Fasting Serum Glucose Research Articles

Modulation of PPAR-γ, SREBP-1c and inflammatory mediators by luteolin ameliorates β-cell dysfunction and renal damage in a rat model of type-2 diabetes mellitus.

Natural products have been recommended as a complementary therapy for type 2 diabetes mellitus (T2DM) due to constraints of safety and tolerability of existing anti-diabetic agents. Luteolin exhibits anti-diabetic and anti-inflammatory effects. Hence, the impact of luteolin on glucose homoeostasis and organ damage was investigated in high-fat diet (HFD) and streptozotocin (STZ) induced T2DM in rats. Male Wistar rats were maintained on HFD (provided 55% energy as fat) for 10days. Subsequently, a single dose of 40mg/kg STZ was injected intraperitoneally on the 11th day. Seventy-two hours after STZ administration, diabetic rats with established hyperglycemia (fasting serum glucose > 200mg/dL) were randomized into different groups having six rats each and orally administered either 0.5% hydroxy propyl cellulose or pioglitazone (10mg/kg) or luteolin (50mg/kg or 100mg/kg) once daily for 28days, while continuing HFD for respective groups. Luteolin significantly reduced hyperglycaemia, homoeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) levels, and improved hypoinsulinemia and HOMA of b-cell function (HOMA-B) in a dose-dependent manner. Increased TNF-α, IL-6 and NFκB levels in diabetic rats were significantly regulated. Additionally, luteolin significantly augmented PPAR-γ expression while attenuating sterol regulatory element binding protein-1c (SREBP-1c) expression. Histopathological scrutiny validated that luteolin effectively attenuated HFD-STZ-induced injury in pancreatic β-cells and kidneys to near normalcy. Our study showed that luteolin ameliorated hyperglycemia and improved hypoinsulinemia, β-cell dysfunction, and renal impairment in HFD-STZ-induced diabetic rats by attenuating inflammation and dysregulated cytokine secretion through modulation of PPAR-γ, TNF-α, IL-6 and NF-kB expression and down-regulation of SREBP-1c.

Safety and Efficacy of Efpeglenatide in Patients With Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.

The aim of this study was to assess the efficacy and safety of efpeglenatide in patients with type 2 diabetes (T2D). The study was reported according to the 2020 guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.Web of Science, PubMed, and Scopus databases were searched by two authors independently, with no restriction on language and year of publication, using the following key terms: (efpeglenatide) OR (glucagon-like peptide-1 receptor agonist) AND (type 2 diabetes) OR (diabetes) OR (T2DM) AND (HbA1c) OR (FSG) OR (fasting serum glucose) OR (weight) OR (bodyweight) OR (adverse events) OR (safety) OR (AE).Outcomes assessed in this meta-analysis included change in hemoglobin A1C (HbA1C) from baseline (%), change in weight from baseline (Kg), and change in fasting serum glucose (FSG) from baselines. For the safety analysis, we assessed total adverse events and gastrointestinal (GI) adverse events. A total of four studies fulfilled the inclusion and exclusion criteria and were included in this meta-analysis, encompassing six randomized controlled trials (RCTs).Compared with a control group, efpeglenatide lowered the HbA1c(mean difference (MD): -0.81, 95% confidence interval (CI): -1.01 to -0.60), body weight(MD: -1.15, 95% CI: -1.82 to -0.47), and FSG (MD: -0.98, 95% CI: -1.19 to -0.77). However, the risk of GI-related adverse events was significantly higher in the efpeglenatide group compared to the control group.

Effect of Adding Taurine to Gabapentin on Toronto Clinical Neuropathy Score in Patient with Diabetic Neuropathy

Diabetic neuropathy is a type of nerve damage that can occur in patients with diabetes mellitus. High blood glucose can injure nerves throughout the body. Diabetic neuropathy most often damages nerves in the legs and feet causing symptoms like pain and numbness. Taurine has been widely investigated regarding to its properties as a neuroprotective agent, antioxidant, anti-inflammatory in several neurodegenerative diseases. A sample consist of 40 participants enrolled randomly into two groups; group A, 20 patients treated with gabapentin capsules 300 mg once daily at night for 3 consecutive months, and group B, 20 patients treated with gabapentin capsules 300 mg once daily at night plus taurine 1 g thrice daily for 3 consecutive months. Adding taurine in combination with gabapentin significantly improves numbness, tingling, and temperature when compared with gabapentin alone. As well as, has a highly significant improving on ataxia. Taurine is better in improving insulin sensitivity due to lowering HbA1c level significantly, beside a medium degree in increasing insulin secretion; as evidenced by decreased fasting serum glucose, decreased HbA1c significantly, increased insulin level significantly, and increased C-peptide level. The conclusion of this study, adding taurine to patients with diabetic neuropathy has a significant improving effect on Toronto clinical neuropathy score by alleviating signs and symptoms, and improving insulin sensitivity.

