Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes

Risk factors for hepatocellular carcinoma: an umbrella review of systematic review and meta-analysis

BACKGROUND

Numerous meta-analyses have identified various risk factors for hepatocellular carcinoma (HCC), prompting a comprehensive study to synthesize evidence quality and strength.

METHODS

This umbrella review of meta-analyses was conducted throughout PubMed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. Evidence strength was evaluated according to the evidence categories criteria.

RESULTS

We identified 101 risk factors throughout 175 meta-analyses. 31 risk factors were classified as evidence levels of class I, II, or III. HBV and HCV infections increase HCC risk by 12.5-fold and 11.2-fold, respectively. These risks are moderated by antiviral treatments and virological responses but are exacerbated by higher HBsAg levels, anti-HBc positivity, and co-infection. Smoking, obesity, non-alcoholic fatty liver disease, diabetes, low platelet, elevated liver enzymes and liver fluke infection increase HCC risk, while coffee consumption, a healthy diet, and bariatric surgery lower it. Medications like metformin, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), aspirin, statins, and selective serotonin reuptake inhibitors reduce HCC risk, while acid suppressive agents, particularly proton pump inhibitors, elevate it. Blood type O reduces the risk of HCC, while male gender and older age increase the risk.

CONCLUSIONS

HBV and HCV are major HCC risk factors, with risk mitigation through antiviral treatments. Lifestyle habits such as smoking and alcohol use significantly increase HCC risk, highlighting the importance of cessation. Certain drugs like aspirin, statins, GLP-1 RAs, and metformin may reduce HCC occurrence, but further research is needed to confirm these effects.

The association between uric acid to high-density cholesterol ratio and depression: A population-based cross-sectional study

BACKGROUND

Depression is associated with inflammation, and the uric acid to HDL-C cholesterol ratio (UHR) has emerged as a potential marker of increased inflammation; however, the association between UHR and depression is unclear. Therefore, we aimed to explore this association in a sample from the general US population.

METHODS

We conducted a cross-sectional study of 11,444 participants ≥20 years of age from the 2009-2014 NHANES database. We conducted weighted multivariate logistic regression analyses and restricted cubic spline function (RCS) models exploring the association between UHR and risk of depression, as well as subgroup analyses and tests of interaction.

RESULTS

UHR was positively associated with depression, especially in participants who drank alcohol (interaction P < 0.05).The prevalence of depression increased by 4 % for each 1-unit increase in UHR (OR = 1.04, 95 % CI = 1.02, 1.07, P = 0.003). After dividing the UHR into quartiles compared with the lowest reference group for UHR, participants in the fourth quartile had a significantly increased risk of depression after full adjustment (OR = 1.36, 95 % CI = 1.03, 1.80, P = 0.033).There was a linear dose-response relationship between the UHR and the risk of depression (P for nonlinear = 0.744).

LIMITATIONS

As this was a cross-sectional study, we could not determine a causal relationship between UHR and depression.

CONCLUSION

The UHR is positively associated with an increased prevalence of depression among adults in the U.S.

Effects of black seed (Nigella sativa L.) on cardiometabolic indices in type 2 diabetic patients: A systematic review and meta-analysis of RCTs

BACKGROUND

Black seed is known for its health benefits in traditional medicine. While recent studies suggest it may improve cardiometabolic health, its impact on type 2 diabetes mellitus (T2DM) remains unclear. This study aims to meta-analysis randomized controlled trials (RCTs) to assess the effects of black seed supplementation on cardiometabolic indices in T2DM patients.

METHODS

Following PRISMA guidelines, a comprehensive database search was conducted up to January 2025, and data were extracted from relevant RCTs. Mean differences (MD) and standard deviations (SD) were analyzed using a random-effects model, heterogeneity was assessed, and publication bias was evaluated.

RESULTS

The pooled meta-analysis of 16 RCTs showed that black seed supplementation significantly reduced fasting blood glucose (FBG) (MD: -21.43 mg/dL; p = 0.005), hemoglobin A1c (HbA1c) (MD: -0.44; p = 0.01), total cholesterol (TC) (MD: -18.80 mg/dL; p = 0.04) and low-density lipoprotein (LDL) (MD: -19.53 mg/dL; p = 0.003). No significant effects were observed for 2-hour postprandial glucose (2-hpp), fasting insulin, homeostatic model assessment (HOMA), triglycerides (TG), high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and body weight, or body mass index (BMI). Subgroup analyses revealed that black seed supplementation effectively reduced FBG for longer than 8 weeks; additionally, HbA1c, HOMA, and LDL in higher doses (>1 g/day), shorter durations (≤8 weeks), and use of the oil form.

CONCLUSION

Black seed supplementation appears to significantly improve FBG, HbA1c, TC, and LDL levels in patients with T2DM. However, no significant effects were observed on other metabolic parameters, including insulin, TG, liver enzymes, kidney function, or body weight. These findings suggest that black seed may be a beneficial adjunct therapy for glycemic and lipid control in T2DM patients but require further research to confirm its broader metabolic effects.

The relationship of inflammatory markers NLR and PLR with HbA1c in Turkish diabetic patients

AIM

As inflammation plays a role in the pathogenesis of DM, we aimed to show the relationship between the best indicator of DM-HbA1c levels and inflammatory parameters Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in the present study.

MATERIALS & METHODS

This study was conducted in December 2023 at Ankara Bilkent Training and Research Hospital Clinical Biochemistry Department with a total of 136 participants. The data were analyzed with SPSS for Windows, Version 22, and Microsoft Excel 365.

RESULTS

In the study, the subjects were divided into three groups according to their HbA1c levels: DM group (HbA1c ≥ 6.5 %), Pre-DM group (HbA1c ≥ 5.7 and < 6.5 %), and control group (HbA1c < 5.7 %). The NLR values were statistically different in control between the T2DM patients and control group and the T2DM patients and Pre-DM people (p = 0.025), (p = 0.034) respectively. The platelet and PLR levels were not statistically significant in group comparisons.

CONCLUSIONS

In light of our findings, we propose a greater emphasis on routinely measuring inflammatory markers, such as NLR, in order to evaluate the glycemic control in patients with type 2 diabetes. We suggest that inflammatory marker-based approaches may be useful to monitor disease progression and maximize treatment outcomes in type 2 diabetes.

Combined influence of healthy lifestyles, nutritional and inflammatory status on mortality among US adults with depression

OBJECTIVE

Healthy lifestyles, nutritional and inflammatory status are interrelated and influence mortality. This study aimed to evaluate their separate and combined effects on all-cause and cause-specific mortality in individuals exhibiting depression.

METHODS

6143 individuals with depression (median age 47) were recruited from the US National Health and Nutrition Examination Survey (NHANES 2005-2018), with mortality followed up through December 31, 2019. A healthy lifestyle score (0-5) was constructed based on current non-smoking, low-to-moderate alcohol consumption, adequate sleep, sufficient physical activity and healthy diet. Higher scores indicated healthier lifestyles. The Advanced Lung Cancer Inflammation Index (ALI), a composite marker of inflammation and nutritional status, was calculated as Body Mass Index (BMI) (kg/m2) × albumin (g/dl)/Neutrophil-to-Lymphocyte Ratio (NLR). Higher ALI values denoted lower inflammation and better nutrition. Weighted Cox proportional-hazards models were used to estimate mortality hazard ratios.

RESULTS

Healthier lifestyles significantly lowered all-cause (hazard ratio [HR] 0.72, 95 % confidence interval [CI] 0.66-0.78), cardiovascular (HR 0.70, 95 % CI 0.58-0.83), and non-cardiovascular mortality (HR 0.72, 95 % CI 0.64-0.81). High ALI reduced all-cause (HR 0.70, 95 % CI 0.54-0.91) and cardiovascular mortality (HR 0.46, 95 % CI 0.28-0.77) compared with low ALI. Joint analyses showed that individuals with both healthy lifestyle scores ≥3 and high ALI had the lowest risk of all-cause, cardiovascular, and non-cardiovascular mortality (HR 0.44, 95 % CI 0.33-0.60; 0.32, 95 % CI 0.16-0.63; 0.49, 95 % CI 0.35-0.68).

CONCLUSION

The joint presence of healthy lifestyles and high ALI was significantly associated with lower risk of mortality among individuals with depression.

Chronic administration of tetrahydrofuran extracts of Cochlospermum vitifolium (Wild) Sprengel in a mouse diabetes model: Hypoglycemic, antioxidant, and genoprotective effects

Diabetes and its complications represent a major global health burden, contributing to rising mortality rates, escalating healthcare costs, and an increasing prevalence worldwide. This has driven renewed interest in traditional medicine as a complementary approach to disease management. Cochlospermum vitifolium (Wild) Sprengel, a medicinal plant traditionally used to treat kidney pain, liver disorders (including hepatitis C and jaundice), and metabolic syndrome, has demonstrated promising antidiabetic potential. Previous studies report hypoglycemic effects in both in vitro and short-term in vivo models. In this study, we evaluated the hypoglycemic activity of tetrahydrofuran (THF) extracts from C. vitifolium heartwood and bark in mice over a six-week period (500 mg/kg dose). The heartwood extract exhibited notable antioxidant activity, scavenging over 50 % of DPPH radicals at 3.2 mg/mL, while the bark extract showed higher potency at 1.5 mg/mL. Both extracts demonstrated genoprotective effects at doses of 250 and 500 mg/kg, mitigating damage from mutagenic agents. Notably, the heartwood extracts significantly reduced blood glucose levels from > 300 mg/dL to < 100 mg/dL, whereas the bark extract had no significant hypoglycemic effect. These findings suggest that C. vitifolium extracts, particularly from the heartwood, may modulate oxidative stress-related pathways implicated in chronic degenerative diseases such as diabetes. Further research is warranted to elucidate the underlying mechanisms and long-term safety profile of these extracts.

Obesity-related early structural alterations in the retina detected by optical coherence tomography

AIMS

This retrospective cross-sectional study, using retinal spectral-domain optical coherence tomography (SD-OCT) scans, investigated obesity-related structural alterations in the retina.

