Branched-chain amino acids and innate immunity in metabolic disease: Mechanisms, paradox, and therapeutic opportunities.

Drug information is an indispensable component of clinical practice and outpatient care. The core objective of providing drug information is to ensure that patients have adequate knowledge to use medications safely, appropriately, and effectively—while adhering to prescribed treatment regimens and minimizing potential risks and errors. This underscores the importance of clearly identifying patient characteristics and their specific needs regarding medication information, thereby enabling the development of appropriate strategies to improve the quality of care and therapeutic outcomes in outpatient settings. To investigate the characteristics and drug information needs of outpatients at Nam Can Tho University Hospital. A cross-sectional study was conducted involving 212 outpatients who were interviewed during the period from March 1st ,2025 to May 31st ,2025. Most outpatients at Nam Can Tho University Hospital were aged 40 years and older, had low educational attainment, and reported an average monthly income with an average monthly income estimated between 5 and 10 million VND. A total of 88.2% of patients were diagnosed with at least one chronic condition, with the most common being diabetes mellitus (32.1%), hypertension (31.1%), dyslipidemia (30.2%), and coronary artery disease (25.9%). In addition, the demand for drug information among outpatients was high and varied. All 16 proposed drug information indicators were rated as necessary by over 40.0% of participants. These findings highlight the necessity of establishing a coordinated counseling process between physicians and pharmacists, along with the standardization of drug counseling content tailored to individual patient characteristics and specific information needs.

This review examines the role of programmed cell death in the pathogenesis of obesity and associated conditions. It provides the comprehensive examination of the key mechanisms of apoptosis and NETosis in the context of the pathogenesis of obesity and associated metabolic diseases, particularly type 2 diabetes mellitus, dyslipidemia, and metabolic dysfunction-associated steatotic liver disease (MASLD). One of the key consequences of excessive adipose tissue accumulation in obesity is chronic low-grade inflammation. The development of a proinflammatory state, the resulting cellular stress, and mitochondrial dysfunction contribute to the activation of signaling pathways that trigger programmed cell death. Apoptosis of adipocytes, cardiomyocytes, endothelial cells, pancreatic β-cells, and hepatocytes is mediated by an imbalance of proand antiapoptotic proteins of the Bcl-2 family and caspase activation and is implicated in the development of MASLD, type 2 diabetes mellitus, diabetic cardiomyopathy, and endothelial dysfunction. Studies of potentially protective molecules (apelin-13, agomelatine) and triggers are described. NETosis plays a key role in maintaining inflammation, endothelial dysfunction, and the development of thrombotic complications in obesity. Increased activity of NETosis markers, myeloperoxidase and neutrophil elastase, correlates with the severity of obesity, MASLD, and microvascular complications, while their inhibition restores endothelial function in preclinical models. Thus, key molecular factors and signaling pathways of apoptosis and NETosis are significant components in the pathogenesis of obesity and associated diseases. Studying the mechanisms of programmed cell death is a promising area in the context of the search for potential therapeutic targets for these diseases.

Background/Objectives: Fucoidan is a sulfated long-chain polysaccharide found mainly in sea cucumbers and brown algae. Studies suggest that fucoidan may play a role in treating various diseases, including metabolic syndrome and diabetes mellitus. The purpose of the current study was to investigate the effects of fucoidan isolated from brown algae on diabetic hyperglycemia and dyslipidemia. Methods: Two databases, PubMed and Embase, were searched to identify peer-reviewed articles written in English and published up to 30 June 2025. Studies reporting blood glucose and serum/plasma lipid levels of diabetic rodents treated with fucoidan or vehicle were included in the meta-analysis. Results: Forty-seven studies reported blood glucose levels. The pooled effect size for blood glucose levels was -2.26 (95% CI: -2.78 to -1.75), with substantial heterogeneity. Subsequent analyses showed that diabetic dyslipidemia was markedly improved in the fucoidan-treated group compared with the control. Conclusions: Fucoidan treatment could improve hyperglycemia and dyslipidemia in diabetic rodents.

