Pathophysiology of obesity and its associated diseases

Pathophysiology of heart failure with preserved ejection fraction in overweight and obesity - Clinical and treatment implications

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with vast prevalence worldwide. Despite recent advances in understanding its pathophysiology, HFpEF remains under-diagnosed in clinical practice. Obesity-related HFpEF is a distinct and frequent phenotype with an additionally challenging diagnosis. We address the importance of overweight and obesity in HFpEF, focusing on the influence of adipose tissue in inflammation and neurohormonal activity. We also discuss atrial and ventricular remodelling in obesity-related HFpEF and potential clinical implications. Obesity is an independent risk factor for HFpEF. Adipose tissue synthesizes aldosterone, causing lower levels of natriuretic peptide. Adipocytes dysfunction promotes a pro-inflammatory state and leads to extracellular matrix remodelling and consequently stiffening of the heart and vessels. Thus, the quantity, distribution and quality of the excess fat influences cardiovascular risk. Visceral and epicardial adipose tissue are often associated with an increased likelihood of developing HFpEF. Obesity-related HFpEF presents higher risk of left ventricular concentric remodelling and inadequate accommodation of the expanded volume due to the obesity, resulting in higher left ventricular filling pressure. Nevertheless, microvascular endothelium inflammation modifies cardiomyocyte elasticity and increases collagen deposition, which enhances myocardial fibrosis and results in HFpEF. Furthermore, neurohormonal activation may also contribute to cardiac remodelling by inducing plasma volume expansion. In turn, leptin also stimulates aldosterone synthesis and enhances renin-angiotensin-aldosterone system. Obesity-related HFpEF presents worse overall prognosis, with increased risk of heart failure hospitalization and all-cause mortality. Intentional weight loss through caloric restriction, physical activity, pharmacological intervention and/or bariatric surgery are promising strategies.

Hemoglobin level, anemia, and obesity among pregnant women in Kigali, Rwanda: a hospital-based cross-sectional study

BACKGROUND

Globally, there is an increasing trend of obesity in pregnant women, and Sub-Saharan Africa is not an exception. Recently, hemoglobin and anemia have received more attention as predictors of maternal obesity. No such study exists in Rwanda. Thus, the current study aimed to investigate the prevalence and the factors associated with obesity, including hemoglobin and anemia, among pregnant women in Kigali, Rwanda.

METHODS

A cross-sectional study was conducted in two hospitals in Kigali, Rwanda, from June to August 2024. A questionnaire was used to collect sociodemographic data. Weight, height, and hemoglobin were measured using standard procedures. Multinomial logistic regression analysis was performed.

RESULTS

A total of 445 pregnant women were recruited. The median (interquartile range [IQR]) age and parity were 30.0 (26.0‒35.0) years and 1 (0‒3), respectively. Of the 445 women, 143 (32.1%), 249 (56.0%), and 53 (11.9%) were of normal weight, overweight, and obese, respectively. One hundred and seven (24.0%) pregnant women had anemia. In multivariate multinomial regression, no significant association was found between age, parity, residency, education, maternal occupation, hemoglobin level, anemia, and overweight status. Being from rural areas (adjusted odds ratio [AOR] = 2.54, 95% confidence interval [CI] 1.16‒5.56) and being a housewife (AOR = 4.34, 95% 1.42‒13.26) were significantly associated with obesity. While an increase in hemoglobin level was associated with obesity (AOR = 1.28, 95% CI 1.02‒1.60), anemia was inversely negatively associated with obesity (AOR = 0.33, 95% CI 0.12‒0.93).

CONCLUSION

This study indicates that 12% of the pregnant women in Rwanda were obese. Hemoglobin and anemia are associated with maternal obesity in Rwanda. There is a need for more efforts in nutritional programs targeting pregnant women to combat maternal obesity in Rwanda. Future research is recommended to explore the impact of maternal obesity on maternal and perinatal health.

Obesity-related drug-metabolizing enzyme expression alterations in the human liver

OBJECTIVE

Implications of obesity extend beyond the association with various health conditions, impacting physiological changes that affect the liver and the activity of metabolizing enzymes. Given the prevalence of obesity and the risk for drug-drug interactions owing to the comorbidity burden, the current drug dosage recommendations may need reevaluation for patients with obesity. This study evaluated the implications of obesity on the gene expression of hepatic drug-metabolizing enzymes. As drug clearance is an essential pharmacokinetic parameter for maintaining drug dosing regimens, investigating alterations in metabolizing enzymes expression is a critical step.

METHODS

Human liver samples were collected post-mortem from 32 individuals and classified into the control (18.5 ≤ BMI <25 kg/m2; range 18.9-24.4 kg/m2; median 22.3 kg/m2) and the study group (BMI ≥25 kg/m2; range 25.1-55.5 kg/m2; median 31.2 kg/m2). Real-time quantitative PCR was performed for the analysis of 168 drug-metabolizing enzymes.

RESULTS

Our studies revealed several potential physiologically relevant differences, but the statistical significance was reached only for ALDH3B1, PTGS1, and CEL (all being up-regulated in the study group).

CONCLUSIONS

The study adds to our understanding of the mechanisms of pharmacokinetic changes in overweight and obesity. The findings require further exploration on the protein level, through proteomic and functional studies.

Comparing the effectiveness of calorie restriction with and without time-restricted eating on the circadian regulation of metabolism: rationale and protocol of a three-arm randomised controlled trial in adults at risk of type 2 diabetes

Time-restricted eating (TRE) may extend the cardiometabolic health benefits of calorie restriction (CR). However, few studies have compared its effect on the circadian regulation of glucose metabolism and the optimal time of day to initiate TRE is also unclear. This study aims to compare the effectiveness of CR with and without TRE on glucose tolerance in response to 3 identical meals consumed over the day. A parallel, single-blinded, 3-arm randomised controlled trial will be conducted in 114 adults, aged 35 to 75 years with a BMI ≥25.1 but <45.0 kg/m2, elevated waist circumference and fasting blood glucose (≥5.6 mmol/L), and who score ≥12 on the Australian Type 2 Diabetes Risk Assessment tool. Participants will be stratified by sex and fasting blood glucose (≤6.0 mmol/L; >6.0 mmol/L) and then randomised (1:1:1) to CR (unrestricted meal timing), eCR (0800 to 1600) or dCR (1200-2000) for 8 weeks. The primary outcome is the change in the natural logarithm of the mean over 3 identical meals of the postprandial glucose area under the curve (AUC). The analysis will be performed using a covariate adjusted linear regression of the differences in postprandial glucose log AUC at 8 weeks from baseline. This randomised clinical trial will be the first to delineate the benefits of CR alone or in combination with time restricted eating on postprandial glucose metabolism over the day in adults at increased risk of type 2 diabetes.

Insulin for oral bone tissue engineering: a review on innovations in targeted insulin-loaded nanocarrier scaffold

The occurrence of oral bone tissue degeneration and bone defects by osteoporosis, tooth extraction, obesity, trauma, and periodontitis are major challenges for clinicians. Traditional bone regeneration methods often come with limitations such as donor site morbidity, limitation of special shape, inflammation, and resorption of the implanted bone. The treatment oriented with biomimetic bone materials has achieved significant attention recently. In the oral bone tissue engineering arena, insulin has gained considerable attention among all the known biomaterials for osteogenesis and angiogenesis. It also exhibits osteogenic and angiogenic properties by interacting with insulin receptors on osteoblasts. Insulin influences bone remodelling both directly and indirectly. It acts directly through the PI3K/Akt and MAPK signalling pathways and indirectly by modulating the RANK/RANKL/OPG pathway, which helps reduce bone resorption. The current review reports the role of insulin in bone remodelling and bone tissue regeneration in the oral cavity in the form of scaffolds and nanomaterials. Different insulin delivery systems, utilising nanomaterials and scaffolds functionalised with polymeric biomaterials have been explored for oral bone tissue regeneration. The review put forward a theoretical basis for future research in insulin delivery in the form of scaffolds and composite materials for oral bone tissue regeneration.

Do Individuals With Overweight and Obesity Have Reduced Affective and Cognitive Empathy? A Systematic Review and Meta-Analysis

Background and Objectives

Obesity is associated with various interpersonal difficulties. Previous research on empathy has indicated that weight is negatively correlated with empathic skills in children and adolescents. However, few studies have examined this question in adults, and the existing studies have provided inconsistent results.

Methods

This systematic review and meta‐analysis aimed to examine empathic skills among people with overweight and obesity. Six databases were searched to find studies based on performance measures and self‐report questionnaires investigating cognitive and affective empathy in adults with overweight and obesity (BMI > 25 kg/m2) compared with normal‐weight individuals.

Results

Ten studies involving 2648 individuals were included after screening the 6779 references that were initially retrieved from the database. Analyses revealed a significant difference between individuals with overweight/obesity and normal‐weight individuals (k = 11, Hedge's g = −0.52 [−0.97, −0.07], Z = −2.26, p = 0.024). Subgroup analyses revealed no significant difference between people with overweight and people with obesity (Q = 0.36, p = 0.546). However, the effect size for cognitive empathy was higher than that for affective empathy (Q = 7.30, p = 0.007), and the effect size for performances measures was higher than that for self‐report questionnaires (Q = 6.61, p = 0.010).

Conclusion

Adults with overweight or obesity present lower scores of empathy, particularly for cognitive empathy. These results emphasize the need to better understand which specific components of cognitive empathy might be affected and to conduct studies to evaluate affective empathy beyond self‐report questionnaires. Future research should also determine the underlying mechanisms and longitudinally test the role of empathy in the onset and maintenance of obesity.

The role of Adiponectin and Leptin in Colorectal Cancer and Adenoma: a systematic review and meta-analysis

BACKGROUND

Colorectal cancer ranks as the third most frequently diagnosed cancer globally. Adipokines, including adiponectin and leptin, are believed to play a vital role in the development and progression of tumors. This study aimed to clarify the association between circulating adiponectin and leptin concentrations and the risk of colorectal cancer and adenoma.

