Fasting Serum Research Articles

Clinical Pharmacology of Pemafibrate Extended-release Formulation in Patients with Hypertriglyceridemia-A Phase 2, Multicenter, Active-controlled, Randomized, Single-blind, Crossover study.

Efficacy, safety, and pharmacokinetics of the selective PPARα modulator pemafibrate as once-daily extended-release (XR) tablets were compared with those of twice-daily immediate-release (IR) tablets in patients with hypertriglyceridemia. A multicenter, randomized, single-blind, active-controlled crossover, phase 2 clinical pharmacology study was performed in patients with hypertriglyceridemia. Patients were randomly assigned to IR 0.2 mg/day, XR 0.4 mg/day, or XR 0.8 mg/day before/after meals (fasted/fed) and treated for a total of eight weeks. The primary endpoint was percentage change in fasting serum triglycerides (TG). Of 63 randomized patients, 60 received the study drug. Patients were 78.3% male, mean age (±SD) 57.5±9.8 years, BMI 25.5±3.7 kg/m2, and fasting TG 221.3±68.1 mg/dL. Fasting serum TG decreased significantly from baseline in all groups (LS mean [95% CI];-43.6 [-47.7, -39.5] % for IR 0.2 mg/day, -41.1 [-45.1, -37.0] % for XR 0.4mg/day, -39.7 [-43.8, -35.6] % for XR 0.8 mg/day), indicating that XR 0.4 and XR 0.8 mg/day were not inferior to IR 0.2 mg/day. TG-lowering effects tended to be stronger for fed than fasted administration. MRTss, tmax, and t1/2 were longer for XR than for IR. Adverse events showed no major inter-group differences: 12.5% (5/40 patients) for IR 0.2, 17.5% (7/40) for XR 0.4, and 20.0% (8/40) for XR 0.8 mg/day. In patients with hypertriglyceridemia, XR substantially lowered TG at all doses, with maximum effectiveness at 0.4 mg/day, the dose approved in Japan, to a level comparable to IR 0.2 mg/day. There were no safety concerns up to 0.8 mg/day.

Opuntia humifusa stems rich in quercetin and isorhamnetin alleviate insulin resistance in high-fat diet-fed rats.

Obesity, characterized by abnormal fat accumulation and metabolic disturbances, presents a significant health challenge. Opuntia humifusa Raf., commonly known as Korean Cheonnyuncho, is rich in various beneficial compounds and has demonstrated antioxidant and anti-inflammatory effects. However, its potential impact on glucose and lipid metabolism, particularly in obese rats, remains unexplored. We aimed to investigate whether O. humifusa stems and fruits could beneficially alter glucose metabolism and lipid profiles in a rat model of high-fat diet (HFD)-induced obesity. Thirty-two rats were allocated into 4 groups: normal diet (NF), HFD control (HF), HFD treated with 2% O. humifusa stems (HF-OS), and HFD treated with 2% O. humifusa fruits (HF-OF). Experimental diets were administered for 6 weeks. At the end of the treatment, liver and fat tissues were isolated, and serum was collected for biochemical analysis. The major flavonoid from O. humifusa stems and fruits was identified and quantified. After 6 weeks of treatment, the serum fasting glucose concentration in the HF-OS group was significantly lower than that in the HF group. Serum fasting insulin concentrations in both HF-OS and HF-OF groups tended to be lower than those in the HF group, indicating a significant improvement in insulin sensitivity in the HF-OS group. Additionally, the HF-OS group exhibited a tendency towards the restoration of adiponectin levels to that of the NF group. The 2% O. humifusa stems contain abundant quercetin and isorhamnetin, which alter fasting blood glucose levels in rats fed a HFD, leading to a favorable improvement in insulin resistance.

Is Serum Magnesium Associated with Prehypertension? Two-Year Cross-sectional Study at Rural Central India

