japan
| | - Fumiaki Hanzawa
- Department of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, 470-0196, Japan
| | - Saiko Ikeda
- Department of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, 470-0196, Japan
| | - Hiroaki Oda
- Laboratory of Nutritional Biochemistry, Department of Applied Molecular Biosciences, Nagoya University, Furo-Cho, Chikusa-Ku, Nagoya, 464-8601, Japan.
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167
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Rossmeislová L, Krauzová E, Koc M, Wilhelm M, Šebo V, Varaliová Z, Šrámková V, Schouten M, Šedivý P, Tůma P, Kovář J, Langin D, Gojda J, Šiklová M. Obesity alters adipose tissue response to fasting and refeeding in women: A study on lipolytic and endocrine dynamics and acute insulin resistance. Heliyon 2024; 10:e37875. [PMID: 39328508 PMCID: PMC11425135 DOI: 10.1016/j.heliyon.2024.e37875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 09/04/2024] [Accepted: 09/11/2024] [Indexed: 09/28/2024] Open
Abstract
Fasting induces significant shifts in substrate utilization with signs of acute insulin resistance (IR), while obesity is associated with chronic IR. Nonetheless, both states substantially influence adipose tissue (AT) function. Therefore, in this interventional study (NCT04260542), we investigated if excessive adiposity in premenopausal women alters insulin sensitivity and AT metabolic and endocrine activity in response to a 60-h fast and a subsequent 48-h refeeding period. Using physiological methods, lipidomics, and AT explants, we showed that obesity partially modified AT endocrine activity and blunted the dynamics of AT insulin resistance in response to the fasting/refeeding challenge compared to that observed in lean women. AT adapted to its own excess by reducing lipolytic activity/free fatty acids (FFA) flux per mass. This adaptation persisted even after a 60-h fast, resulting in lower ketosis in women with obesity. This could be a protective mechanism that limits the lipotoxic effects of FFA; however, it may ultimately impede desirable weight loss induced by caloric restriction in women with obesity.
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Affiliation(s)
- Lenka Rossmeislová
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Franco-Czech Laboratory for Clinical Research on Obesity, Third Faculty of Medicine, Charles University, Prague and Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Eva Krauzová
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - Michal Koc
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marek Wilhelm
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Viktor Šebo
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - Zuzana Varaliová
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Šrámková
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Franco-Czech Laboratory for Clinical Research on Obesity, Third Faculty of Medicine, Charles University, Prague and Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Moniek Schouten
- Department of Movement Sciences, Exercise Physiology Research Group, KU Leuven, Leuven, Belgium
| | - Petr Šedivý
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Tůma
- Department of Hygiene, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Kovář
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Dominique Langin
- Franco-Czech Laboratory for Clinical Research on Obesity, Third Faculty of Medicine, Charles University, Prague and Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, I2MC, University of Toulouse, Inserm, Toulouse III University - Paul Sabatier (UPS), Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- Institute Universitaire de France (IUF), Paris, France
| | - Jan Gojda
- Franco-Czech Laboratory for Clinical Research on Obesity, Third Faculty of Medicine, Charles University, Prague and Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
- Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - Michaela Šiklová
- Department of Pathophysiology, Centre for Research on Nutrition, Metabolism and Diabetes, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Franco-Czech Laboratory for Clinical Research on Obesity, Third Faculty of Medicine, Charles University, Prague and Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
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Cabral-García GA, Cruz-Muñoz JR, Valdez-Morales EE, Barajas-Espinosa A, Liñán-Rico A, Guerrero-Alba R. Pharmacology of P2X Receptors and Their Possible Therapeutic Potential in Obesity and Diabetes. Pharmaceuticals (Basel) 2024; 17:1291. [PMID: 39458933 PMCID: PMC11509955 DOI: 10.3390/ph17101291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/21/2024] [Accepted: 09/26/2024] [Indexed: 10/28/2024] Open
Abstract
The role of P2X ionotropic receptors in the behavior of purinergic signaling on pathophysiological processes has been widely studied. In recent years, the important participation of P2X receptors in physiological and pathological processes, such as energy metabolism, characteristic inflammatory responses of the immune system, and nociceptive activity in response to pain stimuli, has been noted. Here, we explore the molecular characteristics of the P2X receptors and the use of the different agonist and antagonist agents recently described, focusing on their potential as new therapeutic targets in the treatment of diseases with emphasis on obesity, diabetes, and some of the complications derived from these pathologies.
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Affiliation(s)
- Guillermo A. Cabral-García
- Departamento de Fisiología y Farmacología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Mexico; (G.A.C.-G.); (J.R.C.-M.); (E.E.V.-M.)
| | - José R. Cruz-Muñoz
- Departamento de Fisiología y Farmacología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Mexico; (G.A.C.-G.); (J.R.C.-M.); (E.E.V.-M.)
| | - Eduardo E. Valdez-Morales
- Departamento de Fisiología y Farmacología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Mexico; (G.A.C.-G.); (J.R.C.-M.); (E.E.V.-M.)
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCyT), Ciudad de México 03940, Mexico;
| | - Alma Barajas-Espinosa
- Escuela Superior de Huejutla, Universidad Autónoma del Estado de Hidalgo, Huejutla de Reyes 43000, Hidalgo, Mexico;
| | - Andrómeda Liñán-Rico
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCyT), Ciudad de México 03940, Mexico;
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima 28045, Mexico
| | - Raquel Guerrero-Alba
- Departamento de Fisiología y Farmacología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Mexico; (G.A.C.-G.); (J.R.C.-M.); (E.E.V.-M.)
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169
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Chen Y, Ding Y, Jin S, Zhang Y. Association between a body shape index and cognitive impairment among US older adults aged 40 years and above from a cross-sectional survey of the NHANES 2011-2014. Front Endocrinol (Lausanne) 2024; 15:1411701. [PMID: 39377074 PMCID: PMC11456444 DOI: 10.3389/fendo.2024.1411701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 08/29/2024] [Indexed: 10/09/2024] Open
Abstract
Purpose This research aimed to assess the correlation between the Adjusted Body Shape Index (ABSI) and the presence of abdominal aortic calcification (AAC) among middle-aged and older American adults. Methods Employing a cross-sectional design, this study analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), focusing on 3077 participants aged 40 and above. AAC detection was conducted using dual-energy X-ray absorptiometry (DXA). ABSI was determined based on waist circumference (WC), weight, and height data. The association between ABSI and AAC was examined through multiple linear regression, smoothed curve analysis, threshold effect evaluation, subgroup analysis, and interaction testing. Results The study encompassed 3077 individuals aged 40 and above. Findings indicated a noteworthy positive relationship between ABSI and AAC when adjusting various covariates. Analysis of threshold effects identified a K-point at 0.0908, showing no significant effect to its left but a significant effect to its right. Further, subgroup and interaction analyses highlighted the ABSI-AAC connection specifically within different age groups and among individuals with diabetes. Conclusion Higher ABSI was correlated with higher AAC score.
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Affiliation(s)
| | | | - Shanliang Jin
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanwei Zhang
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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170
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Shang M, Li Z, Du D, Xu G, Lian D, Liao Z, Wang D, Amin B, Wang Z, Chen W, Zhang N, Wang L. Comparative Study for Safety and Efficacy of OAGB and SADJB-SG: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:3499-3508. [PMID: 39319304 PMCID: PMC11420895 DOI: 10.2147/dmso.s484616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Purpose Obesity and related complications are managed by One Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Jejunal Bypass with Sleeve Gastrectomy (SADJB-SG), both of which are adapted from traditional gastric bypass procedures. However, there are no current comparative studies on the safety and efficacy of these two surgical procedures. Patients and Methods Preoperative baseline data of patients who had undergone OAGB and SADJB-SG surgeries from June 2019 to June 2021 were retrospectively analyzed at our bariatric facility. Postoperative data, including weight changes, improvement in type 2 diabetes (T2DM), and complication rates were collected over 2 years. This was followed by a comprehensive evaluation of the safety and efficacy of the two surgical procedures. Results A total of 63 patients completed the follow-up in this study. At the 24-month follow-up, excess weight loss percentage (EWL%) for the OAGB and SADJB-SG was 73.970±5.005 and 75.652±7.953, respectively (P-value = 0.310); total weight loss percentage (TWL%) was 24.006±8.231 and 23.171±6.600, respectively (P-value = 0.665). The diabetes remission rates for the two groups were 71.429% and 69.048%, respectively (P-value = 0.846). The cost for OAGB was 55088.208±1508.220 yuan, which was significantly lower than the 57538.195±1374.994 yuan for SADJB-SG (P-value< 0.001). Conclusion The two surgical procedures are reliable in terms of safety and efficacy, and each has distinct advantages. While OAGB has reduced operational expenses, SADJB-SG offers a broader range of applicability.
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Affiliation(s)
- Mingyue Shang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zhehong Li
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Guangzhong Xu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dongbo Lian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zhaohui Liao
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dezhong Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Buhe Amin
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Weijian Chen
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
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171
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Raubenheimer JE, Myburgh PH, Bhagavathula AS. Sweetening the deal: an infodemiological study of worldwide interest in semaglutide using Google Trends extended for health application programming interface. BMC GLOBAL AND PUBLIC HEALTH 2024; 2:63. [PMID: 39681910 DOI: 10.1186/s44263-024-00095-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 09/03/2024] [Indexed: 12/18/2024]
Abstract
BACKGROUND Off-label use of semaglutide for non-diabetic weight loss (which regulators have linked to social media promotion) created worldwide supply shortages. We evaluated worldwide semaglutide interest measured by online search behavior to gauge social media and conventional print media reporting's effect on search interest. METHODS Using Google Trends Extended for Health (GTEH) multiple sampling, we retrieved regional online interest (ROI) for all countries and extracted timelines and top search queries for January 2021-August 2023 for countries with median ROI ≥ 20 using the "semaglutide" topic. We obtained semaglutide media reporting from the ProQuest database. We estimated the effect of media and within-country semaglutide interest on between-country interest with Granger causality analysis. We determined changepoints for trends within each country with joinpoint regression. We determined prominent themes in search queries for each country with natural language processing thematic analysis. RESULTS Twenty-seven countries were included. Most countries showed an increase in semaglutide interest over time, with Canada and the USA showing the largest sustained interest. Most of the search interest arose from 2022 onwards. Granger's analysis showed that media coverage could only partially explain interest, and interest in some countries partially preceded interest in others, with the UK and Germany showing strong relationships between news reports and lagged search interest. Joinpoint analysis identified up to four significant within-country changepoints. Most countries showed significant positive weekly trends in 2021-2022, although uptrends in search interest varied considerably between countries. One episode of the Dr. Oz show (TV media event) coincided with strong peaks in numerous countries. Natural language processing of top search queries showed some agreement between countries and country-specific themes. Weight loss was a major theme in most countries, while a diabetes theme was generally absent or weak. Some countries (Australia, Chile, South Africa, UK) had themes for buying Ozempic from (named) local retailers, and Germany had a theme related to buying Ozempic without a script. CONCLUSIONS GTEH data provided insights into global search interest in semaglutide and regional variation. Studies focusing on specific countries which include social media data can elucidate specific drivers behind the surge in off-label use of semaglutide.