METHODS

A detailed literature review was conducted in different databases, including Google Scholar, Web of Science, Scopus, and PubMed. Articles measuring serum concentrations of adiponectin and leptin in colorectal adenoma or cancer patients were analyzed. Pooled odds ratios (ORs) and their related 95% confidence intervals (CIs) were estimated through a random-effects meta-analysis.

RESULTS

In total, 30 articles were analyzed. According to the meta-analysis, higher adiponectin concentrations were inversely linked to a reduced CRC risk (OR: 0.85, 95% CI: 0.74-0.96), particularly in men. However, no notable connection was detected between higher leptin concentrations and risk of CRC (OR: 1.12, 95% CI: 0.96-1.31). In subgroup analyses, BMI adjustment reinforced the negative association between higher adiponectin levels and risk of CRC, while insulin adjustment yielded non-significant results. Additionally, higher leptin levels revealed a meaningful relationship with colorectal adenoma risk (OR: 1.39, 95% CI: 1.06-1.84), whereas higher levels of adiponectin were not significantly linked to adenoma (OR: 0.79, 95% CI: 0.46-1.36).

CONCLUSION

According to this meta-analysis, elevated adiponectin concentrations may play a protective role against CRC, while leptin could potentially contribute to an elevated colorectal adenoma risk. Further studies are required to explore the potential mechanisms underlying adipokine-mediated colorectal carcinogenesis.

Benzyl isothiocyanate ameliorates hepatic insulin resistance in mice with high-fat diet-induced nonalcoholic fatty liver disease

The global prevalence of overweight and obesity has risen sharply over the past few decades as a result of excess calorie intake and sedentary lifestyles. Obesity increases the risk for various metabolic disorders, such as hyperlipidemia, fatty liver disease, and diabetes mellitus. Isothiocyanates, which are abundant in cruciferous vegetables, have been shown to exhibit anti-cancer, anti-inflammatory, and antioxidant properties. However, the efficacy of benzyl isothiocyanate (BITC) in preventing the adverse effects of obesity, such as hepatic steatosis and insulin resistance, remains uncertain. To address this knowledge gap, we assessed whether BITC protects against hepatic insulin resistance by using primary mouse hepatocytes and AML12 cells treated with palmitic acid (PA) and mice fed a high-fat diet supplemented with cholesterol and cholic acid (HFCCD). We found that the impairments in insulin sensitivity caused by PA, such as decreases in the phosphorylation of insulin receptor substrate (IRS) 1 (Tyr608), Akt, glycogen synthase kinase (GSK) 3β, and FOXO1 and increases in the expression of glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase 1 (PEPCK) mRNA in hepatocytes, were mitigated by pretreatment with BITC. BITC also attenuated PA-induced hepatic lipid accumulation and reactive oxygen species production. In vivo, BITC significantly reduced blood glucose levels and the HOMA-IR and inhibited hepatic lipid accumulation, IRS1 phosphorylation at Ser307, and G6Pase and PEPCK expression compared with that in mice fed the HFCCD alone. These results show that BITC ameliorates the lipotoxicity associated with insulin resistance by activating the IR/IRS/Akt/FOXO1 and GSK3β pathways, which leads to decreased gluconeogenesis and increased glycogen synthesis.

Relationship between tobacco use and body mass index- a propensity score matching analysis of an indian National Survey

BACKGROUND

Tobacco and obesity control is among the major health priorities. Previous studies have mixed opinions about their association. The present study was done to investigate the association between Body Mass Index (BMI) and tobacco use (smokers, smokeless tobacco users and dual users) among Indian adults.

METHODS

Secondary analysis of the fifth National Family Health Survey (2019-21) was conducted that included 724,115 women (15-49 years) and 101,839 men (15-54 years). Nutritional status (BMI) was dependent variable. Current tobacco use was primary independent variable. Using sampling weights, bivariate analysis assessed the association, the determinants were explored using the binary logistic multinomial regression. Propensity Score Matching (PSM) was employed using STATA software to control for potential confounding and strengthen causal inference.

RESULTS

Weighted prevalence of overweight/obesity and underweight was 38.17%, and 18.05%. Underweight prevalence was highest in smokeless tobacco users (17.09%). Overweight/obesity was highest among smokers (41.62%). Compared to non-users, tobacco users had higher odds of being underweight (AOR: 1.2; 95% CI: 1.2-1.2) and lower odds of being overweight (0.9; 0.9-0.9). PSM confirmed the BMI lower effect of Tobacco (ATT: 0.159), with a non-significant impact on overweight/obesity (ATT: -0.360).

CONCLUSIONS

We present clear evidence that tobacco use, especially smokeless forms, is significantly associated with undernutrition among Indian adults, while its impact on overweight/obesity remains minimal, which otherwise was more common in smokers. The findings clarify the previously mixed evidence and highlight the nutritional impact of tobacco, reinforcing the need for integrated interventions targeting both tobacco cessation and nutritional improvement.

Comorbid cardiovascular diseases and predictors among adults with type 2 diabetes in Bahir Dar city, Ethiopia: a multicentre hospital-based cross-sectional study

OBJECTIVE

The burden of comorbid cardiovascular disease (CVD) and its preventable factors in type 2 diabetes is not well acknowledged in Ethiopia. Therefore, this study aimed to identify the magnitude of comorbidity of CVD and predictors among individuals with type 2 diabetes.

DESIGN

A multicentre hospital-based cross-sectional study.

SETTING

Bahir Dar city Administration Public Hospitals, Ethiopia.

METHODS

Data on comorbid CVDs among individuals with type 2 diabetes were collected through patient chart reviews. To identify predictors of CVDs in type 2 diabetes, information on lifestyle and psychosocial characteristics, medication and dietary adherence, and disease management status was collected using standardised questionnaires. Statistical analyses were performed using SPSS V.26. The level of statistical significance was set at p<0.05, with ORs and 95% CIs.

RESULTS

The participants' mean age (±SD) was 51.5±10.9 years. The overall prevalence of comorbid CVDs among type 2 diabetes was 27.9% (95% CI 23.6% to 32.3%). Factors that statistically predicted the occurrence of comorbid CVDs in type 2 diabetes were: age >60 years (adjusted ORs (AORs)=2.6, 95% CI 1.1 to 6.6), non-adherence to diabetes-friendly diet (AOR=4.0, 95% CI 1.9 to 8.2), low medication adherence (AOR=2.8, 95% CI 1.5 to 5.3), being overweight (AOR=5.3, 95% CI 2.9 to 9.8), and diabetes duration >10 years (AOR=3.7, 95% CI 1.7 to 8.1).

CONCLUSION

Comorbid cardiovascular disease is a significant issue among type 2 diabetic patients. Its prevalence is higher in patients over 60 years of age, with modifiable factors identified as key contributors. Appropriate interventions are recommended, including educating type 2 diabetic patients on dietary regimens, medication adherence, weight management, and the benefits of timely healthcare for effective disease management.

Akkermansia muciniphila ameliorates fatty liver through microbiota-derived α-ketoisovaleric acid metabolism and hepatic PI3K/Akt signaling

Akkermansia muciniphila (Akk) has been shown to improve obesity via gut microbiota, while its effects on modulating gut fungi remain underexplored. This study investigates the effects of Akk on obese mice, focusing on gut fungi, metabolites, and hepatic lipid metabolism. We found that Akk treatment significantly modulated gut fungal diversity, enhanced gut immune responses, and improved fatty liver. Specifically, the abundance of harmful fungi Fusarium decreased. Subsequently, Akk improved hepatic lipid metabolism via the PI3K/Akt pathway, as determined by proteomics analysis. Additionally, an in vitro colonic organoid and microbiota co-culture system confirmed these effects by validating changes in key fungi and metabolites. Crucially, α-ketoisovaleric acid was identified as a pivotal metabolite, as its supplementation significantly improved hepatic lipid metabolism via PI3K/Akt pathway in obese mice. This study highlights Akk's potential as a therapeutic agent for obesity by modulating gut fungi and identifying α-ketoisovaleric acid as a critical metabolite.

Adipocyte-expressed SIRT3 manipulates carnitine pool to orchestrate metabolic reprogramming and polarization of macrophages

Obesity is accompanied with accumulation and pro-inflammatory polarization of macrophages in adipose tissue (AT), leading to systematical inflammation and insulin resistance. Impaired lipid metabolism and endocrine function in adipocytes is recognized as a culprit in the onset of adipose tissue inflammation. Lipid levels can be managed via inhibiting both synthesis and transport or via increasing fatty acid oxidation (FAO). The deacetylase Sirtuin 3 (SIRT3) participates in inflammatory responses via regulating mitochondrial function and FAO. Herein, an AT-specific SIRT3 overexpression mice model (AT-SIRT3OE) was generated using adeno-associated virus transduction. AT-specific SIRT3 overexpression did not alter body weight or adiposity in either regular chow diet or high-fat diet (HFD) fed mice. AT-SIRT3OE mice exhibited improved insulin sensitivity in HFD-fed mice, through alleviating infiltration of macrophage and pro-inflammatory macrophage polarization in the epididymal AT. The metabolomics analysis indicated that SIRT3 overexpressed adipocytes accumulated more L-carnitine (LC) and less long-chain acylarnitines in the medium. Furthermore, SIRT3 directly deacetylates and activates carnitine palmitoyltransferase 2 (CPT2), an obligate step in mitochondrial long-chain FAO, to enhance the LC turnover pool in adipocytes, which in turn promoted lipid metabolism and anti-inflammatory polarization in macrophages. Collectively, our study provided new evidence that adipocyte-expressed SIRT3 alleviates inflammatory crosstalk between adipocytes and macrophages through manipulating LC pool. Activating SIRT3 in adipocytes could be a potential strategy to alleviate obesity-related metabolic diseases.

Quantitative proteomics identifies plasma protein alterations that associate with metabolic and thrombotic profile changes after bariatric surgery

OBJECTIVE

Roux-en-Y gastric bypass (RYGB) surgery has been shown to lead to favourable health outcomes in obese patients. However, the molecular changes that occur and how they relate to clinical measures are poorly understood. Here, we characterise the proteomic alterations that occur in plasma of RYGB patients before and 9 months after surgery using quantitative proteomics.