The objective of this study was to investigate the global profile of plasmatic proteins of individuals affected simultaneously or not by type 2 diabetes mellitus (T2DM, well/poorly-controlled), Dyslipidemia (DL), and Periodontitis (P). Besides periodontal examination, plasma was collected for glycemic, and lipid analyses from 150 individuals divided into five groups. The same plasma was submitted to global proteomic investigation using the Liquid Chromatography Electrospray Ionization Tandem Mass Spectrometry (LC-ESI-MS/MS), following searching data in the UniProt catalog by Proteome Discoverer 1.3. Funcional enrichment was evaluated by Cytoscape. In groups (G1)T2DMpoorly-DL-P, (G2)T2DMwell-DL-P, and (G3)DL-P, the presence of positively regulated CO4A (mediator of the inflammatory complement cascade) and TTN (sarcomeric protein linked to insulin-dependent muscle stiffness) proteins was observed, similar to VDBP (vitamin D transporter and systemic inflammatory modulator) protein in groups (G2)T2DMwell-DL-P and (G3)DL-P. Among others, LDLR, DST, SYNE1 (mediators of the lipid homeostasis axis and nuclear-cytoskeletal integrity) and Ceruloplasmin (involved in iron metabolism and oxidative stress regulation) proteins were exclusively found in respective (G1)T2DMpoorly-DL-P, (G2)T2DMwell-DL-P, (G3)DL-P and (G4)Perio groups. Functional enrichment analyses demonstrated complement binding, DNA metabolism and repair among the most up-regulated PPI. Each of the combined pathological conditions exhibited a distinct plasmatic proteomic profile. This specificity provides a foundation for future studies to functionally characterize the identified upregulated proteins, both unique and shared. Our findings, therefore, contribute to the identification of potential diagnostic and therapeutic targets for each of these disease scenarios.

Hyperlipidemia is a major, modifiable driver of global cardiovascular risk. The intestinal microbiota, comprising bacteria, archaea, fungi, and viruses, modulates lipid metabolism through bile acid transformation, energy harvest, and inflammatory signaling. This study profiled the gut microbiota of 15 adults with type 2 diabetes mellitus (T2DM) and explored associations with fasting lipid measures using 16S rRNA gene sequencing (V3–V4 region) on the Illumina MiSeq platform and PICRUSt2 functional prediction. Overall α‐diversity was reduced, and community composition was dominated by Firmicutes and Actinobacteria with relative depletion of Bacteroidetes. At lower taxonomic ranks, enrichment of Prevotella copri, Collinsella spp., Ruminococcus spp., and selected Bifidobacterium spp. was observed, alongside depletion of short‐chain fatty acid (SCFA)‐linked taxa, including Akkermansia muciniphila, Lactobacillus plantarum, and members of the Bacteroides and Parabacteroides lineages. Exploratory within‐cohort trends indicated that higher triglycerides (TGs) and lower HDL‐C tended to co‐occur with increased Collinsella and clostridial signals and reduced SCFA‐associated taxa. Predicted Kyoto Encyclopedia of Genes and Genomes (KEGG) ortholog functions suggested shifts in lipid, carbohydrate, and secondary bile acid metabolism, consistent with a metabolically activated and proinflammatory intestinal milieu. In this single‐arm cohort of adults with T2DM, a low‐diversity, Firmicutes/Actinobacteria‐weighted microbiome with depletion of SCFA‐linked taxa paralleled an atherogenic lipid profile, supporting an association between gut microbial dysbiosis and lipid abnormalities in adults with T2DM. These findings suggest the potential of microbiota‐informed adjuncts, including dietary fermentable fiber, targeted probiotics and next‐generation biotherapeutics, and bile‐acid‐modulating strategies as supportive approaches to lipid management in T2DM. This was a pilot, single‐arm, exploratory study without a nondiabetic control group, and findings should be interpreted as hypothesis‐generating. Nevertheless, the cross‐sectional design, small sample size, and 16S‐based taxonomic resolution limit causal interpretation. Larger, longitudinal studies integrating shotgun metagenomics and metabolomics are needed to confirm these associations, validate biomarkers, and elucidate mechanistic pathways that could guide precision interventions for diabetic dyslipidemia.