Efficacy and safety of adding once-weekly dulaglutide to basal insulin for inadequately controlled type 2 diabetes in Chinese patients (AWARD-CHN3): A randomized, double-blind, placebo-controlled, phase III trial.

To determine the efficacy and safety of once-weekly dulaglutide added to basal insulin in Chinese patients with type 2 diabetes mellitus (T2DM) with inadequate glycaemic control. In the phase III, double-blind AWARD-CHN3 study, Chinese patients with T2DM (N = 291) and glycated haemoglobin (HbA1c) ≥7.0% and ≤11.0% receiving stable doses of basal insulin glargine with metformin and/or acarbose were randomized (1:1) to receive add-on dulaglutide 1.5 mg once weekly or placebo once weekly. The primary endpoint was the superiority of dulaglutide/glargine to placebo/glargine for change from baseline in HbA1c at Week 28. The least squares (LS) mean ± standard error change in HbA1c from baseline to Week 28 was -2.0 ± 0.08% with dulaglutide/glargine and -1.1 ± 0.07% with placebo/glargine (LS mean difference: -1.0%, 95% confidence interval [CI] -1.1 to -0.8; P < 0.001), and more patients receiving dulaglutide/glargine achieved HbA1c levels <7.0% (75.9% vs. 33.8%; P < 0.001 vs. placebo/glargine). Body weight decreased with dulaglutide/glargine and increased with placebo/glargine (LS mean difference: -1.2 kg, 95% CI -1.8 to - 0.6; P < 0.001). Reductions in fasting serum glucose were greater with dulaglutide/glargine than with placebo/glargine (LS mean difference: -0.8 mmol/L, 95% CI -1.1 to - 0.5; P < 0.001). The incidence of hypoglycaemia was similar with dulaglutide/glargine and placebo/glargine (29.2% vs. 31.3%; P = 0.704); no patient in either group had severe hypoglycaemia. The most common treatment-emergent adverse events with dulaglutide/glargine were decreased appetite (22.2%), diarrhoea (13.2%) and nausea (10.4%). Dulaglutide added to basal insulin was efficacious and well tolerated in Chinese patients with T2DM.

Gestational diabetes mellitus is associated with a low serum level of mitochondrial-derived peptide-MOTS-C

Abstract Objectives Although MOTS-C has been reported to have a role in diabetes mellitus, no human studies have evaluated the serum level of MOTS-C in GDM. It was aimed to investigate serum levels of MOTS-C in patients with gestational diabetes mellitus (GDM). Methods Comparisons were made of 44 pregnant patients diagnosed with GDM and a control group of 44 healthy pregnant women in respect of serum MOTS-C, insulin, and glucose levels, and serum lipid profile. Results A significantly higher level of fasting serum glucose and significantly lower serum levels of MOTS-C and high density lipoprotein were determined in the GDM group compared to the control group (p&lt;0.05 for all). A cut-off value of 173.5 ng/mL for serum MOTS-C level had sensitivity of 81.8 % and specificity of 61.4 % for GDM diagnosis (p&lt;0.001). A significant correlation was determined between the serum MOTS-C and serum glucose levels (r=−0.239, p=0.025). Conclusions For the first time in literature, the results of this study showed that patients with GDM had a decreased serum level of MOTS-C and that increasing serum MOTS-C levels were associated with a decrease in serum glucose levels, thereby supporting the view that mitochondrial dysfunction plays a role in GDM pathogenesis. Therefore, MOTS-C could be a promising diagnostic biomarker for GDM cases.