METHODS

Plasma proteomics was performed by sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS) to identify and quantify differentially abundant proteins. Relationships between significantly altered proteins and clinical markers were examined. A gene set enrichment analysis was also conducted to identify altered pathways.

RESULTS

From the proteomic analysis, 27 proteins increased, and 43 proteins decreased in abundance 9 months after surgery, providing insights into the physiological changes that accompany weight loss. Proteins including sex hormone binding globulin (SHBG), inter-alpha-trypsin inhibitor heavy chain 3 (ITIH3) and apolipoprotein D (APOD), which increased in abundance post-surgery, highlight improvements in lipid regulation, insulin sensitivity and inflammation. Proteins involved in coagulation, including α2-macroglobulin, kallikrein-B1, prothrombin, and factor (FX, FXI and FXII), exhibited reduced levels, aligning with a decrease in thrombotic potential.

CONCLUSIONS

These findings provide a mechanistic understanding of how bariatric surgery leads to systemic changes in metabolic and haemostatic pathways, thus favourably modulating the risk of developing cardiovascular disease.

Alpha-aminobutyric acid administration suppressed visceral obesity and modulated hepatic oxidized PUFA metabolism via gut microbiota modulation

BACKGROUND

High-fat diet (HFD) is associated with visceral obesity due to disruption in the lipid metabolism and gut dysbiosis. These symptoms may contribute to hepatic steatosis and the formation of oxidized polyunsaturated fatty acids (PUFAs). Alpha-aminobutyric acid (ABA) is an amino-acid derived metabolite, and its concentration has been correlated with several metabolic conditions and gut microbiome diversity while its direct effects on visceral obesity, lipid metabolism and the gut microbiota are not well understood. This study was designed to investigate the effect of physiological dose of ABA on diet-induced visceral obesity and lipid metabolism dysregulation by examining the fatty acids and oxidized PUFAs profile in the liver as well as the gut microbiota.

RESULTS

ABA administration reduced visceral obesity by 28 % and lessened adipocyte hypertrophy. The expression of liver Cd36 was lowered by more than 50 % as well as the saturated and monounsaturated FA concentration. Notably, the desaturation index for C16 and C18 FAs that are correlated with adiposity were reduced. The concentration of several DHA-derived oxidized PUFAs were also enhanced. Faecal metagenomics sequencing revealed enriched abundance of Leptogranulimonas caecicola and Bacteroides sp. ZJ-18 and were positively correlated with several DHA- and ALA-derived oxidized PUFAs in ABA group.

CONCLUSION

Our study revealed the modulatory effect of physiological dose of ABA on attenuating visceral obesity, reducing hepatic steatosis, and promoting the production of anti-inflammatory oxidized PUFAs that were potentially mediated by the gut microbiota.

The paternal contribution to shaping the health of future generations

Paternal health and exposure to adverse environments in the period prior to conception have a profound impact on future generations. Adversities such as stress, diet, and toxicants influence offspring health. Emerging evidence indicates that epigenetic mechanisms including noncoding RNA, DNA methylation, and chromatin remodelling mediate these effects. Preclinical studies have contributed to advancing mechanistic understanding in the field; however, human research is limited and primarily observational. Here, we discuss the evidence linking paternal to offspring health and advocate for further research in this area, which may ultimately inform policy and healthcare guidelines to improve paternal preconception health and offspring outcomes.

Synergistic amelioration of renal oxidative stress, inflammation, and fibrosis by combination of metformin and Clinacanthus nutans leave extracts in a type 2 diabetic rat model

Background

Combination treatment enhances the therapeutic potential for diabetes, particularly for patients with severe complications. Combining standard therapeutic drugs with alternative bioactive compounds provides a promising option for long-term treatment, given the high safety profile of bioactive substances. Objective in this study, we aimed to evaluate the synergistic effects of metformin and Clinacanthus nutans (Burm. f.) Lindau (CN) on glucose metabolism and renal dysfunction parameters in a type 2 diabetic rat model.

Methods

Male Wistar rats were fed a high-fat diet for 4 weeks and then received a low dose of streptozotocin to induce type 2 diabetes. The diabetic rats were randomly divided into four groups: untreated diabetic rats (DM), diabetic rats treated with CN at doses of 100 or 200 mg/kg/day (DM100 or DM200), diabetic rats treated with a combination of CN and metformin (DMCOM), and diabetic rats treated with metformin at 100 mg/kg/day (DMMET). The treatments were administered by gavage for 4 weeks.

Results

Compared to single treatments, DMCOM showed a remarkable effect in reducing several parameters, including serum creatinine and blood urea nitrogen, while enhancing creatinine clearance in diabetic rats. Additionally, DMCOM significantly decreased malondialdehyde levels. Notably, diabetic rats treated with DMCOM exhibited a significant reduction in parameters associated with renal dysfunction, as evidenced by decreased inflammation markers, along with downregulated fibrotic markers.

Conclusion

Our findings provide a scientific basis for the clinical application of CN and suggest a new strategy for preventing nephrotoxicity and other kidney diseases in diabetic patients.

Association between Sarcopenic Obesity and Changes in Skeletal Muscle Mass and Quality in Patients with Stroke Who Undergo Convalescent Rehabilitation

Introduction

Sarcopenic obesity substantially affects the recovery of physical function in patients with stroke. However, few studies have investigated the relationship between changes in skeletal muscle mass (SMM) and skeletal muscle quality (SMQ) and sarcopenic obesity diagnosed using the Japanese Working Group on Sarcopenic Obesity (JWGS) diagnostic criteria in patients with stroke who undergo rehabilitation. Therefore, this study aimed to investigate the relationship between sarcopenic obesity and changes in SMM and SMQ in patients with stroke who undergo rehabilitation.

Methods

Patients with stroke admitted to a rehabilitation ward in a single center in Japan were enrolled in this retrospective cohort study. The inclusion criteria were age 40-75 years and hospitalization for rehabilitation therapy due to stroke. The exclusion criteria were length of hospital stay <14 days and missing clinical data. Data were collected from medical records. Classification of sarcopenic obesity was based on the JWGS diagnostic criteria. The outcomes were the change in SMM and phase angle (PhA) from admission to discharge. Multiple regression analysis was used to investigate the relationship between sarcopenic obesity and changes in SMM and PhA after adjustment for confounding factors.

Results

A total of 173 patients were analyzed. 8 patients (3 male and 5 female) were diagnosed with sarcopenic obesity using the JWGS criteria. Multiple regression analysis revealed that sarcopenic obesity was negatively associated with changes in SMM (β: -0.281, 95% confidence interval [CI]: -0.449 to -0.113, p < 0.001) and PhA (β: -0.189, 95% CI: -0.367 to -0.010, p = 0.038).

Conclusions

Sarcopenic obesity is negatively associated with changes in SMM and SMQ in patients with stroke who undergo rehabilitation, highlighting the importance of evaluating sarcopenic obesity in patients with stroke from an early stage.

Hypocaloric low-carbohydrate versus low-fat diets on flow-mediated dilation, blood pressure, cardiovascular biomarkers, and body composition in individuals with overweight or obesity: a systematic review and meta-analysis of randomized clinical trials

Obesity can impair cardiometabolism, but low-carbohydrate diets (LCDs) may be beneficial for mitigating risk. We aimed to investigate the effects of LCDs versus low-fat diets (LFDs), under hypocaloric conditions, on flow-mediated dilation (FMD) in individuals with overweight/obesity. Secondarily, we assessed other cardiovascular markers (systolic blood pressure, diastolic blood pressure, C-reactive protein [CRP], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], total cholesterol [TC]), and anthropometric and body composition measurements. PubMed, Scopus, and Web of Science were searched through May 2023 for studies involving hypocaloric LCDs versus LFDs on FMD. Meta-analyses were conducted for LCDs vs. LFDs to calculate weighted mean differences (WMD), including 10 studies reporting FMD (n = 475). Overall, hypocaloric LCDs resulted in a non-significant decrease in FMD compared with hypocaloric LFDs [WMD = -1.04% (95% CI -2.28 to 0.20), p = 0.10], while very-low-carbohydrate diets (VLCDs) significantly reduced FMD when compared with LFDs [WMD = -2.12% (95% CI: -3.35 to -0.9) p = 0.001]. LCDs did not change anthropometric and body composition measurements, nor CRP, blood pressure, HDL, or TC when compared with LFDs. However, LCDs significantly decreased TG [WMD = -19.94 mg/dL (95% CI -31.83 to -8.06), p = 0.001] and increased LDL [WMD = 20.00 mg/dL (95% CI 14.09 to 25.90), p = 0.001] when compared with LFDs. In conclusion, LCDs did not exert superior effects on cardiovascular markers or body composition when compared with LFDs in individuals with overweight or obesity, but LCDs reduced TG and increased LDL levels more than LFDs. Yet, vascular function (FMD) was reduced primarily for VLCDs.

Non-linear association between visceral adipose tissue area and serum uric acid concentration in US adults: findings from NHANES 2011-2018

BACKGROUND

Research on the relationship between visceral adipose tissue (VAT) and serum uric acid (SUA) in the general population remains limited. This study aims to comprehensively examine the association between VAT area and SUA concentrations in a representative sample of U.S. adults.

METHODS

Data were drawn from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2018. A total of 10,514 participants aged 18 to 59 years were included in the analysis. VAT area was measured using dual-energy X-ray absorptiometry (DXA) scans, and SUA levels were collected at mobile examination centers. Multivariable linear regression models were employed to assess the association between VAT and SUA. Restricted cubic splines (RCS) were used to detect potential non-linear relationships. Subgroup analyses were conducted based on age, sex, drinking status, and renal function to test the robustness of the findings.