MATERIALS AND METHODS

Ninety-two eyes of 92 healthy asymptomatic participants were categorized into two groups based on body mass index (BMI) measurements: non-obese (BMI < 25, 45%) and pre-obese/obese (BMI ≥ 25, 55%) to compare imaging parameters of different retinal layers. Structural parameters, including thickness and volume values, were obtained across distinct retinal layers segmented on SD-OCT scans.

RESULTS

The retinal nerve fibre layer volume was lower in the high-BMI group than in the low-BMI group (p = 0.048). However, the high-BMI group presented significantly higher inner nuclear layer volume than the low-BMI group (p = 0.036). In the region analysis, the retinal nerve fibre layer volume difference was prominent in the superior (p = 0.033) and inferior (p = 0.001) parafoveal and nasal perifoveal (p = 0.041) regions, while inner nuclear layer changes were prominent in the inferior (p = 0.009) perifoveal regions. A stepwise hierarchical binary logistic regression model, controlling for age and gender, pointed to significant associations of the regionally decreased retinal nerve fibre layer volume and increased inner nuclear layer volume with high BMI (p = 0.001).

CONCLUSIONS

Retinal SD-OCT imaging detected structural alterations in distinct retinal layers between healthy, asymptomatic individuals in non-obese and pre-obese/obese groups. Besides a decreased volume of the retinal nerve fibre layer, a significant increase was detected in the inner nuclear layer volume with a high BMI, possibly due to Müller glia responses to obesity-related osmotic, metabolic and inflammatory stress, awaiting further investigation.

Beyond body mass index: exploring the role of visceral adipose tissue in intensive care unit outcomes

Obesity is a worldwide health crisis and poses significant challenges in critical care. Many studies suggest an 'obesity paradox', in which obesity, defined by body mass index (BMI), is associated with better outcomes. However, the inability of BMI to discriminate between fat and muscle or between visceral adipose tissue and subcutaneous adipose tissue, limits its prediction of metabolic ill health. We suggest that the 'obesity paradox' may be more reflective of the limitations of BMI than the protective effect of obesity. We explore the biological processes leading to visceral fat accumulation, and the evidence linking it to outcomes in critical illness. In the 'spillover' hypothesis of adipose tissue expansion, caloric excess and impaired expansion of storage capacity in the subcutaneous adipose tissue lead to accumulation of visceral adipose tissue. This is associated with a chronic inflammatory state, which is integral to the link between visceral adiposity, type 2 diabetes mellitus, and ischaemic heart disease. We review the current evidence on visceral adiposity and critical illness outcomes. In COVID-19, increased visceral adipose tissue, irrespective of BMI, is associated with more severe disease. This is mirrored in acute pancreatitis, suggesting visceral adiposity is linked to poorer outcomes in some hyperinflammatory conditions. We suggest that visceral adiposity's chronic inflammatory state may potentiate acute inflammation in conditions such as COVID-19 and acute pancreatitis. Further work is required to investigate other critical illnesses, especially sepsis and acute respiratory distress syndrome, in which current evidence is scarce. This may give further insights into pathophysiology and inform tailored treatment and nutrition strategies based on body fat distribution.

Reducing Alzheimer's disease risk with SGLT2 inhibitors: From glycemic control to neuroprotection

Recent research has established a strong link between metabolic abnormalities and an increased risk of dementia. In parallel, there is growing epidemiological evidence supporting the neuroprotective effects of antidiabetic medications against cognitive impairments. Among these, sodium-glucose co-transporter (SGLT2) inhibitors have emerged as pharmacological candidates with promising potential in alleviating the burden of age-related diseases, particularly neurodegenerative diseases (NDD). SGLT2 inhibitor therapies are FDA-approved medications routinely prescribed to manage diabetes. This novel class was initially developed to address cardiovascular disorders and to reduce the risk of hypoglycemia associated with insulin-secretagogue agents. It subsequently attracted growing interest for its beneficial effects on central nervous system (CNS) disorders. However, the molecular mechanisms through which these glucose-lowering therapies mitigate cognitive decline and limit the progression of certain brain degenerative diseases remain largely unexplored. Consequently, the neuroscientific community needs further studies that gather, analyze, and critically discuss the available mechanistic evidence regarding the neuroprotective effects of SGLT2 inhibitors. This review aims to critically examine the most relevant published findings, both in vitro and in vivo, as well as human studies evaluating the impact of SGLT2 inhibitors exposure on Alzheimer's disease (AD). It seeks to integrate the current understanding of their beneficial effects at the molecular level and their role in addressing the pathophysiology and neuropathology of AD. These insights will help extend our knowledge of how SGLT2 inhibitor therapies are associated with reduced risk of dementia and thus shed light on the link between diabetes and AD.

Higher Residual and Metabolic Dysfunction-Associated Fatty Liver Disease Risk of the R-Enantiomer of Famoxadone in Mice

Famoxadone (FAM) is a widely used chiral fungicide that may contribute to metabolic dysfunction-associated fatty liver disease (MAFLD). However, the enantioselective toxicity and mechanism of action of famoxadone enantiomers remain unclear. The enantioselective bioaccumulation of famoxadone in mice was investigated, and the hepatotoxicity of famoxadone enantiomers, specifically in relation to MAFLD, was evaluated by a 12 week oral exposure to Rac-FAM, R-FAM, and S-FAM. R-FAM showed higher bioaccumulation than S-FAM, in which the concentrations of R-FAM were 3.52 and 242.69 times that of S-FAM in the liver at the no observed effect level (NOEL) and 1/10 NOEL, respectively. R-FAM was found to cause an increase in liver coefficients, a decrease in the AST/ALT ratio, enhanced expression of inflammation-related genes, and lipid droplet accumulation in the liver. In contrast, mice treated with S-FAM exhibited no significant changes in the quality of these indicators. These results suggest that R-famoxadone is more likely to be the dominant enantiomer affecting the liver. Furthermore, the important functional genes involved in glucose and lipid metabolism were detected. It was found that R-FAM significantly disrupted key lipid metabolic pathways in the liver, including glucose metabolism, fatty acid synthesis, triglyceride synthesis, and fatty acid β-oxidation. Additionally, R-FAM induced more severe disruptions in liver glucose and lipid metabolism compared to S-FAM. These research findings provide insights into the enantioselective toxicity of famoxadone enantiomers in terms of their role in promoting MAFLD development, contributing to the safe utilization of the chiral pesticide famoxadone.

Association between asthma and type 2 diabetes in a Swedish adult population: a register-based cross-sectional study

OBJECTIVE

Asthma and type 2 diabetes are two important causes of morbidity globally. We examined both the association of type 2 diabetes with asthma in Swedish adults and the familial co-aggregation of the diseases.

METHODS

We conducted a cross-sectional study of all adults aged 25-85 in Sweden between 2009 and 2013. Asthma and type 2 diabetes status were ascertained from the health registers. Models were adjusted for sex, age, education level, income and country of birth and in a subset, for body mass index (BMI). We further conducted a familial coaggregation analysis to determine if shared familial factors could explain any observed findings.

RESULTS

The study included 5 299 245 participants, 25 292 (0.5%) had both asthma and type 2 diabetes. In the total population, the OR for the association between type 2 diabetes and asthma was 1.47 (95% CI 1.45 to 1.49); in the population of men (1.30 (95% CI 1.27 to 1.32)) and women (1.63 (95% CI 1.60 to 1.66)). The ORs were slightly higher among men (1.51 (95% CI 1.45 to 1.56)) and women (2.04 (95% CI 1.96 to 2.11)) for whom BMI measurements were available but attenuated with adjustment for BMI (1.45 (95% CI 1.40 to 1.51)) and (1.76 (95% CI 1.68 to 1.84)). Diabetes was more likely if a full sibling had asthma than if the sibling did not (1.13 (95% CI 1.10 to 1.15)).

CONCLUSIONS

We found an association between asthma and type 2 diabetes that was sustained after adjusting for BMI, indicating that BMI alone does not explain this relationship. We also found that the two conditions coaggregate in siblings, indicating that the association is partly due to shared familial genetic and environmental risk factors.

The intensity of exercise and inflammation markers in women with overweight & obesity: a systematic review and network meta-analysis

OBJECTIVES

The purpose of this network meta-analysis (NMA) of randomized controlled trials (RCT) was to examine the effects of different exercise intensities on inflammatory markers in women with overweight/obesity.

METHODS

A systematic search for RCTs that met the inclusion criteria for the period up to October 2024. random effects NMA was performed within a frequency-based framework.

RESULTS

A total of 75 RCTs were included (3989 participants). High-intensity exercise significantly modulated leptin and adiponectin levels, but had a nonsignificant effect on TNF-α, CRP, and IL-6 levels. Moderate-intensity exercise significantly modulated TNF-α, CRP, IL-6, leptin, and adiponectin levels. Surface under the cumulative ranking curve (SUCRA) probability ranking showed that moderate-intensity exercise was the most recommended exercise intensity for reducing TNF-α, CRP, IL-6, and leptin levels, and for modulating adiponectin levels, moderate-intensity exercise also had a SUCRA value of 65.4%, so we believe that moderate-intensity exercise may be the most robust type of exercise intensity in terms of the breadth of effects. Subgroup analysis showed that moderate-intensity aerobic exercise (MAE) significantly reduced TNF-α levels. Moderate-intensity resistance training (MRT) is the most recommended type for decreasing IL-6 and leptin levels. Moderate-intensity combined exercise (MCE) is the best type of exercise for managing CRP and adiponectin levels.

CONCLUSIONS

There were significant differences in the effects of different exercise intensities on specific inflammatory markers in women living with overweight and obesity. Moderate-intensity exercise may be the most robust type of exercise intensity. Future studies should consider the importance of exercise duration and volume (e.g., in MET* minutes/week) to better understand the relationship between exercise intensity and inflammatory markers. The effects of combining exercise and diet on inflammatory markers in women with overweight and obesity should also be explored in greater depth.

