Insulin: The master regulator of glucose metabolism

Quercetin alleviates metabolic-associated fatty liver disease by tuning hepatic lipid metabolism, oxidative stress and inflammation

The natural flavonoid quercetin, which exhibits a range of biological activities, has been implicated in liver disease resistance in recent research. In vivo study attesting to quercetin's protective effect against metabolic-associated fatty liver disease (MAFLD) is inadequate, however. Here, our investigation explored the potential benefits of quercetin in preventing MAFLD in C57BL/6 mice fed a high-fat diet (HFD). The results revealed that quercetin ameliorated the aberrant enhancement of body and liver weight. The hepatic histological anomalie induced by MAFLD were also mitigated by quercetin. HFD-induced imbalance in serum LDL, HDL, AST, ALT, TG, and LDH was mitigated by quercetin. Mechanically, we found that quercetin improved lipid metabolism by reducing lipogenesis proteins including ACC, FASN, and SREBP-1c and enhancing β-oxidation proteins including PPARα and CPT1A. In vitro study demonstrated that quercetin regulated hepatic lipid metabolism by targeting SREBP-1c and PPARα. Additionally, quercetin enhanced the antioxidant capacity in HFD-treated mice by downregulating Nrf2 and HO-1 expressions and upregulating SOD and GPX1 expressions. The hyper-activation of inflammation was also restored by quercetin via eliminating the phosphorylation of IκBα and NF-κB p65. Collectively, our observations highlight that quercetin exerts hepatoprotective properties in MAFLD mice by regulating hepatic lipid metabolism, oxidative stress and inflammatory response.

Ginsenoside Rk1 inhibits the malignant progression of lung cancer by inactivating the INSR/PI3K/AKT pathway

BACKGROUND

Lung cancer continues to be a primary contributor to global cancer deaths. The urgent need for effective therapeutic interventions has led researchers to explore natural compounds with potential anti-cancer properties. Ginsenoside Rk1 (Rk1), a pharmacologically active component derived from ginseng, has garnered attention for its reported anti-cancer effects, however, the molecular mechanisms underlying its action against lung cancer remain poorly understood.

METHODS

This study employed a series of in vitro assays, including cell counting kit-8, cell colony formation, 5-Ethynyl-2'-deoxyuridine, flow cytometry, and transwell assays, to assess the effects of Rk1 on lung cancer cell viability, proliferation, apoptosis, migration, and invasion. Western blotting, immunohistochemistry assay, and quantitative real-time polymerase chain reaction were used to evaluate the protein and mRNA expression, respectively. Bioinformatics tools such as Genecards, Swiss Target Prediction, and Cytoscape 3.9.1 were utilized for network pharmacological analysis and pathway mapping. The interaction between Rk1 and INSR was analyzed using a cellular thermal shift assay. Animal experiment was performed to validate the effect of Rk1 and INSR overexpression on the malignant progression of lung cancer cells.

RESULTS

Rk1 treatment significantly inhibited lung cancer cell proliferation, migration, and invasion, while inducing cell apoptosis and autophagy. Importantly, we identified insulin receptor (INSR) as a pivotal target of Rk1. Notably, INSR expression was found to be upregulated in lung cancer tissues and cells. In addition, Rk1 treatment heat-stabilized INSR and reduced its protein expression in A549 cells. Depletion of INSR mimicked the inhibitory effects of Rk1, whereas overexpression of INSR mitigated these effects. Furthermore, Rk1 inactivated the PI3K/AKT pathway through the regulation of INSR. Further, INSR overexpression attenuated Rk1 treatment-induced inhibitory effect on the malignant progression of lung cancer cells.

CONCLUSION

This study provided novel insights into the molecular mechanisms by which Rk1 exerted its anti-cancer effects in lung cancer, specifically through targeting the INSR/PI3K/AKT pathway. These findings not only contributed to the understanding of Rk1's therapeutic potential but also offered a rationale for its further development as a promising therapeutic agent for the treatment of lung cancer. The identification of INSR as a key target represents a significant advancement in the field, highlighting the importance of natural compounds in modern cancer therapy.

Genomics and transcriptomics identify quantitative trait loci affecting growth-related traits in silver pomfret (Pampus argenteus)

Pampus argenteus, a species distributed throughout the Indo-West Pacific, plays a significant role in the yield of aquaculture species. However, cultured P. argenteus has always been characterised by unbalanced growth synchronisation among individuals, slow growth rate, and lack of excellent germplasm resources. Therefore, we conducted mass selection for fast-growing strain P. argenteus for several consecutive years. Various genetic improvement programs have modified its genome sequence through selective pressure, leaving nucleotide signals that can be detected at the genomic level. In the present study, we combined bulked segregant analysis and transcriptome sequencing to identify candidate single nucleotide polymorphisms (SNPs) and key genes for growth-related traits in P. argenteus. A total of 7,280,936 SNPs and 2,212,379 insertions/deletions were identified in the extreme phenotypes of the fast-growing and slow-growing groups. Based on the examination of SNP frequency differences and sliding-window analysis, 42 SNPs were identified as candidate markers. Moreover, 14 of the 42 SNPs linked to growth-related traits were confirmed to be credible SNPs, and eight growth-related genes were screened, namely myb-binding protein 1 A, insulin A/B chains, α-1B adrenoceptor, engulfment and cell motility protein 3, myosin light chain kinase family member 4, insulin receptor located, unconventional myosin-9b, and matrilin-1. An optimal three-factor model (SNP4&SNP12&SNP14) was constructed using the generalized multifactor dimensionality reduction method, and its accuracy was verified as 67.72 %. These results may benefit genetic studies and accelerate genetic improvement of fast-growing strains of P. argenteus.

Glucose variability as a key mediator in the relationship between pre-pregnancy overweight/obesity and late-onset hypertensive disorders of pregnancy

To evaluate the role of high glucose variability (High-GV) in early pregnancy as a potential mediating factor between pre-pregnancy overweight/obesity and late-onset HDP (LoHDP), where effective preventive strategies remain limited. This multicenter retrospective study analyzed data from 802 pregnancies across 14 facilities. Pregnancies with a 75 g-OGTT performed by 20 weeks of gestation were included. Structural equation modeling (SEM) was used to evaluate direct and indirect effects of body mass index (BMI), High-GV, and covariates (e.g., age, ART, primiparity) on LoHDP. Overweight/obese women had significantly higher rates of High-GV (26.1 vs. 16.4%, p = 0.001) and LoHDP (17.6 vs. 7.9%, p < 0.001) compared to non-overweight/obese women. SEM revealed that BMI influenced LoHDP through both direct and indirect pathways. BMI had a direct effect on LoHDP (β = 0.20, p < 0.01), and an indirect effect mediated by High-GV, with BMI significantly associated with High-GV (β = 0.15, p < 0.01), and High-GV positively associated with LoHDP (β = 0.12, p < 0.01). In Non-GDM pregnancies, High-GV showed an even stronger association with LoHDP (β = 0.25, p < 0.001). This study identifies High-GV as a key mediator linking pre-pregnancy overweight/obesity to LoHDP. These findings suggest that targeting glucose variability in early pregnancy could mitigate LoHDP risk, particularly in overweight/obese women, regardless of GDM status. Future preventive strategies should integrate multifaceted approaches addressing maternal BMI and glucose regulation to improve maternal and neonatal outcomes.

Updated Insights into Probiotic Interventions for Metabolic Syndrome: Mechanisms and Evidence

Metabolic syndrome (MetS) is a disease with complex and diverse etiologies. Extrinsic factors such as diet and lifestyle can induce dysbiosis of gut microbes, compromising intestinal barrier integrity and leading to inflammation and insulin resistance, thereby advancing MetS. Probiotic interventions have shown potential in ameliorating gut microbiota dysbiosis and regulating host metabolism by assimilating lipids, metabolizing carbohydrates, and producing short-chain fatty acids (SCFA), indole compounds, secondary bile acids, conjugated linoleic acid (CLA), and other active ingredients. An increasing number of new strains are being isolated and validated for their effective roles intervening on MetS in animal and population studies. This review aims to provide updated insights into the pathogenic mechanisms of MetS, highlight the newly identified probiotic strains that have demonstrated improvements in MetS, and elucidate their mechanisms of action, with the aim of offering contemporary perspectives for the future use of probiotics in mitigating MetS.

Adipokines and Adipose Tissue: The Role and Use of Sodium-Glucose Co-Transporter-2 (SGLT-2) Inhibitors in Patients with Diabetes or Heart Failure

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have become integral in treating both diabetes mellitus and heart failure, independent of left ventricular ejection fraction. Their pleiotropic effect influences multiple mechanisms, enhancing the function of various systems within the body. They exhibit nephroprotective and cardioprotective effects by improving cell metabolism, endothelial function, and slowing the fibrosis of the cardiac muscle, and they also have a beneficial impact on other organs. At the cellular level, they protect against the harmful effects of free radicals both by lowering glucose levels and by supporting the function of the antioxidant system. Moreover, SGLT-2 inhibitors can modify the metabolism of adipocytes by affecting the production of cytokines such as adiponectin-which increases insulin sensitivity, leading to weight loss and improved glycemic control.

