Association between decreased thyroid stimulating hormone and hyperuricemia in type 2 diabetic patients with early-stage diabetic kidney disease

Diabetic ketoacidosis treatment outcomes and associated factors among adult diabetic patients in Ethiopia: A systematic review and meta-analysis

Background

Diabetic ketoacidosis is a severe complication of diabetes that can threaten life and has a considerable effect on healthcare systems, especially in developing nations such as Ethiopia. Although it is clinically significant, comprehensive data on the factors that lead to unsatisfactory treatment outcomes in diabetic ketoacidosis patients in Ethiopia are lacking. This review aims to investigate and evaluate unsatisfactory treatment outcomes and multiple contributing factors related to diabetic ketoacidosis among patients with diabetes in Ethiopia. This review seeks to identify these factors to provide insights that can guide improvements in the management and treatment of diabetic patients.

Methods

Articles documenting unfavorable treatment outcomes and related aspects of diabetic ketoacidosis among Ethiopian diabetes patients were meticulously sought from various databases, including PubMed/MEDLINE, the Cochrane Library, Science Direct, HINARI, Google Scholar, and gray literature. After the data were extracted, they were imported into Stata software version 17 for analysis. The Cochrane Q test and I2 statistic were used to evaluate heterogeneity.

Results

A total of 580 duplicates were eliminated from the initial set of 1578 papers obtained from PubMed (3), Google Scholar (1,550), HINARI (11), Science Direct (13), and the Cochrane Library (1). The pooled prevalence of poor treatment outcomes for diabetic ketoacidosis was 8 %. Key risk factors for poor treatment outcomes included a Glasgow Coma Scale (GCS) score of less than 15 (POR = 3.16; 95 % CI: 1.52-4.80), sepsis (POR = 2.92; 95 % CI: 1.12-4.72), and comorbidities (POR = 3.66; 95 % CI: 1.64-5.68).

Conclusion

The pooled prevalence of poor treatment outcomes of diabetic ketoacidosis in Ethiopia was high. A GCS score of less than 15, sepsis, and comorbidities were identified as significant risk factors for poor treatment outcomes in diabetic ketoacidosis patients. Addressing and minimizing these factors could help reduce the incidence of poor treatment outcomes in diabetic ketoacidosis patients in Ethiopia.

Metabolic crosstalk and therapeutic interplay between diabetes and hyperuricemia

Hyperuricemia and diabetes mellitus (DM) are prevalent metabolic disorders with high comorbidity, imposing a substantial global public health burden. Their coexistence is not merely additive but synergistic, exacerbating metabolic dysregulation through mechanisms such as insulin resistance and β-cell apoptosis, ultimately establishing a vicious cycle. Both disorders induce acute and chronic damage to vital organs, particularly the cardiovascular, renal systems. Hyperuricemia aggravates diabetic complications, notably diabetic cardiomyopathy, nephropathy and retinopathy via oxidative stress, inflammation, and metabolic dysregulation.Current urate-lowering therapies (ULTs), such as xanthine oxidase inhibitors and urate transporter 1 (URAT1, also known as SLC22A12) antagonists, demonstrate potential benefits in ameliorating diabetic complications but face challenges including safety concerns and dose adjustments. Similarly, several glucose-lowering drugs also exhibit the benefits of improving hyperuricemia. This review summarizes the metabolic crosstalk and therapeutic interplay between hyperuricemia and DM, examines the pathogenic role of uric acid in diabetic complications, and discusses the benefits and challenges of existing ULTs and glucose-lowering drugs in disrupting this cycle of metabolic dysregulation and concurrent organ damage. We hope our findings deepen the comprehension of the intricate metabolic crosstalk between glucose and urate homeostasis, providing novel therapeutic insights for patients with comorbid DM and hyperuricemia.

Evaluation of the Prevalence of Hypomagnesemia and the Related Risk Factors in Patients Admitted to a Referral Heart Hospital in Isfahan

Background

Magnesium is one of the most abundant cations in the body and plays a vital role in the function of the cardiovascular system. Hypomagnesemia can cause severe and dangerous cardiovascular complications. Also, since drugs that can lead to hypomagnesemia are commonly prescribed to cardiac patients, we decided to investigate the prevalence of hypomagnesemia in the population of cardiac patients to be aware of the prevalence of this condition as an important risk factor for cardiovascular events.

Materials and Methods

This study is a retrospective cross-sectional study of an analytical-observational type with a fundamental-applied approach, in which by recording the information of patients in pre-designed forms, the prevalence of hypomagnesemia in them and also the prevalence of hypomagnesemia separation of different heart diseases and the relationship of hypomagnesemia with age, sex, glomerular filtration rate (GFR), and drugs used have been evaluated.

Results

A total of 982 patients were included in the study, of which 636 were men and 346 were women. The average age of the patients in this study was 63 years. Hypomagnesemia was observed in 138 patients (14%), and the prevalence of hypomagnesemia in patients with ventricular arrhythmias was 40%. It was also observed that only 47% of the patients with hypomagnesemia received magnesium, and the rest were not treated.

Conclusion

This study highlights the importance of magnesium status and its relationship with various clinical factors in the studied population. This emphasizes the need to increase attention to hypomagnesemia, especially among vulnerable groups such as women and older adults.

Association between FT4/FT3 ratio and microalbuminuria in euthyroid patients with type 2 diabetes mellitus

Aims Studies confirm that microalbuminuria (MAU) can not only predict diabetic kidney disease (DKD) but also indicate of systemic vascular endothelial injury. Thyroid hormones (TH) have been reported to be associated with various cardiovascular diseases and endothelial cell damage. Currently, few studies have reported the association between free thyroxine (FT4) to free triiodothyronine (FT3) ratio and MAU. The purpose of this study was to investigate the association between FT4/FT3 ratio and MAU in euthyroid patients with type 2 diabetes mellitus (T2DM). Methods This study enrolled a total of 1734 T2DM patients with euthyroid status. MAU was defined as 30 ≤ urinary albumin-to-creatinine ratio (UACR) < 300 mg/g. The participants were divided into MAU group and normal albuminuria group (NAU group). The relationship between FT4/FT3 ratio and MAU was analyzed. Results In this study, there were 367 patients with MAU. Compared with the NAU group, the MAU group had higher FT4/FT3 ratio (P < 0.001). In univariate analysis, the FT4/FT3 ratio was positively related to both UACR and MAU (both P < 0.001). In multivariate linear stepwise regression, the FT4/FT3 ratio is independently related to UACR (Standardized coefficients: 0.148, P < 0.001). In binary logistic regression analysis, the FT4/FT3 ratio emerges as an independent risk factor for MUA (odds ratio: 1.947, 95% confidence interval: 1.522-2.491). Conclusion The FT4/FT3 ratio was independently and positively correlated with MAU in euthyroid patients with T2DM.