Abstract Background: Prehypertension (HTN) raises the likelihood of developing HTN. Very few studies have been conducted on the serum magnesium responsible for causing pre-HTN. Materials and Methods: In this cross-sectional study, 300 subjects (150 cases and 150 controls) were enrolled to investigate the association between serum magnesium levels and pre-HTN. One hundred and fifty individuals with pre-HTN were compared with 150 controls without pre-HTN. All subjects had undergone anthropometric measurements such as body mass index (BMI) and waist–hip ratio along with lipid profile. Results: Levels of serum magnesium were low among the study population with pre-HTN when compared to controls without pre-HTN. Prehypertensive individuals show high BMI (24.09 ± 2.10 vs. 21.54 ± 2.02), waist–hip ratio (0.86 ± 0.08 vs. 0.82 ± 0.07), fasting blood sugar levels (103.15 ± 7.47 vs. 94.41 ± 8.21), serum triglyceride (141.12 ± 41.41 vs. 128.37 ± 23.46), and total cholesterol (175.95 ± 28.12 vs. 159.59 ± 19.03) levels when compared to controls. Multivariate logistic regression analysis was conducted which revealed a strong correlation between pre-HTN and hypomagnesemia. Conclusion: This study found a positive correlation between pre-HTN and low blood magnesium levels.

Association between baseline insulin resistance and hospital mortality in moderate-to-severe coronavirus disease 2019 patients without diabetes mellitus: An observational study.

Insulin resistance is often implicated as a risk factor of cell-mediated immune dysfunction in sepsis patients and results in poor clinical outcome. However, it is unclear whether early insulin resistance is contributory to T-cell dysfunction and poor clinical outcome in coronavirus disease 2019 (COVID-19) patients. Adult patients with moderate-to-severe or critically ill COVID-19 infection were included in this study. Serum samples were collected at the time of diagnosis for fasting plasma glucose, serum insulin, serum cortisol, and serum glucagon measurements, and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score was calculated. One hundred and twenty-six subjects with a mean (standard deviation) age of 49.6 (16.3) years were recruited in this study, and 62.4% (78 of 125 patients) were male. HOMA-IR was a predictor of inhospital mortality with the area under the receiver operating characteristics curve (AUROC) (95% confidence interval [CI] of 0.61 [0.49-0.73]). With a cutoff value of 1.91, sensitivity was 75.5% and specificity was 45.2%. Higher serum insulin was associated with higher survival with AUROC (95% CI) of 0.65 (0.53-0.76), and the best cutoff was 7.15, with a sensitivity and specificity of 62.1% and 64.5%. Serum cortisol was also a predictor of inhospital mortality with an AUROC (95% CI) of 0.67 (0.56-0.77). An independent association between baseline serum cortisol and poor outcome in moderate-to-severe COVID-19 patients was observed. Hyperglycemia and HOMA-IR can also predict poor outcome in these patients with some accuracy.

The Association between Vitamin D and Lipid Profile among Healthy Malay Adults in K ota Bharu, Malaysia

Background:The effect of vitamin D in regulating lipid profiles is one of the proposed mechanisms for the association between vitamin D deficiency and cardiovascular heart disease (CHD). However, the relationship between vitamin D status and lipid profiles remained unclear.
 Objective: The objective of this study is to evaluate the association of vitamin D status on serum lipids among healthy adults.
 Material and Methods: This is cross-sectional study, involving 120 healthy adults with age of 18-50 years from the Malay adult in Kota Bharu, Malaysia which were selected via random sampling. To decrease the seasonal variability, the study was conducted within 2 months, between July and August 2015. Serum 25(OH)D, serum parathyroid hormone (PTH), serum triglycerides (TG), serum total cholesterol (TC), serum low density lipoprotein cholesterol (LDL-C) and serum high density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS) and serum insulin were measured.
 Results: The mean serum 25(OH) D was 23.50 ± 8.74 nmol/L. Based on the definition of vitamin D deficiency as serum 25(OH)D less than 30mmol/L, the proportion of vitamin D deficiency among our study subjects was 76.7%. Our data revealed that serum 25(OH) D had significant inverse association with HDL-C and significant positive association with TC, TG and LDL-C.
 Conclusions: Our study shows highly prevalence of vitamin D deficient among healthy Malay adult population in Kota Bharu, Malaysia. Serum 25(OH) D was positively associated with TC, TG and LDL-C and negatively associated with HDL-C. Perhaps optimizing the level of vitamin D might improve the lipid profiles among healthy Malay adults.
 Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 214-220

Cardioprotective effects of Ganoderma atrum polysaccharide in a type 2 diabetes mellitus involvement with gut-derived metabolites and NLRP3 inflammasome

