Management Of Metabolic Syndrome Research Articles

Metabolic syndrome in children and adolescents

Background: Metabolic syndrome is a serious condition associated with multiple diseases. The prevalence of metabolic syndrome is increasing caused by an increase in obesity rates among children and adolescents.Current Concepts: Owing to the various definitions used, there is lack of consensus regarding the diagnostic criteria for metabolic syndrome in children and adolescents. Although the exact pathogenesis remains unclear, insulin resistance and subsequent inflammation are key mechanistic contributors. Metabolic syndrome is characterized by overweight and obesity accompanied by abnormalities in glucose metabolism, dyslipidemia, and hypertension and is associated with other conditions such as fatty liver, polycystic ovary syndrome, and a pro-inflammatory state. Prevention and management of metabolic syndrome can be achieved through lifestyle modifications, behavioral interventions, pharmacotherapy, and surgical interventions.Discussion and Conclusion: Childhood and adolescent obesity serves as a risk factor for metabolic syndrome during later life. Early identification and intervention are important to prevent the progression of metabolic syndrome. Clinicians must identify at-risk children and adolescents and provide guidance for the prevention and management of metabolic syndrome.

Deep learning imaging phenotype can classify metabolic syndrome and is predictive of cardiometabolic disorders

BackgroundCardiometabolic disorders pose significant health risks globally. Metabolic syndrome, characterized by a cluster of potentially reversible metabolic abnormalities, is a known risk factor for these disorders. Early detection and intervention for individuals with metabolic abnormalities can help mitigate the risk of developing more serious cardiometabolic conditions. This study aimed to develop an image-derived phenotype (IDP) for metabolic abnormality from unenhanced abdominal computed tomography (CT) scans using deep learning. We used this IDP to classify individuals with metabolic syndrome and predict future occurrence of cardiometabolic disorders.MethodsA multi-stage deep learning approach was used to extract the IDP from the liver region of unenhanced abdominal CT scans. In a cohort of over 2,000 individuals the IDP was used to classify individuals with metabolic syndrome. In a subset of over 1,300 individuals, the IDP was used to predict future occurrence of hypertension, type II diabetes, and fatty liver disease.ResultsFor metabolic syndrome (MetS) classification, we compared the performance of the proposed IDP to liver attenuation and visceral adipose tissue area (VAT). The proposed IDP showed the strongest performance (AUC 0.82) compared to attenuation (AUC 0.70) and VAT (AUC 0.80). For disease prediction, we compared the performance of the IDP to baseline MetS diagnosis. The models including the IDP outperformed MetS for type II diabetes (AUCs 0.91 and 0.90) and fatty liver disease (AUCs 0.67 and 0.62) prediction and performed comparably for hypertension prediction (AUCs of 0.77).ConclusionsThis study demonstrated the superior performance of a deep learning IDP compared to traditional radiomic features to classify individuals with metabolic syndrome. Additionally, the IDP outperformed the clinical definition of metabolic syndrome in predicting future morbidities. Our findings underscore the utility of data-driven imaging phenotypes as valuable tools in the assessment and management of metabolic syndrome and cardiometabolic disorders.

Association between Mothers' Working Hours and Metabolic Syndrome in Children and Adolescents: Data from the Korea National Health and Nutrition Examination Survey, 2016-2020.

Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers' working hours. The present study was conducted to determine the relationship between mothers' working hours and MetS in their children. Data from the 2016-2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10-18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers' working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers' working hours and the number of risk factors for MetS. Abdominal obesity in children was higher when the mothers' working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21-4.25). In the trend analysis, the OR of children's abdominal obesity increased significantly as mothers' working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954-18.822). Mothers' working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Perceptions of metabolic syndrome management utilization in relation to patient experience and health-related quality of life

BackgroundOne factor for the poor health outcomes among adult people with metabolic syndrome (MetS) is poor utilization of disease management resources, which may be attributable to prior experience with pharmacists (PEwP) and perceptions of disease management resource utilization (PMU). Therefore, understanding patients' experience could be critical to improving their perceptions and promoting health outcomes. ObjectivesThe study explored the influence of PEwP and PMU on the HRQoL of people with MetS. MethodsData on perceptions of healthcare, medication, and pharmacy services utilization, PEwP, and HRQoL were collected using validated tools via an electronic survey. Chi-square and ordinal regression tests were used to predict the association between PMU, PEwP, and HRQoL. Also, mediation analysis through Haye's model 4 explored the direct and indirect relationship of PMU and PEwP on HRQoL. ResultsA total of 706 completed surveys were collected and used for analyses. On average, respondents reported three comorbidities. Of the respondents, 72.0% had good PEwP, while 32.6% had good PMU. Comparatively, 38.4% of those with good PEwP had good PMU, compared with 17.3% of those with poor PEwP. Also, 47.0% of those with good PMU had good HRQoL compared to 35.3% with poor PMU. The odds of having fair or good PMU were nearly triple (OR = 2.97, P < 0.001) among those with good PEwP compared to those with poor PEwP. Also, respondents with good PMU had 58% (OR = 1.58, P = 0.008) higher odds of having fair or good HRQoL. Analysis through bootstrap indicated a significant relationship (BootCI = −0.072, −0.022) between PEwP and HRQoL via respondents' PMU. ConclusionsMetS individuals with good experience and PMU were more likely to have good HRQoL. Prior experience with pharmacists influenced PMU and indirectly impacted HRQoL. Therefore, pharmacists must consider patients' experience and management utilization perceptions to promote health outcome among people with MetS, while implementing interventions.

