Management Of Metabolic Diseases Research Articles

Effects of hydroethanolic garlic extract on oxidative stress, lipolysis, and glycogenesis in high-fat diet-fed Drosophila melanogaster

Introduction: Metabolic syndrome is multifaceted health condition associated with metabolism, which leads to the accumulation of oxidation products and impairment of the antioxidant system. Medicinal, edible plant alternatives are being sought to prevent the predisposing factors of metabolic syndrome, one of which is obesity. We studied the effects of hydroethanolic garlic extract (HGE) on oxidative stress, lipolysis, and glycogenesis in high-fat diet-fed Drosophila melanogaster. Methods: The HGE was processed and antioxidant assays (in vitro and in vivo) coupled with metabolic biomarkers were assayed following standard procedures. Results: HGE inhibited ABTS (2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), hydroxyl, and hydrogen peroxide radicals in high-fat-fed D. melanogaster. The HGE also reduced the activity of superoxide dismutase and increased catalase activity significantly. The HGE promoted lipolysis and glycogenesis by reducing cholesterol, triglycerides, and total sugar concentrations while glycogen content was increased. Conclusion: Our results revealed that HGE improved the antioxidant defense system and promoted lipolysis and glycogenesis in metabolic deranged D. melanogaster. This suggests the therapeutic usefulness of garlic in the management of metabolic diseases.

Methanolic Extract of Ricinus Communis ameliorated cardiovascular dysfunction in dichlorvos-exposed rats

 Cardiovascular diseases are the leading causes of death globally resulting in 17-19 million death every year. The search for an effective medicine to manage cardiovascular disorder without any side effect has led to the use of traditional based medicine. 75% of the world’s population has been reported to depend on traditional medicine as their basic form of health care and this has resulted to the use of herbal medicine in the treatment and management of metabolic diseases. The study evaluated the effect of methanolic extract of Ricinus communis on DDVP-induced cardiotoxicity in male Wistar rats. Thirty-two (32) male Wistar rats were randomly divided into four groups of eight (8) rats each. Group A served as control rats, received 10mL/Kg of dimethyl sulfoxide (DMSO) and distilled water solution (vehicle) for six weeks. Group B served as DDVP-induced rats and were exposed to DDVP (15 minutes daily) for 3 weeks without any treatment. Group C rats received DDVP as in group B and then administered 300mg/kg of R. communis extract for 42days. While Group D rats were administered 300mg/kg of R. communis extract daily, for 6 weeks in addition to normal feed and water. Exposure to DDVP caused significant cardiac dysfunction evidence by alteration in cardiovascular variables and electrocardiac function, compromised lipid profile and reduced antioxidant enzymes. However, treatment with methanolic extract of Ricinus communis improved antioxidant defense system, attenuate hemodynamic impairment and left ventricular dysfunction, as well as inhibit lipid peroxidation and prevent hyperlipidemia in rats. In addition, histopathology observation showed that Ricinus communis extract was able to regenerate the myocardial injury caused by exposure to dichlorvos. In conclusion, Ricinus communis exhibited cardioprotective properties and may be a potential remedy for cardiovascular diseases with low risk of toxicity

Long-Term Management of Patients with Mild Urea Cycle Disorders Identified through the Newborn Screening: An Expert Opinion for Clinical Practice.

Urea cycle disorders (UCDs) are a group of rare inborn errors of metabolism caused by a deficiency in one of the six enzymes or one of the two transporters involved in the urea cycle. Current guidelines suggest that early diagnosis and treatment of mild UCDs may improve survival and prevent decompensation and neurocognitive impairment. Nevertheless, clinical studies are very difficult to carry out in this setting due to the rarity of the diseases, and high-level evidence is scant and insufficient to draw conclusions and provide clinical guidelines. With the early introduction of newborn screening, the Italian healthcare organization fostered an advancement in expertise in metabolic disease management and screening programs, by allocating resources, and favoring the expansion of newborn screening. A group of experts operating in Italian centers decided to share their experience and provide advice for the management of mild UCDs in clinical practice. A consensus was reached by the Estimate-Talk-Estimate (ETE) method. Five items were identified, and statements for each item were agreed. Briefly, the panel advised completing the diagnosis by expanded newborn screening (ENS) with biochemical and genetic confirmation and by following up with the patient during the first year of life, with a routine laboratory and metabolic profile as well as with clinical observation. Early initiation of therapy is advised and should be followed by therapy adjustment once the diagnostic profile is completed. The therapy should be based on a low-protein diet and nitrogen scavengers. The long-term follow-up is based on growth and nutritional assessment, clinical and neurocognitive evaluation, and laboratory and instrumental parameter monitoring.