Deciphering the NLRP3 inflammasome in diabetic encephalopathy: Molecular insights and emerging therapeutic targets

Diabetic encephalopathy (DE) is a neurological complication characterized by neuroinflammation, cognitive impairment, and memory decline, with its pathogenesis closely linked to the activation of the NLRP3 inflammasome. As a central regulator of the innate immune system, the NLRP3 inflammasome plays a pivotal role in DE progression by mediating neuroinflammation, pyroptosis, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum (ER) stress, and microglial polarization. This review systematically explores the molecular mechanisms by which the NLRP3 inflammasome contributes to DE, focusing on its role in neuroinflammatory cascades and neuronal damage, as well as the diabetes-associated physiological changes that exacerbate DE pathogenesis. Furthermore, we summarize emerging therapeutic strategies targeting the NLRP3 inflammasome, including small-molecule inhibitors and bioactive compounds derived from traditional herbal medicine, highlighting their potential for DE treatment. These findings not only advance our understanding of DE but also provide a foundation for developing NLRP3-targeted pharmacological interventions.

Impaired efferocytosis by monocytes and monocyte-derived macrophages in patients with poorly controlled type 2 diabetes

BACKGROUND

Deficient efferocytosis (i.e., phagocytic clearance of apoptotic cells) by macrophages has been frequently reported in experimental models of type 2 diabetes (T2D).

AIM

To translate these findings to humans by testing whether the efferocytosis capacity of blood monocytes and monocyte-derived macrophages is impaired in T2D patients.

METHODS

Overall, 30 patients with poorly controlled T2D [glycosylated hemoglobin (HbA1c) ≥ 8.0%] and 30 age- and sex-matched control subjects were enrolled in the study. The efferocytosis capacities of peripheral blood monocytes and monocyte-derived macrophages were assessed by flow cytometry and immunostaining. Macrophage membrane CD14 expression was examined by flow cytometry. Metabolic factors such as 25(OH)D and immune factors such as interleukin-1β were also measured.

RESULTS

The mean monocyte efferocytosis index in the diabetes group was significantly lower than that in the control group. Notably, efferocytosis remained impaired after monocytes differentiated into macrophages. Additionally, the percentages of classical monocytes (CD14⁺⁺CD16^- monocytes) and CD14⁺ macrophages were significantly lower in the diabetes group. Multivariate linear regression analysis in diabetes patients demonstrated that the monocyte efferocytosis index was independently associated with the HbA1c level, and that the macrophage efferocytosis index was significantly associated with the percentage of CD14⁺ macrophages.

CONCLUSION

Impaired efferocytosis was observed in T2D patients, with poor glycemic control affecting both blood monocytes and monocyte-derived macrophages. The efferocytosis index was negatively associated with metrics of glycemic control, and glucotoxicity may impact efferocytosis through reducing CD14 expression on both monocytes and macrophages.

Explainable predictive models of short stature and exploration of related environmental growth factors: a case-control study

BACKGROUND

Short stature is a prevalent pediatric endocrine disorder for which early detection and prediction are pivotal for improving treatment outcomes. However, existing diagnostic criteria often lack the necessary sensitivity and specificity because of the complex etiology of the disorder. Hence, this study aims to employ machine learning techniques to develop an interpretable predictive model for normal-variant short stature and to explore how growth environments influence its development.

METHODS

We conducted a case‒control study including 100 patients with normal-variant short stature who were age-matched with 200 normal controls from the Endocrinology Department of Nanjing Children's Hospital from April to September 2021. Parental surveys were conducted to gather information on the children involved. We assessed 33 readily accessible medical characteristics and utilized conditional logistic regression to explore how growth environments influence the onset of normal-variant short stature. Additionally, we evaluated the performance of the nine machine learning algorithms to determine the optimal model. The Shapley additive explanation (SHAP) method was subsequently employed to prioritize factor importance and refine the final model.

RESULTS

In the multivariate logistic regression analysis, children's weight (OR = 0.92, 95% CI: 0.86, 0.99), maternal height (OR = 0.79, 95% CI: 0.72, 0.87), paternal height (OR = 0.83, 95% CI: 0.75, 0.91), sufficient nighttime sleep duration (OR = 0.48, 95% CI: 0.26, 0.89), and outdoor activity time exceeding three hours (OR = 0.02, 95% CI: 0.00, 0.66) were identified as protective factors for normal-variant short stature. This study revealed that parental height, caregiver education, and children's weight significantly influenced the prediction of normal-variant short stature risk, and both the random forest model and gradient boosting machine model exhibited the best discriminatory ability among the 9 machine learning models.

CONCLUSIONS

This study revealed a close correlation between environmental growth factors and the occurrence of normal-variant short stature, particularly anthropometric characteristics. The random forest model and gradient boosting machine model performed exceptionally well, demonstrating their potential for clinical applications. These findings provide theoretical support for clinical identification and preventive measures for short stature.

The mediating roles of obesity indicators and serum albumin in the association of DEET exposure with depression and sleep disorders in adults: evidence from NHANES 2007-2016

BACKGROUND

DEET (N, N-diethyl-m-toluamide) is a widely used insect repellent with potential neurotoxic effects. However, its impact on mental health in the general population remains unclear. This study investigates the association between DEET exposure and depression and sleep disorders, exploring the mediating roles of obesity indicators and serum albumin.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2016 were analyzed. Urinary levels of 3-(diethylaminoformyl) benzoic acid (DCBA), a DEET metabolite, were used as an exposure marker. Depression was defined according to the scores of Patient Health questionnaire-9 (PHQ-9), and sleep disorders were diagnosed according to participants' self-reports. Multivariate logistic regression and restricted cubic spline analysis were employed to assess the associations of DCBA with depression and sleep disorders. Mediating analyses explored the roles of obesity indicators and serum albumin. Subgroup analysis further explored the differences among different populations.

RESULTS

Higher DCBA levels were positively associated with depression and sleep disorders. Mediating analysis revealed that body mass index (BMI), waist circumference (WC), and serum albumin mediated 11.16%, 12.66%, and 7.04% of the association between DEET exposure and depression, respectively. Subgroup analysis identified increased susceptibility among women and individuals of other races. Sensitivity analysis enhanced the robustness of the results.

CONCLUSION

DEET exposure is associated with an increased risk of depression and sleep disorders, mediated by obesity and liver function indicators. These findings highlight the need for public health measures to reduce DEET exposure and further research into its mechanisms of action on mental health.

Overfeeding in rainbow trout (Oncorhynchus mykiss): Metabolic disruptions, impaired immunity, and increased infection risk

Excess adiposity impairs immune function and host defense in obese individuals, but studies on this concept in fish remain limited. In aquaculture, rapid growth is often encouraged through intensive farming practices, leading to overfeeding and negatively impacting production. This study aimed to induce obesity in rainbow trout through overfeeding, exploring metabolic abnormalities, immune response alterations, and infection susceptibility via transcriptomic and metabolomic analyses. In the overfed group, fish were fed until they refused to eat, while the control group was fed according to recommended feeding rates for four weeks. Sampling was conducted at weeks 1, 2, and 4 for serological, histopathological, metabolomic, and transcriptomic analyses. After four weeks, mortality rates were compared following Aeromonas salmonicida challenge, and immunological changes assessed one day post-infection. Overfed fish exhibited significant increases in weight gain (WG), body mass index (BMI), elevated AST/ALT levels, hepatocyte hypertrophy, lipid droplet formation, and triglyceride accumulation. At 1, 2, and 4 wpf, the overfed group exhibited distinct metabolic changes, with key alterations in glycolysis/gluconeogenesis, lipid metabolism and amino acid metabolism. KEGG analysis of transcriptomic data revealed a significant decrease in complement and coagulation cascades, including C3, FB, FH, an FI, accompanied by heightened TNF and IL-17 signaling pathways, involving the upregulation of genes such as TNF-α, IL-1β, and IL-6, indicating an enhanced inflammatory response. The overfed group experienced higher mortality post-infection. Excess energy from overfeeding led to hepatic fat accumulation, liver damage, and reduced innate immune responses, particularly in complement activation. These physiological disruptions compromised immune function, highlighting the detrimental effects of overfeeding-induced obesity on fish health. This study offers critical insights into the immunological mechanisms linking obesity to increased disease susceptibility.

Structural insights and therapeutic potential of plant-based pectin as novel therapeutic for type 2 diabetes mellitus: A review

Type 2 diabetes mellitus (T2DM) is a global health challenge with limited efficacy of current treatments, necessitating alternative therapies. Plant-derived pectin, composed of galacturonic acid and structural domains such as homogalacturonan, has shown promise as an anti-diabetic agent. Pectin exerts its therapeutic effects through multiple mechanisms, including enhancing β-cell function, regulating glucose metabolism, improving insulin sensitivity, inhibiting digestive enzymes, and restoring gut microbiota balance. Its bioactivity is influenced by physicochemical properties like molecular weight, degree of methylation, and structural complexity. This review explores the anti-diabetic potential of pectin, its structure-activity relationships, and mechanisms of action, providing insights for its development as a novel therapeutic agent in T2DM management.

Total dietary fiber of tartary buckwheat alleviates T2DM through the IRS-1/PI3K/AKT pathway and gut microbiota-bile acids-TGR5/FXR axis in db/db mice

Buckwheat dietary fiber has good hypoglycemic activity, with its water-soluble parts and modification widely studied, however, the specific effects and mechanisms of action regarding buckwheat total dietary fiber (BDF) to improve T2DM need to be further explored. In this study, we investigated the improvement of diabetes-related symptoms in db/db mice by 10 % BDF and explored the possible mechanisms. The results showed that hyperglycemia, hyperlipemia, insulin resistance, elevated body weight, severe inflammatory response and impaired intestinal function were significantly improved after 8 weeks of BDF intervention. Moreover, BDF was able to ameliorate the distribution of gut microbiota, enhance the bacteria associated with T2DM, and improve glucose metabolism by altering the levels of the metabolites of gut microbiota, bile acids (BAs), and their receptors, TGR5 and FXR. In addition, BDF activated the hepatic IRS-1/PI3K/AKT pathway which can reduce hepatic gluconeogenesis and promoted glycogen synthesis. Taken together, our results suggest that BDF can alleviate T2DM symptoms by activating the IRS-1/PI3K/AKT pathway and the gut microbiota-BAs-TGR5/FXR axis. The results of this study deepen the exploration of the active ingredients of cereals and suggesting a scientific basis for the development of glucose-lowering functional foods and nutraceuticals.

Exploring Therapeutic Targets for Age-Related Macular Degeneration From Circulating Proteins to Plasma Metabolites in the European Population

Purpose

To explore the causal associations among circulating proteins, plasma metabolites, and age-related macular degeneration (AMD).