RESULTS

The median VAT area and SUA concentration were 91.24 cm² and 5.2 mg/dL, respectively. In the unadjusted model, each standard deviation (SD) increase in VAT was positively associated with SUA (β = 0.43; 95% CI: 0.39-0.47). After adjusting for covariates, this positive association remained consistent across all models. RCS analysis revealed a non-linear relationship (P for non-linearity < 0.001), with a stronger association observed when VAT was below 3.3 SDs. Significant interactions were identified in age and sex subgroups (P for interaction < 0.05).

CONCLUSION

This study demonstrates a positive, non-linear association between VAT area and SUA concentrations in young and middle-aged U.S. adults. The observed threshold effect provides valuable insight for clinicians in stratifying risks for hyperuricemia and related comorbidities, particularly among individuals with elevated VAT levels.

A Cascade of Microbiota-Leaky Gut-Inflammation- Is it a Key Player in Metabolic Disorders?

PURPOSE OF REVIEW

This review addresses critical gaps in knowledge and provides a literature overview of the molecular pathways connecting gut microbiota dysbiosis to increased intestinal permeability (commonly referred to as "leaky gut") and its contribution to metabolic disorders. Restoring a healthy gut microbiota holds significant potential for enhancing intestinal barrier function and metabolic health. These interventions offer promising therapeutic avenues for addressing leaky gut and its associated pathologies in metabolic syndrome.

RECENT FINDINGS

In metabolic disorders such as obesity and type 2 diabetes (T2D), beneficial microbes such as those producing short-chain fatty acids (SCFAs) and other key metabolites like taurine, spermidine, glutamine, and indole derivatives are reduced. Concurrently, microbes that degrade toxic metabolites such as ethanolamine also decline, while proinflammatory, lipopolysaccharide (LPS)-enriched microbes increase. These microbial shifts place a higher burden on intestinal epithelial cells, which are in closest proximity to the gut lumen, inducing detrimental changes that compromise the structural and functional integrity of the intestinal barrier. Such changes include exacerbation of tight junction protein (TJP)s dysfunction, particularly through mechanisms such as destabilization of zona occludens (Zo)-1 mRNA or post-translational modifications. Emerging therapeutic strategies including ketogenic and Mediterranean diets, as well as probiotics, prebiotics, synbiotics, and postbiotics have demonstrated efficacy in restoring beneficial microbial populations, enhancing TJP expression and function, supporting gut barrier integrity, reducing leaky gut and inflammation, and ultimately improving metabolic disorders. This review summarizes the mechanisms by which gut microbiota contribute to the development of leaky gut and inflammation associated with metabolic syndrome. It also explores strategies for restoring gut microbiota balance and functionality by promoting beneficial microbes, increasing the production of beneficial metabolites, clearing toxic metabolites, and reducing the proportion of proinflammatory microbes. These approaches can alleviate the burden on intestinal epithelial cells, reduce leaky gut and inflammation, and improve metabolic health.

Yeast hydrolysate and exercise ameliorate high-fat diet-induced obesity in C57BL/6 mice

BACKGROUND

Yeast hydrolysate (YH) has been shown to be effective in inhibiting fat accumulation. This study aimed to investigate the effects of YH and exercise on high-fat diet-induced obesity and their underlying mechanisms in C57BL/6J mice.

METHODS

In this study, 6-week-old C57BL/6 mice were divided into 7 groups; a normal group fed a normal chow diet, an HFD group (CON) fed ad libitum, an exercise group (15m/min, 30min), an HFD supplemented with low dose of YH (100 mg/kg, YHL), an HFD supplemented with high dose of YH (200 mg/kg, YHH), and a combination of exercise and YHH group. After 12 weeks of HFD and YH administration, white adipocytes and liver tissue were analyzed.

RESULTS

Both YH and exercise significantly reduced the weight of the body and adipose tissues; however, the greatest effect was observed when YH and exercise were combined. Similarly, most reduction in adipocyte size and fat formation in the liver was notable following the combination of YH and exercise. Furthermore, both YH and exercise effectively downregulated lipid synthesis genes, namely fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), and HMG-CoA reductase (HMGCR), and SREBP1 and SREBP2 proteins. YH and/or exercise also significantly increased the mRNA levels of hormone sensitive lipase (HSL) and carnitine palmitoyltransferase 1 (CPT1), both of which are related to fatty acid oxidation. In addition, pAMPKα and PPARα levels were significantly increased by YH and exercise, with the greatest increase noted following the combination of YH and exercise. Additionally, YH and exercise combined caused the most significant increase in the antioxidant response, as evidenced by nuclear factor erythroid 2-related factor 2 (Nrf2) and superoxide dismutase 1 (SOD1) upregulation at protein and mRNA levels. Their combination also exhibited strongest suppression of inflammatory responses via the downregulation of NF-κB, TNF-α, and IL-1β at protein and mRNA levels. Collectively, YH and exercise combination showed an inhibitory effect on obesity, leading to decreased lipogenesis and increased lipolysis, with favorable regulation of antioxidant and inflammatory responses.

CONCLUSION

This study suggests the potential use of a combination of physical activity and YH supplementation to control obesity and related metabolic diseases.

Metabolic and bariatric surgery versus glucagon-like peptide-1 receptor agonist therapy: A comparison of cardiovascular outcomes in patients with obesity

BACKGROUND

This study compared cardiovascular outcomes associated with metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in individuals with obesity.

METHODS

The TriNetX network was used to compare cardiovascular risk in adult patients with BMI ≥35 who underwent MBS with those who received GLP-1 RA therapy for ≥2 years. Primary outcome was cardiovascular disease (CVD), a composite of incident heart failure (HF), coronary artery disease (CAD), and cerebrovascular disease. Patient follow-up lasted up to 10 years.

RESULTS

MBS was associated with lower hazard of the primary composite outcome of CVD (HR, 0.54, 95 ​% CI, 0.49-0.60), and the secondary outcomes of incident HF (HR, 0.45, 95 ​% CI, 0.39-0.52), CAD (HR, 0.54, 95 ​% CI, 0.45-0.66), and cerebrovascular disease (HR, 0.64, 95 ​% CI, 0.53-0.77).

CONCLUSIONS

A lower risk of adverse cardiovascular outcomes was noted after MBS compared with GLP-1 RA therapy in patients with obesity.

Monocyte CCL2 signaling possibly contributes to increased asthma susceptibility in type 2 diabetes

In recent years, the respiratory system has been increasingly recognized as a key target organ in diabetes. Although observational studies have established significant clinical associations between type 2 diabetes (T2D), antidiabetic medication use, and asthma, the causal relationships and underlying molecular mechanisms remain unclear. This study employed a bidirectional two-sample Mendelian randomization (MR) approach combined with bioinformatics analysis to explore the causal relationships between T2D and asthma subtypes and complications, with a focus on immune-regulatory mechanisms. The MR analysis utilized inverse-variance weighted (IVW) and meta-analysis methods to evaluate overall effects, with sensitivity analyses confirming the robustness of the findings. Bioinformatics analysis focused on differential gene expression and pathway enrichment to identify potential molecular networks. The MR analysis showed that T2D has a significant positive causal effect on asthma (P < 0.05), with severe autoimmune T2D showing strong associations with specific asthma subtypes (eosinophilic and mixed asthma) and complications (e.g., acute respiratory infections and pneumonia) (P < 0.05). Bioinformatics analysis identified the monocyte-CCL2 signaling axis as a key mechanism linking T2D and asthma, where hyperglycemia-induced monocyte activation may promote asthma development. These findings reveal shared inflammatory pathways and deepen our understanding of the molecular mechanisms linking these two chronic diseases.

High-Fat Diet and Altered Radiation Response

High-fat diets (HFDs) have become increasingly prevalent in modern societies, driving rising rates of obesity and metabolic syndrome. Concurrently, radiation exposure from medical treatments and environmental sources poses health risks shaped by both biological and environmental factors. This review explores the intersection between HFDs and radiation sensitivity/susceptibility, focusing on how diet-induced metabolic alterations influence the body's response to radiation. Evidence from preclinical and clinical studies indicates that HFDs significantly alter metabolism, leading to increased oxidative stress and immune system dysregulation. These metabolic changes can exacerbate radiation-induced oxidative stress, inflammation, and DNA damage, potentially increasing radiation sensitivity in normal tissues. Conversely, obesity and HFD-induced metabolic disruptions may activate cellular pathways involved in DNA repair, cell survival, and inflammatory responses, fostering tumor resistance and modifying the tumor microenvironment, which may impair the efficacy of radiation therapy in cancer treatment. Understanding the interplay between diet and radiation exposure is critical for optimizing public health guidelines and improving therapeutic outcomes. These findings underscore the need for further research into dietary interventions that may mitigate radiation-associated risks.

Relationship between weight-to-waist index and post-stroke depression

BACKGROUND

The weight-to-waist index (WWI) serves as an innovative metric specifically designed to assess central obesity. However, the relationship between WWI and the prevalence of post-stroke depression (PSD) remains inadequately explored in the literature.

AIM

To elucidate the relationship between WWI and PSD.

METHODS

Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed. Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD, with adjustments for potential confounders. The restricted cubic spline statistical method was applied to explore non-linear associations.

RESULTS

Participants with elevated WWI values had a significantly greater risk of developing PSD. Specifically, individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values (odds ratio = 2.21, 95% confidence interval: 1.84-2.66, P < 0.0001). After propensity score matching, the risk of PSD remained significantly elevated (odds ratio = 1.43, 95%confidence interval: 1.09-1.88, P = 0.01). Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile. Restricted cubic spline analysis further revealed a non-linear association, with the risk of PSD plateauing at higher WWI values.

CONCLUSION

There is a significant association between elevated WWI and increased risk of PSD. Thus, regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.

Targeting Diabetic Atherosclerosis: The Role of GLP-1 Receptor Agonists, SGLT2 Inhibitors, and Nonsteroidal Mineralocorticoid Receptor Antagonists in Vascular Protection and Disease Modulation

Atherosclerosis is a closely related complication of diabetes mellitus (DM), driven by endothelial dysfunction, inflammation, and oxidative stress. The progression of atherosclerosis is accelerated by hyperglycemia, insulin resistance, and hyperlipidemia. Novel antidiabetic agents, SGLT2 inhibitors, and GLP-1 agonists improve glycemic control and offer cardiovascular protection, reducing the risk of major adverse cardiovascular events (MACEs) and heart failure hospitalization. These agents, along with nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), promise to mitigate metabolic disorders and their impact on endothelial function, oxidative stress, and inflammation. This review explores the potential molecular mechanisms through which these drugs may prevent the development of atherosclerosis and cardiovascular disease (CVD), supported by a summary of preclinical and clinical evidence.

