Fasting Lipid Profile Research Articles

Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi

BackgroundDyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi.MethodsUsing a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis.ResultsPrevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. None of the participants were receiving any lipid-lowering therapy. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05- 2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8;(95% CI 1.15- 3.37); p = 0.04].ConclusionDyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.

Association of visceral adiposity index with cardiovascular risk factors among young adults

Introduction and Aim: The frequent cause of mortality today is cardiovascular disease. Though dyslipidemia predicts cardiovascular risk, the possibility of risk cannot be excluded in normal lipid profile. Therefore, the study was conducted to associate visceral adiposity index (VAI) with cardiovascular risk factors among young adults. Materials and Methods: It is a cross-sectional study in which 150 men and 150 women between the ages of 20 and 40 participated. A detailed clinical history, anthropometric measurements, fasting plasma glucose and fasting lipid profile were estimated. VAI was calculated. Results: Mean VAI was 2.13±0.5 in men and 2.65±0.8 in women. Based on visceral adiposity index, 53% men and 61% women have a high risk of cardiovascular disease. VAI correlated positively with waist circumference, BMI, waist hip ratio, blood pressure, fasting plasma glucose, serum triglyceride, lipid ratios. VAI showed significant negative correlation with HDL cholesterol. Conclusion: We explored the increase in cardiovascular risk among young adults. Though mean values of lipid profile and lipid ratios were within the desired range in our study, around 50% of the young adults had high risk for cardiovascular disease. Hence, VAI index can be used along with the existing lipid profile to identify those at increased cardiovascular risk.

A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.

Objective: This study aims to compare the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in hypertensive patients. Study Design: Prospective Observational. Setting: Hayatabad Medical Complex Peshawar. Period: December 2022 to May 2023. Material & Methods: Approach was employed to investigate the metabolic impact of these antihypertensive medications. Involving a cohort of 660 hypertensive individuals. Data collection spanned over 12-week duration, with fasting glucose and lipid profiles assessed at baseline and 4, 8, and 12 weeks. Participants were categorized into hydrochlorothiazide and captopril groups, receiving standardized dosages of 25 mg/day and 50 mg/day, respectively. Fasting blood samples were analyzed for glucose and lipid parameters. Statistical analyses included paired t-tests and subgroup comparisons. Results: Both groups exhibited reductions in fasting glucose and lipid levels; however, these changes were not statistically significant within the 12-week timeframe. Comparison with national and international studies underscores population-specific variations in antihypertensive effects on metabolism. Conclusion: This study provides insights into the metabolic effects of hydrochlorothiazide and captopril among hypertensive patients. While immediate changes were not significant, the study contributes to the body of knowledge and calls for further research with extended follow-up and broader participant cohorts.

Pattern of Thyroid Dysfunction in Type II Diabetes Mellitus Patients in a Tertiary Care Center: A Cross-Sectional Study

Background: Early identification and intervention of thyroid dysfunction which occurs in association with type-II diabetes mellitus may significantly reduce the risk of adverse cerebrovascular and cardiovascular events in such patients. Hence, this study analyzed the pattern of thyroid dysfunction in T2DM (Type 2 Diabetes mellitus) patients. Methods: The present cross-sectional study was done on 250 T2DM patients, who visited the department of General Medicine in a tertiary care teaching center. Medical history was recorded and venous blood samples were collected for investigations (HbA1C (Hemoglobin A1C), FBS (Fasting blood sugar), PPBS (Postprandial blood sugar), TSH (Thyroid stimulating hormone), T4 (Tetraiodothyronine), anti-TPO (Thyroid peroxidase), and fasting lipid profile). Thyroid dysfunction in patients with T2DM was considered as the primary outcome variable. P value <0.05 was considered statistically significant. Data were analyzed using coGuide software, V.1.03. Results: Females (55.6%) outnumbered males (44.4%) in this study. The prevalence of thyroid dysfunction in our study was 23.6% (95%CI 0.184 to 0.293). Subclinical hypothyroidism was found in 67.79% (95%CI 0.543 to 0.793) participants, overt hypothyroidism in 27.11% (95%CI 0.163 to 0.402), and hyperthyroidism in 5.10% (95%CI 0.010 to 0.141). Females (84.6%) had significantly higher prevalence of anti-TPO positivity compared to males (15.4%)(p=0.013). Conclusions: Findings of this study showed that T2DM patients have higher prevalence of thyroid dysfunction with predominance of subclinical hypothyroidism. Hence, this study emphasizes the importance of annual investigation of TSH levels in all the patients with T2DM. Keywords: Autoimmune Diseases, Hyperthyroidism, Hypothyroidism, Thyroid­Stimulating Hormone, Type II Diabetes Mellitus