Methods

We employed Mendelian randomization (MR) analysis and colocalization analysis to discern the causal relationship between proteomes and AMD. This investigation utilized data from protein quantitative trait loci (pQTL) studies in deCODE and the UK Biobank. Additionally, plasma metabolite-related genome-wide association studies (GWAS) data and AMD-related GWAS data were incorporated.

Results

Our findings confirmed a potential causal relationship between cytoplasmic tryptophanyl-tRNA synthetase 1 (WARS1) and a higher risk of AMD. The observed causal impact of WARS1 on the two subtypes of AMD (dry and wet) align consistently with the aforementioned outcomes. Three plasma metabolites-N-acetyl-kynurenine, N-acetyltyrosine, and caproate (6:0)-were identified as mediators of the causal effect of WARS1 on AMD, and subgroup analysis revealed that N-acetyltyrosine is a specific negative metabolite associated with WARS1 and dry AMD, whereas X-16580 is a specific positive metabolite linked to WARS1 and wet AMD.

Conclusions

The outcomes of this study suggest a potential causal role of specific circulating proteins in AMD and identified the mediating role of plasma metabolites between WARS1 and AMD by integrating multiple genetic analyses. Nevertheless, further research is essential to validate and strengthen these conclusions.

Translational Relevance

This study establishes the causal role of specific circulating proteins in AMD and identified the mediating role of plasma metabolites between WARS1 and AMD.

Knockout of Trpc6 attenuates T2DM-induced liver injury and inflammation by inhibiting CN-NFAT2-NLRP3 signalling in mice

Diabetic liver disease is a common complication of diabetes mellitus that poses significant harm to patients. Transient receptor potential cation channel 6 (TRPC6) is a non-selective cation channel with calcium permeability, playing a key role in signalling pathways associated with liver disease progression. This study aimed to investigate the effects of Trpc6 knockout on liver injury and its regulation of the calcineurin (CN)-nuclear factor of activated T cells 2 (NFAT2) signalling pathway in mice with type 2 diabetes mellitus (T2DM). Serum aspartate aminotransferase and alanine aminotransferase levels were measured to assess liver function, while haematoxylin and eosin staining, periodic acid-Schiff staining, and Masson staining were used to evaluate pathological injury. Nile Red and Oil Red O staining were performed to assess hepatic lipid deposition. Western blotting, quantitative real-time polymerase chain reaction, and immunohistochemistry were used to analyse fibrosis- and inflammation-related markers in mouse liver tissues. The results showed that Trpc6 knockout had no significant effect on hepatic lipid deposition, CD36 expression, or phosphorylated phospholipase C levels in the liver tissues of mice with T2DM. However, Trpc6 knockout significantly inhibited NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome activation, thereby alleviating liver injury and fibrosis in mice with T2DM. Further findings indicated that Trpc6 knockout markedly reduced CN and NFAT2 expression in T2DM liver tissues and resisted intracellular calcium overload in liver cells in vitro. This study suggests that Trpc6 knockout attenuates T2DM-induced hepatic inflammation and fibrosis by inhibiting hepatocyte calcium overload and suppressing the CN-NFAT2-NLRP3 signalling pathway.

Dietary essential oil components: A systematic review of preclinical studies on the management of gastrointestinal diseases

BACKGROUND

The gut is responsible for the digestion and absorption of nutrients, immune regulation, and barrier function. However, factors like poor diet, stress, and infection, can disrupt the balance of the gut microbiota and lead to intestinal inflammation and dysfunction.

PURPOSE

This systematic review aims to evaluate the effects of dietary plants-derived essential oil components on gut health and intestinal functions in animal models.

METHODS

The literature was gathered from the Scopus, Web of Science, PubMed, and Embase databases by using related search terms, such as "dietary plants", "dietary sources", "essential oils", "gut health", "intestine", "anti-inflammatory", "antioxidant", and "gut microbiota".

RESULTS

The results indicate that plant-derived dietary essential oil components, such as butyrolactone-I, carvacrol, cinnamaldehyde, citral, D-limonene, eugenol, farnesol, geraniol, indole, nerolidol, oleic acid, thymol, trans-anethole, vanillin, α-bisabolol, α-linolenic acid, α-pinene, α-terpineol, β-carotene, β-caryophyllene, and β-myrcene have been found to regulate gut health by influencing vital signalling pathways associated with inflammation. Dietary essential oil components modulate the expression of tumor necrosis factor alpha, interleukin 1 beta (IL-1β), interleukin (IL)-6, IL-10, inducible nitric oxide synthase, cyclooxygenase-2, toll-like receptor-4, matrix metalloproteinase, and interferon gamma in mitigating gut inflammation. The primary signalling molecules controlled by these molecules were AMP-activated protein kinase (AMPK), protein kinase B, extracellular signal-regulated kinase, c-Jun N-terminal kinase, mitogen-activated protein kinase, myeloid differentiation primary response 88, nuclear factor erythroid-2-related factor-2, and phosphoinositide 3-kinase (PI3K). Moreover, these phytochemicals have been shown to improve glucose homeostasis by regulating glucose transporter 4, glucagon-like peptide-1, peroxisome proliferator-activated receptor gamma, nuclear factor kappa B, AMPK, PI3K, and uncoupling protein-1. They can also reduce thiobarbituric acid reactive substance, malondialdehyde, and oxidative stress and enhance superoxide dismutase, catalase, and glutathione peroxidase levels.

CONCLUSION

In conclusion, dietary plants-derived essential oil components have the potential to mitigate inflammation and oxidative stress in the gut. However, additional clinical investigations are necessary to confirm their complete potential in improving human gut health functions.

Associations between daily composition of 24 h physical behavior with affective states and working memory

The daily association between 24-hour physical behavior compositions (moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), standing, sedentary, and sleep) and psychological outcomes-such as momentary affective state assessments and working memory-remains understudied. We investigated whether the daily 24-hour compositions, particularly MVPA and SB considering the remaining behaviors, are associated with affective states and working memory. We conducted an ambulatory assessment study with 199 university employees. Physical behaviors were measured continuously via thigh-worn accelerometers throughout the day. Affective states (i.e., valence, energetic arousal, and calmness) and working memory performance (i.e., numeric updating task) were captured up to six times a day via electronic diaries and tasks on a smartphone. We conducted Bayesian multilevel compositional data analysis to analyze within-person, and between-person associations of 24-hour physical behavior composition with affective states, and working memory. Aggregated same-day outcomes were used for main analyses to capture concurrent associations, and next-day outcomes were used for exploratory analyses to capture prospective associations. Concurrent analyses showed that higher moderate-to-vigorous physical activity relative to the remaining physical behaviors was associated with 2.49 [95%CI 1.00, 4.06] higher valence and 3.65 [95%CI 2.11, 5.28] higher energetic arousal (but not calmness) ratings at the within-person, but not at the between-person level. Sedentary behavior relative to the remaining physical behaviors was not associated with any affective states. Spending more time in moderate-to-vigorous physical activity, followed by light physical activity, and standing, each at the expense of the other behaviors was associated with higher affective state ratings on the same day (between-person: ≥1.29 [0.19, 2.51] higher valence, 1.23 [0.04, 2.40] higher calmness; within-person: ≥0.62 [0.04, 1.22] higher valence, ≥ 1.10 [0.63, 1.58] higher energetic arousal, ≥ 0.95 [0.18, 1.74] higher calmness). The 24-hour physical behavior composition was not associated with working memory. Findings underline the importance of the 24-hour composition of physical behavior for mental health, by demonstrating significant concurrent associations with affective states. Even small reallocations of behaviors may positively influence affective states, providing valuable insights for the development of future interventions.

Combinations of BMI and metabolic syndrome and the risk of myocardial infarction, stroke, and heart failure

BACKGROUND AND AIMS

The relationship between uncommon phenotypes, such as metabolically healthy obesity and normal weight with metabolic syndrome (MetS), and cardiovascular disease (CVD) risk, remains unclear. We investigated how different combinations of body mass index (BMI) and MetS are associated with overall and specific CVDs and how the number of MetS components influences CVD risk in individuals with obesity.

METHODS AND RESULTS

We performed separate analyses and a meta-analysis of 36,233 individuals from four Swedish cohorts to assess the risk of incident CVDs across BMI/MetS combinations (normal-weight, overweight or obese/MetS yes or no). Participants were followed for CVDs and death through linkage to the Swedish National Registers. Compared to normal weight without MetS, overweight and obesity without MetS had most pronounced association with the risk of heart failure [multivariable hazard ratios, HR (95 % CI) = 1.37 (1.16-1.63) and 1.85 (1.37-2.48), respectively, p < 0.001]. In obese individuals, the risk of incident CVD (composite endpoint) increased with an increasing number of MetS components, but this relationship was not statistically significant in obese participants without additional MetS components, likely due to the small at-risk group. Normal-weight individuals with MetS had an increased risk of myocardial infarction [HR (95 % CI) 2.0 (1.51-2.64)], p < 0.001, and stroke [HR (95 % CI) 1.63 (1.17-2.28), p = 0.004].

CONCLUSIONS

Overweight and obesity without MetS showed a greater impact on the risk of heart failure, whereas normal-weight individuals with MetS had a higher risk of myocardial infarction and stroke. In obese individuals, CVD risk increased as the number of MetS components increased.

Human Milk Oligosaccharides Modulating Inflammation in Infants, Adults, and Older Individuals-From Concepts to Applications

The increasing global prevalence of inflammatory diseases, such as ulcerative colitis and irritable bowel syndrome, represents a challenging task for healthcare systems. Several approaches to disease management target the intestinal microbiome, which plays a key role in health and disease. One promising approach is modulating the microbiome using human milk oligosaccharides (HMOs). Originating from human milk, HMOs are indigestible carbohydrates that act in a host-optimized prebiotic fashion by providing an energy source for health-promoting intestinal bacteria and exhibiting systemic effects. Commercial products supporting infant health and development have been the primary fields of HMO application. Advancements in the large-scale production of HMOs through bioengineering and precision fermentation have led to evaluation of their potential for managing inflammatory diseases. Several in vitro studies and observations on model systems have been clinically validated in infants, resulting in a large body of evidence supporting the safety and efficacy of HMOs in inflammatory disorders. Although novel approaches seek to explore interventions in adults, the primary goal for the future is to provide cost-efficient, safe, and reliable healthcare compounds across all age groups.