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Affiliation(s)
- Jacques Eugene Raubenheimer
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Room 107, A26 (R C Mills bldg.) Science Rd, Sydney, NSW, Australia.
| | | | - Akshaya Srikanth Bhagavathula
- Department of Public Health, North Dakota State University, Fargo, ND, USA
- Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, FL, USA
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172
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Lingvay I, Cohen RV, Roux CWL, Sumithran P. Obesity in adults. Lancet 2024; 404:972-987. [PMID: 39159652 DOI: 10.1016/s0140-6736(24)01210-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 08/21/2024]
Abstract
Obesity has increased in prevalence worldwide and WHO has declared it a global epidemic. Population-level preventive interventions have been insufficient to slow down this trajectory. Obesity is a complex, heterogeneous, chronic, and progressive disease, which substantially affects health, quality of life, and mortality. Lifestyle and behavioural interventions are key components of obesity management; however, when used alone, they provide substantial and durable response in a minority of people. Bariatric (metabolic) surgery remains the most effective and durable treatment, with proven benefits beyond weight loss, including for cardiovascular and renal health, and decreased rates of obesity-related cancers and mortality. Considerable progress has been made in the development of pharmacological agents that approach the weight loss efficacy of metabolic surgery, and relevant outcome data related to these agents' use are accumulating. However, all treatment approaches to obesity have been vastly underutilised.
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Affiliation(s)
- Ildiko Lingvay
- Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnel Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Ricardo V Cohen
- The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland; Diabetes Research Centre, Ulster University, Coleraine, UK
| | - Priya Sumithran
- Department of Surgery, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
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173
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Chen T, Liu YL, Li F, Qiu HN, Haghbin N, Li YS, Lin CY, Wu F, Xia LF, Li JB, Lin JN. Association of waist-to-hip ratio adjusted for body mass index with cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus: a cross-sectional study. BMC Public Health 2024; 24:2424. [PMID: 39243030 PMCID: PMC11378611 DOI: 10.1186/s12889-024-19985-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Numerous reports indicate that both obesity and type 2 diabetes mellitus (T2DM) are factors associated with cognitive impairment (CI). The objective was to assess the relationship between abdominal obesity as measured by waist-to-hip ratio adjusted for body mass index (WHRadjBMI) and CI in middle-aged and elderly patients with T2DM. METHODS A cross-sectional study was conducted, in which a total of 1154 patients with T2DM aged ≥ 40 years were included. WHRadjBMI was calculated based on anthropometric measurements and CI was assessed utilizing the Montreal Cognitive Assessment (MoCA). Participants were divided into CI group (n = 509) and normal cognition group (n = 645). Correlation analysis and binary logistic regression were used to explore the relationship between obesity-related indicators including WHRadjBMI, BMI as well as waist circumference (WC) and CI. Meanwhile, the predictive power of these indicators for CI was estimated by receiver operating characteristic (ROC) curves. RESULTS WHRadjBMI was positively correlated with MoCA scores, independent of sex. The Area Under the Curve (AUC) for WHRadjBMI, BMI and WC were 0.639, 0.521 and 0.533 respectively, and WHRadjBMI had the highest predictive power for CI. Whether or not covariates were adjusted, one-SD increase in WHRadjBMI was significantly related to an increased risk of CI with an adjusted OR of 1.451 (95% CI: 1.261-1.671). After multivariate adjustment, the risk of CI increased with rising WHRadjBMI quartiles (Q4 vs. Q1 OR: 2.980, 95%CI: 2.032-4.371, P for trend < 0.001). CONCLUSIONS Our study illustrated that higher WHRadjBMI is likely to be associated with an increased risk of CI among patients with T2DM. These findings support the detrimental effects of excess visceral fat accumulation on cognitive function in middle-aged and elderly T2DM patients.
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Affiliation(s)
- Tong Chen
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Yan-Lan Liu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Fang Li
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Hui-Na Qiu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Nahal Haghbin
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao-Shuang Li
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Chen-Ying Lin
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Fan Wu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Long-Fei Xia
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Jing-Bo Li
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
| | - Jing-Na Lin
- School of Medicine, Nankai University, Tianjin, China.
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
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Wang Y, Feng C, Yu B, Wang J, Chen W, Song C, Ji X, Guo R, Cheng G, Chen H, Wang X, Zhang L, Li Z, Jiang J, Xie C, Du H, Zhang X. Enhanced Effects of Intermittent Fasting by Magnetic Fields in Severe Diabetes. RESEARCH (WASHINGTON, D.C.) 2024; 7:0468. [PMID: 39238846 PMCID: PMC11376831 DOI: 10.34133/research.0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/13/2024] [Indexed: 09/07/2024]
Abstract
Intermittent fasting (IF) is a convenient dietary intervention for multiple diseases, including type 2 diabetes. However, whether it can be used as a long-term antidiabetic approach is still unknown. Here, we confirm that IF alone is beneficial for both moderate and severe diabetic mice, but its antidiabetic effects clearly diminish at later stages, especially for severe diabetic db/db mice, which have obviously impaired autophagy. We found that static magnetic fields can directly promote actin assembly and boost IF-induced autophagy. Consequently, the pancreatic islet and liver were improved, and the antidiabetic effects of IF were boosted. In fact, at later stages, combined static magnetic field and IF could reduce the blood glucose level of moderate type 2 diabetic mice by 40.5% (P < 0.001) and severe type 2 diabetes by 34.4% (P < 0.05), when IF alone no longer has significant blood glucose reduction effects. Therefore, although IF is generally beneficial for diabetes, our data reveal its insufficiency for late-stage diabetes, which can be compensated by a simple, noninvasive, long-lasting, and nonpharmacological strategy for effective long-term diabetic control.
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Affiliation(s)
- Ying Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Chuanlin Feng
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Biao Yu
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
| | - Junjun Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Weili Chen
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, China
| | - Chao Song
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xinmiao Ji
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Ruowen Guo
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Guofeng Cheng
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Hanxiao Chen
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Xinyu Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, China
| | - Lei Zhang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Zhiyuan Li
- Medical Research Council (MRC) Protein Phosphorylation and Ubiquitylation Unit, School of Life Sciences, University of Dundee, Dundee, UK
| | - Jialiang Jiang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Can Xie
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
| | - Haifeng Du
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, China
| | - Xin Zhang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
- Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui, China
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, China
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175
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Janota O, Mantovani M, Kwiendacz H, Irlik K, Bucci T, Lam SHM, Huang B, Alam U, Boriani G, Hendel M, Piaśnik J, Olejarz A, Włosowicz A, Pabis P, Wójcik W, Gumprecht J, Lip GYH, Nabrdalik K. Metabolically "extremely unhealthy" obese and non-obese people with diabetes and the risk of cardiovascular adverse events: the Silesia Diabetes - Heart Project. Cardiovasc Diabetol 2024; 23:326. [PMID: 39227929 PMCID: PMC11373332 DOI: 10.1186/s12933-024-02420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia). METHODS We analysed persons who were enrolled in the prospective Silesia Diabetes Heart Project (NCT05626413). Individuals were divided into 6 categories according to the presence of different clinical risk factors (obesity and CKM comorbidities): (i) Group 1: non-obese with 0 CKM comorbidities; (ii) Group 2: non-obese with 1-2 CKM comorbidities; (iii) Group 3: non-obese with 3 CKM comorbidities (non-obese "extremely unhealthy"); (iv) Group 4: obese with 0 CKM comorbidities; (v) Group 5: obese with 1-2 CKM comorbidities; and (vi) Group 6: obese with 3 CKM comorbidities (obese "extremely unhealthy"). The primary outcome was a composite of CV death, myocardial infarction (MI), new onset of heart failure (HF), and ischemic stroke. RESULTS 2105 people with DM were included [median age 60 (IQR 45-70), 48.8% females]. Both Group 1 and Group 6 were associated with a higher risk of events of the primary composite outcome (aHR 4.50, 95% CI 1.20-16.88; and aHR 3.78, 95% CI 1.06-13.47, respectively). On interaction analysis, in "extremely unhealthy" persons the impact of CKM comorbidities in determining the risk of adverse events was consistent in obese and non-obese ones (Pint=0.824), but more pronounced in individuals aged < 65 years compared to older adults (Pint= 0.028). CONCLUSION Both non-obese and obese people with DM and 3 associated CKM comorbidities represent an "extremely unhealthy" phenotype which are at the highest risk of CV adverse events. These results highlight the importance of risk stratification of people with DM for risk factor management utilising an interdisciplinary approach.
