The effect of tai chi intervention on NLRP3 and its related antiviral inflammatory factors in the serum of patients with pre-diabetes

Anti-diabetic effect of dicaffeoylquinic acids is associated with the modulation of gut microbiota and bile acid metabolism

INTRODUCTION

The human gut microbiome plays a pivotal role in health and disease, notably through its interaction with bile acids (BAs). BAs, synthesized in the liver, undergo transformation by the gut microbiota upon excretion into the intestine, thus influencing host metabolism. However, the potential mechanisms of dicaffeoylquinic acids (DiCQAs) from Ilex kudingcha how to modulate lipid metabolism and inflammation via gut microbiota remain unclear.

OBJECTIVES AND METHODS

The objectives of the present study were to investigate the regulating effects of DiCQAs on diabetes and the potential mechanisms of action. Two mice models were utilized to investigate the anti-diabetic effects of DiCQAs. Additionally, analysis of gut microbiota structure and functions was conducted concurrently with the examination of DiCQAs' impact on gut microbiota carrying the bile salt hydrolase (BSH) gene, as well as on the enterohepatic circulation of BAs and related signaling pathways.

RESULTS

Our findings demonstrated that DiCQAs alleviated diabetic symptoms by modulating gut microbiota carrying the BSH gene. This modulation enhanced intestinal barrier integrity, increased enterohepatic circulation of conjugated BAs, and inhibited the farnesoid X receptor-fibroblast growth factor 15 (FGF15) signaling axis in the ileum. Consequently, the protein expression of hepatic FGFR4 fibroblast growth factor receptor 4 (FGFR4) decreased, accompanied by heightened BA synthesis, reduced hepatic BA stasis, and lowered levels of hepatic and plasma cholesterol. Furthermore, DiCQAs upregulated glucolipid metabolism-related proteins in the liver and muscle, including v-akt murine thymoma viral oncogene homolog (AKT)/glycogen synthase kinase 3-beta (GSK3β) and AMP-activated protein kinase (AMPK), thereby ameliorating hyperglycemia and mitigating inflammation through the down-regulation of the MAPK signaling pathway in the diabetic group.

CONCLUSION

Our study elucidated the anti-diabetic effects and mechanism of DiCQAs from I. kudingcha, highlighting the potential of targeting gut microbiota, particularly Acetatifactor sp011959105 and Acetatifactor muris carrying the BSH gene, as a therapeutic strategy to attenuate FXR-FGF15 signaling and ameliorate diabetes.

Comparative efficacy of various mind-body exercise types on cardiometabolic health in patients with type 2 diabetes: a network meta-analysis of randomized controlled trials

OBJECTIVE

This study aims to compare the efficacy of different mind-body exercises (MBEs) on cardiometabolic risk factors in patients with type 2 diabetes mellitus (T2DM) using a network meta-analysis of randomized controlled trials (RCTs).

METHODS

This study followed PRISMA guidelines and was registered in PROSPERO (CRD42025630741). A systematic search of PubMed, Cochrane Library, Web of Science, and Embase was conducted up to December 15, 2024, using MeSH terms related to mind-body therapies and cardiometabolic risk in type 2 diabetes. Randomized controlled trials (RCTs) evaluating mind-body exercises (MBEs) on glucose metabolism, body composition, cardiovascular physiology, and lipid metabolism were included. Data extraction and risk of bias assessment (RoB 2 tool) were performed independently by two reviewers. Network meta-analysis was conducted using R (gemtc package) and Stata 17.0, with effect sizes reported as mean difference (MD) or standardized mean difference (SMD). Evidence quality was assessed using CINeMA.

RESULTS

This network meta-analysis compared the effects of various mind-body exercise interventions on ten cardiometabolic risk factors. Meditative Exercise (ME) was most effective in reducing fasting plasma glucose (SUCRA = 97.9%, SMD = -7.23, 95% CI: -8.27 to -6.20), while Mindfulness Intervention Training (MIT) showed the greatest benefit for glycated hemoglobin (SUCRA = 92.2%, MD = -0.78, 95% CI: -1.12 to -0.44) and blood pressure reduction (SBP: SUCRA = 86.1%, MD = -13.00, 95% CI: -17.22 to -8.78; DBP: SUCRA = 99.8%, MD = -6.00, 95% CI: -7.64 to -4.36), significantly outperforming conventional exercise. Yoga with Meditation (YWM) was most effective in lowering body mass index (SUCRA = 99.4%, MD = -2.90, 95% CI: -4.05 to -1.75). CINeMA assessments rated most comparisons as very low certainty due to within-study bias and between-study heterogeneity. Nevertheless, consistency was supported by node-splitting analysis, and no significant publication bias was detected, indicating robust and reliable findings.