The study aimed to explore the effects of Ganoderma atrum polysaccharide (PSG) on diabetic cardiomyopathy in type 2 diabetic rats. Results suggested that PSG significantly attenuated diabetic cardiomyopathy, as evidenced by alleviating heart histopathological changes and LDH release, mitigating weight loss, and improving fasting blood glucose and serum insulin levels. PSG could also reduce ROS generation and malondialdehyde contents, while significantly enhancing antioxidant enzyme activities and Nrf2 expression. Furthermore, PSG reduced inflammation by suppressing NLRP3 inflammasome, caspase-1, TLR4, NF-κB p65 expression, IL-1β and IL-6 secretion. Moreover, PSG treatment significantly manipulated intestinal microbiota metabolites, including short-chain fatty acids, plasma lipopolysaccharide, and trimethylamine N-oxide. These metabolites might mediate gut-heart communication through interaction with NLRP3 inflammasome. Collectively, PSG attenuated diabetic cardiomyopathy by activating the Nrf2 antioxidant pathway, controlling inflammation via NLRP3/Caspase-1/IL-1β signaling, and using gut microbial metabolites as alternative biomarkers for predicting the mechanisms of diabetic cardiomyopathy and assessing PSG interventions.

Serum Zinc Levels in Women with Polycystic Ovarian Syndrome are Lower as Compared to Those without Polycystic Ovarian Syndrome: A Cohort Study.

Zinc is an essential micronutrient, a vital stabiliser and a cofactor in many enzymes such as superoxide dismutase and phospholipase C and also acts as an antioxidant by protecting the sulfhydryl groups of different proteins and enzymes against free radicals. It is unclear if serum zinc levels are correlated with polycystic ovary syndrome (PCOS) and its pathophysiology, although relation between diabetes and insulin resistance has been established. This study aimed to investigate circulating serum zinc levels in PCOS subjects compared with non-PCOS subjects. In this cohort study, PCOS subjects were compared with normal subjects aged between 18 and 35. All the included subjects underwent measurement of anthropometric parameters, fasting insulin, luteinising hormone, follicle-stimulating hormone, thyroid-stimulating hormone, prolactin, progesterone, oestrogen and serum zinc levels. These values were taken on days 2-5 of the menstrual cycle. Univariate analysis and linear regression were performed for serum zinc levels and fasting insulin levels in PCOS subjects and non-PCOS subjects using SPSS (version 21) and Microsoft Excel (2019). Serum zinc levels in the PCOS group were lower than in the control group (P = 0.012). Fasting insulin levels in the PCOS group were higher than in non-PCOS subjects (P = 0.001). We found a negative correlation between zinc and fasting insulin (r = -0.580, P < 0.0001) in the normal group and (r = -0.332, P = 0.019) in the PCOS group. A positive correlation was found between body mass index (BMI) and fasting insulin levels in both the PCOS group (r = 0.227, P = 0.112) and normals (r = 0.612, P < 0.0001). A negative statistically significant correlation between BMI and zinc in both the PCOS group (r = -0.378, P = 0.007) and the non-PCOS group (r = -0.7452, P < 0.0001) was seen. The data suggest that serum zinc levels were found to be lower in PCOS subjects as compared to normal controls and evaluation of these levels may indicate that zinc has a vital role in PCOS pathophysiology.

Correlation of Serum Calcium with Components of Metabolic Syndrome: A Cross-sectional Study

Introduction: Metabolic syndrome is a cluster of symptoms following impaired glucose tolerance, adiposity, abnormal lipid profiles and hypertension. Metabolic syndrome may serve as a precursor for type II diabetes mellitus and cardiovascular diseases. Therefore, it should be considered when interpreting calcium levels, as calcium is inexpensive, readily available and can also serve as a predictor for diabetic and cardiovascular risks. Aim: To investigate the correlation of serum calcium with components of metabolic syndrome. Materials and Methods: A cross-sectional study was conducted in the Department of Biochemistry, Government Medical College and General Hospital, Aurangabad, Maharashtra, India, from January 2016 to March 2016. A total of 80 patients were divided into two groups: subjects with metabolic syndrome (group I) and subjects without metabolic syndrome (group II). Data including age and components of metabolic syndrome such as Body Mass Index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Waist Circumference (WC) and various biochemical parameters {plasma glucose, calcium, albumin, corrected calcium, total cholesterol, Triglycerides (TG), High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL)}. were collected and compared between the two groups. The differences in the studied variables among the groups were analysed using an Unpaired t-test. A p-value less than 0.05 was considered statistically significant. Results: In the present study, group I consisted of 23 males and 17 females with the mean±Standard Deviation (SD) age 49.88±8.7 years and group II had 19 males and 21 females with mean age 47.5±7.60 years. There were no significant differences in age, gender and blood pressure, while BMI and WC were significantly higher in group I. Serum calcium, fasting plasma glucose levels, and lipid profiles were significantly higher in subjects with metabolic syndrome compared to those without metabolic syndrome. Additionally, serum corrected calcium levels showed a positive correlation with serum TG and fasting plasma glucose (r-value=0.4, p-value=0.008), and a negative correlation with HDL-cholesterol (HDL-C) (r-value=- 0.3, p-value=0.03). Conclusion: In the present study, serum total calcium was found to be positively associated with metabolic syndrome. Estimation of serum calcium can help predict the risk of developing cardiovascular diseases or diabetes mellitus, which are associated with the metabolic syndrome.