Newly diagnosed type 1 diabetes mellitus in a human immunodeficiency virus-infected patient with antiretroviral therapy-induced immune reconstitution inflammatory syndrome: a case report

BackgroundDiabetes that develops in human immunodeficiency virus (HIV)-infected patients who receive antiretroviral therapy (ART) is usually type 2 diabetes mellitus (T2DM); however, autoimmune diabetes, such as type 1 diabetes mellitus (T1DM) can also develop in this population. After treatment with ART, patients might experience clinical deterioration following an increase in the CD4 cell count, which is termed immune reconstitution inflammatory syndrome (IRIS). Here, we describe an HIV-infected patient on ART who developed T1DMat due to IRIS, highlighting the clinical complexity in diagnosis and treatment.Case presentationA 36-year-old man infected with HIV had a nadir CD4 cell count of 15.53/μL before medication, which increased to 429.09/μL after 9 months of regular ART. The fasting serum glucose at 9 months was between 96 mg/dL and 117 mg/dL. After 11 months of ART, the patient was admitted to hospital for diabetic ketoacidosis (DKA) and Graves’ disease (GD). Noninsulin antidiabetics (NIADs) were prescribed following the resolution of DKA. However, poor glycemic control was noted despite well-titrated NIADs. Further investigation demonstrated poor pancreatic beta cell function and elevated anti-glutamic acid decarboxylase (anti-GAD) and anti-tyrosine phosphatase-like insulinoma antigen 2 (anti-IA2) titers. According to the results, he was diagnosed with T1DM and received multiple daily injections(MDI) of insulin. The regimen of MDI was insulin degludec as basal insulin and insulin aspart as prandial insulin. After MDI therapy, his glycemic control was improved.ConclusionIn this case, T1DM was ascribed to IRIS. Although this phenomenon has been demonstrated in previous case reports, further study is necessary to realize the mechanism of this association. Therefore, we emphasize that when HIV-infected patients on ART experience an unstable blood glucose level and abnormal thyroid function, physicians should consider T1DM and GD associated with ART-induced IRIS to reduce the subsequent complications and more serious endocrine dysfunction.

Brown adipocyte mineralocorticoid receptor deficiency impairs metabolic regulation in diet-induced obese mice

Activation of brown adipose tissue (BAT) contributes to energy dissipation and metabolic health. Although mineralocorticoid receptor (MR) antagonists have been demonstrated to improve metabolism under obesity, the underlying mechanisms remain incompletely understood. We aimed to evaluate the role of BAT MR in metabolic regulation. After 8 weeks of high-fat diet (HFD) feeding, BAT MR KO (BMRKO) mice manifested significantly increased bodyweight, fat mass, serum fasting glucose, and impaired glucose homeostasis compared with littermate control (LC) mice, although insulin resistance and fasting serum insulin were not significantly changed. Metabolic cage experiments showed no change in O2 consumption, CO2 production, or energy expenditure in obese BMRKO mice. RNA sequencing analysis revealed downregulation of genes related to fatty acid metabolism in BAT of BMRKO-HFD mice compared with LC-HFD mice. Moreover, H&E and immunohistochemical staining demonstrated that BMRKO exacerbated HFD-induced macrophage infiltration and proinflammatory genes in epididymal white adipose tissue (eWAT). BMRKO-HFD mice also manifested significantly increased liver weights and hepatic lipid accumulation, an increasing trend of genes related to lipogenesis and lipid uptake, and significantly decreased genes related to lipolytic and fatty acid oxidation in the liver. Finally, the level of insulin-induced AKT phosphorylation was substantially blunted in eWAT but not liver or skeletal muscle of BMRKO-HFD mice compared with LC-HFD mice. These data suggest that BAT MR is required to maintain metabolic homeostasis, likely through its regulation of fatty acid metabolism in BAT and impacts on eWAT and liver.

Dolutegravir use over 48 weeks is not associated with worsening insulin resistance and pancreatic beta cell function in a cohort of HIV-infected Ugandan adults

