Letter to the editor: “The effects of atorvastatin consumption on blood levels of sortilin, glycemic, and lipid indices in type 2 diabetic patients: A randomized clinical trial”

Dysregulated blood glucose levels and insulin resistance are key contributors to various metabolic complications and increased mortality. Among lifestyle interventions, dietary modification is a crucial strategy for improving glucose tolerance. Barley, rich in fiber and β-glucan, may offer a promising dietary approach for glycemic control. To evaluate the impact of barley intake on short- and long-term glycemic and insulin responses through a systematic review and meta-analysis. Through comprehensive searches in major scientific databases, 31 controlled trials with 34 intervention arms were identified, including a total of 660 case patients and 665 control participants. Two reviewers independently extracted data, and a random-effects model was used to calculate pooled estimates of outcomes. Barley supplementation significantly reduced postprandial glucose levels at 30 (-10.48 mg dL-1), 60 (-12.38 mg dL-1), and 120 (-6.95 mg dL-1) minutes; however, no significant effects were observed at 180 minutes. Barley supplementation significantly reduced postprandial insulin levels at 30 (-6.02 pmol L-1), 60 (-12.83 pmol L-1), and 180 (-5.89 mg dL-1) minutes; however, no significant effects were observed at 120 minutes. No significant changes in insulin levels were observed beyond the early postprandial period. In the long term, barley intake did not significantly affect fasting glucose or hemoglobin A1c levels. This meta-analysis supports the short-term benefits of barley consumption in improving early postprandial glucose and insulin responses. No significant impact was found on later or long-term glycemic markers. More high-quality trials are needed to confirm these outcomes. PROSPERO registration No. CRD42022368122.

Blackberry fruits ( Rubus fructicosus L.) are categorised as functional foods due to their rich bioactive compounds and high nutraceutical properties with a low glycaemic index. However, fresh blackberries necessarily deteriorate after harvest because of their fragile fruit tissue, causing difficulties in shelf life. Therefore, this study was carried out to investigate the effects of postharvest methyl jasmonate (MeJa) immersion treatments (0, 0.1, 1.0 and 10 mM) on the physicochemical and bioactive quality of organically produced ‘Jumbo’ blackberries during 16 days storage at 1 ± 0.5°C with an 85% relative humidity. MeJa efficiently maintained the physicochemical and bioactive properties of organic blackberries during the storage. MeJa delayed the losses in fruit weight and visual quality by restricting the polygalacturonase activity. Antioxidant activity was extended by MeJa through maintaining the total phenols, anthocyanins and ascorbic acids. Improvements in bioactive phytochemicals in MeJa‐treated fruits significantly delayed the malondialdehyde (MDA) and hydrogen peroxide (H 2 O 2 ) increases. MeJa treatment at 1 mM MeJa could be recommended to apply prior to storage as an innovative and health‐friendly approach for extending physical, bioactive and visual quality of fresh blackberries due to its greatest effects on extending many quality properties.

White maize (Zea mays L.) is an important cereal for human consumption in temperate regions, yet its genetic improvement remains limited due to inadequate evaluation of adapted germplasm and insufficient integration of agronomic and nutritional traits. The present study aimed to assess the extent of agro-morphological variability, yield potential, and nutritional quality among 100 white maize inbred lines, along with three locally adapted checks, under temperate agro-climatic conditions of Kashmir. Field evaluation was conducted during two consecutive kharif seasons (2022 and 2023) using an Augmented Block Design. Thirteen agro-morphological and yield-related traits were recorded to quantify phenotypic diversity and genotypic performance. Descriptive statistics and analysis of variance revealed highly significant differences among inbred lines for flowering, maturity, plant height, ear characteristics, kernel traits, and grain yield across both years, indicating a broad and stable genetic base. Several inbred lines consistently outperformed the checks for yield and maturity traits, demonstrating their suitability for temperate environments with short growing seasons. The consistency of trait expression across years further confirmed the reliability of the evaluated germplasm for selection and breeding. Biochemical profiling of selected inbred lines showed substantial variation in glycemic index (GI), protein content, and resistant starch (RS). Notably, inbred lines G37, G41, G72, and G63 exhibited low GI, high protein content, and elevated RS, identifying them as nutritionally superior and suitable for health-oriented maize improvement. An inverse association between GI and RS/protein content highlighted the scope for simultaneous improvement of yield and nutritional quality. Overall, the study identified genetically diverse, agronomically superior, and nutritionally enriched white maize inbred lines that can serve as valuable parental resources for developing early-maturing, high-yielding, and nutritionally enhanced hybrids adapted to temperate agro-climatic conditions.