C-reactive Protein and Suicidality in Patients with Treatment-resistant Depression

Abstract Objective: Increasing evidence suggests a crucial rȏle of C-reactive protein (CRP) in the pathological mechanisms of suicide. Whether CRP levels may be associated with suicidal ideation (SI) among patients with treatment-resistant depression (TRD) remains unclear. In this study, we intended to explore the relation between TRD and SI. Methods: Totally 36 patients with TRD and SI, 24 with TRD without SI, and 32 healthy controls were enrolled in the present study. SI was defined based on scores of ≥ 2 at the 17-item Hamilton Depression Rating Scale item 3. Fasting serum CRP levels were also measured. Results: The generalized linear model with gamma log link demonstrated that patients with TRD and SI had significantly higher CRP levels (p &lt; 0.05) than the control group after adjusting for age, sex, and body mass index. Conclusion: Patients with TRD and SI, but not those without SI, were associated with increased CRP levels. Whether CRP may be a predictor of further suicidal risk among such high-risk patients would need further investigation.

Self-reported menses physiology is positively modulated by a well-formulated, energy-controlled ketogenic diet vs. low fat diet in women of reproductive age with overweight/obesity.

Weight loss can positively alter female physiology; however, whether dietary carbohydrate- or fat- restriction confer unique effects is less studied. Precisely designed, hypocaloric well-formulated ketogenic diets (KD; ~75% energy for weight maintenance) were compared to isocaloric/isonitrogenous low-fat diet (LFD) on self-reported menses in pre-menopausal overweight and obese women (mean ± SD: 34 ± 10 years, BMI: 32.3 ± 2.7 kg/m2). Women received a precisely-weighed and formulated KD with either twice-daily with ketone salts (KS; n = 6) or a flavor-matched placebo (PL; n = 7) daily for six-weeks. An age and BMI-matched cohort (n = 6) was later assigned to the LFD and underwent the same testing procedures as the KD. Self-reported menses fluctuations were assessed bi-weekly along with measures of body weight, body composition, and fasting serum clinical chemistries using repeated measures ANOVA with Bonferroni post-hoc corrections. Both diets elicited clinically-significant weight-loss (Δ: -7.0 ± 0.5 kg; p < 0.001), primarily from fat-mass (Δ: -4.6 ± 0.3 kg; p < 0.001), and improved insulin-sensitivity and serum lipids (all p < 0.05). Fasting plasma glucose and inflammatory markers were not different between diets. Fasting capillary beta-hydroxybutyrate (R-βHB) increased significantly during the KD, independent of supplementation (Δ: 1.2 ± 0.3 mM R-βHB; p < 0.001). Women randomized to the KD+KS (30%) and KD+PL (43%) reported subjective increases in menses frequency and intensity after 14 days, whereas another third reported a regain of menses (>1 year since the last period) after 28 days. No LFD participants reported menses changes. Nutrient-dense, whole-food KDs and LFD improved weight, BMI, body composition, and blood parameters in pre-menopausal women after six-weeks. Changes in self-reported menses were described by most of the KD participants, but none of the LFD women suggesting there may be unique effects of nutritional ketosis, independent of weight loss.

