Molecular Events Linking Oxidative Stress and Inflammation to Insulin Resistance and β-Cell Dysfunction

A decade review on phytochemistry and pharmacological activities of Cynomorium songaricum Rupr.: Insights into metabolic syndrome

BACKGROUND

Cynomorium songaricum Rupr. (CSR), a perennial herb with a rich history in traditional medicine, has demonstrated therapeutic potential against metabolic syndrome (MetS) through its active compounds, including proanthocyanidins, polysaccharides, and triterpenoids. MetS, a global health concern, encompasses interlinked conditions such as obesity, type 2 diabetes mellitus (T2DM), and inflammation. This review synthesizes recent findings on CSR's pharmacological and phytochemical properties, focusing on its role in ameliorating MetS.

METHODS

Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, relevant studies were retrieved from PubMed, Web of Science, and CNKI databases up to December 2024. Keywords included "Cynomorium Songaricum Rupr.", "Cynomorii Herba", "Suoyang", "Suo Yang", "Metabolic syndrome", "Proanthocyanidins", "Polysaccharides" and "Triterpenoids" and their combinations. Inclusion criteria emphasized studies exploring CSR's impact on MetS, while duplicate, low-quality studies and studies not written in Chinese, English, or unrelated were excluded.

RESULTS

A total of 92 studies were analyzed, revealing that CSR's active components exhibit multi-target effects. Proanthocyanidins reduce glucose absorption and oxidative stress, polysaccharides enhance insulin sensitivity and gut microbiota composition, and triterpenoids mitigate obesity and mitochondria damage. These mechanisms collectively contribute to the beneficial effects of CSR against MetS.

CONCLUSION

CSR presents a promising natural therapy for MetS, utilizing its pharmacologically active compounds to address core metabolic dysfunctions. Future studies should focus on clinical validation and safety assessments to facilitate CSR's integration into modern therapeutic regimens.

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.

Nine undescribed pregnane glycosides from Gymnema sylvestre and their glucose uptake and GLUT4 translocation activities

A phytochemical investigation on the ethyl acetate fraction of Gymnema sylvestre led to the production of nine previously undescribed C21 steroidal glycosides sylvepregosides F-N (1-9), as well as ten known analogues, prosapogenin (10), 20-O-benzoyl-12-O-cinnamoyl-3β,5α,8β,12β,14β,17β,20-heptahydroxy-(20S)-pregn-6-ene (11), 12-O-cinnamoyl-3β,5α,8β,12β,14β,17β,20-heptahydroxy- (20S)-pregn-6-ene (12), stephanoside K (13), gymnepregoside C (14), gymnepregoside D (15), stephanoside O (16), isokidjoladinin (17), gymsyloside D (18) and gymsyloside C (19). The structures of these isolated compounds were elucidated based on extensive 1D and 2D nuclear magnetic resonance (NMR) spectra with mass spectrometry data. The biological activities screening demonstrated that compounds 1, 3-6, 8-10, 12-14, 17, and 18 promoted glucose uptake by the range of 1.06-1.97 folds. In addition, compounds 3-6, 8, 13, 14, and 19 could promote GLUT-4 translocation to the plasma membrane in L6 cells.

Assessing the Impact of Serum Per- and Polyfluoroalkyl Substance Concentrations on Immune Function in an Industrialized Region of China

This study investigates the presence and health implications of per- and polyfluoroalkyl substances (PFAS) in human serum samples collected from white-collar workers in an industrialized region of China. Our research offers fresh insights into the underexplored area of nonoccupational PFAS exposure among white-collar workers, shedding light on health risks linked to industrial PFAS pollution. Seven PFAS compounds were measured. Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) emerged as predominant pollutants, with Σ7PFAS concentrations averaging 65.486 ng/mL. Gender differences showed higher serum Σ7PFAS levels in males, and age-related analyses suggested PFAS accumulation over time, with higher concentrations in older groups. Additionally, significant correlations were found between PFAS concentrations and biomarkers of oxidative stress and immune interference, specifically malondialdehyde (MDA) and immunoglobulin M (IgM), indicating that PFAS exposure may contribute to oxidative damage and potential immunosuppression. The study highlights regional and international variations in PFAS serum concentrations, underscoring the influence of industrial activities on PFAS exposure and expanding on the established links between PFAS exposure and health outcomes. These findings call for targeted strategies to mitigate PFAS exposure in high-risk regions and warrant further research on PFAS health impacts, especially in regard to immune interference.

Liver lipid metabolism, oxidative stress, and inflammation in glutamine-supplemented ob/ob mice

Glutamine availability may be reduced in chronic diseases, such as type 2 diabetes mellitus (T2DM)-induced by obesity. Herein, the antioxidant, anti-inflammatory and lipid metabolism effects of chronic oral glutamine supplementation in its free and dipeptide form were assessed in ob/ob mice. Adult male C57BL/6J ob/ob mice were supplemented with L-alanyl-L-glutamine (DIP) or free L-glutamine (GLN) in the drinking water for 40 days, whilst C57BL/6J Wild-type lean (WT) and control ob/ob mice (CTRL) received fresh water only. Plasma and tissue (skeletal muscle and liver) glutamine levels, and insulin resistance parameters (e.g., GTT, ITT, insulin) were determined. Oxidative stress (e.g., GSH system, Nrf2 translocation), inflammatory (e.g., NFkB translocation, TNF-α gene expression) and lipid metabolism parameters (e.g., plasma and liver triglyceride levels, SRBP-1, FAS, ACC, and ChRBP gene expression) were also analyzed. CTRL ob/ob mice showed lower glutamine levels in plasma and tissue, as well as increased insulin resistance and fat in the liver. Conversely, chronic DIP supplementation restored glutamine levels in plasma and tissues, improved glucose homeostasis and reduced plasma and liver lipid levels. Also, Nrf2 restoration, reduced NFkB translocation, and lower TNF-α gene expression was observed in the DIP group. Interestingly, chronic free GLN only increased muscle glutamine stores but reduced overall insulin resistance, and attenuated plasma and liver lipid metabolic biomarkers. The results presented herein indicate that restoration of body glutamine levels reduces oxidative stress and inflammation in obese and T2DM ob/ob mice. This effect attenuated hepatic lipid metabolic changes observed in obesity.

Combined effects of natural products and exercise on apoptosis pathways in obesity-related skeletal muscle dysfunction

Obesity and related metabolic disorders are closely linked to increased apoptosis in skeletal muscle, leading to muscle degeneration, insulin resistance, and the progression of diseases such as type 2 diabetes and sarcopenia. This review explores the combined effects of natural products, including resveratrol, curcumin, and quercetin, and physical exercise on modulating apoptosis pathways in skeletal muscle. Both natural products and regular physical activity independently reduce oxidative stress and improve mitochondrial function, thereby regulating the balance between pro-apoptotic and anti-apoptotic signals. When combined, these interventions amplify their protective effects on muscle health, promoting mitochondrial biogenesis, reducing apoptosis, and enhancing muscle regeneration. This review also discusses the molecular mechanisms by which these strategies influence apoptosis, with a focus on the Bcl-2 pathway, and explores the clinical implications for the prevention and treatment of obesity-related diseases. The synergistic benefits of combining exercise with natural product supplementation offer a promising therapeutic approach for managing metabolic disorders, preserving muscle function, and improving overall metabolic health.

Naringenin cationic lipid-modified nanoparticles mitigate MASLD progression by modulating lipid homeostasis and gut microbiota

Naringenin (NAR) possesses various pharmacological activities including antioxidant, anti-inflammatory, and hepatoprotective effects. However, its therapeutic efficacy is limited by its hydrophobic and crystalline nature. This study aimed to investigate the therapeutic potential and molecular mechanisms of NAR efficiently loaded into cationic nanoparticles (NP-NAR) for treating metabolic dysfunction-associated steatotic liver disease (MASLD) in a mouse model. The results demonstrated that NP-NAR effectively ameliorated lipid metabolism dysbiosis, oxidative stress, insulin resistance, and inflammation in MASLD mice. Transcriptomic analysis and molecular data revealed that NP-NAR promoted fatty acid oxidation via activation of the PPAR signaling pathway, reduced hepatic lipid uptake and lipogenesis by inhibiting the expressions of key genes including CD36, ACC, and FASN. Moreover, NP-NAR modulated cholesterol metabolism by inhibiting the classical bile acid synthesis pathway. 16 S rDNA gene sequencing revealed a disbalanced gut microbiota in MASLD mice, whereas NP-NAR treatment statistically reversed the abundance changes of several intestinal bacteria at the phylum and genus levels, which partly contributed to the balance in intestinal metabolite production, including short-chain fatty acids. In conclusion, these findings suggest that NP-NAR may be a promising candidate for the treatment of obesity-associated MASLD, offering new insight into the mechanisms underlying NAR's efficacy against MASLD.