The role of advanced glycation end products between thyroid function and diabetic nephropathy and metabolic disorders

purpose of this study was to investigate the relationship between AGEs, TSH, metabolic metrics and DN, and to provide evidence for future intervention.

METHOD

This study selected community health service centers which had signed medical alliance agreement with the First Affiliated Hospital of Anhui Medical University and outpatints and inpatients in Anhui province. From March 2018 to July 2022, the multi-stage cluster sampling. method was used to screen residents aged 18-90 years in the above areas. Participants' blood was collected on an empty stomach to detect TSH, blood lipids, liver and kidney function and blood glucose, in addition, AGEs levels were detected by skin autofluorescence (SAF), and urine was retained to measure the ratio of urinary microalbumin to creatinine concentration by ACR. One-way ANOVA was used to compare the differences between general data, biochemical markers, and urinary ACR, association between variables.

RESULT

A total of 7000 patients who participated in community health examination and inpatients and also had no history of serious mental disorders were selected. After excluding data with missing value of more than 5%, 6921 samples were finally included, and the effective rate was 94.4%. Following health risk factors (HRFs), such as body mass index (BMI), TSH, low-density lipoprotein (LDL), TyG (triglyceride glucose index), systolic blood pressure (SBP), cholesterol (TC), and uric acid (UA) were associated with a higher incidence of urine ACR. In moderation analysis, there is an significant effect among TSH, AGEs and DN, HRFs moderate also these effect.

CONCLUSION

The findings suggest that HRFs such as HDL, TyG and TC should be prioritized when evaluating indicators related to DN to effectively reduce DN in Chinese patients with high health risk levels. Comprehensive indicators may be an effective and practical. method to evaluate the metabolic progression of DN. Optimizing thyroid function management may be a new strategy to prevent and treat DN and may help reduce the risk of AGE-related complications in people with diabetes. This study highlights the important role of AGEs in the relationship between TSH and DN. In addition, future studies should further explore how to improve the management and prevention of DN by regulating TSH.Among the leading causes of disability and death in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes (T2DM), chronic kidney disease (CKD) occupies a certain position. Multi-factor intervention targeting advanced glycation end products (AGEs), blood glucose, blood pressure and lipids can reduce the morbidity and mortality of diabetic nephropathy (DN) in T2DM patients through thyroid stimulating hormone (TSH), which plays an important role in the pathological process of metabolic diseases such as DN. AGEs, as a key factor in metabolic regulation, may affect the formation and function of the thyroid gland; However, in DN, the correlation between AGEs and TSH has not been clarified. We hypothesized that AGEs aggravated the negative effect of TSH on DN. The.

Validity and reliability of the health belief model questionnaire for dietary patterns and physical activity in prediabetes

BACKGROUND

The health belief model (HBM) questionnaire for dietary patterns and physical activity is important for assessing behavior in prediabetes subjects. Assessing health behavior important to design intervention that can control development of prediabetes. The study aimed to examine the validity and reliability of the HBM questionnaire for dietary patterns and physical activity in prediabetes.

MATERIALS AND METHODS

A descriptive method was used comprising validity and reliability tests; specifically, the content validity was assessed by 10 panelists of nutrition in public health and education experts. Meanwhile, face validity and reliability tests were performed by 10 and 30 respondents, respectively. Content validity was conducted quantitatively with the content validity index (CVI), kappa statistics score, along with qualitative assessment. The reliability test was carried out based on Cronbach's alpha.

RESULTS

The results showed that CVI analysis and kappa statistics obtained values between 0.77-1 and -5.24-0.99, respectively. The face validity analysis produced a value >1,5, while the reliability test obtained Cronbach's alpha value of 0,821. The final questionnaire was based on the recommendations of the panelists as well as the results of validity and reliability tests including 47 HBM item statements.

CONCLUSIONS

The HBM questionnaire was found to be valid and reliable for assessing behavior about dietary patterns and physical activity in prediabetic. This instrument could be used by healthcare providers in studies and clinical practice to measure behavior dietary patterns and physical activity as well as to develop interventions for prediabetes.

SERS profiling of blood serum filtrate components from patients with type II diabetes using 100 kDa filtration devices

Blood carries some of the most valuable biomarkers for disease screening as it interacts with various tissues and organs in the body. Human blood serum is a reservoir of high molecular weight fraction (HMWF) and low molecular weight fraction (LMWF) proteins. The LMWF proteins are considered disease marker proteins and are often suppressed by HMWF proteins during analysis. This issue is addressed by using a filtration device to isolate the filtrate portion from blood serum samples having biomarker proteins up to the size of the cutoff value of the filtration device. In this research, 100 kDa filter devices are employed to obtain the filtrate portions from blood serum samples of type II diabetes mellitus patients and healthy volunteers, followed by characterization using surface-enhanced Raman spectroscopy (SERS) with silver nanoparticles (Ag NPs) as the SERS substrate. By using this approach, the collected filtrate is expected to contain marker proteins at a size of <100 kDa, which are associated with type II diabetes. These marker proteins are in a narrow size range (cutoff value of 100 kDa). Hence, they may be more easily identified by their characteristic SERS spectral features as compared to their analysis in the respective whole blood serum samples due to the exclusion of larger size proteins. These proteins that are present in the filtrate portions of type II diabetes may include adiponectin, C-reactive protein, insulin, leptin, RBP4, IL-6, TNF-α, Fibroblast Growth Factor 21 (FGF21), albumin, transthyretin, alpha-antitrypsin, transferrin, apolipoprotein A-1 (ApoA-1) and fetuin-A. Some prominent SERS bands are observed at 356 cm-1, 435 cm-1, 490 cm-1, 548 cm-1, 596 cm-1, 729 cm-1, 746 cm-1, 950 cm-1, 1330 cm-1, 1362 cm-1, 1573 cm-1 and 1689 cm-1, which differentiate type II diabetes patients from healthy individuals. Moreover, the SERS spectral data sets of various samples are classified using two chemometric approaches: principal component analysis (PCA) and partial least square discriminant analysis (PLS-DA). The validation of the PLS-DA analysis classification model is indicated with 81% accuracy, 79% specificity, and 85% sensitivity, having a value of AUC = 0.75.