INFLUENCE OF FERMENTED MELON SEED (OGIRI) PROTEIN ISOLATE ON POSTPRANDIAL BLOOD GLUCOSE LEVELS IN DIABETIC RATS

ABSTRACT Abstract Introduction Diabetes mellitus is a prevalent endocrine disorder affecting millions worldwide, characterized by chronic hyperglycemia and associated with serious complications. Aim This study aimed to evaluate the anti-diabetic properties of Ogiri Protein Isolate (OPI) derived from fermented melon seeds (Citrullus vulgaris) and its effects on blood glucose levels, lipid profiles, and key organs in alloxan-induced diabetic rats. Methods Forty-two rats were divided into seven groups: positive control, negative control, diabetic group treated with 20% OPI, non-diabetic group treated with 20% OPI, diabetic group treated with 10% OPI, non-diabetic group treated with 10% OPI, and diabetic group treated with 80mg/kg Glibenclamide for 14 days. Fasting serum glucose levels, feed and water intake, weight gain, and plasma HDL-cholesterol and triglyceride levels were measured. Results OPI treatment significantly reduced fasting serum glucose levels in diabetic rats. There was a significant (p&lt;0.05) decrease in feed and water intake in treated groups. Weight gain improved in OPI-treated diabetic rats compared to untreated diabetic rats. Plasma HDL-cholesterol levels increased significantly in all treated groups compared to the control, with the highest levels in non-diabetic and untreated groups. Similar trends were observed in plasma and liver triglycerides. Conclusion The findings suggest that OPI possesses anti-diabetic properties, significantly lowering blood glucose levels and improving lipid profiles in diabetic rats. OPI holds promise as a potential therapeutic agent for diabetes management. Further research is needed to validate these results in human studies. Keywords: Ogiri Protein Isolate (OPI), anti-diabetic, Diabetes mellitus, Postprandial blood glucose and Alloxan.

Prevalence of chronic kidney disease and associated risk factors among people living with HIV in a rural population of Limpopo Province, South Africa.

Limited evidence informs on the prevalence of chronic kidney disease (CKD) in people living with HIV (PLWH) in South Africa. Thus, this study aimed to determine the prevalence of CKD and its associated risk factors among PLWH within the rural province of Limpopo, South Africa. We conducted a cross-sectional study of 143 participants, subdivided into groups of PLWH (n = 103) and individuals without HIV (n = 43). Structured questionnaires were used to collect and capture sociodemographic information including age, sex, alcohol intake, smoking status, and educational status. Basic measurements taken included levels of cluster of differentiation 4 (CD4+) count, body mass index (BMI), blood pressure, plasma cystatin C, and fasting serum glucose levels. Plasma cystatin C-based estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) estimator to determine the prevalence of CKD. The prevalence of CKD was approximately 7% in PLWH. Multivariate logistic regression analysis showed that it was only diabetes mellitus (odds ratio of 5.795, 95% confidence interval, p = 0.034) and age (odds ratio of 1.078, 95% confidence interval, p = 0.039) that were significantly associated with CKD in PLWH. Chronic kidney disease was prevalent in PLWH, and it was further associated with cardiovascular risk factors, diabetes, and ageing. As PLWH age, the burden of CKD may be increased with the increase in cardiovascular-related comorbidities such as diabetes.

Pharmacogenetics: Influence of CYP2C9*2 and *3 alleles polymorphisms on Iraqi type 2 diabetic patients

Abstract Background: Sulfonylureas (SUs) are the most prescribed anti-diabetic drugs. The enzyme responsible for metabolizing of SUs is hepatic cytochrome P4502C9 (CYP2C9). The CYP2C9 gene has numerous allelic variations; among those, the CYP2C9*2 and CYP2C9*3 are the most common and clinically significant allelic variations. The pharmacokinetics of SUs are dramatically impacted by CYP2C9 genotype. Objective: Evaluation of the association of genetic polymorphisms in CYP2C9 gene with the efficacy of glibenclamide (GB), second-generation SUs, by investigating two CYP2C9 allelic variants. Materials and Methods: Blood samples were collected from 113 type 2 diabetes patients. Allele specific amplification-polymerase chain reaction was used to genotype the CYP2C9 gene. Fasting serum glucose, fasting insulin, and glycated hemoglobin (HbA1c) levels were measured as part of the biochemical analysis. Results: The CYP2C9 gene variants were analyzed in a study group. The results exposed that 75 patients carried the wild (CYP2C9*1/*1) genotype, 25 were heterozygote allele (CYP2C9*1/*2) for CYP2C9*2 gene, 4 were homozygous for the variant CYP2C9*2 allele (CYP2C9*2/*2), and 9 were heterozygous for the variant CYP2C9*3 allele (CYP2C9*1/*3). Statistically significant difference was found in mean HbA1c between the mutant and wild alleles group (P = 0.044). The mean HbA1c for those carrying the CYP2C9*2 and*3 alleles (n = 38) was 8.4750 compared to 9.3177 for those carrying the CYP2C9*1 allele (n = 75), which indicate better glycemic control. Conclusion: The accordance of CYP2C9*2 and*3 was found to be associated with severe hypoglycemia (odd ratio [OR] = 2.045). The OR suggests a strong association between CYP2C9*2 and*3 alleles and hypoglycemia. Our findings imply that the diabetic patients with CYP2C9 polymorphism are more likely to suffer hypoglycemia than those with wild type alleles when treated with GB.

