Metabolic Indices Research Articles

A Review of Lifestyle Interventions in Weight Loss Programs for Community-Based Psychiatric Patients

Abstract Background Psychiatric patients face aggravated physical health issues and reduced life expectancy, primarily due to premature cardiovascular diseases. The intricate relationship between lifestyle factors, illness, and psychotropic medications contributes to this phenomenon. The focus of this research is to evaluate weight management interventions for individuals with Severe Mental Disorders through a comprehensive scoping review, focusing on diverse study designs, outcomes, and their clinical implications. Methods 20 studies were analyzed to understand the effectiveness of interventions and characteristics, such as duration, delivery, and professional involvement. Assessment criteria included weight modifications, BMI changes, and metabolic measures like blood pressure and lipid profiles. Results The total number of participants included in the 20 studies evaluated was 3886. All trials included individuals of all genders. The studies included patients with a weighted mean age of 44.37 (SD = 4.72) and a mean BMI of 34.7 kg/m2 (SD = 3.56). Varied interventions, mostly conducted in the US, showed promising weight reduction and cardiovascular risk management results among psychiatric patients. However, disparate methods used in the studies hindered the evaluation of outcomes. The studies which yielded more interesting results included Gaughran F. et al, 2017 who showed improvements in HDL cholesterol and metabolic indicators, (HR 0.085; 95% CI:0.007-0.16), and Bartels S. et al, 2015 who reported that 51% of participants achieved clinically significant reduction in overall cardiovascular risk. Conclusions Although interventions displayed potential benefits for beneficiaries, the lack of standardized protocols and non-uniform endpoints poses challenges in effectively addressing weight-related concerns in psychiatric patients. Clear guidelines and standardized assessments are necessary to implement psychiatric patients’ weight management interventions. Key messages • The health issues and reduced life expectancy of psychiatric patients is a major health burden. The mean BMI of 34.7 kg/m2, indicating a prevalence of Obese individuals needs to be addressed. • Psychotropic medications are associated with increase in weight. More effort in increasing awareness and including mandatory nutritional educational classes when prescribing these drugs is needed.

Frailty and MECKI score in predicting mortality in advanced heart failure

Abstract Background Physical frailty (PF), characterized by decreased physiological reserves and increased vulnerability to stressors, has emerged as a significant predictor of adverse outcomes in heart failure (HF). The MECKI (Metabolic Exercise Cardiac Kidney Index) score, a composite index derived from cardiopulmonary exercise testing parameters and renal function, has shown promise in predicting outcomes in HF patients. Purpose The aim of the study is to evaluate the independent prognostic role of the MECKI score and PF on mortality in patients with advanced heart failure (AHF). Methods Ninety-one patients with AHF were enrolled, including 42 on the heart transplant waiting list, 10 undergoing evaluation for listing, and 49 removed from the list due to transplant contraindications or reaching age limits. All patients included in the study were on medically optimized therapy. MECKI score assessment was conducted upon enrollment, along with hematological and biochemical evaluations including creatinine, hemoglobin, Na+, and NT-pro-BNP levels. Patients also underwent echocardiography assessing ejection fraction (EF), TAPSE, Inferior Vena Cava (IVC) diameters, and PASP. Additionally, all patients performed the 6-minute walk test (6MWT) and cardiopulmonary exercise testing with assessment of VO2max and VE/VCO2. Frailty was assessed based on modified Fried criteria. Results The mean age was 56.5±11.2 years. Mean NYHA class was 2.7±0.6, EF was 28.8±7.6, TAPSE was 17.5±4.2, and NT-proBNP was 2912.2±3249.0. Mean VO2max was 12.0±3.5 ml/kg/min, and mean distance walked during 6MWT was 278.8±137.2 meters. Mean frailty score was 3.2±1.2 while mean MECKI score was 15.2±14,2. During a mean follow-up of 32.0±15.3 months, there were 21 deaths, 15 patients received heart transplants, and 1 patient underwent LVAD implantation. Stratified data for mortality showed statistically significant differences in deceased patients compared to survivors regarding NYHA class (3.2±0.3 vs 2.6±0.7; p<0.001), Frailty Index (4.4±0.7 vs 2.7±1.13; p<0.001), NT-proBNP (5425.0±2863.0 vs 1731.0±1618.0; p<0.001), VE/VCO2 (42.7±12.3 vs 35.0±9.1; p<0.003), and MECKI score (29.4±15.2 vs 11.2±11.2; p<0.001). Linear regression analysis demonstrated a significant positive correlation for Frailty Index and MECKI score with age, NYHA class, VE/VCO2, IVC, and NT-proBNP, while showing a negative correlation with TAPSE, VO2max, and 6-minute walk test. Cox regression analysis on mortality demonstrated the predictive role of Frailty (HR=2.121; 95%CI=1.017-4.421; p=0.045) and MECKI score (HR=1.043; 95%CI=1.009-1.079; p=0.014) independently from age, sex, NYHA class, NT-proBNP, EF, TAPSE, VO2max, 6MWT, and IVC diameter. ROC curves demonstrated an AUC of 0.896 for MECKI score and mortality, and 0.884 for Frailty Index and mortality. Conclusions The MECKI score and physical frailty are both valid independent predictors of mortality in patients with advanced heart failure.