Glucagon-like peptide-1 receptor agonists: a review from a cardiovascular perspective

Introduction

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are novel agents with proven cardiovascular (CV) benefits. GLP-1 RAs have been used for diabetes and found to improve CV outcomes in diabetic and nondiabetic patients. They are authorized for treating obesity. Our narrative review discussed the CV benefits of GLP-1 RAs in terms of controlling CV risk factors and improving CV outcomes in diabetic and nondiabetic patients regardless of their CV history, and the CV perspectives related to their use in clinical practice.

Areas covered

Literature was searched with no limits on date or language, using various combinations of keywords. Data on the CV benefits of GLP-1 RAs and their use in clinical practice were summarized.

Results

Several studies have discussed the CV beneficial effects of GLP-1 RAs in terms of reducing blood pressure, lipid levels, body weight, risk for arrhythmias, reducing the risk of major adverse CV events, and hospital admission for heart failure.

Conclusion

The cardioprotective effects and low risk of hypoglycemia of GLP-1 RAs make them preferred agents in any multidisciplinary approach aiming to reduce CV disease burden and improve prognosis. Cardiologists are encouraged to strongly consider the CV benefits of GLP-1 RAs in their risk-reduction strategies.

Abdominal obesity and the risk of young-onset dementia in women: a nationwide cohort study

BACKGROUND AND OBJECTIVES

The association between obesity and young-onset dementia (YOD, defined as dementia diagnosed before age 65) is established, but the specific impact of abdominal obesity in women remains unclear. Abdominal obesity, driven by excess visceral fat, may increase dementia risk through metabolic and vascular pathways. We investigated the association between abdominal obesity and YOD risk in women using a large nationwide cohort.

METHODS

We analyzed 964,536 Korean women aged 40-60 years who underwent national health checkups in 2009. General obesity was defined by body mass index (BMI), and abdominal obesity was categorized by waist circumference (WC) into < 75 cm, 76-84 cm, 85-94 cm, and ≥ 95 cm. YOD was identified using ICD-10 codes and dementia medication prescriptions. Hazard ratios (HRs) for YOD were estimated using multivariable Cox proportional hazard models adjusted for lifestyle and clinical factors.

RESULTS

Over a median follow-up of 8.2 years, YOD incidence increased progressively with higher WC. Women with WC ≥ 95 cm had a 55% increased risk of YOD (HR 1.55; 95% CI 1.34-1.79) compared to those with WC < 75 cm. The association was particularly strong for vascular dementia (VD), with HR 1.83 (95% CI 1.30-2.57). By contrast, BMI showed a U-shaped relationship, with the lowest YOD risk observed in women with normal BMI (18.5-22.9 kg/m²), and significantly elevated risks in both underweight (BMI < 18.5 kg/m²; HR 1.39, 95% CI 1.13-1.71) and morbidly obese women (BMI ≥ 30 kg/m²; HR 1.26, 95% CI 1.10-1.45).

DISCUSSION

Abdominal obesity is a significant, independent risk factor for YOD in women, particularly for VD. These findings underscore the importance of addressing abdominal obesity in middle-aged women to reduce dementia risk.

Potential regulation of artesunate on bone metabolism through suppressing inflammatory infiltration in type 2 diabetes mellitus

OBJECTIVE

Osteoimmunology is an emerging field that explores the interplay between bone and the immune system. The immune system plays a critical role in the pathogenesis of diabetes and significantly affects bone homeostasis. Artesunate, a first-line treatment for malaria, is known for its low toxicity and multifunctional properties. Increasing evidence suggests that artesunate possesses anti-inflammatory, immunoregulatory, and osteogenic effects. This review aims to explore the relationship between immune regulation and bone metabolism in type 2 diabetes (T2DM) and to investigate the potential therapeutic application of artesunate.

METHODS

This review systematically examines literature from PubMed/Medline, Elsevier, Web of Science, Embase, the International Diabetes Federation, and other relevant databases.

RESULTS

This review synthesizes evidence from multiple sources to delineate the relationship between T lymphocytes and T2DM, the regulation of T lymphocyte subsets in bone metabolism, and the effects of artesunate on both T lymphocytes and bone metabolism. Recent studies suggest a bidirectional regulatory relationship between T2DM and T lymphocytes (CD4+ T and CD8+ T) during the onset and progression of the disease, with inflammatory and anti-inflammatory cytokines serving as key mediators. T lymphocyte subsets and their cytokines play a pivotal role in regulating osteogenesis and osteoclastogenesis in pathological conditions. Furthermore, artesunate has shown promise in modulating inflammatory infiltration and bone metabolism.

CONCLUSION

The accumulated evidence indicates that artesunate exerts regulatory effects on bone metabolism in T2DM by influencing T lymphocyte differentiation.

Whey Protein Intervention and Inflammatory Factors and Oxidative Stress: Systematic Review and Meta-analysis of Randomized Controlled Trials

CONTEXT

Whey protein (WP), a high-biological-value protein contained in milk, may have anti-inflammatory properties and can reduce proinflammatory cytokines; however, the current evidence is inconclusive.

OBJECTIVE

The aim of this study was to further investigate the effects of whey protein supplementation on inflammatory factors and oxidative stress in adults.

DATA SOURCES

We conducted a comprehensive search up to March 2022 using relevant key words in databases such as PubMed, Scopus, Embase, and the Cochrane Central Register of Controlled Trials, focusing on randomized controlled trials (RCTs).

DATA EXTRACTION

RCTs that examined the impact of WP on C-reactive protein, tumor necrosis factor alpha, interleukin-6, glutathione, malondialdehyde, and total antioxidant capacity were selected independently by 2 authors. Results were pooled using a random-effects model as weighted mean differences and 95% CIs.

DATA ANALYSIS

The results of the present study demonstrated that WP supplementation had no significant effect on the modulation of inflammation and oxidative stress compared with the control. None of the predefined subgroup analyses explained the differences in the effects of WP supplementation on inflammatory factors and oxidative stress.

CONCLUSION

This research suggests that WP supplementation had no significant effect on inflammatory factors and oxidative stress.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022325855.

Body composition markers are more strongly associated with type 2 diabetes than inflammatory markers-Results from the study of health in Pomerania

BACKGROUND AND AIMS

Evidence links body composition and inflammatory markers with type 2 diabetes (T2D). However, the comparative analysis of body composition markers derived from different modalities and inflammatory markers in relation to T2D remains unexplored. This study aims to evaluate and compare the association of body composition and inflammatory markers with T2D.

METHODS

We included 4043 participants (2081 female, 51.4%) aged 20-84 enrolled in the population-based Study of Health in Pomerania. Multivariable logistic regression models adjusted for confounding were used to analyse associations of standardized body composition markers derived from classic anthropometry, bioelectrical impedance analysis, magnetic resonance imaging as well as inflammatory markers C-reactive protein, white blood cell count, fibrinogen, ferritin and CRP-to-albumin ratio with prevalent T2D.

RESULTS

Body composition markers were more strongly associated with T2D than inflammatory markers. Waist circumference exhibited the strongest association with T2D (female: odds ratio (OR) = 2.55; 95% confidence interval [CI]: 2.17-3.00; male: OR = 2.20; 95% CI: 1.86-2.60). Similarly, body weight (female: 2.07; 1.78-2.41; male: OR = 1.99; 95% CI = 1.71-2.31), waist-to-height ratio (female: OR = 2.39; 95% CI = 2.05-2.77; male: 2.28; 1.92-2.70) and visceral adipose tissue (female: 3.02; 95% CI = 2.11-4.32; male: 1.50; 1.19-1.89) showed strong associations with T2D. Among inflammatory markers, white blood cell count in male and CRP-to-albumin ratio in female exhibit the strongest association with T2D.

CONCLUSIONS

Body composition markers seem to be more tightly associated with prevalent T2D compared to inflammatory markers.

Targeting metabolic diseases with celastrol: A comprehensive review of anti-inflammatory mechanisms and therapeutic potential

ETHNOPHARMACOLOGICAL RELEVANCE

Tripterygium wilfordii is a traditional Chinese medicine used to treat rheumatic diseases, with properties such as clearing heat, detoxifying, dispelling wind, and relieving pain. In recent years, its active compound, celastrol, garnered significant attention for its potential therapeutic effects on metabolic diseases. Celastrol exhibits bioactivities such as regulating metabolic functions and anti-inflammatory effects, positioning it as a promising candidate for the treatment of obesity, diabetes, atherosclerosis (AS), and non-alcoholic fatty liver disease (NAFLD).

AIM OF THE REVIEW

This review aims to explore the pharmacological mechanisms of celastrol in metabolic diseases, focusing on its anti-inflammatory mechanisms and metabolic regulation effects, providing theoretical support for further investigation of its therapeutic potential in metabolic diseases.

METHODS

Literature was retrieved from PubMed, Web of Science, Scopus, Cochrane, and Google Scholar. This review primarily focuses on anti-inflammatory mechanisms of celastrol, its metabolic regulation, and toxicity studies, by systematically analyzing its effects in obesity, diabetes, AS, and NAFLD, providing scientific evidence for its potential clinical applications.

RESULTS

Celastrol regulates multiple signaling pathways, particularly inhibiting NF-κB and activating AMPK, reducing the production of pro-inflammatory cytokines and improving insulin sensitivity, enhancing its therapeutic potential in metabolic diseases. Additionally, celastrol regulates adipogenesis and energy metabolism by influencing key transcription factors such as PPARγ and SREBP-1c. Numerous studies highlight its role in alleviating oxidative stress and improving mitochondrial function, further enhancing its metabolic benefits.

CONCLUSION

In summary, celastrol holds great promise as a multi-target therapeutic agent for metabolic diseases, offering anti-inflammatory, metabolic regulatory, and antioxidative benefits. Despite these, challenges remain for the clinical application of celastrol due to its poor bioavailability and potential toxicity. Advanced formulation strategies and targeted delivery systems are urgently needed to overcome challenges related to bioavailability and clinical translation.