A Cross-sectional Study to Assess Insulin Resistance and Atherogenic Index of Plasma as Predictors of Risk of Cardiometabolic Disease among Undergraduate Medical Students at a Tertiary Care Teaching Hospital, Karnataka

Background: Medical profession is known for stress and challenges due to hectic academic schedules which makes students, high-risk candidates for diabetes mellitus, hypertension and cardiometabolic disease (CMD). Surrogate markers such as homeostatic model assessment insulin resistance (HOMA-IR) and atherogenic index of plasma (AIP) along with routine parameters enable early prediction of the disease. Hence, this study aimed at determining HOMA-IR and AIP along with assessment of their correlation with anthropometric and biochemical parameters associated with CMD risk among undergraduate medical students. Methodology : 460 medical students consented to participate in the study. The data related to socio-demographic profile, anthropometry, blood pressure and biochemical parameters such as fasting plasma glucose (FPG), fasting plasma insulin (FPI) and lipid profile was collected and analyzed. HOMA-IR and AIP were calculated. The strength of association between study variables was determined by relevant statistics. Results: The study showed the prevalence of overweight (17.8%), obesity (20.4%), pre-hypertension (37.82%) and hypertension (3.47%). 98.5% of the participants had normal FPG and FPI, whereas 1.5% had impaired levels. Lipid profile analysis showed hypercholesterolemia (3.7%), hypertriglyceridemia (8.1%), increased LDL-c (33.7%) and reduced HDL-c (55.2%). High HOMA-IR and AIP were contributed by 28.9% and 73.3% respectively. HOMA-IR and AIP showed statistically significant positive correlation with CMD risk factors. Conclusion: HOMA-IR and AIP considered as the better predictors of CMD risk among apparently healthy medical students. Thus, incorporation of these surrogate markers along with routine parameters for regular screening can help in early prediction of the risk of CMD among undergraduate medical students. Keywords: Homeostatic model assessment insulin resistance, Atherogenic index of plasma, Cardiometabolic disease, Medical students

Atherosclerotic cardiovascular disease risk profile of patients with chronic hepatitis B treated with tenofovir alafenamide or tenofovir disoproxil fumarate for 96 weeks.

Patients with chronic hepatitis B (CHB) who switch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) show changes in lipid profiles. To evaluate how these changes affect cardiovascular risk. This pooled analysis, based on two large prospective studies, evaluated fasting lipid profiles of patients with CHB who were treated with TAF 25 mg/day or TDF 300 mg/day for 96 weeks. Patients who fulfilled the American College of Cardiology criteria (age 40-79 years, high-density lipoprotein [HDL] 20-100 mg/dL, total cholesterol [TC] 130-320 mg/dL and systolic blood pressure 90-200 mmHg) required to assess 10-year atherosclerotic cardiovascular disease (ASCVD) risk with baseline lipid data and at least one post-baseline measurement were included in the ASCVD-risk population. The 10-year ASCVD risk was calculated for patients in this population, and changes from baseline to Week 96 were assessed using intermediate- (≥7.5%) and high-risk (≥20%) cut-offs. Among 1632 patients, 620 (38%) met the criteria for the ASCVD-risk population. At Week 96, fasting levels of all lipids, except TC:HDL ratio, were lower with TDF than TAF. No significant increase was observed in overall ASCVD risk or in any ASCVD-risk categories during the 96-week treatment period compared with baseline. A similar proportion of patients in the TAF and TDF treatment groups (1.3% and 2.3%, respectively; p = 0.34) reported cardiovascular events. Despite on-treatment differences in lipid profiles with TAF and TDF, predicted cardiovascular risk and clinical events were similar for both groups after 96 weeks.