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Affiliation(s)
- Oliwia Janota
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
- Doctoral School, Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
- Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Katowice, 40-055, Poland.
| | - Marta Mantovani
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Hanna Kwiendacz
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Irlik
- Doctoral School, Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Tommaso Bucci
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Department of General and Specialized Surgery, Sapienza University of Rome, Rome, Italy
| | - Steven H M Lam
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Bi Huang
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Uazman Alam
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Diabetes & Endocrinology Research and Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital National Health Service Foundation Trust, Liverpool, UK
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Mirela Hendel
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Julia Piaśnik
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Anna Olejarz
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Włosowicz
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Patrycja Pabis
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Wiktoria Wójcik
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Student's Scientific Association, Medical University of Silesia, Katowice, Poland
| | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Katarzyna Nabrdalik
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
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Lahooti A, Rizvi A, Canakis A, Akagbosu C, Johnson KE, Hassan K, Lahooti I, Abu-Hammour M, Dawod E, Dawod Q, Newberry C, Sampath K, Carr-Locke D, Mahadev S, Afaneh C, Dakin G, Kumar S, Yeung M, Barenbaum S, Tchang B, Shukla AP, Aronne LJ, Sharaiha RZ. Navigating the Predictive Landscape: DiaRem's Role in Unveiling Outcomes for Diabetes Remission following ESG. Obes Surg 2024; 34:3358-3365. [PMID: 39117857 DOI: 10.1007/s11695-024-07408-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/24/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Rising obesity and type 2 diabetes mellitus (T2DM) rates can be mitigated by various strategies, with a 10% total body weight loss (TBWL) threshold often required for T2DM remission. T2DM remission rates after bariatric surgery like Roux-en-Y gastric bypass (RYGB) are well established; endoscopic sleeve gastroplasty (ESG) is a less invasive option that averages 15% TBWL and allows for T2DM remission. This study explores the DiaRem (Diabetes Remission post-RYGB) score's ability to predict T2DM remission 1-year post-ESG. MATERIALS AND METHODS We conducted a retrospective cohort study on 39 individuals with T2DM who underwent ESG. Age, utilization of diabetes medications, insulin administration, and hemoglobin A1c levels were used to calculate the DiaRem score. The area under the receiver operating characteristic curve (AUC) was employed to evaluate the discriminative ability of DiaRem in distinguishing diabetes remission. RESULTS Among the 39 patients with a median hemoglobin A1c of 6.7, 12.8% required insulin, and 43.6% used diabetes medication. At 1-year post-ESG, 69.2% of patients experienced diabetes remission with a median %TWBL of 12.7. The DiaRem score's ability to detect diabetes resolution for ESG patients had a sensitivity of 100% and a specificity of 58.3%, at the optimal cutoff value of 10. The AUC was 0.779 (95% CI 0.546-0.959). CONCLUSION Our study demonstrated the DiaRem score's predictive value for T2DM remission post-ESG, highlighting its utility in clinical decision-making for ESG-related outcomes. Further investigation is needed to identify alternative indicators that may enhance predictive accuracy, thus refining personalized decision-making for this patient group.
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Affiliation(s)
- Ali Lahooti
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Anam Rizvi
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Andrew Canakis
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cynthia Akagbosu
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Kate E Johnson
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Kamal Hassan
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Ila Lahooti
- Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Mohamed Abu-Hammour
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Enad Dawod
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Qais Dawod
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Carolyn Newberry
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Kartik Sampath
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - David Carr-Locke
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - SriHari Mahadev
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | | | - Gregory Dakin
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Sonal Kumar
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA
| | - Michele Yeung
- Division of Endocrinology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Sarah Barenbaum
- Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY, USA
| | - Beverly Tchang
- Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY, USA
| | - Alpana P Shukla
- Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY, USA
| | - Louis J Aronne
- Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY, USA
| | - Reem Z Sharaiha
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA.
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Markou M, Katsouda A, Papaioannou V, Argyropoulou A, Vanioti M, Tamvakopoulos C, Skaltsounis LA, Halabalaki M, Mitakou S, Papapetropoulos A. Anti-obesity effects of Beta vulgaris and Eruca sativa-based extracts. Phytother Res 2024; 38:4757-4773. [PMID: 39120436 DOI: 10.1002/ptr.8291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 08/10/2024]
Abstract
Obesity is a major source of morbidity worldwide with more than 2 billion adults being overweight or obese. The incidence of obesity has tripled in the last 50 years, leading to an increased risk for a variety of noncommunicable diseases. Previous studies have demonstrated the positive effects of green leafy vegetables on weight gain and obesity and have attributed these beneficial properties, at least in part, to nitrates and isothiocyanates. Nitrates are converted to nitric oxide (NO) and isothiocyanates are known to release hydrogen sulfide (H2S). Herein, we investigated the effect of extracts and fractions produced from Beta vulgaris and Eruca sativa for their ability to limit lipid accumulation, regulate glucose homeostasis, and reduce body weight. Extracts from the different vegetables were screened for their ability to limit lipid accumulation in adipocytes and hepatocytes and for their ability to promote glucose uptake in skeletal muscle cultures; the most effective extracts were next tested in vivo. Wild type mice were placed on high-fat diet for 8 weeks to promote weight gain; animals receiving the selected B. vulgaris and E. sativa extracts exhibited attenuated body weight. Treatment with extracts also led to reduced white adipose tissue depot mass, attenuated adipocyte size, reduced expression of Dgat2 and PPARγ expression, and improved liver steatosis. In contrast, the extracts failed to improve glucose tolerance in obese animals and did not affect blood pressure. Taken together, our data indicate that extracts produced from B. vulgaris and E. sativa exhibit anti-obesity effects, suggesting that dietary supplements containing nitrates and sulfide-releasing compounds might be useful in limiting weight gain.
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Affiliation(s)
- Maria Markou
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Laboratory of Pharmacology, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonia Katsouda
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Laboratory of Pharmacology, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Varvara Papaioannou
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Argyropoulou
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
- PharmaGnose S.A., Oinofyta, Greece
| | - Marianna Vanioti
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Tamvakopoulos
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Leandros A Skaltsounis
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Halabalaki
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Mitakou
- Division of Pharmacognosy and Natural Products Chemistry, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Papapetropoulos
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Laboratory of Pharmacology, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
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178
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Astbury NM. Interventions to improve glycaemic control in people living with, and at risk of developing type 2 diabetes. Diabetes Obes Metab 2024; 26 Suppl 4:39-49. [PMID: 39157890 DOI: 10.1111/dom.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/19/2024] [Accepted: 07/20/2024] [Indexed: 08/20/2024]
Abstract
Type 2 diabetes mellitus is one of the most prevalent health conditions worldwide, affecting millions of individuals and posing significant public health challenges. Understanding the nature of type 2 diabetes, its causes, symptoms and treatments is crucial for managing and preventing its complications. Many different dietary strategies are used by individuals to treat and manage diabetes. This review provides an overview of popular dietary strategies that have evidence for improving long-term glycaemic control or achieving diabetes remission, as well as strategies that may be useful to reduce postprandial hyperglycaemia, which may be of use in the prevention of diabetes, but also as strategies for those already diagnosed but trying to manage their condition better. Recent clinical trials have provided evidence that in people living with type 2 diabetes who also live with overweight or obesity, using a total diet replacement weight loss programme results in significant and substantial weight loss, and as a result, many people can achieve remission from their diabetes. There has been considerable interest in whether similar effects can be achieved without reliance on formula foods, using real diet approaches. Reduced or low-carbohydrate diet approaches hold some promise, with observational or preliminary findings suggesting beneficial effects, but evidence from robust trials or systematic reviews of randomized controlled trials is still lacking. The Mediterranean dietary pattern, low in saturated fat and high in monounsaturated fat, also has some potential, with evidence to suggest some people can lose weight and achieve remission using this approach, which may be easier to adhere to longer term than more intensive total diet replacement and low-carbohydrate strategies. Plant-based diets that advocate for the elimination of animal-based and/or animal-derived foods have increased in popularity. There is evidence from epidemiological studies that people who follow these diets have a lower risk of developing type 2 diabetes, and evidence from trials and systematic reviews of trials that changing to a dietary pattern lower in animal-based and animal-derived foods has benefits on glycaemic control and other markers of cardiovascular disease. While these approaches all provide food or nutrient prescriptions, approaches that incorporate periods of fasting do not provide rules on the types of foods that can or cannot be consumed, but rather provide time windows of when to eat. Evidence suggests that these approaches can be as effective in achieving energy restriction and weight loss as approaches that advocate continuous energy restriction, and there is evidence for benefits on glycaemic control independent of weight loss. Finally, popular dietary strategies that may be useful to use or combine to help prevent postprandial hyperglycaemia include reducing the glycaemic index or glycaemic load of the diet, high-fibre diets, eating foods in a meal in the order vegetables > protein > carbohydrates, preloading or combining acids such as vinegar or lemon juice with meals and engaging in low-intensity aerobic exercise immediately after meals.
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Affiliation(s)
- Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Inokuchi T, Fukumoto Y, Lee G, Yokomizo Y, Tanaka K, Chosa M, Doi M, Tamaki N, Goto S, Ichikawa K, Kobayashi K. Efficacy and tolerability of oral semaglutide in Japanese patients with type 2 diabetes mellitus: Analysis report from diabetes specialist clinics. J Diabetes Investig 2024; 15:1202-1210. [PMID: 38700282 PMCID: PMC11363112 DOI: 10.1111/jdi.14225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Glucagon-like peptide 1 receptor agonists (GLP1Ras) have emerged as pivotal agents in diabetes management and organ protection. However, their use is limited due to the necessity for injectable administration. The advent of the first oral GLP1Ra (oral semaglutide) in Japan since 2021 is expected to expand its usage. The aim of this study is to survey the efficacy and tolerability of oral semaglutide in clinical practice. MATERIALS AND METHODS We retrospectively analyzed 120 outpatients diagnosed with type 2 diabetes mellitus who had received oral semaglutide for >6 months. Changes in clinical parameters during oral semaglutide treatment from baseline to 12 months were analyzed. The inverse probability weighting method using the propensity score was used to evaluate the differences in clinical parameters at 6 months after treatment, based on the patients' obesity levels. RESULTS Body weight (BW), glycated hemoglobin A1c (HbA1c), and alanine aminotransferase (ALT) levels at baseline decreased significantly after treatment compared with those at 12 months (P < 0.001, P < 0.001, and P = 0.03, respectively). The patients were divided into two groups using a cutoff baseline body mass index (BMI) of 30.3 kg/m2. Although no significant difference was observed, changes in body weight and HbA1c indicated a potentially greater decrease in the BMI ≧ 30.3 group than that in the BMI < 30.3 group (P = 0.07 and 0.13, respectively). Among 206 registered patients, 25 (12.1%) discontinued oral-semaglutide treatment owing to adverse effects, including gastrointestinal symptoms. CONCLUSIONS Oral semaglutide treatment demonstrates efficacy and tolerability for managing type 2 diabetes mellitus in Japan. Significant improvements in metabolic factors induced by oral semaglutide are anticipated, particularly in obese patients.