Flavonoid Derivatives Isolated from Hypericum monogynum Ameliorate Insulin Resistance via Modulation of IRS-1/PI3K/Akt/FOXO1 Pathway in HepG2 Cells

In this study, two high-content flavonoid derivatives [3-8 biapigenin (HM 104) and quercetin-3-O-β-d-galactopyranoside (HM 111)] were obtained through the bioactivity-guided isolation of antidiabetic compounds from Hypericum monogynum flowers. HM 104 and HM 111 exhibited good glucose consumption in fatty acid-induced insulin-resistant HepG2 cells. Moreover, both active compounds enhanced glucose uptake by restoring the expression of key regulators of glucose metabolism, including insulin receptor substrate 1, phosphoinositide 3-kinase, protein kinase B, and glucose transporter type 4, and by mitigating the expression of forkhead box O1 and the factors involved in gluconeogenesis. They upregulate the phosphorylation of glycogen synthase kinase-3β, which may affect glycogen synthesis. Furthermore, the production of reactive oxygen species was decreased by the two compounds. This study provides novel mechanistic insights into the protective effects of flavonoid derivatives isolated from H. monogynum flowers in preventing and managing insulin resistance and associated metabolic disorders.

Association of insulin resistance surrogates with disease severity and adverse outcomes in chronic thromboembolic pulmonary hypertension: a multicenter cohort study

BACKGROUND

Chronic thromboembolic pulmonary hypertension (CTEPH) is a severely progressive disease that leads to right heart failure and death. Previous studies have shown that diabetes and insulin resistance (IR) are closely related to pulmonary hypertension, but the role of IR in patients with CTEPH remains unexplored. In this study, we investigated the relationship between four insulin resistance indices and disease severity, hemodynamic parameters, and adverse outcomes in patients with CTEPH.

METHODS

We conducted a multicenter, retrospective cohort study involving 516 patients diagnosed with CTEPH between January 2013 and December 2022. The metabolic score for IR (METS-IR), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride and glucose (TyG) index, and triglyceride-glucose-body mass (TyG-BMI) index were used to quantify IR levels in patients with CTEPH. The primary endpoint events were clinical worsening. Multivariable Cox regression, restricted cubic splines, and receiver operating characteristic analyses were used to evaluate the predictive value of surrogates for IR.

RESULTS

Compared with in low to intermediate-low risk patients, the METS-IR (36.2 ± 6.7 vs. 37.7 ± 8.7, p = 0.038) and TyG-BMI index (204.0 ± 36.2 vs. 212.6 ± 46.5, p = 0.022) were significantly increased in high to intermediate-high risk patients. METS-IR correlated with markers of disease severity, such as World Health Organization functional class, 6-minute walk distance, and N-terminal pro-brain natriuretic peptide levels. During a mean of 2.5 years' follow-up, 110 participants experienced all-cause death or worsening condition. METS-IR independently predicted clinical worsening (hazard ratio: 1.27; 95% confidence interval 1.06-1.53 per 1.0-standard deviation increment, p = 0.009) after fully adjusting for covariates. Adding METS-IR to the COMPERA 2.0 risk score significantly improved its predictive ability, reclassification and discrimination ability.

CONCLUSIONS

METS-IR is an independent predictor of clinical worsening in patients with CTEPH. It offers a convenient marker for assessing disease severity and long-term outcomes in clinical risk assessment.

The Association of Physical Activity With Overweight/Obesity and Type 2 Diabetes in Nepalese Adults: Evidence From a Nationwide Non-Communicable Disease Risk Factor Survey

Background

The rising prevalence of obesity and type 2 diabetes (T2DM) is a significant public health concern, particularly in low- and middle-income countries. This study aimed to explore the association between physical activity levels, overweight/obesity, and T2DM in a nationwide survey of Nepalese adults.

Methods

This was a secondary analysis of the 2019 non-communicable diseases (NCD) risk factors STEPS survey conducted in Nepal. Demographic and anthropometric data, body mass index (BMI) and T2DM status were collected along with assessment of physical activity using Global Physical Activity Questionnaire (GPAQ). A two-stage data analysis was conducted, first using descriptive statistics to summarize participant characteristics and differences across BMI and T2DM status, and then applying multivariate analyses to assess associations between physical activity levels, BMI and T2DM.

Results

Of the 5284 participants included, 28.0% had overweight/obesity, 5.8% had obesity, and 6.5% had T2DM. The mean age of the participants was 40.1 years (95% CI: 39.8-40.6), and 63.9% were female. The overall physical activity energy expenditure was higher in the lean group (BMI < 25 kg/m2) compared to the those with overweight/obesity, and among participants without T2DM compared to those with T2DM. Sedentary behavior was more common among individuals with overweight/obesity and T2DM. A higher proportion of participants with low physical activity was observed in the overweight/obesity group compared to the lean group (8.9% vs. 6.3%) and the T2DM group compared to the non-T2DM group (11.7% vs. 6.7%). Low physical activity was associated with overweight/obesity (OR:1.4; 95% CI:1.1-1.8), obesity (OR:2.1; 95% CI:1.5-2.3), T2DM (OR:1.6; 95% CI:1.1-2.3) and T2DM in the presence of obesity (OR:3.6; 95% CI:1.7-7.8).

Conclusion

This study highlights the low rates of physical activity and higher rates of sedentary behavior among adults with overweight/obesity and T2DM in Nepal. Public health interventions promoting physical activity and reducing sedentary behavior may help reduce the burden of these NCDs.

Physicochemical properties, structural characterization, and antidiabetic activity of selenylated low molecular weight apple pectin in HFD/STZ-induced type 2 diabetic mice

A novel selenylated low molecular weight apple pectin (Se-LMWAP) was prepared through enzymatic modification combined with selenylation. The physicochemical properties, the structural characterization of Se-LMWAP were evaluated by FT-IR, NMR and SEM. Moreover, the antidiabetic activity and potential mechanism of Se-LMWAP were investigated using high-fat diet (HFD)/streptozotocin (STZ)-induced type 2 diabetic mice. The results revealed that the physicochemical properties of Se-LMWAP were distinctly improved after modifications, and the primary structure was not altered significantly compared to apple pectin and low molecular weight apple pectin. Se-LMWAP had a relative molecular weight of 8.91 × 103 Da (accounted for 61.3 %) and total selenium content of 148.3 ± 2.0 μgselenium/gsample. It consisted of Rha, Ara, Gal, Glc, Xyl and GalA at a molar ratio of 0.093:0.014:0.132:0.020:0.118:0.622, with the selenium substitution occurred at the C-6 position. Se-LMWAP was able to significantly reduce weight loss, hyperglycemia, oxidative stress and liver, kidney and pancreas damage. Additionally, improved glucose tolerance, relieved lipid metabolism disorders, elevated hepatic glycogen content and ameliorated insulin resistance were observed in the Se-LMWAP group. Overall, Se-LMWAP can be used as a promising dietary selenium supplement to exert -antidiabetic effect through modulating hepatic glucose metabolism and liver insulin-signaling transduction and oxidative stress.

Exposure to Volatile Organic Compounds in Relation to Visceral Adiposity Index and Lipid Accumulation Product Among U.S. Adults: NHANES 2011-2018

Volatile organic compounds (VOCs) are associated with obesity health risks, while the association of mixed VOCs with visceral adiposity indicators remains unclear. In this study, a total of 2015 adults from the National Health and Nutrition Examination Survey (NHANES) were included. Weighted generalized linear models, restricted cubic spline (RCS), weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR) were adopted to assess the association of VOC metabolites (mVOCs) with the visceral adiposity index (VAI) and lipid accumulation product (LAP). Multiple mVOCs were positively associated with the VAI and LAP in the single-exposure model, especially N-acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA) and N-acetyl-S-(N-methylcarbamoyl)-L-cysteine (AMCC). The associations of mVOCs with VAI and LAP were more significant in <60-year-old and non-obese individuals, with interactions of CEMA with age and AMCC with obesity status. Nonlinear relationships between certain mVOCs and the VAI or the LAP were also observed. In the WQS model, co-exposure to mVOCs was positively correlated with the VAI [β (95%CI): 0.084 (0.022, 0.147)]; CEMA (25.24%) was the major contributor. The result of the BKMR revealed a positive trend of the association between mixed mVOCs and the VAI. Our findings suggest that VOC exposure is strongly associated with visceral obesity indicators. Further large prospective investigations are necessary to support our findings.

Identification of TIGAR, a direct proteomic target associated with the hypoglycemic effect of Berberine

Diabetes mellitus is a global chronic metabolic disease and the prevalence of diabetes mellitus is increasing dramatically every year. Berberine (BBR) from Coptidis Rhizoma has potent hypoglycemic effects, however, the specific proteins targeted by berberine that contribute to its hypoglycemic action remain to be elucidated. In this work, TIGAR (TP53-induced glycolysis and apoptosis regulator) was identified as a direct target protein for berberine using activity-based protein profiling (ABPP) and other chemical proteomics techniques with active photoaffinity probes as chemical tools. In addition, the study revealed that berberine-targeted TIGAR attenuated the conversion of fructose-2, 6-bisphosphate to fructose-6-phosphate. This study demonstrated an innovative mechanism by which berberine directly targets TIGAR and its hypoglycemic effects. Therefore, TIGAR emerges as a novel target for the treatment of diabetes mellitus, with TIGAR inhibitors offering a new and promising therapeutic strategy for managing the disease.