Prevalence of metabolic syndrome in adult patients with obstructive sleep apnea syndrome

To assess metabolic syndrome prevalence in adult patients with OSAS. We administered a standardized clinical questionnaire and four sleep questionnaires (Berlin, Epworth Sleepiness Scale, STOP, and STOP-Bang), and measured anthropometric variables. We also measured serum glucose and lipids, and blood pressure following an overnight fast. Metabolic syndrome was diagnosed according to National Cholesterol Education Program criteria. Patients underwent an overnight ambulatory respiratory polygraphy to confirm the diagnosis of OSAS. The predictive variables were subjected to univariate and multivariate analysis in a logistic regression model. Of 1,030 screened patients, 68% were male, 92% had comorbidities and 58% had moderate-severe OSAS. Subjects with OSAS were more obese, had higher cervical and waist circumference, blood pressure and fasting serum glucose, had lower HDL cholesterol, and an increased incidence of metabolic syndrome (55.4% vs. 44.8%, p<0.013). Age, male sex, hypertension, body mass index, cervical, waist and hip circumferences, intense snoring, witnessed apnea, nocturia, and components of metabolic syndrome were associated with the risk of OSAS and its severity. Fasting blood glucose, blood pressure, and waist circumference were associated with the risk of moderate or severe OSAS, which was not significant for the alteration of blood lipids. Patients with OSAS have a high prevalence of metabolic syndrome. OSAS was associated with an increase in the cardiovascular risk factors that comprise the metabolic syndrome.

Evaluation of lipid profile in patients with cherry angioma: A case–control study in Iraqi patients

Abstract Background: Cherry angioma (CA) is a common lesion among adults and elderly people. Both CA and dyslipidemia have vital common areas, such as their effect on elderly people at a certain age and their interaction with the vascular system. Therefore, we have found it to be an interesting topic for our research to investigate the connection between CA and dyslipidemia. Objectives: The motivation of this project is to investigate the association between CA and dyslipidemia among a sample of Iraqi patients. Materials and Methods: A total number of 104 Iraqi people were selected (39 male and 65 female); 52 of them were affected with CA, and the other 52 were healthy controls. For the purpose of assessing lipid profile, we used Beckman Coulter/Olympus—AU480 Chemistry Analyser was used in measuring fasting serum lipid profile parameters, including triglyceride (TG), total cholesterol (Tch), high-density lipoprotein-cholesterol (HDL-C). Results: The results showed a significant difference between patients with CA and control subjects in TG, CHOL, and LDL. The mean levels of the TG, total CHOL, and LDL were significantly higher in cases with CA compared to a group of controls, in which the differences were significant for TG, total CHOL, and LDL (P-value = 0.000). There was no significant difference between the two groups in the mean level of HDL (P-value = 0.059). additionally, there was no significant difference in levels of lipid value regarding ages and sex distribution between patients with CA and controls (P-value &gt; 0.05). Conclusion: Based on its outcomes, the study proposed that dyslipidemia could play a vital role in the pathogenesis of CA lesions. Hence, dyslipidemia treatments may represent an effective means for CA therapy.

Quantitative PCR-based high-sensitivity detection of HBV-DNA levels reflects liver function deterioration in patients with hepatitis B virus-related cirrhosis.