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Affiliation(s)
- Tetsuaki Inokuchi
- Inokuchi Medical ClinicFukuokaJapan
- Department of AuditorsJapan Physicians AssociationTokyoJapan
| | | | - Gendai Lee
- Diabetes and Endocrinology, Diabetes and Kidney Medical Corporation Gendai ClinicFukuokaJapan
| | | | | | | | | | | | | | | | - Kazuo Kobayashi
- Department of Clinical Research Support CenterJapan Physicians AssociationTokyoJapan
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
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180
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Abdul-Ghani M, Maffei P, DeFronzo RA. Managing insulin resistance: the forgotten pathophysiological component of type 2 diabetes. Lancet Diabetes Endocrinol 2024; 12:674-680. [PMID: 39098317 DOI: 10.1016/s2213-8587(24)00127-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/29/2024] [Indexed: 08/06/2024]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists have gained widespread use in the treatment of individuals with type 2 diabetes because of their potent weight loss promoting effect, ability to augment β-cell function, and cardiovascular protective effects. However, despite causing impressive weight loss, GLP-1 receptor agonists do not normalise insulin sensitivity in people with type 2 diabetes and obesity, and the long-term effects of this class of antidiabetic medication on muscle mass, frailty, and bone density have been poorly studied. Although GLP-1 receptor agonists improve insulin sensitivity secondary to weight loss, the only true direct insulin-sensitising drugs are thiazolidinediones. Because of side-effects associated with type 2 diabetes therapy, these drugs have not gained widespread use. In lieu of the important role of insulin resistance in the cause of type 2 diabetes and in the pathogenesis of atherosclerotic cardiovascular disease in type 2 diabetes, development of potent insulin-sensitising drugs that can be used in combination with GLP-1 receptor agonists remains a large unmet need in the management of individuals with type 2 diabetes.
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181
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Feng J, Chen W, Li S, Fang Q, Chen X, Bai G, Tian M, Huang Y, Xu P, Wang Z, Ma Y. PACAP ameliorates obesity-induced insulin resistance through FAIM/Rictor/AKT axis. FEBS J 2024; 291:4096-4110. [PMID: 39041617 DOI: 10.1111/febs.17228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/17/2024] [Accepted: 07/05/2024] [Indexed: 07/24/2024]
Abstract
Obesity and obesity-related insulin resistance have been a research hotspot. Pituitary adenylate cyclase activating polypeptide (PACAP) has emerged as playing a significant role in energy metabolism, holding promising potential for attenuating insulin resistance. However, the precise mechanism is not fully understood. Palmitic acid and a high-fat diet (HFD) were used to establish insulin resistance model in Alpha mouse liver 12 cell line and C57BL/6 mice, respectively. Subsequently, we assessed the effects of PACAP both in vivo and in vitro. Lentivirus vectors were used to explore the signaling pathway through which PACAP may ameliorate insulin resistance. PACAP was found to selectively bind to the PACAP type I receptor receptor and ameliorate insulin resistance, which was characterized by increased glycogen synthesis and the suppression of gluconeogenesis in the insulin-resistant cell model and HFD-fed mice. These effects were linked to the activation of the Fas apoptotic inhibitory molecule/rapamycin-insensitive companion of mammalian target of rapamycin/RAC-alpha serine/threonine-protein kinase (FAIM/Rictor/AKT) axis. Furthermore, PACAP ameliorated insulin resistance by increasing solute carrier family 2, facilitated glucose transporter members 2/4 and inhibiting gluconeogenesis-related proteins glucose 6-phosphatase catalytic subunit 1 and phosphoenolpyruvate carboxykinase 2 expression. Meanwhile, the phosphorylation of hepatic AKT/glycogen synthase kinase 3β was promoted both in vivo and in vitro by PACAP. Additionally, PACAP treatment decreased body weight, food intake and blood glucose levels in obese mice. Our study shows that PACAP ameliorated insulin resistance through the FAIM/Rictor/AKT axis, presenting it as a promising drug candidate for the treatment of obesity-related insulin resistance.
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Affiliation(s)
- Jia Feng
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Wenhui Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shanshan Li
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Qianchen Fang
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Xingwu Chen
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Ge Bai
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Meng Tian
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Yongmei Huang
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Pei Xu
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Zixian Wang
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
| | - Yi Ma
- Department of Cellular Biology, Institute of Biomedicine, Jinan University, Guangzhou, China
- Key Laboratory of Bioengineering Medicine of Guangdong Province, Jinan University, Guangzhou, China
- The National Demonstration Center for Experimental Education of Life Science and Technology, Jinan University, Guangzhou, China
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182
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Dhore-Patil A, Urina-Jassir D, Samson R, Le Jemtel TH, Oparil S. Epicardial Adipose Tissue Thickness and Preserved Ejection Fraction Heart Failure. Curr Hypertens Rep 2024; 26:381-388. [PMID: 38642285 PMCID: PMC11324708 DOI: 10.1007/s11906-024-01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE OF THE REVIEW Preserved ejection fraction heart failure and obesity frequently coexist. Whether obesity plays a consistent role in the pathogenesis of preserved ejection fraction heart failure is unclear. Accumulation of visceral adiposity underlies the pathogenic aftermaths of obesity. However, visceral adiposity imaging is assessed by computed tomography or magnetic resonance and thus not routinely available. In contrast, epicardial adiposity thickness is assessed by echocardiography and thus routinely available. We review the rationale for assessing epicardial adiposity thickness in patients with preserved ejection fraction heart failure and elevated body mass index. RECENT FINDINGS Body mass index correlates poorly with visceral, and epicardial adiposity. Visceral and epicardial adiposity enlarges as preserved ejection fraction heart failure progresses. Epicardial adiposity may hasten the progression of coronary artery disease and impairs left ventricular sub-endocardial perfusion and diastolic function. Epicardial adiposity thickness may help monitor the therapeutic response in patients with preserved ejection failure heart failure and elevated body mass index.
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Affiliation(s)
- Aneesh Dhore-Patil
- Division of Cardiovascular Imaging, Weill Cornell Medical College, Houston Methodist DeBakey Heart & Vascular Center, 6505 Fanin St., Houston, TX, 77030, USA
| | - Daniela Urina-Jassir
- Section of Cardiology, John W. Deming Department of Medicine, Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Rohan Samson
- Advanced Heart Failure Therapies Program, University of Louisville Health-Heart Hospital, 201Abraham Flexner Way, Suite 1001, Louisville, KY, 40202, USA
| | - Thierry H Le Jemtel
- Section of Cardiology, John W. Deming Department of Medicine, Tulane Avenue, SL-48, New Orleans, LA, 70112, USA.
| | - Suzanne Oparil
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Wen J, Nadora D, Bernstein E, How-Volkman C, Truong A, Akhtar M, Prakash NA, Puglisi J, Frezza E. Semaglutide Versus Other Glucagon-Like Peptide-1 Agonists for Weight Loss in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e69008. [PMID: 39385875 PMCID: PMC11463578 DOI: 10.7759/cureus.69008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
Obesity places patients at higher risk for numerous problems, including prediabetes, type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome, cardiovascular disease, and nonalcoholic fatty liver disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are antidiabetic drugs that have a recognized effect on weight loss. This systematic review analyzed semaglutide against alternative GLP-1 agonists in facilitating weight loss and evaluated their associated adverse events (AEs) in diabetic patients. A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed using PubMed, Embase, and Cochrane Library for studies comparing semaglutide and other GLP-1 RAs for weight loss. A narrative synthesis and meta-analysis using SPSS program version 29 were performed to analyze the differences in weight loss between cohorts. Nine studies with 5,445 patients whose mean age was 60.01 years (55.5-70) and mean follow-up of 32.5 weeks (4-58.7) were included. The meta-analysis showed that semaglutide had a greater mean weight loss compared to liraglutide (-6.08, 95% confidence interval (Cl) = -8.40, -3.75) and dulaglutide (-2.85, 95% CI = -5.59, 0.11). Tirzepatide had a greater mean weight loss compared to semaglutide (-3.78, 95% CI = -5.52, -2.04). Common AEs included minor and moderate gastrointestinal events. In conclusion, GLP-1 RAs have shown efficacy in reducing body weight in T2DM patients. Semaglutide, liraglutide, dulaglutide, tirzepatide, and exenatide demonstrated mean weight loss reductions of 4.81 kg, 2.81 kg, 4.03 kg, 9.7 kg, and 1.9 kg, respectively, with high rates of minimal to moderate-severity AEs. Semaglutide demonstrated increased numerical weight loss compared to its comparators (dulaglutide, liraglutide, and exenatide). However, tirzepatide, a dual-agonist, produced greater weight loss compared to semaglutide. The paucity of comparative head-to-head trials prevents a definitive conclusion of the superiority of one GLP-1 RA over another.