Association of the Triglyceride-Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes

Background/Objectives: Insulin resistance during pregnancy is a key factor underlying gestational diabetes mellitus (GDM) and other adverse perinatal outcomes (APOs). While traditional markers, such as HOMA-IR, are used to evaluate insulin resistance, they may be inaccessible in resource-limited settings. The triglyceride-glucose (TyG) index has emerged as a practical alternative. This study aimed to assess whether or not a TyG index > 8.6 during the first trimester of pregnancy is associated with an increased risk of APOs, including GDM, preeclampsia, and other maternal and neonatal complications. Methods: A prospective cohort study was conducted involving 333 pregnant women in Mexico City, divided into two groups: Group 1 (TyG index > 8.6, n = 153) and Group 2 (TyG index ≤ 8.6, n = 180). Primary outcomes included gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy, preeclampsia, preterm birth, cesarean section, and large-for-gestational-age (LGA) and small-for-gestational-age (SGA) neonates. Logistic regression models were used to calculate the adjusted relative risk (aRR) and 95% confidence intervals (CIs), adjusting for maternal age, pregestational weight, and body mass index (BMI). Results: Women with a TyG index > 8.6 had a significantly higher pregestational weight and BMI than those with a TyG index ≤ 8.6. Group 1 demonstrated a higher risk of GDM (RR 2.05; 95% CI: 1.23-3.41) and preeclampsia (RR 2.15; 95% CI: 1.10-4.21). After adjusting for maternal age, pregestational weight, and BMI, these associations remained significant: GDM (aRR 1.87; 95% CI: 1.0-2.5) and preeclampsia (aRR 2.18; 95% CI: 1.1-5.0). No significant associations were found between an elevated TyG index and other APOs, including LGA, SGA, preterm birth, or cesarean delivery. Conclusions: A first-trimester TyG index > 8.6 is significantly associated with an increased risk of GDM and preeclampsia, highlighting its potential as a predictive marker for adverse perinatal outcomes. These findings underscore the utility of the TyG index as a practical, cost-effective tool for early risk stratification, particularly in resource-limited settings. Further multi-center research is needed to validate these results and refine population-specific thresholds.

Tryptophan-Derived Metabolites and Glutamate Dynamics in Fatal Insulin Poisoning: Mendelian Randomization of Human Cohorts and Experimental Validation in Rat Models

Insulin overdose may cause hypoglycemic encephalopathy. In this study, Mendelian randomization was employed to analyze changes in the serum metabolites of patients with hypoglycemic encephalopathy, and metabolomics analysis was conducted to detect differential metabolites in the serum of a rat model of hypoglycemic encephalopathy induced by insulin overdose. The results indicated an overall upward trend in the tryptophan metabolism pathway in patients with hypoglycemic encephalopathy and rats with hypoglycemic encephalopathy caused by insulin overdose, while serum glutamate levels declined. The metabolic changes in the tryptophan pathway provide new insights into the impact of hypoglycemia on brain function. The related products of the tryptophan metabolism pathway have a certain diagnostic value for hypoglycemic encephalopathy and forensic identification of insulin overdose-induced hypoglycemic encephalopathy death.

Metabolic Signalling Peptides and Their Relation to Clinical and Demographic Characteristics in Acute and Recovered Females with Anorexia Nervosa

Background/Objectives: Recent research has established that metabolic factors may increase the vulnerability to develop anorexia nervosa (AN). The aim of this study was to explore the serum concentrations of leptin, insulin-like growth factor-1 (IGF-1), insulin and insulin receptor substrate (IRS-1) as possible state or trait biomarkers for AN in the acute and recovery (recAN) phases. Our secondary aim was to test associations between the tested markers and demographic and clinical characteristics. Methods: This cross-sectional study included data from 56 participants with AN, 24 recAN participants and 51 healthy controls (HCs). Enzyme-linked immunosorbent assays (ELISAs) were used to quantify serum concentrations of leptin, IGF-1, insulin and IRS-1. An analysis of covariance (ANCOVA) and linear regression models were utilised to test our results. Results: There were significant differences with a large effect size between the groups for serum leptin (p < 0.001; d = 0.80), whereby people with AN had lower leptin than those with recAN (p = 0.023; d = 0.35) and HCs (p < 0.001; d = 0.74). The between-group comparison of IGF-1 did not reach significance, although the effect size was moderate (d = 0.6) and was driven by lower levels of IGF-1 in people with acute AN compared to HCs (p = 0.036; d = 0.53). Serum insulin and IRS-1 did not differ between groups. Conclusions: Low leptin levels seen in individuals with AN may be due to starvation leading to fatty tissue depletion. Understanding the regulation of IGF-1 and insulin signalling over the course of the disorder requires further investigation.

Branched-Chain Amino Acid Supplementation Enhances Substrate Metabolism, Exercise Efficiency and Reduces Post-Exercise Fatigue in Active Young Males

Background: Branched-chain amino acids (BCAAs, isoleucine, leucine, and valine) are commonly applied to promote muscle protein synthesis. However, the effects of BCAAs on exercise-induced substrate metabolism, performance and post-exercise fatigue during endurance exercise remain unclear. Methods: In a double-blind cross-over design, eleven active males completed 1 h of constant load exercise (CLE) at 60% VO2max power followed by a time to exhaustion (TTE) test at 80% VO2max power after supplementation with BCAAs or placebo on consecutive three days. During exercise, indirect calorimetry was used to measure the carbohydrate (CHO) and fat oxidation rate, as well as the cycling efficiency. In addition, rating of perceived exertion (RPE) and visual analogue scale (VAS) scores were obtained at interval times during the whole period. Fingertips and venous blood (n = 8) were collected for the measurement of metabolic responses at different time points during exercise. Results: Compared to the placebo group, the fat oxidation rate was significantly higher after 20 and 30 min of CLE (p < 0.05). The CHO oxidation rates showed a significant increase in the BCAA group during TTE (p < 0.05). Meanwhile, the cycling efficiency during TTE was significantly improved (p < 0.05). Interestingly, VAS significantly decreased post-exercise in the BCAA group (p < 0.05). Additionally, the levels of blood insulin between the two groups were significantly higher in the post-exercise period compared to the pre-exercise periods (p < 0.001), while insulin levels were significantly lower in the post-exercise period with supplemental BCAAs compared to the placebo (p < 0.001). BCAAs also enhanced the levels of blood ammonia in the post-exercise period compared to the fasting and pre-exercise periods (BCAA: p < 0.01; Placebo: p < 0.001). However, in the post-exercise period, blood ammonia levels were significantly lower in the BCAA group than in the placebo group (p < 0.05). Conclusions: This study shows the critical role of BCAAs during exercise in active males and finds that BCAA supplementation enhanced fat oxidation during the CLE, increased carbohydrate oxidation and exercise efficiency during the TTE, and reduced immediate post-exercise fatigue.

The impact of high-intensity interval training on insulin resistance, oxidative stress, and muscle function in a PCOS rat model

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders . This study aimed to investigate the effects of high-intensity interval training (HIIT) on insulin resistance, oxidative stress, soleus muscle function, and myokine levels in a PCOS rat model. Female rats were assigned to four groups: Control, PCOS, PCOS+Exercise, and Exercise (n=15 each). PCOS was induced by subcutaneous administration of dehydroepiandrosterone (DHEA) for 3 weeks, and exercise groups underwent HIIT for 12 weeks. Insulin resistance (HOMA-IR), serum oxidative stress markers, hormone levels (FSH, LH), soleus myokine expression, and muscle function were analyzed. Results showed that the PCOS group exhibited increased blood pressure and insulin resistance compared to controls, with a significant reduction in FSH and LH levels in the PCOS+Exercise group. Exercise improved insulin sensitivity and reduced insulin resistance in the PCOS+Exercise group. Serum oxidative stress markers did not differ significantly between groups. Soleus muscle IL-6 levels were significantly reduced in the PCOS+Exercise group. Histological analysis revealed a larger cross-sectional area of the soleus muscle in the PCOS+Exercise group compared to the PCOS group, suggesting improved muscle morphology. Furthermore, exercise improved the functional capacity of soleus muscles, as evidenced by weightlifting performance. These findings indicate that HIIT has beneficial effects on insulin resistance, reproductive hormone levels in PCOS. Exercise also shows potential in slowing oocyte loss and improving follicle health, highlighting its role as a therapeutic intervention for reproductive health in PCOS. This study suggests that HIIT could be a beneficial approach for managing PCOS, and further research is needed to better understand its underlying mechanisms and potential long-term benefits.

Association between the triglyceride glucose-Chinese visceral adiposity index and new-onset stroke risk: a national cohort study

BACKGROUND

Numerous studies have investigated the effect of an integrated index that combines the triglyceride‒glucose (TyG) index with various obesity indicators on stroke incidence. However, how to use the TyG index and the Chinese Visceral Adiposity Index (CVAI) for stroke prevention remains unclear. This study examined the associations between dynamic changes in the TyG-CVAI index and cumulative, baseline, and new-onset stroke risk.

METHODS

Data from 3,769 participants in the China Health and Retirement Longitudinal Study(CHARLS) were analyzed, concentrating on the baseline TyG-CVAI, TyG-CVAI in 2015, and the cumulative TyG-CVAI derived from these. The fluctuations of the TyG-CVAI index were grouped into three clusters using K-means clustering analysis. Logistic regression models were used to examine the relationship between the TyG-CVAI index and new-onset stroke risk. Restricted cubic splines (RCS) were employed to investigate potential nonlinear relationships while assessing the predictive capability by receiver operating characteristic curve.

RESULTS

During the follow-up period, 181 participants experienced stroke events. The stroke incidence rates in Clusters 1, 2, and 3 were 2.42%, 8.72%, and 4.37%, respectively. After adjustment for confounding factors, Cluster 2 with high and increasing TyG-CVAI index (OR = 3.16, 95% CI 1.94-5.22), the Q3 group with high cumulative TyG-CVAI index (OR = 2.53, 95% CI 1.60-4.02), and the Q3 group with high baseline TyG-CVAI index (OR = 2.49, 95% CI 1.57-3.95),which were all correlated with an elevated risk of new-onset stroke. The RCS analysis disclosed a U-shaped relationship between cumulative and baseline TyG-CVAI index and stroke risk.