The purpose of the study is to search for simple, widely available markers that combine adiposity and lipoprotein status to improve coronary artery disease (CAD) risk discrimination. For this, we evaluated whether the body mass index to high-density lipoprotein cholesterol ratio (BMI/HDL-C) discriminates angiographically confirmed CAD better than BMI or HDL-C alone. In this multicenter observational study, we enrolled 834 adults undergoing coronary angiography at three tertiary centers. CAD was defined as ≥50% stenosis in ≥1 major coronary artery and its branches. BMI and fasting HDL-C were measured on admission; BMI/HDL-C was calculated. We assessed associations using Spearman correlation, logistic regression, receiver operating characteristic (ROC) analysis, and Area under the curve (AUC). Mean age was 58.5 ± 11.9 years; 53.7% were male; 440had CAD. BMI/HDL-C correlated most strongly with CAD (rho = 0.68) versus HDL-C (rho = -0.65) and BMI (rho = 0.142). In logistic regression (after adjusting for Diabetes Mellitus, Hypertension, dyslipidemia, and smoking), a one-unit increase in the HDL-C was associated with a 26.2% reduction in the odds of CAD, while a 6.4% and 55.2% increase in the odds of CAD was noted with a one-unit increase in the BMI and BMI/HDL ratio, respectively. ROC analysis showed superior discrimination for BMI/HDL-C (AUC 0.892; 95% CI 0.870-0.913) compared with HDL-C (AUC 0.875; 95% CI 0.849-0.901) and BMI (AUC 0.582; 95% CI 0.543-0.621). An optimal BMI/HDL-C cutoff of 19.7 achieved 100% sensitivity and 83.5% specificity. AUC differences were statistically significant (p < 0.001). In conclusion, the BMI/HDL-C ratio demonstrated superior discriminatory ability for angiographically defined CAD compared to BMI or HDL-C alone, suggesting its potential as a simple and clinically useful marker, although further validation in prospective studies is warranted.

Preventive strategies in endocrinology focus on five major fields (the big five): thyroid gland disorders, obesity and diabetes mellitus, dyslipidemia, arterial hypertension and osteoporosis. These highly prevalent conditions have a high morbidity and mortality. As many can be prevented by relatively simple nonpharmacological measures or effectively mitigated by low-threshold pharmacological interventions, they represent model diseases for prevention in internal medicine. This article outlines the current options and discusses them in the context of current prevention strategies. Endocrine and diabetic diseases are among the most common and consequential chronic disorders in industrialized countries and essentially contribute to the total morbidity and mortality. Principal preventive strategies include structural prevention (environmental prevention), such as promoting anti-adipogenic and anti-diabetogenic social structures and behavioral prevention. The emphasis of preventive strategies is on population-related measures, structured screening programs and evidence-based lifestyle interventions. Based on current epidemiological data and guidelines, practical approaches are presented, ranging from iodine prophylaxis, lipid and blood pressure screening to promotion of healthy bone and obesity preventive structures. The concepts discussed demonstrate that effective endocrine and diabetological prevention requires coordinated action across clinical medicine, public health and health policy to realize its full potential.

Abstract Background Coronary artery disease (CAD) remains one of the leading causes of mortality worldwide. Non-invasive tests (NIT) play a key role in diagnosing CAD and assessing the need for revascularisation (1). Purpose Comparison of positive predictive value of three non-invasive tests (coronary computed tomography angiography (CCTA), stress echocardiography (SE) and single-photon emission computed tomography (SPECT)) in predicting obstructive CAD which met the criteria for revascularisation. Methods Retrospective study of all consecutive patients with positive NITs who were referred for elective invasive coronary angiography from January 2024 to August 2025 in a tertiary hospital in Greece. Patients with positive exercise stress test were excluded. Patients’ demographics, risk factors and type of NIT were correlated with the need of revascularization defined as percutaneous coronary intervention or coronary artery bypass grafting. Categorical variables were compared using Pearson’s Chi-square test. Binary logistic regression was used to identify independent predictors of coronary revascularization. Variables who entered the model were only those statistically significant from univariate analysis. IBM SPSS Statistics (v. 26) was used for statistical analysis. Results 524 patients undergoing elective angiography were included (402 males,76.7%) and mean age was 66.8(±SD:10). 270 (51.5%) had obstructive CAD meeting revascularisation criteria. Most common NIT was SPECT (43.7% of all elective catheterization patients), followed by CCTA (30%) and SE (26.3%). Demographics and baseline characteristics are shown in Figure 1. Need for revascularisation was highest among those with positive CCTA findings (58.5%), compared with 48.4% for SPECT and 48.5% for SE. Univariate analysis demonstrated that only positive CCTA was significantly associated with revascularization (p=0.034). Neither SPECT (p=0.593) nor SE (p=0.731) were statistically important. Patients who underwent revascularisation were more likely to be male (p&amp;lt;0.001) and have diabetes mellitus (p=0.010), dyslipidemia (p=0.046), known CAD (p=0.036) or peripheral artery disease (PAD) (p=0.006). In multivariate logistic regression, significant independent predictors of revascularization were positive CCTA (OR=1.72,95%CI[1.15–2.57],p=0.009), male sex (OR=2.21,95%CI[1.43–3.41],p&amp;lt;0.001), CAD (OR=1.67,95%CI[1.06–2.62],p=0.028), diabetes mellitus (OR=1.76,95%CI[1.17–2.65],p=0.007) and PAD (OR=2.61,95%CI[1.12–6.06],p=0.025) (Table 1). Conclusion These findings highlight the positive predictive value of CCTA in comparison to SPECT and SE. Male sex, diabetes mellitus, PAD and established CAD were also associated with revascularisation, reflecting their well-established role in disease burden. Overall, these findings support the superior discriminative performance of anatomical imaging with CCTA in identifying patients requiring revascularization in routine clinical practice (2).Figure 1:Baseline characteristicsFor image description, please refer to the figure legend and surrounding text. Table 1:Independent PredictorsFor image description, please refer to the figure legend and surrounding text.