Impact of a new coronavirus infection on the level of inflammatory, haemostasis markers and microcirculatory parameters of patients with arterial hypertension

Relevance. The COVID-19 pandemic and its consequences have significantly affected the health of the population as a whole. Persons who have undergone coronavirus infection against the background of chronic cardiovascular diseases and obesity deserve special attention. Aim. To study and compare the main indicators of carbohydrate and lipid metabolism the level of inflammatory and haemostasis markers, microvascular changes in obesity AH patients and in AH patients with normal body weight 1 month after a new coronavirus infection in moderate to severe form. Materials and methods. The study included 87 patients of both sexes, aged from 18 to 55 years, from which three groups were formed: the first group included people with AH and normal body weight (BMI<25 kg/m²) who had undergone COVID-19 within a month, the second group included people with AH and obesity (BMI≥30 kg/m²) who had undergone COVID-19 within a month, the control group consisted of 20 people with AH and obesity without COVID-19. The parameters of height, weight, waist circumference, and BMI were assessed in all subjects. The parameters of lipid profile, glucose level were determined, inflammatory markers and haemostasis parameters. All participants underwent laser Doppler flowmetry (LDF) on the forearm with constrictor and dilator functional tests, and single-photon emission computed tomography (SPECT) in combination with x-ray computed tomography (SPECT/CT). Results. Patients of groups 1 and 2 naturally differed from each other in anthropometric indicators. Lipid and carbohydrate metabolism rates were also significantly higher in group 2 patients compared to group 1 patients (p < 0.05). The CRP level in the group of people with hypertension and obesity who underwent COVID-19 was significantly higher than in people with hypertension without obesity (p < 0.001) and than in people with hypertension and obesity without a history of COVID-19. When comparing microcirculation parameters by LDF, there was a decrease in tissue hemoperfusion (M), blood flow reserve (RK) in all three groups (p < 0.001), the most pronounced dysfunction of neurogenic and myogenic blood flow regulation was detected in the group of people with hypertension andobesity who underwent COVID-19. Conclusion. The study of microcirculation indicators by LDF method in persons with hypertension and obesity after suffering a coronavirus infection indicates the predominance of the spastic type of microcirculation, which, together with an increase in the levels of inflammatory markers, indicates a higher risk of thrombosis and cardiovascular complications, requiring more careful monitoring and treatment of this group of patients.

The Effect of a Multidisciplinary Lifestyle Intervention Program on Apelin-12, Vaspin and Resistin Concentrations in Children and Adolescents with Overweight and Obesity

Background: Obesity in childhood and adolescence has reached epidemic proportions in recent decades. Methods: In the present study, we determined the concentrations of apelin-12, vaspin and resistin in 106 children and adolescents with overweight or obesity before and after the implementation of a multidisciplinary, personalized lifestyle intervention program of diet, sleep and exercise for 1 year. All subjects attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence. Results: Following the lifestyle intervention, there were significant decreases in BMI (p < 0.01), apelin-12 (p < 0.05) and resistin (p < 0.01) concentrations, and an increase in vaspin (p < 0.01) concentration. Glucose was the best positive predictor of apelin-12 (b = 0.236, p < 0.05), and osteopontin was the best negative predictor of changes in apelin-12 (b = −0.299, p < 0.05). Vaspin correlated positively with adiponectin (b = 0.29, p < 0.05), while vitamin D (b = 0.621, p < 0.05) was the best positive predictor of vaspin. BMI z score (b = −0.794, p < 0.05), HDL (b = −0.284, p < 0.05) and HbA1C (b = −0.262, p < 0.05) were the best negative predictors of changes in vaspin. BMI z score was the best positive predictor of resistin (b = 0.437, p < 0.05). Conclusions: These findings suggest that apelin-12, vaspin and resistin correlate with indices of obesity, glucose, lipids and bone metabolism, while interaction with other proteins, such as osteopontin and adiponectin, was also noted. Therefore, apelin-12, vaspin and resistin may be used as biomarkers in children and adolescents with overweight and obesity.

Accuracy enhancement of metabolic index-based blood glucose estimation with a screening process for low-quality data.

Many researchers have proposed various non-invasive glucose monitoring (NIGM) approaches using wearable or portable devices. However, due to the limited capacity of detectors for such compact devices and the movement of the body during measurement, the precision of the acquired data frequently diminishes, which can cause problems during actual use in daily life. In addition, intensive smoothing is often used in post-processing to mitigate the effects of erroneous values. However, this requires a considerable amount of data and results in a delay in the response to the actual blood glucose level (BGL). Instead of just applying data smoothing in the post-process of the data acquisition, we propose an active low-quality data screening method in the pre-process. In the proposal phase of the screening process, we employ an analytical approach to examine and formulate factors that might affect the BGL estimation accuracy. A signal quality index inspired by the standard deviation concept is introduced to detect visually apparent noise on signals. Furthermore, the total estimation error in the metabolic index (MI) is calculated based on potential perturbations defined by the signal-to-noise ratio (SNR) and the uncertainty due to discrete sampling. Thereafter, the acquired data were screened by these quality indices. By applying the proposed data screening process to the data obtained from a commercially available smartwatch device in the pre-process, the estimation accuracy of the MI-based BGL was improved significantly. Adopting the proposed screen process improves BGL estimation accuracy in the smartwatch-based prototype. Applying the proposed screen process will facilitate the integration of wearable and continuous BGL monitoring into size- and SNR-limited devices such as smartwatches and smart rings.