Application of composite reference intervals in the diagnosis of subclinical hypothyroidism in the elderly: a retrospective study

Background

Thyroid stimulating hormone releasing hormone (TSH) is a key indicator for diagnosing subclinical hypothyroidism (SCH). We evaluated factors affecting TSH levels in elderly SCH, establishing a composite reference interval, and comparing it with traditional one in diagnosis.

Methods

We collected data on patients aged ≥60 undergoing physical examinations in Chengdu, screening the influencing factors associated with TSH. Then, a two-dimensional composite reference interval was established for TSH and FT4, and the differences between the new and traditional diagnosing methods were compared.

Results

The incidence of subclinical thyroid dysfunction was about 14%, with SCH accounting for 97%. Regression analysis found that TSH levels increase as FT4 and uric acid levels decrease. Compared with the two-dimensional composite reference interval, the traditional one has a higher incidence rate of SCH.

Conclusion

Compared with the two-dimensional composite reference interval, the traditional one is more likely to overestimate the incidence rate of SCH, leading to excessive diagnosis and treatment.

Association between serum vitamin D and the risk of diabetic kidney disease in patients with type 2 diabetes

Aims

This investigation explored the potential correlation between serum vitamin D concentration and diabetic kidney disease (DKD) among patients with type 2 diabetes mellitus (T2DM).

Methods

This cross-sectional study assessed 4,570 patients with T2DM drawn from the National Health and Nutrition Examination Survey (NHANES) dataset. Restricted cubic splines were utilized to examine the dose-response relationship between serum vitamin D levels and the risk of DKD in patients with T2DM. Serum vitamin D concentrations were divided into quartiles for multivariable logistic regression analysis to evaluate the association between varying serum vitamin D levels and DKD risk in patients with T2DM. Additionally, sex-stratified analyses were conducted to determine consistency of the results. The influence of vitamin D concentrations on mortality risk was assessed using a Cox regression model.

Results

Of the patients with T2DM, 33% were diagnosed with DKD. Restricted cubic spline plots revealed a U-shaped relationship between vitamin D levels and DKD risk, with a protective effect noted in the mid-range, indicating optimal serum vitamin D concentrations between 59.6 nmol/L and 84.3 nmol/L. The multivariate Cox regression analysis suggested that higher VID levels were associated with a reduced mortality risk, particularly in male patients.

Conclusion

The regulation and monitoring of serum vitamin D levels within an optimal range may play a pivotal role in the prevention of DKD in patients with T2DM. Public health strategies should emphasize the regular monitoring of vitamin D levels, especially among populations at elevated risk, to mitigate the progression of DKD and decrease the associated mortality rates.

Evaluation of elevated serum liver enzymes and metabolic syndrome in the PERSIAN Guilan cohort study population

Objective

The purpose of this study is to evaluate the association between elevated serum liver enzymes and Metabolic Syndrome (MetS) in Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population.

Methods

This cross-sectional study involved 10,519 individuals between the ages of 35 and 70 enrolled in the PGCS. The gathered data encompassed demographic information, anthropometric measurements, blood pressure, and biochemical indicators. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria (NCEP-ATP III). The associations between elevated liver enzymes and MetS were examined using logistic regression analysis. Odds ratio (OR) and 95 % confidence interval (CI) were calculated.

Results

The prevalence of MetS was 41.8 %, and the prevalence of elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were 19.4, 4.6, 11.6, and 5.1 %, respectively. In the unadjusted model, elevated ALT, AST, and GGT were associated with increased odds of MetS (OR = 1.55, 95 % CI: 1.41-1.71; OR = 1.29, 95 % CI: 1.07-1.55, and OR = 1.90, 95 % CI: 1.69-2.14, respectively). These associations remained significant for ALT and GGT after adjustment for some demographic and clinical characteristics (aOR = 1.31, 95 % CI: 1.17-1.46 and aOR = 1.30, 95 % CI: 1.14-1.49, respectively). In addition, the odds of MetS increased with the number of elevated liver enzymes, up to almost 1.32-fold among subjects with three/four elevated liver enzymes.

Conclusion

The higher incidence of elevated liver enzymes was associated with an increased likelihood of MetS. Including liver markers in diagnosing and predicting MetS holds promise and is considered a possible approach.

Antidiabetic, antidyslipidemia, and renoprotector potency of butterfly pea flower extract (Clitorea ternatea L.) in diabetes mellitus and dyslipidemia rats model

Background

Diabetes mellitus (DM) is a long-term condition marked by high blood glucose levels caused by insulin resistance which will lead to complications of other diseases such as dyslipidemia, which also affects the health of the liver and kidneys. Butterfly pea flower (Clitorea ternatea L.) has phenolic and flavonoid compounds which have the potential as herbal medicines for antidiabetics.

Aim

The purpose of this study is to examine the potential of butterfly pea flower extract (BPE) as an antidiabetic, anti-dyslipidemia, and renoprotection.

Methods

In vivo test was performed on Sprague Dawley rats (Rattus norvegicus L.) induced by Streptozotocin-Nicotinamide and High Fat Diet-Propylthiouracil as models of DM and dyslipidemia, and BPE was administered orally (200, 400, and 800 mg/kg BW) for 28 days. glutathione peroxidase (GSH-Px), glutathione S-transferase (GST), tumor necrosis factor-α (TNF-α), nuclear factor-kappa beta (NF-kB), alkaline phosphatase (ALP), liver albumin levels, serum blood urea nitrogen (BUN), serum creatinine, and serum uric acid (UA), were measured by ELISA and colorimetry methods.

Results

Treatment of BPE 800 mg/kg BW increased levels of GSH-Px, GST, albumin, and serum protein. BPE decreased TNF-α, NF-kB, and ALP. BPE also decreased BUN, serum CR, and serum UA.

Conclusion

BPE has the potential to be used as a drug alternative for the treatment of DM and dyslipidemia as well as a hepatoprotective and renoprotective agent.

Poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia: A systematic review and meta-analysis

Background

Despite the fact that hyperglycemic crisis poses a significant threat to the health care systems of developing countries like Ethiopia, there is a dearth of reliable data regarding the poor treatment outcome and associated factors among hyperglycemic emergencies in Ethiopia. Therefore, this review aimed to assess poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia.

Methods

Published articles regarding poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia were extensively searched from PubMed, Google Scholar, Cochrane library, and African journal online. After extraction, data were exported to Stata software version 11 (Stata Corp LLC, TX, USA) for analysis. Statistically, the Cochrane Q-test and I2 statistics were used to determine the presence or absence of heterogeneity.

