Prevalence rates of metabolic health and body size phenotypes by different criteria and association with insulin resistance in a Maltese Caucasian population

The prevalence of metabolically healthy obesity and its transition into the unhealthy state: A 5-year follow-up study

People with metabolically healthy obesity (MHO) are at risk of developing cardiometabolic diseases. We investigated the prevalence of MHO and factors influencing its transition into a metabolically unhealthy state (MUS). This study was conducted as part of the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS). From 2014 to 2018, 9997 people were evaluated. The obesity and metabolic status of the MHO participants were re-examined after 5 years of their initial participation in the study. Out of 347 MHO, 238 individuals were accessed at follow-up. Twenty-nine (12.2%) had metabolic unhealthy normal weight (MUNW), 169 (71.0%) had metabolic unhealthy obesity (MUO), and the others had healthy metabolic state. Among age, total cholesterol, diastolic blood pressure and triglyceride (TG) variables, the baseline serum TG level was associated with a significant increase in the risk of developing MUS during 5 years (p <.05). The TG level optimal cut-off point for predicting the development into MUS was 107 mg/dL with 62.1% sensitivity and 77.5% specificity (AUC = 0.734, p <.001). A high percentage of MHO people transit into MUS during 5 years. A TG level higher than 107 mg/dL can help to identify people at a higher risk of developing into MUS.

Puerarin Attenuates Insulin Resistance by Inhibiting Endoplasmic Reticulum Stress and Suppresses Inflammation by Modulating the JNK and IKKβ/NF-κB Pathways in Epididymal White Adipose Tissue of Mice on a High-Fat Diet

SCOPE

Obesity is associated with insulin resistance (IR), which is characterized by endoplasmic reticulum (ER) stress in multiple organs. ER stress in adipose tissue causes metabolic disturbances and activates inflammatory signaling pathways. Puerarin, an isoflavone extracted from Pueraria lobata, exhibits antioxidant, anti-inflammatory, and antidiabetic effects. This study explores the potential mechanisms underlying puerarin's role in mitigating insulin resistance in high-fat diet (HFD)-induced obese mice.

METHODS AND RESULTS

In this study, insulin resistant in mice is induced by a high-fat diet, followed by treatment with puerarin. The results demonstrate that puerarin effectively attenuates insulin resistance, including weight loss, improvement of glucose tolerance and insulin sensitivity, and activation of insulin signaling pathway. Additionally, puerarin administration suppresses ER stress by down-regulation of ATF6, ATF4, CHOP, GRP78 expressions in epididymal white adipose tissue (eWAT), along with decreased phosphorylation IRE1α, PERK, and eIF2α. Furthermore, puerarin exerts anti-inflammatory effects by inhibiting JNK and IKKβ/NF-κB pathways, leading to reduction of TNF-α and IL-6.

CONCLUSION

These findings suggest that puerarin mitigates insulin resistance by inhibiting ER stress and suppressing inflammation through the JNK and IKKβ/NF-κB pathways. This highlights the promising clinical application of puerarin in the treatment of insulin resistance.

Metabolic Health and Carotid Intima-Media Thickness: Association of Different Definitions in Women

The concept of metabolic health and the metabolic syndrome is to identify subjects at a higher cardiovascular risk. However, many definitions are currently in use, and it is uncertain which is the best in identifying at-risk subjects. We performed a cross-sectional study whereby women were invited to participate and were assessed for several anthropometric and biochemical parameters. Carotid intima-media thickness (CIMT) was measured in both common carotid arteries in each participant. The study cohort consisted of 203 white premenopausal women with a mean age of 38.3 ± 5.4 years. The prevalence of the metabolically unhealthy varied from 7.3% to 61.6%, according to the definition used. The prevalence of the metabolic syndrome, as defined by the International Diabetes Federation, was 20.7%. Women with a metabolically unhealthy phenotype had a higher referent CIMT for all definitions of metabolic health. Defining metabolically unhealthy phenotype as having <2 abnormalities using the National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (NCEP-ATPIII) cutoffs had the highest odds ratio for an abnormal CIMT. In conclusion, we found that in a contemporary cohort of middle-aged women, the NCEP-ATPIII definition of the metabolic syndrome was more strongly associated with atherosclerosis as determined by the CIMT than the International Diabetes Federation definition or other definitions of metabolic health; it was also more strongly associated than body mass index or waist circumference. Our results need to be validated by other investigators in other populations.