CONCLUSION

The fluctuations in and baseline, and cumulative TyG-CVAI index are independently correlated with an increased risk of stroke. The TyG-CVAI index is anticipated to be a more efficient and significant indicator for evaluating early stroke.

Testing the carbohydrate-insulin model: Short-term metabolic responses to consumption of meals with varying glycemic index in healthy adults

The carbohydrate-insulin model predicts that meals with varying glycemic indices will elicit distinct metabolic and hunger responses, including greater intake at subsequent meals following high-glycemic-index meals. To test this, a randomized trial (NCT05804942) was conducted in healthy adults using intervention meals with low, medium, and high glycemic indices and a constant macronutrient composition. After intake of the intervention meals, glucose and insulin followed the predicted pattern, but subjective hunger did not. At the group level, low glycemic index meals led to lower energy intake changes. At the individual level, energy intake changes were unrelated to body fatness or levels of glucose, β-hydroxybutyrate, free fatty acids, L-lactate, leptin, adrenaline, glucagon-like peptide-1, glucagon, and insulin-glucagon ratio. A weak negative association was observed between energy intake changes and insulin or insulin-glucagon ratio at 300 min, opposite to the model's prediction. These data provide little support for the carbohydrate-insulin model.

Biological Polymers: Evolution, Function, and Significance

A holistic description of biopolymers and their evolutionary origins will contribute to our understanding of biochemistry, biology, the origins of life, and signatures of life outside our planet. While biopolymer sequences evolve through known Darwinian processes, the origins of the backbones of polypeptides, polynucleotides, and polyglycans are less certain. We frame this topic through two questions: (i) Do the characteristics of biopolymer backbones indicate evolutionary origins? (ii) Are there reasonable mechanistic models of such pre-Darwinian evolutionary processes? To address these questions, we have established criteria to distinguish chemical species produced by evolutionary mechanisms from those formed by nonevolutionary physical, chemical, or geological processes. We compile and evaluate properties shared by all biopolymer backbones rather than isolating a single type. Polypeptide, polynucleotide, and polyglycan backbones are kinetically trapped and thermodynamically unstable in aqueous media. Each biopolymer forms a variety of elaborate assemblies with diverse functions, a phenomenon we call polyfunction. Each backbone changes structure and function upon subtle chemical changes such as the reduction of ribose or a change in the linkage site or stereochemistry of polymerized glucose, a phenomenon we call function-switching. Biopolymers display homo- and heterocomplementarity, enabling atomic-level control of structure and function. Biopolymer backbones access recalcitrant states, where assembly modulates kinetics and thermodynamics of hydrolysis. Biopolymers are emergent; the properties of biological building blocks change significantly upon polymerization. In cells, biopolymers compose mutualistic networks; a cell is an Amazon Jungle of molecules. We conclude that biopolymer backbones exhibit hallmarks of evolution. Neither chemical, physical, nor geological processes can produce molecules consistent with observations. We are faced with the paradox that Darwinian evolution relies on evolved backbones but cannot alter biopolymer backbones. This Darwinian constraint is underlined by the observation that across the tree of life, ribosomes are everywhere and always have been composed of RNA and protein. Our data suggest that chemical species on the Hadean Earth underwent non-Darwinian coevolution driven in part by hydrolytic stress, ultimately leading to biopolymer backbones. We argue that highly evolved biopolymer backbones facilitated a seamless transition from chemical to Darwinian evolution. This model challenges convention, where backbones are products of direct prebiotic synthesis. In conventional models, biopolymer backbones retain vestiges of prebiotic chemistry. Our findings, however, align with models where chemical species underwent iterative and recursive sculpting, selection, and exaptation. This model supports Orgel's "gloomy" prediction that modern biochemistry has discarded vestiges of prebiotic chemistry. But there is hope. We believe an understanding of biopolymer origins will progress during the challenging and exciting integration of chemical sciences and evolutionary theory. These efforts can provide new perspectives on pre-Darwinian mechanisms and can deepen our understanding of evolution and of chemical sciences. Our working definition of chemical evolution is continuous chemical change with exploration of new chemical spaces and avoidance of equilibrium. In alignment with our model, we observe chemical evolution in complex mixtures undergoing wet-dry cycling, which does appear to undergo continuous chemical change and exploration of new chemical spaces while avoiding equilibrium.

Treatment of Type 2 Diabetes in Patients with Obesity: A Review

Type 2 diabetes and obesity have some overlapping pathophysiology. This has allowed for the creation of therapies which are highly effective in treating both conditions. Weekly subcutaneous incretin agonists are preferred agents as they provide significant improvement in glycemic parameters, weight, and other comorbidities, like heart failure and reduce major adverse cardiovascular event. Bariatric surgery continues to show the most durable benefits for patients with both type 2 diabetes mellitus and obesity and should be considered in patients who are unable to meet goals with pharmacotherapy and lifestyle.

Mechanisms of starchy foods glycemic index reduction under different means and their impacts on food sensory qualities: A review

Diabetes has become a significant global health issue, driving the adoption of low glycemic index (GI) diets and positioning low-GI foods as a key research focus. Although methods for lowering the GI of foods have been reviewed, a comprehensive analysis of the underlying mechanisms is lacking. Moreover, GI-lowering techniques, whether through exogenous additives or specific processing methods, can influence food sensory qualities and impact storage stability. However, systematic reviews on these effects are limited. This review summarizes mechanisms for reducing the GI of starchy foods, focusing on four key strategies: inhibiting digestive enzymes, altering substrate structure, blocking enzyme-substrate interactions, and stimulating insulin secretion. It also addresses the sensory impacts of these GI-reduction methods. Additionally, the review evaluates how certain nutrient additions affect food stability during storage, aiming to offer scientific guidance for the development of low-GI starchy foods.

Relevance of Milk Composition to Human Longitudinal Growth from Infancy Through Puberty: Facts and Controversies

Milk is the principal nutrient of newborn humans and a diagnostic feature of the order Mammalia. Its release is elicited as a reflex by infant sucking under the control of the hormone oxytocin. While it is recognized that breast milk optimally promotes infant longitudinal growth and development, this review explores facts and controversies regarding the extent to which the milks of several dairy animals and infant formula milk (IF) approximate special properties and bioactivities of breast milk. It also provides evidence that early exposure to undernutrition during the very rapid fetal and early infancy growth predominantly and permanently stunts longitudinal growth trajectory in both animals and humans and is often followed in later life by obesity and metabolic dysfunction, and sometimes also by precocious timing of sexual maturation. There is a knowledge gap as to whether there may be additional critical periods of nutritional vulnerability in human development, which is characterized by a relatively prolonged period of slow childhood growth bracketed by the rapid fetal-neonatal and pubertal growth spurts. It is also unclear whether any quantitative differences in caloric intake and supply during neonatal period may influence developmental fatness programming. A further knowledge gap exists regarding the role of infant microbiome composition and development in the possible epigenetic programming of longitudinal growth or fatness in later life. Extending the research of early developmental programming to the entire period of human growth from conception to the end of puberty, examining infant caloric intake and supply as possible factors modulating the epigenetic programming in favor of obesity, and examining the role of infant gut microbiome in developing infant's capacity to process nutrients may provide a better understanding of the interaction between critical nutritional influences in the control of human longitudinal growth and later-life obesity.

Emerging roles of the acid sphingomyelinase/ceramide pathway in metabolic and cardiovascular diseases: Mechanistic insights and therapeutic implications

Metabolic diseases have emerged as a leading cause of mortality from non-communicable diseases, posing a significant global public health challenge. Although the association between ceramides (Cers) and metabolic diseases is well-established, the role of the acid sphingomyelinase (ASMase)/Cer pathway in these diseases remains underexplored. This review synthesizes recent research on the biological functions, regulatory mechanisms, and targeted therapies related to the ASMase/Cer pathway in metabolic conditions, including obesity, diabetes, non-alcoholic fatty liver disease, and cardiovascular disease. The effects of the ASMase/Cer pathway on metabolic disease-related indicators, such as glycolipid metabolism, insulin resistance, inflammation, and mitochondrial homeostasis are elucidated. Moreover, this article discusses the therapeutic strategies using ASMase/Cer inhibitors for inverse prevention and treatment of these metabolic diseases in light of the possible efficacy of blockade of the ASMase/Cer pathway in arresting the progression of metabolic diseases. These insights offered herein should provide insight into the contribution of the ASMase/Cer pathway to metabolic diseases and offer tools to develop therapeutic interventions for such pathologies and their severe complications.

Physical activity in patients receiving peritoneal dialysis: a systematic evaluation and meta-analysis

BACKGROUND

Exercise has been proven to be beneficial for both the general population and individuals with chronic diseases. However, the specific effects of physical activity on patients undergoing peritoneal dialysis (PD) remain unclear.

AIM

This systematic review and meta-analysis aims to evaluate the effects of physical exercise on quality of life, physical function, pain, energy, sleep, and malnutrition-inflammation-atherosclerosis (MIA) syndrome in PD patients.

METHODS

We conducted a systematic search of PubMed, EMBASE, Web of science and the Cochrane Library for randomized controlled trials (RCTs) that compared routine care with physical activity interventions in patients with chronic kidney disease (CKD) undergoing PD. The search covered studies from database inception to December 2023. Outcomes were reported as mean differences (MD) with standard deviations (SD) and 95% confidence intervals (CI). All statistical analyses were performed using RevMan version 5.3.