The impact of obesity on mitochondrial dysfunction during pregnancy

Mitochondria play a central role in nutrient metabolism, besides being responsible for the production of adenosine triphosphate (ATP), the main source of cellular energy. However, the ATP production process is associated with the generation of reactive oxygen species (ROS), which excessive accumulation can cause mitochondrial dysfunction. This dysfunction, in turn, causes the accumulation of fatty acids in the adipose tissue, triggering a local inflammatory process that can evolve into systemic inflammation. In women with obesity, an increase in lipid levels in the placental environment is observed. The high presence of fatty acids compromises the structural integrity and mitochondrial membrane, culminating in the release of ROS. This process damages the DNA of placental cells and causes an inflammatory state, affecting metabolic efficiency. This vicious cycle is characterized by defects in mitochondrial ATP production, which can lead to lipid accumulation and inflammation. In pregnant women with obesity, these mitochondrial changes play a determining role in pregnancy outcomes. Hence, the objective of this study was to search the literature to review the impact of mitochondrial dysfunction in the maternal obesity.

The Role of TLRs in Obesity and Its Related Metabolic Disorders

Obesity affects the adaptability of adipose tissue (AT), impairing its ability to regulate energy and metabolism. Obesity is associated with many metabolic disorders, including dyslipidemia, hypertension, sleep disorders, non-alcoholic liver disease, and some types of cancer. Toll-like receptors (TLRs) are important in obesity and related metabolic disorders. TLRs are pattern-recognizing receptors (PRRs) involved in the innate immune system and recognize pathogen-associated molecular patterns (PAMPs) and endogenous ligands. TLRs, especially TLR2 and TLR4, are activated by fatty acids, endotoxins, and other ligands. TLR2 and TLR4 activation triggers inflammatory responses. Chronic inflammation driven by TLR activation is a hallmark of obesity and metabolic diseases. The inflammatory response triggered by TLR activation alters insulin signaling, contributing to insulin resistance, a key feature of metabolic syndrome and type 2 diabetes. Modulation of TLR activity through lifestyle changes (diet and exercise), obesity surgery, and pharmacological agents is under study as a possible therapeutic approach to controlling obesity and its complications.

Yoga-A complementary and traditional medicine for human health

Yoga is a therapeutic practice renowned for its multifaceted benefits across the body's systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body's various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga's effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers. Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga-A complementary and traditional medicine for human health. J Integr Med. 2025; 23(2): 93-105.

The crucial role of hypertension in determining latent classes of metabolic syndrome in northern Iran and predictive power of these classes in non-alcoholic fatty liver: a gender-based insight

Introduction

This study investigates the subclasses of metabolic syndrome (Mets) and their relationship with non-alcoholic fatty liver (NAFLD) and the probable predictive role of serum vitamin D and CRP levels.

Methods

This community-based, cross-sectional study was performed on adults in the framework of the Amol cohort prospective study (AmolCPS). Mets was defined as Adult Treatment Panel III criteria (ATP III) and ultrasound was used to diagnose NAFLD. Anthropometric and blood pressure measurements were conducted, and biochemical measurements were assessed after fasting. Data analysis included Latent class analysis, two-tailed χ2 statistics, one-way analysis of variance, and logistic regression using Mplus (version 7.4) and spss (version 26) softwares.

Results

The study involved 2308 participants, with a mean age of 43.17 ± 12.30 years. Mets prevalence was 25.64%, with three identified classes: Mets with Hypertension (HTN), Mets without HTN (Non-HTN), and Low Risk. Mets with HTN had a high probability of at least four components, particularly high SBP. Non-HTN had at least three high probable components, especially high TG and low HDL but not high SBP and DBP. The low-risk class had a low probability of all components except low HDL in women. Serum vitamin D and CRP levels did not significantly predict Mets classes in men, while CRP level significantly predicted the HTN class in women (OR:1.03, CI:1.004-1.067). Both HTN, and Non-HTN Mets classes significantly increased the odds of NAFLD compared to the low risk class, especially in women (HTN class OR: 4.20 vs 2.94; non-HTN class OR: 5.60 vs 3.12 in women and men respectively).

Conclusion

The latent class analysis in northern Iran identified three Mets classes: HTN, Non-HTN, and low-risk, with hypertension playing a crucial role in determining these classes. These classes were stronger predictors of NAFLD in women. Serum CRP and vitamin D levels did not emerge as significant predictors of the classes, except for serum CRP in the HTN class among women.

Relationship Between the Single Nucleotide Polymorphism A35C in the Cu/Zn-Superoxide Dismutase-1 Gene and Glycemic Control in Individuals with Type 2 Diabetes Mellitus

Hyperglycemia in type 2 diabetes mellitus (T2DM) increases oxidative stress. Furthermore, the presence of the single nucleotide polymorphism A35C (SNP A35C) in Cu/Zn-superoxide dismutase1 (SOD1) gene is closely related to this increase in oxidative stress and the development and progression of T2DM and its complications. This study aimed to evaluate the association between SNP A35C (rs2234694) genotypes and glycemic control in T2DM individuals. A total of 110 individuals were evaluated for anthropometric parameters, body composition, glycemic metabolism markers (fasting serum glucose, %HbA1c, insulin, C-peptide, and HOMA-IR, -%B, -%S), and SOD activity. Individuals were grouped according to SNP A35C genotypes. Variables of interest were assessed according to groups. The T-test for independent samples or the Mann-Whitney U test was used to analyze the differences in continuous variables between groups, and the chi-square test was performed for categorical variables. A binary logistic regression model was constructed, with p < 0.05 considered significant. Overweight was found in 81.8% of individuals with T2DM. Individuals with the AC genotype for SNP A35C had higher levels of fasting serum glucose (p = 0.018) and lower values of HOMA-%B (p = 0.044). The presence of the variant allele was positively associated with higher values of fasting serum glucose (OR: 11.340; 95%IC 1.173-109.649; p = 0.036) and HOMA-IR (OR: 9.987; 95%IC 1.127-88.506; p = 0.039). Individuals with the AC genotype of SNP A35C had poorer glycemic control than individuals with the AA genotype, and the presence of the variant allele was associated with poor glycemic control in T2DM individuals.

Therapeutic Strategies to Modulate Gut Microbial Health: Approaches for Chronic Metabolic Disorder Management

Numerous recent studies have suggested that the composition of the intestinal microbiota can trigger metabolic disorders, such as diabetes, prediabetes, obesity, metabolic syndrome, sarcopenia, dyslipidemia, hyperhomocysteinemia, and non-alcoholic fatty liver disease. Since then, considerable effort has been made to understand the link between the composition of intestinal microbiota and metabolic disorders, as well as the role of probiotics in the modulation of the intestinal microbiota. The aim of this review was to summarize the reviews and individual articles on the state of the art regarding ideal therapy with probiotics and prebiotics in order to obtain the reversion of dysbiosis (alteration in microbiota) to eubiosis during metabolic diseases, such as diabetes, prediabetes, obesity, hyperhomocysteinemia, dyslipidemia, sarcopenia, and non-alcoholic fatty liver diseases. This review includes 245 eligible studies. In conclusion, a condition of dysbiosis, or in general, alteration of the intestinal microbiota, could be implicated in the development of metabolic disorders through different mechanisms, mainly linked to the release of pro-inflammatory factors. Several studies have already demonstrated the potential of using probiotics and prebiotics in the treatment of this condition, detecting significant improvements in the specific symptoms of metabolic diseases. These findings reinforce the hypothesis that a condition of dysbiosis can lead to a generalized inflammatory picture with negative consequences on different organs and systems. Moreover, this review confirms that the beneficial effects of probiotics on metabolic diseases are promising, but more research is needed to determine the optimal probiotic strains, doses, and administration forms for specific metabolic conditions.

4D-DIA-based proteomics analysis reveals the protective effects of Pidanjiangtang granules in IGT rat model

ETHNOPHARMACOLOGICAL RELEVANCE

The Pidanjiangtang (PDJT) formula was founded on the "Pidan" theory from the "Nei Jing." PDJT is considered to eliminate the accumulation of pathological products, remove heat sources, and prevent damage to organs such as the liver and islets. It is widely used in clinical practice to treat impaired glucose tolerance (IGT). However, the bioactive ingredients and underlying mechanisms are still unclear and need further investigation.

OBJECTIVE

This study aimed to determine the therapeutic effect of PDJT on IGT rats and explore the mechanism of PDJT intervention on IGT by four-dimensional independent data acquisition (4D-DIA) proteomics analysis.

MATERIALS AND METHODS

The IGT model was established by a high-fat diet combined with Streptozotocin (STZ) injection. The IGT rats were treated with low, medium, and high doses of PDJT orally for 42 days and compared with the Metformin positive control group. The therapeutic effects of PDJT on IGT rats were evaluated using the oral glucose tolerance test (OGTT), serum lipoprotein detection, insulin detection, liver histopathology, and hepatic steatosis assessment. 4D-DIA proteomics analysis was used to explore the differential proteins (DEPs) and potential pathways of PDJT. Finally, Western blotting and ELISA techniques were used to verify DEPs and major targets.

RESULTS

PDJT can enhance glucose metabolism, restore islet β cell function, regulate lipoprotein metabolism, reduce hepatic steatosis, and consequently slow down the progression of IGT. In the proteomic analysis, a total of 355 DEPs were identified, and critical proteins were validated. The results indicated that the JAK2/STAT1 signaling pathway plays a pivotal role in the effects of PDJT. IκB-ζ may be a potential target for PDJT in regulating the inflammatory response of IGT.

CONCLUSION

PDJT is an effective formula for improving IGT, with its potential mechanism linked to the JAK2/STAT1/IκB-ζ signaling pathway. This study offers a novel approach to investigating the mechanisms of TCM formula through proteomics and offers new insight into exploring TCM treatment for IGT.

Increased plasma lipopolysaccharide-binding protein and altered inflammatory mediators reveal a pro-inflammatory state in overweight women

BACKGROUND

Chronic low-grade inflammation has been recognized as an underlying event linking obesity to diabetes and cardiovascular disease (CVD). However, inflammatory alterations in individuals and specifically women who are overweight remain understudied. Providing relevant insights is of substantial interest for women's cardiovascular health.

METHODS

We determined the levels of key circulating biomarkers of innate immune responses and inflammation, including lipopolysaccharide-binding protein (LBP), C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and adiponectin in adult female subjects who were lean (n = 20) or overweight (n = 20) and had high cholesterol and/or high blood pressure - two important conventional risk factors for CVD.