METABOLIC SYNDROME AMONG PATIENTS OF HEPATITIS C PRESENTING TO A TERTIARY CARE HOSPITAL

Background and objectives: Hepatitis C has evolved to become a global pandemic, equally affecting Pakistan as well. According to one WHO report the estimated prevalence of chronic hepatitis C is 1% worldwide (71 million people) while Pakistan alone contributes more than 12 million people to this figure, with Punjab reporting the highest prevalence of 6.7%. This infection does not only affect the Liver but also produces extrahepatic manifestations in various organs like skin, blood, and gastrointestinal tract as well as leads to many autoimmune conditions. There are many more linked to hepatitis but still remains unclear hence in this study we aim to assess the frequency of metabolic syndrome and the distribution of its features among patients of hepatitis C.Methods: Conducted from 01.08.2019 to 02.01.2020 at Sheikh Zayed Hospital Lahore this cross-sectional study enrolled a total of 110 patients with hepatitis C presenting to the Outpatient Medicine Department. After informed consent, the demographic profile was noted in the proforma. The blood pressure and BMI of the patients were assessed using a standard protocol. A sample of 3ml of blood was taken for fasting lipid profile. Information regarding the study variable was recorded in the proforma and confidentiality of the data was ensured. SPSS was used to analyze the data.Results: Of the total 110 hepatitis C patients enrolled, 54.5% were male, the mean age was 41.06 ± 14.78 years and the mean duration of having hepatitisC was 6.76 ± 3.27 months. Metabolic syndrome was present in 31.8%of the total study participants. Further analysis revealed that metabolic syndrome was not significantly associated with age (p-value = 0.955), gender (p-value = 0.970), or duration of hepatitis C (p-value = 0.125).Conclusion: Metabolic syndrome affects 1 in every 3 patients of Hepatitis C presenting to the tertiary care hospital. Hence screening for metabolic syndrome must be performed among all patients suffering from hepatitis C from an early disease period and all such patients must be educated regarding prevention and control of this syndrome.

Insulin resistance in non-diabetic hypothyroid patients: a critical examination of METS-IR as a diagnostic marker

Objectives Insulin resistance (IR) is a significant metabolic disturbance that plays a pivotal role in various health conditions, including hypothyroidism. Homeostatic Model Assessment For Insulin Resistance (HOMA-IR) is widely used for assessing IR. However, alternative indices, such as the Metabolic Score for Insulin Resistance (METS-IR), have been developed for diverse applications. This study aimed to meticulously investigate IR in patients with hypothyroidism and to compare the effectiveness of METS-IR with HOMA-IR. To enrich our analyses, additional metrics, including the Triglyceride Glucose (TyG) Index, the Triglyceride to High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C), and the Quantitative Insulin Sensitivity Check Index (QUICKI) have been incorporated. Methods This cross-sectional study included 260 non-diabetic adults, 130 with hypothyroidism (case group), and 130 healthy volunteers (control group). Parameters, including Thyroid-Stimulating Hormone (TSH), free thyroxine (T4), fasting blood glucose, HbA1c, insulin levels, and lipid profiles, were measured. IR indices were calculated. Results The groups were matched for age and gender (p = .143; p = .099). The case group demonstrated a notably elevated mean METS-IR of 195.58, in contrast to the control group’s mean METS-IR of 131.10 (p = .044). The mean HOMA-IR was significantly higher in the case group than in the control group, with average of 2.00 and 1.81, respectively (p = .027). METS-IR was positively correlated with TyG (r = 0.505, p = .001) and TG/HDL-C (r = 0.844, p = .001). Meanwhile, the relationships between METS-IR, HOMA-IR, and QUICKI were significant at r = 0.194 (p = .027) and r = .210 (p = .016), respectively. METS-IR was significantly higher in patients with overt hypothyroidism (p = .016). Conclusion This study emphasizes the efficacy of METS-IR as a diagnostic tool for IR in patients with hypothyroidism, establishing it as a proficient alternative to HOMA-IR. These findings were substantiated by the correlations observed with the TyG, TG/HDL-C, and QUICKI measurements. Variations in METS-IR between individuals with subclinical and overt hypothyroidism accentuate its effectiveness in identifying metabolic abnormalities in hypothyroid conditions.

Assessment of global histone acetylation in pediatric and adolescent obesity: Correlations with SIRT1 expression and metabolic-inflammatory profiles.

