Metabolic Syndrome Disorders Research Articles

A systematic review and meta-analysis of the anti-inflammatory benefits of curcumin supplementation in individuals with metabolic syndrome and related diseases

Several randomized controlled studies (RTCs) have investigated the potential beneficial effects of curcumin in inflammatory process in metabolic syndrome. These studies have presented results controversial and inconclusive. In the present study, we aimed to conduct a systematic review and meta‐analysis of RCTs to assess the effect of curcumin supplementation on inflammatory markers such as tumor necrosis factor‐alpha (TNF‐α), C‐reactive protein (CRP), and interleukin‐6 (IL‐6) among in patients with metabolic syndrome and related disorders. PubMed, Scopus, Web of Science, and SciELO were searched from inception up to September 2023. The review has been registered at PROSPERO (CRD42023447460). Weighted mean differences (WMDs) were reported. P-values < 0.05 were considered significant. By employing the Cochrane tool, RCTs were assessed for bias risk. Assessment of study quality was conducted using the GRADE approach. Publication bias was evaluated using funnel plots and Egger’s tests. In total, 26 studies were included in the meta-analysis, including 27 arms. The meta‐analysis indicated that curcumin supplementation significantly decreased CRP (-0.75mg/dL, 95 % CI: -1.10, -0.39; p= <.0001), IL-6 (-1.41pg/mL, 95 % CI: -2.04, -0.77; p = <.0001), and TNF‐α (-3,15pg/mL, 95 % CI: -4.52, -1.48; p = 0.0001) levels. Thus, this meta-analysis suggests that curcumin supplementation may exert anti-inflammatory effects, however, additional trials are needed to validate these results and reduce heterogeneity between studies.

Phytonutrient Formulation Using Gum Arabic and Adansonia Digitata Pulp: Lessons for Boosting the Human Immune System - Part 1

BackgroundThe intrinsic immune system (HIIs) defends the body against pathogens and relies on the energy obtained from food sources to increase its metabolic activity. AimIn this study, a new blended 3 in1 formula comprising A. senegal, A. seyal, and Adansonia digitata at a ratio of 5:3:2 was proposed as a potential aid in the management of Covid-19 patients with Metabolic Syndrome (MeT-S) disorders, with a specific focus on those presenting with impaired health. MethodsThe utilization of Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-MS) was employed to analyze 3 blended ingredient combinations, including the 3in1 formula, A. senegal, A. seyal, and A. digitata pulp, for the presence of elements by detecting the levels of moisture, ash, minerals, protein, amino acids, carbohydrates, sugars, prebiotic polysaccharides, energy, dietary fibers, and crude fibers. This advanced technique has replaced the titration method used in previous studies. ResultsThe mineral content of the blended 3in1 sample was found to be dominated by potassium (70.56±2.35), Calcium (68.54±3.12), Magnesium (16.60±4.80), Phosphorus (11.50±2.50), Sodium (31.4±4.80), Zinc (19.19±2.10), Iron (19 ± 0.14), Copper (15.12±1.81), and selenium (0.037 ± 0.005) g/100 g DW. The blended 3 in1 sample also had a higher hydroxyproline content (30.17 g/100 g and a higher total protein and carbohydrate content than the blended 2 in1 sample. Additionally, arabinose was identified as the major reducing sugar with up to 48.23 and 49.97g/100 gDW. The prebiotic polysaccharide content was 88.61±3.12g/100 gDW for the blended 3 in1 sample, which was significantly higher than that of the blended 2 in1 sample. Furthermore, the energy value of the blended 3 in1 sample was significantly higher at 350.12±5.210 kcal/100 g than the blended 2 in1 sample at 340.67±3.155 kWh. The Insoluble Dietary Fibers (IDFs) and Soluble Dietary Fibers (SDFs) of the blended 3 in1 sample were 12.6±2.10 g/100 gDW and 87±2.124 g/100 g DW, respectively, which were significantly higher than those of the blended 2 in1 sample. ConclusionThe discovery of distinct molecular compositions of A. senegal and A. seyal when combined with Adansonia Digitata Pulp (ADLP) in the 3 in1 blend demonstrated enhanced HIIs among Covid-19 patients with compromised MeT-S disorders. This may be considered a valuable natural antiviral agent for the treatment of such individuals.