Background/Objective: Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM), dysglycemia, and dyslipidemia. However, the role of postpartum weight change in long-term metabolic outcomes remains unclear. Here, we determined the long-term incidence of dysglycemia and dyslipidemia after GDM and evaluated whether postpartum changes in body mass index (BMI) independently predicted these outcomes. Methods: This single-center prospective cohort study included 205 Japanese women diagnosed with GDM. All participants underwent a 75 g oral glucose tolerance test at 6-12 weeks postpartum. The incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), T2DM, and dyslipidemia was evaluated over a median follow-up of 3.6 years. Cumulative incidence was estimated using the Kaplan-Meier method, and Cox proportional hazards models identified independent risk factors, particularly postpartum BMI change. Results: During follow-up, 42.4%, 6.3%, and 35.6% of women developed IFG or IGT (prediabetes), T2DM, and dyslipidemia, respectively. The estimated cumulative incidence rates at 6 years postpartum were 57.1% and 50% for IFG/IGT and dyslipidemia, respectively, whereas the 5-year incidence of T2DM was 10.3%. Postpartum BMI increase was independently associated with new-onset dysglycemia. No independent predictor of T2DM progression was identified. Dyslipidemia was independently associated with higher pre-pregnancy BMI and multiparity, whereas postpartum BMI change was not independently associated after multivariable adjustment. Conclusions: Postpartum BMI change was independently associated with dysglycemia in women with a history of GDM. These findings suggest that postpartum weight change may help identify women at higher risk of subsequent metabolic abnormalities, particularly dysglycemia, in this high-risk population, although causal relationships cannot be inferred from this observational study.

Metabolic dysfunction-associated steatotic liver disease (MASLD) occupies a leading place in the structure of modern hepatology. A growing body of literature identifies MASLD as a global epidemic. Accumulated data from studies in the field of hepatology support the idea that MASLD is a hepatic manifestation of a systemic metabolic disease. MASLD is a multifactorial metabolic disease associated with the presence of insulin resistance, abdominal obesity, oxidative stress, endothelial dysfunction and a systemic inflammatory response. Current scientific data demonstrate the existence of a relationship between MASLD and an increased risk of developing cardiovascular disease, regardless of traditional risk factors such as diabetes mellitus, dyslipidemia, obesity and hypertension. The pathogenesis of MASLD includes the development of hepatic steatosis with subsequent progression to metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Epigenetics, a new field of biology that studies the influence of external factors on gene activity without changing in deoxyribonucleic acid (DNA) sequences, offers a new perspective on the pathogenesis of MASLD. This review summarizes current knowledge on the epigenetic determinants of MASLD, such as DNA methylation, histone modifications, noncoding ribonucleic acids (RNAs) and N6-methyladenosine in patients with MASLD which may also contribute to the development of preventive or therapeutic strategies for MASLD-associated complications.