Epigenetic modifications, particularly histone acetylation-deacetylation and its related enzymes, such as sirtuin 1 (SIRT1) deacetylase, may have substantial roles in the pathogenesis of obesity and its associated health issues. This study aimed to evaluate global histone acetylation status and SIRT1 gene expression in children and adolescents with obesity and their association with metabolic and anthropometric parameters. This study included 60 children and adolescents, 30 with obesity and 30 normal-weight. The evaluation consisted of the analysis of global histone acetylation levels and the expression of the SIRT1 gene in peripheral blood mononuclear cells, by specific antibody and real-time PCR, respectively. Additionally, insulin, fasting plasma glucose, lipid profile and tumor necrosis factor α (TNF-α) levels were measured. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Metabolic syndrome was determined based on the diagnostic criteria established by IDF. Individuals with obesity, particularly those with insulin resistance, had significantly higher histone acetylation levels compared to control group. Histone acetylation was positively correlated with obesity indices, TNF-α, insulin, and HOMA-IR. Additionally, a significant decrease in SIRT1 gene expression was found among obese individuals, which was negatively correlated with the histone acetylation level. Furthermore, SIRT1 expression levels showed a negative correlation with various anthropometric and metabolic parameters. Histone acetylation was enhanced in children and adolescents with obesity, potentially resulting from down-regulation of SIRT1, and could play a role in the obesity-associated metabolic abnormalities and insulin resistance. Targeting global histone acetylation modulation might be considered as an epigenetic approach for early obesity management.

Short term effect of tetrahydrocurcumin on adipose angiogenesis in very high-fat diet-induced obesity mouse model.

Tetrahydrocurcumin (THC) has been shown to possess anti-angiogenic activities. This study aims to investigate the effects of THC on adipose angiogenesis and expression of angiogenic factors that occurs in 60% high-fat diet-induced obese mice. Male ICR mice were randomly divided into 3 groups: mice fed with a low-fat diet (LFD group); mice fed with very high fat diet (VHFD group), and mice fed with VHFD supplemented with THC (300 mg/kg/day orally) (VHFD+THC treated group) for 6 weeks. Body weight (BW), food intake, fasting blood sugar (FBS), lipid profiles and visceral fats weight (VF) were measured. The microvascular density (MVD), TNF-α, VEGF, MMP-2, and MMP-9 expressions were evaluated. The VHFD group had significantly increased total cholesterol, triglyceride, food intake, BW, VF, VF/BW ratio, adipocyte size and the number of crown-liked structures as compared to LFD group. THC supplementation markedly reduced these parameters and adipocyte hypertrophy and inflammation in white adipose tissues. MVD, TNF-α, VEGF, MMP-2, and MMP-9 were over-expressed in the VHFD group. However, THC supplementation decreased MVD and reduced expression of TNF-α, VEGF, MMP-2, and MMP-9. In conclusion, THC suppressed angiogenesis in adipose tissue by the downregulation of TNF-α, VEGF, MMP-2, and MMP-9. With its effects on lipid metabolism as well as on food consumption, THC could contribute to lower visceral fat and body weight. Overall, our study demonstrated the potential benefit of THC in mitigating obesity and associated metabolic disorders along with elucidated the suppression of adipose angiogenesis as one of its underlying mechanisms.

Toll-like receptor 4 and cytotoxic T cells CD8+ are prognostic markers in type 1 Diabetes Mellitus

Objective: To determine the correlation between toll-like receptor 4 and cytotoxic T cells in patients with type-1diabetes mellitus.Method: The cross-sectional, case control study was conducted at Al-Manatharah Hospital in the Al-Najaf province ofIraq from June 2021 to December 2021, and comprised patients of either gender aged 20-69 years having type-1diabetes mellitus in group A, and healthy subjects in control group B. From all the subjects, 4ml blood was collectedby vein puncture. Fasting blood glucose and lipid profile were estimated using a precipitant kit. Also measured weretoll-like receptor 4 and cytotoxic T cell levels using an enzyme-linked immunosorbent assay kit. Data was also notedon age, gender and body mass index. Data was analysed using SPSS version 23Results: Of the 100 subjects, 60(60%) were cases; 30(50%) males and as many females with mean age 59.21±18.092years. The remaining 40(40%) were controls; 20(50%) males and as many females with mean age 42.076±11.019 years.BMI values were not significantly different between the groups (p>0.05), and all lipid profile values were significantlyhigher in group A compared to group B (p<0.05) except high-density lipoprotein which was higher in group Bcompared to group A (p<0.05). Group A patients had significantly higher levels of toll-like receptor 4 and cytotoxicT cell than group B subjects (p<0.05).Conclusion: A significant relationship was found between type-1 diabetes and higher levels of toll-like receptor 4 andcytotoxic T cells.Keywords: Diabetes mellitus, Toll-like receptor 4, Cytotoxic T cells, CD8.