Effect of ultrahigh frequency ozone therapy on oxidative metabolism in the blood of rats with ischemic skin flaps: A preclinical experimental randomized study

Background. Maintaining and restoring skin microcirculation in surgical flaps, as well as accelerating rehabilitation after skin flap transplantation, in order to mitigate the consequences of burns and injuries, remain a pressing issue. In addition to various timings and techniques for plastic surgery, physiotherapeutic approaches prove to be efficient and include low-intensity electromagnetic radiation in millimeter waves as their prominent techniques. In recent years, experts have paid an increasing attention to the application of low-intensity electromagnetic radiation across different frequency ranges for the enhancement of microcirculation in patients after surgical correction of burn consequences. However, this approach is yet to be further validated. Objective. To investigate the effect of different combinations of ultrahigh frequency electromagnetic radiation with ozone therapy on the oxidative metabolism of blood in rats using a model of ischemic skin flaps. Methods. A preclinical experimental randomized study was conducted on 100 adult male Wistar rats weighing between 200 and 250 grams. Five equal-sized groups of animals were formed in the study: Group 1: intact (no interventions), and Groups 2, 3, 4, and 5: after surgical intervention (modeling of ischemic skin flaps). Animals in Group 2 (control group) received no therapeutic procedures. Rats in Groups 3 and 5 underwent a 10-minute course of electromagnetic radiation exposure with a dose of 0.06 mJ for seven days. Animals in Group 3 were exposed to electromagnetic radiation of ultrahigh frequency with a range of 53–78 GHz. Animals in Group 4 received injections of ozonized saline solution (with a saturating ozone concentration in the ozonized oxygen mixture of 3000 µg/L) daily for 7 days, administered intraperitoneally at a volume of 1 mL. Group 5 underwent a combined treatment: daily exposure to ultrahigh frequency electromagnetic radiation along with intraperitoneal ozone therapy (the application modalities of these treatments were similar to those used in Groups 3 and 4, respectively). The intensity of lipid peroxidation, peroxide resistance in erythrocytes, and overall antioxidant system activity were assessed in order to investigate the balance of pro- and antioxidant systems in plasma and erythrocytes. Additionally, the study involved determination of the level of malondialdehyde content and evaluation of the activity of superoxide dismutase and catalase in erythrocytes. The obtained date were analyzed, using MS Office 2013 (Microsoft Corporation, USA) and Statistica 10 (StatSoft, USA). Results. The conducted analysis revealed an antioxidant effect from ultrahigh frequency electromagnetic radiation, with this effect being enhanced by ozone therapy. In addition, the study detected the inhibition of free radical oxidation under the ultrahigh frequency electromagnetic radiation and ozone therapy. Conclusion. Thus, the positive effects of the studied therapeutic factors manifest at the systemic level, as evidenced by the optimization of biochemical parameters and indicators of oxidative metabolism in the plasma of animal blood. It has been established that ultrahigh frequency electromagnetic radiation, administered in a noise mode, exerts a regulatory effect on pro- and antioxidant systems in the body, as demonstrated in a model of transplanted skin flap. This intervention leads to a reduction in the severity of oxidative stress and an enhancement of antioxidant reserves in the blood. The observed effect is further amplified with the additional application of ozone therapy.

Bidirectional causal relationship between glucose-lipid metabolism, obesity indicators, and myocardial infarction: a bidirectional Mendelian randomization analysis study