Results

3650 duplicates were eliminated from the 4291 papers (PubMed [18], Google scholar (1170), African journal online [21], and Cochrane library (3082)). The pooled estimate of poor treatment outcome among hyperglycemic emergencies in Ethiopia is found to be 16.21% (95% CI: 11.01, 21.41, P < 0.001). Creatinine level >1.2 mg/dl, stroke, sepsis and comorbidity were associated factors of poor treatment outcome.

Conclusion

Poor treatment outcome from hyperglycemic emergencies among diabetic patients was found to be high. Poor treatment outcome was predicted for those patients who had creatinine level >1.2 mg/dl, stroke, sepsis and comorbidity. As a result, we recommend healthcare providers to monitor thoroughly and have close follow-ups for patients with the identified predictors to improve poor treatment outcome from hyperglycemic crises.

Development of a nomogram to predict 30-day mortality of sepsis patients with gastrointestinal bleeding: An analysis of the MIMIC-IV database

Background

We aimed to establish and validate a prognostic nomogram model for improving the prediction of 30-day mortality of gastrointestinal bleeding (GIB) in critically ill patients with severe sepsis.

Methods

In this retrospective study, the current retrospective cohort study extracted data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, then partitioned the cohort randomly into training and validation subsets. The cohort was partitioned into training and validation subsets randomly. Our primary endpoint was 30-day all-cause mortality. To reduce data dimensionality and identify predictive variables, the least absolute shrinkage and selection operator (LASSO) regression was employed. A prediction model was constructed by multivariate logistic regression. Model performance was evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).

Results

The analysis included 1435 total patients, comprising 1005 in the training cohort and 430 in the validation cohort. We found that age, smoking status, glucose, (BUN), lactate, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilation≥48h (MV), parenteral nutrition (PN), and chronic obstructive pulmonary disease (COPD) independently influenced mortality in sepsis patients with concomitant GIB. The C-indices were 0.746 (0.700-0.792) and 0.716 (0.663-0.769) in the training and validation sets, respectively. Based on the area under the curve (AUC) and DCA, the nomogram exhibited good discrimination for 30-day all-cause mortality in sepsis with GIB.

Conclusions

For sepsis patients complicated with GIB, we created a unique nomogram model to predict the 30-day all-cause mortality. This model could be a significant therapeutic tool for clinicians in terms of personalized treatment and prognosis prediction.

LncRNA HCP5 is Highly Expressed in Gestational Diabetes Mellitus to Suppress Insulin Secretion

Purpose

LncRNA HCP5 has been reported to participate in high glucose-induced pathological processes, whereas its role in gestational diabetes mellitus (GDM) is unclear. This study aimed to explore the role of HCP5 in GDM.

Methods

This study enrolled a total of 220 pregnant women (gestational age = 1 month). A follow-up study was performed until delivery. The occurrence of GDM was checked every month during follow-up. Plasma samples were collected from all participants and expression of HCP5 was determined with RT-qPCR. The 220 patients were divided into high and low GDM groups, and GDM-free curves were plotted for both groups and compared. The ROC curve was plotted to explore the predictive value of plasma HCP5 on the day of admission for GDM. INS-1 cells were transfected with HCP5 expression vector or siRNA, and cell viability under high glucose was determined by the MTT assay. An ELISA was applied to determine insulin levels in the cell culture medium.

Results

During follow-up, the level of HCP5 was increased during pregnancy and the high HCP5 level group showed a significantly higher incidence of GDM. Plasma levels of HCP5 on the day of admission effectively separated GDM patients from healthy controls. HCP5 negatively regulated cell viability and insulin secretion under high glucose treatment.

Conclusion

HCP5 may act as a predictor for GDM, and it negatively regulated INS-1 cell viability and insulin secretion under high glucose conditions.

Investigation of the interaction between Genetic Risk Score (GRS) and fatty acid quality indices on mental health among overweight and obese women

BACKGROUND & AIMS

Mental disorders are associated with dietary fatty acids and genome-wide association studies have found multiple risk loci robustly related to depression, anxiety, and stress. The aim of this study is to investigate the interaction of genetic risk score (GRS) and dietary fat quality indices on mental health.

METHODS

This cross-sectional study included 279 overweight and obese women for N6/N3 ratio and 378 overweight and obese women for CSI aged 18-68 years. Using reliable and verified standard protocols, body composition, anthropometric indices, blood pressure, physical activity, and dietary fat quality were measured. Serum samples were used to determine biochemical tests. A genetic risk score (GRS) was calculated using the risk alleles of the three SNPs. A generalized linear model (GLM) was applied to assess the interactions between GRS and fat quality indices. Mental health was evaluated using Depression Anxiety Stress Scales (DASS-21).

RESULTS

The mean (± SD) age and BMI of our participants were 36.48 (8.45) and 30.73 (3.72) kg/m2 respectively. There was a marginally significant mean difference among tertiles of the CSI in terms of stress (P = 0.051), DASS-21 (P = 0.078) in the crude model. After adjusting for age, energy intake, physical activity and BMI in model 1, there was a positive interaction between GRS and T3 of N6/N3 ratio on anxiety (β = 0.91, CI = 0.08,1.75, P = 0.031), depression (β = 1.05, CI = 0.06,2.04, P = 0.037), DASS-21 (β = 2.22, CI= -0.31,4.75, P = 0.086).

CONCLUSION

Our findings indicate that higher ratio of N-6 to N-3 considering genetics were predictive of mental disorder in our population.

Artemisinin attenuates type 2 diabetic cardiomyopathy in rats through modulation of AGE-RAGE/HMGB-1 signaling pathway

Diabetes mellitus is a common metabolic disorder. About two-thirds of diabetic patients develop diabetic cardiomyopathy (DCM), which becomes a challenging issue as it severely threatens the patient's life. Hyperglycemia and the resulting advanced glycated end products (AGE) and their receptor (RAGE)/High Mobility Group Box-1 (HMGB-1) molecular pathway are thought to be key players. Recently, artemisinin (ART) has gained more attention owing to its potent biological activities beyond its antimalarial effect. Herein, we aim to evaluate the effect of ART on DCM and the possible underlying mechanisms. Twenty-four male Sprague-Dawley rats were divided into: control, ART, type 2 diabetic and type 2 diabetic treated with ART groups. At the end of the research, the ECG was recorded, then the heart weight to body weight (HW/BW) ratio, fasting blood glucose, serum insulin and HOMA-IR were evaluated. Cardiac biomarkers (CK-MB and LDH), oxidative stress markers, IL-1β, AGE, RAGE and HMGB-1 expression were also measured. The heart specimens were stained for H&E as well as Masson's trichrome. DCM induced disturbances in all studied parameters; contrary to this, ART improved these insults. Our study concluded that ART could improve DCM through modulation of the AGE-RAGE/HMGB-1 signaling pathway, with subsequent impacts on oxidative stress, inflammation and fibrosis. ART could therefore be a promising therapy for the management of DCM.

Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population

BACKGROUND

Impaired sensitivity to thyroid hormones is a newly proposed clinical entity associated with hyperuricemia in the subclinical hypothyroid population. However, it is unknown whether the association exists in the euthyroid population. This study aimed to explore the association of impaired sensitivity to thyroid hormones (assessed by the thyroid feedback quantile-based index [TFQI], parametric thyroid feedback quantile-based index [PTFQI], thyrotrophic thyroxine resistance index [TT4RI] and thyroid-stimulating hormone index [TSHI]) with hyperuricemia and quantify the mediating effect of body mass index BMI in the euthyroid population.

METHODS

This cross-sectional study enrolled Chinese adults aged ≥ 20 years who participated in the Beijing Health Management Cohort (2008-2019). Adjusted logistic regression models were used to explore the association between indices of sensitivity to thyroid hormones and hyperuricemia. Odds ratios [OR] and absolute risk differences [ARD] were calculated. Mediation analyses were performed to estimate direct and indirect effects through BMI.

RESULTS

Of 30,857 participants, 19,031 (61.7%) were male; the mean (SD) age was 47.3 (13.3) years; and 6,515 (21.1%) had hyperuricemia. After adjusting for confounders, individuals in the highest group of thyroid hormone sensitivity indices were associated with an increased prevalence of hyperuricemia compared with the lowest group (TFQI: OR = 1.18, 95% CI 1.04-1.35; PTFQI: OR = 1.20, 95% CI 1.05-1.36; TT4RI: OR = 1.17, 95% CI 1.08-1.27; TSHI: OR = 1.12, 95% CI 1.04-1.21). BMI significantly mediated 32.35%, 32.29%, 39.63%, and 37.68% of the associations of TFQI, PTFQI, TT4RI and TSHI with hyperuricemia, respectively.

CONCLUSIONS

Our research revealed that BMI mediated the association between impaired sensitivity to thyroid hormones and hyperuricemia in the euthyroid population. These findings could provide useful evidence for understanding the interaction between impaired sensitivity to thyroid hormone and hyperuricemia in euthyroid individuals and suggest the clinical implications of weight control in terms of impaired thyroid hormones sensitivity.

Ameliorative effect of cheqianzi decoction on hyperuricemia and kidney injury and underlying mechanism in rats

Cheqianzi Decoction (CQD) is a Traditional Chinese Medicine (TCM) formula comprising four herbs and is recorded in the Ancient Materia Medica "Shengji Zonglu". Individually, these four herbs have been shown to reduce uric acid (UA) levels, to treat hyperuricemia (HUA), and alleviate kidney damage. However, the therapeutic efficacy of the CQD and related mechanism are not yet clear. In this study, high performance liquid chromatography (HPLC) analysis confirmed that the contents of the chemical components of the four herbal medicines were in accordance with the provisions of the Chinese Pharmacopoeia. A total of 99 potential targets were identified in the network pharmacology analysis of CQD, indicating its involvement in the regulation of inflammatory and apoptotic signaling pathways, and potential value for treating HUA and alleviating kidney injury. In vivo pharmacodynamic studies showed that compared with the Model group, significantly decreased levels of serum uric acid (SUA), serum creatinine (SCr), blood urea nitrogen (BUN) (all P < 0.05), and inflammatory factors (P < 0.01) were detected in the CQD group. Quantitative real-time PCR and Western blot analyses showed that compared with the Model group, adenosine triphosphate (ATP)-binding cassette efflux transporter G2 (ABCG2) expression in the CQD group was significantly upregulated (P < 0.01) at both the mRNA and protein levels, while mRNA expression of Caspase3 and NOD-like receptor family member 3 (NLRP3) (P < 0.05) and protein expression of NLRP3 (P < 0.01) were significantly downregulated. In conclusion, CQD promotes UA excretion by activating ABCG2, and induces inflammasome NLRP3-mediated reduction in inflammatory and apoptotic factors to achieve renal protection. Thus, our findings indicate the therapeutic potential of CQD in HUA with kidney injury.

A high Diabetes Risk Reduction Score (DRRS) is associated with a better cardio-metabolic profile among obese individuals

BACKGROUND

Dietary indices and scores are valuable predictive markers against chronic diseases. Several previous studies have revealed the beneficial effects of diabetes risk reduction score (DRRS) against diabetes and cancer incidence. However, its association with metabolic abnormalities among obese individuals have not been revealed before. In the current study, we aimed to investigate the association between DRRS and metabolic risk factors among obese individuals.

METHODS

In the current cross-sectional study, 342 obese individuals [Body mass index (BMI) ≥ 30 kg/m2] aged 20-50 years were included. Dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 168 food items and DRRS was calculated. Metabolic syndrome (MetS) was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by a sphygmomanometer and body composition with bioelectrical impedance analysis (BIA).

RESULTS

Those with a higher adherence to DRRS had a significantly higher intake of energy, fiber, and lower protein compared with those in the lower quartiles. Moreover, lower intakes of trans fats, meat, sugar sweetened beverages (SSB), and glycemic index (GI) with higher intakes of fruits, cereal fiber, polyunsaturated fatty acids/ saturated fatty acids (PUFA/ SFA) ratio, coffee, and nuts were observed in the highest versus lowest DRRS categories. Lower systolic blood pressure, diastolic blood pressure, triglyceride and, higher high-density lipoprotein values were observed in higher DRRS categories. Logistic regression analysis showed that hypertension was significantly associated with adherence to DRRS among obese individuals, the odds ratio (OR) was 0.686 (95% confidence interval [CI], 0.26-0.84) after adjustment for potential confounders. But the risk of other components of MetS was not significantly associated with higher quartiles of adherence to DRRS. Also, a non-significantly lower prevalence of MetS was observed in the higher quartile of DRRS.

CONCLUSIONS

According to the results of the current study, higher DRRS was associated with lower blood pressure, modified serum lipids, and lower Mets prevalence. Further studies in different populations are warranted for better generalization of the obtained findings.