Determinants of serum cytokines in a population sample of healthy subjects from Iran

IntroductionCytokines are synthesized and released by immune system cells and mediate critical immune responses. Aging is associated with increased serum levels of some pro-inflammatory cytokines . A positive correlation between the concentration of several cytokines and blood pressure has been reported; higher cytokine concentrations may be related to the underlying causes of hypertension through the effects of inflammatory responses or as an independent etiology for hypertension .To assess the relationship between the serum levels of inflammatory cytokines and growth factors, with biochemical and anthropometric characteristics in healthy Iranian subjects.Material and methodsAnthropometric measurements and blood sampling were performed in 103 healthy Iranian participants. Fasting blood glucose (FBG), hs-CRP and lipid profile were measured in these participants. 12 serum cytokines/growth factors (MCP-1, TNF-α, EGF, IFN-γ, VEGF, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8 and IL-10 were measured.ResultsFBG was positively associated with serum IL-2, IL-4 and IL-1α (P = 0.044, < 0.001 and = 0.017, respectively). Serum EGF and IL-4 were positively associated with age (P < 0.001). IL-8 was inversely associated with SBP (P = 0.002) and gender (P = 0.028). There was a positive association between VEGF and HDL (P = 0.007). The serum levels of IFN-γ and TNF-α were positively associated with serum TG (P = 0.018 and 0.006, respectively).ConclusionsThere are associations between various pro-and anti-inflammatory cytokines in serum and several anthropometric measurements.

Proximate nutrient analysis of elephant apple (Dillenia indica) fruit and its hypoglycemic, and hypolipidemic potentials in alloxan-induced diabetic rats

Elephant apple (Dillenia indica) fruit is widely used in traditional and ayurvedic medicine. AimsTo estimate the nutrient contents of this fruit with the evaluation of hypoglycemic and hypolipidemic activities in alloxan-induced diabetes rats. MethodologyProximate composition and twenty bioactive compounds of elephant apple (EA) fruit were determined using standard methods. Rats were randomly divided into four groups, and each group consisted of six rats. Elephant apple (EA) fruit powder (500 mg/kg body wt./rat/day) was orally fed to the experimental rats in addition to the regular diet for six consecutive weeks. Fasting blood glucose level and lipid profile parameters were analysed from the serum samples of the experimental animals. ResultElephant apple (EA) fruit is rich in carbohydrates (64.52 %), protein (6.81 %), fiber (1.38 %), phosphorus (0.026 %), and ascorbic acid (0.004 %). This fruit also contains different phytochemicals viz. alkaloids, anthraquinone, phenol, flavonoids, terpenoids, and coumarin, except carotenoids and triterpenoids. This study found that oral administration of EA powder significantly (p ≤ 0.01) reduced fasting blood glucose levels (FBG) and serum lipid profiles such as total cholesterol (TC), total triglycerides (TG), and low-density lipoprotein (LDL), but improves high-density lipoprotein (HDL). ConclusionsEA fruit is potentially important to manage diabetes and hyperlipidemia.

Association of Serum Homocysteine Level with Acute Ischaemic Stroke among Young Adult Patients: Experience at a Largest Medical College Hospital in Bangladesh

Background: Hyperhomocysteinemia is emerging as a possible risk factor for stroke, possibly because of accelerated atherosclerosis. Objectives: This study was conducted to evaluate the association between the serum homocysteine level and ischemic stroke in young Bangladeshi patients. Methodology: This cross-sectional study was carried out among patients 18 to 40 years of either gender with sign and symptoms of acute focal neurological deficit, in the Department of Medicine of Dhaka Medical College Hospital, Dhaka, from January 2015 to December 2015. History taking and physical examination were done in a predesigned data collection sheet. Then required investigations like CT-scan of brain, fasting serum homocysteine, fasting blood sugar, 2 hours ABF blood glucose, HbA1c and fasting lipid profile were done. Results: Out of 96 patients after completing brain imaging 61(65.0%) patients were found suffering from ischemic stroke. Among the patients 74 had normal homocysteine level, 17 patients had moderate hyperhomocysteinemia and 5 patients had intermediate hyperhomocysteinemia. Mean levels of fasting serum homocysteine were significantly higher in patients those had ischemic stroke (16.02 μmol/L, 95% CI: 12.87 to 19.87) compared with those who did not have ischemic stroke (10.47 μmol/L, 95% CI: 9.16 to 11.95, P<0.001). Logistic regression showed fasting homocysteine as an important independent risk factor, with an adjusted OR of 1.1 (95% CI: 1.1 to 1.2; p=0.04966) for every 1 μmol/L increase in homocysteine. Conclusion: The relationship between increasing homocysteine and ischemic stroke risk is strong, graded, and significant. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):24-29