Objective: To explore the causal association of glucose-lipid metabolism and obesity indicators with myocardial infarction by a two-sample Mendelian randomization analysis. Methods: Single nucleotide polymorphisms (SNPs) related to phenotypes were obtained from genome-wide association study databases. The body mass index (BMI) and glycated hemoglobin dataset includes 99 998 samples and 8 126 035 SNPs; the waist-to-hip ratio dataset includes 224 459 samples and 2 562 516 SNPs; the waist circumference and hip circumference dataset includes 462 166 samples and 9 851 867 SNPs; the fasting glucose dataset includes approximately 12 million SNPs; the low-density lipoprotein cholesterol (LDL-C) dataset includes 201 678 samples and 12 321 875 SNPs; the high-density lipoprotein cholesterol (HDL-C), and triglycerides dataset includes 156 109 samples and 15 784 414 SNPs; and the body fat percentage, whole-body fat mass, trunk fat percentage, and trunk fat mass dataset includes 454 588 samples and 9 851 867 SNPs. This study primarily used inverse-variance weighted method to analyze the associations between various exposure factors and outcomes. Heterogeneity among SNPs was assessed using Cochran's Q test, and horizontal pleiotropy of SNPs was examined using the MR-Egger method. Additionally, a multivariable MR approach was used to adjust for BMI, further validating associations between exposure factors and the risk of myocardial infarction. Results: Higher BMI (OR=1.070, 95%CI: 1.041-1.100), waist-to-hip ratio (OR=1.366, 95%CI: 1.113-1.677), LDL-C (OR=1.638, 95%CI: 1.488-1.803), triglycerides (OR=1.445, 95%CI: 1.300-1.606), waist circumference (OR=1.841, 95%CI: 1.650-2.055), hip circumference (OR=1.247, 95%CI: 1.132-1.372), body fat percentage (OR=1.795, 95%CI: 1.568-2.055), whole-body fat mass (OR=1.519, 95%CI: 1.381-1.670), trunk fat percentage (OR=1.538, 95%CI: 1.374-1.723), and trunk fat mass (OR=1.421, 95%CI: 1.294-1.561), as well as lower HDL-C (OR=0.799, 95%CI: 0.729-0.875), have causal effects on myocardial infarction (all P<0.05). After adjusting for BMI, hip circumference, trunk fat percentage, and trunk fat mass were no longer associated with myocardial infarction. However, waist-to-hip ratio (OR=1.457, 95%CI: 1.132-1.877), fasting glucose (OR=1.191, 95%CI: 1.024-1.383), glycated hemoglobin (OR=1.129, 95%CI: 1.034-1.233), LDL-C (OR=1.592, 95%CI: 1.314-1.929), triglycerides (OR=1.410, 95%CI: 1.279-1.553), waist circumference (OR=1.922, 95%CI: 1.448-2.551), body fat percentage (OR=1.421, 95%CI: 1.072-1.884), and whole-body fat mass (OR=1.295, 95%CI: 1.031-1.626) remained positively associated with myocardial infarction, while HDL-C (OR=0.809, 95%CI: 0.729-0.897) remained negatively associated. Conclusions: Abdominal obesity and dysregulation of glucose-lipid metabolism are risk factors for myocardial infarction. Screening for glucose-lipid metabolism (fasting glucose, HDL-C, LDL-C, triglycerides) and obesity-related indicators (waist circumference, waist-to-hip ratio, body fat percentage, and whole-body fat mass) is of great importance for the primary prevention of myocardial infarction.

Mesona chinensis Benth. Extract Ameliorates Hyperlipidemia in High-Fat Diet-Fed Mice and Rats by Regulating the Gut Microbiota

Mesona chinensis Benth. (or Platostoma palustre (Blume) A. J. Paton), an edible and medicinal plant, is the main ingredient in black jelly, Hsian-tsao tea, and beverages, and its processed products are popular in China as well as in Southeast Asian countries. Previous studies have shown that the alcohol extract of Mesona chinensis Benth. (MC) can reduce the accumulation of oleic acid and ameliorate hyperlipidemia. However, researchers have not yet determined whether it could improve intestinal permeability and metabolic dysfunction by controlling gut microbial dysbiosis and thus reducing hyperlipidemia. This study aimed to explore the potential mechanism by which MC regulates metabolic function disorders in hyperlipidemic high-fat diet (HFD)-fed rats and mice from the perspective of gut microbiota. This study analyzed the effects of MC on metabolic indices related to hyperlipidemia in HFD-fed rats and the abundance and diversity of the gut microbiota via 16S rRNA V3–4 region pyrosequencing to investigate the regulation of the gut microbiota by MC. We further confirmed that MC ameliorates hyperlipidemia by regulating the gut microbiota by simultaneously administering antibiotics and MC to C57BL/6 mice and measuring their metabolic indices. These results indicate that MC reduces the lipid concentration in the serum of HFD-fed rats, thereby significantly alleviating hyperlipidemia, and regulates the abundance ratio and diversity of the gut microbiota, thereby exerting a beneficial effect on hyperlipidemia. Our further antibiotic experiments in mice revealed that the administration of MC was unable to reduce body weight or serum and organ lipid concentrations in the antibiotic-treated group of hyperlipidemic mice. This study provides evidence that the microbiota is an alternative target for the antihyperlipidemic effect of MC.

Effects of Formaldehyde-Treated Feed on Rumen Metabolism and Blood Biochemistry in Lambs: A Review

This review evaluates the impact of formaldehyde treatment on feed for lambs, focusing on its effects on rumen metabolism and blood biochemical indicators. Formaldehyde is commonly used as a feed additive to improve nutritional efficiency and preserve feed quality. This review synthesizes data from various studies to assess how formaldehyde-treated feed influences rumen fermentation parameters, including volatile fatty acid (VFA) production, rumen pH, and microbial activity. Additionally, the review examines the effects of formaldehyde treatment on key blood biochemical markers such as glucose, urea nitrogen, and liver enzymes. Studies indicate that formaldehyde treatment can enhance the stability and digestibility of feed, potentially improving nutrient utilization and overall animal performance. The preservation of protein and reduction in feed spoilage are highlighted as significant benefits, contributing to more consistent rumen function and metabolic efficiency. However, the impact on rumen microbial populations and VFA profiles shows mixed results, with some studies reporting improved microbial efficiency and others noting minimal changes. The review also discusses potential adverse effects, including alterations in blood biochemical parameters. While formaldehyde treatment generally maintains or improves key indicators like blood glucose and protein levels, excessive use may lead to concerns such as elevated urea nitrogen levels and potential liver enzyme disruptions, the review concludes that formaldehyde-treated feed can be a valuable tool in optimizing feed efficiency and lamb health, provided it is used judiciously. Future research is recommended to further elucidate the long-term effects on rumen microbiota and metabolic processes, ensuring balanced benefits without compromising animal welfare.