Comparative analysis of high-fat diets: Effects of mutton, beef, and vegetable fats on body weight, biochemical profiles, and liver histology in mice

BackgroundHigh-fat diets are associated with metabolic syndrome, cardiovascular diseases, and liver disorders. Beef and mutton, both widely consumed meats, are significant sources of animal fat, while soybean oil, a commonly used cooking oil, is a prominent source of plant-derived fat. This study aimed to compare the effects of regular consumption of beef fat, mutton fat, and soybean oil in mice to assess potential health risks. MethodsSixty Swiss albino male mice were divided into four groups: a control group (Group A) fed a standard mice pellet, and three treatment groups (Groups B, C, D) receiving 10% dietary fat from mutton, beef, and soybean oil, respectively. Parameters such as body weight, caloric intake, serum markers, and liver histopathology were studied. ResultsConsumption of mutton fat, beef fat, or soybean oil supplemented diet in groups B, C, and D led to higher caloric intake and body weight compared to control group A, which received a standard diet. These diets also caused elevated serum glucose, impaired glucose tolerance, and increased triglycerides, cholesterol, LDL-C, and reduced HDL-C. Elevated AST and ALT levels in the high-fat diet groups, indicated liver damage and fat accumulation. Histological analysis confirmed steatosis, hepatocyte ballooning, and inflammation in all three high-fat diet groups, while the control group had normal liver histology. ConclusionHigh-fat diets, whether plant- or animal-based, led to weight gain in mice and resulted, poor glucose tolerance, dyslipidemia, liver damage and steatohepatitis. Further research is needed to explore the mechanisms behind these effects and improve understanding and management of high-fat diet consequences

AGING GRACEFULLY IN OSTEOARTHRITIS: IMPACT OF COMORBIDITIES

Background: Osteoarthritis (OA) is a prevalent musculoskeletal disorder, often complicated by comorbid conditions such as cardiovascular diseases, metabolic syndromes, and mental health issues. These comorbidities significantly impact the progression of OA and the effectiveness of its management, posing challenges for comprehensive patient care. Objectives: This review examines the relationship between OA and its common comorbidities, focusing on cardiovascular diseases, metabolic conditions, and mood disorders. We also explore the impact of pharmacological and non-pharmacological treatments in these patients, emphasizing the importance of integrated care strategies. Methods: Data from multiple studies were analyzed to assess the association between OA and comorbid conditions. The studies examined mortality risk, cardiovascular incidents, metabolic syndrome, diabetes, obesity, and mood disorders, while considering the effects of various OA treatment modalities, particularly non-steroidal anti-inflammatory drugs (NSAIDs). Results: Cardiovascular comorbidities, including coronary heart disease, are significantly linked to OA, with functional limitations such as impaired mobility being major contributors to increased cardiovascular risks and mortality. NSAIDs, commonly prescribed for OA, present substantial cardiovascular and renal risks, complicating their use in patients with pre-existing cardiovascular conditions. Metabolic comorbidities, particularly obesity and diabetes, are highly prevalent in OA patients and are associated with reduced quality of life and exacerbation of OA symptoms. Furthermore, mood disorders like depression and anxiety are common among OA patients, leading to a vicious cycle of pain and psychological distress that worsens functional outcomes. Conclusions: OA is closely related to various comorbidities, necessitating a holistic, multimodal approach to treatment. Beyond pharmacologic interventions, lifestyle changes, psychosocial support, and careful management of comorbid conditions are essential for improving outcomes in OA patients.