Diabetes and the associated complications: The role of antioxidants in diabetes therapy and care

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia). Poorly managed diabetes can lead to complications affecting multiple organ systems. Antioxidants play a crucial role in reducing oxidative stress caused by reactive oxygen species (ROS), primarily triggered by uncontrolled high blood sugar levels in diabetes. Antioxidants like vitamin C, E, selenium, and alpha-lipoic acid, when used as supplements, have shown promise in reducing oxidative stress markers and improving antioxidant status in laboratory and animal studies and diabetic patients. Antioxidant supplementation may help reduce the risk of diabetic complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Additionally, antioxidants also have anti-inflammatory properties, which could be beneficial in reducing inflammation associated with diabetes. Antioxidant supplementation has been shown to enhance endothelial function, insulin sensitivity, and glucose metabolism, thereby aiding in glycemic control and overall diabetic management. Combining antioxidants with certain medications may have therapeutic benefits, such as effectively neutralizing free radicals and enhancing the regulation of antioxidant defense systems. This review presents an update on diabetes, the sources of free radical generation, the body's natural defense mechanisms, the clinical evidence regarding using antioxidants in managing diabetic complications, and the potential new therapeutic approaches. Overall, antioxidant supplementation may offer some benefits in managing diabetic complications. However, further studies are needed to understand the mechanisms of action, determine the optimal supplementation, explore potential interactions with other medications, and conduct long-term studies to establish the possible use of antioxidants for optimal benefits in diabetes care.

Lactobacillus reuteri TISTR 2736 alleviates type 2 diabetes in rats via the hepatic IRS1/PI3K/AKT signaling pathway by mitigating oxidative stress and inflammatory mediators

PURPOSE

This study investigated the beneficial effects of Lactobacillus reuteri TISTR 2736 on glucose homeostasis, carbohydrate metabolism, and the underlying mechanisms of its actions in type 2 diabetic (T2D) rats.

METHODS

A rat model of T2D was established by a combination of a high-fat diet and streptozotocin. The diabetic rats were treated daily with L. reuteri TISTR 2736 (2 × 108 CFU/day) for 30 days. Biochemical, histopathological, and molecular analyses were carried out to determine insulin signaling, carbohydrate metabolism, oxidative stress, and inflammation.

RESULTS

The results demonstrated that treatment with L. reuteri TISTR 2736 significantly ameliorated fasting blood glucose and glucose intolerance, and improved insulin sensitivity indices in the diabetic rats. The hepatic histopathology was improved with L. reuteri TISTR 2736 treatment, which was correlated with a reduction of hepatic lipid profiles. L. reuteri TISTR 2736 significantly reduced glycogen content, fructose 1,6-bisphosphatase activity, and phosphoenolpyruvate carboxykinase 1 protein expression, and enhanced hexokinase activity in the diabetic liver. The downregulation of IRS1 and phosphorylated IRS1Ser307 and upregulation of PI3K and phosphorylated AKTSer473 proteins in the liver were found in the L. reuteri TISTR 2736-treated diabetic group. Furthermore, it was able to suppress oxidative stress and inflammation in the diabetic rats, as demonstrated by decreased malondialdehyde and protein levels of NF-κB, IL-6 and TNF-α, but increased antioxidant enzyme activities of superoxide dismutase, catalase, and glutathione peroxidase.

CONCLUSION

By inhibiting oxidative and inflammatory stress, L. reuteri TISTR 2736 alleviated hyperglycemia and improved carbohydrate metabolism through activating IRS1/PI3K/AKT pathway in the T2D rats.

The role of low-carbohydrate, high-fat diet in modulating autophagy and endoplasmic reticulum stress in aortic endothelial dysfunction of metabolic syndrome animal model

Background

Endothelial dysfunction (ED) is induced by insulin resistance, mediated by endoplasmic reticulum (ER) stress and disturbed autophagy. This study investigates the protective role of a low-carbohydrate, high-fat (LCHF) diet on ED, ER stress, and autophagy dysregulation in an experimental animal model of metabolic syndrome.

Methods

Forty male Sprague-Dawley rats were divided into four groups: a Control group (standard diet) and three Dexamethasone (DEX) treated groups. Group II continued the standard diet, Group III received an LCHF diet, and Group IV received a high-carbohydrate, low-fat (HCLF) diet. At the end of the experiment, aortic tissue samples were obtained and used for histological, immunohistochemical (Endothelin and PCNA, biochemical MDA, TCA, NO, 8-OH-dG, and Nrf2/ARE protein) and molecular (Endothelin, eNOS, Nrf-2 α, p62, LC3, BECN-1, PINK1, CHOP, BNIP3, PCNA) analysis.

Results

Oxidative stress, autophagy markers, and ED markers are increased in the metabolic syndrome group. LCHF diet mitigates the adverse effects of DEX on endothelial dysfunction and oxidative stress, as evidenced by reduced BMI, HOMA-IR, and improved histological and molecular parameters.

Conclusion

Oxidative stress, autophagy dysregulation, and ER stress play crucial roles in the pathogenesis of insulin resistance-induced endothelial dysfunction. An LCHF diet offers protective benefits against insulin resistance and related comorbidities, including endothelial dysfunction.

The relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status in adolescents with overweight and obesity: results from a cross-sectional study in Iran

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12-18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

Combined effects of loneliness and diabetes mellitus on disability incidence among older Japanese adults

BACKGROUND

Developed countries worldwide face the challenge of aging populations in which loneliness is problematic, leading to mental and physical health issues. Diabetes mellitus (DM) can cause decreased physical activity, reduced functioning, and depressive symptoms. However, how interactions between loneliness and DM influence health outcomes remains unclear. We aimed to determine the effects of loneliness and DM-related complications on the incidence of disability among older individuals.

METHODS

We analyzed data from the Japanese National Center for Geriatrics and Gerontology Study of Geriatric Syndromes for community-dwelling adults aged ≥65 years without initial long-term care needs. Loneliness was assessed using the University of California Los Angeles Loneliness Scale, and DM status was determined based on medical history obtained through face-to-face interviews. Disability incidence was identified by monthly tracking of certifications under the Japanese long-term care insurance system. The combined effect of DM and loneliness on care needs was examined using Cox proportional hazard regression models.

RESULTS

Among 5,160 participants, 298 (5.8 %) developed incident disabilities within 24 months. Cox models adjusted for potential confounders revealed a significantly increased disability risk among persons with DM and loneliness. Having DM without loneliness and vice versa were not significant risk factors for disability incidence compared with having neither.

CONCLUSIONS

The combination of loneliness with DM was a risk factor for disability development among community-dwelling older adults. Loneliness and DM might be interrelated and associated with disability development, suggesting that support along with assessments of mental health and illness might help to avoid disability in this population.

Nitric oxide in modulating oxidative stress mediated skeletal muscle insulin resistance

Insulin resistance (IR) being the major cause behind different metabolic disorders, has attracted a lot of attention. Epidemiological data shows marked rise in the cases over a period of time. Nitric oxide (NO), produced from nitric oxide synthases (NOS), is involved in a variety of biological functions, alteration in which causes various disorders like hypertension, atherosclerosis, and angiogenesis-associated disorders. IR has been found to be a contributing factor, which is associated with abnormal NO signalling. Skeletal muscle is essential for metabolism, both for its role in glucose uptake and its importance in metabolic disease. In this article, we give an overview of the significance of NO in oxidative stress (OS) mediated IR, describing its role in different conditions that are associated with skeletal muscle IR. NO is found to be involved in the activation of insulin receptor downstream pathway, which suggests absence of NO could lead to reduced glucose uptake, and may ultimately result in IR.