Asprosin in early detection of nephropathy in type2 diabetes mellitus

Abstract Background: Diabetic nephropathy (DN) accounts for the most prevalent cause of chronic kidney disease and end-stage renal disease (ESRD) globally, accounting for about 50% of all ESRD patients that need management with dialysis or a renal transplant. Objectives: The aim of this study was to the role of Asprosin as an independent and trustworthy biomarker for the quick diagnosis of DN by knowing the sensitivity and specificity, acceptable to add to the diagnostic protocol. Evaluated fasting blood glucose asprosin, lipid profile, urea, creatinine, and albumin levels in apparently healthy groups, diabetic groups, and diabetic groups with nephropathy to determine their medical significance; asprosin can be used as an independent and trustworthy biomarker for the quick diagnosis of DN by knowing the sensitivity and specificity, acceptable to add to the diagnostic protocol. Materials and Methods: Blood samples were obtained from the Diabetes and Endocrine Center in Hilla city, Babylon province’s Marjan Medical City, from October 25, 2021 to January 31, 2022. Sixty type 2 diabetes mellitus (T2DM) patients were classified into 30 with diabetes mellitus, 30 with DN, and 30 apparently healthy patients. Serum asprosin levels were measured using a commercial enzyme-linked immunosorbent assay kit. SPSS software was used to conduct the statistical analysis. Results: Both T2DM patients with and without nephropathy had considerably higher levels of fasting blood glucose (FBG), asprosin, serum urea, creatinine, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol compared to the healthy appearance group, although both groups had significantly lower levels of albumin and high-density lipoprotein cholesterol (HDL-C). Asprosin additionally showed a positively correlated with serum urea, TG, and HDL-C and shown negative correlation with serum albumin. The sensitivity and specificity of the test at the cut-off value of asprosin 17.5 ng/mL were 86.7% and 80%, respectively, and the area under the curve was 0.92, P-value = 0.001. Conclusion: Because blood asprosin levels have a sensitivity and specificity of more than 80% in T2DM patients with nephropathy, they can be used as an independent and trustworthy biomarker for the quick diagnosis of DN.

Glutamine Defended the Kidneys Versus Lead Intoxication Via Elevating Endogenous Antioxidants, Reducing Inflammation and Carbonyl Stress, as well as Improving Insulin Resistance and Dyslipidemia.

Kidneys are primarily sensitive to lead (Pb) poisoning due to their cardinal role in lead excretion. Then, we studied the effect of glutamine (Gln) on lead nephrotoxicity in rats by assessing the histopathological and biochemical parameters (the renal NF-kβ expression, metabolic profile, oxidative stress, inflammatory markers, methylglyoxal (MGO), and glyoxalase-I activity). Forty rats were allotted into four groups (ten rats in each): normal (N), Gln-treated N, Pb intoxication (Pbi), and Gln-treated Pbi. The treated groups took 0.1% Gln in drinking water for 1 month. To motivate lead poisoning, rats gained 50 mg/l lead acetate in drinking water for 1 month. Oxidative stress indices (total glutathione, its reduced and oxidized forms, their ratios, advanced protein oxidation products, malondialdehyde, and ferric ion reducing power) and inflammatory markers (renal nuclear factor-kβ expression, interleukin 1β level, and myeloperoxidase activity) were measured. Furthermore, metabolic profile (fasting blood sugar, insulin, insulin resistance, lipid profile, and atherogenic index) and renal dysfunction parameters were determined. Pb-induced renal histopathological alterations were investigated by a pathologist. In the kidney of Pbi rats, the glomerulus was damaged. Gln prevented kidney damage and reduced kidney dysfunction parameters. In addition, Gln decreased oxidative stress and inflammation in sera and kidney homogenates. In addition, it improved insulin resistance, dyslipidemia, and carbonyl stress (p < 0.001). Gln guarded the kidneys versus lead intoxication by improving insulin resistance and dyslipidemia, elevating antioxidant markers, and diminishing inflammation and carbonyl stress.