BackgroundThe Uganda Ministry of Health issued restrictive guidelines on the use of dolutegravir (DTG) in persons stratified to have a heightened risk of diabetes mellitus. This followed multiple reports of persons with HIV (PWH) presenting with accelerated hyperglycemia after a few weeks to months of exposure to DTG. Having demonstrated a low incidence of diabetes mellitus and improving blood glucose trajectories in a cohort of ART naïve Ugandan PWH on DTG, we sought to determine whether the observed improvement in blood glucose did not mask background compensated insulin resistance.MethodsIn this analysis, 63 patients underwent serial oral glucose tolerance tests over 48 weeks. Using fasting serum insulin and glucose, we calculated insulin resistance and pancreatic beta cell function by homeostatic modelling (HOMA IR and HOMA%β respectively). Absolute mean changes between baseline and post-baseline blood glucose, pancreatic beta cell function and insulin resistance were computed by subtracting each post-baseline value from the baseline value and compared using student t-test. Multiple linear regression models were used to determine the factors associated with changes in pancreatic beta cell function and insulin resistance.ResultsOf the 63 participants, 37 (58%) were female. Median age was 31 (IQR: 28–37). Despite a trend towards an initial increase in both HOMA IR and HOMA%β at 12 weeks followed by a decline through 36 weeks to 48 weeks, the HOMA IR and HOMA%β at 48 weeks were not significantly different from baseline i.e. (difference in mean HOMA IR from baseline: 0.14, 95%CI: -0.46, 0.733, p = 0.648) and (difference in mean HOMA %β from baseline: 6.7, 95%CI: -13.4, 26.8, p = 0.506) respectively.ConclusionWe demonstrated insignificant changes in both insulin resistance and pancreatic beta cell function in clinically stable young adult Ugandan PWH on dolutegravir for 48 weeks. We add to the body of evidence demonstrating glucose metabolic safety of dolutegravir in ART naïve patients. Ugandan guidelines should reconsider restricting DTG initiation in ART naive adults at high risk for diabetes.

Menstrual Cycle Irregularity in Adolescence Is Associated With Cardiometabolic Health in Early Adulthood.

Background Menstrual cycle irregularities are associated with cardiovascular and cardiometabolic disease. We tested associations between age at menarche and cycle irregularity in adolescence and cardiometabolic health in early adulthood in a subsample from the Pittsburgh Girls Study. Methods and Results Data from annual interviews were used to assess age at menarche and cycle irregularity (ie, greater or less than every 27-29 days) at age 15 years. At ages 22 to 25 years, cardiometabolic health was measured in a subsample of the Pittsburgh Girls Study (n=352; 68.2% Black), including blood pressure, waist circumference, and fasting serum insulin, glucose, and lipids. T tests were used for continuous data and odds ratios for dichotomous data to compare differences in cardiometabolic health as a function of onset and regularity of menses. Early menarche (ie, before age 11 years; n=52) was associated with waist circumference (P=0.043). Participants reporting irregular cycles (n=50) in adolescence had significantly higher levels of insulin, glucose, and triglycerides, and higher systolic and diastolic blood pressure (P values range from 0.035 to 0.005) and were more likely to have clinical indicators of cardiometabolic predisease in early adulthood compared with women who reported regular cycles (odds ratios ranged from 1.89 to 2.56). Conclusions Increasing rates and earlier onset of cardiovascular and metabolic disease among women, especially among Black women, highlights the need for identifying early and reliable risk indices. Menstrual cycle irregularity may serve this purpose and help elucidate the role of women's reproductive health in protecting and conferring risk for later cardiovascular and cardiometabolic diseases.

Assessment of the potential role of Trefoil Factor-3 marker as a predictive marker of complication in splenectomized and non splenectomized patients with beta thalassemia major

Abstract The study’s goal is to appraise the immunological inflammatory marker Trefoil Factor 3, which interacts with thalassemia pathogenesis particularly following splenectomy, and may offer new therapy options for the illness and its repercussions. This is a case-control study design that included 60 patients identified as β-thalassemia major as participators in this study, in addition to 30 seemingly healthy subjects with age and sex close to the patients group who served as a control group. The participants were distributed into four groups: control group, splenectomized patients, non-splenectomized patients, and total patients. Suitable statistical techniques were employed to investigate the results. The study’s findings demonstrated that there was a significance increase in the serum levels of TFF3 when comparing between (splenectomized, non-splenectomized and total patients) with healthy group (322.16±51.241, p-value=0.01, 317.20±42.449, p-value=0.01, 320±46.6, p-value=0.01), vs (309.38±21.94), respectively. Moreover, a comparison between splenectomized and non-splenectomized showed a significantly decrease in TFF3 (322.16±51.241) vs (317.20±42.449), (p-value=0.043).The presented study also revealed significant positive correlation between TFF3 level with ferritin, iron, total iron binding capacity, transferrin saturation, transferrin, fasting serum glucose, insulin and homeostasis model assessment-insulin resistance. Furthermore, unsaturated iron binding capacity and homeostasis model assessment-beta found a significant negative correlation with TFF3 level. High serum levels of TFF3 in beta thalassemia patients, especially in splenectomies patients, are downregulated by inflammatory cytokines, which are primarily regarded as traditional inflammatory cytokines and are related to insulin resistance. Hence, TFF3 level can serve as a potential predictive for the early detection of beta thalassemia in the development and progression of complications.