Endoplasmic reticulum stress inhibition ameliorated WFS1 expression alterations and reduced pancreatic islets' insulin secretion induced by high-fat diet in rats

Endoplasmic reticulum (ER) stress is involved in the development of glucose homeostasis impairment. When ER stress occurs, the unfolded protein response (UPR) is activated to cope with it. One of the UPR components is WFS1 (Wolfram syndrome 1), which plays important roles in ER homeostasis and pancreatic islets glucose-stimulated insulin secretion (GSIS). Accordingly and considering that feeding high-fat food has a major contribution in metabolic disorders, this study aimed to investigate the possible involvement of pancreatic ER stress in glucose metabolism impairment induced by feeding high-fat diet (HFD) in male rats. After weaning, the rats were divided into six groups, and fed on normal diet and HFD for 20 weeks, then 4-phenyl butyric acid (4-PBA, an ER stress inhibitor) was administered. Subsequently, in all groups, after performing glucose tolerance test, the animals were dissected and their pancreases were removed to extract ER, islets isolation and assessment of GSIS. Moreover, the pancreatic ER stress [binding of immunoglobulin protein (BIP) and enhancer-binding protein homologous protein (CHOP)] and oxidative stress [malondialdehyde (MDA), glutathione (GSH) and catalase] biomarkers as well as WFS1 expression level were evaluated. HFD decreased pancreatic WFS1 protein and GSH levels, and enhanced pancreatic catalase activity, MDA content, BIP and CHOP protein and mRNA levels as well as Wfs1 mRNA amount. Accordingly, it increased BIP, CHOP and WFS1 protein levels in the extracted ER of pancreas. In addition, the HFD caused glucose intolerance, and decreased the islets' GSIS and insulin content. However, 4-PBA administration restored the alterations. It seems that, HFD consumption through inducing pancreatic ER stress, altered WFS1 expression levels, reduced the islets' GSIS and insulin content and finally impaired glucose homeostasis.

A Multifactorial Risk Score System for the Prediction of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus

PURPOSE

In-depth investigations of risk factors for the identification of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) are rare. We aimed to investigate the risk factors for developing DKD from multiple types of clinical data and conduct a comprehensive risk assessment for individuals with diabetes.

METHODS

We carried out a case-control study, enrolling 958 patients to identify the risk factors for developing DKD in T2DM patients from a database established from inpatient electronic medical records. Multivariable logistic regression was applied to develop a prediction model and the performance of the model was evaluated using the area under the curve (AUC) and calibration curve. A multifactorial risk score system was established according to the Framingham Study risk score.

RESULTS

DKD accounted for 34.03% of eligible patients in total. Twelve risk factors were selected in the final prediction model, including age, duration of diabetes, duration of hypertension, fasting blood glucose, fasting C-peptide, insulin use, systolic blood pressure, low-density lipoprotein, γ-glutamyl transpeptidase, platelet, uric acid, and thyroid stimulating hormone; and one protective factor, serum albumin. The prediction model showed an AUC of 0.862 (95% Confidence Interval (CI) 0.834-0.890) with an accuracy of 81.5% in the derivation dataset and an AUC of 0.876 (95% CI 0.825-0.928) in the validation dataset. The calibration curves were excellent and the estimated probability of DKD was more than 80% when the cumulative score for risk factors reached 17 points.

CONCLUSION

Newly recognized risk factors were applied to assess the development of DKD in T2DM patients and the established risk score system was a reliable and feasible tool for assisting clinicians to identify patients at high risk of DKD.

Advance in the Correlation between Diabetic Nephropathy and Abnormal Serum Thyroid Hormone Levels in Patients

This study was developed to explore the correlation between diabetic nephropathy (DN) and abnormal serum thyroid hormone (TH) levels in patients, which can provide a reference for disease prevention and control in patients with DN. DN is the most serious complication of diabetes. The mortality rate of diabetic patients with DN is approximately 30 times higher than that of diabetic patients without DN. DN leads to high blood sugar, which causes vascular dysfunction in patients, causes cardiovascular disease, aggravates the disease and disease complexity, and thus increases the mortality of patients. DN patients often have oxidative stress and even fibrosis in severe cases. TH has a potential renal protective effect and can also regulate glucose metabolism and improve abnormal glucose tolerance and insulin resistance. Abnormal serum TH levels increase the risk of DN. Normal thyroid function plays an important role in regulating the physiological functions of the human body. Hormonal disorders promote the development of diabetes mellitus (DM) into DN. The pathogenesis, clinical manifestations, detection, and treatment methods of DN were reviewed in this study. The research progress of the influence of TH on DN was analyzed. This study is conducive to clinical research on DN and provides a reference.

Maternal stress induced endoplasmic reticulum stress and impaired pancreatic islets’ insulin secretion via glucocorticoid receptor upregulation in adult male rat offspring

Exposure to perinatal (prenatal and/or postnatal) stress is considered as a risk factor for metabolic disorders in later life. Accordingly, this study aimed to investigate the perinatal stress effects on the pancreatic endoplasmic reticulum (ER) stress induction, insulin secretion impairment and WFS1 (wolframin ER transmembrane Glycoprotein, which is involved in ER homeostasis and insulin secretion) expression changes, in rat offspring. According to the dams’ period of exposure to variable stress, their male offspring were divided into, control (CTRL); pre-pregnancy, pregnancy, lactation stress (PPPLS); pre-pregnancy stress (PPS); pregnancy stress (PS); lactation stress (LS); pre-pregnancy, pregnancy stress (PPPS); pregnancy, lactation stress (PLS); pre-pregnancy, lactation stress (PPLS) groups. Offspring pancreases were removed for ER extraction and the assessment of ER stress biomarkers, WFS1 gene DNA methylation, and isolated islets’ insulin secretion. Glucose tolerance was also tested. In the stressed groups, maternal stress significantly increased plasma corticosterone levels. In PPS, PS, and PPPS groups, maternal stress increased Bip (Hsp70; heat shock protein family A member 4), Chop (Ddit3; DNA- damage inducible transcript3), and WFS1 protein levels in pancreatic extracted ER. Moreover, the islets’ insulin secretion and content along with glucose tolerance were impaired in these groups. In PPS, PS, LS and PPPS groups, the pancreatic glucocorticoid receptor (GR) expression increased. Maternal stress did not affect pancreatic WFS1 DNA methylation. Thus, maternal stress, during prenatal period, impaired the islets’ insulin secretion and glucose homeostasis in adult male offspring, possibly through the induction of ER stress and GR expression in the pancreas, in this regard the role of WFS1 protein alteration in pancreatic ER should also be considered.