RESULTS

Plasma levels of LBP were significantly higher in the overweight group compared with the lean group (P = 0.017). The levels of CRP were also significantly higher in overweight subjects (P = 0.023), as were IL-6 (P = 0.016) and leptin (P = 0.004), pro-inflammatory mediators associated with cardiovascular risk. Levels of adiponectin, an adipokine with anti-inflammatory and anti-atherogenic functions, were significantly lower in the overweight group (P = 0.006). The leptin/adiponectin ratio, a preferential atherogenic marker was significantly increased in women who are overweight (P = 0.0007). LBP, CRP, leptin, IL-6, leptin, and adiponectin levels significantly correlated with BMI, but not with age and there was a significant correlation between LBP and IL-6 levels and LBP and CRP levels.

CONCLUSIONS

These results reveal the presence of a pro-inflammatory state in overweight women and are of interest for further studies with the goal for improved understanding of cardiovascular health risks in women.

FcγRI plays a pro-inflammatory role in the immune response to Chlamydia respiratory infection by upregulating dendritic cell-related genes

BACKGROUND

FcγRI, a pivotal cell surface receptor, is implicated in diverse immune responses and is ubiquitously expressed on numerous immune cells. However, its role in intracellular bacterial infections remains understudied.

METHODS

Wild-type (WT) and FcγRI knockout (FcγRI-KO) mice were inoculated intranasally with a specific dose of C. muridarum. Lung tissues were harvested for transcriptome sequencing, and flow cytometry was employed to validate bioinformatics immune infiltration analysis. Differentially expressed DC-associated genes were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses to elucidate their functions during infection. A PPI network was constructed to pinpoint crucial genes, and qPCR was utilized to confirm their expression changes. Additionally, we compared body weight, lung Chlamydia load, and pathological alterations between WT and FcγRI-KO mice post-infection to assess the effect of FcγRI on inflammation via gene regulation. Lastly, an mRNA-miRNA-lncRNA network was formulated to further probe the molecular mechanisms of FcγRI in C. muridarum infection.

RESULTS

Post-C. muridarum infection, FcγRI-KO mice exhibited a notable decrease in DC infiltration and maturation, along with downregulated co-stimulatory molecules (CD40, CD80, CD86) in lung tissues. Differential gene analysis identified 26 differentially expressed DC-related genes implicated in DC proliferation, migration, and inflammatory responses. KEGG analysis revealed their close association with key immune pathways. The PPI network delineated two modules, with the top six genes in the pivotal cluster 1 (Ccl4, Il6, Ccl3, Ptgs2, Il 1α, Il7) being significantly downregulated in FcγRI-KO mice. A ceRNA network encompassing 12 miRNAs and 37 lncRNAs regulating four key genes (Ptgs2, Il1α, Il6, Il7) was also constructed.

CONCLUSIONS

In C. muridarum respiratory infections, FcγRI facilitates DC infiltration and maturation, upregulates six pro-inflammatory genes (Ccl4, Il6, Ccl3, Ptgs2, Il1α, Il7), and exhibits a pro-inflammatory role. A key ceRNA network was formulated to unravel the underlying molecular mechanisms.

Pilot application of an inflammation and physiological dysregulation index based on noninvasive salivary biomarkers

BACKGROUND AND OBJECTIVE

Noninvasive salivary biomarkers can be used to assess the cumulative subclinical health impacts of social and environmental stressors. We evaluated seven salivary biomarkers of neuroendocrine and immune functions and a group index of physiological dysregulation based on these biomarkers in a pilot survey in a socioeconomically disadvantaged population.

RESULTS

Participants recruited at subsidized public housing projects in Denver, Colorado, completed a sociodemographic, behavioral, and health questionnaire and used passive drool samplers to collect five saliva samples over the course of 1 day. Samples were tested for the neuroendocrine biomarkers alpha-amylase, cortisol, and dehydroepiandrosterone (DHEA) as well as immune system/inflammation biomarkers C-reactive protein (CRP), interleukin (IL)-1β, IL-6 and total immunoglobulin A (IgA). A composite Inflammation and Physiological Dysregulation Index (IPDI) was calculated as a count of potentially unhealthy values of dichotomized biomarkers. In 20 individuals who completed the survey (average age 46 years, 75% females), allergy to house dust was significantly associated with increased IPDI (adjusted for age) and significantly increased odds of potentially unhealthy values of total IgA, IL-1β, and CRP. Age, obesity, diabetes, allergy to pollen, recent loss of employment, and depression, anxiety, and stress scores from the standard DASS-21 questionnaire were positively but not significantly (0.05 < p < 0.2) associated with IPDI. This project demonstrated an application of a composite index based on noninvasive salivary biomarkers to assess subclinical health impacts of chronic social stressors.

Systemic immune-inflammation index mediates the association between abdominal obesity and serum klotho levels

The weight-adjusted waist index (WWI) has emerged as a reliable indicator of abdominal obesity. α-Klotho, a transmembrane protein, functions as a suppressor of aging. However, the relationship between these two factors remains underexplored. This study aims to investigate the association between WWI and serum α-Klotho levels in middle-aged and elderly Americans, with a focus on exploring the potential mediating role of the systemic immune inflammation index (SII). A cross-sectional study was conducted using data from 6997 middle-aged and elderly Americans participating in the National Health and Nutrition Examination Surveys (NHANES) between 2011 and 2016. Multiple linear regression analysis was employed to assess the relationship between WWI and serum α-Klotho concentrations. Additionally, mediation analysis was performed to investigate the mediating effect of SII on the relationships. Our analysis revealed a significant negative correlation between WWI and serum α-Klotho levels in the survey-weighted multiple linear regression models (adjusted percent change: -7.79; 95% CI: -10.15, -5.37). Mediation analysis demonstrated that the association between WWI and α-Klotho levels was partially mediated by SII (adjusted percent change: -0.88; 95% CI: -1.24, -0.45), with the proportion of mediation amounting to 11.6%. Further age-stratified results showed that the mediating role of SII was more pronounced among individuals aged ≥ 60 years, exhibiting a mediating effect of 26.3%, in contrast to 4.2% for those < 60 years. The findings suggest that WWI is inversely associated with serum α-Klotho concentrations and that this association is partially mediated by SII, especially in older people.

The alleviation by wheat and oat dietary fiber alone or combined of T2DM symptoms in db/db mice

The effects of wheat and oat dietary fiber (DF) alone or combined on T2DM remain unclear. In this research, db/db diabetic mice were fed with diets containing 10% insoluble wheat dietary fiber (WDF), 10% insoluble oat dietary fiber (ODF), and 10% WODF (mixture of WDF and ODF, WDF : ODF = 1 : 1) for 8 weeks. The results showed that WDF, ODF, and WODF all reduced the body weight and fasting blood glucose (FBG) and improved oral glucose tolerance in db/db mice. WDF and ODF alone further relieved insulin resistance and decreased the levels of glycated hemoglobin A1c (GHbA1c), and glycosylated serum protein (GSP). In addition, WDF and ODF alone decreased the levels of TNF-α, IL-6, and IL-1β in serum. The colon function was improved and similar changes were observed in the gut microbiota structure and abundance in all the DF groups. The change of gut microbiota mainly manifested as reducing F/B ratio at the phylum level, while at the genus level as decreasing Enterococcus, Escherichia-Shigella, Erysipelatoclostridium, and unclassified_f_Lachnospiraceae and increase of norank_f_Muribaculaceae, Bacteroides, and Alistipes. Further testing of colonic bile acids (BAs) revealed that WDF, ODF, and WODF all significantly changed the composition of BAs, mainly reducing the levels of UDCA, HDCA, and 3β-UDCA. WODF further decreased DCA and increased β-MCA, LCA-3S, and 12-KCDCA. Importantly, WODF reduced the values of 12-OH-BAs/non-12-OH-BAs. Moreover, the TGR5 level was up-regulated in both the liver and colon, and the FXR level was up-regulated in the liver while down-regulated in the colon in all the DF groups. Furthermore, for the protein level, IRS-1, p-PI3K/PI3K, and AKT were up-regulated in the liver in all the DF groups, while for the mRNA expression level, GLUT4 was up-regulated, and FOXO1, GSK3β, PEPCK, and PGC-1α were down-regulated. WDF and WODF further up-regulated the mRNA expression levels of GYS and down-regulated that of G6Pase. These results suggested that WDF, ODF, and WODF all can alleviate T2DM through the gutmicrobiota-BAs-TGR5/FXR axis and liver IRS-1/PI3K/AKT pathway in db/db mice. WDF and ODF alone are beneficial for improving glucose metabolism and inflammation indicators, while WODF helps improve BAs' profile more in the colon.

Effects of various exercise types on inflammatory response in individuals with overweight and obesity: a systematic review and network meta-analysis of randomized controlled trials

OBJECTIVE

To explore effective exercise types for reducing chronic inflammation in individuals with overweight and obesity (IOO) while accounting for confounders.

METHODS

A systematic search for RCTs in English between January 2000 and August 2023 was conducted to evaluating exercise effects on inflammatory biomarkers in IOO. A network meta-analysis conducted.

RESULTS

A total of 123 RCTs were analyzed. Different exercise type yielded distinct effects on various inflammatory biomarkers. Specifically, aerobic exercise combined with resistance training (COM) and aerobic exercise (AE) were the most effective for improving leptin levels. AE exhibited the greatest effectiveness in reducing CRP and increasing adiponectin. High-intensity interval training (HIIT) was identified as the most effective exercise modality for ameliorating IL-6, TNF-α, and IL-10. Resistance training (RT) had the least effect compared to other exercise types. Meta regression and subgroup analyses revealed that high-intensity AE demonstrated a greater effect size compared to moderate-intensity AE. The impact of AE on IL-10 was positively associated with both the training period and the age of participants. Positive correlations were observed between reductions in body fat and the effect sizes of CRP, TNF-α, and IL-10. Gender influenced AE effects on IL-6 and TNF-α, with females responding better.

CONCLUSION

This study highlights the potential of exercise in alleviating the inflammatory status in IOO, with different exercise types showing various effects on specific inflammatory biomarkers. The intensity and duration of exercise had a dose-response relationship with intervention effectiveness. Changes in body composition correlated with the effectiveness of the intervention. COM, AE, and HIIT are recommended exercise approaches.