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Affiliation(s)
- Jimmy Wen
- Physical Medicine and Rehabilitation, California Northstate University College of Medicine, Elk Grove, USA
| | - Denise Nadora
- Neurology, California Northstate University College of Medicine, Elk Grove, USA
| | - Ethan Bernstein
- Physical Medicine and Rehabilitation, California Northstate University College of Medicine, Elk Grove, USA
| | | | - Alina Truong
- Cardiology, California Northstate University College of Medicine, Elk Grove, USA
| | - Muzammil Akhtar
- Surgery, California Northstate University College of Medicine, Elk Grove, USA
| | | | - Jose Puglisi
- Biostatistics, California Northstate University College of Medicine, Elk Grove, USA
| | - Eldo Frezza
- Surgery, California Northstate University College of Medicine, Elk Grove, USA
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Buwaider A, Backlund EO, Almqvist P, Lippitz B, Fletcher-Sandersjöö A, Bartek J. 55-Year Follow-Up of the First Adult Patient With Craniopharyngioma Treated With Gamma Knife Radiosurgery. Neurosurgery 2024; 95:e71-e78. [PMID: 38690888 DOI: 10.1227/neu.0000000000002973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 05/03/2024] Open
Abstract
In May 1968, Lars Leksell and Erik-Olof Backlund achieved a pioneering breakthrough by performing the first Gamma Knife radiosurgery (GKRS) on a craniopharyngioma (CP). Today, more than 50 years later, this patient remains under continuous monitoring, providing the longest documented follow-up of a GKRS-treated CP. This case report provides a complete record of the patient's preoperative presentation, surgical assessment, GKRS, and an extensive long-term follow-up with multiple interventions. The investigation involved analysis of archived and digitalized patient records and radiological images. The patient was a 21-year-old female who presented with amenorrhea and low levels of gonadotropins. Pneumoencephalography showed a calcified 2 × 2.5 cm mass located in the suprasellar region, indicative of a CP. Subsequent stereotactic puncture confirmed a predominantly solid nature of the CP. Given the size and composition of the tumor, the surgical team opted for GKRS. Dose planning was performed manually, with coordinates determined using Leksell's stereotactic frame. The tumor was targeted with a total dose of 50 Gy using 179 beams of 60 Co. Over the subsequent 55 years, the patient underwent radiological and clinical follow-ups. Throughout this period, 4 cystic tumor recurrences occurred and were managed by stereotactic puncture and Yttrium-90 instillation radiotherapy. The solid component remained stable without repeated GKRS. The patient suffered lateral quadrant anopsia and endocrinological deficits, necessitating pharmaceutical intervention. Despite these challenges, the patient is still living an active life at age 76 years. This case stands as historic evidence of long-term safety and efficacy of GKRS for CPs.
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Affiliation(s)
- Ali Buwaider
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden
| | - Erik-Olof Backlund
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden
- Department of Neurosurgery, Karolinska University Hospital, Stockholm , Sweden
| | - Per Almqvist
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden
- Department of Neurosurgery, Karolinska University Hospital, Stockholm , Sweden
| | - Bodo Lippitz
- Interdisciplinary Centre for Radiosurgery (ICERA), Radiological Alliance, Hamburg , Germany
| | - Alexander Fletcher-Sandersjöö
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden
- Department of Neurosurgery, Karolinska University Hospital, Stockholm , Sweden
| | - Jiri Bartek
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden
- Department of Neurosurgery, Karolinska University Hospital, Stockholm , Sweden
- Department of Neurosurgery, Rigshospitalet, Copenhagen , Denmark
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185
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Anson M, Henney AE, Broadwell N, Zhao SS, Ibarburu GH, Lip GYH, Wilding JPH, Cuthbertson DJ, Alam U. Incidence of new onset type 2 diabetes in adults living with obesity treated with tirzepatide or semaglutide: real world evidence from an international retrospective cohort study. EClinicalMedicine 2024; 75:102777. [PMID: 39246719 PMCID: PMC11377141 DOI: 10.1016/j.eclinm.2024.102777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 09/10/2024] Open
Abstract
Background Tirzepatide, a novel dual agonist of glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), has demonstrated greater magnitude of weight loss compared to semaglutide in a phase 3 clinical trial. However, the effect of tirzepatide on incidence of type 2 diabetes (T2D) in individuals with overweight and obesity, and the effect on major adverse cardiovascular outcomes in individuals with pre-existing T2D, remains unknown. Methods We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (TriNetX LLC, Cambridge, MA, USA) a global federated database. The data used in this study was collected on 5th June 2024. Two cohorts of individuals were generated: 1) without pre-existing T2D and, 2) with T2D. We adopted an active comparator new user design on new initiations of either tirzepatide or semaglutide therapy. Analysis began from the index event which was defined as individuals on respective therapy for 6 months only. Analysis of outcomes was conducted off-drug, in individuals without a pre-existing history of the disease of interest. Individuals were followed up for 12 months post the index event. Primary outcome for cohort 1 was incidence of T2D, and for cohort 2 was composite: all-cause mortality, cerebral infarction, acute coronary syndrome, and heart failure. Secondary outcomes for cohort 1 were change in HbA1c and body weight and for cohort 2: incidence of micro- and macrovascular complications, suicidal ideation and/or attempt, and all-cause mortality. We propensity score matched (1:1) for potential confounders: baseline demographics, socioeconomic circumstances, HbA1c, weight, relevant co-morbidities, and anti-obesity, hypoglycaemic and cardioprotective agents. Findings The study population without T2D consisted of 13,846 individuals, equally split between tirzepatide and semaglutide users. Tirzepatide was associated with both lower risk for incident T2D (HR 0.73, 95% CI 0.58-0.92, p < 0.001) and greater weight loss (-7.7 kg, [95% CI -6.8, -8.5 kg], p < 0.001), compared to semaglutide (-4.8 kg, [95% CI -3.9, -5.6 kg], p < 0.001). In individuals with pre-existing T2D (n = 8446), tirzepatide was associated with lower risk of the composite outcome (HR 0.54, 95% CI 0.38-0.76, p < 0.001), cerebral infarction (HR 0.45, 95% CI 0.24-0.84, p = 0.010) and all-cause mortality (HR 0.33, 95% CI 0.15-0.73, p = 0.004) compared to semaglutide. Interpretation Tirzepatide is associated with significantly reduced risk of developing T2D and major adverse cardiovascular events in individuals living with obesity and T2D respectively. Randomised controlled trials investigating the utility of dual incretin agonists in the primary prevention of T2D and cardiovascular disease in higher risk populations are now required. Funding Nil.
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Affiliation(s)
- Matthew Anson
- Diabetes & Endocrinology Research, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | - Alex E Henney
- Diabetes & Endocrinology Research, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | | | - Sizheng S Zhao
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - John P H Wilding
- Diabetes & Endocrinology Research, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | - Daniel J Cuthbertson
- Diabetes & Endocrinology Research, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | - Uazman Alam
- Diabetes & Endocrinology Research, Institute of Life Course and Medical Sciences, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
- Visiting Fellow, Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
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186
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Khattab R. Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management. Curr Nutr Rep 2024; 13:478-499. [PMID: 38861120 DOI: 10.1007/s13668-024-00551-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE OF REVIEW Despite the prevalence of weight loss programs, their success rates remain discouraging, with around half of individuals regaining lost weight within two years. The primary objective of this review is to explore the factors contributing to the failure of weight loss programs and to provide insights into effective weight management strategies. RECENT FINDINGS Factors contributing to the failure of weight loss programs include the impracticality of restrictive diets, potential metabolic impacts, limited focus on lifestyle changes, genetic predispositions, psychological influences, socioeconomic status, and medical conditions. A holistic approach considering these factors is crucial for safe and sustainable weight loss. Key findings indicate the importance of holistic approaches to weight management, including lifestyle modifications, medical interventions, and behavioral and psychological strategies. Effective weight loss strategies emphasize low-calorie, nutrient-rich diets, regular physical activity, and interventions tailored to individual needs. Combining multiple approaches offers the best chance of successful weight management and improved health outcomes. This review provides insights into the complexities of obesity management and the factors contributing to the failure of weight loss programs. It highlights the necessity of adopting a holistic approach that addresses dietary habits, physical activity, genetic factors, psychological well-being, and socioeconomic influences. Recommendations include implementing lifestyle modifications, medical interventions when necessary, and integrating behavioral and psychological support to achieve sustainable weight loss and mitigate the global health challenge posed by obesity.
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Affiliation(s)
- Rabie Khattab
- Clinical Nutrition Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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187
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Serban D, Dascalu AM. New Diagnostic and Therapeutic Approaches in Diabetic Microvascular Complications. Biomedicines 2024; 12:1858. [PMID: 39200322 PMCID: PMC11351895 DOI: 10.3390/biomedicines12081858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024] Open
Abstract
Diabetes mellitus is a major global health problem with an ascendant trend that makes it expected to reach up to 700 million cases by 2045 [...].
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Affiliation(s)
- Dragos Serban
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Ana Maria Dascalu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
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188
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Mirasierra M, Fernández-Pérez A, Lizarbe B, Keiran N, Ruiz-Cañas L, Casarejos MJ, Cerdán S, Vendrell J, Fernández-Veledo S, Vallejo M. Alx3 deficiency disrupts energy homeostasis, alters body composition, and impairs hypothalamic regulation of food intake. Cell Mol Life Sci 2024; 81:343. [PMID: 39129011 PMCID: PMC11335267 DOI: 10.1007/s00018-024-05384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/03/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024]
Abstract
The coordination of food intake, energy storage, and expenditure involves complex interactions between hypothalamic neurons and peripheral tissues including pancreatic islets, adipocytes, muscle, and liver. Previous research shows that deficiency of the transcription factor Alx3 alters pancreatic islet-dependent glucose homeostasis. In this study we carried out a comprehensive assessment of metabolic alterations in Alx3 deficiency. We report that Alx3-deficient mice exhibit decreased food intake without changes in body weight, along with reduced energy expenditure and altered respiratory exchange ratio. Magnetic resonance imaging reveals increased adiposity and decreased muscle mass, which was associated with markers of motor and sympathetic denervation. By contrast, Alx3-deficient mice on a high-fat diet show attenuated weight gain and improved insulin sensitivity, compared to control mice. Gene expression analysis demonstrates altered lipogenic and lipolytic gene profiles. In wild type mice Alx3 is expressed in hypothalamic arcuate nucleus neurons, but not in major peripheral metabolic organs. Functional diffusion-weighted magnetic resonance imaging reveals selective hypothalamic responses to fasting in the arcuate nucleus of Alx3-deficient mice. Additionally, altered expression of proopiomelanocortin and melanocortin-3 receptor mRNA in the hypothalamus suggests impaired regulation of feeding behavior. This study highlights the crucial role for Alx3 in governing food intake, energy homeostasis, and metabolic nutrient partitioning, thereby influencing body mass composition.