Visceral Fat, Metabolic Health, and Lifestyle Factors in Obstructive Bronchial Diseases: Insights from Bioelectrical Impedance Analysis

Background/Objectives: This study examines the relationship between visceral fat (VF), metabolic health, and dietary patterns in patients with obstructive bronchial diseases (OBDs) using bioelectrical impedance analysis (BIA). Methods: A total of 75 patients diagnosed with OBD, including chronic obstructive pulmonary disease (COPD) and/or asthma, were assessed for VF levels via BIA. Dietary habits were evaluated using a structured questionnaire to explore their correlation with VF accumulation. Results: The study cohort comprised predominantly male participants (66.7%), with the majority aged between 61 and 70 years (46.7%). Significant gender differences in VF distribution were observed, with 60% of females maintaining normal VF levels (1-9) compared to only 28% of males, while 38% of males exhibited very high VF levels (15-30; p = 0.003). Body mass index (BMI) showed a strong correlation with VF (p < 0.0001), as overweight and obese individuals predominantly displayed elevated VF levels (≥10). Moreover, metabolic syndrome (MS) was present in 66.7% of participants, with these individuals exhibiting significantly higher VF levels compared to those without MS (p = 0.001). Dietary analysis revealed that frequent consumption of fast food (r = 0.717, p < 0.001), carbonated drinks (r = 0.366, p = 0.001), and refined carbohydrates (r = 0.438, p < 0.001) was significantly associated with increased VF accumulation. Conversely, higher intake of water (r = -0.551, p < 0.001), fruits (r = -0.581, p < 0.001), and vegetables (r = -0.482, p < 0.001) correlated with lower VF levels. Lack of physical activity was also strongly linked to VF accumulation (r = 0.481, p < 0.001), further reinforcing the role of lifestyle factors in metabolic health. Conclusions: The findings underscore the significant impact of dietary habits and physical activity on VF accumulation in OBD patients. BMI and MS emerged as critical predictors of VF, while unhealthy dietary patterns and sedentary lifestyles further exacerbated VF deposition. Elevated VF levels were linked to adverse lipid profiles, reinforcing the need for dietary and lifestyle modifications in managing metabolic health among OBD patients. Although no direct association was identified between VF and forced expiratory volume in one second (FEV1), the results highlight the necessity of integrated nutritional and metabolic interventions in the management of chronic respiratory diseases.

Association of Metabolic Score for Visceral Fat (METS-VF) with Gout Risk in Patients with Hypertension and Hyperuricemia: A Multicenter Study Based on the Chinese Population

Background

Gout, a rheumatic disease precipitated by hyperuricemia, has become a global health concern due to its increasing prevalence, especially in China. Hyperuricemia and hypertension are significant risk factors for gout, and their coexistence amplifies this risk. Visceral adipose tissue (VAT) plays a crucial role in cardiometabolic diseases, and the metabolic score for visceral fat (METS-VF) is a non-invasive tool for estimating VAT and predicting cardiometabolic risk.

Methods

We conducted a multicenter cross-sectional study involving 8877 patients with hypertension and hyperuricemia from three Chinese medical centers between March 2021 and September 2024. We calculated the METS-VF and other obesity indices and analyzed their associations with gout risk using logistic regression models. The predictive performance of these indices was evaluated using receiver operating characteristic (ROC) curve analysis and clinical decision curve analysis (DCA).

Results

The METS-VF demonstrated a significant positive association with gout risk, independent of traditional risk factors. Each 1-standard deviation increase in the METS-VF was associated with an 82% higher odds of gout (OR=1.82, 95% CI: 1.62 to 2.03). The METS-VF outperformed other obesity indices in predicting gout risk, with a higher area under the ROC curve (AUC) value. DCA indicated that the METS-VF provided a significant net benefit across a wide range of threshold probabilities for predicting gout risk in both genders.

Conclusion

The METS-VF's robust association with gout risk in our multicenter study, independent of conventional risk factors, positions it as a potent predictor for gout. Further investigation is warranted to clarify the underlying mechanisms and the long-term predictive validity of the METS-VF across diverse populations.

Potential Therapeutic Exploitation of G Protein-Coupled Receptor 120 (GPR120/FFAR4) Signaling in Obesity-Related Metabolic Disorders

The increasing prevalence of overweight and obesity not only in adults but also among children and adolescents has become one of the most alarming health problems worldwide. Metabolic disorders accompanying fat accumulation during pathological weight gain induce chronic low-grade inflammation, which, in a vicious cycle, increases the immune response through pro-inflammatory changes in the cytokine (adipokine) profile. Obesity decreases life expectancy, largely because obese individuals are at an increased risk of many medical complications, often referred to as metabolic syndrome, which refers to the co-occurrence of insulin resistance (IR), impaired glucose tolerance, type 2 diabetes (T2D), atherogenic dyslipidemia, hypertension, and premature ischemic heart disease. Metabotropic G protein-coupled receptors (GPCRs) constitute the most numerous and diverse group of cell surface transmembrane receptors in eukaryotes. Among the GPCRs, researchers are focusing on the connection of G protein-coupled receptor 120 (GPR120), also known as free fatty acid receptor 4 (FFAR4), with signaling pathways regulating the inflammatory response and insulin sensitivity. This review presents the current state of knowledge concerning the involvement of GPR120 in anti-inflammatory and metabolic signaling. Since both inflammation in adipose tissue and insulin resistance are key problems in obesity, there is a rationale for the development of novel, GPR120-based therapies for overweight and obese individuals. The main problems associated with introducing this type of treatment into clinical practice are also discussed.

Impact of exercise training in a hypobaric/normobaric hypoxic environment on body composition and glycolipid metabolism in individuals with overweight or obesity: a systematic review and meta-analysis

Objective

This study aims to assess the impact of hypoxia training on body composition and glycolipid metabolism in excess body weight or living with obese people through meta-analysis.

Methods

Randomized controlled trials investigating the effects of hypoxia training on body composition, glucose, and lipid metabolism in excess body weight or living with obese people were systematically searched from databases including CNKI, PubMed, and Web of Science. The meta-analysis was performed by using Stata 18 and RevMan 5.4 analytic tools. The risk of bias was assessed using the Cochrane evaluation tool, and the level of certainty of evidence was determined by the GRADE framework. Between-study heterogeneity was examined using the I 2 test, and the publication bias was evaluated via the Egger test or funnel plot.

Results

A total of 32 RCTs with 1,011 participants were included. A meta-analysis of 25 RCTs was performed (499 men and 480 women, Age: 40.25 ± 15.69, BMI: 30.96 ± 3.65). In terms of body composition, the outcome indexes of body fat ratio (MD is -1.16, 95% CI -1.76 to -0.56, P = 0.00) in the hypoxia group were better than the normal oxygen group. There was no significant difference in body mass and BMI between the hypoxia group and the normal-oxygen group (P > 0.05). In terms of lipid and glucose metabolism, no significant changes were found between the hypoxia group and the normoxia group (P > 0.05). Subgroup analysis showed that training in hypoxic environment at altitude 2001-2,500 m could effectively improve body mass, TG and LDL-C (P < 0.05). The effective program to reduce body mass is to carry out moderate intensity training of 45-60 min for ≤8 weeks, ≥4 times a week (P < 0.05).

Conclusion

Hypoxic training is essential for reducing body fat ratio in excess body weight or obese people. It is recommended to carry out 45-60 min of moderate-intensity aerobic exercise for ≤8 weeks, ≥4 times a week, in a hypoxia environment of 2,001-2,500 m to lose body mass. The effects of hypoxia training and normoxia training on lipid and glucose metabolism in excess body weight or obese people are the same.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024628550.

Hesperetin mitigates adipose tissue inflammation to improve obesity-associated metabolic health

Metabolically unhealthy obesity (MUO) poses significant health risks, including increased susceptibility to type 2 diabetes and cardiovascular diseases. Hesperetin is a key bioactive compound found in citrus fruits. Previous studies have shown that hesperetin can correct metabolic abnormalities and mitigate the progression of various metabolic disorders, but the underlying mechanisms remain unclear. Here, we explored the impact of hesperetin on MUO using ob/ob mice and investigated its potential pharmacological mechanisms. The present data indicated that administration of hesperetin for 12 weeks led to notable improvements in metabolic parameters, including reduced fasting blood glucose, fasting insulin levels, and the HOMA-IR index in ob/ob mice. Glucose and insulin tolerance tests demonstrated that hesperetin effectively enhanced insulin sensitivity, with high-dose effects comparable to metformin. Hesperetin treatment decreased inguinal white adipose tissue (iWAT) weight and improved insulin signaling by increasing AKT phosphorylation. Additionally, it reduced the expression of pro-inflammatory cytokines (Il-6 and Il-1β), chemokine Ccl2 and its receptor Ccr2, and macrophage activation markers Nos2 and Ptgs2 within iWAT of ob/ob mice, likely by inhibiting NF-κB activation and macrophage-mediated inflammation. In vitro studies further confirmed hesperetin's anti-inflammatory effects in LPS-stimulated macrophages, where it suppressed cytokine production and NF-κB signaling. Hesperetin also impaired CCL2-induced macrophage chemotaxis, reducing migration velocity and distance. Mechanistically, hesperetin directly interacts with and inhibits IKKβ kinase activity by binding to key residues (LEU21, VAL465, CYS99, and GLU97) and stabilizing the complex, as demonstrated by molecular docking and molecular dynamics simulations. These findings underscore hesperetin's therapeutic potential in mitigating metabolically unhealthy obesity, obesity-induced insulin resistance, and inflammation through direct modulation of the IKKβ and NF-κB pathways.