Current Strategies for Atrial Fibrillation Prevention and Management: Taming the Commonest Cardiac Arrhythmia.

Atrial fibrillation (AF) is the commonest cardiac arrhythmia, constituting a major cause of morbidity and mortality, with an age-dependent incidence and prevalence ranging from 1-2% in the general population to ~10% in persons aged >60 years. The global prevalence of AF is rapidly increasing, mostly due to the aging population. If not properly and timely managed, this arrhythmia adversely affects left ventricular function, increases the risk of stroke five-fold, impairs quality of life, and shortens longevity. There is a genetic, hence non-modifiable, predisposition to the arrhythmia, while several life-style and cardiometabolic inciting factors, such as hypertension, heart failure, coronary disease, metabolic syndrome, alcohol use, and thyroid disorders, can be addressed, attesting to the importance of a holistic approach to its management. Thromboembolism is a serious consequence of AF, which could lead to a disabling stroke or have a lethal outcome. The risk of a thromboembolic complication can be estimated as based on a scoring system that takes into consideration the patient's age, previous thromboembolic events, and clinical comorbidities. In addition, rapid AF could affect cardiac performance, leading to an elusive type of arrhythmia-induced cardiomyopathy and heart failure with grave consequences if undetected and untreated. Furthermore, AF may cause silent brain infarcts and/or its hemodynamic perturbations can account for a type of dementia that needs to be taken into account, emphasizing the need for AF screening and prevention strategies. All these issues are herein detailed, the causes of the arrhythmia are tabulated, and an algorithm illustrates our current approach to its management.

Association between incidental perirenal fat stranding on CT and metabolic syndrome in otherwise healthy adults.

To investigate the association between metabolic syndrome and perirenal fat stranding (PRFS), which is defined as linear or curvilinear soft tissue densities in the perirenal fat on computed tomography (CT). Adults who had abdominal CT for health screening at a single institution between October 2022 and March 2023 were included retrospectively. Two radiologists assessed the extent of PRFS for each CT and graded it as absent, mild/moderate, and severe. Logistic regression analyses were used to investigate the associations between PRFS and metabolic syndrome-related factors, as well as age and gender. Among 701 participants (mean age, 56.8years ± 9.7; 336 women and 365 men), 87 (12.4%) had mild (n = 80) or moderate (n = 7) PRFS. None had severe PRFS. The presence of PRFS was independently associated with higher body mass index (odds ratio [OR], 2.561 and 9.842 for overweight and obese, respectively; p ≤ 0.001), elevated blood pressure with or without anti-hypertensive medication (OR, 2.232; p = 0.015), anti-diabetic medication (OR, 3.129; p < 0.001), and lipid-lowering medication (OR, 1.919; p = 0.019), older age (OR, 4.545 and 9.109 for 50-59years and ≥ 60years, respectively; p ≤ 0.002), and male gender (OR, 10.065; p < 0.001). Sixty three of 87 (72.4%) participants with PRFS had metabolic syndrome, while 265 of 614 (43.2%) participants without PRFS did (p < 0.001). Incidental mild or moderate PRFS may be associated with the presence of metabolic syndrome or related disorders in otherwise healthy adults.

Long-Term Management of Sleep Apnea-Hypopnea Syndrome: Efficacy and Challenges of Continuous Positive Airway Pressure Therapy

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a prevalent condition characterized by intermittent upper airway obstruction during sleep, leading to significant health issues, including cardiovascular disease, metabolic syndrome, and neurodegenerative disorders. The primary treatment for OSAHS is Continuous Positive Airway Pressure (CPAP) therapy, which maintains airway patency through a continuous flow of air, effectively reducing apnea-hypopnea indices, improving sleep quality, and lowering cardiovascular risks.

Promising Influences of Moringa oleifera in Functional Foods against Metabolic Syndrome: A Comprehensive and Mechanistic Review.