CONCLUSION

Compared with conventional exercise intervention, MBE exerts unique and superior effects on various cardiometabolic risk factors in T2DM, underscoring their potential as effective and integrative interventions for personalized diabetes management. Clinicians should consider incorporating MBEs, such as MIT, ME, and YWM, into treatment plans based on individual patient needs, particularly for glycemic control, weight management, and cardiovascular health. Further research is warranted to explore the long-term benefits and optimal implementation strategies, especially given the heterogeneity in intervention protocols and the relatively short duration of the included trials.

Revisiting traditional Chinese exercise in prediabetes: effects on glycaemic and lipid metabolism - a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Most existing studies have primarily focused on the effects of Traditional Chinese Exercises (TCEs) on glycemic control in individuals with prediabetes, while specific recommendations for managing dyslipidemia in this population remain insufficient. Moreover, there is a lack of systematic research and conclusive evidence regarding the optimal exercise dose required to achieve metabolic improvements in individuals with prediabetes. Therefore, this meta-analysis aims to comprehensively evaluate the efficacy of TCEs in improving glycemic and lipid profiles in individuals with prediabetes and to explore the potential impact of exercise dose on these metabolic parameters.

METHODS

A comprehensive search of six databases (PubMed, Web of Science, Cochrane Library, Embase, CNKI, and WanFang Data) followed PRISMA guidelines to identify randomized controlled trials (RCTs) on TCEs (e.g., "Tai Chi," "Yijinjing," "Baduanjin") and prediabetes (e.g., "impaired glucose tolerance," "impaired glucose regulation") published up to November 10, 2024. Three reviewers independently screened studies, extracted data, and assessed bias risk. Meta-analysis and subgroup/meta-regression analyses were conducted using Stata 17 software. The review protocol is registered in PROSPERO (CRD42024615150).

RESULTS

A total of 15 studies involving 1,839 participants were included. The meta-analysis revealed that TCEs significantly improved HbA1c (MD = -0.28%; 95% CI: -0.38% to -0.18%; P = 0.001), FBG (MD = -0.44 mmol/L; 95% CI: -0.53 to -0.34 mmol/L; P < 0.001), 2hPG (MD = -1.16 mmol/L; 95% CI: -1.48 to -0.85 mmol/L; P < 0.001), TC (MD = -0.31 mmol/L; 95% CI: -0.50 to -0.11 mmol/L; P = 0.002), TG (MD = -0.28 mmol/L; 95% CI: -0.50 to -0.06 mmol/L; P = 0.012), and HDL (MD = -0.28 mmol/L; 95% CI: -0.50 to -0.06 mmol/L; P = 0.012) compared to control groups.

CONCLUSIONS

TCEs significantly improve prediabetics' blood glucose and lipid levels. The recommended exercise regimen is 30-50 min per session, 2-3 times per week, for at least three months.

Effects of exercise and walnut oil on CES1 and inflammatory factors in the liver of type 2 diabetic rats

Carboxylesterase 1 (CES1) and inflammatory factors play important roles in regulating lipid metabolism and maintaining glucose homeostasis. Exercise and walnut oil have anti-inflammatory effects, but the effects of exercise and walnut oil on CES1 and inflammatory factors in type 2 diabetes mellitus (T2DM) remain to be revealed. 8-week-old SD male rats were randomly divided into normal control group (NC group, N = 12) and high fat group (HFD group, N = 28) after 1 week of adaptive feeding. HFD rat models were established by high-fat diet and one-time injection of streptozocin. The successfully constructed rats were randomly divided into diabetes control group (T2DM-NC group, N = 6), the diabetes plus moderate intensity exercise group (T2DM-MED group, N = 6), the diabetes plus high intensity intermittent exercise group (T2DM-HIIT group, N = 6), and the diabetes plus walnut oil group (T2DM-WO group, N = 6). After 6 weeks of intervention, ELISAs were used to determine the blood glucose and lipid-related indices of the rats. Histomorphologic changes in the liver were observed by hematoxylin‒eosin staining. The mRNA expression levels of CES1 and inflammatory cytokines were determined by real-time quantitative PCR. The protein expression levels of CES1 and inflammatory factors were determined by immunofluorescence staining. Compared with those in the NC group, in the T2DM-NC group, FBG, TG, LDL-C and HOMA-IR were increased (P < 0.01), FINS activity was decreased (P < 0.01), liver morphology was more disorganized, and CES1 and inflammatory cytokines were highly expressed in the liver tissue (P < 0.05 or P < 0.01). After 6 weeks of intervention, TG levels were significantly decreased (P < 0.05 or P < 0.01), whereas FINS levels were increased (P < 0.05 or P < 0.01), liver morphology was significantly ameliorated, and the CES1, TXNIP and IL-1β expression levels were decreased (P < 0.05 or P < 0.01) in the T2DM-MED, T2DM-HIIT and T2DM-WO groups when compared with those in the T2DM-NC group. The T2DM rats presented abnormal blood glucose and lipid levels, and CES1, TXNIP and IL-1β were highly expressed in the liver. Exercise and walnut oil intervention ameliorated the glycolipid metabolism and liver morphology, and reduce the expression of CES1, TXNIP and IL-1β in the liver.