Bariatric surgery is an effective treatment for severe obesity, resulting in significant weight loss and remission of obesity-related diseases. However, weight gain remains a challenge, potentially impacting long-term outcomes. The Swiss-Finnish BARIatric metabolic outcome score (SF-BARI) is a composite tool that integrates percentage total weight loss (%TWL), obesity associated disease remission, and operative complications rates to evaluate surgical optimal clinical response. This study assessed the associations between SF-BARI scores, obesity associated diseases remission, and weight gain 5 years after bariatric surgery. This retrospective cohort study included 81 patients who underwent Roux-en-Y gastric bypass (RYGB) at a Portuguese hospital, with complete 5-year follow-up data. Data on weight, body mass index (BMI), %TWL, weight gain (> 5% of nadir weight), and remission of type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, and obstructive sleep apnea (OSA) were collected at baseline and at 1 year and 5 years post-surgery. SF-BARI scores were calculated to assess outcomes. Statistical analyses included t tests, chi-square tests, and regression models to explore associations between SF-BARI scores, weight gain, and obesity associated diseases remission. At 1 year, the mean BMI decreased from 44.8 ± 5.1 kg/m² to 27.7 ± 3.8 kg/m² (p < 0.001), with a mean SF-BARI score of 103 ± 20.3 (good). At 5 years, the BMI increased to 30.6 ± 4.7 kg/m², 57.1% of patients experienced > 5% weight gain, and the SF-BARI score decreased to 93.8 ± 25.3 (good). Obesity associated diseases remission was significant, with 60.7% of hypertensive patients, 66.7% of diabetic patients, 50% of dyslipidemic patients, and 66.7% of OSA patients having improved disease control. No significant association was found between weight gain and obesity associated diseases control (p > 0.05). Greater % excess weight loss was the strongest predictor of higher SF-BARI scores (r²=0.596, p < 0.001), whereas weight gain and higher BMI were associated with lower scores (p < 0.001). Bariatric surgery yields durable improvements in weight and obesity associated diseases control at 5 years, despite frequent weight gain. The SF-BARI score effectively captures multidimensional outcomes, and the lack of association between weight gain and obesity associated diseases remission suggests weight-independent mechanisms. However, further studies are needed to validate the prognostic value of the SF-BARI in larger cohorts.

Background: Obesity was declared by the World Health Organization as one of the 21st century pandemics. In Portugal, about 53% of the population are overweight (BMI &gt; 27 kg/m²), and around 1.5 million are obese (1). Approach: At a more local scale, Odemira (Alentejo), is estimated that 24.3% of the population aged ≥18 years is obese(2). Moreover, among patients registered at Odemira UCSP, between the ages of 40 and 64, there were in 2023, 1,175 people (12.2% of this population)(3), with obesity and either Hypertension or Diabetes Mellitus. In response to this scenario, ULSLA EPE (UCSP Odemira), in partnership with Municipio de Odemira, launched an integrated municipal primary prevention program for individuals with obesity and high cardiovascular disease risk (CVD), named Living More, Living Better. The program aims to reduce CVD risk, promote healthy behaviors, and empower individuals to effectively manage their health/disease. People between 40 to 64 years old with obesity and another CVD risk factor – Diabetes Mellitus, Hypertension, and/or Dyslipidemia – were identified and recruted by their health team. Exclusion criteria include: pregnancy, uncontrolled psychiatric illness or conditions that prevent moderate-intensity physical exercise. A multidisciplinary team composed by a doctor, nurse, nutritionist, psychologist and physical education teacher was assembled to follow the patients. A closed group of 10 people received personalized care over 12 months, with periodic biometric, analytical, and psychological evaluations by the multidisciplinary team every 3 months. Participants received weekly personalized physical training from a physical education teacher and weekly/biweekly dietary consultations with a nutritionist. Monthly educational/capacity-building sessions were held in a mutual aid group format. Results: Regarding the first group of the project, we could observe that half of the participants moved from obesity to overweight. All increased their HDL levels and reduced baseline systolic blood pressure, resulting in a reduced CVD risk. All improved their aerobic endurance. Implications: Health should increasingly occupy a central place in the territorial and community policies of each municipality, as community development is limited without health.