Comparing Efficacy and Safety of Different Doses of Tirzepatide for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials.

Our study assessedthe efficacyand safety of the three primary tirzepatide (TZP) doses, 5 mg, 10 mg, and 15 mg using network meta-analysis to assess their relative impact on type 2 diabetes mellitus (T2DM) treatment.This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Two authors independently screened online databases, including PubMed, Cochrane Library, and Embase. We employed the keywords "Type 2 diabetes OR T2DM or diabetes" AND "Tirzepatide OR LY3298176 OR twincretin OR dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist" AND "randomized controlled trial". The outcomes evaluated in this study comprised changes in hemoglobin (Hb)A1c levels from baseline (%), changes in weight from baseline (Kg), changes in fasting serum glucose from baseline (mg/dL), and occurrences of serious adverse events (SAE), adverse events (AE) and major adverse cardiovascular events (MACE). A total of eight studies met the inclusion criteria and were included in this meta-analysis. Our findings suggest that among the evaluated doses, TZP at 15 mg demonstrated superior effectiveness in reducing HbA1c, weight, and fasting serum glucose compared to doses of 10 mg and 5 mg. Notably, the reduction in HbA1c and weight showed a dose-dependent trend, with the 15 mg dose achieving the most substantial benefits. The safety analysis indicated that while serious adverse events and major adverse cardiovascular events (MACE) did not significantly differ among the three doses, the risk of overall adverse events was notably higher in the 10 mg and 15 mg TZP groups compared to the 5 mg group.

Relationship among dietary intake of vitamin D, magnesium, and calcium, 25-hydroxyvitamin D levels, and glycemic control markers in individuals with type 2 diabetes

AimsTo investigate the associations of 25-hydroxyvitamin D (25(OH)D) concentrations, vitamin D intake, magnesium, and calcium with glycemic control in individuals with type 2 diabetes mellitus (T2DM). MethodsA total of 107 adult with T2DM, residing in the state of Sergipe/Brazil (latitude: 10°), were evaluated for serum concentrations of 25(OH)D, parathyroid hormone, fasting glucose, %HbA1c, insulin, C-peptide, total cholesterol and fractions, homeostasis of beta-cell function (HOMA-B), insulin sensitivity (HOMA-S) and resistance (HOMA-IR), anthropometry, body composition, and usual food intake. The results were analyzed according to 25(OH)D status (insufficient/deficient <30 ng/mL; adequate ≥30 ng/mL). Mann–Whitney, chi-square, and binary logistic regression tests were performed. P-value<0.05 was considered significant. ResultsThe median age and time to T2DM diagnosis were 49 and 5 years, respectively. High inadequacy was observed in the dietary intake of vitamin D, magnesium, and calcium. Higher HOMA-B values were observed in the vitamin D adequate group (p = 0.032) and higher fasting serum glucose concentrations (p = 0.012) and %body fat (p = 0.048) in the insufficient/deficient group, which had a higher chance of elevated serum glucose (odds ratio [OR]:2.937; p = 0.020) and HOMA-IR (OR:2.496; p = 0.045). ConclusionVitamin D deficiency is associated with poor glycemic control and insulin resistance, and these aspects are unrelated to inadequate dietary intake of vitamin D, magnesium, and calcium.

Prevalence of metabolic syndrome and chronic inflammation in psoriasis before and after biologic therapy: a prospective study.

As a chronic inflammatory disease, psoriasis affects not only the skin but also the metabolic profile of the patients. Biologic therapies, including tumor necrosis alpha (TNF-a) inhibitors and interleukin (IL)-12/23 and IL-17 antagonists, have proven effective in the reduction of psoriasis severity; however their impact on the metabolic and chronic inflammatory profiles of the patients remains incompletely elucidated. We performed a longitudinal case-control study on 106 psoriasis patients and an equal number of controls without the disease, as well as a prospective study on the patient group with the end point being 6 months of biologic therapy. Patients received either ixekizumab, secukinumab, guselkumab, certolizumab, ustekinumab, risankizumab, or adalimumab. Abdominal circumference, serum fasting glucose, triglycerides (TG), high-density lipoproteins (HDL), erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were measured for both patients and controls, with an additional measurement for patients after 6 months. At baseline, the number of psoriasis patients suffering from obesity, metabolic syndrome, and chronic inflammation significantly outnumbered controls (p<0.05), with the calculated odds ratio being 1.88, 6.83, and 81.84 for these conditions in psoriasis, respectively. Biologic therapies increased the abdominal circumference of patients in a slight but significant fashion (p<0.05), as well as significantly improved HDL, CRP, ESR levels at 6 months (p<0.05). Moreover, after 6 months, the number of patients meeting the diagnostic criteria for metabolic syndrome and chronic inflammation was significantly lower than at baseline (p<0.001). According to our results, biologic therapies improve the overall metabolic and inflammatory profiles of psoriasis patients, the most significant ameliorations being noticed for serum HDL, CRP, and ESR.