SAT447 Gaps In Care: Endocrine-disrupting Chemicals And Metabolic Disease Management Guidelines

Abstract Disclosure: M. Obeid: None. A. Majid: None. R.M. Sargis: None. In recent decades, global rates of obesity, diabetes, and non-alcoholic fatty liver disease have increased substantially, imposing significant morbidity and mortality on patients and severe economic strain on healthcare systems. Discussions of modifiable risk factors responsible for metabolic dysfunction have classically centered upon the role of excess energy intake and insufficient energy expenditure. Consequently, clinical practice guidelines have largely focused upon these factors when addressing disease risk and treatment. In recent years, however, new metabolic risk factors have emerged, including exposure to endocrine-disrupting chemicals (EDCs). Because exposure to EDCs is potentially modifiable through individual action and/or public policy, we sought to understand how practice guidelines for metabolic disorders have incorporated this new knowledge into clinical care. To accomplish this, we searched PubMed for the years 2007 to 2022 for European, Asian, and American clinical practice guidelines related to obesity, diabetes, non-alcoholic fatty, dyslipidemia, chronic kidney disease, and cardiovascular disease. Each guideline was then searched by two reviewers for 83 terms related to environmental factors linked to metabolic dysfunction. Environment-related statements were then adjudicated by three reviewers for relevance. Select guidelines for non-metabolic disorders linked to environmental factors were similarly reviewed for comparison, including asthma, chronic obstructive pulmonary disease (COPD), and obstetrics/gynecology guidelines. In total, 68 guidelines and statements were systematically reviewed. While environmental risk reduction was partially addressed in COPD, asthma, and cardiovascular guidelines, those focused on obesity, diabetes, and non-alcoholic fatty liver disease did not address the contribution of EDCs or other ambient environmental factors. Across all guidelines only air pollution received substantive attention, leaving other EDCs nearly entirely neglected. A clear but inadequately considered component of the social and structural determinants of health, environmental exposures have emerged as modifiable risk factors for multiple metabolic disorders. While further work is needed, future clinical practice guidelines should incorporate clinical interventions, research initiatives, and policy recommendations to address the impact of poor environments on human metabolic health. Presentation: Saturday, June 17, 2023

Anti-Dyslipidemic and Anti-Diabetic Properties of Corosolic Acid: A Narrative Review

Corosolic acid (CA), a natural compound derived from the Banaba tree (Lagerstroemia speciosa), has attracted attention for its potential therapeutic properties in the management of metabolic diseases. This narrative review aims to summarize the current evidence on the anti-dyslipidemic, anti-diabetic, and anti-inflammatory effects of CA and to understand the pharmacokinetics and molecular mechanisms through the analysis of preclinical and clinical studies.

Relationship between Perceived Stress, Obesity, and Hypertension in Korean Adults and Older Adults.

Perceived stress has a significant effect on metabolic diseases, including obesity and hypertension. However, the association between stress levels, obesity, and hypertension according to age and sex is not fully understood. Therefore, this study investigated the relationship between stress levels and obesity and hypertension in Korean adults and older adults. We analyzed data from the 2015 survey of the Korea National Physical Fitness Project conducted by the Korea Institute of Sports Science and the Korea Ministry of Culture, Sports, and Tourism. Of the 3457 participants, 2829 were adults (20-64 years old) and 628 were older adults (≥65 years old). The correlation between obesity and hypertension according to the degree of perceived stress (low, medium, and high) was analyzed using the chi-square test. Binary logistic regression analysis was used to investigate the influence of perceived stress levels on obesity and hypertension. Age, body mass index (BMI), blood pressure, exercise frequency, smoking, breakfast, and sleeping hours were included as covariates. In adult males, perceived stress levels, age, and diastolic blood pressure were found to have a significant impact on obesity rates, whereas age and breakfast had a significant effect on hypertension rates. In adult females, age and systolic blood pressure were found to significantly influence obesity rates, whereas age, BMI, and exercise frequency had a significant impact on hypertension rates. In older adult females, perceived stress levels and systolic blood pressure were found to significantly impact obesity rates, and sleep duration influenced the rates of hypertension. The effect of perceived stress level on obesity and hypertension rates was less pronounced in the elderly population than in the adult population. This study revealed age and sex differences in the relationship between perceived stress, obesity, and hypertension among Koreans. These findings contribute to a better understanding of the complex relationship between perceived stress and metabolic disorders and emphasize the need for a deeper understanding of the specific factors involved in the prevention and management of metabolic diseases.