A 62-year-old Iraqi woman exhibited progressive enlargement of her hands, feet, and facial features over several years, accompanied by poorly controlled type 2 diabetes mellitus, hypertension, and dyslipidemia—metabolic disorders that had become increasingly challenging to manage despite conventional treatment. These gradual physical changes, which are often very small in middle-aged and older people, eventually made doctors think that the person might have acromegaly. Biochemical testing confirmed the diagnosis by showing consistently high levels of growth hormone, no suppression on oral glucose tolerance testing, and insulin-like growth factor-1 concentrations that were much higher than normal for someone of the same age and sex. A macroadenoma measuring 14 × 12 × 9 mm was found on a pituitary magnetic resonance imaging scan. There was no suprasellar extension, optic chiasm compression, or visual field problems on formal testing. After a thorough discussion of treatment options, the patient opted against transsphenoidal surgery, citing personal preference and apprehensions about surgical risks, and instead chose to initiate primary medical treatment. She began taking Sandostatin LAR (octreotide), a long-acting somatostatin receptor ligand, at a low dose that was gradually increased over the next few months based on how well she tolerated it and how her biochemical response changed. Regular follow-up lab tests showed that insulin-like growth factor-1 levels were steadily dropping toward the normal range. This showed that the excess growth hormone was being successfully suppressed. A follow-up MRI about a year into treatment showed a good response, with the adenoma getting smaller and cystic degeneration appearing in the tumor, which is what you would expect from somatostatin analog–mediated regression. This hormonal enhancement was accompanied by improved management of her metabolic comorbidities, including enhanced glycemic control, lowered blood pressure, and optimized lipid profiles, highlighting the close association between acromegaly and cardiometabolic complications. This case underscores the necessity of early recognition of acromegaly in patients primarily exhibiting metabolic disturbances and subtle physical manifestations, particularly when surgical intervention is not feasible. It also shows how effective somatostatin analogs can be as a powerful nonsurgical treatment that can help with biochemical control, tumor reduction, and overall metabolic health. In these cases, successful management depends on a personalized, multidisciplinary framework that includes regular endocrinological evaluations, hormonal monitoring, and periodic imaging. This is done to get the best disease control, reduce long-term complications, and improve quality of life.

Type 2 diabetes mellitus (T2DM) and dyslipidemia commonly coexist and increase cardiovascular risk through interconnected mechanisms involving insulin resistance, oxidative stress, and chronic inflammation. While conventional pharmacological therapies effectively control metabolic abnormalities, concerns related to side effects, cost, and long-term adherence have encouraged exploration of medicinal herbs as complementary multi-target interventions. This review provides a mechanism-based overview of medicinal herbs with dual antidiabetic and antilipidemic potential, integrating evidence from both preclinical and clinical studies. Medicinal herbs regulate metabolic homeostasis through multiple pathways, including enhancement of insulin secretion, improvement of insulin sensitivity via AMPK and PI3K/Akt signaling, inhibition of carbohydrate-digesting enzymes, modulation of lipid metabolism, and reduction of oxidative and inflammatory stress. Botanicals such as Trigonella foenum-graecum, Curcuma longa, Momordica charantia, Berberis aristata, and Allium sativum demonstrate overlapping mechanisms that simultaneously influence glucose and lipid regulation. Antioxidant phytochemicals further support β-cell protection and metabolic balance. Despite promising mechanistic evidence, clinical translation remains limited due to variability in extract standardization, dosage, and study design, with several herbs still supported mainly by preclinical data. Future research should focus on standardized formulations and well-designed clinical trials to establish evidence-based therapeutic applications for metabolic disorders.