Therapeutic effect of oral insulin-chitosan nanobeads pectin-dextrin shell on streptozotocin-diabetic male albino rats

The current study inspects the therapeutic effects of orally ingested insulin-loaded chitosan nanobeads (INS-CsNBs) with a pectin-dextrin (PD) coating on streptozotocin (STZ)-induced diabetes in Wistar rats. The study also assessed antioxidant effects in pancreatic tissue homogenate, insulin, C-peptide, and inflammatory markers interleukin-1 beta and interleukin-6 (IL-1β and IL-6) in serum. Additionally, histopathological and immunohistochemical examination of insulin granules, oxidative stress, nuclear factor kappa B (NF-κB P65), and sirtuin-1 (SIRT-1) protein detection, as well as gene expression of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), B-cell lymphoma 2 (Bcl2), and Bcl-2-associated X protein (Bax) in pancreatic tissue were investigated. After induction of diabetes with STZ, rats were allocated into 6 groups: the normal control (C), the diabetic control (D), and the diabetic groups treated with INS-CsNBs coated with PD shell (50 IU/kg) (NF), free oral insulin (10 IU/kg) (FO), CsNBs-PD shell (50 IU/kg) (NB), and subcutaneous insulin (10 IU/kg) (Sc). The rats were treated daily for four weeks. Treatment of diabetic rats with INS-CsNBs coated with PD shell resulted in a significant improvement in blood glucose levels, elevated antioxidant activities, decreased NF-κB P65, IL-1β, and IL-6 levels, upregulated Nrf-2 and HO-1, in addition to a marked improvement in the histological architecture and integrity compared to the diabetic group. The effects of oral INS-CsNBs administration were comparable to those of subcutaneous insulin. In conclusion, oral administration of INS-loaded Cs-NBs with a pectin-dextrin shell demonstrated an ameliorative effect on STZ-induced diabetes, avoiding the drawbacks of subcutaneous insulin.

Ca2+ signaling and metabolic stress-induced pancreatic β-cell failure

Early in the development of Type 2 diabetes (T2D), metabolic stress brought on by insulin resistance and nutrient overload causes β-cell hyperstimulation. Herein we summarize recent studies that have explored the premise that an increase in the intracellular Ca2+ concentration ([Ca2+]i), brought on by persistent metabolic stimulation of β-cells, causes β-cell dysfunction and failure by adversely affecting β-cell function, structure, and identity. This mini-review builds on several recent reviews that also describe how excess [Ca2+]i impairs β-cell function.

Tauroursodeoxycholic Acid (TUDCA) Relieves Streptozotocin (STZ)-Induced Diabetic Rat Model via Modulation of Lipotoxicity, Oxidative Stress, Inflammation, and Apoptosis

Tauroursodeoxycholic acid (TUDCA) is approved for the treatment of liver diseases. However, the antihyperglycemic effects/mechanisms of TUDCA are still less clear. The present study aimed to evaluate the antidiabetic action of TUDCA in streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) in rats. Fifteen adult Wistar albino male rats were randomly divided into three groups (n = five in each): control, diabetic (STZ), and STZ+TUDCA. The results showed that TUDCA treatment significantly reduced blood glucose, HbA1c%, and HOMA-IR as well as elevated the insulin levels in diabetic rats. TUDCA therapy increased the incretin GLP-1 concentrations, decreased serum ceramide synthase (CS), improved the serum lipid profile, and restored the glycogen content in the liver and skeletal muscles. Furthermore, serum inflammatory parameters (such as TNF-α, IL-6, IL-1ß, and PGE-2) were substantially reduced with TUDCA treatment. In the pancreas, STZ+TUDCA-treated rats underwent an obvious enhancement of enzymatic (CAT and SOD) and non-enzymatic (GSH) antioxidant defense systems and a marked decrease in markers of the lipid peroxidation rate (MDA) and nitrosative stress (NO) compared to STZ-alone. At the molecular level, TUDCA decreased the pancreatic mRNA levels of iNOS and apoptotic-related factors (p53 and caspase-3). In conclusion, TUDCA may be useful for diabetes management and could be able to counteract diabetic disorders via anti-hyperlipidemic, antioxidant, anti-inflammatory, and anti-apoptotic actions.

The signaling pathways in obesity-related complications

Obesity, a rapidly expanding epidemic worldwide, is known to exacerbate many medical conditions, making it a significant factor in multiple diseases and their associated complications. This threatening epidemic is linked to various harmful conditions such as type 2 diabetes mellitus, hypertension, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, cardiovascular diseases (CVDs), dyslipidemia, and cancer. The rise in urbanization and sedentary lifestyles creates an environment that fosters obesity, leading to both psychosocial and medical complications. To identify individuals at risk and ensure timely treatment, it is crucial to have a better understanding of the pathophysiology of obesity and its comorbidities. This comprehensive review highlights the relationship between obesity and obesity-associated complications, including type 2 diabetes, hypertension, (CVDs), dyslipidemia, polycystic ovary syndrome, metabolic dysfunction-associated steatotic liver disease, gastrointestinal complications, and obstructive sleep apnea. It also explores the potential mechanisms underlying these associations. A thorough analysis of the interplay between obesity and its associated complications is vital in developing effective therapeutic strategies to combat the exponential increase in global obesity rates and mitigate the deadly consequences of this polygenic condition.

Differential ischemic stroke risk linked to novel subtypes of type 2 diabetes: insights from a Mendelian randomization analysis

PURPOSE

This study employs a two-sample Mendelian randomization (MR) approach to investigate the variation in ischemic stroke risk across novel subtypes of adult-onset type 2 diabetes.

METHODS

Leveraging pooled genome-wide association study (GWAS) data from the Swedish ANDIS cohort, we explored the association of four newly identified type 2 diabetes subtypes-severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD)-with ischemic stroke risk. The outcome data for ischemic stroke and its three subtypes (large artery, cardioembolic, and small vessel stroke) were sourced from the MEGASTROKE Consortium. Our analysis applied multiple MR methods, focusing on the inverse-variance weighted (IVW) technique, complemented by thorough sensitivity analyses to examine heterogeneity and potential horizontal pleiotropy.

RESULTS

Our findings reveal a significant causal relationship between the SIDD subtype and small vessel stroke (OR = 1.06, 95% CI: 1.01-1.11, p = 0.025), while no causal associations were observed for SIRD with any stroke subtype. MOD was causally linked to small vessel stroke (OR = 1.07, 95% CI: 1.02-1.12, p = 0.004) and large artery stroke (OR = 1.07, 95% CI: 1.01-1.13, p = 0.015). Similarly, MARD showed a causal relationship with small vessel stroke (OR = 1.09, 95% CI: 1.03-1.16, p = 0.006) and overall ischemic stroke risk (OR = 1.04, 95% CI: 1.01-1.08, p = 0.010).

CONCLUSIONS

Our study highlights distinct causal links between specific type 2 diabetes subtypes and ischemic stroke risks, emphasizing the importance of subtype-specific prevention and treatment strategies.

Novel targets and therapies of metformin in dementia: old drug, new insights

Dementia is a devastating disorder characterized by progressive and persistent cognitive decline, imposing a heavy public health burden on the individual and society. Despite numerous efforts by researchers in the field of dementia, pharmacological treatments are limited to relieving symptoms and fail to prevent disease progression. Therefore, studies exploring novel therapeutics or repurposing classical drugs indicated for other diseases are urgently needed. Metformin, a first-line antihyperglycemic drug used to treat type 2 diabetes, has been shown to be beneficial in neurodegenerative diseases including dementia. This review discusses and evaluates the neuroprotective role of metformin in dementia, from the perspective of basic and clinical studies. Mechanistically, metformin has been shown to improve insulin resistance, reduce neuronal apoptosis, and decrease oxidative stress and neuroinflammation in the brain. Collectively, the current data presented here support the future potential of metformin as a potential therapeutic strategy for dementia. This study also inspires a new field for future translational studies and clinical research to discover novel therapeutic targets for dementia.

Glucometabolic-Related Genes as Diagnostic Biomarkers and Therapeutic Targets for Alzheimer's Disease and Type 2 Diabetes Mellitus: A Bioinformatics Analysis

Background

Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) are two widespread chronic disorders characterized by shared risk factors and molecular pathways. Glucose metabolism, pivotal for cellular homeostasis and energy supply, plays a critical role in these diseases. Its disturbance has been linked to the pathogenesis of both AD and T2DM. However, a comprehensive investigation into the specific roles of glucometabolic genes in the onset and progression of AD and T2DM has yet to be conducted.

Methods

By analyzing microarray datasets from the Gene Expression Omnibus (GEO) repository, we identified differentially expressed glucometabolic genes (DEGs) in AD and T2DM cohorts. A range of bioinformatics tools were employed for functional annotation, pathway enrichment, protein interaction network construction, module analysis, ROC curve assessment, correlation matrix construction, gene set enrichment analysis, and gene-drug interaction mapping of these DEGs. Key genes were further validated using quantitative real-time polymerase chain reaction (qRT-PCR) in AD and T2DM murine models.

Results

Our investigation identified 41 glucometabolic-related DEGs, with six prominent genes (G6PD, PKM, ENO3, PFKL, PGD, and TALDO1) being common in both AD and T2DM cohorts. These genes play crucial roles in metabolic pathways including glycolysis, pentose phosphate pathway, and amino sugar metabolism. Their diagnostic potential was highlighted by area under curve (AUC) values exceeding 0.6 for AD and 0.8 for T2DM. Further analysis explored the interactions, pathway enrichments, regulatory mechanisms, and potential drug interactions of these key genes. In the AD murine model, quantitative real-time polymerase chain reaction (qRT-PCR) analysis revealed significant upregulation of G6pd, Eno3, and Taldo1. Similarly, in the T2DM murine model, elevated expression levels of G6pd, Pfkl, Eno3, and Pgd were observed.