Metabolic syndrome in patients with obsessive-compulsive disorder.

Metabolic syndrome (MetS) is a collection of chemical and clinical risk factors. Patients with obsessive-compulsive disorder (OCD) might be at risk of MetS. This study aimed to investigate the prevalence and clinical correlates of MetS in an Iranian clinical sample of patients with OCD. We included 107 patients with OCD in a cross-sectional study. Demographic and clinical characteristics including OC symptoms, duration of treatment, age of onset, medications history, and comorbidity with other psychiatric disorders were collected. The prevalence of MetS was 39.2%. Abdominal obesity was the most frequent component of MetS (68.2%), followed by low high-density lipoprotein cholesterol (50.5%). High serum triglycerides, high fasting serum glucose, high systolic blood pressure, and high diastolic blood pressure were observed in 47.7, 20.6, 18.7, and 9.3% of patients, respectively. Patients with MetS were older, married, had a low education level, had a high body mass index, and had no aggressive OC symptoms. MetS was not associated with psychiatric disorders comorbidities, age of onset, and duration of treatment. The results of this study were in line with the results of other studies that reported the poor health status of patients with OCD. A large number of patients are affected or are at risk of developing MetS. These patients need medical care along with the usual OCD treatments.

Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children.

Understanding the normal range of laboratory values as pertained to different age groups and males or females is paramount in health care delivery. We aimed to assess the distribution of morning fasting serum glucose levels by age and sex in the general population of children using a large-scale population-based cohort. A retrospective study with real-world de-identified data from a large, state mandated health fund in Israel among children aged 2-18 years old between 2006 and 2019. Age, sex, and BMI differences in mean glucose levels were evaluated. Study included 130,170 venous blood samples from 117,411 children, 53.3 % were female. After adjusting for age boys had higher fasting serum glucose levels than girls, with a mean of 89.21±8.66 mg/dL vs. 87.59±8.35 (p<0.001) [4.95±0.48 mmol/L vs. 4.86±0.46]. Compared to the 15 to 18 year-olds (88.49±7.63 mg/dL) [4.92±0.42 mmol/L], 2 to 5 year-olds had lower glucose levels (84.19±10.65, [4.68±0.59] (p<0.001)), 11 to 14 year-olds had higher glucose (90.40±7.42 [5.02±0.41], (p<0.001)) and 6 to 10 year-olds showed no difference (88.45±8.25) [4.91±0.46]. 33.0 % (n=42,991) had a BMI percentile record the same year as their glucose test result. There was a weak yet significant positive association between blood glucose levels and BMI. Our large cohort indicates that boys have slightly higher fasting serum glucose levels than girls, as do adolescents compared to younger children. This finding is important for the delivery of adequate health care, screening for illness and avoiding unnecessary investigations and tests.

Adiposity and insulin resistance moderate the links between neuroelectrophysiology and working and episodic memory functions in young adult males but not females

IntroductionObesity and insulin resistance negatively influence neural activity and cognitive function, but electrophysiological mechanisms underlying these interrelationships remain unclear. This study investigated whether adiposity and insulin resistance moderated neural activity and underlying cognitive functions in young adults. MethodsReal-time electroencephalography (EEG) was recorded in 38 lean (n = 12) and obese (n = 26) young adults with (n = 15) and without (n = 23) insulin resistance (18–38 years, 55.3% female) as participants completed three neurocognitive tasks in working memory (Operation Span), inhibitory control (Stroop), and episodic memory (Visual Association Test). Body fat percentage was quantified by a dual-energy X-ray absorptiometry scan (DEXA/DXA). Fasting serum insulin and glucose were quantified to calculate Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) values, for which a higher value indicates more insulin resistance. Hierarchical moderated regression analysis tested these interrelationships. ResultsIn males, greater frontal negative slow wave (fNSW) and positive slow wave (PSW) amplitudes were linked to higher working memory accuracy in participants with low, but not high, body fat percentage and HOMA-IR levels. In contrast, body fat percentage and HOMA-IR did not moderate these associations in females. Furthermore, body fat percentage and HOMA-IR values moderated the relationship between greater fNSW amplitudes and better episodic memory accuracy in males, but not females. Finally, body fat percentage and insulin resistance did not moderate the link between neural activity and inhibitory control for either sex. ConclusionYoung adult males, but not females, with higher body adiposity and insulin resistance showed reduced neural activity and worse underlying working and episodic memory functions.