RESULTS

We included nine RCTs involving 398 patients, with 199 (50%) randomized to the physical activity group. Follow-up ranged from 12 weeks to 6 months. Compared to routine care, the exercise group showed significant improvements in BKD (MD 9.98; 95% CI 2.14-17.82; p = 0.01), EKD (MD 7.15; 95% CI - 0.13-14.43; p = 0.05), social support (MD 9.51; 95% CI 0.27-18.75; p = 0.04), social interaction (MD 6.91; 95% CI 0.82-13.00; p = 0.03), and physical pain (MD 14.35; 95% CI 3.60-25.10; p = 0.009). Qualitative analysis revealed a significant decrease in homeostatic model assessment of insulin resistance (HOMA-IR), a significant increase in C-reactive protein (CRP), and improvements in sitting and standing tests (CS-30, FTTST, SS5) in the exercise group (p < 0.05).

CONCLUSIONS

This study represents the first meta-analysis comparing usual care with exercise interventions in PD patients. The findings indicate that exercise is a viable therapeutic option. Future research should prioritize the development of tailored exercise programs to optimize PD management.

Energy metabolism in health and diseases

Energy metabolism is indispensable for sustaining physiological functions in living organisms and assumes a pivotal role across physiological and pathological conditions. This review provides an extensive overview of advancements in energy metabolism research, elucidating critical pathways such as glycolysis, oxidative phosphorylation, fatty acid metabolism, and amino acid metabolism, along with their intricate regulatory mechanisms. The homeostatic balance of these processes is crucial; however, in pathological states such as neurodegenerative diseases, autoimmune disorders, and cancer, extensive metabolic reprogramming occurs, resulting in impaired glucose metabolism and mitochondrial dysfunction, which accelerate disease progression. Recent investigations into key regulatory pathways, including mechanistic target of rapamycin, sirtuins, and adenosine monophosphate-activated protein kinase, have considerably deepened our understanding of metabolic dysregulation and opened new avenues for therapeutic innovation. Emerging technologies, such as fluorescent probes, nano-biomaterials, and metabolomic analyses, promise substantial improvements in diagnostic precision. This review critically examines recent advancements and ongoing challenges in metabolism research, emphasizing its potential for precision diagnostics and personalized therapeutic interventions. Future studies should prioritize unraveling the regulatory mechanisms of energy metabolism and the dynamics of intercellular energy interactions. Integrating cutting-edge gene-editing technologies and multi-omics approaches, the development of multi-target pharmaceuticals in synergy with existing therapies such as immunotherapy and dietary interventions could enhance therapeutic efficacy. Personalized metabolic analysis is indispensable for crafting tailored treatment protocols, ultimately providing more accurate medical solutions for patients. This review aims to deepen the understanding and improve the application of energy metabolism to drive innovative diagnostic and therapeutic strategies.

The De Ritis ratio mediates the association between creatinine-to-body weight ratio and normoglycemic conversion in Chinese health examinees

To assess the associations between the creatinine-to-body weight (Cre/BW) ratio and reversion to normoglycemia mediated by the aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio. This retrospective cohort study included 24,884 prediabetic participants from health check-ups in 32 regions across 11 Chinese cities. We employed multivariable Cox regression to assess time-to-event outcomes, smooth curve fitting for trend analysis, and inflection point analysis to determine critical thresholds. Subgroup analyses were performed to explore interactions. Mediation analysis was conducted to clarify the mechanisms linking prediabetes with health outcomes. In the analysis of 24,884 individuals, it was observed that 49.08% of the prediabetic subjects experienced normoglycemic conversion during a follow-up period spanning 73,517.66 person-years. Following full adjustment, the Cre/BW ratio was positively associated with normoglycemic conversion among prediabetic individuals (HR 1.42, 95% CI 1.30-1.55). Multivariate smooth spline analysis revealed a nonlinear relationship between the Cre/BW ratio and glucose status conversion (P for nonlinearity < 0.05), with the curves leveling off when the Cre/BW ratio (×100) reached 1.34. Subgroup analysis and additional sensitivity analyses confirmed that the results between the Cre/BW ratio and glucose status conversion were robust. Additionally, the De Ritis ratio was found to explain 50% of the association between the Cre/BW ratio and the prediabetes-to-normoglycemia transition. A higher Cre/BW ratio was associated with a better chance of controlling blood glucose levels in prediabetic individuals, with the De Ritis ratio playing a key mediating role.

Natural compounds in the management of polycystic ovary syndrome: a comprehensive review of hormonal regulation and therapeutic potential

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder characterized by irregularities in gonadotropin secretion, hyperandrogenism, chronic anovulation, and polycystic ovarian morphology. In addition, it is often associated with metabolic dysfunctions, most notably insulin resistance (IR). This disorder affects approximately 6-20% of individuals, primarily emerging during early adolescence, and considerably increases the risk of conditions such as impaired glucose tolerance, type 2 diabetes, endometrial cancer, cardiovascular diseases, dyslipidemia, and postpartum complications. To date, there is no standardized protocol for treating PCOS. Existing therapies primarily rely on personalized pharmacotherapy and lifestyle modifications. However, these treatments may often lead to adverse effects, and most medications prescribed for PCOS are used off-label and have not secured approval from the U.S. Food and Drug Administration specifically for this condition. Recently, natural compounds have garnered considerable attention due to their efficacy in hormone modulation and minimal toxicity. Substances such as myo-inositol, resveratrol, berberine, and quercetin have shown promise in mitigating PCOS symptoms. Their multi-target properties offer the potential to achieve outcomes unattainable by single-target pharmaceuticals, particularly in managing heterogeneous conditions. This review aims to comprehensively analyze in vivo and in vitro research alongside clinical interventions to evaluate the influence of natural compounds on the prevalence of PCOS and their therapeutic potential. These investigations lay the groundwork for developing innovative therapeutic strategies for PCOS.

Clinical features of pneumatosis intestinalis induced by alpha- glucosidase inhibitor in patients with type 2 diabetes mellitus: a single center retrospective study

Purpose

Pneumatosis intestinalis (PI) is a rare but significant side effect associated with the use of alpha-glucosidase inhibitor (αGI) in the treatment of diabetes. This study aims to analyze the clinical features of PI induced by αGIs in patients with type 2 diabetes mellitus.

Methods

We conducted a retrospective analysis of patients diagnosed with PI between January 2018 and December 2023. Data collected included demographic characteristics, clinical symptoms and signs, laboratory findings, imaging results, endoscopic manifestations, treatments, and outcomes. Clinical characteristics were compared between patients who used acarbose and those who did not.

Results

A total of 48 patients with PI were included in the study, of whom 22 had used acarbose and 26 had not. The acarbose taken group was significantly older than the acarbose untaken group. Additionally, the prevalence of coronary heart disease and hypertension was markedly higher in patients taking acarbose. Importantly, total bilirubin levels were lower in those with PI who were on acarbose therapy.

Conclusion

Our findings highlight the need for increased vigilance regarding the potential development of PI in older diabetic patients with cardiovascular conditions following αGI administration. Timely intervention is crucial to prevent adverse outcomes. This study offers valuable insights for the future management of αGI in diabetes treatment.

Effects of supplementation with vitamin D3 on growth performance, lipid metabolism and cecal microbiota in broiler chickens

Lower intramuscular fat (IMF) and excessive abdominal fat reduce carcass quality in broilers. The study aimed to investigate the effects of dietary VD3 on growth performance, lipid metabolism and cecal microbiota in broilers over an 84-d feeding experiment. One-day-old male Luhua broilers (210) were randomly assigned to control (basal diet) and VD group (basal diet supplemented with 3,750 IU/kg VD3). Samples were collected after a 12-h fasted feeding on days 28, 56, and 84. Supplementary VD3 significantly enhanced average daily gain (ADG) in broilers aged 57-84 d and 1-84 d, and increased leg muscle rate and fat content in breast and leg muscles and reduced abdominal fat rate of broilers at 84 d. VD3 increased TG and glycogen content in the liver of 28- and 84-d-old broilers, serum TG and VLDL-C content at 56 and 84 d, and TC, HDL-C and LDL-C at 84 d. VD3 increased mRNA expressions of genes related to de novo lipogenesis (DNL) (mTOR, SREBP-1c, FAS and ACC), lipid oxidation (AMPK, PPARα, CPT-1α and ACO) and lipid transport (ApoB and MTTP), and FAS, ACC and CPT1 enzyme activities in the liver. However, mRNA levels of genes involved in DNL and cellular lipid uptake (LPL and FATP1) and LPL activity were decreased in abdominal adipose tissue, and that of genes involved in lipid oxidation and lipolysis (HSL and ATGL) was increased by VD3. LPL and FATP1 expression in breast and leg muscles was increased by VD3. Moreover, VD3 increased the abundance of cecum Bacteroides at 28 and 84 d, Rikenellaceae_RC9_gut_group and Faecalibacterium at 56 and 84 d, and Lachnoclostridium at 84 d. These bacteria were correlated with increased DNL, lipid oxidation and lipid transport in liver, and cellular lipid uptake in muscle, as well as decreased DNL and cellular lipid uptake, and increased lipid oxidation and lipolysis in abdominal adipose tissue. Altogether, supplementary VD3 in basal diet improved growth performance, increased IMF, and reduced abdominal fat rate, which is significant for enhancing feed utilization and improving the carcass quality of broilers. The regulation of VD3 on lipid metabolism could was associated with variation in cecal microbiota composition.