Metabolic syndrome (MetS) is now considered a global issue with a growing financial and health impact. Numerous herbal alternatives have been examined and researched due to the ever-increasing demand for new medications to treat metabolic syndrome disorders. People have empirically employed Moringa oleifera (MO), a native plant to several Asian nations, for a variety of diseases. We sought to examine recent research on MO in MetS and its potential mechanism of action in the current review. Four databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, were thoroughly searched, and the data were then compiled. In total, 146 papers covering nonclinical and clinical MO investigations in metabolic syndromerelated disorders are included in this study. Numerous research confirmed MO's positive impact on the control of blood glucose, blood pressure, hyperlipidemia, and obesity. Many molecular processes have been investigated, including increasing glucose transporter type 4 (GLUT4) expression, inhibition of β-Hydroxy-β-methylglutaryl-coenzyme A (HMG-CoA), α-glucosidase inhibiting, AMP-activated protein kinase (AMPK) activation, and other suggested mechanisms. The current review established much data favoring MO's potential advantages in metabolic syndrome. However, further research involving human studies is required in this area to determine whether Moringa can effectively treat metabolic syndrome.

The role of synbiotics in correcting gut microbiota disorders and increased intestinal permeability: A review

The gut microbiota participates in all metabolic processes in the human body, and its state determines the course of pathological processes. Intestinal infections, IBS, IBD, SIBO, diverticular disease, celiac disease, cancer, food intolerance, allergies, liver and pancreatic diseases, obesity, diabetes, metabolic syndrome, hematological, cardiological, genitourinary, rheumatological, neurological, neuropsychiatric and other disorders are associated with dysbiosis and increased permeability of the intestinal barrier. The means of correcting the gut microbiota are constantly being improved. The importance and expediency of using pro- and prebiotics as part of the complex therapy of many diseases is currently confirmed not only by large international clinical studies, but also by modern methods of diagnosing microbiota disorders. The review article presents clinically confirmed data on the effectiveness of the use of synbiotic Maxilac® for the correction of gut microbiota disorders and increased intestinal permeability in infectious diseases, postCOVID syndrome, IBS, including post-infectious IBS, as well as in severe atopic dermatitis in children.

Functions of Adipocytokines and Link with Primary Glomerulonephritis

Abstract Adipocytokines are substances with endocrine functions produced by adipose tissue, playing crucial roles in regulating metabolic functions and inflammatory processes. Dysregulation of fatty tissue's endocrine functions and dysregulation of the production of adipocytokines such as adiponectin, leptin, fibroblast-stimulating factor, and others can lead to a low-grade systemic inflammation and an insulin resistance in patients. These conditions contribute to the pathophysiology of type 2 diabetes mellitus, atherosclerosis, arterial hypertension, metabolic syndrome, and other disorders. Conversely, these metabolic disorders exert feedback-regulatory effects on adipocytokines and their functions. Glomerulonephritis encompasses a group of immune-mediated diseases characterized by inflammation of the glomeruli. Diagnosis can involve examining urine sediment, detecting autoantibodies, and identifying immune complexes in the blood. However, a kidney biopsy is required for definitive confirmation of glomerulonephritis and is considered the gold standard and a necessity in diagnosis. Affecting the level of adipocytokines could be one of the new strategies for the pharmacological treatment of many diseases. Given a better understanding of their functions and molecular targets, adipocytokines may herald the emergence of new diagnostic approaches (1, 2). Monitoring the level of adipocytokines could contribute to a better patient management and thus become an auxiliary tool for predicting and diagnosing diseases.