Is tirzepatide 15 mg the preferred treatment strategy for type 2 diabetes? A meta-analysis and trial-sequence-analysis.

The study aims to evaluate tirzepatide's efficacy and safety in treating type 2 diabetes by meta-analysis and trial-sequential-analysis (TSA). Eight databases were searched for clinical trials on tirzepatide for type 2 diabetes with a time limit of November 2022. Revman5.3 and TSA 0.9.5.10 Beta were selected for meta-analysis and TSA. Compared with placebo, the meta-analysis demonstrated that tirzepatide 15 mg reduced hemoglobin-type-A1C (HbA1c) (p<0.00001), fasting-serum-glucose (FSG) (p<0.00001), and weight (p<0.00001). Compared with insulin, tirzepatide 15 mg reduced HbA1c (p<0.00001), FSG (p<0.00007), and weight (p<0.00001). Compared with glucagon-like-peptide-1 receptor-agonist (GLP-1 RA), tirzepatide 15 mg reduced HbA1c (p=0.00004), FSG (p=0.001), and weight (p<0.00001). In safety endpoints, the meta-analysis revealed that adverse events (AEs) of placebo, insulin and GLP-1 RA were comparable to tirzepatide 15 mg. The total AEs (p=0.02) and gastrointestinal (GI) AEs (p=0.03) were higher in tirzepatide 15 mg than in the placebo, while hypoglycemia (<54 mg/dl) was comparable. The major adverse cardiovascular events-4 (MACE-4) (p=0.03) and hypoglycemia (<54 mg/dl) (p<0.00001) of tirzepatide 15 mg were lower when compared to insulin, while total AEs (p=0.03) were increased. Compared with GLP-1 RA, tirzepatide 15 mg was comparable in safety endpoints in total AEs and GI AEs, while hypoglycemia (<54 mg/dl) (p=0.04) was higher. TSA indicated that HgA1c, FSG, and weight benefits were conclusive. In safety endpoints, only MACE-4 and hypoglycemia (<54 mg/dl) of Tirzepatide 15 mg vs. Insulin were conclusive. Harbord regression of AEs suggested no evident publication bias (p=0.618). Tirzepatide 15 mg reduced HbA1c and weight more effectively than placebo, insulin, and GLP-1 RA. Total AEs were higher than placebo and insulin but comparable to GLP-1 RA. Tirzepatide 15 mg is a kind of optimal strategy to treat type 2 diabetes. However, there is a need to focus on GI AEs.

Vegetarian diets on anthropometric, metabolic and blood pressure outcomes in people with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials.

It is unknown whether vegetarian diets (VDs) may improve outcomes in people with overweight and obesity. To systematically assess the effects of VDs vs. omnivore diets on anthropometric, metabolic, and blood pressure outcomes in people with overweight and obesity. We searched for randomized controlled trials (RCTs) in EMBASE, PubMed, Web of Science, and Scopus until February 2, 2022. Primary outcomes were anthropometric risk factors (weight, body mass index [BMI], waist circumference [WC], hip circumference [HC], and body fat percentage). Secondary outcomes were metabolic risk factors (fasting serum glucose, HbA1c, insulin levels) and blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP]). Random-effects meta-analyses were performed and effects were expressed as mean difference (MD) and their 95% confidence intervals (CI). The quality of evidence was assessed using GRADE methods. Nine RCTs (n = 1628) were included. VDs decreased weight (MD -3.60 kg, 95%CI -4.75 to -2.46) and glucose (MD -10.64 mg/dL, 95%CI -15.77 to -5.51), but did not decrease WC (MD -3.00 cm, 95%CI -6.20 to 0.20), BMI (MD -0.87 kg/m2, 95%CI -1.80 to 0.06), or HC (MD: -0.86 cm, 95%CI -3.46 to 1.74). VDs did not decrease HbA1c (MD -0.40%, 95%CI -0.89 to 0.10), insulin (MD -3.83 mU/L, 95%CI -8.06 to 0.40), SBP (MD -0.25 mmHg, 95%CI -2.58 to 2.07), or DBP (MD -1.57 mmHg, 95%CI -3.93 to 0.78). Subgroup analyses by type of VD (four RCTs evaluated lacto-ovo-vegetarian diets and five RCTs vegan diets) showed similar results to the main analyses. QoE was very low for most of the outcomes. In comparison to an omnivorous diet, VDs may reduce weight and glucose, but not blood pressure or other metabolic or anthropometric outcomes. However, the QoE was mostly very low. Larger RCTs are still needed to evaluate the effects of VD on anthropometric, metabolic factors, and blood pressure in people with overweight and obesity.