Conclusion

Our rigorous research sheds light on the molecular interconnections between AD and T2DM from a glucometabolic perspective, revealing new opportunities for pharmacological innovation and therapeutic approaches. This study appears to be the first to extensively investigate glucometabolic-associated DEGs and key genes in both AD and T2DM, utilizing multiple datasets. These insights are set to enhance our understanding of the complex pathophysiology underlying these widespread chronic diseases.

Coenzyme Q10: A Key Antioxidant in the Management of Diabetes-Induced Cardiovascular Complications-An Overview of Mechanisms and Clinical Evidence

Background

Diabetes mellitus (DM) presents a significant global health challenge with considerable cardiovascular implications. Coenzyme Q10 (CoQ10) has gained recognition for its potential as a natural antioxidant supplement in the management of diabetes and its associated cardiovascular complications.

Aim

This comprehensive review systematically examines the scientific rationale underlying the therapeutic properties of CoQ10 in mitigating the impact of diabetes and its cardiovascular consequences. The analysis encompasses preclinical trials (in vitro and in vivo) and clinical studies evaluating the efficacy and mechanisms of action of CoQ10. Result & Discussion. Findings reveal that CoQ10, through its potent antioxidant and anti-inflammatory attributes, demonstrates significant potential in reducing oxidative stress, ameliorating lipid profiles, and regulating blood pressure, which are crucial aspects in managing diabetes-induced cardiovascular complications. CoQ10, chemically represented as C59H90O4, was administered in capsule form for human studies at doses of 50, 100, 150, 200, and 300 mg per day and at concentrations of 10 and 20 μM in sterile powder for experimental investigations and 10 mg/kg in powder for mouse studies, according to the published research. Clinical trials corroborate these preclinical findings, demonstrating improved glycemic control, lipid profiles, and blood pressure in patients supplemented with CoQ10.

Conclusion

In conclusion, CoQ10 emerges as a promising natural therapeutic intervention for the comprehensive management of diabetes and its associated cardiovascular complications. Its multifaceted impacts on the Nrf2/Keap1/ARE pathway, oxidative stress, and metabolic regulation highlight its potential as an adjunct in the treatment of diabetes and related cardiovascular disorders. However, further extensive clinical investigations are necessary to fully establish its therapeutic potential and assess potential synergistic effects with other compounds.

In vitro and functional investigation reveals the curative effect of thymoquinone from black cumin-loaded chitosan nanoparticles on streptozotocin induced paediatric diabetes

Diabetic ketoacidosis (DKA) is regarded to be a communal complication of both type 1 and type 2 diabetes mellitus in children and adolescents. Successful therapy of DKA in children requires prompt diagnosis, strict monitoring of medical indicators, and prompt action. Thymoquinone (Tq) from black cumin loaded chitosan nanoparticles (ChNPs) intend to assess an effective agent to overcome this problem. XRD, FTIR, SEM, and TEM were used in the physicochemical analysis. Enzymatic activity of α-amylase and α-glucosidase was used in in vitro tests of anti-diabetic efficacy. Protecting insulin against enzyme breakdown is a crucial part of the insulin delivery mechanism. In the STZ-induced diabetes RIN-5F cell line, the anti-apoptotic capability of Tq-ChNPs was demonstrated through the NF-κB mediated apoptotic pathway. The combination of thymoquinone and chitosan NPs demonstrated that a wide variety of incredibly effective substances to elevate their curative effects, thus contributing to the growth of clinical and pharmaceutical fields.

Protective effects of madecassoside, a triterpenoid from Centella asiatica, against oxidative stress in INS-1E cells

Progressive decline in β cell function and reduction in the β cell mass is important in type 2 diabetes. Here, we tested the hypothesis that madecassoside's previously demonstrated in vivo protective effects on the β cell in experimental diabetes were exerted directly. We investigated the effects of madecassoside in protecting a β cell line (INS-1E) against a variety of agents. INS-1E cells were treated with madecassoside in the presence of high glucose (HG), a cytokine mixture, hydrogen peroxide (H2O2), or streptozotocin (STZ). HG, the cytokine mixture, H2O2 and STZ each produced a significant decrease in cell viability; this was significantly reversed by madecassoside. Pre-treatment with madecassoside reduced the number of apoptotic cells induced by HG, the cytokine mixture, H2O2, and STZ, and concentration-dependently reduced ROS production. Madecassoside also significantly enhanced glucose-induced insulin secretion. The results suggest that madecassoside's in vivo effects are exerted directly on the β cell.

Resolution of inflammation in chronic disease via restoration of the heat shock response (HSR)

Effective resolution of inflammation via the heat shock response (HSR) is pivotal in averting the transition to chronic inflammatory states. This transition characterizes a spectrum of debilitating conditions, including insulin resistance, obesity, type 2 diabetes, nonalcoholic fatty liver disease, and cardiovascular ailments. This manuscript explores a range of physiological, pharmacological, and nutraceutical interventions aimed at reinstating the HSR in the context of chronic low-grade inflammation, as well as protocols to assess the HSR. Monitoring the progression or suppression of the HSR in patients and laboratory animals offers predictive insights into the organism's capacity to combat chronic inflammation, as well as the impact of exercise and hyperthermic treatments (e.g., sauna or hot tub baths) on the HSR. Interestingly, a reciprocal correlation exists between the expression of HSR components in peripheral blood leukocytes (PBL) and the extent of local tissue proinflammatory activity in individuals afflicted by chronic inflammatory disorders. Therefore, the Heck index, contrasting extracellular 70 kDa family of heat shock proteins (HSP70) (proinflammatory) and intracellular HSP70 (anti-inflammatory) in PBL, serves as a valuable metric for HSR assessment. Our laboratory has also developed straightforward protocols for evaluating HSR by subjecting whole blood samples from both rodents and human volunteers to ex vivo heat challenges. Collectively, this discussion underscores the critical role of HSR disruption in the pathogenesis of chronic inflammatory states and emphasizes the significance of simple, cost-effective tools for clinical HSR assessment. This understanding is instrumental in the development of innovative strategies for preventing and managing chronic inflammatory diseases, which continue to exert a substantial global burden on morbidity and mortality.

Endothelial Dysfunction in Obesity and Therapeutic Targets

Parallel to the increasing prevalence of obesity in the world, the mortality from cardiovascular disease has also increased. Low-grade chronic inflammation in obesity disrupts vascular homeostasis, and the dysregulation of adipocyte-derived endocrine and paracrine effects contributes to endothelial dysfunction. Besides the adipose tissue inflammation, decreased nitric oxide (NO)-bioavailability, insulin resistance (IR), and oxidized low-density lipoproteins (oxLDLs) are the main factors contributing to endothelial dysfunction in obesity and the development of cardiorenal metabolic syndrome. While normal healthy perivascular adipose tissue (PVAT) ensures the dilation of blood vessels, obesity-associated PVAT leads to a change in the profile of the released adipo-cytokines, resulting in a decreased vasorelaxing effect. Higher stiffness parameter β, increased oxidative stress, upregulation of pro-inflammatory cytokines, and nicotinamide adenine dinucleotide phosphate (NADP) oxidase in PVAT turn the macrophages into pro-atherogenic phenotypes by oxLDL-induced adipocyte-derived exosome-macrophage crosstalk and contribute to the endothelial dysfunction. In clinical practice, carotid ultrasound, higher leptin levels correlate with irisin over-secretion by human visceral and subcutaneous adipose tissues, and remnant cholesterol (RC) levels predict atherosclerotic disease in obesity. As a novel therapeutic strategy for cardiovascular protection, liraglutide improves vascular dysfunction by modulating a cyclic adenosine monophosphate (cAMP)-independent protein kinase A (PKA)-AMP-activated protein kinase (AMPK) pathway in PVAT in obese individuals. Because the renin-angiotensin-aldosterone system (RAAS) activity, hyperinsulinemia, and the resultant IR play key roles in the progression of cardiovascular disease in obesity, RAAS-targeted therapies contribute to improving endothelial dysfunction. By contrast, arginase reciprocally inhibits NO formation and promotes oxidative stress. Thus, targeting arginase activity as a key mediator in endothelial dysfunction has therapeutic potential in obesity-related vascular comorbidities. Obesity-related endothelial dysfunction plays a pivotal role in the progression of type 2 diabetes (T2D). The peroxisome proliferator-activated receptor gamma (PPARγ) agonist, rosiglitazone (thiazolidinedione), is a popular drug for treating diabetes; however, it leads to increased cardiovascular risk. Selective sodium-glucose co-transporter-2 (SGLT-2) inhibitor empagliflozin (EMPA) significantly improves endothelial dysfunction and mortality occurring through redox-dependent mechanisms. Although endothelial dysfunction and oxidative stress are alleviated by either metformin or EMPA, currently used drugs to treat obesity-related diabetes neither possess the same anti-inflammatory potential nor simultaneously target endothelial cell dysfunction and obesity equally. While therapeutic interventions with glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide or bariatric surgery reverse regenerative cell exhaustion, support vascular repair mechanisms, and improve cardiometabolic risk in individuals with T2D and obesity, the GLP-1 analog exendin-4 attenuates endothelial endoplasmic reticulum stress.