Effect of whole-grain Tartary buckwheat fermentation with Monascus purpureus on the metabolic syndrome and intestinal flora in mice

This study investigated changes in the composition of fermented whole-grain Tartary buckwheat (FTB) by Monascus purpureus and the therapeutic effects of FTB on metabolic diseases in mice fed high-fat and high-sugar (HFHS) diets. Compared to raw Tartary Buckwheat (RTB), the protein, total phenol, and total flavonoid contents of FTB were significantly increased by 67.88%, 24.97%, and 45.74%, respectively, especially the rutin content reached 2607.31 mg/100g DW (p < 0.05, p < 0.01, p < 0.0001). Meanwhile, it exhibits stronger antioxidant properties of DPPH, ABTS, and FRAP (p < 0.05, p < 0.01). Then, the treatment of low (3 g/kg), medium (6 g/kg), and high (12 g/kg) doses of FTB (FL, FM, FH) could positively regulate weight, blood lipids, pro-inflammatory factors, glucose tolerance, and liver damage in HFHS mice. Among all groups, the levels of weight (35.53 g), fat (0.93 g/100 g), TG (0.77 mmol/L), IL-1β (84.77 ng/L), IL-6 (127.62 pg/L) and insulin (7.06 mIU/L) of serum, IL-1β (74.89 ng/L) and TNF-α (840.32 pg/L) of liver were all the lowest in FH group. Furthermore, the intestinal flora compositions were positively regulated by FTB treatment, including reducing the relative abundance of harmful bacteria (Clostridia_UCG-014, Candidatus_Saccharimonas, and Enterorhabdus) and enhancing the relative abundance of beneficial bacteria (Akkermansia and Eubacterium coprostanoligenes). Particularly, the phyla Firmicutes/Bacteroidetes (F/B) ratio was markedly restored and the abundance of Akkermansia and Eubacterium coprostanoligenes was significantly increased in the FH group (p < 0.0001). In conclusion, FTB can be used as a dietary supplement for improving metabolic syndrome and intestinal flora disorders. This study provides new ideas for the use of whole-grain Tartary buckwheat, new product development, and industry chain enhancement.

Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity.

Dietary nutrition plays a crucial role in determining pregnancy outcomes, with poor diet being a major contributor to pregnancy metabolic syndrome and metabolic disorders in offspring. While carbohydrates are essential for fetal development, the excessive consumption of low-quality carbohydrates can increase the risk of pregnancy complications and have lasting negative effects on offspring development. Recent studies not only highlighted the link between carbohydrate intake during pregnancy, maternal health, and offspring well-being, but also suggested that the quality of carbohydrate foods consumed is more critical. This article reviews the impacts of low-carbohydrate and high-carbohydrate diets on pregnancy complications and offspring health, introduces the varied physiological effects of different types of carbohydrate consumption during pregnancy, and emphasizes the importance of both the quantity and quality of carbohydrates in nutritional interventions during pregnancy. These findings may offer valuable insights for guiding dietary interventions during pregnancy and shaping the future development of carbohydrate-rich foods.

Identifying influencing factors of metabolic syndrome in patients with major depressive disorder: A real-world study with Bayesian network modeling

BackgroundThe bidirectional relationships between metabolic syndrome (MetS) and major depressive disorder (MDD) were discovered, but the influencing factors of the comorbidity were barely investigated. We aimed to fully explore the factors and their associations with MetS in MDD patients. MethodsThe data were retrieved from the electronic medical records of a tertiary psychiatric hospital in Beijing from 2016 to 2021. The influencing factors were firstly explored by univariate analysis and multivariate logistic regressions. The propensity score matching was used to reduce the selection bias of participants. Then, the Bayesian networks (BNs) with hill-climbing algorithm and maximum likelihood estimation were preformed to explore the relationships between influencing factors with MetS in MDD patients. ResultsTotally, 4126 eligible subjects were included in the data analysis. The proportion rate of MetS was 32.6 % (95 % CI: 31.2 %–34.1 %). The multivariate logistic regression suggested that recurrent depression, uric acid, duration of depression, marriage, education, number of hospitalizations were significantly associated with MetS. In the BNs, number of hospitalizations and uric acid were directly connected with MetS. Recurrent depression and family history psychiatric diseases were indirectly connected with MetS. The conditional probability of MetS in MDD patients with family history of psychiatric diseases, recurrent depression and two or more times of hospitalizations was 37.6 %. ConclusionUsing the BNs, we found that number of hospitalizations, recurrent depression and family history of psychiatric diseases contributed to the probability of MetS, which could help to make health strategies for specific MDD patients.