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Affiliation(s)
- Mercedes Mirasierra
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Fernández-Pérez
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Centro para el Desarrollo Tecnológico e Industrial (CDTI), Madrid, Spain
| | - Blanca Lizarbe
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain
- Department of Biochemistry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Noelia Keiran
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Laura Ruiz-Cañas
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain
- Chronic Diseases and Cancer Area 3, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | - María José Casarejos
- Neuropharmacology Laboratory, Neurobiology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | - Sebastián Cerdán
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Sonia Fernández-Veledo
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Research Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV) - Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Mario Vallejo
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas/Universidad Autónoma de Madrid, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.
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Chebaro Z, Mesmar JE, Badran A, Al-Sawalmih A, Maresca M, Baydoun E. Halophila stipulacea: A Comprehensive Review of Its Phytochemical Composition and Pharmacological Activities. Biomolecules 2024; 14:991. [PMID: 39199379 PMCID: PMC11353240 DOI: 10.3390/biom14080991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/09/2024] [Accepted: 08/10/2024] [Indexed: 09/01/2024] Open
Abstract
Halophila stipulacea (Forsskål and Niebuhr) Ascherson is a small marine seagrass that belongs to the Hydrocharitaceae family. It is native to the Red Sea, Persian Gulf, and Indian Ocean and has successfully invaded the Mediterranean and Caribbean Seas. This article summarizes the pharmacological activities and phytochemical content of H. stipulacea, along with its botanical and ecological characteristics. Studies have shown that H. stipulacea is rich in polyphenols and terpenoids. Additionally, it is rich in proteins, lipids, and carbohydrates, contributing to its nutritional value. Several biological activities are reported by this plant, including antimicrobial, antioxidant, anticancer, anti-inflammatory, anti-metabolic disorders, and anti-osteoclastogenic activities. Further research is needed to validate the efficacy and safety of this plant and to investigate the mechanisms of action underlying the observed effects.
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Affiliation(s)
- Ziad Chebaro
- Department of Biology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon; (Z.C.); (J.E.M.)
| | - Joelle Edward Mesmar
- Department of Biology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon; (Z.C.); (J.E.M.)
| | - Adnan Badran
- Department of Nutrition, University of Petra, Amman 11196, Jordan;
| | - Ali Al-Sawalmih
- Marine Science Station, University of Jordan, Aqaba 11942, Jordan;
| | - Marc Maresca
- Aix Marseille Univ, CNRS, Centrale Med, ISM2, 13013 Marseille, France
| | - Elias Baydoun
- Department of Biology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon; (Z.C.); (J.E.M.)
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190
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Svart M, Rittig N, Luong TV, Gopalasingam N, Vestergaard ET, Gormsen L, Søndergaard E, Thomsen HH, Gravholt CH. Three Weeks on a Ketogenic Diet Reduces Free Testosterone and Free Estradiol in Middle-Aged Obese Men and Women. J Nutr Metab 2024; 2024:9301369. [PMID: 39139216 PMCID: PMC11321886 DOI: 10.1155/2024/9301369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 08/15/2024] Open
Abstract
Background Beta-hydroxybuturate (β-OHB) supplements are commonly utilized in sports by both recreational and professional athletes. In a recent study, we observed a drop in testosterone levels following the oral ingestion of racemic sodium-β-OHB. In this investigation, we aim to determine whether a single oral dose of ketone ester (study I) and prolonged endogenous ketosis (study II) also reduces testosterone levels. Design This investigation integrated samples from two distinct studies. Study I was a randomized, controlled, crossover trial with ten healthy, young male participants receiving either a weight-adjusted ketone ester or control (water, CTR) and vice versa following an overnight fast. Repeated blood sampling was used to monitor plasma β-OHB and testosterone levels. Study II, another randomized, controlled, crossover trial, included 11 middle-aged participants (five males). They followed either a ketogenic diet (KD) characterized by low carbohydrates and high fat content or a standard diet (SDD) for three weeks. After each study period, participants underwent examination following an overnight fast, with repeated measures employed to analyze concentrations of plasma β-OHB and sex hormone levels. Results Study I: Testosterone decreased from 23.8 ± 2.4 nmol/l to 22.3 ± 2.5 nmol/l 300 minutes after the ketone ester and increased from 20.9 ± 2.1 nmol/l to 22.2 ± 1.9 300 minutes after CTR. This difference was not significant, p = 0.06. Study II. Total testosterone was unaffected after the KD compared to the SDD in men (20.2 ± 1.23 nmol/l vs. 18.2 ± 1.23 nmol/l (p = 0.1)) and was lower after KD in women (0.87 ± 0.06 vs. 1.1 ± 0.06 nmol/l (p < 0.0001)). Sex hormone-binding globulin (SHBG) increased in men after KD compared with SDD (31.2 ± 2.6 nmol/l vs 25.0 ± 2.6 nmol/l, p < 0.0001) and women (26.5 ± 3.05 nmol/l vs 24.2 ± 3.05 nmol/l, p = 0.003). The free androgen index decreased after KD in men (ratio: 0.65 ± 0.05 vs. ratio: 0.74 ± 0.05, p = 0.04) and in women (ratio: 0.036 ± 0.006 vs. SDD 0.05 ± 0.006, p = 0.0001). Free estradiol index was also found lower after KD in men (ratio: 3.1 ± 0.8 vs. ratio: 4.8 ± 0.8, p = 0.0003) and in women (ratio: 1.2 ± 2.2 vs. 9.8 ± 2.2, p = 0.0001). Conclusion Our findings indicate that the acute ingestion of ketone ester may not reduce testosterone levels in healthy young males. However, a three-week exposure to KB from a KD results in an increase in SHBG in men and women with obesity as well as it lowers free testosterone and estradiol for men and women. We thus present evidence of crosstalk between alterations in a metabolite, β-OHB, and the regulation of the hypothalamic-pituitary-gonadal axis from a KD. The clinical impact of this reduction remains to be investigated. This trial is registered with NCT04156477 and NCT05012748.
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Affiliation(s)
- Mads Svart
- Department of Internal MedicineHorsens Regional Hospital, Horsens, Denmark
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center AarhusAarhus University Hospital, Aarhus, Denmark
| | - Nikolaj Rittig
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center AarhusAarhus University Hospital, Aarhus, Denmark
| | - Thien Vinh Luong
- Steno Diabetes Center AarhusAarhus University Hospital, Aarhus, Denmark
- Department of Nuclear Medicine & PET-centreAarhus University Hospital, Aarhus, Denmark
| | - Nigopan Gopalasingam
- Department of CardiologyAarhus University Hospital, Aarhus, Denmark
- Department of CardiologyGødstrup Hospital, Herning, Denmark
| | - Esben Thyssen Vestergaard
- Steno Diabetes Center AarhusAarhus University Hospital, Aarhus, Denmark
- Department of PediatricsAarhus University Hospital, Aarhus, Denmark
| | - Lars Gormsen
- Department of Nuclear Medicine & PET-centreAarhus University Hospital, Aarhus, Denmark
| | - Esben Søndergaard
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center AarhusAarhus University Hospital, Aarhus, Denmark
- Department of Clinical MedicineAarhus University Hospital, Aarhus, Denmark
| | - Henrik Holm Thomsen
- Department of Clinical MedicineAarhus University Hospital, Aarhus, Denmark
- Department of Internal MedicineViborg Regional Hospital, Viborg, Denmark
| | - Claus H. Gravholt
- Department of Internal Medicine and EndocrinologyAarhus University Hospital, Aarhus, Denmark
- Department of Clinical MedicineAarhus University Hospital, Aarhus, Denmark
- Department of Molecular MedicineAarhus University Hospital, Aarhus, Denmark
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191
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Chen W, Hu H, Cao C, Liu D, Han Y. Link between remnant cholesterol and the reversion to normoglycemia in Chinese adults with prediabetes: a 5-year cohort study. Sci Rep 2024; 14:18098. [PMID: 39103476 PMCID: PMC11300864 DOI: 10.1038/s41598-024-69169-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024] Open
Abstract
Despite the clear association between remnant cholesterol (RC)and diabetes risk, no study to date has examined the relationship between RC and reversal of prediabetes to normoglycemia. This retrospective cohort study included a total of 15,023 patients with prediabetes who underwent a physical examination between 2010 and 2016. The link between initial RC levels and the reversion from prediabetes to normoglycemia was analyzed using the Cox proportional-hazards regression model. Additionally, the study explored the possible relationship between RC and the probability of returning normoglycemia by applying Cox proportional hazards regression models with cubic spline functions. To address competing risks, a multivariate Cox regression analysis was undertaken, treating the onset of diabetes as a competing risk event for reversing prediabetes to normoglycemia. Additionally, the study incorporated extensive subgroup analyses alongside multiple sensitivity analyses, enhancing the reliability and robustness of the results. After adjusting for covariates, the findings indicated that RC was inversely associated with the likelihood of reverting to normoglycemia (per 5 mg/dL increase, HR = 0.918, 95% CI 0.909-0.927). The analysis also revealed a nonlinear relationship between RC and normoglycemia reversion, with an inflection point at 51.08 mg/dL. For RC values below this inflection point (RC < 50.08 mg/dL), the HR for the probability of returning to normoglycemia was 0.907 (95% CI 0.897-0.917 per 5 mg/dL). Additionally, the competing risks model demonstrated a negative relationship between RC and the reversal of prediabetes to normoglycemia (SHR = 0.92, 95% CI 0.91-0.93). Sensitivity analyses confirmed the robustness and stability of these results. This study demonstrated a negative and non-linear association between RC and the probability of reversion to normoglycemia in Chinese adults with prediabetes. By actively intervening to reduce RC levels, at least to below 51.08 mg/dL, further reduction of RC may significantly increase the probability of returning to normoglycemia from prediabetes.