Hallmarks of Quercetin Benefits as a Functional Supplementary in the Management of Diabetes Mellitus-Related Maladies: From Basic to Clinical Applications

Quercetin (QE), a particular flavonoid, is well known for its medicinal effects, including anti-oxidant, hypoglycemic, and anti-inflammatory effects. In this review, the findings of QE effects on diabetes STZinduced, alloxan-induced, and its complications have been summarized with a particular focus on in vitro, in vivo, and clinical trials. Consequently, QE mediates several mechanisms, including ameliorating tumor necrosis factor (TNF)-α, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin (IL)-1β, IL-8, and IL-10 expression, increasing insulin glucose uptake to inhibit insulin resistance. Moreover, QE stimulates insulin secretion and attenuates insulin resistance through various pathways, namely transient KATP channel, motivating peroxisome proliferator-activated receptor expression, increasing glucose transporter-4, and decreasing inducible nitric oxide synthase in skeletal muscle. QE has protective effects on the complications caused by diabetes, such as polycystic ovary syndrome, high-fat diet-induced obesity, diabetic-induced hepatic damage, vascular inflammation, nephropathy, and neuropathy.

Renoprotective Potency of Sitagliptin versus Pioglitazone in Type 2 Diabetic Patients: Impact on LncMIAT

Background: Diabetes mellitus (DM) represents one of the most important reasons for chronic kidney diseases due to the high level of blood glucose that destructs blood vessels. Objective: The present study focused on investigating the protective impact of sitagliptin on kidney complication in type 2 diabetes mellitus (T2DM) patients in comparison to pioglitazone to examine which has the superior effect against the nephritic complication of DM. Methods: Eighty adult subjects were classified into four groups: control group, pioglitazone-treated T2DM patients (P group), sitagliptin-treated T2DM patients for less than one year (SL group), and sitagliptin-treated T2DM patients for more than one year (SM group). Blood samples were withdrawn from all subjects for analysis of neutrophil gelatinase-associated lipocalin (NGAL), vanin-1, kidney injury molecule-1 (KIM-1), glyoxalase-1 (Glo-1), methylglyoxal (MG), cystatin-C, and interleukin-18 (IL-18) using competitive ELISA kits. Also, long noncoding myocardial infarction associated transcript (lncMIAT) was measured in whole blood using qRT-PCR. Results: The present study revealed that the lncMIAT expression level was significantly higher in the P group as compared to the SL group, SM group, or healthy control group. Additionally, serum NGAL, vanin-1, KIM-1, Glo-1, MG, and cystatin-C were significantly higher in the P group and SL group as compared to the SM group and healthy control group. Conclusion: Sitagliptin protected the kidney through downregulation of lncMIAT besides amelioration of kidney injury marker levels, which was more preferable than in pioglitazone therapy.

The Role of Sirtuin-1 (SIRT1) in the Physiology and Pathophysiology of the Human Placenta

Sirtuins, especially SIRT1, play a significant role in regulating inflammatory response, autophagy, and cell response to oxidative stress. Since their discovery, sirtuins have been regarded as anti-ageing and longevity-promoting enzymes. Sirtuin-regulated processes seem to participate in the most prevalent placental pathologies, such as pre-eclampsia. Furthermore, more and more research studies indicate that SIRT1 may prevent pre-eclampsia development or at least alleviate its manifestations. Having considered this, we reviewed recent studies on the role of sirtuins, especially SIRT1, in processes determining normal or abnormal development and functioning of the placenta.

Exploration of natural flavones' bioactivity and bioavailability in chronic inflammation induced-type-2 diabetes mellitus

Diabetes, being the most widespread illness, poses a serious threat to global public health. It seems that inflammation plays a critical role in the pathophysiology of diabetes. This review aims to demonstrate a probable link between type 2 diabetes mellitus (T2DM) and chronic inflammation during its development. Additionally, the current review examined the bioactivity of natural flavones and the possible molecular mechanisms by which they influence diabetes and inflammation. While natural flavones possess remarkable anti-diabetic and anti-inflammatory bioactivities, their therapeutic use is limited by the low oral bioavailability. Several factors contribute to the low bioavailability, including poor water solubility, food interaction, and unsatisfied metabolic behaviors, while the diseases (diabetes, inflammation, etc.) causing even less bioavailability. Throughout the years, different strategies have been developed to boost flavones' bioavailability, including structural alteration, biological transformation, and innovative drug delivery system design. This review addresses current advancements in improving the bioavailability of flavonoids in general, and flavones in particular. Clinical trials were also analyzed to provide insight into the potential application of flavonoids in diabetes and inflammatory therapies.

Comparative study on main compounds and hypoglycemic effects of dispensing granules of Coptidis Rhizoma and Scutellaria-Coptis herb couple with traditional decoction

BACKGROUND

The clinical applications of dispensing granules (DG) have increased dramatically. However, it is controversial whether the DG has the same quality and efficacy compared with traditional decoction (TD). In this study, the contents of main compounds, hypoglycemic effects, and potential mechanism of Coptidis Rhizoma (CR) and Scutellaria-coptis (SC), constituted of a 1:1 mixture of CR and Scutellariae Radix (SR), in the forms of TD and DG were compared.

METHODS

The quantitative analysis was performed on an UPLC-PDA method. The 6-weeks-old male db/db mice were used as Type 2 Diabetes Mellitus (T2DM) mouse modle to investigate the antidiabetic effects of CR and SC in TD form (CR TD and SC TD), as well as CR and SC in DG form (CR DG and SC DG).

RESULTS

The total content of five alkaloids in CR TD ranged from 71.00 to 78.62 mg, whereas in CR DG it ranged from 38.77 to 53.68 mg in CR DG per 1 g of decoction pieces. Compared to CR TD, CR DG exhibited a 36% reduction on average. For SC samples, the precipitation occurred in the processing of TD but not in the DG, and the relative ratio of alkaloids to flavonoids was determined to be 1:1 in TD and 1:2 in DG. Furthermore, the animal experiments showed that the CR DG (equivalent to 3 g decoction pieces/kg) had almost the same hypoglycemic effect as CR TD when they were administered for 6 weeks. Compared with SC DG (equivalent to 6 g decoction pieces/kg), SC TD showed a better trend in ameliorating T2DM via ameliorating pancreatic structure and function, and activating Akt/AMPK/GLUT4 signaling pathways.

CONCLUSION

This study indicated that the contents of main compounds were generally higher in CR TD than CR DG originated from the same raw materials. Additionally, changes in the contents of the primary components validated that the compound interactions are exclusive to SC TD during co-decoction, rather than SC DG. The disparate prossing of SC DG and SC TD caused differences both in chemical composition and hypoglycemic effect, suggesting that the substitutability of DG and TD requires further research.

Risk Estimation of Gestational Diabetes Mellitus in the First Trimester

CONTEXT

There is no early, first-trimester risk estimation available to predict later (gestational week 24-28) gestational diabetes mellitus (GDM); however, it would be beneficial to start an early treatment to prevent the development of complications.

OBJECTIVE

We aimed to identify early, first-trimester prediction markers for GDM.

METHODS

The present case-control study is based on the study cohort of a Hungarian biobank containing biological samples and follow-up data from 2545 pregnant women. Oxidative-nitrative stress-related parameters, steroid hormone, and metabolite levels were measured in the serum/plasma samples collected at the end of the first trimester from 55 randomly selected control and 55 women who developed GDM later.

RESULTS

Pregnant women who developed GDM later during the pregnancy were older and had higher body mass index. The following parameters showed higher concentration in their serum/plasma samples: fructosamine, total antioxidant capacity, testosterone, cortisone, 21-deoxycortisol; soluble urokinase plasminogen activator receptor, dehydroepiandrosterone sulfate, dihydrotestosterone, cortisol, and 11-deoxycorticosterone levels were lower. Analyzing these variables using a forward stepwise multivariate logistic regression model, we established a GDM prediction model with a specificity of 96.6% and sensitivity of 97.5% (included variables: fructosamine, cortisol, cortisone, 11-deoxycorticosterone, SuPAR).

CONCLUSION

Based on these measurements, we accurately predict the development of later-onset GDM (24th-28th weeks of pregnancy). Early risk estimation provides the opportunity for targeted prevention and the timely treatment of GDM. Prevention and slowing the progression of GDM result in a lower lifelong metabolic risk for both mother and offspring.