FcRn-dependent IgG accumulation in adipose tissue unmasks obesity pathophysiology

Immunoglobulin G (IgG) is traditionally recognized as a plasma protein that neutralizes antigens for immune defense. However, our research demonstrates that IgG predominantly accumulates in adipose tissue during obesity development, triggering insulin resistance and macrophage infiltration. This accumulation is governed by neonatal Fc receptor (FcRn)-dependent recycling, orchestrated in adipose progenitor cells and macrophages during the early and late stages of diet-induced obesity (DIO), respectively. Targeting FcRn abolished IgG accumulation and rectified insulin resistance and metabolic degeneration in DIO. By integrating artificial intelligence (AI) modeling with in vivo and in vitro experimental models, we unexpectedly uncovered an interaction between IgG's Fc-CH3 domain and the insulin receptor's ectodomain. This interaction hinders insulin binding, consequently obstructing insulin signaling and adipocyte functions. These findings unveil adipose IgG accumulation as a driving force in obesity pathophysiology, providing a novel therapeutic strategy to tackle metabolic dysfunctions.

Modulation of Δ5- and Δ6-desaturases in the brain-liver axis

OBJECTIVE

Obesity is associated with liver depletion of ω-3 polyunsaturated fatty acids (ω-3 PUFAS) promoting steatosis and inflammation, whose levels are maintained by diet or biosynthesis involving Δ-5D, Δ-6D desaturases and elongases.

METHOD

We aimed to assess Δ-5D and Δ-6D activities in liver and brain from mice fed a control diet (CD) or high-fat diet (HFD) for four to sixteen weeks.

RESULTS

HFD led to (1) an early (4 weeks) enhancement in liver Δ-5D, Δ-6D, and PPAR-α activities, without changes in oxidative stress, liver damage or fat accumulation; (2) a latter progressive loss in hepatic desaturation with insufficient compensatory increases in mRNA and protein expression, leading to ω-3 PUFA depletion, PPAR-α down-regulation reducing FA oxidation, and liver steatosis with enhancement in lipogenesis; and (3) brain ω-3 PUFA depletion after 12 to 16 weeks of HFD feeding.

CONCLUSION

In conclusion, the brain-liver axis is drastically affected by obesity in a time dependent fashion.

Diabetes-associated sleep fragmentation impairs liver and heart function via SIRT1-dependent epigenetic modulation of NADPH oxidase 4

Although clinical evidence suggests that nonalcoholic fatty liver disease is an established major risk factor for heart failure, it remains unexplored whether sleep disorder-caused hepatic damage contributes to the development of cardiovascular disease (CVD). Here, our findings revealed that sleep fragmentation (SF) displayed notable hepatic detrimental phenotypes, including steatosis and oxidative damage, along with significant abnormalities in cardiac structure and function. All these pathological changes persisted even after sleep recovery for 2 consecutive weeks or more, displaying memory properties. Mechanistically, persistent higher expression of nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) in the liver was the key initiator of SF-accelerated damage phenotypes. SF epigenetically controlled the acetylation of histone H3 lysine 27 (H3K27ac) enrichment at the Nox4 promoter and markedly increased Nox4 expression in liver even after sleep recovery. Moreover, fine coordination of the circadian clock and hepatic damage was strictly controlled by BMAL1-dependent Sirtuin 1 (Sirt1) transcription after circadian misalignment. Accordingly, genetic manipulation of liver-specific Nox4 or Sirt1, along with pharmacological intervention targeting NOX4 (GLX351322) or SIRT1 (Resveratrol), could effectively erase the epigenetic modification of Nox4 by reducing the H3K27ac level and ameliorate the progression of liver pathology, thereby counteracting SF-evoked sustained CVD. Collectively, our findings may pave the way for strategies to mitigate myocardial injury from persistent hepatic detrimental memory in diabetic patients.

Comparative Effects of Tumor Necrosis Factor Alpha, Lipopolysaccharide, and Palmitate on Mitochondrial Dysfunction in Cultured 3T3-L1 Adipocytes

We have previously reported that dysregulated lipid metabolism and inflammation in 3T3-L1 adipocytes is attributed to tumor necrosis factor alpha (TNFα) rather than lipopolysaccharide (LPS) and palmitate (PA). In this study, we further compared the modulative effects of TNFα, LPS, and PA on mitochondrial function by treating 3T3-L1 adipocytes with TNFα (10 ng/mL), LPS (100 ng/mL), and PA (0.75 mM) individually or in combination for 24 h. Results showed a significant reduction in intracellular adenosine triphosphate (ATP) content, mitochondrial bioenergetics, total antioxidant capacity, and the mRNA expression of citrate synthase (Cs), sirtuin 3 (Sirt3), protein kinase AMP-activated catalytic subunit alpha 2 (Prkaa2), peroxisome proliferator-activated receptor gamma coactivator 1 alpha (Ppargc1α), nuclear respiratory factor 1 (Nrf1), and superoxide dismutase 1 (Sod1) in cells treated with TNFα individually or in combination with LPS and PA. Additionally, TNFα treatments decreased insulin receptor substrate 1 (Irs1), insulin receptor substrate 2 (Irs2), solute carrier family 2, facilitated glucose transporter member 4 (Slc2a4), and phosphoinositide 3 kinase regulatory subunit 1 (Pik3r1) mRNA expression. Treatment with LPS and PA alone, or in combination, did not affect the assessed metabolic parameters, while the combination of LPS and PA increased lipid peroxidation. These results show that TNFα but not LPS and PA dysregulate mitochondrial function, thus inducing oxidative stress and impaired insulin signaling in 3T3-L1 adipocytes. This suggests that TNFα treatment can be used as a basic in vitro model for studying the pathophysiology of mitochondrial dysfunction and related metabolic complications and screening potential anti-obesity therapeutics in 3T3-L1 adipocytes.

Nitazoxanide protects against heart failure with preserved ejection and metabolic syndrome induced by high-fat diet (HFD) plus L-NAME "two-hit" in mice

The clinical antiprotozoal drug nitazoxanide has been demonstrated to improve the experimental diabetes mellitus, lipid metabolism disorders, atherosclerosis and inhibit inflammation. Since the pathogenesis of heart failure with preserved ejection (HFpEF) is multifactorial and closely associated with the aforementioned diseases, we aim to study the effect of nitazoxanide on high-fat diet (HFD) plus L-NAME (N ω-nitro-l-arginine methyl ester)-induced HFpEF and metabolic syndrome in mice. We found that oral nitazoxanide improved cardiac hypertrophy, cardiac fibrosis, cardiac diastolic dysfunction, increased blood pressure, impaired exercise tolerance, impaired glucose handling, serum lipid disorders, hepatic steatosis, increased weight of white adipose tissues and kidney fibrosis in HFD + L-NAME-treated mice. In the established HFD + L-NAME-induced HFpEF and metabolic syndrome mouse model, therapeutic treatment with nitazoxanide rescued HFD + L-NAME-induced pathological phenotypes as mentioned above. The in vitro experiments revealed that tizoxanide, the active metabolite of nitazoxanide, increased the basal mitochondria metabolism of cardiomyocytes, inhibited cardiomyocyte hypertrophy and collagen secretion from cardiac fibroblasts, and relaxed phenylephrine- and U46619-induced constriction of rat mesenteric arteries, indicating that the direct effect of tizoxanide might partly contribute to the protective effect of nitazoxanide against HFpEF in vivo. The present study suggests that nitazoxanide might be a potential drug for HFpEF and metabolic syndrome therapy.

The arabic version of the fat phobia scale-short form: reliability and structural validity

BACKGROUND

Weight bias, often known as fat phobia or weight stigma, refers to unfavorable attitudes and stereotypes that are associated with, and applied to, larger bodies. Fat phobia can include an unreasonable and abnormal dread of being overweight or being associated with obese people. Currently, there is no validated tool available to measure fat phobia in Arabic. Measuring fat phobia in Arabic-speaking populations is crucial, because cultural attitudes toward body weight can be quite negative and discriminatory; these negative attitudes can negatively impact mental health. The current study aimed to adapt, translate, and assess the structural validity of the Fat Phobia Scale-Short Form (F-Scale 14) in Arabic.

METHODS

The gold standard approach to translation was used. Forward translation involved translation from the English language to the Arabic language by independent translators. Subsequently, a back-translation review was performed on the translated Arabic version for comparison with the original language. A cross-sectional study was conducted online that included 1246 participants from 22 Arabic countries, of whom 74% were female, 66% single, 83% university graduates, with a mean age of 35 ± 6 years.

RESULTS

The F-Scale 14 demonstrated good reliability in the Arabic language, with a Cronbach's α of 0.82 (95% CI 0.80-0.83), comparable to the original scale. The test-retest reliability of the scale was 0.92 (95% CI 0.90-0.94). According to the fit indices, the F-Scale 14 demonstrated a satisfactory level of structural validity in Arab cultures. Fit indices are statistical measures used in confirmatory factor analysis (CFA) to assess how well a proposed model fits the observed data. The scale showed a small improvement in factorial structure after the removal of some items. The two items removed were self-indulgent versus self-sacrificing and disliking food versus likes food. The correlation between F-Scale 14 and the figure rating scale was r = 0.76 (p < 0.001), suggesting adequate convergent validity.

CONCLUSIONS

The F-Scale 14 is a crucial indicator of attitudes and opinions concerning obese or overweight individuals. Based on increased internal consistency reliability and the problematic cultural relevance of two items, we recommend adopting a 12-item version of the scale for better cultural relevance in Arabic populations. It is anticipated that the Arabic F-Scale-12 will be highly useful for research and clinical purposes. Future research should test and adapt the Fat Phobia Scale for diverse Arabic populations to ensure its cultural relevance. Exploring its application in clinical settings will enhance our understanding of weight stigma and inform targeted interventions that promote body positivity. By addressing these areas, we can develop effective strategies to foster healthier attitudes toward body image in Arabic communities.

LEVEL V

Evidence obtained from a cross-sectional descriptive study.