Increased lipogenesis and lipidosis of gallbladder epithelium in dogs with gallbladder mucocele formation.

Gallbladder disease in people is frequently associated with disorders of lipid metabolism and metabolic syndrome. A recently emergent gallbladder disease of dogs, referred to as mucocele formation, is characterized by secretion of abnormal mucus by the gallbladder epithelium and is similarly associated with hyperlipidemia, endocrinopathy, and metabolic dysfunction. The cause of gallbladder mucocele formation in dogs is unknown. A prospective case-controlled study was conducted to gain insight into disease pathogenesis by characterization of plasma lipid abnormalities in 18 dogs with gallbladder mucocele formation and 18 age and breed matched control dogs using direct infusion mass spectrometry for complex plasma lipid analysis. This analysis was complemented by histochemical and ultrastructural examination of gallbladder mucosa from dogs with gallbladder mucocele formation and control dogs for evidence of altered lipid homeostasis of the gallbladder epithelium. Gallbladder mucocele formation in dogs carried a unique lipidomic signature of increased lipogenesis impacting 50% of lipid classes, 36% of esterified fatty acid species, and 11% of complex lipid species. Broad enrichment of complex lipids with palmitoleic acid (16:1) and decreased abundance within complex lipids of presumptive omega-3 fatty acids eicosapentaenoic (20:5) and docosahexaenoic (22:6) was significant. Severe lipidosis of gallbladder epithelium pinpoints the gallbladder as involved causally or consequently in abnormal lipid metabolism. Our study supports a primary increase in lipogenesis in dogs with mucocele formation and abnormal gallbladder lipid metabolism in disease pathogenesis.

Research progress on the effects of sodium-glucose linked transporter 2 inhibitors on multiple metabolic disorders in metabolic syndrome.

Metabolic syndrome is a complex group of metabolic disorders with an increasing global incidence rate, posing a serious threat to human health. Sodium-glucose linked transporter 2 (SGLT2) inhibitors are a new type of oral hypoglycemic drug. SGLT2 inhibitors not only lower blood glucose level in a non-insulin-dependent manner by inhibiting glucose reabsorption by renal proximal convoluted tubular epithelial cell to promote urinary glucose excretion, but also by improving islet β cell function, reducing inflammatory responses, and inhibiting oxidative stress. In addition, SGLT2 inhibitors can reduce body weight through osmotic diuresis and increase fat metabolism; reduce blood pressure by inhibiting excessive activation of sympathetic nervous system and by improving vascular function. They can also improve blood lipids by increasing degradation of triacylglycerol; reduce blood uric acid by promoting uric acid excretion in kidney and intestine, and by reducing uric acid synthesis. This article reviews the effects and mechanisms of SGLT2 inhibitors on multiple metabolic disorders in metabolic syndrome and explores their potential application in metabolic syndrome treatment.

Evaluation of the Association between Insulin Resistance and Subclinical Hypothyroidism Using Triglyceride-Glucose Index: a Cross-Sectional Study.