Bidirectional improvement in characteristic aroma and anti-digestibility of taro puree via precise addition.

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder with both reproductive and metabolic manifestations. Subclinical hypothyroidism (SCH), is defined by elevated thyroid-stimulating hormone (TSH) with normal free thyroxine levels, is increasingly recognized in women with PCOS, yet its clinical impact remains debated. This study intended to explore the prevalence of SCH in PCOS and examine its influence on metabolic, hormonal, and anthropometric profiles in an Indian population. A cross-sectional study was conducted between January 2023 and January 2025 at a tertiary care center in South India. A total of 368 women with PCOS, diagnosed according to Rotterdam criteria, were enrolled and classified as either euthyroid (n = 316) or having SCH (n = 52). Comprehensive evaluations included anthropometry, blood pressure, glycemic indices, lipid profile, insulin resistance via HOMA-IR, and reproductive hormone levels. Statistical analyses included t-tests and Spearman correlation. The prevalence of SCH among women (with PCOS) was 14.13%. Compared with the euthyroid group, SCH-PCOS patients exhibited significantly higher BMI, fasting blood glucose, HbA1c, serum insulin, HOMA-IR, and adverse lipid profiles (p < 0.05). No significant diffe-rences were observed in LH, FSH, or testosterone levels. TSH demonstrated positive correlations with BMI, Glycemic markers, and HOMA-IR, underscoring its association with metabolic risk. SCH is a common and metabolically relevant comorbidity in women with PCOS, aggravating insulin resistance and dyslipi-demia without significantly affecting reproductive hormones. These findings highlight the need for routine thyroid function screening in PCOS management, especially among those with metabolic syndrome features. Further longitudinal studies are warranted to evaluate the benefits of targeted thyroid intervention in this subgroup.

Improving brown rice quality: Effects of different processing treatments on functionality and nutrition.

Effects of rice starch esterified with citric acid and malic acid: Functional properties and structural characteristics.

Severe hypoglycemia (SH) in adults with type 1 diabetes mellitus (T1DM) is associated with significant morbidity and mortality; however, its underlying causes are often complex and multifactorial. Improved tools to identify individuals at a high risk of SH are critically needed. In this study, machine learning techniques were applied to continuous glucose monitoring (CGM) data to identify distinguishing features between individuals with and without SH episodes. We analyzed data from the real-world study of adults with T1DM enrolled in the FGM-Japan study. Eleven machine learning algorithms using continuous glucose monitoring (CGM) metrics were applied to identify SH and assess the relative importance of the contributing features. The CGM metrics included mean glucose/GMI, time above range (TAR > 250 and > 180mg/dL), time in range (TIR 70-180mg/dL), time below range (TBR < 70 and < 54mg/dL), coefficient of variation (%CV), and glycemic risk index (GRI). The model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score. Data from 264 adults with T1DM were analyzed. Across the models, XGBoost showed the highest AUC, significantly outperforming logistic regression, k-NN, and SVM but performed marginally below Naive Bayes. The F1-score analysis showed that logistic regression and neural networks provided a better balance between precision and recall. The model using four CGM variables (TBR < 70, %CV, GMI, and GRI) achieved the highest AUC of 0.794. XGBoost offers strong overall discrimination; however, simpler models exhibit better F1 performance. Features like 'TBR', '%CV', 'GMI,' and 'GRI' were key features, suggesting their usefulness in identifying individuals at risk for adverse glycemic events. Clinical Trial Registry No. UMIN000039376. The online version contains supplementary material available at 10.1007/s13340-025-00872-4.

Type 2 diabetes (T2D) is one of the fastest-growing global health emergencies of the 21st century. However, high antioxidant capacity of supplementation of vitamin C and/or E was inversely associated with insulin resistance. However, each antioxidant possesses a distinct biological function that may be influenced by both dosage and duration of supplementation, potentially resulting in significantly different effects. This meta-analysis aimed to evaluate whether vitamin C, vitamin E, or their combination is more effective in improving glycemic control, blood lipids, and blood pressure in individuals with T2D. A systematic search was conducted in PubMed, Scopus, and Web of Science databases for randomized clinical trials, identifying 52 studies (n = 1425 participants). Random-effects models were used to assess the effects of vitamin C and/or E supplementation on glycemic control, blood lipid levels, and blood pressure. These findings indicate that supplementation with vitamin C, vitamin E, or their combination has a comparable effect on glycemic index values, systolic blood pressure, and blood lipid profiles. However, a significant reduction in systolic blood pressure was observed only with vitamin C and combined vitamin C + E supplementation. Additionally, a significant increase in high-density-lipoprotein (HDL) levels was noted exclusively with the combined vitamin C + E supplementation. Consequently, supplementation with vitamin C, vitamin E, and their combination (C + E) exhibited differing effects on HDL levels and systolic blood pressure. However, their effects on glycemic control, diastolic blood pressure, and blood lipids other than HDL were comparable. PROSPERO registration no. CRD42023399366.