Exploring the Barriers and Enablers to Implementing a 16-Week Low-Carbohydrate Diet for Patients With Diabetic Cardiomyopathy.

Cardiac dysfunction in patients with diabetes, referred to as diabetic cardiomyopathy, is primarily precipitated by dysregulations in glucose and lipid metabolism. Diet and lifestyle changes are considered crucial for successful heart failure and diabetes management and are often difficult to achieve. Low-carbohydrate diets (LCDs) have gained popularity for the management of metabolic diseases. Although quantitative research in this field is evolving, little is known about the personal experience of patients with diabetic cardiomyopathy on specific diets. The aim of this qualitative study was to identify enablers and barriers of patients with diabetic cardiomyopathy who engage in an LCD. It further explored patients' perception of dietary education and dietary support received while in hospital. Participants who previously consented to a 16-week LCD trial were invited to share their experiences. Nine patients agreed to be interviewed. Semistructured interviews and a focus group interview were conducted, which were transcribed verbatim. Data were analyzed by using the 6-step approach for thematic analysis. Four themes were identified: (1) nutrition literacy (2) disease-related health benefits, (3) balancing commitments, and (4) availability of resources and support. Improvements in disease-related symptoms acted as strong enablers to engage in an LCD. Barriers such as access to resources and time constraints were identified. These challenges may be overcome with efficient communication and ongoing dietary support. More research exploring the experience of patients with diabetic cardiomyopathy on an LCD are warranted.

Abstract #1406876: Use of Continuous Glucose Monitoring in Conjunction with the GluCare Health Care Model in Patients with Prediabetes

Prediabetes is a state which increases the risk of type 2 diabetes. Continuous Glucose Monitoring (CGM) provides data for glycaemic variability (GV) as a coefficient of variation (CV). GluCare Health is a hybrid, data-driven approach in the management of metabolic diseases and combines in-clinic treatment with Continuous Metabolic Monitoring (CMM) through wearables, so patients are in continuous contact with their care team in the cloud. This team consists of physicians, educators, nurses, dietitians, and coaches, and provides real-time support when the patient needs it most, not just during their clinical visits. Patients were also encouraged to log their meals via a picture using a connected app. Previous studies have shown improvement in models utilizing digital biomarker tracking in chronic diseases as diabetes and obesity and GluCare Health showed a relevant reduction in HbA1C in a population with diabetes in 2021. All patients visited a GluCare Center located in Dubai, UAE at the initial visit and were tested for HbA1C, fasting blood glucose (FBG) and provided with CGMs and other wearables. We retrospectively evaluated patients with prediabetes between 18-65 ages who wore CGMs for at least 2 weeks and compared the GV between the first and second weeks. All patients received feedback via a cause-and-effect approach primarily on nutritional choices which included advice from the team regarding glucose patterns-peaks and how to manage them. Change in glycaemic variability according to CGM device and gender is also evaluated. 26 patients who wore CGM were evaluated.10 patients were female and 16 patients were male. The mean age was 45.6. Mean HbA1C was 5.5%. Mean FBG was 103mg/dL (89-110),15 patients wore DEXCOM G6 and 11 patients wore Freestyle Libre. In the whole group, mean CV was 15.7% in the first week and 13.97% in the second week. There was a significant improvement in GV in the whole group (p< 0.01). CV decreased from 17.07% to 14.77% in DEXCOM G6 group which was statistically significant (p= 0.03) and 13.84% to 12.90% in Freestyle Libre group which could not reach significance (p= 0.06). CV significantly decreased from 15.16% to 13.59% in females (p=0.01) and from 15.74% to 14.0% (p= 0.06) in males which could not reach significance. This study showed GV can be improved in patients with prediabetes who used CGM devices along with the GluCare Health’s CMM. A continuous model of monitoring along with increased engagement in conjunction with CGM use, can be a better approach to tackling prediabetes, prevent progression to diabetes and improve glucose hemostasis, in comparison to episodic or usual care.