Thyroid disorders and diabetes mellitus are often known to co-exist, implying an interrelationship between thyroid dysfunction and insulin resistance. Triglyceride-glucose (TyG) index is a relatively new surrogate marker of insulin resistance, which is cost-effective and easily calculated with routine lab tests. Data about association of subclinical hypothyroidism (SCH) and insulin resistance, especially with reference to TyG index, is lacking. To evaluate the association of SCH and insulin resistance using the TyG index by comparing its value in patients with SCH and age- and gender-matched euthyroid controls. Also, to determine if there is a correlation between TyG index values and thyroid profile parameters (TSH, FT3 and FT4) in both study groups. Thirty-five patients with SCH and an equal number of age- and gender-matched euthyroid controls were included in the present study. The TyG index was calculated for each group and compared. The correlation between TyG index and thyroid profile parameters (TSH, FT3 and FT4) was also assessed. The TSH values were significantly higher in the SCH group (6.6±1.7 µIU/mL) than the control one (2.5±1.2 µIU/mL; p<0.0001). There was no significant difference in FT3 in the SCH group (2.93±0.49 pg/ mL) and the control one (3.05±0.64 pg/mL; p=0.310). The level of FT4 was also not found to be significantly different in SCH subjects (1.23±0.44 ng/dL) and controls (1.4±0.42 ng/dL; p=0.077). The TyG index values were significantly higher in the SCH group (4.8±0.2) as compared to the control one (4.7±0.2; p = 0.015). The TyG index did not show any significant correlation with the thyroid parameters in any of the two groups. There is a positive association between SCH and insulin resistance in terms of TyG index. This index may thus be helpful in early screening and management of such patients for insulin resistance related conditions like diabetes mellitus, metabolic syndrome and cardiovascular disorders.

Experience of using genetic engineering biological therapy in a patient with psoriasis and chronic renal failure under hemodialysis

Psoriasis is a chronic immune-associated disease of a multifactorial nature. The prevalence of the disease, chronic course, impact on the patient’s quality of life, as well as the connection with the risk of progression of various comorbid conditions necessitate a detailed and comprehensive approach to the treatment of this group of patients. There has been a correlation of psoriasis with the risk of many comorbid pathologies, such as psoriatic arthritis, metabolic syndrome, liver and kidney disorders. There is evidence in the literature about the relationship between chronic renal failure and psoriasis, but the data are limited and require further study. According to Russian clinical guidelines, for moderate and severe forms of psoriasis, the prescription of systemic immunosuppressive therapy, targeted and genetically engineered biological drugs is indicated. Of particular interest is the determination of management tactics and selection of therapy if a patient with psoriasis has concomitant pathology due to the lack of a sufficient number of safety studies taking into account this or that comorbidity. We present the data known to us from a literature review on the stated problem. In view of the need to expand the data of real clinical practice on the possible risks of managing patients with psoriasis, we present a description of our own clinical experience of using the inhibitor interleukin 17A in a patient with chronic renal failure and hemodialysis.

Deep learning imaging phenotype can classify metabolic syndrome and is predictive of cardiometabolic disorders

BackgroundCardiometabolic disorders pose significant health risks globally. Metabolic syndrome, characterized by a cluster of potentially reversible metabolic abnormalities, is a known risk factor for these disorders. Early detection and intervention for individuals with metabolic abnormalities can help mitigate the risk of developing more serious cardiometabolic conditions. This study aimed to develop an image-derived phenotype (IDP) for metabolic abnormality from unenhanced abdominal computed tomography (CT) scans using deep learning. We used this IDP to classify individuals with metabolic syndrome and predict future occurrence of cardiometabolic disorders.MethodsA multi-stage deep learning approach was used to extract the IDP from the liver region of unenhanced abdominal CT scans. In a cohort of over 2,000 individuals the IDP was used to classify individuals with metabolic syndrome. In a subset of over 1,300 individuals, the IDP was used to predict future occurrence of hypertension, type II diabetes, and fatty liver disease.ResultsFor metabolic syndrome (MetS) classification, we compared the performance of the proposed IDP to liver attenuation and visceral adipose tissue area (VAT). The proposed IDP showed the strongest performance (AUC 0.82) compared to attenuation (AUC 0.70) and VAT (AUC 0.80). For disease prediction, we compared the performance of the IDP to baseline MetS diagnosis. The models including the IDP outperformed MetS for type II diabetes (AUCs 0.91 and 0.90) and fatty liver disease (AUCs 0.67 and 0.62) prediction and performed comparably for hypertension prediction (AUCs of 0.77).ConclusionsThis study demonstrated the superior performance of a deep learning IDP compared to traditional radiomic features to classify individuals with metabolic syndrome. Additionally, the IDP outperformed the clinical definition of metabolic syndrome in predicting future morbidities. Our findings underscore the utility of data-driven imaging phenotypes as valuable tools in the assessment and management of metabolic syndrome and cardiometabolic disorders.