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Affiliation(s)
- Weifeng Chen
- Department of General Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Dehong Liu
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
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Alshuweishi Y, Abudawood A, Alfayez D, Almufarrih AA, Alanazi F, Alshuweishi FA, Almuqrin AM. Platelet/High-Density Lipoprotein Ratio (PHR) Predicts Type 2 Diabetes in Obese Patients: A Retrospective Study. Healthcare (Basel) 2024; 12:1540. [PMID: 39120243 PMCID: PMC11311744 DOI: 10.3390/healthcare12151540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/27/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
Background: Obesity and type 2 diabetes (T2D) pose global health problems that continue to rise. A chronic low-grade inflammation and activation of the immune system are well established in both conditions. The presence of these factors can predict disease development and progression. Emerging evidence suggests that platelet-high density lipoprotein ratio (PHR) is a potential inflammatory marker. The purpose of this study was to investigate the relationship between PHR and T2D among obese patients. Methods: 203 patients with BMI ≥ 30 kg/m2 participated in the study. Patients were categorized into two groups: non-diabetic obese and diabetic obese. Comorbidities, baseline characteristics, laboratory data, as well as PHR levels of the study groups were analyzed. Medians, risk assessment, and the diagnostic performance of PHR values were examined in both groups. Results: In obese patients, the median PHR were significantly increased in obese patients with T2D compared to non-diabetic obese (p < 0.0001). Furthermore, T2D obese with high PHR had a significantly higher FBG and HbA1c (p < 0.05). Although PHR was weakly yet significantly correlated with glycemic markers, ROC curve analysis of the PHR indicated an AUC of 0.700 (p < 0.0001) in predicting T2D in obese patients, and the cutoff value was 6.96, with a sensitivity and specificity of 53.4% and 76.1%, respectively. Moreover, increased PHR (OR = 4.77, p < 0.0001) carried a significantly higher risk for developing T2D in obese individuals. Conclusions: The PHR is a convenient and cost-effective marker that can reliably predict the presence of T2D in high-risk obese population.
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Affiliation(s)
- Yazeed Alshuweishi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (F.A.); (A.M.A.)
| | - Arwa Abudawood
- Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia; (A.A.); (D.A.); (A.A.A.)
| | - Dalal Alfayez
- Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia; (A.A.); (D.A.); (A.A.A.)
| | - Abdulmalik A. Almufarrih
- Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia; (A.A.); (D.A.); (A.A.A.)
| | - Fuad Alanazi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (F.A.); (A.M.A.)
| | - Fahd A. Alshuweishi
- King Fahad Kidney Center, King Saud Medical City, Riyadh 12746, Saudi Arabia;
| | - Abdulaziz M. Almuqrin
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (F.A.); (A.M.A.)
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193
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Gijbels A, Jardon KM, Trouwborst I, Manusama KC, Goossens GH, Blaak EE, Feskens EJ, Afman LA. Fasting and postprandial plasma metabolite responses to a 12-wk dietary intervention in tissue-specific insulin resistance: a secondary analysis of the PERSonalized glucose Optimization through Nutritional intervention (PERSON) randomized trial. Am J Clin Nutr 2024; 120:347-359. [PMID: 38851634 DOI: 10.1016/j.ajcnut.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/06/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND We previously showed that dietary intervention effects on cardiometabolic health were driven by tissue-specific insulin resistance (IR) phenotype: individuals with predominant muscle IR (MIR) benefited more from a low-fat, high-protein, and high-fiber (LFHP) diet, whereas individuals with predominant liver insulin resistance (LIR) benefited more from a high-monounsaturated fatty acid (HMUFA) diet. OBJECTIVES To further characterize the effects of LFHP and HMUFA diets and their interaction with tissue-specific IR, we investigated dietary intervention effects on fasting and postprandial plasma metabolite profile. METHODS Adults with MIR or LIR (40-75 y, BMI 25-40 kg/m2) were randomly assigned to a 12-wk HMUFA or LFHP diet (n = 242). After the exclusion of statin use, 214 participants were included in this prespecified secondary analysis. Plasma samples were collected before (T = 0) and after (T = 30, 60, 120, and 240 min) a high-fat mixed meal for quantification of 247 metabolite measures using nuclear magnetic resonance spectroscopy. RESULTS A larger reduction in fasting VLDL-triacylglycerol (TAG) and VLDL particle size was observed in individuals with MIR following the LFHP diet and those with LIR following the HMUFA diet, although no longer statistically significant after false discovery rate (FDR) adjustment. No IR phenotype-by-diet interactions were found for postprandial plasma metabolites assessed as total area under the curve (tAUC). Irrespective of IR phenotype, the LFHP diet induced greater reductions in postprandial plasma tAUC of the larger VLDL particles and small HDL particles, and TAG content in most VLDL subclasses and the smaller LDL and HDL subclasses (for example, VLDL-TAG tAUC standardized mean change [95% CI] LFHP = -0.29 [-0.43, -0.16] compared with HMUFA = -0.04 [-0.16, 0.09]; FDR-adjusted P for diet × time = 0.041). CONCLUSIONS Diet effects on plasma metabolite profiles were more pronounced than phenotype-by-diet interactions. An LFHP diet may be more effective than an HMUFA diet for reducing cardiometabolic risk in individuals with tissue-specific IR, irrespective of IR phenotype. Am J Clin Nutr 20xx;x:xx. This trial was registered at the clinicaltrials.gov registration (https://clinicaltrials.gov/study/NCT03708419?term=NCT03708419&rank=1) as NCT03708419 and CCMO registration (https://www.toetsingonline.nl/to/ccmo_search.nsf/fABRpop?readform&unids=3969AABCD9BA27FEC12587F1001BCC65) as NL63768.068.17.
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Affiliation(s)
- Anouk Gijbels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands; Top Institute Food and Nutrition (TiFN), Wageningen, The Netherlands.
| | - Kelly M Jardon
- Top Institute Food and Nutrition (TiFN), Wageningen, The Netherlands; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Inez Trouwborst
- Top Institute Food and Nutrition (TiFN), Wageningen, The Netherlands; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Koen Cm Manusama
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ellen E Blaak
- Top Institute Food and Nutrition (TiFN), Wageningen, The Netherlands; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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194
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Hu X, Fang X, Wu M. Prevalence, awareness, treatment and control of type 2 diabetes in southeast China: A population-based study. J Diabetes Investig 2024; 15:1034-1041. [PMID: 38741389 PMCID: PMC11292384 DOI: 10.1111/jdi.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 05/16/2024] Open
Abstract
AIMS/INTRODUCTION To estimate the prevalence, awareness, treatment, control rate, and influence factors of type 2 diabetes in Fujian province and provide the scientific basic for prevention. MATERIALS AND METHODS A population-based study with the analysis of binary logistic regression was carried out to estimate the odds ratios of the influencing factor on type 2 diabetes. Data of the Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) in southeast China were used. The study sample originated from 12 counties in Fujian province and included 135,352 permanent residents aged 35-75 years in 2021. RESULTS The prevalence of type 2 diabetes was 18.32% (24,801/135,352). Among them, 13,921 (56.13%) were aware of their condition, 11,894 (47.96%) were receiving treatment, and 4,537 (18.29%) had achieved control of blood glucose. Multivariate logistic regression analysis showed that older age, men, low-family income, low-education level, urban locality, no medical insurance, and histories of myocardial infarction, stroke, dyslipidemia, hypertension, alcohol consumption, and obesity were associated with a higher prevalence of type 2 diabetes. CONCLUSIONS The prevalence of type 2 diabetes among residents aged 35-75 years in southeast China is high, whereas the status of its low awareness, treatment and control is severe, warranting a broad-based global strategy, including greater efforts in earlier screening, and more effective and affordable treatment is essential.
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Affiliation(s)
- Xiangju Hu
- School of Public HealthFujian Medical UniversityFuzhouChina
- Department for Chronic and Noncommunicable Disease Control and PreventionFujian Provincial Center for Disease Control and PreventionFuzhouChina
| | - Xin Fang
- Department for Chronic and Noncommunicable Disease Control and PreventionFujian Provincial Center for Disease Control and PreventionFuzhouChina
| | - Minxia Wu
- Public Technology Service CenterFujian Medical UniversityFuzhouChina
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195
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Belsti Y, Moran LJ, Goldstein R, Mousa A, Cooray SD, Baker S, Gupta Y, Patel A, Tandon N, Ajanthan S, John R, Naheed A, Chakma N, Lakshmi JK, Zoungas S, Billot L, Desai A, Bhatla N, Prabhakaran D, Gupta I, de Silva HA, Kapoor D, Praveen D, Farzana N, Enticott J, Teede H. Development of a risk prediction model for postpartum onset of type 2 diabetes mellitus, following gestational diabetes; the lifestyle InterVention in gestational diabetes (LIVING) study. Clin Nutr 2024; 43:1728-1735. [PMID: 38909514 DOI: 10.1016/j.clnu.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/18/2024] [Accepted: 06/07/2024] [Indexed: 06/25/2024]
Abstract
AIMS This study aimed to develop a prediction model for identifying a woman with gestational diabetes mellitus (GDM) at high risk of type 2 diabetes (T2DM) post-birth. METHODS Utilising data from 1299 women in the Lifestyle Intervention IN Gestational Diabetes (LIVING) study, two models were developed: one for pregnancy and another for postpartum. Key predictors included glucose test results, medical history, and biometric indicators. RESULTS Of the initial cohort, 124 women developed T2DM within three years. The study identified seven predictors for the antenatal T2DM risk prediction model and four for the postnatal one. The models demonstrated good to excellent predictive ability, with Area under the ROC Curve (AUC) values of 0.76 (95% CI: 0.72 to 0.80) and 0.85 (95% CI: 0.81 to 0.88) for the antenatal and postnatal models, respectively. Both models underwent rigorous validation, showing minimal optimism in predictive capability. Antenatal model, considering the Youden index optimal cut-off point of 0.096, sensitivity, specificity, and accuracy were measured as 70.97%, 70.81%, and 70.82%, respectively. For the postnatal model, considering the cut-off point 0.086, sensitivity, specificity, and accuracy were measured as 81.40%, 75.60%, and 76.10%, respectively. CONCLUSIONS These models are effective for predicting T2DM risk in women with GDM, although external validation is recommended before widespread application.