Bile acids as a key target: traditional Chinese medicine for precision management of insulin resistance in type 2 diabetes mellitus through the gut microbiota-bile acids axis

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease caused by insulin resistance (IR) and insufficient insulin secretion. Its characteristic pathophysiological processes involve the interaction of multiple mechanisms. In recent years, globally, the prevalence of T2DM has shown a sharp rise due to profound changes in socio-economic structure, the persistent influence of environmental factors, and the complex role of genetic background. It is worth noting that most T2DM patients show significant IR, which further exacerbates the difficulty of disease progression and prevention. In the process of extensively exploring the pathogenesis of T2DM, the dynamic equilibrium of gut microbes and its diverse metabolic activities have increasingly emphasized its central role in the pathophysiological process of T2DM. Bile acids (BAs) metabolism, as a crucial link between gut microbes and the development of T2DM, not only precisely regulates lipid absorption and metabolism but also profoundly influences glucose homeostasis and energy balance through intricate signaling pathways, thus playing a pivotal role in IR progression in T2DM. This review aims to delve into the specific mechanism through which BAs contribute to the development of IR in T2DM, especially emphasizing how gut microbes mediate the metabolic transformation of BAs based on current traditional Chinese medicine research. Ultimately, it seeks to offer new insights into the prevention and treatment of T2DM. Diet, genetics, and the environment intricately sculpt the gut microbiota and BAs metabolism, influencing T2DM-IR. The research has illuminated the significant impact of single herbal medicine, TCM formulae, and external therapeutic methods such as electroacupuncture on the BAs pool through perturbations in gut microbiota structure. This interaction affects glucose and lipid metabolism as well as insulin sensitivity. Additionally, multiple pathways including BA-FXR-SHP, BA-FXR-FGFR15/19, BA-FXR-NLRP3, BA-TGR5-GLP-1, BAs-TGR5/FXR signaling pathways have been identified through which the BAs pool significantly alter blood glucose levels and improve IR. These findings offer novel approaches for enhancing IR and managing metabolic disorders among patients with T2DM.

Managing Type 2 Diabetes Mellitus via the Regulation of Gut Microbiota: A Chinese Medicine Perspective

BACKGROUND

Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by insulin resistance and inadequate insulin production. Given the increased frequency of T2DM and the health issues it can cause, there is an increasing need to develop alternative T2DM management strategies. One such approach is Chinese Medicine (CM), a complementary therapy widely used in T2DM treatment. Given the emphasis on gut microbiota in current research, studying CM in the treatment of T2DM via gut microbiota modulation could be beneficial. Scope and approach: The use of various CM methods for managing T2DM via gut microbiota modulation is highlighted in this review. Following an introduction of the gut microbiota and its role in T2DM pathogenesis, we will review the potential interactions between gut microbiota and T2DM. Thereafter, we will review various CM treatment modalities that modulate gut microbiota and provide perspectives for future research. Key findings and discussion: In T2DM, Akkermansia, Bifidobacterium, and Firmicutes are examples of gut microbiota commonly imbalanced. Studies have shown that CM therapies can modulate gut microbiota, leading to beneficial effects such as reduced inflammation, improved metabolism, and improved immunity. Among these treatment modalities, Chinese Herbal Medicine and acupuncture are the most well-studied, and several in vivo studies have demonstrated their potential in managing T2DM by modulating gut microbiota. However, the underlying biomolecular mechanisms of actions are not well elucidated, which is a key area for future research. Future studies could also investigate alternate CM therapies such as moxibustion and CM exercises and conduct large-scale clinical trials to validate their effectiveness in treatment.

Inhibition of SPARC signal by aerobic exercise to ameliorate atherosclerosis

BACKGROUND AND AIMS

Inflammation and atherosclerosis (AS) are closely associated to Secreted Protein Acidic and Rich in Cysteine (SPARC) and its related factors. This study attempted to define the role and the potential mechanism of SPARC and its related factors in ameliorating hyperlipidemia and AS by aerobic exercise intervention.