Obesity as a Disease: A Primer on Clinical and Physiological Insights

Obesity is now recognized as a multifaceted chronic disease that is intricately linked to metabolic, biochemical, and psychosocial dysfunction. In this article, we review the epidemiology of obesity, current understanding of its physiopathology, and the recommended staging system used to approach it as a chronic disease, and we include an overview of its health implications.

Prospective Single-Arm Study of Remifentanil-Propofol Anesthesia with Manual Right Hypochondrial Compression for Painless Gastroscopy in Obese Patients

Purpose

The provision of comfortable and safe environment for painless gastroscopy in obese patients is an urgent clinical problem. This study aimed to determine the efficacy and safety of the novel Li anesthetic protocol for obesity (LAPO) which included remifentanil-propofol regimen, manual right hypochondrial compression (MRHC), easy-to-create mask, and jaw thrust at preoperative painless gastroscopy in obese patients.

Patients and Methods

This prospective, single-center, single-arm trial recruited 106 participants underwent LAPO for gastroscopy. The primary outcome was the incidence of hypoxemia (peripheral oxygen saturation [SpO2]: 75% ≤ SpO2 <90%, for >10 s and ≤60 s). Second outcomes included severe hypoxemia, the lowest SpO2 (L-SpO2), duration of hypoxemia, and other events.

Results

The 98 obese patients under LAPO, the median body mass index (BMI) was 39.2 kg/m2 and the incidence of hypoxemia was 27.5%, while the conventional anesthetic protocol for obesity (CAPO) in the reference was 40.4% with BMI 31.4 kg/m2. With the increase of class of obesity, a significant rise in the incidence of hypoxemia was observed, from class I by 11.8%, to 15.1% in class II, and 41.7% in class III. Paired t test showed that the L-SpO2 was significantly higher than L-SpO2 in overnight polysomnography (Nadir SpO2) (92% vs 76%, P<0.001). Moreover, severe obstructive sleep apnea (OSA) was associated with a 4.019-fold higher risk of hypoxemia (Odds ratios [OR], 4.019; 95% confidence interval [CI], 1.184 to 14.610; P=0.028); diabetes was associated with a 4.790-fold higher risk of hypoxemia (OR, 4.790; 95% CI, 1.288 to 23.600; P=0.030).

Conclusion

Compared with CAPO, LAPO reduced the incidence of hypoxemia from 40.4% to 27.5%, so, LAPO was safe and effective for painless gastroscopy. The finding might provide some new schedules for anesthetic management in the absence of advanced airway support instruments.

Clinical Trial Registration

ChiCTR2300077889.

Type 2 Diabetes Mellitus: A Comprehensive Review of Pathophysiology, Comorbidities, and Emerging Therapies

Humans are perhaps evolutionarily engineered to get deeply addicted to sugar, as it not only provides energy but also helps in storing fats, which helps in survival during starvation. Additionally, sugars (glucose and fructose) stimulate the feel-good factor, as they trigger the secretion of serotonin and dopamine in the brain, associated with the reward sensation, uplifting the mood in general. However, when consumed in excess, it contributes to energy imbalance, weight gain, and obesity, leading to the onset of a complex metabolic disorder, generally referred to as diabetes. Type 2 diabetes mellitus (T2DM) is one of the most prevalent forms of diabetes, nearly affecting all age groups. T2DM is clinically diagnosed with a cardinal sign of chronic hyperglycemia (excessive sugar in the blood). Chronic hyperglycemia, coupled with dysfunctions of pancreatic β-cells, insulin resistance, and immune inflammation, further exacerbate the pathology of T2DM. Uncontrolled T2DM, a major public health concern, also contributes significantly toward the onset and progression of several micro- and macrovascular diseases, such as diabetic retinopathy, nephropathy, neuropathy, atherosclerosis, and cardiovascular diseases, including cancer. The current review discusses the epidemiology, causative factors, pathophysiology, and associated comorbidities, including the existing and emerging therapies related to T2DM. It also provides a future roadmap for alternative drug discovery for the management of T2DM.

Effect of caloric restriction with probiotic supplementation on body composition, quality of life, and psychobiological factors of obese men: A randomized, double-blinded placebo-controlled clinical trial

BACKGROUND & AIMS

Obesity is a chronic disease characterized by an excess of fat mass. It is accompanied by a low-grade chronic systemic inflammation state that leads to numerous health disorders. To counteract this scenario, dietary-derived caloric restriction (CR) is the principal intervention for weight loss. Furthermore, probiotic supplementation has gained attention as a co-intervention to optimize weight loss and other health-related factors. As such, we aimed to verify the effect of CR with probiotic supplementation on the body composition, quality of life, sleep quality, anxiety, stress, and depression symptoms of adult men living with obesity.

METHODS

The study is called the Clinical Study of Obesity and Intestinal Microbiota (ECOMI). It is a randomized, double-blind, placebo-controlled clinical trial involving two parallel groups of stable-weight adult men living with obesity. The inclusion criteria were male individuals aged 25-44 years, with body mass index (BMI) ranging from 30.0 to 39.99 kg/m2, and stable body mass over the preceding three months. Participants were randomly assigned to two groups: Caloric Restriction with Probiotic (CRPRO) and Caloric Restriction with Placebo (CRPLA). The achieved CR was 30 % of the total daily energy expenditure. Macronutrients were distributed as 50 % carbohydrates, 30 % lipids, and 20 % proteins. Probiotic supplementation was carried out using two sachets/day of 1 g, containing 1 × 109 Colony Forming Units (CFU) of each strain: Lactobacillus acidophilus NCFM, Lactobacillus rhamnosus HN001, Lactobacillus paracasei Lpc-37 and Bifidobacterium lactis HN019, totaling 8 billion CFU/day. CR and probiotic (or placebo) supplementation intervention lasted 12 weeks. Body composition and psychobiological-related parameters (e.g., sleep, anxiety, stress, and depression) were assessed at baseline and following 12 weeks of intervention. Data are presented as mean and 95 % confidence interval (CI) and mean difference (MD).

RESULTS

The present study applied the per protocol analysis. Thirty-three subjects were evaluated and randomized, but only data from 25 (CRPLA n = 12 vs CRPRO n = 13) participants were included in the final analysis. We verified that CR resulted in weight loss (p < 0.001; η2ρ = 0.754) in both CRPLA (MD: -6.30 kg; p < 0.001) and CRPRO (MD: -5.97 kg; p < 0.001), without differences between groups (p = 0.823; η2ρ = 0.002). Moreover, both CRPLA (MD: -4.83 kg; p < 0.001) and CRPRO (MD: -5.20 kg; p < 0.001) decreased body fat without difference between groups (p = 0.712; η2ρ = 0.006). Regarding obesity-related problems, only the corporeality dimension (p < 0.001; η2ρ = 0.474) in both CRPLA (p = 0.028) and CRPRO (p = 0.039) improved. World Health Organization Quality of Life (WHOQoL)-related dimensions were improved for perception (p < 0.001; η2ρ = 0.630), satisfaction (p < 0.001; η2ρ = 0.778), and psychological domain (p < 0.001; η2ρ = 0.567), without differences between groups. Moreover, sleep quality (p < 0.001; η2ρ = 0.522) improved in both groups, without differences between groups. Finally, anxiety (p = 0.013; η2ρ = 0.250) and depression (p = 0.003; η2ρ = 0.345) scores assessed via the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Beck Depression Inventory (BDI-II) (p < 0.001; η2ρ = 0.448) improved only in the CRPRO group.

CONCLUSIONS

Probiotic supplementation did not enhance the effects of caloric restriction on body composition, QoL-, or sleep-related parameters. However, anxiety and depressive symptoms improved only in the CRPRO group, despite no differences between groups after 12 weeks. Further studies are needed to confirm these findings.

Beyond cancer: The potential application of CD47-based therapy in non-cancer diseases

CD47 is an immune checkpoint widely regarded as a 'don't eat me' signal. CD47-based anti-cancer therapy has received considerable attention, with a significant number of clinical trials conducted. While anti-cancer therapies based on CD47 remain a focal point of interest among researchers, it is noteworthy that an increasing number of studies have found that CD47-based therapy ameliorated the pathological status of non-cancer diseases. This review aims to provide an overview of the recent progress in comprehending the role of CD47-based therapy in non-cancer diseases, including diseases of the circulatory system, nervous system, digestive system, and so on. Furthermore, we sought to delineate the promising mechanisms of CD47-based therapy in treating non-cancer diseases. Our findings suggest that CD47-based agents may exert their effect by regulating phagocytosis, regulating T cells, dendritic cells, and neutrophils, and regulating the secretion of cytokines and chemokines. Additionally, we put forward the orientation of further research to bring to light the potential of CD47 and its binding partners as a target in non-cancer diseases.

Clinical Data Mega-Collection of Obesity and Obesity-Related Trials: Primary Inclusion Criteria from All Studies and Highlights of Clinical Efficacy Analysis of GLP-1 Drugs

Background/Objectives: Obesity is heterogeneous and considered a chronic epidemic with significant un-met needs for management, treatment, and prevention. Methods: In this study, we used LizAI's software TAITAN (alpha version) for the mega-collection and analysis of clinical data from 10,407 trials addressing obesity and obesity-related diseases and their associated publications, mainly on PubMed. Results: We report an intensive growth of clinical trials until the end of 2024 and highlight the use of the body mass index (BMI) as a critical criterion in clinical participant selection despite its limitations. The significant disparities in races, regions, and the sites of trials across all studies have not been addressed, posing the possibility of research in the far future on the applications of precision medicine in weight management. In the latter parts of this paper, we analyze and discuss the clinical efficacy, mainly focusing on the primary endpoints and benchmarks of the recently FDA-approved once-weekly injectable glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs, including semaglutide and tirzepatide. Both drugs have functioned comparably when considering the 5% weight loss FDA threshold. Tirzepatide outperforms semaglutide and impacts fewer participants as the weight loss level increases from 5 to 20% and has greater effects in different populations, especially in people with type 2 diabetes (T2D). Conclusions: We would, however, like to highlight that (i) the weight loss level should be dependent on the clinically relevant needs of patients, and faster and greater weight loss might not be a win, and (ii) the clinical benefits, safety, and quality of life of patients should be carefully assessed when the weight loss is significant in a short period. In our search, we found that the specificities and impacts of weight loss therapies on organs like the kidneys and heart, different muscle types, bones, and fat accumulation in different parts of body were not investigated or disclosed during the clinical study period and longer term monitoring. In light of scientific needs and remarkable public interest in weight loss, our report provides findings on the buzz around losing weight in clinical trials, and our TAITAN software continues to collect data in real time and enrich its knowledge for future updates.