To investigate the clinical implication of quantitative polymerase chain reaction (PCR)-based high-sensitivity detection of hepatitis B virus (HBV)-DNA levels in patients with HBV-related liver cirrhosis (LC). From January 2020 to December 2022, 100 fasting serum samples were collected and retrospectively analyzed from patients with treated HBV-related LC attending the Suzhou Hospital of Integrated Traditional Chinese and Western Medicine and Suzhou Guangci Cancer Hospital. Patients were divided into a negative group (HBV-DNA < 20 IU/mL) and a positive group (HBV-DNA ≥ 20 IU/mL) according to their high-sensitivity HBV-DNA test results. The clinical characteristics and serological indicators of the two groups were compared, mainly including gender, age, liver function [total protein (TP), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL)], lipids [total cholesterol (TC) and triglycerides (TG)], platelets (PLT), five serum liver fibrosis markers [cholyglycine (CG), hyaluronic acid (HA), laminin (LN), precollagen type III (PCIII), and type IV collagen (IV-C)], serum gastrointestinal tumor markers [α-fetoprotein (AFP) and carcinoembryonic antigen (CEA)], and hepatitis B surface antigen (HBsAg). The differences between the two groups in terms of liver function Child-Pugh grades and the incidence of hepatocellular carcinoma (HCC) were also compared. There were 39 patients in the positive group, including 29 males and 10 females, and 61 patients in the negative group, including 38 males and 23 females, with no statistically significant differences in gender and age distribution between the two groups (P > 0.05). The levels of serological indicators (TP, ALB, AST, GGT, ALP, TBIL, DBIL, IBIL, TC, TG, PLT, CG, HA, LN, PCIII, IV-C, AFP, CEA, and HBsAg) in both groups showed no significant differences (P > 0.05), but the ALT level in the positive group was higher than that in the negative group (P < 0.0001). The positive group had worse Child-Pugh grades and higher HCC incidence compared to the negative group (P < 0.0001, P = 0.028). Patients with HBV-related LC and HBV-DNA ≥ 20 IU/mL have higher serum ALT levels, worse liver function Child-Pugh grades, and higher HCC incidence than those with HBV-DNA < 20 IU/mL. High-sensitivity HBV-DNA quantification can reflect the deterioration of liver function in patients with HBV-related LC to some extent.

Inspiratory muscle strength training to improve cardiometabolic health in patients with type 2 diabetes mellitus: protocol for the diabetes inspiratory training clinical trial.

Type 2 diabetes mellitus (T2DM) is a complex, chronic metabolic disease that carries with it a high prevalence of comorbid conditions, making T2DM one of the leading causes of death in the U.S. Traditional lifestyle interventions (e.g., diet, exercise) can counter some adverse effects of T2DM, however, participation in these activities is low with reasons ranging from physical discomfort to lack of time. Thus, there is a critical need to develop novel management strategies that effectively reduce cardiometabolic disease risk and address barriers to adherence. High-resistance inspiratory muscle strength training (IMST) is a time-efficient and simple breathing exercise that significantly reduces systolic and diastolic BP and improves vascular endothelial function in adults with above-normal blood pressure. Herein we describe the study protocol for a randomized clinical trial to determine the effects of a 6-week IMST regimen on glycemic control and insulin sensitivity in adults with T2DM. Our primary outcome measures include fasting plasma glucose, fasting serum insulin, and insulin resistance utilizing homeostatic model assessment for insulin resistance (HOMA-IR). Secondary outcome measures include resting systolic BP and endothelium-dependent dilation. Further, we will collect plasma for exploratory proteomic analyses. This trial seeks to establish the cardiometabolic effects of 6 weeks of high-resistance IMST in patients with T2DM.

Associations of Changes in Alcohol Consumption on the Risk of Depression/Suicide Among Initial Nondrinkers