METHODS

The AS rat model was established with a high-fat diet plus vitamin D3 intraperitoneal injection. Treadmill exercises training (5 days/week at 14 m/min for 60 min/day) for 6 weeks was carried out for AS rat intervention method. Western blotting and qRT-PCR were used to analyze the mRNA and protein expression of SPARC and its related factors, respectively. H&E staining was applied to evaluate the morphological changes and inflammation damage. Von Kossa staining was used to measure the degree of vascular calcification. Fluorescence immunohistochemistry staining was used to detect the expression and distribution of SPARC signal molecules.

RESULTS

SPARC was highly expressed and co-localization with the smooth muscle marker α-SMC in the AS rat. And its downstream factors, NF-κB, Caspase-1, IL-1β and IL-18 were upregulated (P < 0.05 or P < 0.01), FNDC5 expression was downregulated in AS rat model. However, slight declined body weight, delayed AS progression, decreased hyperlipidemia and favorable morphology of skeletal muscle and blood vessels have been detected in AS rat with aerobic exercise intervention. Moreover, the expression of SPARC and its downstream factors were decreased (P < 0.05 or P < 0.01), while elevated the expression of FNDC5 (P < 0.01) was observed after aerobic exercise intervention.

CONCLUSIONS

This study suggested that aerobic exercise ameliorated hyperlipidemia and AS by effectively inhibiting SPARC signal, and vascular smooth muscle cells may contribute greatly to the protection of AS.

Inflammation in diabetes complications: molecular mechanisms and therapeutic interventions

At present, diabetes mellitus (DM) has been one of the most endangering healthy diseases. Current therapies contain controlling high blood sugar, reducing risk factors like obesity, hypertension, and so on; however, DM patients inevitably and eventually progress into different types of diabetes complications, resulting in poor quality of life. Unfortunately, the clear etiology and pathogenesis of diabetes complications have not been elucidated owing to intricate whole-body systems. The immune system was responsible to regulate homeostasis by triggering or resolving inflammatory response, indicating it may be necessary to diabetes complications. In fact, previous studies have been shown inflammation plays multifunctional roles in the pathogenesis of diabetes complications and is attracting attention to be the meaningful therapeutic strategy. To this end, this review systematically concluded the current studies over the relationships of susceptible diabetes complications (e.g., diabetic cardiomyopathy, diabetic retinopathy, diabetic peripheral neuropathy, and diabetic nephropathy) and inflammation, ranging from immune cell response, cytokines interaction to pathomechanism of organ injury. Besides, we also summarized various therapeutic strategies to improve diabetes complications by target inflammation from special remedies to conventional lifestyle changes. This review will offer a panoramic insight into the mechanisms of diabetes complications from an inflammatory perspective and also discuss contemporary clinical interventions.

Effects of Tai Chi in diabetes patients: Insights from recent research

Tai Chi, a practice that combines elements of both exercise and mindfulness, offers a wide range of health benefits. The body of evidence concerning the impact of Tai Chi on diabetes has recently been growing. This editorial aims to provide a concise summary of the current state of evidence for Tai Chi's effects on individuals with type 2 diabetes (T2D). The review includes 3 randomized controlled trials (RCTs) and 5 systematic reviews and meta-analyses, all of which investigate the effectiveness of Tai Chi on various health outcomes in individuals with T2D. Tai Chi demonstrates a significant effect to enhance glycemic control, lower blood pressure, improve serum lipid profiles, reduce insulin resistance, positively influence obesity-related indices, and improve overall quality of life in individuals with T2D. However, it is noteworthy that recent RCTs have reported inconsistent findings regarding the effects of Tai Chi on glycemic control and insulin resistance. The author also delves into potential mechanisms by which Tai Chi may exert its influence on the human body. Finally, the editorial highlights the critical issues that warrant further exploration in the future.

Non-drug interventions of traditional Chinese medicine in preventing type 2 diabetes: a review

Traditional Chinese medicine (TCM) is increasingly used to manage type 2 diabetes and its nonpharmacological interventions are showing potential for preventing type 2 diabetes. This study mainly reviews relevant research. The most mentioned non-drug treatments for preventing type 2 diabetes in TCM are healthy diet, physical activity, emotional therapy, and acupuncture. In most studies, blood glucose status in patients with prediabetes and type 2 diabetes was significantly improved after TCM non-drug interventions, and there was no significant difference between the adverse effect of TCM and control groups or other intervention groups, while the methodological quality of the clinical trials involving TCM generally kept a low level. The effectiveness of TCM in preventing type 2 diabetes has yet to be validated in large randomized controlled trials and the underlying mechanism also needs further exploration.