Phenolics Extracted from Jasminum sambac Mitigates Diabetic Cardiomyopathy by Modulating Oxidative Stress, Apoptotic Mediators and the Nfr-2/HO-1 Pathway in Alloxan-Induced Diabetic Rats.

Diabetes mellitus is a chronic metabolic disorder defined as hyperglycemia and pancreatic β-cell deterioration, leading to other complications such as cardiomyopathy. The current study assessed the therapeutic effects of phenolic acids extracted from Jasminum sambac phenols of leaves (JSP) against diabetes-induced cardiomyopathy in rats. The rats were divided into four groups, with each group consisting of 20 rats. The rats were given intraperitoneal injections of alloxan monohydrate (150 mg/kg) to induce diabetes. The diabetes-induced groups (III and IV) received treatment for six weeks that included 250 and 500 mg/kg of JSP extract, respectively. In the treated rats, the results demonstrated that JSP extract restored fasting glucose, serum glucose, and hyperlipidemia. Alloxan induced cardiomyopathy, promoted oxidative stress, and altered cardiac function biomarkers, including cardiac troponin I, proBNP, CK-MB, LDH, and IMA. The JSP extract-treated rats showed improved cardiac function indicators, apoptosis, and oxidative stress. In diabetic rats, the mRNA expression of caspase-3, BAX, and Bcl-2 was significantly higher, while Bcl-2, Nrf-2, and HO-,1 was significantly lower. In the treated groups, the expression levels of the BAX, Nrf-2, HO-1, Caspase-3, and Bcl-2 genes were dramatically returned to normal level. According to our findings, the JSP extract prevented cardiomyopathy and heart failure in the hyperglycemic rats by improving cardiac biomarkers and lowering the levels of hyperlipidemia, oxidative stress, apoptosis, hyperglycemia, and hyperlipidemia.

&lt;i&gt;Apium graveolens&lt;/i&gt; Aqueous Extract Reduced Cardiovascular Diseases and Inflammatory Biomarkers Expression in High-Fat Diet-Fed BALB/C Mice

Background and Aims: Cardiovascular disease prevention has always been a high goal. The goal of this study is to investigate if Apium graveolens has any influence on cardiovascular disease risk factors, biomarkers, and inflammatory biomarkers in male BALB/c mice that have been given a high-fat diet. Methods: Apium graveolens aqueous extract was given to male BALB/c mice, and they were either fed a standard pellet or a diet composed of cholesterol (0.15%), sodium cholate (0.5%), and pure coconut oil (21%) for 12 weeks. Serum fasting glucose, a lipid profile, liver function tests, and cardiac indicators were used to evaluate the extract’s anti-dyslipidemic, hypoglycemic, hepatoprotective, and cardioprotective characteristics. Antioxidant enzyme markers in tissues were also evaluated. To evaluate inflammatory and CVD biomarkers in cardiac tissue, RT-qPCR and ELISA were used. An unpaired t-test assessed group differences. P &lt; 0.05 showed significance. Results: The HFD control group exhibited considerably higher levels of blood glucose, lipid profile, hepatic indicators, inflammatory and cardiac markers, and lower levels of HDL-C and antioxidant enzymes. When administered orally, an aqueous extract of Apium graveolens significantly reduced blood glucose levels. Serum lipids and liver indicators returned to nearnormal levels. In addition to a considerable reduction in MDA levels, treated mice showed a large increases in catalase and reduced glutathione activities. Inflammatory and cardiovascular disease biomarker expression was reduced in the extract-treated groups. Conclusions: Apium graveolens consumption may help reduce the risk of cardiovascular disorders.