Exploring the heterogeneous targets of metabolic aging at single-cell resolution

Our limited understanding of metabolic aging poses major challenges to comprehending the diverse cellular alterations that contribute to age-related decline, and to devising targeted interventions. This review provides insights into the heterogeneous nature of cellular metabolism during aging and its response to interventions, with a specific focus on cellular heterogeneity and its implications. By synthesizing recent findings using single-cell approaches, we explored the vulnerabilities of distinct cell types and key metabolic pathways. Delving into the cell type-specific alterations underlying the efficacy of systemic interventions, we also discuss the complexity of integrating single-cell data and advocate for leveraging computational tools and artificial intelligence to harness the full potential of these data, develop effective strategies against metabolic aging, and promote healthy aging.

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

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

Epiberberine Improves Hyperglycemia and Ameliorates Insulin Sensitivity in Type 2 Diabetic Mice

AIM

Type 2 diabetes mellitus (T2DM) is a metabolic syndrome characterised by absolute or relative insufficiency of insulin secretion. The alkaloids from Rhizoma coptidis have potential hypoglycemic effects. Epiberberine (EPI), a protoberberine alkaloid extracted from Rhizome coptidis, has been found to regulate lipid metabolism. Our study aimed to investigate the antidiabetic effects of EPI on mice with T2DM, as well as its underlying mechanism.

METHODS

The T2DM model in mice was established using a combination of high-fat diet and streptozotocin. Animals were divided into the control, T2DM, EPI-low dose (50 mg/kg EPI), EPI-medium dose (100 mg/kg EPI), EPI-high dose (200 mg/kg EPI) and metformin (MTF) (200 mg/kg MTF) groups. Body weight, water/food intake, serum lipids, blood glucose tolerance, insulin sensitivity, histopathological alterations, insulin signalling pathway and inflammation-related pathways in each group were detected.

RESULTS

EPI significantly reduced blood glucose levels and water/food intake in T2DM mice. EPI reduced the levels of total cholesterol, total triglyceride, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase, and elevated the levels of high-density lipoprotein cholesterol in serum. EPI effectively improved oral glucose tolerance, alleviated hepatic insulin resistance, decreased glycosylated haemoglobin levels and increased liver glycogen content. EPI ameliorated the histopathological alterations of skeletal muscle and liver in T2DM mice. EPI stimulated the insulin signalling pathway by increasing glucose transporter type 4 levels and activating insulin receptor substrate-1, phosphatidylinositol 3-kinase and protein kinase B in skeletal muscle and liver. EPI reduced the levels of proinflammatory cytokine in serum and inhibited the activation of mitogen-activated protein kinase signalling in skeletal muscle and liver of diabetic mice.

CONCLUSION

Overall, these data demonstrate that EPI alleviates the symptoms of T2DM, providing new insights into EPI as a therapeutic compound for the alleviation of T2DM.

bta-miR-484 Inhibits Bovine Intramuscular Adipogenesis by Regulating Mitotic Clonal Expansion via the MAP3K9/JNK/CCND1 Axis

Intramuscular fat (IMF) content is a critical indicator of the beef nutritional value and flavor. In this study, we focused on bta-miR-484, a microRNA that is differentially expressed during the adipogenic differentiation of bovine intramuscular adipocytes and is negatively correlated with the IMF content across different cattle breeds. Our findings demonstrate that bta-miR-484 inhibits adipogenic differentiation without altering the fatty acid composition of bovine intramuscular adipocytes. miRNA pull-down and dual-luciferase reporter assays confirmed that MAP3K9 is a target gene of bta-miR-484. Furthermore, bta-miR-484 suppresses the JNK signaling pathway by targeting MAP3K9, leading to decreased CCND1 expression, which impedes the mitotic clonal expansion (MCE) process and inhibits intramuscular adipocyte differentiation. In summary, this study uncovers a novel mechanism by which bta-miR-484 regulates bovine IMF content and provides the first exploration of MCE during intramuscular adipocyte adipogenic differentiation. These findings offer valuable theoretical insights into beef cattle breeding and molecular improvements.

Effects of microencapsulated essential oils and seaweed meal on growth performance, digestive enzymes, intestinal morphology, liver functions, and plasma biomarkers in broiler chickens

Globally, poultry production has increased to meet the demand for animal protein. Traditionally, antibiotic growth promoters have been used to enhance growth performance and prevent infections in commercial poultry practices. However, concerns regarding antimicrobial resistance have triggered interest in alternative solutions, such as essential oils (EOs) and seaweed additives. The aim of the current study was to assess the impact of a microencapsulated blend of EOs (cinnamaldehyde, eugenol, and thymol) and Ascophyllum nodosum seaweed meal on growth performance, intestinal function, blood biomarkers, and hepatic gene expression in broiler chickens. A total of 440 Arbor Acres chicks were randomly assigned to either a control (CON) or treatment (NEX) group. Each treatment was divided into 11 replicates (20 birds per replicate). NEX chicks were supplemented with 100 mg/kg feed containing a microencapsulated blend of EOs (cinnamaldehyde, eugenol, and thymol) and Ascophyllum nodosum seaweed meal. Data were analyzed using the UNIVARIATE procedure in SAS software. Each replicate was considered an experimental unit. Over a 35-d period, NEX supplementation improved the feed conversion ratio (P = 0.02), reduced mortality rate (P = 0.01), and increased the European performance efficiency factor. No differences in carcass traits were observed between the 2 treatments (P > 0.05). Jejunal digestive enzyme activities, particularly those of amylase and lipase, were higher in NEX birds (P < 0.05) and correlated with morphometric parameters, such as villus height (P = 0.04) and muscular layer thickness (P < 0.01). Gene expression analysis revealed the upregulation of key genes related to nutrient transporters (solute carrier family 5 member 1 gene (SLC5A1), solute carrier family 1 member 1 gene (SLC1A1), solute carrier family 15 member 1 gene (SLC15A1)) in the jejunum (P < 0.05) and lipid metabolism (peroxisome proliferator-activated receptor alpha gene (PPARA) and microsomal triglyceride transfer protein gene (MTTP)) in the liver (P < 0.05) of NEX-supplemented birds. NEX treatment altered plasma biomarkers, including increased glucose (P < 0.01), insulin (P < 0.01), and protein profiles (P < 0.05) but decreased low-density lipoprotein cholesterol (P = 0.03), suggesting enhanced metabolic health. NEX supplementation improved growth performance, economic efficiency, intestinal morphology, digestive enzyme activity, liver function, and metabolic biomarkers in broiler chickens.

Effects of Sympathetic Denervation in Metabolism Regulation: A Novel Approach for the Treatment of MASLD?

Although metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, has become the most common chronic liver disorder, its complex pathophysiology has not been fully elucidated up to date. A correlation between elevated sympathetic activation and MASLD has been highlighted in recent preclinical and clinical studies. Furthermore, increased sympathetic activity has been associated with the main mechanisms involved in MASLD, such as lipid accumulation in the liver, insulin resistance, and metabolic dysregulation, while it has been also correlated with the progression of MASLD, leading to liver fibrosis. Preclinical studies demonstrated that therapies which ameliorate the activation of the sympathetic nervous system, such as renal and liver sympathetic denervation, reduce hepatic insulin resistance, decrease hepatic glucose production, and reverse hepatic steatosis in high-fat-diet models. However, data from clinical trials regarding the effect of renal denervation on metabolic parameters are conflicting, since several trials reported a favorable effect, while other trials stated no significant difference, with the profound limitation of the lack of originally designed denervation trials in this setting. Thus, a thorough review of the role of the sympathetic nervous system in the pathophysiology of MASLD, as well as the results of recent sympathetic denervation studies and trials regarding metabolic regulation and MASLD treatment would be of great importance.

Mitochondria and the Repurposing of Diabetes Drugs for Off-Label Health Benefits

This review describes our current understanding of the role of the mitochondria in the repurposing of the anti-diabetes drugs metformin, gliclazide, GLP-1 receptor agonists, and SGLT2 inhibitors for additional clinical benefits regarding unhealthy aging, long COVID, mental neurogenerative disorders, and obesity. Metformin, the most prominent of these diabetes drugs, has been called the "Drug of Miracles and Wonders," as clinical trials have found it to be beneficial for human patients suffering from these maladies. To promote viral replication in all infected human cells, SARS-CoV-2 stimulates the infected liver cells to produce glucose and to export it into the blood stream, which can cause diabetes in long COVID patients, and metformin, which reduces the levels of glucose in the blood, was shown to cut the incidence rate of long COVID in half for all patients recovering from SARS-CoV-2. Metformin leads to the phosphorylation of the AMP-activated protein kinase AMPK, which accelerates the import of glucose into cells via the glucose transporter GLUT4 and switches the cells to the starvation mode, counteracting the virus. Diabetes drugs also stimulate the unfolded protein response and thus mitophagy, which is beneficial for healthy aging and mental health. Diabetes drugs were also found to mimic exercise and help to reduce body weight.

Association Between Peritoneal Glucose Absorption, Lipid Metabolism, and Cardiovascular Disease Risk in Nondiabetic Patients on Peritoneal Dialysis

BACKGROUND

Excessive sugar intake increases the energy metabolic burden and the risk of cardiovascular disease (CVD). Patients on peritoneal dialysis absorb much more glucose than the World Health Organization recommends, but the link to CVD is unclear.

OBJECTIVE

To identify the association between peritoneal glucose absorption, lipid metabolism, and CVD.

METHODS

We applied generalized additive mixed effects and mixed effects Cox proportional hazard models to evaluate the impact of peritoneal glucose absorption on lipid profiles and CVD risk. We performed subgroup analyses by using protein intake (normalized protein nitrogen appearance [nPNA] and normalized protein catabolic rate [nPCR] were used to assess protein intake) and high-sensitivity C-reactive protein (hs-CRP).