Contribution of intestinal triglyceride-rich lipoproteins to residual atherosclerotic cardiovascular disease risk in individuals with type 2 diabetes on statin therapy

Aims/hypothesisThis study explored the hypothesis that significant abnormalities in the metabolism of intestinally derived lipoproteins are present in individuals with type 2 diabetes on statin therapy. These abnormalities may contribute to residual CVD risk.MethodsTo investigate the kinetics of ApoB-48- and ApoB-100-containing lipoproteins, we performed a secondary analysis of 11 overweight/obese individuals with type 2 diabetes who were treated with lifestyle counselling and on a stable dose of metformin who were from an earlier clinical study, and compared these with 11 control participants frequency-matched for age, BMI and sex. Participants in both groups were on a similar statin regimen during the study. Stable isotope tracers were used to determine the kinetics of the following in response to a standard fat-rich meal: (1) apolipoprotein (Apo)B-48 in chylomicrons and VLDL; (2) ApoB-100 in VLDL, intermediate-density lipoprotein (IDL) and LDL; and (3) triglyceride (TG) in VLDL.ResultsThe fasting lipid profile did not differ significantly between the two groups. Compared with control participants, in individuals with type 2 diabetes, chylomicron TG and ApoB-48 levels exhibited an approximately twofold higher response to the fat-rich meal, and a twofold higher increment was observed in ApoB-48 particles in the VLDL1 and VLDL2 density ranges (all p < 0.05). Again comparing control participants with individuals with type 2 diabetes, in the latter, total ApoB-48 production was 25% higher (556 ± 57 vs 446 ± 57 mg/day; p < 0.001), conversion (fractional transfer rate) of chylomicrons to VLDL was around 40% lower (35 ± 25 vs 82 ± 58 pools/day; p=0.034) and direct clearance of chylomicrons was 5.6-fold higher (5.6 ± 2.2 vs 1.0 ± 1.8 pools/day; p < 0.001). During the postprandial period, ApoB-48 particles accounted for a higher proportion of total VLDL in individuals with type 2 diabetes (44%) compared with control participants (25%), and these ApoB-48 VLDL particles exhibited a fivefold longer residence time in the circulation (p < 0.01). No between-group differences were seen in the kinetics of ApoB-100 and TG in VLDL, or in LDL ApoB-100 production, pool size and clearance rate. As compared with control participants, the IDL ApoB-100 pool in individuals with type 2 diabetes was higher due to increased conversion from VLDL2.Conclusions/interpretationAbnormalities in the metabolism of intestinally derived ApoB-48-containing lipoproteins in individuals with type 2 diabetes on statins may help to explain the residual risk of CVD and may be suitable targets for interventions.Trial registrationClinicalTrials.gov NCT02948777.Graphical

Effects of levothyroxine replacement therapy on insulin resistance in patients with untreated primary hypothyroidism

ObjectivesThis study investigated the effects of levothyroxine replacement therapy on insulin resistance, lipid profile, and thyroid function in patients with untreated primary hypothyroidism. 105 patients with hypothyroidism with indication for levothyroxine replacement were enrolled in the present study. Insulin, fasting blood glucose and lipid profile were assessed at the beginning of diagnosis and three months after levothyroxine replacement. Insulin resistance was calculated by hemostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI).ResultsOur data revealed a significant reduction in body mass index (27.18 ± 4.27 versus 26.81 ± 4.18 kg/m2, p = 0.028), cholesterol (199.79 ± 37.61 versus 178.10 ± 32.25 mg/dl, p < 0.001), triglyceride (160.41 ± 71.86 versus 146 ± 61.11 mg/dl, p = 0.012), low density lipoprotein-cholesterol (123.54 ± 30.7 versus 107.08 ± 26.98 mg/dl, p < 0.001), fasting insulin (8.91 ± 3.92 versus 8.05 ± 2.65 mIU/l, p < 0.001), and thyroid stimulating hormone (47.47 ± 3.4 versus 2.22 ± 1.84 µIU/ml, p < 0.001) levels before and after drug intervention. However, no statistical differences were observed in HOMA-IR, QUICKI, and high density lipoprotein-cholesterol. In conclusion, in patients with untreated primary hypothyroidism, levothyroxine replacement therapy based on HOMA-IR and QUICKI did not improve insulin resistance; however, lipid profile was significantly improved following levothyroxine administration.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20130610013612N10 on the date 2019-09-02.