Biophysical insights into glucose-dependent transcriptional regulation by PDX1

The pancreatic and duodenal homeobox 1 (PDX1) is a central regulator of glucose-dependent transcription of insulin in pancreatic β cells. PDX1 transcription factor activity is integral to the development and sustained health of the pancreas; accordingly, deciphering the complex network of cellular cues that lead to PDX1 activation or inactivation is an important step toward understanding the etiopathologies of pancreatic diseases and the development of novel therapeutics. Despite nearly 3 decades of research into PDX1 control of Insulin expression, the molecular mechanisms that dictate the function of PDX1 in response to glucose are still elusive. The transcriptional activation functions of PDX1 are regulated, in part, by its two intrinsically disordered regions, which pose a barrier to its structural and biophysical characterization. Indeed, many studies of PDX1 interactions, clinical mutations, and posttranslational modifications lack molecular level detail. Emerging methods for the quantitative study of intrinsically disordered regions and refined models for transactivation now enable us to validate and interrogate the biochemical and biophysical features of PDX1 that dictate its function. The goal of this review is to summarize existing PDX1 studies and, further, to generate a comprehensive resource for future studies of transcriptional control via PDX1.

Epigenetic and transcriptomic alterations in offspring born to women with type 1 diabetes (the EPICOM study)

BACKGROUND

Offspring born to women with pregestational type 1 diabetes (T1DM) are exposed to an intrauterine hyperglycemic milieu and has an increased risk of metabolic disease later in life. In this present study, we hypothesize that in utero exposure to T1DM alters offspring DNA methylation and gene expression, thereby altering their risk of future disease.

METHODS

Follow-up study using data from the Epigenetic, Genetic and Environmental Effects on Growth, Metabolism and Cognitive Functions in Offspring of Women with Type 1 Diabetes (EPICOM) collected between 2012 and 2013.

SETTING

Exploratory sub-study using data from the nationwide EPICOM study.

PARTICIPANTS

Adolescent offspring born to women with T1DM (n=20) and controls (n=20) matched on age, sex, and postal code.

MAIN OUTCOME MEASURES

This study investigates DNA methylation using the 450K-Illumina Infinium assay and RNA expression (RNA sequencing) of leucocytes from peripheral blood samples.

RESULTS

We identified 9 hypomethylated and 5 hypermethylated positions (p < 0.005, |ΔM-value| > 1) and 38 up- and 1 downregulated genes (p < 0.005, log2FC ≥ 0.3) in adolescent offspring born to women with T1DM compared to controls. None of these findings remained significant after correction for multiple testing. However, we identified differences in gene co-expression networks, which could be of biological significance, using weighted gene correlation network analysis. Interestingly, one of these modules was significantly associated with offspring born to women with T1DM. Functional enrichment analysis, using the identified changes in methylation and gene expression as input, revealed enrichment in disease ontologies related to diabetes, carbohydrate and glucose metabolism, pathways including MAPK1/MAPK3 and MAPK family signaling, and genes related to T1DM, obesity, atherosclerosis, and vascular pathologies. Lastly, by integrating the DNA methylation and RNA expression data, we identified six genes where relevant methylation changes corresponded with RNA expression (CIITA, TPM1, PXN, ST8SIA1, LIPA, DAXX).

CONCLUSIONS

These findings suggest the possibility for intrauterine exposure to maternal T1DM to impact later in life methylation and gene expression in the offspring, a profile that may be linked to the increased risk of vascular and metabolic disease later in life.

Type 2 Diabetes Mellitus (T2DM) and Carbohydrate Metabolism in Relation to T2DM from Endocrinology, Neurophysiology, Molecular Biology, and Biochemistry Perspectives

Type 2 diabetes mellitus (T2DM) is a severe disease caused by metabolic disorders, particularly carbohydrate metabolism disorders. The disease is a fatal global trouble characterised by high prevalence rates, causing death, blindness, kidney failure, myocardial infarction, amputation of lower limps, and stroke. Biochemical metabolic pathways like glycolysis, gluconeogenesis, glycogenesis, and glycogenolysis are critical pathways that regulate blood glucose levels with the glucokinase (GK) enzyme playing a central role in glucose homeostasis. Any factor that perturbs the aforementioned biochemical pathways is detrimental. Endocrinological, neurophysiological, and molecular biological pathways that are linked to carbohydrate metabolism should be studied, grasped, and manipulated in order to alleviate T2DM global chaos. The challenge, howbeit, is that, since the body is an integration of systems that complement one another, studying one “isolated” system is not very useful. This paper serves to discuss endocrinology, neurophysiology, and molecular biology pathways that are involved in carbohydrate metabolism in relation to T2DM.

A randomised controlled trial on the effects of a structural education module among women with polycystic ovarian syndrome on nutrition and physical activity changes

Background

Polycystic ovarian syndrome (PCOS) is a complex metabolic, endocrine and reproductive disorder that has a huge impact on the life of women. To ascertain the effectiveness of health education module among women with PCOS.

Methods

This single-centre, randomised controlled trial was conducted on female staff of the University Putra Malaysia who were diagnosed with PCOS. Subjects were randomly assigned into intervention (n = 34) and control group (n = 35). In the intervention group, they need to take part in 8 education sessions in total over 6 months, and feedback was collected at the end of the session.

Results

Primary outcome was changes in knowledge, attitude and practise of nutrition. Secondary outcomes were eating attitude and behaviour as well as knowledge, attitude and practise towards physical activity. After 6-months of intervention, there was a significant difference observed in nutrition knowledge 1 score (p < 0.001) and nutrition knowledge 2 score (p = 0.01) between intervention and control groups. Similarly, there was a significant difference observed in international physical activity questionnaire score (p = 0.02) between intervention and control groups. However there was no significant changes for attitude and practice of nutrition, eating attitude as well as knowledge, attitude and practise of physical activity.

Conclusions

Our study showed that 6-months of education intervention can improve nutrition and physical activity knowledge. Based on this study, the education module may be considered an effective intervention for women with PCOS.