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Affiliation(s)
- Yitayeh Belsti
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Rebecca Goldstein
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Shamil D Cooray
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia
| | - Susanne Baker
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Yashdeep Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Anushka Patel
- The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia
| | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Renu John
- The George Institute for Global Health, New Delhi, India
| | - Aliya Naheed
- Non-Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Nantu Chakma
- Non-Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Josyula K Lakshmi
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India; The George Institute for Global Health, New Delhi, India; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Laurent Billot
- The George Institute for Global Health, New Delhi, India; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Ankush Desai
- Department of Endocrinology, Goa Medical College, Goa, India
| | - Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Ishita Gupta
- Centre for Chronic Disease Control, New Delhi, India
| | - H Asita de Silva
- Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Deksha Kapoor
- All India Institute of Medical Sciences, New Delhi, India
| | - Devarsetty Praveen
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; George Institute for Global Health, Hyderabad, India
| | - Noshin Farzana
- Non-Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia
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Jiménez-Cortegana C, Gutiérrez-García C, Sánchez-Jiménez F, Vilariño-García T, Flores-Campos R, Pérez-Pérez A, Garnacho C, Sánchez-León ML, García-Domínguez DJ, Hontecillas-Prieto L, Palazón-Carrión N, De La Cruz-Merino L, Sánchez-Margalet V. Impact of obesity‑associated myeloid‑derived suppressor cells on cancer risk and progression (Review). Int J Oncol 2024; 65:79. [PMID: 38940351 PMCID: PMC11251741 DOI: 10.3892/ijo.2024.5667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024] Open
Abstract
Obesity is a chronic disease caused by the accumulation of excessive adipose tissue. This disorder is characterized by chronic low‑grade inflammation, which promotes the release of proinflammatory mediators, including cytokines, chemokines and leptin. Simultaneously, chronic inflammation can predispose to cancer development, progression and metastasis. Proinflammatory molecules are involved in the recruitment of specific cell populations in the tumor microenvironment. These cell populations include myeloid‑derived suppressor cells (MDSCs), a heterogeneous, immature myeloid population with immunosuppressive abilities. Obesity‑associated MDSCs have been linked with tumor dissemination, progression and poor clinical outcomes. A comprehensive literature review was conducted to assess the impact of obesity‑associated MDSCs on cancer in both preclinical models and oncological patients with obesity. A secondary objective was to examine the key role that leptin, the most important proinflammatory mediator released by adipocytes, plays in MDSC‑driven immunosuppression Finally, an overview is provided of the different therapeutic approaches available to target MDSCs in the context of obesity‑related cancer.
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Affiliation(s)
- Carlos Jiménez-Cortegana
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Cristian Gutiérrez-García
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Flora Sánchez-Jiménez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Teresa Vilariño-García
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Rocio Flores-Campos
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Antonio Pérez-Pérez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Carmen Garnacho
- Department of Normal and Pathological Histology and Cytology, School of Medicine, University of Seville, 41009 Seville, Spain
| | - Maria L. Sánchez-León
- Oncology Service, Virgen Macarena University Hospital, School of Medicine, University of Seville, 41009 Seville, Spain
| | - Daniel J. García-Domínguez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Lourdes Hontecillas-Prieto
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Natalia Palazón-Carrión
- Oncology Service, Virgen Macarena University Hospital, School of Medicine, University of Seville, 41009 Seville, Spain
| | - Luis De La Cruz-Merino
- Oncology Service, Virgen Macarena University Hospital, School of Medicine, University of Seville, 41009 Seville, Spain
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville 41013, Spain
| | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville 41013, Spain
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197
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Lyu Z, Chan YT, Lu Y, Fung Lam T, Wu X, Wu J, Xu L, Yang W, Zhang C, Lidan Zhong L, Wang N. Osteoprotegerin mediates adipogenesis in obesity. J Adv Res 2024; 62:245-255. [PMID: 38906326 PMCID: PMC11331166 DOI: 10.1016/j.jare.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Adipogenesis, the process of white adipose tissue expansion, plays a critical role in the development of obesity. Osteoprotegerin (OPG), known for its role in bone metabolism regulation, emerges as a potential regulator in mediating adipogenesis during obesity onset. OBJECTIVES This study aims to elucidate the involvement of OPG in adipogenesis during the early phases of diet-induced obesity and explore its therapeutic potential in obesity management. METHODS Using a diet-induced obesity model, we investigated OPG expression patterns in adipocytes and explored the mechanisms underlying its involvement in adipogenesis. We also assessed the effects of targeted silencing of OPG and recombinant OPG administration on obesity progression and insulin resistance. Additionally, the impact of electroacupuncture treatment on OPG levels and obesity management was evaluated in both animal models and human participants. RESULTS OPG expression was prominently activated in adipocytes of white adipose tissues during the early phase of diet-induced obesity. Hyperlipidemia induced Cbfa1-dependent OPG transcription, initiating and promoting adipogenesis, leading to cell-size expansion and lipid storage. Intracellular OPG physically bound to RAR and released the PPARɤ/RXR complex, activating adipogenesis-associated gene expression. Targeted silencing of OPG suppressed obesity development, while recombinant OPG administration promoted disease progression and insulin resistance in obese mice. Electroacupuncture treatment suppressed obesity development in an OPG-dependent manner and improved obesity parameters in obese human participants. CONCLUSION OPG emerges as a key regulator in mediating adipogenesis during obesity development. Targeting OPG holds promise for the prevention and treatment of obesity, as evidenced by the efficacy of electroacupuncture treatment in modulating OPG levels and managing obesity-related outcomes.
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Affiliation(s)
- Zipan Lyu
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Yau-Tuen Chan
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuanjun Lu
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tsz Fung Lam
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Xingyao Wu
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Junyu Wu
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lin Xu
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wei Yang
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Cheng Zhang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Linda Lidan Zhong
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China.
| | - Ning Wang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Huttasch M, Roden M, Kahl S. Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? Metabolism 2024; 157:155937. [PMID: 38782182 DOI: 10.1016/j.metabol.2024.155937] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/25/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) closely associates with obesity and type 2 diabetes. Lifestyle intervention and bariatric surgery aiming at substantial weight loss are cornerstones of MASLD treatment by improving histological outcomes and reducing risks of comorbidities. Originally developed as antihyperglycemic drugs, incretin (co-)agonists and SGLT2 inhibitors also reduce steatosis and cardiorenovascular events. Certain incretin agonists effectively improve histological features of MASLD, but not fibrosis. Of note, beneficial effects on MASLD may not necessarily require weight loss. Despite moderate weight gain, one PPARγ agonist improved adipose tissue and MASLD with certain benefit on fibrosis in post-hoc analyses. Likewise, the first THRβ-agonist was recently provisionally approved because of significant improvements of MASLD and fibrosis. We here discuss liver-related and metabolic effects induced by different MASLD treatments and their association with weight loss. Therefore, we compare results from clinical trials on drugs acting via weight loss (incretin (co)agonists, SGLT2 inhibitors) with those exerting no weight loss (pioglitazone; resmetirom). Furthermore, other drugs in development directly targeting hepatic lipid metabolism (lipogenesis inhibitors, FGF21 analogs) are addressed. Although THRβ-agonism may effectively improve hepatic outcomes, MASLD treatment concepts should consider all cardiometabolic risk factors for effective reduction of morbidity and mortality in the affected people.
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Affiliation(s)
- Maximilian Huttasch
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Sabine Kahl
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany.
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Dróżdż O, Bińczyk W, Siudek B, Błaszczyszyn K, Grajnert FJ, Grzelka MZ, Rabczyński M. Obesity as a misleading factor in the diagnosis of type 1 diabetes mellitus: A case report. Clin Case Rep 2024; 12:e9301. [PMID: 39135771 PMCID: PMC11317497 DOI: 10.1002/ccr3.9301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/15/2024] Open
Abstract
A comprehensive evaluation, including symptoms, medical history, C-peptide levels, and anti-GAD antibodies, is essential for distinguishing between diabetes' types, particularly in cases of diagnostic uncertainty. While obesity is often associated with T2DM, BMI should be viewed as a factor rather than a criterion for the exclusion of diabetes type.
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Affiliation(s)
- Olgierd Dróżdż
- Department and Clinic of Diabetology and Internal MedicineUniversity Teaching HospitalWrocławPoland
| | - Wiktoria Bińczyk
- Department and Clinic of Diabetology and Internal MedicineUniversity Teaching HospitalWrocławPoland
| | | | - Katarzyna Błaszczyszyn
- Department and Clinic of Diabetology and Internal MedicineUniversity Teaching HospitalWrocławPoland
| | | | | | - Maciej Rabczyński
- Department and Clinic of Diabetology and Internal MedicineUniversity Teaching HospitalWrocławPoland
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200
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Stefan N, Schiborn C, Machann J, Birkenfeld AL, Schulze MB. Impact of higher BMI on cardiometabolic risk: does height matter? Lancet Diabetes Endocrinol 2024; 12:514-515. [PMID: 38968941 DOI: 10.1016/s2213-8587(24)00164-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 07/07/2024]
Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen 72076, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany.
| | - Catarina Schiborn
- German Center for Diabetes Research, Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Jürgen Machann
- Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Andreas L Birkenfeld
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen 72076, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Matthias B Schulze
- German Center for Diabetes Research, Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
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