3D Printed Hydrogel Microneedle Arrays for Interstitial Fluid Biomarker Extraction and Colorimetric Detection

To treat and manage chronic diseases, it is necessary to continuously monitor relevant biomarkers and modify treatment as the disease state changes. Compared to other bodily fluids, interstitial skin fluid (ISF) is a good choice for identifying biomarkers because it has a molecular composition most similar to blood plasma. Herein, a microneedle array (MNA) is presented to extract ISF painlessly and bloodlessly. The MNA is made of crosslinked poly(ethylene glycol) diacrylate (PEGDA), and an optimal balance of mechanical properties and absorption capability is suggested. Besides, the effect of needles' cross-section shape on skin penetration is studied. The MNA is integrated with a multiplexed sensor that provides a color change in a biomarker concentration-dependent manner based on the relevant reactions for colorimetric detection of pH and glucose biomarkers. The developed device enables diagnosis by visual inspection or quantitative red, green, and blue (RGB) analysis. The outcomes of this study show that MNA can successfully identify biomarkers in interstitial skin fluid in a matter of minutes. The home-based long-term monitoring and management of metabolic diseases will benefit from such practical and self-administrable biomarker detection.

Preparation and nutritional characterisation of protein concentrate prepared from foxtail millet (Setaria italica).

Plant-based protein sources as a sustainable alternative to animal sources are highly relevant for food and dietary supplements industries. Plant proteins are becoming popular as an eco-friendly source for meeting global protein requirements due to their importance in nutrition, management of metabolic diseases, biological activities, functionality in processed food products and their low carbon footprints. We applied biochemical protein extraction protocol and prepared protein concentrate from an underutilised cereal, foxtail millet, with plausible applications in foods and supplements. Herein efforts were utilised to obtain foxtail millet protein (FMP) concentrate by means of standardisation of processes of extraction cum isolation. The conditions including flour to solvent ratio, extraction-precipitation pH, dissolution time, etc. were optimised to significantly improve protein yield and recovery. The FMP concentrate prepared was also analysed for nutritional composition, bioactive compounds, amino acid content and digestion properties in comparison to packaged brown rice protein concentrate. The protein concentrate prepared was found to have high digestibility, rich in essential amino acids with good phenolic and flavonoid content, thereby making it a potential sensory and antioxidant additive for food/pharmaceutical applications.

Deoxyschizandrin ameliorates obesity and non-alcoholic fatty liver disease: Involvement of dual Farnesyl X receptor/G protein-coupled bile acid receptor 1 activation and leptin sensitization.

Natural dual farnesyl X receptor (FXR)/G protein-coupled bile acid receptor 1 (TGR5) activators have received little attention in the management of metabolic diseases. Deoxyschizandrin (DS), a natural lignan, occurs in S. chinensis fruit and has potent hepatoprotective effects, whereas its protective roles and mechanisms against obesity and non-alcoholic fatty liver disease (NAFLD) are largely elusive. Here, we identified DS as a dual FXR/TGR5 agonist using luciferase reporter and cyclic adenosine monophosphate(cAMP) assays. DS was orally or intracerebroventricularly administrated to high-fat diet-induced obesity (DIO) mice, and methionine and choline-deficient L-amino acid diet (MCD diet)-induced non-alcoholic steatohepatitis to evaluate its protective effects. Exogenous leptin treatment was employed to investigate the sensitization effect of DS on leptin. The molecular mechanism of DS was explored by Western blot, quantitative real-time PCR analysis, and ELISA. The results showed that DS activated FXR/TGR5 signaling and effectively reduced NAFLD in DIO and MCD diet-fed mice. DS countered obesity in DIO mice by promoting anorexia and energy expenditure and reversing leptin resistance, involving both peripheral and central TGR5 activation and leptin sensitization. Our findings indicate that DS may be a novel therapeutic approach for alleviating obesity and NAFLD through regulating FXR and TGR5 activities and leptin signaling.

Culinary Counselling in Chronic Care: The Pentad of Cs & Ps.

Diet and nutrition are an integral part of chronic metabolic disease management. Medical nutrition therapy (MNT) providers focus upon caloric and nutrient adequacy, but do not necessarily incorporate person-friendly recipes in their ambit. In this communication, we share a simple framework of culinary counseling. This supplements MNT, and enhances its value by encouraging adherence and persistence to prescribed therapy.

Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet.

The Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear. We evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. VLCKD is a severely restricted diet (<800 Kcal/die), characterized by a very low carbohydrate intake (<50 g/day), 1.2-1.5 g protein/kg of ideal body weight and 15-30 g of fat/day. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment. We found a significant improvement in body weight and composition and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD [194.0 (137.6-284.6) to 167.8 (90.9-281.5) p < 0.001] and greater weight loss was predicted by lower baseline FGF21 (Beta = -0.410; p = 0.012), male sex (Beta = 0.472; p = 0.011), and central obesity (Beta = 0.481; p = 0.005). VLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further studies investigating whether this is specific to this diet or to any caloric restriction are warranted.

The Gut Microbiota's Impact on Metabolic Wellness or Disease

Controlling the human gut microbiota by dietary interventions has the potential to prevent and cure metabolic illnesses. The human gut microbiota has a substantial influence on the health of the metabolic system. Within the scope of this investigation, a randomized controlled trial was used to investigate the effect of a particular dietary intervention on the microbiota of the gut, as well as the following influence that this intervention had on metabolic indicators. Significant improvements in metabolic outcomes were seen among the individuals in the intervention group. These improvements included a significant decrease in fasting glucose levels as well as positive changes in specific microbial taxa, such as an increase in the abundance of Bifidobacterium. These results provide insight on the prospect of using treatments that particularly target the microbiota in order to enhance metabolic health. Our understanding of the dynamic interplay between the microbiota in the gut and the metabolism of the host is improved as a result of this study, which provides essential insights for the development of future individualized strategies for the prevention and management of metabolic diseases.

Fermented seeds of Pentaclethra macrophylla mitigate against memory deficit and restored altered enzymatic activity in the brain of streptozotocin-diabetic rats.

Memory deficit has been reported as one of the complications of diabetes. Fermented seeds of Pentaclethra Macrophylla (P. macrophylla) have been used in folklore for the management of metabolic diseases. The research aims to evaluate the impact of diets with the inclusion of the fermented seed of P. macrophylla on memory deficit in diabetic rats and its underlying mechanisms. Before the induction, the rats were subjected to training sessions. Thereafter, streptozotocin (50mg/kg body weight) was administered to the trained rats via intraperitoneal (i.p). 72hours after, the rats blood glucose level was checked, rats with blood glucose level greater than 250mg/dl were selected for the memory index evaluation study. The induced rats were randomly distributed into groups: Normal rats (group 1), untreated diabetic rat (Group 2), acarbose treated diabetic rats (group 3); diabetic rats placed on diet supplemented with fermented seed of P. macrophylla (10 & 20% inclusion) were allotted to group 4 & 5. Then, evaluation of memory retention capacity was performed on the day 14 of the experiment. Thereafter, experimental rats were sacrificed, tissue of interest (brain) was excised, homogenized and homogenates were used for biochemical analysis. The cholinergic, angiotensin-1-converting enzyme (ACE), arginase activity and biomarkers for oxidative stress were significantly altered in untreated diabetic rats when compared with non-diabetes rats. Also, the memory capacity of the diabetic rats was significantly reduced when compared with the non-diabetes rats. Meanwhile, diabetic rats placed on diet with fermented seeds of P. macrophylla (10 & 20% inclusion) exhibited significantly higher memory capacity, lower activity of cholinergic, ACE, arginase activity in relation to untreated diabetic rats while the antioxidant status of the brain was enhanced. Nevertheless, fermented seeds of P. macrophylla ameliorated memory deficit in STZ induced diabetes rats. This gave credence to P. macrophylla nutraceutical potential as claimed in folk medicine.

Combinatorial pathway disruption is a powerful approach to delineate metabolic impacts of endocrine disruptors.

The prevalence of metabolic diseases, such as obesity, diabetes, metabolic syndrome and chronic liver diseases among others, has been rising for several years. Epidemiology and mechanistic (in vivo, in vitro and in silico) toxicology have recently provided compelling evidence implicating the chemical environment in the pathogenesis of these diseases. In this review, we will describe the biological processes that contribute to the development of metabolic diseases targeted by metabolic disruptors, and will propose an integrated pathophysiological vision of their effects on several organs. With regard to these pathomechanisms, we will discuss the needs, and the stakes of evolving the testing and assessment of endocrine disruptors to improve the prevention and management of metabolic diseases that have become a global epidemic since the end of last century.

Circadian rhythms and pancreas physiology: A review.