Trial registration: Name of the registry: Australian New Zealand Clinical Trials Registry (ANZCTR). Trial registration number: ACTRN12617000135314. Date of registration: 24/01/2017. URL of trial registry record: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372037

Targeted metabolomics analysis of amino acids and acylcarnitines as risk markers for diabetes by LC-MS/MS technique

Diabetes is a common chronic disease affecting millions of people worldwide. It underlies various complications and imposes many costs on individuals and society. Discovering early diagnostic biomarkers takes excellent insight into preventive plans and the best use of interventions. Therefore, in the present study, we aimed to evaluate the association between the level of amino acids and acylcarnitines and diabetes to develop diabetes predictive models. Using the targeted LC-MS/MS technique, we analyzed fasting plasma samples of 206 cases and 206 controls that were matched by age, sex, and BMI. The association between metabolites and diabetes was evaluated using univariate and multivariate regression analysis with adjustment for systolic and diastolic blood pressure and lipid profile. To deal with multiple comparisons, factor analysis was used. Participants' average age and BMI were 61.6 years, 28.9 kg/m2, and 55% were female. After adjustment, Factor 3 (tyrosine, valine, leucine, methionine, tryptophan, phenylalanine), 5 (C3DC, C5, C5OH, C5:1), 6 (C14OH, C16OH, C18OH, C18:1OH), 8 (C2, C4OH, C8:1), 10 (alanine, proline) and 11 (glutamic acid, C18:2OH) were positively associated with diabetes. Inline, factor 9 (C4DC, serine, glycine, threonine) and 12 (citrulline, ornithine) showed a reverse trend. Some amino acids and acylcarnitines were found as potential risk markers for diabetes incidents that reflected the disturbances in the several metabolic pathways among the diabetic population and could be targeted to prevent, diagnose, and treat diabetes.

Metformin versus sulphonylureas for new onset atrial fibrillation and stroke in type 2 diabetes mellitus: a population-based study

AIMS

To gain insights on the cardiovascular effects of metformin and sulphonylurea, the present study compares the rates of incident atrial fibrillation, stroke, cardiovascular mortality and all-cause mortality between metformin and sulphonylurea users in type 2 diabetes mellitus.

METHODS

This was a retrospective population-based cohort study of type 2 diabetes mellitus patients receiving either sulphonylurea or metformin monotherapy between January 1, 2000, and December 31, 2019. The primary outcome was new-onset AF or stroke. Secondary outcomes were cardiovascular, non-cardiovascular and all-cause mortality. Propensity score matching (1:2 ratio) between sulphonylurea and metformin users was performed, based on demographics, CHA-DS-VASc score, past comorbidities and medication use. Cox regression was used to identify significant risk factors. Competing risk analysis was conducted using cause-specific and subdistribution hazard models. Sensitivity analyses using propensity score stratification, high-dimensional propensity score and inverse probability of treatment weighting were conducted. Subgroup analyses were conducted for age and gender in the matched cohort.

RESULTS

A total of 36,228 sulphonylurea users and 72,456 metformin users were included in the propensity score-matched cohort. Multivariable Cox regression showed that sulphonylurea users had higher risks of incident AF (hazard ratio [HR]: 2.89, 95% confidence interval [CI]: 2.75-3.77; P < 0.0001), stroke (HR: 3.23, 95% CI: 3.01-3.45; P < 0.0001), cardiovascular mortality (HR: 3.60, 95% CI: 2.62-4.81; P < 0.0001) and all-cause mortality (HR: 4.35, 95% CI: 3.16-4.75; P < 0.0001) compared to metformin users. Similarly, significant results were observed using cause-specific and subdistribution hazard models. Sensitivity analysis using techniques based on the propensity score also yielded similar results.

CONCLUSIONS

Sulphonylurea use was associated with higher risks of incident AF, stroke, cardiovascular mortality and all-cause mortality compared to metformin. Males and patients older than 65 years with sulphonylurea use were exposed to the highest risks.

Serum adiponectin and cortisol levels are not affected by studied ADIPOQ gene variants: Tehran lipid and glucose study

BACKGROUND

Obesity is a major public health concern in developed and even developing countries worldwide. Adiponectin is a protein secreted by adipose tissue that modulates many metabolic processes and plays a vital role in obesity. This study aimed to determine the association of four variants of the ADIPOQ gene with serum adiponectin, cortisol levels and obesity status.

METHODS

This case-control study was performed on 164 obese individuals compared by 156 control from the Tehran Lipid and Glucose Study (TLGS). Standard procedures obtained anthropometric measures and metabolic parameters. Cortisol and adiponectin levels were measured by ELISA method. rs1501299, rs266729, rs17300539, and rs17366743 on the ADIPOQ gene were genotyped using the PCR-RFLP. The correlation between adiponectin gene SNPs and obesity were calculated by Additive, dominant, and recessive genetic models. Pearson's or Spearman's found correlations between adiponectin levels and metabolic and anthropometric variables. Data were analyzed using SPSS software Version 20.

RESULTS

Adiponectin and cortisol levels were significantly lower in obese subjects compared to the control group (p < 0.05). There was a significant negative correlation between serum adiponectin level and BMI, waist circumference (WC), waist-hip ratio, hip circumference (HC), Fasting blood sugar (FBS) Triglyceride (TG), Total cholesterol (TC), Systolic blood pressure (SBP), Diastolic blood pressure (DBP) (r = - 0.147, r = - 0.324, r = 0.371, r = - 0.179, r = - 0.299, r = - 0.277, r = - 0.041, r = - 0.134, and r = - 0.149, respectively). A positive correlation was found between adiponectin and high-density lipoprotein cholesterol (HDL-C) (r = 0.29), but no significant correlations were found between adiponectin and Low-density lipoprotein cholesterol(LDL-C) and cortisol. ADIPOQ variant rs1501299 was significantly associated with cortisol levels in subjects with BMI ≥ 25 (P-value =0.039).

CONCLUSIONS

Adiponectin and cortisol levels were associated with obesity. No ADIPOQ gene variants and haplotypes were associated with cortisol, Adiponectin, and obesity.

What we know about protein gut metabolites: Implications and insights for human health and diseases

Gut microbiota is a complex ecosystem of symbiotic bacteria that contribute to human metabolism and supply intestinal metabolites, whose production is mainly influenced by the diet. Dietary patterns characterized by a high intake of protein promotes the growth of proteolytic bacteria's, which produce metabolites from undigested protein fermentation. Microbioal protein metabolites can regulate immune, metabolic and neuronal responses in different target organs. Metabolic pathways of these compounds and their mechanisms of action on different pathologies can lead to the discovery of new diagnostic techniques, drugs and the potential use as functional ingredients in food. This review discusses the potential mechanisms by which amino acid catabolism is involved in microbial protein metabolites. In addition, results from several studies on the association of products from the intestinal metabolism of indigestible proteins and the state of health or disease of the host are revised.