BACKGROUND Gestational diabetes mellitus (GDM), characterized by glucose intolerance, is an increasingly prevalent public health issue linked to both maternal and neonatal complications. Dyslipidemia, a cardiovascular risk factor associated with insulin resistance, can exacerbate GDM and lead to more severe maternal and fetal outcomes. While lipid changes are normal in pregnancy, excessive dysregulation may cause endothelial dysfunction, inflammation, and complications such as preeclampsia, macrosomia, and cesarean delivery. Understanding the burden of these conditions in local settings is crucial for early risk identification, targeted prevention, and improved maternal-fetal health. AIM To determine the prevalence and identify factors associated with GDM and its association with dyslipidemia among pregnant women attending health facilities in the Buea Health District (BHD), Cameroon. METHODS A cross-sectional hospital-based study was conducted from January 2024 to July 2024 in the BHD. A total of 113 pregnant women were selected by convenience. Sociodemographic, obstetric, and lifestyle data were collected using a structured and pretested questionnaire. Lipid profile was evaluated by enzymatic colorimetric methods. GDM was diagnosed by the oral glucose tolerance test using the National Institute for Health and Care Excellence 2015 criteria. Data were analyzed using the Statistical Package for Social Sciences version 26. The Student’s t -test was used to compare mean biochemical parameters between groups. Multivariate logistic regression analysis was conducted to assess the association between GDM and dyslipidemia. P &lt; 0.05 was considered statistically significant. RESULTS The age of participants was 28.70 ± 5.19 years. The prevalence of GDM in the BHD was 10.6%. Pregnant women aged ≥ 34 years had an 11.47-fold higher risk of developing GD than their counterparts aged 20-26 years [adjusted odds ratio (aOR) = 11.47, 95% confidence interval (95%CI): 1.19-3.15; P = 0.03]. Also, unemployed women had an 8.80-fold higher risk of developing GDM compared to those who were employed (aOR = 8.80, 95%CI: 1.01-2.06; P = 0.04). Furthermore, women who exercised infrequently had a 10.31-fold higher risk of developing GDM than their counterparts who exercised daily (aOR = 10.31, 95%CI: 1.69-3.06; P = 0.02). Also, women who had a family history of diabetes were 4.35 times more at risk of developing GDM than their counterparts who had no family history (aOR = 4.35, 95%CI: 0.91-2.10; P = 0.04). The prevalence of dyslipidemia was 31.90%, and it was associated with the trimester of pregnancy (P = 0.003). Pregnant women in their third trimester of pregnancy had a 2.86-fold higher risk of developing dyslipidemia compared to those in their second trimester (aOR = 2.86, 95%CI: 1.06-7.70; P = 0.004). Also, GDM was associated with dyslipidemia (P = 0.037). CONCLUSION The prevalence of GDM and dyslipidemia among pregnant women in the BHD was 10.6% and 31.90%, respectively. Dyslipidemia was associated with GDM. Advanced maternal age, unemployment, less frequent exercise, and family history of diabetes mellitus were associated with GDM in the BHD.

Metabolic dysfunction‑associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide, as demonstrated by a 50% increase in the prevalence over the past three decades. More than one quarter of the global population and nearly 40% of adults in the United States are affected by this burdensome disease. Once thought to be an "innocent bystander," MASLD is now understood as a multisystem disease associated with obesity, type 2 diabetes mellitus, dyslipidemia, and cardiovascular disease. Its rising prevalence emphasizes the critical role of primary care providers, including nurse practitioners (NP), in early identification and management. Existing on a spectrum, MASLD ranges from simple hepatic steatosis to nonalcoholic steatohepatitis with inflammation, fibrosis, and cirrhosis. Early stages are often asymptomatic, but progression can lead to portal hypertension, end-stage liver disease, hepatocellular carcinoma, and death. Disease management focuses on lifestyle modification and optimal control of metabolic comorbidities, including glycemic management, statin therapy for dyslipidemia, blood pressure control, and treatment for obstructive sleep apnea. Pharmacologic options remain limited, although vitamin E and pioglitazone may benefit select patients. Furthermore, emerging therapies are under investigation. This article presents a case of MASLD in a patient with metabolic comorbidities and persistently elevated aminotransferases, illustrating the significance of focused assessments and highlighting the role of nurse practitioners in screening, lifestyle counseling, early intervention, and longitudinal follow-up to prevent disease progression and improve outcomes.

Type 2 diabetes mellitus (T2DM), a chronic metabolic disorder, is characterized by insulin resistance and glucose intolerance.Insulin resistance is affected by bodyweight and lipid profile The purpose of this study was to compare the body mass index (BMI) and biochemical markers of diabetic patients to those of healthy controls in Pakhtun population of Peshawar Pakistan.A case control study having T2DM patients and healthy controls were included.The majority of diabetic patients (mean age= 52.46 years) were overweight, (BMI=26.84 5.37) than control (mean age= 43.16 years), (BMI=23.90 4.26).Diabetics with mean HbA1c 8.70% (2.14) and RBS 202.85 mg/dL (79.02) had poor glycemic control as compared to the control subjects.In patients the triglycerides were 245.60 mg/dL (194.01),total cholesterol was 179.61 mg/dL (48.46),low density lipoproteins (LDL) was 100.30mg/dL (35.35), and high density lipo protein (HDL) was 40.28 mg/dL (14.74).While the controls showed the normal values of the total cholesterol of 179.98 mg/dL (40.34),LDL of 96.37 mg/dL (24.78),HDL of 47.84 mg/dL (9.91), and triglycerides of 144.64 mg/dL (70.61).BMI in diabetics had a modest, non-significant relationship with triglycerides (r = 0.19, p = 0.062) and a negligible relationship with LDL (r = 0.01, p = 0.928).However, dyslipidemia in diabetics may worsen with poor glycemic levels.This factor can be used as one of the important predictor of the type 2 diabetes for the future studies on large scale population.