Expression of PGC-1α, PPAR-α and UCP1 genes, metabolic and anthropometric factors in response to sodium butyrate supplementation in patients with obesity: a triple-blind, randomized placebo-controlled clinical trial.

There is increasing evidence that gut metabolites have a role in the etiology of obesity. This study aimed to investigate the effects of sodium butyrate (NaB) supplementation on the expression of peroxisome proliferator-activated receptor (PPAR) gamma coactivator-1α (PGC-1α), PPAR-α, and uncoupling protein-1 (UCP-1) genes, as well as on the metabolic parameters and anthropometric indices in persons with obesity. In this triple-blind placebo-controlled randomized clinical trial, 50 individuals with obesity were randomly assigned to NaB (600 mg/day) + hypo-caloric diet or placebo group + hypo-caloric diet for 8 weeks. The study measured the participants' anthropometric characteristics, food consumption, and feelings of hunger in addition to the serum levels of metabolic indices and the mRNA expression of the PGC-1α, PPAR-α, and UCP-1 genes in peripheral blood mononuclear cells (PBMCs). PGC-1α and UCP-1 genes expression significantly increased in NaB group compared to the placebo at the endpoint. A significant decrease in weight, BMI, and waist circumference (WC) was observed in NaB group. Among the metabolic factors, NaB significantly decreased fasting blood sugar (FBS) (P = 0.04), low-density lipoprotein cholesterol (LDL-C) (P = 0.038) and increased high-density lipoprotein cholesterol (HDL-C) (P = 0.016). NaB could not significantly change serum GLP-1 level. This study unveiled NaB supplementation alone cannot have significant beneficial effects on anthropometric, and biochemical factors. NaB could affect anthropometric and metabolic risk variables associated with obesity only when prescribed, along with calorie restriction. This study was registered in the Iranian Registry of Clinical Trials ( https://en.irct.ir/trial/53968 ) on 31 January 2021 (registry number IRCT20190303042905N2).

Indices of carbohydrate metabolism and antioxidant system state during germination of aged wheat and triticale seeds treated with H(2)S donor

Hydrogen sulfide is a gasotransmitter molecule involved in the realization of many functions of the plant organism, including seed germination. Aging of seeds is shown to be accompanied by oxidative stress and reduced germination. The effect of exogenous hydrogen sulfide on the germination of aged cereal seeds has not been studied. The aim of the work was to estimate the effect of priming with NaHS as an H2S donor on wheat and triticale seeds previously subjected to natural aging. Seeds of winter wheat (Triticum aestivum) and winter ×Triticosecale were stored indoors for 4 years at fluctuating temperature and humidity. Aged seeds were treated with 0.2-5 mM NaHS solution for 3 h and germinated in Petri dishes for 3 days. The hydropriming­ treatment was used as a control. Amylase activity in grains, the biomass of shoots and roots, the content of total sugars, H2O2, lipid peroxidation products and anthocyanin, and the activity of antioxidant enzymes in seedlings were determined. It was shown that after the treatment with H2S donor, the activities of catalase and guaiacol peroxidase, as well as the content of anthocyanins were increased only in triticale seedlings. Nevertheless, treatment of seeds of both cereal species was followed by enhanced growth of shoots and roots, increase in amylase and superoxide dismutase activities, decrease in H2O2 and MDA contents, and elevated accumulation of sugars in shoots. It is concluded that the increase in germination of aged cereal seeds under the influence of H2S donor is caused by increased mobilization of reserve carbohydrates and modulation of antioxidant system activity. Such treatment can be considered as an effective tool to improve seedling growth. Keywords: amylase, antioxidant system, hydrogen sulfide, oxidative stress, seeds aging, total sugar, Triticosecale, Triticum aestivum

Integration of metabolomics and transcriptomics reveals the toxicological mechanism of deltamethrin exposure in Chinese mitten crab Eriocheir sinensis