EXPLORING THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND METABOLIC SYNDROME RISK IN YOUNG ADULTS: A REVIEW

Metabolic syndrome is a cluster of interrelated risk factors that increase the risk of cardiovascular disease and type 2 diabetes, particularly among young adults. Physical activity has been identified as a key lifestyle factor that can help mitigate the risk of developing metabolic syndrome. This review aims to synthesize the current evidence on the association between physical activity and metabolic syndrome risk in young adults. The review discusses the prevalence of metabolic syndrome in young adults and the various mechanisms by which physical activity can influence metabolic syndrome risk, including improvements in body composition, insulin sensitivity, lipid profile, and blood pressure regulation. Several studies have demonstrated that higher levels of physical activity, especially moderate-to-vigorous intensity exercise, are associated with a lower risk of metabolic syndrome in young adult populations. However, the relationship between physical activity and metabolic syndrome risk may be moderated by factors such as sex and socioeconomic status. The review also highlights the need for further research to better understand the long-term impact of physical activity, the optimal types and intensities of exercise, and the development of tailored interventions to promote sustained physical activity and improve metabolic health in young adults. In conclusion, this review emphasizes the importance of encouraging and supporting young adults to engage in regular physical activity as a strategy for the prevention and management of metabolic syndrome. Promoting physically active lifestyles among this population should be a public health priority to address the growing burden of metabolic syndrome and its associated health consequences.

Prevalence of metabolic syndrome and associated factors among patient with type 2 diabetes mellitus in Ethiopia, 2023: asystematic review and meta analysis

BackgroundMetabolic syndrome is a complex pathophysiologic state which characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidaemia. The Adult Treatment Panel III report (ATP III) of the National Cholesterol Education Programme identified the metabolic syndrome as a serious public health issue in the modern era. In Western and Asian nations, the frequency of metabolic syndrome is rising, especially in developing regions experiencing rapid socio-environmental changes, in Sub-Saharan Africa; metabolic syndrome may be present in more than 70% of people with type 2 diabetes mellitus. Therefore the objective of our study was to estimate the pooled prevalence of metabolic syndrome and associated factors among type II diabetes mellitus patient.MethodThis systematic review and meta-analysis included original articles of cross sectional studies published in the English language. Searches were carried out in PubMed, Web of Science, Google Scholar, and grey literature Journals from 2013 to June 2023. A random-effects model was used to estimate the pooled prevalence of metabolic syndrome among type II Diabetes mellitus patient in Ethiopia. Heterogeneity was assessed using the I2 statistic. Subgroup analysis was also conducted based on study area. Egger’s test was used to assess publication bias. Sensitivity analysis was also conducted.ResultsOut of 300 potential articles, 8 cross sectional studies were included in this systematic review and meta-analysis study. The pooled prevalence of metabolic syndrome among patient with type II diabetes mellitus in Ethiopia was found to be 64.49% (95% CI: 62.39, 66.59) and 52.38% (95% CI: 50.05, 54.73) by using NCEP/ATP III and IDF criteria, respectively. The weighted pooled prevalence of metabolic syndrome among type II diabetes mellitus patients by sub group analysis based on the study region was 63.79% (95% CI: 56.48, 71.11) and 52.23% (95%CI: 47.37, 57.22) by using NCEP/ATP III and IDF criteria, respectively. Being female and increased body mass index were factors associated with metabolic syndrome among type II diabetes mellitus patients.ConclusionThe prevalence of metabolic syndrome among type II patient is high. Therefore, policymakers, clinicians, and concerned stakeholders shall urge effective strategies in the control, prevention, and management of metabolic syndrome among type II diabetes mellitus.

The causal relationship between metabolic syndrome and its components and cardiovascular disease: A mendelian randomization study

AimTo investigate the causal relationship between metabolic syndrome (MetS) and its components and 14 cardiovascular diseases using Mendelian randomization (MR). MethodsWe used summary statistics from large-scale genome-wide association studies of MetS, its components, and cardiovascular diseases. We performed a two-sample MR analysis using the inverse-variance weighted method and other sensitivity methods. We also performed multivariate MR to adjust for potential risk factors. ResultsOur study found that MetS was causally associated with an increased risk of ischemic stroke, abdominal aortic aneurysm, pulmonary embolism, coronary heart disease, heart failure, and peripheral artery disease. Waist circumference was causally associated with an increased risk of 6 cardiovascular diseases. Type 2 diabetes mellitus, diastolic blood pressure, systolic blood pressure, triglycerides, and high-density lipoprotein cholesterol were all causally associated with coronary heart disease, with varying causal relationships with the remaining 5 cardiovascular diseases. Multivariate MR showed that, except for ischaemic stroke, waist circumference remained causally associated with the remaining five cardiovascular diseases after adjusting for potential confounders. ConclusionOur study provides evidence that metabolic syndrome is causally associated with 6 cardiovascular diseases. Waist circumference is the most important component of these relationships. These findings have implications for the prevention and management of metabolic syndrome and cardiovascular diseases.