Exploring exercise-driven inhibition of pyroptosis: novel insights into treating diabetes mellitus and its complications

Diabetes mellitus (DM) and its complications are important, worldwide public health issues, exerting detrimental effects on human health and diminishing both quality of life and lifespan. Pyroptosis, as a new form of programmed cell death, plays a critical role in DM and its complications. Exercise has been shown to be an effective treatment for improving insulin sensitivity or preventing DM. However, the molecular mechanisms underlying the effects of exercise on pyroptosis-related diseases remain elusive. In this review, we provided a comprehensive elucidation of the molecular mechanisms underlying pyroptosis and the potential mechanism of exercise in the treatment of DM and its complications through the modulation of anti-pyroptosis-associated inflammasome pathways. Based on the existing evidence, further investigation into the mechanisms by which exercise inhibits pyroptosis through the regulation of inflammasome pathways holds promising potential for expanding preventive and therapeutic strategies for DM and facilitating the development of novel therapeutic interventions.

Differences and Associations of NLRP3 Inflammasome Levels with Interleukins 1α, 1β, 33 and 37 in Adults with Prediabetes and Type 2 Diabetes Mellitus

Inflammasome activation of the nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP3) has been observed to be involved in the pathogenesis of numerous inflammatory diseases, including prediabetes (PD) and type 2 diabetes mellitus (T2DM). Varying levels of glycemia can trigger inflammasome activation; yet, limited studies have reported the associations between NLRP3 levels or other circulating interleukins (ILs) and glycemic status. This study investigated the differences and associations between serum levels of NLRP3 and IL-1α, IL-1β, IL-33 and IL-37 in Arab adults with PD and T2DM. A total of 407 Saudi adults (151 males and 256 females) (mean age = 41.4 ± 9.1 years and mean BMI = 30.7 ± 6.4 kg/m²) were included. Overnight-fasting serum samples were collected. The participants were stratified according to T2DM status. Serum levels of NLRP3 and ILs of interest were assessed using commercially available assays. In all participants, age- and BMI-adjusted circulating levels of IL-37 were significantly higher in the T2DM group (p = 0.02) than in healthy controls (HC) and the PD group. A general linear model analysis revealed that NLRP3 levels were significantly influenced by T2DM status; age; and ILs 18, 1α and 33 (p-values 0.03, 0.04, 0.005, 0.004 and 0.007, respectively). IL-1α and triglycerides significantly predicted NLRP3 levels by as much as 46% of the variance perceived (p < 0.01). In conclusion, T2DM status significantly influenced NLRP3 expression and other IL levels in varying degrees. Whether these altered levels of inflammasome markers can be favorably reversed through lifestyle interventions needs to be investigated prospectively in the same population.

Exercise training-attenuated insulin resistance and liver injury in elderly pre-diabetic patients correlates with NLRP3 inflammasome

Background

Diabetes is one of the most common metabolic diseases and continues to be a leading cause of death worldwide. The NLRP3 inflammasome has been shown to exert detrimental effects on diabetic models. However, evidence linking NLRP3 inflammasome and pre-diabetes has been scarcely explored. Herein, we aimed to determine whether the NLRP3 inflammasome correlates with insulin resistance and liver pathology in a cohort of pre-diabetic subjects.

Methods

50 pre-diabetic subjects were randomly assigned to a Pre-diabetes Control (DC, n=25) and a Pre-diabetes exercise (DEx, n=25) group. 25 Normal subjects (NC) were selected as controls. The DEx group performed a 6-month combined Yijingjing and resistance training intervention, while DC and NC group remained daily routines. Clinical metabolic parameters were determined with an automatic biochemistry analyzer; inflammatory cytokines were quantified by the ELISA assay; the protein expressions of NLRP3 inflammasome components in PBMCs were evaluated by Western Blot.

Results

The insulin resistance, liver injury and NLRP3 inflammasome activity were higher in pre-diabetic individuals than in normal control group. However, 6-month exercise intervention counteracted this trend, significantly improved insulin sensitivity, reduced liver injury and inhibited the overactivation of NLRP3 inflammasome in pre-diabetic subjects. Moreover, positive correlations between insulin resistance, liver pathology and NLRP3 inflammasome were also found.

Conclusions

Our study suggests that exercise training is an effective strategy to alleviate insulin resistance and liver injury in elderly pre-diabetic subjects which is probably associated with the inhibition of NLRP3 inflammasome activity.