A randomized controlled trial of real-time continuous glucose monitoring (RT-CGM) for self-management of gestational diabetes.

Physicochemical and physiological characteristics of resistant starch type 5 derived from rice starch beta-limit dextrin.

Objective: Achieving glycemic control is essential in the prevention and management of metabolic disorders, with several dietary strategies having been proposed. Meal sequence, which is defined as the order of food consumption while maintaining the overall composition and intake, may attenuate postprandial glycemic responses. This systematic review aimed to assess the effects of meal sequences on postprandial glycemic responses in healthy adults and explore its potential as a preventive strategy for glycemic control. Methods: Literature published between January 2015 and March 2025 in PubMed, Cochrane Library, Web of Science, KoreaMed, and RISS was searched using the keywords “healthy adult,” “food order,” “meal sequence,” and “glucose response.” Results: Among the 2,442 records identified, one randomized controlled trial, four randomized crossover studies, and one repeated-measures design with a total of 107 participants aged 20–36.7 years met the inclusion criteria. Most of the studies reported that consuming vegetables, fruits, or protein-rich foods before carbohydrate-rich foods reduced postprandial glucose responses and incremental area under the curve compared with mixed or carbohydrate-first meals. These effects were also noted in randomized controlled trials and randomized crossover design. Conclusion: Our findings indicate that adjusting the order of food consumption can effectively mitigate acute postprandial glucose responses in healthy individuals. Further large-scale and long-term randomized controlled trials across diverse populations and standardized protocols are warranted to strengthen the evidence base.

Estradiol and progesterone may influence glucose regulation, but it remains unclear whether ovarian hormone levels modulate night shift-induced impairments in glucose metabolism. To investigate the effects of a night shift-like schedule on next-morning fasting and postprandial glucose metabolism in reproductive-aged women. Fifty-two women with an HbA1c <5.7% completed a protocol consisting of one night of sleep and one night of wakefulness in a laboratory environment. After each night, fasting blood samples were collected to measure estradiol, progesterone, insulin, leptin, and adiponectin. Insulin resistance was estimated using HOMA-IR, and the leptin-to-adiponectin ratio (LAR)-a marker of fasting and postprandial insulin sensitivity-was calculated. Morning postprandial glucose responses were assessed using an oral glucose tolerance test (OGTT), and substrate utilization was measured via respiratory quotient (RQ) using indirect calorimetry. Linear mixed-effects models were used to test the effects of condition and the progesterone-to-estradiol (P/E) ratio on all outcomes. Fasting glucose, HOMA-IR, and LAR did not differ between conditions. Post-OGTT blood glucose at 60 minutes (mean estimated difference: 0.58 mmol/L, p = 0.016) and peak glucose (0.42 mmol/L, p = 0.037) were higher following the night shift compared with sleep. The P/E ratio was not significantly associated with fasting or postprandial glucose. Pre-OGTT RQ was lower after the night shift (-0.029, p < 0.001), and adjusting for pre-OGTT RQ attenuated the post-OGTT glucose differences between conditions (p ≥ 0.097). One night of wakefulness-as occurs in night shift work-impaired next-morning glucose tolerance in women, independent of ovarian hormone variation. Accordingly, choosing low-glycemic index foods for the first meal after a night shift may help reduce postprandial glucose excursions.