Dendrobium officinale polysaccharide decreases podocyte injury in diabetic nephropathy by regulating IRS-1/AKT signal and promoting mitophagy

BACKGROUNDS

High glucose (HG) caused oxidative stress and mitochondrial dysfunction, resulting in insulin resistance in podocytes, a key mechanism of diabetic nephropathy. Dendrobium officinale polysaccharide (DOP) was able to improve insulin resistance and antioxidant capability.

OBJECTIVE

The purpose of this study is to explore the mechanism by which DOP decreases the podocyte injury induced by HG.

METHODS

MPC5 cells were treated with HG, DOP, and IRS-1/2 inhibitor NT157. Afterwards, glucose consumption, generations of ROS and MDA were measured using the detection kits. Mitophagy was monitored using both MtphagTracyker and LysoTracker. The mitochondrial membrane potential was evaluated by JC-1 staining. DOP was also used in a mouse model of diabetes, with the measurements of urine albumin, blood creatinine and blood urea nitrogen.

RESULTS

Treatment with DOP suppressed the HG-induced reduction of glucose consumption, the phosphorylation of IRS-1 (phospho Y632), AKT (phospho Ser473 and Thr308) and Nephrin. In addition, HG-induced augment of ROS and MDA, formation of γ-H2A.X foci and translocation of AKT to nucleus were inhibited by DOP. DOP enhanced mitophagy, which was associated with decreased mitochondrial membrane potential and ROS production. DOP conferred protective effect on podocyte in the diabetic mouse by reducing the albumin/creatinine ratio and blood urea nitrogen, and restoring Nephrin expression in podocytes.

CONCLUSIONS

DOP alleviates HG-induced podocyte injuryby regulating IRS-1/AKT signal and promoting mitophagy.

Obesity Duration and Cardiometabolic Disease

Cardiovascular disease risk is known to be influenced by both the severity of a risk factor and the duration of exposure (eg, LDL [low-density lipoprotein] cholesterol, tobacco smoke). However, this concept has been largely neglected within the obesity literature. While obesity severity has been closely linked with cardiometabolic diseases, the risk of developing these conditions among those with obesity may be augmented by greater obesity duration over the life span. Few longitudinal or contemporary studies have investigated the influence of both factors in combination-cumulative obesity exposure-instead generally focusing on obesity severity, often at a single time point, given ease of use and lack of established methods to encapsulate duration. Our review focuses on what is known about the influence of the duration of exposure to excess adiposity within the obesity-associated cardiometabolic disease risk equation by means of summarizing the hypothesized mechanisms for and evidence surrounding the relationships of obesity duration with diverse cardiovascular and metabolic disease. Through the synthesis of the currently available data, we aim to highlight the importance of a better understanding of the influence of obesity duration in cardiovascular and metabolic disease pathogenesis. We underscore the clinical importance of aggressive early attention to obesity identification and intervention to prevent the development of chronic diseases that arise from exposure to excess body weight.

Metabolic and Genetic Association of Vitamin D with Calcium Signaling and Insulin Resistance

Various evidences have unveiled the significance of Vitamin D in diverse processes which include its action in prevention of immune dysfunction, cancer and cardiometabolic disorders. Studies have confirmed the function of VD in controlling the expression of approximately nine hundred genes including gene expression of insulin. VD insufficiency may be linked with the pathogenesis of diseases that are associated with insulin resistance (IR) including diabetes as well as obesity. Thus, VD lowers IR-related disorders such as inflammation and oxidative stress. This review provides an insight regarding the molecular mechanism manifesting, how insufficiency of VD may be connected with the IR and diabetes. It also discusses the effect of VD in maintaining the Ca2+ levels in beta cells of the pancreas and in the tissues that are responsive to insulin.

Predictors of subclinical atherosclerosis and microalbuminuria in middle-aged women: a cross-sectional study

BACKGROUND

Cardiovascular disease is of increasing concern in women. The aim was to assess the role of clinical and anthropometric measures in the development of subclinical atherosclerosis.

METHODS

A cross-sectional study in 203 Europid females to determine the prevalence of abnormal carotid intima-media thickness (CIMT) and associated clinical parameters.

RESULTS

The study population had a mean age of the 38.3±5.4 years, a median Body Mass Index of 29.25 (IQR 25.06-36.11) kg/m2 and median waist index (WI) of 1.15 (IQR 1.06-1.34). Increased CIMT was present in 169 (83.25%) participants. Linear regression analysis revealed WI to be the sole predictor of increased CIMT (β=24.387, P<0.001). Post-hoc ROC analysis revealed a WI of 1.12 has 62% sensitivity and 53% specificity for predicting increased CIMT (AUC 0.63, 95% CI 0.55-0.72, P=0.016). The median urinary albumin-creatinine ratio (ACR) was 4.4 mg/g, and the prevalence of microalbuminuria was 8.9%; serum triglycerides were the only independent predictor of ACR.

CONCLUSIONS

Atherosclerosis, as detected by abnormal CIMT, is very prevalent in middle-aged women. Waist index is the major predictor of subclinical atherosclerosis in a contemporary premenopausal female population. A WI of 1.12 exhibits relatively good sensitivity and specificity in predicting the presence of atherosclerosis in this patient population.

Effect of In Vitro Gastrointestinal Digestion on Phytochemicals and Antioxidant Activities in Cherry Tomatoes (Solanum lycopersicum var. cerasiforme)

We investigated the impact of simulated in vitro gastrointestinal digestion on the levels of total polyphenols, total flavonoids, carotenoids, and antioxidant capacity in cherry tomatoes. The initial total polyphenol content of fresh tomatoes was 220.51 μg GAE/g, which decreased to 203.24 μg GAE/g after 120 min of stomach treatment and further decreased to 138.23 μg GAE/g after 120 min of small intestine treatment. Similarly, the initial total flavonoid content in fresh tomatoes was 43.28 μg QE/g, but after 120 min of small intestine digestion, it decreased by approximately 50.72% to 21.33 μg QE/g. Lycopene, lutein, and β-carotene also experienced a decrease of 69.71∼78.38% during the digestion process compared to fresh tomatoes. The antioxidant activity exhibited a reduction of 34.95∼37.67% compared to fresh tomatoes after digestion in the stomach and intestines. The bioactive compounds present in tomatoes undergo decomposition and conversion into other substances during digestion, and these degradation products are believed to inhibit the growth of SK-Hep1 human hepatoma cells while enhancing antioxidant activity within the intracellular environment.

The Synergistic Influence of Polyflavonoids from Citrus aurantifolia on Diabetes Treatment and Their Modulation of the PI3K/AKT/FOXO1 Signaling Pathways: Molecular Docking Analyses and In Vivo Investigations

This study was aimed at probing the modulatory influence of polyflavonoids extracted from Citrus aurantifolia, lemon peel extract (LPE-polyflavonoids), on attenuating diabetes mellitus (DM) and its complications. HPLC investigations of the LPE exhibited the incidence of five flavonoids, including diosmin, biochanin A, hesperidin, quercetin, and hesperetin. The in silico impact on ligand-phosphatidylinositol 3-kinase (PI3K) interaction was investigated in terms of polyflavonoid class to explore the non-covalent intakes and binding affinity to the known protein active site. The drug likeness properties and pharmacokinetic parameters of the LPE-polyflavonoids were investigated to assess their bioavailability in relation to Myricetin as a control. Remarkably, the molecular docking studies demonstrated a prominent affinity score of all these agents together with PI3K, implying the potency of the extract to orchestrate PI3K, which is the predominant signal for lessening the level of blood glucose. To verify these findings, in vivo studies were conducted, utilizing diabetic male albino rats treated with LPE-polyflavonoids and other groups treated with hesperidin and diosmin as single flavonoids. Our findings demonstrated that the LPE-polyflavonoids significantly ameliorated the levels of glucose, insulin, glycogen, liver function, carbohydrate metabolizing enzymes, G6Pd, and AGEs compared to the diabetic rats and those exposed to hesperidin and diosmin. Furthermore, the LPE-polyflavonoids regulated the TBARS, GSH, CAT, TNF-α, IL-1β, IL-6, and AFP levels in the pancreatic and hepatic tissues, suggesting their antioxidant and anti-inflammatory properties. In addition, the pancreatic and hepatic GLUT4 and GLUT2 were noticeably increased in addition to the pancreatic p-AKT in the rats administered with the LPE-polyflavonoids compared to the other diabetic rats. Remarkably, the administration of LPE-polyflavonoids upregulated the expression of the pancreatic and hepatic PI3K, AMPK, and FOXO1 genes, emphasizing the efficiency of the LPE in orchestrating all the signaling pathways necessitated to reduce the diabetes mellitus. Notably, the histopathological examinations of the pancreatic and hepatic tissues corroborated the biochemical results. Altogether, our findings accentuated the potential therapeutic role of LPE-polyflavonoids in controlling diabetes mellitus.