RESULTS

After multivariable adjustment, peritoneal glucose absorption per 10 g/d increase was associated with an increase in cholesterol of 0.145 (95% confidence interval [CI]: 0.086-0.204) mmol/L. No link with the total risk of CVD was observed; however, protein intake and hs-CRP levels affected the relationship between glucose absorption and CVD risk. Patients with values for nPNA and nPCR <1.0 g/(kg·d) were associated with a lower risk of CVD (hazard ratio [HR] 95% CI: 0.68 (0.46-0.98)) with glucose absorption per 10 g/d increase. While patients with hs-CRP levels ≥3 mg/d or values for nPNA or nPCR ≥1.0 g/(kg·d) were associated with a higher risk of CVD (HR 95% CI: 1.32 (1.07-1.63); 1.31 (1.02-1.68)) for glucose absorption per 10 g/d increase.

CONCLUSIONS

Our study found a positive correlation between peritoneal glucose absorption and lipid profiles. Increased glucose absorption was associated with a lower risk of CVD in lower protein intake patients and a higher risk of CVD in higher hs-CRP or protein intake levels in patients on peritoneal dialysis.

Diabetes and its Silent Partner: A Critical Review of Hyperinsulinemia and its Complications

In this complex realm of diabetes, hyperinsulinemia is no longer regarded as just a compensatory response to insulin resistance but rather has evolved into an integral feature. This comprehensive review provides a synthesis of the current literature, including various aspects associated with hyperinsulinemia in diabetic complications. Hyperinsulinemia has been shown to be more than just a compensatory mechanism, and the key findings demonstrate how hyperinsulinism affects the development of cardiovascular events as well as microvascular complications. Additionally, recognizing hyperinsulinemia as a modifiable factor, the diabetes management paradigm shifts towards cognitive ones that consider the use of lifestyle modifications in combination with newer pharmacotherapies and precision medicine approaches. These findings have crucial implications for the clinical work, requiring a careful appreciation of hyperinsulinemia's changing aspects as well as incorporation in personalized treatment protocol. In addition, the review focuses on bigger issues related to public health, showing that prevention and early diagnosis will help reduce the burden of complications. Research implications favor longitudinal studies, biomarker discovery, and the study of emerging treatment modalities; clinical practice should adopt global evaluations, patient education, and precision medicine adaptation. Finally, this critical review provides an overview of the underlying processes of hyperinsulinemia in diabetes and its overall health effects.

Cost-utility analysis of once-weekly insulin icodec and once-daily insulin glargine in patients with type 2 diabetes receiving basal-bolus insulin therapy in China

OBJECTIVE

The purpose of this study is to explore the rational pricing range for the once-weekly administration of insulin icodec in the treatment of type 2 diabetes patients in China who have already received basal insulin therapy.

METHODS

The data foundation of this study originates from the ONWARDS 4 clinical trial and research materials on Chinese type 2 diabetes patients. By comprehensively applying cost-utility analysis methods and binary search techniques, the appropriate price positioning of insulin icodec was determined from the perspective of China's healthcare system.

RESULTS

In the long-term treatment simulation, we found that insulin icodec and insulin glargine performed similarly in terms of quality-adjusted life years (QALYs), with 10.15 and 10.07 years, respectively. Although the annual cost of insulin icodec was initially assumed to be equivalent to that of insulin glargine, in-depth analysis revealed that insulin icodec may have higher cost-effectiveness potential. Further price sensitivity analysis indicated that the reasonable cost range of insulin icodec lies between $851.95 and $1358.25. After fine-tuning through univariate sensitivity analysis, this cost range was revised to $784.90 to $1145.96, a conclusion that was robustly validated in subsequent probabilistic sensitivity analysis and scenario simulations.

CONCLUSION

The conclusion drawn from this study is that, with insulin glargine as the cost reference, the economic cost of insulin icodec for Chinese type 2 diabetes patients is expected to range from $784.90 to $1145.96, providing a reference basis for clinical decision-making and healthcare policy formulation.

Insulin and leptin acutely modulate the energy metabolism of primary hypothalamic and cortical astrocytes

Astrocytes constitute a heterogeneous cell population within the brain, contributing crucially to brain homeostasis and playing an important role in overall brain function. Their function and metabolism are not only regulated by local signals, for example, from nearby neurons, but also by long-range signals such as hormones. Thus, two prominent hormones primarily known for regulating the energy balance of the whole organism, insulin, and leptin, have been reported to also impact astrocytes within the brain. In this study, we investigated the acute regulation of astrocytic metabolism by these hormones in cultured astrocytes prepared from the mouse cortex and hypothalamus, a pivotal region in the context of nutritional regulation. Utilizing genetically encoded, fluorescent nanosensors, the cytosolic concentrations of glucose, lactate, and ATP, along with glycolytic rate and the NADH/NAD+ redox state were measured. Under basal conditions, differences between the two populations of astrocytes were observed for glucose and lactate concentrations as well as the glycolytic rate. Additionally, astrocytic metabolism responded to insulin and leptin in both brain regions, with some unique characteristics for each cell population. Finally, both hormones influenced how cells responded to elevated extracellular levels of potassium ions, a common indicator of neuronal activity. In summary, our study provides evidence that insulin and leptin acutely regulate astrocytic metabolism within minutes. Additionally, while astrocytes from the hypothalamus and cortex share similarities in their metabolism, they also exhibit distinct properties, further underscoring the growing recognition of astrocyte heterogeneity.

Elevated triglyceride glucose index is associated with advanced cardiovascular kidney metabolic syndrome

The cardiovascular kidney metabolic (CKM) syndrome is a dynamic geriatric condition that has received limited research attention regarding its potential associations with the triglyceride glucose (TyG) index. This study aims to explore the potential association between the TyG index and advanced CKM syndrome. Data for this cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. The association between the TyG index and the risk of advanced CKM syndrome was investigated using multivariable logistic regression models. Additionally, a restricted cubic spline (RCS) analysis was employed to assess the dose-response relationship between the TyG index and the risk of advanced CKM syndrome. A total of 7904 participants were included in this study, with a mean TyG index of 5.04 ± 0.41. The prevalence of advanced CKM syndrome among the participants was 14.85%. Our findings indicated that as the TyG index quartiles increased, the risk of advanced CKM syndrome also increased. The results from the three regression analysis models indicated a positive association between the continuous TyG index and advanced CKM syndrome. Furthermore, the quartiles of the TyG index were significantly associated with an increased prevalence of advanced CKM syndrome in the fully adjusted models (TyG index Q4 vs. Q1, OR = 1.94, 95% CI 1.37-2.75, P < 0.001). The results of the RCS analysis indicated a linear and positive association between the TyG index and advanced CKM syndrome. The results indicated that elevated TyG index is associated with an increased prevalence of advanced CKM syndrome. This suggests that the TyG index may be a useful tool for assessing the risk of advanced CKM syndrome.

Role of Abscisic Acid in the Whole-Body Regulation of Glucose Uptake and Metabolism

Abscisic acid (ABA) is a hormone with a long evolutionary history, dating back to the earliest living organisms, of which modern (ABA-producing) cyanobacteria are likely descendants, which existed long before the separation of the plant and animal kingdoms, with a conserved role as signals regulating cell responses to environmental challenges. In mammals, along with the anti-inflammatory and neuroprotective function of ABA, nanomolar ABA regulates the metabolic response to glucose availability by stimulating glucose uptake in skeletal muscle and adipose tissue via an insulin-independent mechanism and increasing metabolic energy production and also dissipation in brown and white adipocytes. Chronic ABA intake of micrograms per Kg body weight improves blood glucose, lipids, and morphometric parameters (waist circumference and body mass index) in borderline subjects for prediabetes and metabolic syndrome. This review summarizes the most recent in vitro and in vivo data obtained with nanomolar ABA, the involvement of the receptors LANCL1 and LANCL2 in the hormone's action, and the importance of mammals' endowment with two distinct hormones governing the metabolic response to glucose availability. Finally, unresolved issues and future directions for the clinical use of ABA in diabetes are discussed.

Association of non-insulin-dependent insulin resistance indices with lower limb artery restenosis after drug-coated balloon angioplasty

BACKGROUND

This study aimed to investigate the associations between noninsulin-dependent insulin resistance indices (NI-IRIs), including the triglyceride-glucose (TyG) index, TyG-BMI, triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), as well as the occurrence of restenosis in patients with lower extremity atherosclerotic occlusive disease after drug-coated balloon (DCB) treatment.

METHODS

The primary endpoint was restenosis within one year after the procedure, which was defined as ≥ 50% stenosis of the treated artery segment. The association between NI-IRIs and restenosis was assessed via multivariable logistic regression analysis. Restricted cubic spline (RCS) analysis was performed to quantify nonlinearity. The consistency of these associations was confirmed through subgroup and interaction analyses. Additionally, the additional predictive value of NI-IRIs beyond established risk factors for restenosis was evaluated via receiver operating characteristic (ROC) curves, the net reclassification improvement (NRI), and integrated discrimination improvement (IDI) indices.

RESULTS

Except for the TyG index, the other three NI-IRIs demonstrated nonlinear relationships with the probability of postoperative restenosis. Specifically, TG/HDL-C (inflection point: 1.48, P for nonlinearity: 0.003) exhibited a saturating effect, whereas METS-IR (inflection point: 49.30, P for nonlinearity: 0.017) and TyG-BMI (inflection point: 221.53, P for nonlinearity: 0.039) showed threshold effects. Subgroup analysis revealed that the interactions among the subgroups were not statistically significant. Furthermore, among the four NI-IRIs, the addition of the TG/HDL-C index significantly enhanced the predictive power of the base model for restenosis in ASO patients following DCB angioplasty (AUC values: 0.726 vs. 0.760, P = 0.042). The P values for the NRI and IDI were 0.001 and 0.002, respectively.