This study investigated the toxicological mechanism of deltamethrin on Chinese mitten crab Eriocheir sinensis juveniles in fresh water. We first conducted an acute toxicity test, followed by laboratory methods to detect changes in immune-related indices in terms of antioxidant enzyme markers, lipid metabolism-related genes, and autophagy-related and apoptosis genes. The acute toxicity (96-h LC50) of deltamethrin to E. sinensis was 7.195 μg/L. After 48 h of exposure, serum showed elevated immune-related indices (P < 0.05) for alkaline phosphatase (AKP), acid phosphatase (ACP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), complement components C3 and C4, and the key pro-inflammatory cytokines interleukin-6, interleukin-1β, and tumor necrosis factor alpha (TNF-α). In hepatopancreas at 48 h, indicators related to the antioxidant system, namely superoxide dismutase (SOD) and glutathione (GSH), were significantly elevated, whereas nitric oxide and total antioxidant capacity (T-AOC) were decreased (P < 0.05). In contrast, lipid metabolism indices for triglyceride (TG), total cholesterol (TC), and malondialdehyde (MDA) were increased (P < 0.05). Transcriptomics and metabolomics revealed that exposure to deltamethrin disrupted the lipid metabolic process in the hepatopancreas mainly by altering fatty acid synthesis, amino acid metabolism, immune signaling, and autophagy activation, while the exposure increased the content of phospholipids and cholesterol but decreased the levels of amino acids and palmitoleic acid. Quantitative genetics revealed significantly aberrantly expressed (P < 0.05) lipid metabolism-related genes, including acc1, fasn, scd1, and pnpla2, all key genes involved in lipid accumulation. Deltamethrin exposure also significantly altered (P < 0.05) gene expression levels for Toll-like receptor (tlr), myeloid differentiation factor 88 (myd88), crustin1, anti-lipopolysaccharide factor isoform 3 (alf3), tumor necrosis factor alpha (tnf-α), and NF-κB transcription factor relish. Furthermore, deltamethrin activated the toll-like receptor/major myeloid differentiation response gene 88/nuclear factor kappa-light-chain-enhancer of activated B cells (TLR/MyD88/NF-kB) signaling pathway, which activates a nonspecific immune response in E. sinensis. Additionally, carnitine palmitoyltransferase 1 A (cpt1a), cytochrome c (cyt-c), adenosine 5′-monophosphate (amp)-activated protein kinase (ampk), the autophagosomal protein microtubule-associated protein 1 light chain 3c (lc3c), and the autophagy-related proteins beclin1, atg5, atg12 were significantly induced (P < 0.05) in the adenosine monophosphate-activated protein kinase/rapamycin (AMPK/mTOR) signaling pathway. These changes resulted in excess free radicals, causing oxidative stress in the mitochondrial membrane, promoting mitochondrial autophagy. The results confirm that deltamethrin exposure can induce hepatopancreatic injury by promoting mitochondrial autophagy, activating an immune response, and inhibiting lipid metabolism. Overall, this study provides multi-level information to reveal the toxic effects of deltamethrin on E. sinensis.

Nonlinear association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and risk of gestational diabetes mellitus

Previous studies have indicated a potential association between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and the risk of Type 2 Diabetes Mellitus, but its relation with gestational diabetes mellitus (GDM) remains uncertain. This study aims to investigate the correlation between the ALT/HDL-C ratio in early pregnancy and the risk of GDM. This study is a secondary analysis based on an open-source cohort study. A total of 590 single pregnant women attending two hospitals in Korea up to 14 weeks gestation were included between November 2014 and July 2016. Logistic regression analysis, subgroup analysis, and smooth curve fitting were employed to explore the association between the ALT/HDL-C ratio and GDM risk. The predictive capability of the ALT/HDL-C ratio for GDM was assessed using ROC curve analysis. The average age of participants was 32.06 ± 3.80 years, with a GDM incidence rate of 6.27%. Multifactorial logistic regression analysis revealed that the serum ALT/HDL-C ratio is an independent influencing factor for GDM (OR = 1.08, 95% CI: 1.02–1.16). Furthermore, a non-linear relationship between the ALT/HDL-C ratio and GDM risk was observed, with a turning point at 5.51. The effect size (OR) on the left and right sides of the turning point were 0.75 (95% CI: 0.37–1.59) and 1.55 (95% CI: 1.18-2.00), respectively. Additionally, when combined with age, pre-pregnancy body mass index, parity, and insulin resistance index in a prediction model for GDM, the ALT/HDL-C ratio demonstrated improved sensitivity of prediction by reaching up to 67.6%, specificity of prediction by reaching up to 87.3%, and an area under curve value of 0.819 (95%CI: 0.743–0.894). In early pregnancy, the serum ALT/HDL-C ratio shows a positive correlation with maternal risk in a nonlinear manner. The combination of ALT/HDL-C ratio with maternal characteristics and metabolic indicators provides good predictive value for GDM. This study may facilitate optimization of GDM prevention in pregnant women and enable timely and effective intervention to enhance their prognosis.