Early or late phase cardiac remodelling in metabolic syndrome heart characterized with SQT or LQT

Cardiac conduction abnormalities are the main disorders in metabolic syndrome (MetS), however, their mechanisms are not known yet. Although ventricular arrhythmia pathogenesis reflects the time course of cardiomyocyte action potentials (APs) associated with QT-interval duration, recent studies emphasize the role of intercellular crosstalk between cardiomyocytes and nonmyocytes via passive (electrotonic)-conduction. Therefore, considering the possible intercellular interactions between cardiomyocytes and nonmyocytes as electrophysiological contributors to cardiac-conduction, we hypothesized an early-cardiac-remodeling which is characterized by short QT-interval (SQT) via contributions and modulations of changes in the expressions and localizations of nonmyocytes to the ventricular APs in an early-stage MetS hearts. Significant increases in MetS (14-16 weeks) heart rates and SQT, shortened AP duration with a strong response to β-adrenergic stimulation in the contractile activity of the papillary muscles were determined. The patch-clamp analysis of ventricular cardiomyocytes showed that voltage-dependent Na+-channel currents were increased with decreased L-type Ca2+-channel (LTCC) currents and unchanged K+-channel currents. A hemichannel protein of connexin 43 (Cx43) was highly localized into intercalated discs while phospho-Cx43 was densely localized laterally on the sarcolemma and cytosol with increased total expression levels. A marked high-level positively-stained α-SMA and CD68 cells in interfibrillar spaces of the heart were prominently localized and distributed, implying the possible contributions of myofibroblasts and macrophages to both shortened APs and abnormal electrical conduction in an early-stage MetS heart.Our data propose a previously unrecognized pathway for induction of SQT in the heart: This pathway may include not only the contribution of short ventricular-APs via ionic-mechanisms but also increasing contributions of the electrotonic-cardiomyocyte depolarization, spontaneous electrical activity-associated fast heterogeneous impulse conduction in the heart via non-myocytes. Overall, SQT in early cardiac remodeling may arise with increased interactions between cardiomyocytes and non-myocytes, through increasing contributions of passive-conduction by non-myocytes. TUBITAK SBAG-119S661 &amp; 222S502. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Diabetes mellitus, metabolic syndrome, and sleep disorders: An underestimated relationship

Abstract Diabetes mellitus (DM) is the most prevalent endocrine disorder globally. DM is under-evaluated and less efficiently managed in terms of ruling out comorbid conditions associated with it and predisposing factors resulting in poor outcomes. Sleep disorders are more common than usually diagnosed due to less awareness in the community regarding the importance of timely diagnosis and the impact of interventions related to proper sleep hygiene and sleep structure. Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiological studies. OSA leads to several physiological disturbances, such as intermittent hypoxia, sleep fragmentation, and an increase in autonomic tone. Metabolic syndrome (MS) is an adverse outcome that is typically associated with obesity. It is a cluster of metabolic risk factors for type 2 DM (T2DM) and cardiovascular diseases (CVDs), including central obesity, hypertension, hyperglycemia, insulin resistance, and dyslipidemia. T2DM is often associated with OSA, and a bidirectional relationship may exist between the two diseases, mediated by both weight- and physiology-dependent mechanisms. OSA is highly associated with T2DM, and treatment of OSA may have a positive impact on the cardiometabolic profile. In this review, we have attempted to summarize the impact of sleep disorders on MS and DM, and vice versa, with special emphasis on newer medical options in the management of DM and cardiometabolic syndrome.