CONCLUSION

TG/HDL-C showed a saturating effect on restenosis within one year after DCB treatment in ASO patients, and METS-IR and TyG-BMI showed threshold effects. The addition of the TG/HDL-C index significantly improved the predictive ability of the base model for restenosis in ASO patients who underwent DCB angioplasty.

Effects of Isoflavone Intake on Energy Requirement, Satiety, and Body Composition of Neutered Adult Cats

Isoflavones are composed of phytoestrogens (genistein and daidzein), which can be metabolized by cats. These compounds can promote the maintenance of lean body mass and control food intake. These effects are desirable in neutered animals, as they are predisposed to obesity. The objective of this study was to evaluate the effects of dietary supplementation of 1.0% isoflavone on the metabolizable energy intake, serum concentrations of satiety-related hormones and peptides, and body composition of neutered cats. Sixteen neutered adult cats were blocked by gender and divided into two groups (n = 8): the control group (CG) received a commercial diet, while the isoflavone group (IG) received the same diet supplemented by 1% of isoflavone for 99 days. Computed tomography was performed on the first and last experimental days to assess the animals' body composition. Satiety challenges were conducted on days 19 and 44. In the last day of the study, blood samples were collected to determine the concentration of insulin, ghrelin, leptin, peptide YY, and GLP-1. A statistical analysis was conducted using R software 3.5.2, considering both the interaction and individual effects of group and time (p < 0.05). The average intake of genistein in the IG was 0.75 ± 0.10 mg/kg body weight, and daidzein intake was 51.73 ± 7.05 mg/kg. No significant individual or interaction effects were observed for any of the analyzed variables. Therefore, the inclusion of 1.0% isoflavone in the diet did not affect the energy requirements, satiety responses, or body composition of neutered adult cats.

The expression of glycolysis-related proteins in urine significantly increases after running

Objective

Glucose metabolism is the main way in which cells obtain energy during exercise and plays an important role in exercise. The purpose of this study was to explore the changes in the expression of glucose metabolism-related proteins in urine after running, and finally applied to the monitoring of running training.

Methods

Urine samples were collected before and after running, and urine proteomics information was collected to explore the expression of proteins in the urine using LC-MS/MS in DDA mode and DIA mode. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of target proteins in monitoring running training.

Results

A total of 140 proteins were identified using LC-MS/MS in DDA mode, of which 49 urine proteins showed increased expression after running. KEGG analysis revealed that glucose metabolism-related proteins are mainly concentrated in glycolysis. There were six glycolysis-related proteins, among which urine proteins PKM, TPI1, ENO1 and LDHB were significantly increased after running (P < 0.05). This changes in urine proteins PKM, TPI1, ENO1 and LDHB were further verified by the results of LC-MS/MS in DIA mode. The concentrations of the urine proteins TPI1, ENO1 and LDHB showed a significant linear relationship with PKM. ROC curve analysis showed that PKM, TPI1, ENO1 and LDHB proteins in urine had good monitoring values for running training.

Conclusion

The expression of glycolysis-related proteins PKM, TPI1, ENO1 and LDHB in urine was significantly increased after running, which may be applied to the monitoring of running training.

Anti-Amyloid Aggregation and Anti-Hyperglycemic Activities of Novel Ruthenium Uracil Schiff Base Compounds

The formation and characterization of new diamagnetic ruthenium uracil mono-imine compounds: [(η6-p-cymene)RuII(L)Cl][BF4] (L=H2urpda=5-((pyridin-2-yl)methyleneamino)-6-aminouracil) for 1, urdpy=6-amino-1,3-dimethyl-5-((pyridin-2-ylmethylene)amino)uracil) for 2 or urqda=5-((quinolin-2-yl)methyleneamino)-6-aminouracil) for 3); cis-[Ru(bipy)2(urpy)](BF4)2 (4) (urpy=5-((pyridin-2-yl)methyleneamino)uracil) and cis-[Ru(bipy)2(dapd)] (5) (H2dadp=5,6-diaminouracil) are described. A ruthenium(IV) uracil Schiff base compound, trans-[Ru(urpda)(PPh3)Cl2] (6) was also formed. Various physicochemical techniques were utilized to characterize the novel ruthenium compounds. Similarly, the stabilities of 1-3 and 6 monitored in chloro-containing and the non-coordinating solvent, dichloromethane show that they are kinetically inert, whereas, in a high nucleophilic environment, the chloride co-ligands of these ruthenium complexes were rapidly substituted by DMSO. In contrast, the substitution of the labile co-ligands for these ruthenium complexes by DMSO molecules in a high chloride content was suppressed. Solution chemical reactivities of the different ruthenium complexes were rationalized by density functional theory computations. Furthermore, the binding affinities and strengths between BSA and the respective ruthenium complexes were monitored using fluorescence spectroscopy. In addition, the in vitro anti-diabetic activities of the novel metal complexes were assessed in selected skeletal muscle and liver cell lines.

Therapeutic opportunities in targeting the protective arm of the renin-angiotensin system to improve insulin sensitivity: a mechanistic review

In recent years, the knowledge of the physiological and pathophysiological roles of the renin-angiotensin system (RAS) in glucose metabolism has advanced significantly. It is now well-established that blockade of the angiotensin AT1 receptor (AT1R) improves insulin sensitivity. Activation of the AT2 receptor (AT2R) and the MAS receptor are significant contributors to this beneficial effect. Elevated availability of angiotensin (Ang) II) for interaction with the AT2R and increased Ang-(1-7) formation during AT1R blockade mediate these effects. The ongoing development of selective AT2R agonists, such as compound 21 and the novel Ang III peptidomimetics, has significantly advanced the exploration of the role of AT2R in metabolism and its potential as a therapeutic target. These agents show promise, particularly when RAS inhibition is contraindicated. Additionally, other RAS peptides, including Ang IV, des-Asp-Ang I, Ang-(1-9), and alamandine, hold therapeutic capability for addressing metabolic disturbances linked to type 2 diabetes. The possibility of AT2R heteromerization with either AT1R or MAS receptor offers an exciting area for future research, particularly concerning therapeutic strategies to improve glycemic control. This review focuses on therapeutic opportunities to improve insulin sensitivity, taking advantage of the protective arm of the RAS.

Co-Micronized Palmitoylethanolamide and Rutin Associated With Hydroxytyrosol Recover Diabesity-Induced Hepatic Dysfunction in Mice: In Vitro Insights Into the Synergistic Effect

Metabolic dysfunction-associated fatty liver disease (MAFLD) and diabesity (diabetes related to obesity) are interrelated since glucose and lipid alterations play a vital role in the development of both disorders. Due to their multi-variant metabolic features, more than one drug or natural product may be required to achieve proper therapeutic effects. This study aimed to evaluate the effectiveness of a formulation containing co-micronized palmitoylethanolamide and rutin (PEA-Rut) associated with hydroxytyrosol (HT), namely NORM3, against hepatic damage and metabolic alterations in high-fat diet (HFD)-induced diabesity in mice. NORM3 decreased the body weight and fat mass of obese mice. The formulation improved HFD-altered insulin sensitivity and hepatic glucose production and metabolism, as shown by glucose, insulin, pyruvate tolerance tests, Western blot, and real-time PCR. In the liver, NORM3 limited macro- and micro-vacuolar steatosis, as revealed by morphological analysis, and reduced the associated hepatic inflammation. NORM3 counteracted lipid dysfunctions of HFD animals, activating AMPK, a key cellular energy sensor, and normalizing the expression of carnitine palmitoyl-transferase (CPT)1, a rate-limiting enzyme of fatty acid β-oxidation, and other genes involved in lipid homeostasis. Relevantly, the hepatic antioxidant activity of NORM3 was proved (reduced ROS and increased detoxifying factors and enzymes). Finally, in vitro synergistic protective effects of the components (PEA-Rut and HT) on H2O2-induced oxidative challenge in HepG2 were determined (ROS production, inflammation, and antioxidant defense). Our results show the beneficial effect of NORM3 and its potential as an innovative phytotherapeutic combination in limiting hepatic damage progression and counteracting glucose and lipid dysmetabolism associated with diabesity.

The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort

BACKGROUND

Globally, cardiovascular disease (CVD) constitutes the primary cause of death, with insulin resistance (IR), measured by the triglyceride-glucose (TyG) index, and visceral obesity, reflected by the Chinese Visceral Adiposity Index (CVAI), as key contributors. However, the relationship between the TyG index and CVAI regarding CVD risk remains insufficiently understood. This research investigates the interactive impact of the TyG index and CVAI on the risk of cardiovascular disease.

METHODS

We analyzed data from 8,358 participants from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Participants were classified into four groups based on median TyG index (8.59) and CVAI values (101.26), and baseline characteristics were summarized. Missing data were addressed using multiple imputation by chained equations (MICE). Cox proportional hazards models assessed associations between TyG index, CVAI, CVD, coronary heart disease (CHD), and stroke risks, with Kaplan-Meier analysis used for cumulative hazard. Interaction effects were evaluated using both multiplicative and additive measures. Subgroup analyses by age, gender, and clinical conditions were conducted to explore interaction effects across different populations. Sensitivity analyses re-tested models, excluding the covariates BMI and diabetes, using tertiles for classification, and re-evaluating imputed data.