Association between olfactory function and metabolic syndrome in bipolar disorder patients: a cross-sectional study

BackgroundOlfactory function is closely related to mood and the endocrine system. However, the role of olfactory function in bipolar disorder combined with metabolic syndrome remains unclear. The purpose of this study was to explore the associations among olfactory function, tumor necrosis factor alpha (TNF-α), and metabolic syndrome and its components in patients with bipolar disorder.MethodsNinety-six bipolar disorder patients were divided into two groups with and without metabolic syndrome. We also included 46 healthy controls. Olfactory function was assessed using the Sniffin’ Sticks test. Blood samples were collected to measure metabolic indicators and serum TNF-α levels.ResultsSignificant differences in olfactory function were found among the three groups. Compared with the healthy controls, the bipolar disorder without metabolic syndrome group showed poorer olfactory identification ability (P < 0.001) and the bipolar disorder with metabolic syndrome group showed impaired olfactory sensitivity (P = 0.003) and olfactory identification (P < 0.001). Moreover, the bipolar disorder with metabolic syndrome group had poorer olfactory identification ability than the bipolar disorder without metabolic syndrome group (P = 0.015). Both bipolar disorder groups showed lower TNF-α levels than healthy controls. However, there was no significant difference between the two patient groups. Correlation analysis showed that, in the bipolar disorder with metabolic syndrome group, olfactory identification was negatively correlated with systolic blood pressure (r = − 0.424, P = 0.031), and serum TNF-α level was negatively correlated with body mass index (BMI; r = − 0.398, P = 0.049), triglyceride (r = − 0.503, P = 0.010), total cholesterol (r = − 0.491, P = 0.013), low-density lipoprotein-cholesterol (r = − 0.491, P = 0.013), and high-density lipoprotein-cholesterol (r = − 0.454, P = 0.023).ConclusionsThe olfactory identification ability of patients with bipolar disorder is worse than that of healthy controls, and the occurrence of metabolic syndrome will further aggravate the olfactory identification impairment of those patients. Furthermore, there may be a stronger link between serum TNF-α level and multiple metabolic indicators in bipolar disorder patients with metabolic syndrome than in bipolar disorder patients without metabolic syndrome.

Assessment of metabolic indicators of the cardiovascular system in children with nephrotic syndrome

Objective: to evaluate the metabolic parameters of the cardiovascular system in nephrotic syndrome in children Material and methods: 110 children hospitalized with nephrotic syndrome in the nephrology department of the Samarkand Regional Children’s Multidisciplinary Medical Center were examined. Results: Renocardial syndrome with nephrotic syndrome develops in 64.8% of cases, the majority of patients are children 3-6 years of age (44.1%), with a predominance of boys (58.8%). In a cardiometric study in patients with nephrotic syndrome, renocardial syndrome is manifested by significant changes in metabolic and adaptation parameters: oxygen and lactate content - by 1.5 times, creatine phosphate - by 20%, tension index - by 4.8 times and vascular stiffness index - by 5.2 times. Conclusion: Deviation of cardiometry indicators in different age groups indicates a decrease in the intensity of blood circulation in organs and systems, indicating a significant load on the cardiovascular system in nephrotic syndrome.

Heterogeneity of metabolic phenotypes in adolescent boys with obesity due to excess calories

The aim of the study was to determine the heterogeneity of metabolic parameters in teenage boys diagnosed with “obesity due to excess calories” using cluster analysis. Materials and methods. One hundred and twenty-three randomly selected patients aged 14 to 17 years diagnosed with “obesity due to excess calories” were examined. The statistical analysis included descriptive and analytical methods, in particular aimed to identify clusters of biochemical indicators, including serum fasting glucose level, insulin level, total cholesterol level, low density lipoproteins (LDLP), very low-density lipoproteins (VLDL), high density lipoproteins (HDLP) and triglycerides. Results. Two clusters of observations have been identified. The first cluster consisted of 72 patients (58.5%) having fasting glucose levels slightly below average, insulin levels above average, total cholesterol, triglycerides, LDLP and VLDL above average, and HDLP levels below average (“metabolically unhealthy” obesity). The second cluster included 51 teenagers (41.5%) who presented with opposite trends in metabolic characteristics (“metabolically healthy” obesity). The adolescents from the first cluster were slightly older, had higher body mass, body mass index (BMI) and z-BMI scores, and higher HOMA-IR scores. Arterial hypertension and non-alcoholic fatty liver disease were diagnosed statistically significantly more frequently in adolescents from this cluster. Conclusion. Teenage boys with obesity are a heterogeneous group in terms of the values of major metabolic indicators.

Integrating aging biomarkers and immune function to predict kidney health: insights from the future of families and child wellbeing study.

Biomarkers of biological aging predict health outcomes more accurately than chronological age. This study examines the relationship between aging biomarkers, immune function, and kidney health using the Future of Families and Child Wellbeing Study Biomarker Dataset. Using Wave 5 (year 9) and Wave 6 (year 15), we examined biomarker data from a total of 4898 individuals. The panel of aging biomarkers, comprised of epigenetic clocks (GrimAge, Horvath), immune function markers (CD8 + T cells, plasmablasts), and metabolic indicators (GDF-15, leptin), was evaluated in depth. We used principal component analysis (PCA) and K-means clustering for subtype identification. A random forest regressor was employed to predict kidney function using Cystatin C levels, and the importance of features was assessed. Three clusters with unique biological age and immune function profiles were identified. Cluster 1 had younger biological age markers. In Cluster 2, both GrimAge and GDF-15 levels were significantly increased, indicating an elevated risk for age-related diseases. According to predictive modeling, GrimAge, Pack Years, and immune function markers had the strongest influence on Cystatin C levels (R2 = 0.856). The incorporation of immune aging markers enhanced the predictive power, emphasizing the importance of immunosenescence in renal health. Aging biomarkers and immune function significantly impact kidney health prediction. The study results call for the utilization of extensive biomarker tests for individualized elderly care and early recognition of kidney deterioration. Clinical practice can be improved by incorporating biological age assessments for the prevention and management of age-related diseases.