Background: Stroke is the most frequent serving form of cerebrovascular disease as it is ranked 2nd globally. when the blood supply to the brain is insufficient or a blood vessel is ruptured. there are 2 main classifications of stoke: ischemic stroke and hemorrhagic. different modalities are used for the diagnosis of stroke, but the gold standard is still computed tomography(CT). Aims and objectives: to determine the frequency of ischemic stroke in patients landed for CT scan brain in Hayatabad Medical Complex hospital Peshawar and to identify the common risk factors associated with ischemic stroke in patients visit for CT scan brain in Hayatabad Medical Complex hospital Peshawar. Methods: the study took place in Hayatabad medical complex Peshawar in duration of 6 months with a cross-sectional study through Convenience sampling with the sample size of 323. Result: A total of 39.3% patients where reported for stroke out of 323, The age range of 41 to 60 was the most impacted. The most prevalent risk factor was hypertension (44%), which was followed by diabetes mellitus (26.6%) and high cholesterol (18.9%). In 4.6% of cases, smoking was reported. Discussion: The results support international research and emphasize the importance of hypertension as the primary risk factor for ischemic stroke. Significant contributions were also made by diabetes mellitus and dyslipidemia, highlighting the significance of metabolic health in preventing stroke. Because of lifestyle factors and a higher prevalence of comorbid diseases, males were more likely to be affected than females. The burden of stroke among middle-aged persons is indicated by the age group most afflicted, which is 41–60 years old. This highlights the importance of early detection and intervention. Analyses of other studies showed comparable patterns. Conclusion: This study highlights how diabetes, dyslipidemia, and hypertension contribute to the pathogenesis of ischemic stroke. The results highlight the significance of public health initiatives and early screening in reducing the incidence of stroke, particularly in middle-aged individuals.

Introduction Early stent thrombosis (ST) (≤30 days) following primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains a rare but serious complication. Despite advances in stent technology and antithrombotic therapy, this condition continues to be associated with high morbidity and mortality, particularly in resource-limited settings where local data are scarce. Purpose The purpose of this study is to evaluate the clinical characteristics, procedural factors, and in-hospital outcomes of patients with early stent thrombosis and to compare these findings with matched controls without stent thrombosis in a tertiary care cardiac center in Peshawar, Pakistan. Materials and methods This retrospective observational study included adult patients undergoing primary PCI who developed acute stent thrombosis (AST) (≤24 hours) or subacute stent thrombosis (24 hours to 30 days) during the same hospitalization. Data were collected from medical records, catheterization laboratory reports, and electronic hospital systems using a structured questionnaire. SPSS version 27.0 (IBM Corp., Armonk, NY) was used for statistical analysis, with comparisons made between cases and matched controls. Results A total of 80 patients with early stent thrombosis and 160 matched controls were analyzed. The majority were men (62/80, 77.5%). Common baseline cardiovascular risk factors included diabetes mellitus (28/80, 35%), hypertension (42/80, 52.5%), dyslipidemia (34/80, 42.5%), smoking (26/80, 32.5%), and prior coronary artery disease (12/80, 15%). Acute stent thrombosis occurred predominantly within 24 hours post-PCI (16/80, 20%). Procedural characteristics, including stent type, vascular access, and adjunctive therapies, were largely similar between sexes. Repeat PCI was the primary management strategy (62/80, 77.5%), and while most patients survived to discharge, a subset experienced serious in-hospital complications: heart failure (18/80, 22.5%), recurrent ischemia (10/80, 12.5%), arrhythmias (12/80, 15%), acute kidney injury (8/80, 10%), or bleeding events (6/80, 7.5%). Procedural factors associated with early stent thrombosis included high thrombus burden, suboptimal stent expansion, overlapping stents, and reduced post-procedural thrombolysis in myocardial infarction (TIMI) flow. Conclusion Early stent thrombosis after primary PCI remains an uncommon but potentially life-threatening complication with substantial in-hospital morbidity. Timely recognition and prompt intervention, primarily through repeat PCI, are essential to improve outcomes. These findings highlight the need for larger, multicenter studies to identify modifiable patient- and procedure-related risk factors, particularly in local populations, to enhance prevention and management strategies for early stent thrombosis.