Type 2 diabetes mellitus, obesity and metabolic syndrome are becoming more prevalent worldwide and will present an increasingly challenging burden on healthcare systems. These interlinked metabolic abnormalities predispose affected individuals to a plethora of complications and comorbidities. Furthermore, diabetes is estimated by the World Health Organization to have caused 1.5 million deaths in 2019, with this figure projected to rise in coming years. This highlights the need for further research into the management of metabolic diseases and their complications. Studies on circadian rhythms, referring to physiological and behavioral changes which repeat approximately every 24 hours, may provide important insight into managing metabolic disease. Epidemiological studies show that populations who are at risk of circadian disruption such as night shift workers and regular long-haul flyers are also at an elevated risk of metabolic abnormalities such as insulin resistance and obesity. Aberrant expression of circadian genes appears to contribute to the dysregulation of metabolic functions such as insulin secretion, glucose homeostasis and energy expenditure. The potential clinical implications of these findings have been highlighted in animal studies and pilot studies in humans giving rise to the development of circadian interventions strategies including chronotherapy (time-specific therapy), time-restricted feeding, and circadian molecule stabilizers/analogues. Research into these areas will provide insights into the future of circadian medicine in metabolic diseases. In this review, we discuss the physiology of metabolism and the role of circadian timing in regulating these metabolic functions. Also, we review the clinical aspects of circadian physiology and the impact that ongoing and future research may have on the management of metabolic disease.

Exercise and Metabolic Health: The Emerging Roles of Novel Exerkines.

Physical inactivity is a major cause of chronic diseases. It shortens the health span by lowering the age of the first chronic disease onset, which leads to decreased quality of life and increased mortality risk. On the other hand, physical exercise is considered a miracle cure in the primary prevention of at least 35 chronic diseases, including obesity, insulin resistance, and type 2 diabetes. However, despite many scientific attempts to unveil the health benefits conferred by regular exercise, the underlying molecular mechanisms driving such benefits are not fully explored. Recent research shows that exercise-induced bioactive molecules, named exerkines, might play a critical role in the regulation of metabolic homeostasis and thus prevent metabolic diseases. Here we summarize the current understanding of the health-promoting effects of exerkines secreted from skeletal muscle, adipose tissue, bone, and liver, including MOTS-c, BDNF, miR-1, 12,13-diHOME, irisin, SPX, OC, GDF15, and FGF21 on obesity, insulin resistance, and type 2 diabetes. Identifying the systemic health benefits of exerkines may open a new area for the discovery of new pharmacological strategies for the prevention and management of metabolic diseases.

Identification and Characterization of a Novel Species of Genus Akkermansia with Metabolic Health Effects in a Diet-Induced Obesity Mouse Model

Akkermansia muciniphila is a well-known bacterium with the ability to degrade mucin. This metabolic capability is believed to play an important role in the colonization of this bacterium in the gut. In this study, we report the identification and characterization of a novel Akkermansia sp. DSM 33459 isolated from human feces of a healthy donor. Phylogenetic analysis based on the genome-wide average nucleotide identity indicated that the Akkermansia sp. DSM 33459 has only 87.5% similarity with the type strain A. muciniphila ATCC BAA-835. Akkermansia sp. DSM 33459 showed significant differences in its fatty acid profile and carbon utilization as compared to the type strain. The Akkermansia sp. DSM 33459 strain was tested in a preclinical obesity model to determine its effect on metabolic markers. Akkermansia sp. DSM 33459 showed significant improvement in body weight, total fat weight, and resistin and insulin levels. Interestingly, these effects were more pronounced with the live form as compared to a pasteurized form of the strain. The strain showed production of agmatine, suggesting a potential novel mechanism for supporting metabolic and cognitive health. Based on its phenotypic features and phylogenetic position, it is proposed that this isolate represents a novel species in the genus Akkermansia and a promising therapeutic candidate for the management of metabolic diseases.

Gut hormones and reproduction

Reproduction and metabolism are intricately linked. Gut hormones play key roles in the regulation of body weight and glucose homeostasis, factors that influence the functioning of the hypothalamic-pituitary-gonadal axis and reproductive outcomes. Data from rodent models suggest gut hormones may have direct stimulatory effects on reproductive hormone release. However, the effects of gut hormones on reproductive function in humans are more complex, with possible involvement of direct (e.g. via gut hormone receptor agonism) as well as indirect (e.g. via weight reduction in people with obesity) mechanisms. The use of gut hormone receptor agonists has become an integral part of the management of metabolic diseases (including obesity and type 2 diabetes), with additional indications for their use on the horizon. Future work may identify specific roles for gut hormone receptor agonists in the treatment of reproductive co-morbidities that are increasingly being recognised in people with metabolic diseases.