Theabrownin from Dark Tea Ameliorates Insulin Resistance via Attenuating Oxidative Stress and Modulating IRS-1/PI3K/Akt Pathway in HepG2 Cells

Dark tea has great potential in regulating glycolipid metabolism, and theabrownin (TB) is considered to be the characteristic and bioactive constituent of dark tea. This study evaluated the ability of TB1 (fermented for 7 days) and TB2 (fermented for 14 days) isolated from dark tea to reverse insulin resistance (IR) in HepG2 cells. The results indicated that TB significantly ameliorated oxidative stress by improving mitochondrial function. In addition, TB improved glycogen synthesis and glucose consumption, and inhibited gluconeogenesis and fatty acid synthesis, by regulating GSK3β (Glycogen synthase kinase 3β), G6Pase (Glucose-6-phosphatase), GCK (Glucokinase), PEPCK1 (Phosphoenolpyruvate carboxy kinase 1), SREBP-1C (sterol regulatory element-binding protein 1C), FASN (fatty acid synthase), and ACC (Acetyl-CoA carboxylase). Additionally, the results of Western blot and real-time PCR experiments demonstrated that TB modulated glucolipid metabolism through the IRS-1 (Insulin receptor substrate 1)/PI3K (phosphatidylinositol-3 kinase)/Akt (protein kinase B) signaling pathway. Treatment with the PI3K inhibitor demonstrated a favorable correlation between PI3K activation and TB action on glycolipid metabolism. Notably, we observed that TB2 had a greater effect on improving insulin resistance compared with TB1, which, due to its prolonged fermentation time, increased the degree of oxidative polymerization of TB.

Protective effect of manganese treatment on insulin resistance in HepG2 hepatocytes

Introduction

Objectives: manganese (Mn) is closely related to type 2 diabetes mellitus and insulin resistance (IR), but the exact mechanism is unclear. This study aimed to explore the regulatory effects and mechanism of Mn on IR using hepatocyte IR model induced by high palmitate (PA), high glucose (HG) or insulin. Methods: HepG2 cells were exposed to PA (200 μM), HG (25 mM) or insulin (100 nM) respectively, alone or with 5 μM Mn for 24 hours. The expression of key proteins in insulin signaling pathway, intracellular glycogen content and glucose accumulation, reactive oxygen species (ROS) level and Mn superoxide dismutase (MnSOD) activity were detected. Results: compared with control group, the expression of phosphorylated protein kinase B (Akt), glycogen synthase kinase-3β (GSK-3β) and forkhead box O1 (FOXO1) in the three IR groups was declined, and this decrease was reversed by Mn. The reduction of intracellular glycogen content and increase in glucose accumulation in IR groups were also inhibited by Mn. Additionally, the production of ROS was increased in IR models, compared with normal control group, while Mn reduced the excessive production of ROS induced by PA, HG or insulin. However, Mn did not alter the activity of MnSOD in the three IR models. Conclusion: this study demonstrated that Mn treatment can improve IR in hepatocytes. The mechanism is probably by reducing the level of intracellular oxidative stress, enhancing the activity of Akt/GSK-3β/FOXO1 signal pathway, promoting glycogen synthesis, and inhibiting gluconeogenesis.

Micro-Executor of Natural Products in Metabolic Diseases

Obesity, diabetes, and cardiovascular diseases are the major chronic metabolic diseases that threaten human health. In order to combat these epidemics, there remains a desperate need for effective, safe, and easily available therapeutic strategies. Recently, the development of natural product research has provided new methods and options for these diseases. Numerous studies have demonstrated that microRNAs (miRNAs) are key regulators of metabolic diseases, and natural products can improve lipid and glucose metabolism disorders and cardiovascular diseases by regulating the expression of miRNAs. In this review, we present the recent advances involving the associations between miRNAs and natural products and the current evidence showing the positive effects of miRNAs for natural product treatment in metabolic diseases. We also encourage further research to address the relationship between miRNAs and natural products under physiological and pathological conditions, thus leading to stronger support for drug development from natural products in the future.

Diabetes mellitus promotes susceptibility to periodontitis-novel insight into the molecular mechanisms

Diabetes mellitus is a main risk factor for periodontitis, but until now, the underlying molecular mechanisms remain unclear. Diabetes can increase the pathogenicity of the periodontal microbiota and the inflammatory/host immune response of the periodontium. Hyperglycemia induces reactive oxygen species (ROS) production and enhances oxidative stress (OS), exacerbating periodontal tissue destruction. Furthermore, the alveolar bone resorption damage and the epigenetic changes in periodontal tissue induced by diabetes may also contribute to periodontitis. We will review the latest clinical data on the evidence of diabetes promoting the susceptibility of periodontitis from epidemiological, molecular mechanistic, and potential therapeutic targets and discuss the possible molecular mechanistic targets, focusing in particular on novel data on inflammatory/host immune response and OS. Understanding the intertwined pathogenesis of diabetes mellitus and periodontitis can explain the cross-interference between endocrine metabolic and inflammatory diseases better, provide a theoretical basis for new systemic holistic treatment, and promote interprofessional collaboration between endocrine physicians and dentists.

Urinary metabolites of multiple volatile organic compounds, oxidative stress biomarkers, and gestational diabetes mellitus: Association analyses

Volatile organic compounds are ubiquitous in the environment, which may cause various adverse health effects. The objectives of this study were to investigate associations of single and mixture of urinary metabolites of volatile organic compounds (mVOCs) with gestational diabetes mellitus (GDM) risk, and examine the possible role of oxidative stress in the associations. This nested case-control study included 454 GDM cases and 454 healthy controls matched by maternal age and infant sex. Urinary concentrations of twenty-one mVOCs and three oxidative stress biomarkers (including 8-OHdG, 8-OHG, and HNEMA), in early pregnancy were measured. Analyses using logistic regression model showed that an interquartile range increase in urinary concentrations of six individual mVOCs (ATCA, BPMA, CEMA, 3HPMA, MU, and TGA) were significantly associated with increased odds of GDM by 19-27%. Weighted quantile sum regression analyses showed that in each quartile increment of the mixture of mVOCs, the odds of GDM increased by 39% (95% CI: 16%, 67%), with 2-aminothiazoline-4-carboxylic acid weighted the most in the associations (weight: 25%). Furthermore, significant associations of the oxidative stress biomarkers with both GDM and certain mVOCs were observed. These results suggested that certain urinary mVOCs (correspondingly, the parent VOCs such as 1-bromopropane, cyanide, and benzene should be concerned as priority ones for regulation and policy making) in early pregnancy were significantly associated with elevated GDM incidence, and the associations were potentially related with oxidative stress biomarkers.

Rice Bran: From Waste to Nutritious Food Ingredients

Rice (Oryza sativa L.) is a principal food for more than half of the world's people. Rice is predominantly consumed as white rice, a refined grain that is produced during the rice milling process which removes the bran and germ and leaves the starchy endosperm. Rice bran is a by-product produced from the rice milling process, which contains many bioactive compounds, for instance, phenolic compounds, tocotrienols, tocopherols, and γ-oryzanol. These bioactive compounds are thought to protect against cancer, vascular disease, and type 2 diabetes. Extraction of rice bran oil also generates various by-products including rice bran wax, defatted rice bran, filtered cake, and rice acid oil, and some of them exert bioactive substances that could be utilized as functional food ingredients. However, rice bran is often utilized as animal feed or discarded as waste. Therefore, this review aimed to discuss the role of rice bran in metabolic ailments. The bioactive constituents and food product application of rice bran were also highlighted in this study. Collectively, a better understanding of the underlying molecular mechanism and the role of these bioactive compounds exerted in the rice bran would provide a useful approach for the food industry and prevent metabolic ailments.

Therapeutic Potential of Molecular Hydrogen in Metabolic Diseases from Bench to Bedside

Oxidative stress and chronic inflammation have been implicated in the pathophysiology of metabolic diseases, including diabetes mellitus (DM), metabolic syndrome (MS), fatty liver (FL), atherosclerosis (AS), and obesity. Molecular hydrogen (H₂) has long been considered a physiologically inert gas. In the last two decades, accumulating evidence from pre-clinical and clinical studies has indicated that H₂ may act as an antioxidant to exert therapeutic and preventive effects on various disorders, including metabolic diseases. However, the mechanisms underlying the action of H₂ remain unclear. The purpose of this review was to (1) provide an overview of the current research on the potential effects of H₂ on metabolic diseases; (2) discuss the possible mechanisms underlying these effects, including the canonical anti-oxidative, anti-inflammatory, and anti-apoptotic effects, as well as suppression of ER stress, activation of autophagy, improvement of mitochondrial function, regulation of gut microbiota, and other possible mechanisms. The potential target molecules of H₂ will also be discussed. With more high-quality clinical trials and in-depth mechanism research, it is believed that H₂ will eventually be applied to clinical practice in the future, to benefit more patients with metabolic disease.