Anticonvulsants impacting bone metabolism: interim results from a cross-sectional study

Background. Despite a wide range of antiepileptic drugs (AEDs) with an improved pharmacological profile, patients often experience a variety of side effects during long-trem anticonvulsant therapy, among which are osteoporotic disorders. Currently, the mechanisms of AED effect on bone metabolism remain poorly understood, which creates certain difficulties in prevention and treatment of AED-induced osteoporosis.Objective: to study bone mineral density and laboratory parameters of bone metabolism in patients with epilepsy and longterm AED administration.Material and methods. A cross-sectional study included two comparison groups: 100 adult patients with epilepsy receiving AEDs for more than 12 months and 58 healthy volunteers without taking AEDs. All participants underwent general clinical examination, computed tomography (CT) densitometry at three time points (L1, L2 and femoral neck) and laboratory tests of mineral metabolism.Results. According to CT-densitometry results, a decrease in bone mineral density was detected in the majority of participants from both study groups. While assessing an impact of osteoporosis risk factors on bone tissue in epileptic patients, low motor activity and duration of AED therapy were the most significant, which was associated with lower bone mineral density indices. The study of laboratory mineral metabolism indicators revealed significant inter-group differences in indicators such as ionized calcium, 25-hydroxy-calciferol, free thyroxine and prolactin (p(U)=0.044, p(U)=0.040, p(U)=0.001, p(U)=0.003, respectively).Conclusion. The intermediate study results showed that long-term anticonvulsant use negatively affected bone metabolism in patients suffering from epilepsy. The data obtained point at need for further in-depth study of AED therapy effect on mineral metabolism.

Obesity in childhood - literature review and educational recommendations

Introduction and purpose Childhood obesity is a major global health concern. The World Health Organization reports that the prevalence of obesity in children and adolescents has increased significantly from 4% in 1975 to over 18% in 2016. The aim of the study is to conduct a comprehensive review of the literature on obesity among children and adolescents, emphasizes the importance of prevention, identification and effective management of childhood obesity. Materials and methods An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “childhood obesity”, “pediatric overweight”, “physical activity”, “activity and health”, “diet and obesity", "bariatric surgery" and "obesity medication". State of knowledge Treating childhood obesity requires following a personalized weight loss program, as well as adopting healthy eating habits and lifestyle practices. Improvements in metabolic and anthropometric indices can be achieved through complex interventions including dietary modification and physical activity, behavioral therapy, health promotion education, pharmacological treatment and bariatric surgery A step-by-step approach to managing weight is recommended, considering the child's age, the severity of obesity, and any accompanying health conditions. Dietary interventions focus on promoting a balanced, nutrient-rich diet that is calorie-appropriate for the child's age and gender. Summary Further research is still necessary to develop additional pharmaceutical options, refine surgical techniques, and better understand long-term outcomes in this patient population.To effectively prevent this disease, a comprehensive approach is necessary, considering both education and changes in the social environment.

Seasonal dynamics of indicators of mineral metabolism in horses in the conditions of the Leningrad region

The article analyzes the seasonal dynamics of mineral metabolism indicators in adult horses kept in private stables in the Leningrad region. As a result of the research, knowledge of the concentration and dependence of indicators on the seasonality of the year was obtained. It is important to remember that macro- and microelements are not synthesized in the body, they come from food, water, and air. The degree of their assimilation depends on the state of the respiratory and digestive organs. The most difficult period for animals is winter, when there is a decrease in the resistance of the body as a whole due to poor climatic conditions and minimizing physical activity in the fresh air. All these are predisposing factors for the imbalance of indicators at the level of the whole organism.It is established that in the autumn-winter period there is a decrease in indicators relative to the average annual digital values. Thus, there is a linear relationship between the concentration of calcium and phosphorus in blood serum – the minimum values are observed in winter and are 2.53±0.27 mmol/l and 1.76± 0.11 mmol/l, respectively. And the maximum values are typical for the autumn period and are 3.63±0.29 mmol/l for calcium and 2.33±0.12 mmol/l for phosphorus. Similar dynamics is observed in other indicators of the body's mineral metabolism. Thus, for trace elements such as copper, iron, protein-bound iodine, the minimum values were noted in the spring period. This can be explained by a decrease in the mineral components of the feed itself, as a result of long-term storage, resulting in changes in the chemical composition of vegetable feed with fat oxidation. Microelementoses and osteodystrophic processes are observed in animals. The autumn period is characterized by the highest concentrations of minerals in the blood serum of horses, on average by 8-12% compared with the average annual figures, This is explained by the fact that it was in the summer period that the greatest benefit was obtained from juicy plant substances of feed and proper exercise.This knowledge is necessary to understand the processes occurring in the body of horses at different times of the year and the possibility of correcting mineral supplements based on the data obtained