Impact of Ramadan fasting on eGFR in patients with late stage chronic kidney disease

Aims: Ramadan fasting is a significant religious practice observed annually by approximately 1.9 billion adult Muslims worldwide. However, its potential impact on kidney health in individuals with chronic kidney disease (CKD) remains a subject of concern. This study aimed to investigate the effects of Ramadan fasting on renal function in patients with stage 3-5 CKD and to identify any associated risk factors.&#x0D; Methods: A single-center, self-controlled longitudinal observational study was conducted on 192 stable patients with stage 3-5 CKD who observed Ramadan fasting. The fasting period was about 14-15 hours per day for one month Various clinical parameters, including eGFR, blood urea nitrogen (BUN), sodium (Na+), potassium (K+), calcium (Ca++), phosphorus, parathyroid hormone (PTH), albumin, uric acid, fasting glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and hemoglobin (Hgb), were measured before and after Ramadan fasting. P0.05). Furthermore, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) did not impact eGFR (0.084). Notably, Ramadan fasting led to improvements in metabolic parameters, such as fasting glucose and lipid profile, except for triglyceride levels (p

Supplementary Effects of Allium hookeri Extract on Glucose Tolerance in Prediabetic Subjects and C57BL/KsJ-db/db Mice.

Allium hookeri (AH) has been used as a nutritional and medicinal food in Asia for many years. Our previous studies have described its anti-diabetic, anti-obesity, and anti-inflammatory activities in animal models and prediabetes. This study investigated whether AH could improve glycemia by modulating insulin secretion in prediabetic subjects through an in-depth study. Eighty prediabetic subjects (100 ≤ fasting plasma glucose < 140 mg/dL) were randomly assigned to a placebo (n = 40) group or an ethanol AH extract (500 mg/day, n = 40) group for 12 weeks. Dietary intake and physical activity, blood glucose (an oral glucose tolerance test for 120 min), insulin (insulin response to oral glucose for 120 min), area under the curve (AUC) of glucose or insulin after oral glucose intake, insulin sensitivity markers, C-peptide, adiponectin, glycated hemoglobin A1c (HbA1c) levels, hematological tests (WBC, RBC, hemoglobin, hematocrit, and platelet count), blood biochemical parameters (ALP, AST, total bilirubin, total protein, albumin, gamma-GT, BUN, creatinine, LD, CK, and hs-CRP), and urine parameters (specific gravity and pH) were examined at both baseline and 12 weeks after supplementation with placebo or AH capsules. Fifty-eight participants (placebo group: 20 men and 10 women; AH group: 13 men and 15 women) completed the study. AH supplementation moderately reduced postprandial blood glucose at 60 min (-6.14 mg/dL, p = 0.061), postprandial insulin levels at 90 min (-16.69 µU/mL, p = 0.017), the glucose AUC at 90 min (-412.52 mg*min/dL, p = 0.021), as well as the insulin AUC at 90 min (-978.77 µU*min/mL, p = 0.021) and 120 min (-1426.41 µU*min/mL, p = 0.015) when compared with the placebo group. However, there were no effects of AH on dietary intake and physical activity; HOMA index; HbAlc; C-peptide; or adiponectin, hematological-, blood biochemical-, and urinary markers. To confirm the effects of AH extract on blood glucose insulin sensitivity, C57BL/6J or C57BL/KsJ-db/db mice were used (n = 8/group). Body weight, fasting plasma glucose level, lipid profiles, liver and renal function, pancreatic histology, and insulin immunoreactivity were assessed. In the diabetic db/db mice, hyperglycemia, which was accompanied by an increase in insulin secretion in diabetic mice, was significantly reduced by AH treatment, resulting in the alleviation of β-cell overcompensation and insulin resistance. We confirmed that AH supplementation can effectively control blood glucose and insulin levels by improving insulin sensitivity and may be a potential agent for glycemic control in subjects with prediabetes and type 2 diabetes mellitus.