Associations between surrogate insulin resistance indexes and osteoarthritis: NHANES 2003-2016

Insulin resistance (IR) and abdominal obesity are key in osteoarthritis (OA) development. The triglyceride glucose (TyG) index, along with indicators such as the visceral adiposity index (VAI), and lipid accumulation product (LAP), are increasingly used to measure IR. This study aims to explore the associations between surrogate IR indexes and OA, assessing their diagnostic efficacy within American populations. This study included 14,715 adults from the National Health and Nutrition Examination Survey 2003-2016. Logistic regression models and restricted cubic spline were used to explore the relationship between surrogate IR indexes and OA. Receiver operating characteristic curves were constructed to assess the diagnostic efficacy of these indices, with the area under the curve (AUC) as the metric. TyG, glucose triglyceride-waist circumference (TyG-WC), glucose triglyceride-body mass index (TyG-BMI), glucose triglyceride-waist height ratio (TyG-WHtR), VAI and LAP were significantly and positively associated with the prevalence of OA (all p < 0.01). After adjusting for various potential confounders, TyG-WC, TyG-BMI, TyG-WHtR and LAP remained significantly correlated with the prevalence of OA. Furthermore, restricted cubic spline revealed a nonlinear association between TyG-BMI, TyG-WHtR and LAP (all P-non-linear < 0.05). Receiver operating characteristic curves indicated that TyG-WHtR (AUC 0.633) demonstrated more robust diagnostic efficacy. Additionally, the sensitivity analysis produced results consistent with the primary findings. TyG and its combination with obesity indicators and LAP, are positively associated with the prevalence of OA, with TyG-WHtR showing the highest diagnostic efficacy.

The Strong Inhibition of Pancreatic Lipase by Selected Indonesian Medicinal Plants as Anti-Obesity Agents

Obesity is characterized by the accumulation of excessive fat, potentially leading to degenerative diseases. Pancreatic lipase, an enzyme responsible for converting 50-70% of dietary fat into monoglycerides, free fatty acids, and various other smaller molecules, plays a crucial role in fat metabolism. Therefore, this study aimed to review selected Indonesian medicinal plants with the potential to inhibit the activity of the pancreatic lipase enzyme. The results showed that kunci pepet (Kaempferiae angustifolia Rosc.), asam gelugur (Garcinia atroviridis), temulawak (Curcuma xanthorrhiza), jombang (Taraxacum officinale F. H. Wigg), pegagan (Centella asiatica), and pala (Myristica fragrans) had strong inhibitory effects, exceeding 50% for both in vitro and in vivo studies. Therefore, further studies are needed to explore the potential of these medicinal plants as anti-obesity treatments.

Periodontal pathogens and obesity in the context of cardiovascular risks across age groups

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity among noncommunicable diseases. Over the past decade, there has been a notable increase in the prevalence of CVDs among young individuals. Obesity, a well-known risk factor for CVDs, is also associated with various comorbidities that may contribute to cardiovascular risk. The relationship between periodontal pathogens and CVD risk factors, including obesity, smoking, lipid metabolism disorders, and inflammatory markers, remains underexplored.

Methods

This study examined the relationship between six periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Tannerella forsythia, Prevotella intermedia, and Fusobacterium nucleatum) and CVD risk factors among 189 subjects stratified by age and body mass index (BMI). Body composition was assessed via bioimpedance analysis, and blood samples were analyzed for lipid profiles, glucose, and proinflammatory cytokines. Oral samples were collected for polymerase chain reaction (PCR) analysis to identify periodontal pathogens. Cardiovascular and diabetes risk scores were calculated using the SCORE and FINDRISC scales.

Results

The prevalence of periodontal pathogens in the population was 33.0% for P. gingivalis, 47.8% for P. intermedia, 63.4% for A. actinomycetemcomitans, 46.6% for T. forsythia, 46.6% for T. denticola, and 89.2% for F. nucleatum. Significant age- and BMI-related differences were observed in pathogen prevalence, particularly with P. gingivalis, P. intermedia, and T. denticola. Young obese individuals exhibited a higher prevalence of P. intermedia and T. forsythia. P. gingivalis was found to be associated with hypertension and dyslipidemia, while P. intermedia was linked to hypertension and obesity. T. denticola was associated with obesity, dyslipidemia and smoking, whereas T. forsythia was linked to dyslipidemia alone.

Conclusions

This study highlights the potential connection between periodontal pathogens and risk factors associated with cardiovascular disease, including smoking, elevated BMI, increased adipose tissue, hypertension, and dyslipidemia. Further research is required to determine the causal relationships between oral microbiome dysbiosis, obesity and, systemic diseases and to develop an effective strategy for preventing oral health-related CVD risk factors in young adults.

The possible protective effect of luteolin on cardiovascular and hepatic changes in metabolic syndrome rat model

The metabolic syndrome, or MetS, is currently a global health concern. The anti-inflammatory, anti-proliferative, and antioxidant properties of luteolin are some of its advantageous pharmacological characteristics. This research was designed to establish a MetS rat model and investigate the possible protective effect of luteolin on cardiovascular, hepatic, and metabolic changes in diet-induced metabolic syndrome in rats. Forty adult male albino rats were split into four groups: a negative control group, a group treated with luteolin, a group induced MetS (fed 20% fructose), and a group treated with luteolin (fed 20% fructose and given luteolin). Following the experiment after 8 weeks, biochemical, histological (light and electron), and immunohistochemistry analyses were performed on liver and heart tissues. Serum levels of cTnI, CK-MB, and LDH were significantly elevated in response to the cardiovascular effect of MetS. Furthermore, compared to the negative control group, the MetS group showed a marked increase in lipid peroxidation in the cardiac and hepatic tissues, as evidenced by elevated levels of MDA and a decline in the antioxidant defense system, as demonstrated by lower activities of GSH and SOD. The fatty liver-induced group exhibited histological alterations, including disrupted hepatic architecture, dilated and congested central veins, blood sinusoids, and portal veins. In addition to nuclear structural alterations, most hepatocytes displayed varying degrees of cytoplasmic vacuolation, mitochondrial alterations, and endoplasmic reticulum dilatation. These alterations were linked to inflammatory cellular infiltrations, collagen fiber deposition, active hepatic stellate cells, and scattered hypertrophied Kupffer cells, as demonstrated by electron microscopy and validated by immunohistochemical analysis. It is interesting to note that eosinophils were seen between the liver cells and in dilated blood sinusoids. Moreover, the biochemical (hepatic and cardiac) and histological (liver) changes were significantly less severe in luteolin-treated rat on a high-fructose diet. These results suggested that luteolin protects against a type of metabolic syndrome that is produced experimentally.

Stimulation, regulation, and inflammaging interventions of natural compounds on nuclear factor kappa B (NF-kB) pathway: a comprehensive review

Nuclear factor kappa B (NF-kB) is a kind of transcription factor which resides in cytoplasm of each cell and on activation, it translocates to the nucleus. It is activated by a many inducible agents including endotoxins, inflammatory stimuli, carcinogens, pathogens, nicotine, and tumour promoters, etc. NF-kB is activated by canonical and non-canonical signalling pathways which has different signalling compounds and its biological functions. It controls the expression of 400 different genes including various enzymes, cytokines, viral proteins, regulatory molecules involved in the cell cycle etc. This pathway is linked with various ailments including respiratory diseases, inflammatory diseases, auto immune diseases, cancer and diabetes. NF-kB factor and signalling pathway are the mainstream of the innate and adaptive immune responses. Human subjects have been able to curb inflammation through inflammaging with the help of the phytomolecules interacting with the NF-κB pathway by adjusting the inflammation processes and alleviating aging stresses in cells. They successfully inhibit the activation of NF-κB, thereby curtailing chronic low-grade inflammation underlying both ageing and age-related disease processes. These phytocompounds discussed herewith not only down-regulate NF-κB-dependent pro-inflammatory pathways but also help build resilience at cellular levels, therefore, offering enhanced healthspan with late commencement of inflammaging pathogenesis. This review describes what stimulation and regulation of the Nuclear Factor kappa B (NF-kB) Pathway and its roles in the pathogenesis of human age related diseases. We also review the recent progress in attenuating the molecular mechanisms of the NF-kB Pathway by phytochemicals, which may open up novel therapeutic avenues.

Could Selected Adipokines/Cytokines Serve as Markers of Adipose Tissue Dysfunction?

Elevated levels of pro-inflammatory adipokines and cytokines increase the risk of developing metabolic disorders and diseases. The aim of this study was to conduct a comparative analysis of selected adipokines/cytokines in the blood serum of adults with obesity and normal body weight. The study also evaluated the correlation of these adipokines/cytokines with selected biochemical blood parameters. The study included 46 individuals with first- and second-degree obesity and 35 individuals with normal body weight. The participants underwent nutritional status assessments, biochemical tests, and evaluations of adipokine and cytokine concentrations in blood serum. The study found higher median CRP concentrations in women with obesity than in those with normal weight. This increase was statistically significant. The results also showed significantly higher IL-6 levels in the obesity group compared to the control group in both women and men. Resistin and MMP-2 were significantly different between women with obesity and women with normal body weight. Multiple regression results indicated that higher total fat content was significantly associated with higher serum CRP and IL-6 levels and lower adiponectin levels. Interleukin 6 was the strongest predictor of adipose tissue dysfunction in both women and men. Potential markers in women could also include resistin and MMP-2. The findings suggest that gender significantly influences the regulation of inflammatory factors.