Although prior studies showed the association between the amount of alcohol ingestion and the risk of depression and suicide, there has been a lack of research considering changes in alcohol intake over time. This research aimed to assess the associations of alcohol consumption level changes and the risk of depression and suicide among initial nondrinkers. Using data from the National Health Insurance Service in South Korea between 2002 and 2019, a total of 129,446 subjects were included and monitored from January 1, 2011, to December 31, 2019, of which 102,721 were never drinkers and 26,725 were former drinkers. For depression, the follow‐up periods ranged from 0.01 to 9.00 years (mean 8.65, median 9.00 years). Moreover, for suicide, the follow‐up periods ranged from 0.03 to 9.00 years (mean 8.99, median 9.00 years). To ensure robust results, the model was adjusted for several confounders in three steps: Model 1 was adjusted for sociodemographic factors (age and sex), Model 2 included additional lifestyle factors (household income, smoking status, and physical activity) in addition to Model 1 variables, and Model 3 included all variables from Model 2 and incorporated further variables including body mass index (BMI), systolic blood pressure, fasting serum glucose, total cholesterol, and the Charlson Comorbidity Index (CCI). The Cox proportional hazard regression was utilized to estimate the adjusted hazard ratio (aHR) and 95% confidence intervals (CIs) for depression and suicide risk after an increase in alcohol consumption. Individuals who increased alcohol consumption lightly up to one glass per day had a reduced risk of depression (aHR, 0.91; 95% CI, 0.84–0.98) compared with individuals who maintained their nondrinking status at the third medical checkup. Notably, stratified analyses indicated that the associations were only evident in those younger than 60 years and those physically active. Additionally, among former drinkers, those who increased their alcohol intake to four or more glasses per day had an increased risk of depression (aHR, 1.31; 95% CI, 1.04–1.66). However, individuals who initiated drinking between two and four glasses of alcoholic beverages per day were found to have a higher risk of suicide (aHR, 2.25; 95% CI, 1.31–3.87) relative to those who continued to abstain from drinking. Our findings suggest that small increases in alcohol intake among the initial nondrinkers are associated with a reduced risk of depression, whereas moderate‐to‐heavy increments in alcohol consumption are associated with a detrimental risk of suicide. This study has several limitations including the low number of suicide events, reliance on self‐reported alcohol consumption which may introduce underreporting bias, and the exclusion of important confounding variables such as educational attainment and dietary factors. Furthermore, the study population was exclusively Korean, limiting the generalizability of the findings to other ethnic groups.

Study the effect of urokinase-type plasminogen activator (UPA) and some biochemical parameters in Iraqi hemodialysis patients with type 2 diabetes

Abstract The most common cause of end-stage renal disease (ESRD) and leading ultimately to hemodialysis (HD) is type 2 diabetes mellitus (T2DM). The current study aims to assess the role of serum urokinase plasminogen activator (UPA) levels among Iraqi hemodialysis patients with ESRD with type 2 diabetes. The study encompassed 50 patients aged 40–74 years (35 males and 15 females), admitted to the Iraqi dialysis center at Baghdad Teaching Hospital, Al-Hayat Center at Al-Karama Teaching Hospital, and Hamida Al-Misfah Dialysis Center in Imam Al-Kadhimin Medical City for the period from October 2022 to February 2023. Were diagnosed based on previous medical reports, and laboratory tests by a consultant nephrologist. UPA, Blood. Urea, Creatinine, fasting serum glucose (FSG), HbA1c, Insulin, HOMA-IR, and lipid profile levels were determined. The present study showed a significant increase in serum UPA levels in HD patients in ESRD with T2DM compared to control. In addition, there was an important negative correlation between UPA and Hb1AC, FSG, and a positive correlation with VLDL-C and TG in HD patients in ESRD with T2DM patients. This study demonstrates increased UPA serum levels in HD in ESRD with T2DM patients and associated with FSG, Hb1AC, TG, and VLDL this shows that it can be considered a good marker for the development of diabetes complications, the most important of which is diabetic kidney disease (DKD).

Anti-Hyperglycemic Effect of the Brown Slime Cap Mushroom Chroogomphus rutilus (Agaricomycetes) Crude Polysaccharide In Vitro and In Vivo.

The prevalence of diabetes is increasing worldwide, and it is very important to study new hypoglycemic active substances. In this study, we investigated the hypoglycemic effect of Chroogomphus rutilus crude polysaccharide (CRCP) in HepG2 cells and streptozotocin-induced diabetic mice. A glucose consumption experiment conducted in HepG2 cells demonstrated the in vitro hypoglycemic activity of CRCP. Furthermore, CRCP exhibited significant hypoglycemic effects and effectively ameliorated insulin resistance in insulin resistant HepG2 cells. In high-fat diet and streptozotocin-induced diabetic mice, after 4 weeks of CRCP administration, fasting blood glucose, fasting serum insulin, triglyceride, total cholesterol, low-density lipoprotein cholesterol, glutamate transaminase, alanine transaminase, and insulin resistance index significantly decreased, while high-density lipoprotein cholesterol and insulin sensitivity index (ISI) were markedly increased. Moreover, hematoxylin-eosin (HE) staining and immunofluorescence labeling of tissue sections indicated that CRCP attenuated the pathological damage of liver and pancreas in diabetic mice. These results indicate that CRCP is a potential hypoglycemic agent.