Abstract Context Plasticizers such as bisphenols and phthalates are endocrine-disrupting chemicals and lead to development of metabolic diseases. Objective To examine associations of prenatal exposure to bisphenols and phthalates with metabolic dysfunction. Design This study was nested in the New York university (NYU) Children’s Health and Environment Study, a prospective birth cohort. Setting Participants were recruited at three NYU-affiliated hospitals. Patients or Other Participants Eligible participants were ≥18 years old, &amp;lt;18 weeks pregnant, and had a medically stable pregnancy. Exposures Twelve phthalate metabolites and two bisphenols were measured in early and mid-pregnancy (&amp;lt;18 and 18-25 weeks) urine samples. Bisphenols were summed, and phthalate metabolites were grouped based by molecular weights and relevant parent compounds. Main Outcome Measures Logistic and linear regression models assessed chemicals groups’ associations with Gestational Diabetes Mellitus (GDM), glucose disturbance (including impaired glucose tolerance (IGT)), and blood glucose response to Glucose Challenge Test (GCT), adjusting for sociodemographic and pregnancy-related factors. Results 79 (6.8%) had GDM, 303 (26.1%) had IGT, and blood glucose response to GCT ranged from 22-386 mg/dL. Bisphenol A (BPA) was negatively associated with blood glucose response to GCT (-1.47 [-2.84, -0.10]), while diethylhexyl phthalate (DEHP; 2.67 [0.98, 4.36]) and high molecular weight phthalates (1.94, [0.17, 3.71]) were positively associated with blood glucose response to GCT. DEHP was also linked to glucose disturbance (1.16 [1.02, 1.31]). Conclusions Our findings suggest that phthalate exposure is associated with GDM. Further mechanistic studies are warranted, particularly given the inverse associations with BPA exposure.

Carotid plaque and osteoporosis commonly coexist in type 2 diabetes mellitus (T2DM), but whether their association differs by sex remains unclear. We examined sex-specific differences in bone measures and the adjusted association between carotid plaque and osteoporosis status in patients with T2DM. This retrospective cross-sectional study included 1,224 patients with T2DM (794 women and 430 men). Carotid plaque was assessed by ultrasound. Lumbar spine bone mineral density (BMD) and T-scores were measured by dual-energy X-ray absorptiometry (DXA), and osteoporosis status was categorized as normal bone mass, osteopenia, or osteoporosis. Clinical characteristics, bone measures, and osteoporosis prevalence were compared between patients with and without carotid plaque within each sex. Sex-stratified ordinal logistic regression models were used to evaluate the adjusted association between carotid plaque and osteoporosis categories with stepwise adjustment for BMI, diabetes duration, lipid parameters, and glycemic indices. In men, patients with carotid plaques showed a modestly higher lumbar spine BMD (P = 0.013); however, lumbar spine T-scores and osteoporosis prevalence were similar between plaque and non-plaque groups, and no adjusted association with osteoporosis category was observed across models. In women, lumbar spine BMD, T-scores, and osteoporosis prevalence were similar between plaque and non-plaque groups in unadjusted comparisons. However, in women, carotid plaques were independently associated with higher odds of worse osteoporosis category after adjustment (Model 1: odds ratio (OR) 1.40 [95% confidence interval (CI) 1.05-1.85]; Model 2: OR 1.45 [95% CI 1.09-1.92]; Model 3: OR 1.50 [95% CI 1.12-1.99]; all P < 0.05). Among patients with T2DM, carotid plaque was independently associated with worse osteoporosis category in women but not in men. These findings indicate sex-specific associations between carotid atherosclerosis and skeletal health; however, given the cross-sectional design and unavailable key confounders (e.g., lifestyle factors, central adiposity measures, medication patterns, and fracture outcomes), the results should be interpreted as associative and require confirmation in prospective studies.

BackgroundGenetic factors play an important role in metabolic disease susceptibility. Apolipoproteins E (APOE) and A1 (APOA1) are key regulators of lipid metabolism and have been individually associated with dyslipidemia and type 2 diabetes mellitus (T2DM).ObjectiveThis study aimed to examine the individual and combined associations of APOE (rs429358, rs7412) and APOA1 (rs5069) gene polymorphisms with obesity and T2DM.MethodsA case–control study was conducted including 350 participants categorized into four groups: controls (n = 100), euglycemic obese individuals (n = 100), obese individuals with T2DM (n = 100), and non-obese individuals with T2DM (n = 50). Biochemical parameters, including lipid profiles and glycemic indices, were assessed. Genotyping was performed using TaqMan® SNP genotyping assays.ResultsMetabolic disturbances and dyslipidemia were observed across all patient groups, with the most pronounced abnormalities in obese individuals with T2DM. The APOE ε4 allele and ε4/ε4 genotype were significantly associated with obese T2DM compared with controls and euglycemic obese subjects. The APOA1 rs5069 A allele and AA genotype were associated with both obesity and T2DM. Spearman correlation analysis revealed a positive co-occurrence of APOE and APOA1 genotypes in euglycemic obese (ρ = 0.264, p = 0.008) and obese T2DM (ρ = 0.347, p < 0.001) groups, but not in non-obese T2DM individuals. However, in multivariate logistic regression models adjusted for age, sex, and BMI, the APOE × APOA1 interaction term did not reach statistical significance (p = 0.138).ConclusionAPOE ε4 and APOA1 rs5069 A alleles were independently associated with obesity-related T2DM. Although these variants demonstrated correlated distribution patterns in obese individuals, the formal gene–gene interaction on T2DM risk was not statistically significant after multivariable adjustment. These findings suggest that obesity may represent a metabolic context in which combined genetic associations are more evident, warranting further investigation in larger and well-powered cohorts.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-025-03829-0.