RESULTS

Over the 9-year follow-up, 1,240 participants (14.8%) developed CVD, including 896 cases of CHD and 475 strokes. Kaplan-Meier curves indicated that participants with low TyG index but high CVAI had the highest cumulative hazard of CVD. Cox regression showed that this group had the highest CVD risk (HR = 1.87, 95% CI: 1.57-2.24), followed by those with both high TyG index and high CVAI (HR = 1.75, 95% CI: 1.49-2.06). Interaction analysis revealed a negative interaction effect between high TyG and high CVAI on CVD and CHD risks, with no significant effect on stroke. Subgroup and sensitivity analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions.

CONCLUSION

This study suggests that the interaction between IR (TyG index) and visceral fat accumulation (CVAI) plays a complex role in CVD risk, with a potential antagonistic effect observed between high TyG and high CVAI on CVD events. These findings highlight the importance of considering both IR and visceral adiposity in CVD risk assessments to improve the identification of high-risk individuals.

Mechanisms of Insulin Signaling as a Potential Therapeutic Method in Intestinal Diseases

Gastrointestinal diseases are becoming a growing public health problem. One of them is inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD). The incidence of IBD is increasing in developing countries and declining in developed countries, affecting people of all ages. Researchers have been exploring new treatment options including insulin signaling pathways in the inflammation of the gastrointestinal tract. It seems that a better understanding of the mechanism of IGF-1, GLP-1 and TL1A on the gut microbiota and inflammation may provide new advances in future therapeutic strategies for patients with IBD, but also other intestinal diseases. This review aims to synthesize insights into the effects of GLP, IGF and anti-TL1A on inflammation and the gut microbiota, which may enable their future use in therapy for people with intestinal diseases.

Effects of Baccharis dracunculifolia DC on an Innovative Animal Model of Cardiometabolic Syndrome

Background/Objective: Cardiometabolic syndrome (CMS) is a complex clinical condition that encompasses metabolic dysregulation, cardiovascular disease, and diabetes risk factors. Worldwide, CMS is underdiagnosed, and its occurrence significantly increases cardiovascular morbimortality. Despite available pharmacological treatments, the approach is fragmented, and the associated clinical conditions are treated independently. This approach may be partially due to limited preclinical models to mimic the clinical conditions of CMS. Therefore, our study aims to present an innovative animal model of cardiometabolic syndrome and evaluate the effects of Baccharis dracunculifolia on the set of clinical alterations associated with the condition. Methods: Female Wistar rats were induced to develop diabetes, fed a cholesterol-enriched diet, and exposed to the smoke of 9 cigarettes/day for 6 weeks. During the last 2 weeks, the rats were treated with vehicle, B. dracunculifolia (30, 100, and 300 mg/kg), or a combination of simvastatin and insulin. At the end of the treatment, plasma lipid levels were measured, and the liver was analyzed histologically for hepatic lipid quantification and oxidative stress assessment. Results: Phytochemical analysis revealed seven phenolic acids and six flavonoids in the extract. B. dracunculifolia showed significant hepatoprotective effects, reducing AST and ALT levels and lowering both plasma and hepatic lipid levels. The extract also reversed hepatic steatosis and demonstrated antioxidant properties. Conclusions: These findings suggest that B. dracunculifolia may be a therapeutic option for the metabolic dysregulation present in CMS.

Metagenomic and transcriptomic profiling of the hypoglycemic and hypotriglyceridemic actions of Tremella fuciformis-derived polysaccharides in high-fat-diet- and streptozotocin-treated mice

Mushroom polysaccharides have great anti-diabetes potential. The fruiting body of Tremella fuciformis is rich in polysaccharides. However, few studies have been performed to date on T. fuciformis-derived polysaccharides (TPs) in terms of anti-diabetes potential. Our previous studies showed that novel TPs with medium molecular weights exhibited the highest anti-skin aging activities among the tested samples in D-galactose-treated mice. In the present study, the effects of these novel TPs, named TP, on high-fat-diet- and streptozotocin-treated mice were assessed, and their potential biological mechanisms were explored by metagenomic and transcriptomic analyses. Oral administration of TP markedly reduced blood glucose and TG levels, alleviated emaciation, improved anti-oxidant capacity, and protected the functions of β-cells at a dose of 100 mg kg-1 in diabetic mice. Meanwhile, the taxonomic compositions and functional properties of fecal microbiota were altered considerably by TP, as evidenced by partial restoration of the imbalanced gut microbiota and the higher abundances of Bacteroides, Phocaeicola, Bifidobacterium, and Alistipes compared to the model mice, corresponding to the upregulation of four enriched KEGG pathways of microbial communities such as the digestive system, cardiovascular disease, parasitic infectious disease, and cell growth and death. Further transcriptomic analysis of liver tissues identified 35 enriched KEGG pathways associated with metabolism and cellular signaling processes in response to TP. These results demonstrated the biological mechanisms underlying the hypoglycemic and hypotriglyceridemic activities of TP. The findings expanded our understanding of the anti-diabetic mechanisms for mushroom polysaccharides and provided new clues for future studies.

Role of SIRPG gene in type 1 diabetes and lichen planus

Type 1 diabetes (T1D) is a form of diabetes caused by pancreatic β-cell destruction and absolute insulin deficiency. Lichen planus (LP) is an idiopathic inflammatory skin disease of unclear etiology. The role of SIRPG gene dysregulation in T1D and LP remains unclear. Mendelian randomization (MR) using matched samples was employed to study causal relationship between T1D and increased risk of LP. T1D-related single nucleotide polymorphism identification was conducted. Datasets GSE156035 for T1D and GSE52130 for LP were obtained from gene expression omnibus. Differentially expressed genes were identified, analyses included weighted gene co-expression network analysis, functional enrichment, gene set enrichment analysis, and protein-protein interaction network construction and analysis. Heatmaps of gene expression levels were generated. Comparative toxicogenomics database was used to identify diseases most relevant to core genes. Inverse variance weighted, MR-Egger, weighted median methods estimated genetic predisposition between T1D and LP, showing consistent positive correlations using both weighted median and inverse variance weighted methods. Horizontal pleiotropy analysis with MR-Egger intercept indicated no evidence of significant directional pleiotropy (P = .70645) for LP. There was no evidence of directional pleiotropy effects between T1D and LP. One hundred eighteen differentially expressed genes were identified. In biological processes, they were mainly enriched in apoptosis, inflammatory response, insulin receptor signaling pathway, glucose metabolism. In cellular components, enrichment was observed in mediator complex and replication fork. In molecular function, they were concentrated in leukotriene receptor activity and helicase activity. Kyoto Encyclopedia of Genes and Genomes analysis revealed enrichment in metabolic pathways, PI3K-Akt signaling pathway, cell cycle, p53 signaling pathway, AGE-RAGE signaling pathway in diabetic complications. Weighted gene co-expression network analysis with a soft threshold power of 4. SIRPG showing high expression in both T1D and LP samples. There is a positive causal relationship between T1D and LP. Comparative toxicogenomics database analysis revealed associations of core genes with metabolic syndrome, lipid metabolism disorders, cardiovascular diseases, immune system diseases, peripheral neuropathic pain, and inflammation. SIRPG is highly expressed in both T1D and LP, providing a new insight into the pathogenesis of T1D and LP.

The Role of Insulin Within the Socio-Psycho-Biological Framework in Type 2 Diabetes-A Perspective from Psychoneuroimmunology

The interplay between socio-psychological factors and biological systems is pivotal in defining human health and disease, particularly in chronic non-communicable diseases. Recent advancements in psychoneuroimmunology and mitochondrial psychobiology have emphasized the significance of psychological factors as critical determinants of disease onset, progression, recurrence, and severity. These insights align with evolutionary biology, psychology, and psychiatry, highlighting the inherent social nature of humans. This study proposes a theory that expands insulin's role beyond traditional metabolic functions, incorporating it into the Mitochondrial Information Processing System (MIPS) and exploring it from an evolutionary medicine perspective to explore its function in processing psychological and social factors into biological responses. This narrative review comprises data from preclinical animal studies, longitudinal cohort studies, cross-sectional studies, machine learning analyses, and randomized controlled trials, and investigates the role of insulin in health and disease. The result is a proposal for a theoretical framework of insulin as a social substance within the socio-psycho-biological framework, emphasizing its extensive roles in health and disease. Type 2 Diabetes Mellitus (T2DM) with musculoskeletal disorders and neurodegeneration exemplifies this narrative. We suggest further research towards a comprehensive treatment protocol meeting evolutionary expectations, where incorporating psychosocial interventions plays an essential role. By supporting the concept of 'insulin resilience' and suggesting the use of heart rate variability to assess insulin resilience, we aim to provide an integrative approach to managing insulin levels and monitoring the effectiveness of interventions. This integrative strategy addresses broader socio-psychological factors, ultimately improving health outcomes for individuals with T2DM and musculoskeletal complications and neurodegeneration while providing new insights into the interplay between socio-psychological factors and biological systems in chronic diseases.

A Study on Nonvibration-Exposed Organs Correlated Indices as Diagnostic Biomarkers of Hand-Arm Vibration Syndrome

OBJECTIVE

The aim of the study is to explore the feasibility of using nonvibration-exposed organ-related indices as vibration-induced white finger (VWF) diagnostic biomarkers.

METHODS

Individuals were selected from a factory in China using the judgment sampling method. They were divided into control (con), non-VWF, and VWF groups according to the presence/absence of exposure to hand-transmitted vibration and VWF. Blood samples were collected for ELISA tests.

RESULTS

Analysis of receiver operating characteristic curves was done on six indicators to assess their diagnostic sensitivity for VWF. Area under the receiver operating characteristic curve for insulin was 0.909 and was 0.923 for aspartate aminotransferase.

CONCLUSIONS

Insulin and aspartate aminotransferase could be used as indices for the diagnosis of hand-arm vibration syndrome.