Metabolic Syndrome and the Risk of Postoperative Complications Following Esophagectomy: National Surgical Quality Improvement Program Study

INTRODUCTION

Metabolic syndrome has become a major health risk affecting patients worldwide and has been shown to be a risk factor for postoperative complications following abdominal surgery. This study aims to elucidate the link between metabolic syndrome and postoperative complications and mortality following esophagectomy.

METHODS

This is a retrospective study analyzing the American College of Surgeons National Surgical Quality Improvement Program database (2017-2021). This study compared 30-d postoperative complications of patients undergoing esophagectomy with and without metabolic syndrome. Metabolic syndrome was defined as obesity (body mass index ≥30 kg/m2), diabetes, and hypertension.

RESULTS

A total of 4911 patients met the study criteria, and of these, 303 patients (6.17%) met the inclusion criteria for the modified definition of metabolic syndrome. The metabolic syndrome group had higher American Society of Anesthesiologists scores compared to the control group (American Society of Anesthesiologists 3 or 4: 96% versus 84%, P < 0.001). Operative time was significantly higher in the metabolic syndrome group (378 mins versus 361, P = 0.004). Mortality was higher in the metabolic syndrome group (4.3% versus 2.3%, P = 0.03), as was serious morbidity (35% versus 30%, P = 0.05). Metabolic syndrome patients also had higher risks of postoperative complications of pneumonia (18.5% versus 14%, P = 0.04), unplanned intubation (15.5% versus 9.9%, P = 0.002), and sepsis (7.6% versus 4.9%, P = 0.04). On multivariate analysis, 30-d mortality was increased in the metabolic syndrome group.

CONCLUSIONS

Metabolic syndrome patients who undergo esophagectomy are associated with increased rates in morbidity and mortality. When controlled for other patient factors in multivariate analysis, 30-d mortality also had an associated increase. By focusing on modifiable risk factors with metabolic syndrome patients, mortality and morbidity for this high-risk procedure could be reduced in the future.

Exploring the mechanism and crosstalk between IL-6 and IL- 1β on M2 macrophages under metabolic stress conditions

Macrophages are highly variable immune cells that are important in controlling inflammation and maintaining tissue balance. The ability to polarize into two major types-M1, promoting inflammation, and M2, resolving inflammation and contributing to tissue repair-determines their specific roles in health and disease. M2 macrophages are particularly important for reducing inflammation and promoting tissue regeneration, but their function is shaped mainly by surrounding cells. This is evident in obesity, diabetes, and chronic inflammation. Although many cytokines regulate macrophage polarization, interleukin-6 (IL-6) and interleukin-1β (IL-1β) are major players, but their effects on M2 macrophage behavior under metabolic stress remain unclear. This study describes the intricacies within M2 macrophages concerning IL-6 and IL-1β signaling when under metabolic stress. Though, more frequently than not, IL-6 is labelled as pro-inflammatory, it can also behave as an anti-inflammatory mediator. On the other hand, IL-1β is the main pro-inflammatory agent, particularly in metabolic disorders. The relationship between these cytokines and the macrophages is mediated through important pathways such as JAK/STAT and NFκB, which get perturbed by metabolic stress. Therefore, metabolic stress also alters the functional parameters of macrophages, including alterations in mitochondrial metabolism, glycolytic and oxidative metabolism. Phosphorylation alters the kinetics involved in energy consumption and affects their polarization and their function. However, it has been suggested that IL-6 and IL-1β may work in concert or competition when inducing M2 polarization and, importantly, implicate cytokine release, phagocytic activity, and tissue repair processes. In this review, we discuss the recent literature on the participation of IL-6 and IL-1β cytokines in macrophage polarization and how metabolic stress changes cytokine functions and synergistic relations. A better understanding of these cytokines would serve as an important step toward exploring alternative antiviral strategies directed against metabolic disturbance and, hence, approve further endeavors.

Exploring the association of metabolic factors and chronic musculoskeletal pain over a period of 10 years - the Doetinchem Cohort Study

OBJECTIVE

To examine (a) the association between metabolic factors and chronic musculoskeletal pain (CMP), (b) metabolic predictors of CMP 10 years later, and (c) the association and evolution of metabolic factors across different CMP trajectory groups.

DESIGN

Data from the longitudinal Doetinchem Cohort Study were used. We used round 4 (2003-2007), with 4519 participants aged 36-75 years, as the baseline for the present study, with follow-up measurements in round 5 (2008-2012), and 6 (2013-2017), including self-reported pain and metabolic factors, which were measured either via self-report or physical assessment. For the three research aims, (a) generalized linear mixed-effects models, (b) binary logistic regression analyses and (c) linear mixed-effects models were used.

RESULTS

(a) Female sex, higher age, presence of diabetes, higher BMI, lower diastolic blood pressure (BP), and elevated cystatin C were significantly associated with CMP in multivariable logistic analyses. (b) Female sex and elevated BMI were predictors of CMP 10 years later. (c) Those pain-free for 10 years had the lowest BMI levels compared to other CMP groups (development, recovery, persistent, and recurrent CMP). BMI was higher in the persistent CMP group than in the development and recovery groups. The pain-free group had higher diastolic BP compared to those in the persistent CMP group. Participants in the persistent CMP group had higher Cystatin C levels than the free, development and recovery CMP groups. Regarding the evolution of metabolic factors over time, BMI, glucose and diastolic BP evolved differently across the CMP trajectory groups.

CONCLUSION

Our findings indicate the importance of metabolic factors, especially BMI, in the onset and progression of CMP. These findings underscore the need to consider metabolic health in the prevention and treatment of CMP. Key Points • Metabolic factors are associated with the presence of chronic musculoskeletal pain. • Female sex and elevated BMI are predictive of musculoskeletal pain (MP) 10 years later. • Metabolic factors evolve differently over time across different pain trajectory groups, with variations in BMI, glucose, and diastolic blood pressure.

Reframing Diabetes Prevention: From Body Shaming to Metabolic Reprogramming

This review integrates new developments in psychology with updated physiological insight on the complex relationships among chronic psychological stress (arising from weight stigmatization and body shaming), food composition, physical activity and metabolic health for the example of diabetes. We address how visual measures of health, such as body mass index (BMI) and waist-to-hip ratio, do not adequately capture metabolic health and can instead contribute to weight stigmatization, chronic stress, and system-wide impairment of metabolic health. We also emphasize the importance of food composition over calorie counting. We summarize how chronic stress interacts with nutritional deficiencies and physical inactivity to disrupt the stress response, immune response, gut microbiome, and function of fat depots. We specifically address how interactions among lifestyle factors and the gut microbiome regulate whether fat stored around the waist has a negative or positive effect on metabolic health. We aim to provide a resource and updated framework for diabetes prevention and health promotion by (i) highlighting metabolic imbalances triggered by lifestyle changes during the transition to industrialized society and (ii) detailing the potential to support metabolic health through access to modest, but comprehensive lifestyle adjustments.

Recent advances and therapeutic applications of PPARγ-targeted ligands based on the inhibition mechanism of Ser273 phosphorylation

PPARγ functions as a master ligand-dependent transcription factor that regulates the expressions of a variety of key genes related to metabolic homeostasis and inflammatory immunity. It has been recognized as a popular and druggable target in modern drug discovery. Similar to other nuclear receptors, PPARγ is a phosphoprotein, and its biological functions are regulated by phosphorylation, especially at Ser273 site which is mediated by CDK5 or ERK. In the past decade, the excessive level of PPARγ-Ser273 phosphorylation has been confirmed to be a crucial factor in promoting the occurrence and development of some major diseases. Ligands capable of inhibiting PPARγ-Ser273 phosphorylation have shown great potentials for treatment. Despite these achievements, to our knowledge, no related review focusing on this topic has been conducted so far. Therefore, we herein summarize the basic knowledge of PPARγ and CDK5/ERK-mediated PPARγ-Ser273 phosphorylation as well as its physiopathological role in representative diseases. We also review the developments and therapeutic applications of PPARγ-targeted ligands based on this mechanism. Finally, we suggest several directions for future investigations. We expect that this review can evoke more inspiration of scientific communities, ultimately facilitating the promotion of the PPARγ-Ser273 phosphorylation-involved mechanism as a promising breakthrough point for addressing the clinical treatment of human diseases.

Relationship between trajectory of Chinese visceral adiposity index and risk of type 2 diabetes mellitus: Evidence from the China-PAR project

AIMS

This study aimed to identify the distinct change trajectories of the Chinese visceral adiposity index (CVAI) over time and to investigate their associations with risk of type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

This study included 52 394 participants from the prospective project, the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). The CVAI was calculated using measures of age, body mass index, waist circumference, triglycerides and high-density lipoprotein cholesterol. Latent mixture modelling was conducted to fit distinct trajectory patterns. The logistic regression model was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of T2DM with various CVAI trajectory patterns.

RESULTS

Four distinct CVAI trajectory patterns were identified: low-increasing, moderate-increasing, moderate high-increasing and high-increasing. Compared with low-increasing CVAI, participants with moderate-increasing (OR 1.73, 95% CI 1.49-2.00), moderate high-increasing (3.48, 3.01-4.03) and high-increasing CVAI (5.50, 4.67-6.47) had a significantly increased risk of T2DM. Similar trajectory patterns were identified in both men and women. The ORs (95% CI) for moderate-increasing, moderate high-increasing and high-increasing groups were 3.28 (2.56-4.19), 7.85 (6.09-10.13) and 13.21 (9.98-17.49) in women respectively, and 1.20 (0.99-1.45), 2.18 (1.82-2.62) and 3.60 (2.93-4.43) in men respectively, when compared to the low-increasing CVAI group. Further, significant effect modifications for age, smoking and physical activity (all Pinteraction <0.05) were observed in the relationship between CVAI trajectory patterns and T2DM.

CONCLUSIONS

Initially high and persistently elevated CVAI is significantly associated with an increased risk of T2DM, with a particular focus on women, younger people, nonsmokers and physically inactive individuals. Continuous monitoring of CVAI levels will benefit effective identification, early intervention and management of individuals at high risk of T2DM.