Effects of melatonin supplementation on blood glycemic indices in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Background: Insulin resistance is a central biochemical abnormality in gestational diabetes mellitus (GDM) and is closely linked to chronic low-grade inflammation. Pro-inflammatory cytokines and adipokines, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and adiponectin (APN), play key roles in metabolic dysregulation during pregnancy. This study investigated the effects of nutritional intervention on insulin resistance–related inflammatory biomarkers and their gene polymorphisms in pregnant women with GDM. Methods: In this retrospective comparative cohort study, 400 pregnant women diagnosed with GDM at Hainan Women and Children’s Medical Center between October 2023 and December 2024 were enrolled and assigned to a conventional treatment group (CT, n = 200) or a nutritional intervention group (NC, n = 200). Both groups received standard glycemic management, while the NC group additionally underwent individualized nutritional intervention. Serum levels of TNF-α, IL-6, and APN were measured by enzyme-linked immunosorbent assay, and polymorphisms of the corresponding genes were analyzed using fluorescence quantitative PCR. Glycemic and lipid parameters were evaluated concurrently. Clinical efficacy and pregnancy outcomes were assessed as secondary endpoints. Results: The genotype distributions of TNF-α, IL-6, and APN showed no significant differences between the two groups (P &gt; 0.05). Baseline inflammatory, glycemic, and lipid indices were comparable between groups. After intervention, both groups demonstrated significant improvements in inflammatory markers, blood glucose, and lipid profiles compared with baseline (P &lt; 0.05). Notably, post-treatment levels of TNF-α and IL-6 were significantly lower, while APN levels were more favorably regulated in the NC group compared with the CT group (P &lt; 0.05). The NC group also exhibited superior metabolic control and a lower incidence of adverse pregnancy outcomes. Conclusion: Nutritional intervention significantly improves insulin resistance–associated inflammatory and metabolic profiles in pregnant women with GDM, independent of TNF-α, IL-6, and APN gene polymorphisms. These findings highlight the biochemical benefits of nutritional modulation in attenuating inflammation and improving metabolic homeostasis in GDM.

Background/Objective: The risk of bleeding is part of blood flow pathophysiology in diabetes mellitus (DM), and there may be potential for the relationship between blood cell indices and estimated whole blood viscosity (eWBV) in DM. However, red blood cell (RBC) indices, platelet ratios, and lymphocyte ratios have been part of routine haematology tests in clinical medicine including diabetes management. This study investigated two research questions. Firstly, how does eWBV correlate with RBC indices, platelet ratios, and lymphocyte ratios? Secondly, which parameters of RBC in routine full blood count (FBC) correlate more with glycated haemoglobin (HbA1c) changes? Methods: This was a laboratory-based clinical observational cohort study using secondary data from ongoing research. Data collected included FBC and biochemistry (HbA1c and serum protein level). Dependent variables were platelet and lymphocyte ratios as well as eWBV. Results: Averages for all parameters in the cross-sectional data were within normal range, except high HbA1c (7.67%) and marginally high monocyte-to-lymphocyte ratio. In the periodic cohort analysis, only RBC distribution width showed a significant difference (p < 0.04) between cohort groups, but least correlated with HbA1c changes. Further analysis for correlations among change scores showed that RBC had the strongest positive linearity for HbA1c (r = 0.30) and among the top three for eWBV (r = 0.54), while mean cell volume (MCV) has the strongest inverse for HbA1c (r = -0.47). Conclusions: The ongoing clinical use of RBC variables is superior to profiles of platelet and/or lymphocyte ratios in assessing the potential risk of bleeding (i.e., hypo-viscosity) in diabetes.