Horse owner experiences and observations with the use of SGLT2i for the management of equine metabolic syndrome and hyperinsulinaemia‐associated laminitis

SummaryBackgroundSodium‐glucose cotransporter 2 inhibitors (SGLT2i) are being used increasingly in equine practice. While there is emerging clinical evidence of the safety and efficacy of these drugs, there are currently no reports to document owner experiences with treatment.ObjectiveThe objective of the study was to report owner experiences and observations following treatment with SGLT2i in horses.Study designA cross‐sectional online survey.MethodsHorse owners were recruited via social media, online forums and their veterinarians to participate in an anonymous online survey to document their experiences and observations when treating their horses with SGLT2i.ResultsThree hundred forty‐two responses met the inclusion criteria. Ertugliflozin was the most commonly prescribed SGLT2i (79.8%), and the most common reasons for treatment were high insulin concentrations (84.2%) and active laminitis (59.7%). 85.3% of owners reported their horses had an improved quality of life after commencing treatment, while 9.4% reported no change and 5.3% reported a worsening of clinical signs. Of owners who had considered euthanasia prior to treatment (n = 77), 80.5% reported their horse's level of pain to be either mild or absent after 30 days of treatment and 94.8% reported their horse's quality of life to be improved. Most owners (n = 220, 64.7%) reported they were either extremely satisfied or somewhat satisfied (n = 72, 21.2%) with treatment. Treatment concerns included safety/side effects, medication cost, availability and long‐term efficacy. 114 owners (33.3%) reported one or more initial adverse effects upon induction onto the medication, particularly excessive urination (n = 70, 20.5%), excessive drinking (n = 38, 11.1%), excessive weight loss (n = 34, 9.9%) and dullness (n = 26, 7.6%).Main limitationSampling bias through social media and veterinary practices and reliance on subjective owner reports.ConclusionThe use of SGLT2i in horses was associated with excellent rates of owner satisfaction and owner‐reported improved quality of life for the horse; however, some adverse effects were observed.

Comparative Evaluation of Virechana Karma and Lekhana Basti in the Management of Metabolic Syndrome

Metabolic Syndrome is a complex metabolic condition which is a rising therapeutic problem in modern society. Additionally, it has been linked to the emergence of CVD, Type 2 DM and other grave health issues. It primarily develops as a result of a diet high in fat, a sedentary lifestyle, stress, insomnia, drinking too much alcohol, being overweight, and other factors. When three out of the five biochemical and physiological abnormalities such as visceral obesity, dyslipidemia, hypertension, increased blood sugar, insulin resistance, etc. are present in the body, it is considered clinically diagnosed. Acharya Charaka has mentioned a group of diseases namely Santarpana Nimittaj Vikara (diseases caused due to over eating) which can be symptomatically co-related with metabolic syndrome, especially Medaavrit (covered by fatty tissues) Vata (one of the three bodily humors representing air in the body). Aims &amp; Objectives: Comparative evaluation of Virechana Karma (therapeutic purgation) and Lekhana Basti (a type of therapeutic enema) in the management of metabolic syndrome. Material &amp; Methods: 43 patients were selected on the basis of classical symptomatology of metabolic syndrome from OPD and IPD of Dept. of Panchakarma, Hospital of Rishikul Campus and randomly divided into two groups - Virechana group and Lekhana Basti group on the basis of inclusion - exclusion criteria. There after the patients were subjected for detailed clinical history and physical examination. Statistical analysis used: Since objective criteria were selected so for intragroup comparison Paired- t- test was applied and for intergroup comparison Unpaired- t- test (t-test) was applied. Conclusion: Virechana Karma is better than Lekhana Basti in the management of metabolic syndrome.

Vitis vinifera L. seed standardized extract; a promising therapeutic against metabolic syndrome induced by high-fat/high-carbohydrate diet and streptozotocin in rats

Metabolic syndrome (MetS) is a group of abnormal disorders; hypertension, glucose intolerance, dyslipidemia, proinflammatory, and prothrombotic states, affecting approximately 14 % of the world's population. The potential of grape seeds extract (GSE) supplementation to improve the metabolic disturbances and their related conditions like obesity, type 2 diabetes, and nonalcoholic fatty liver disease was investigated in this study. In-vitro metabolic syndrome assays were investigated through α-amylase, α-glucosidase, lipase, lipoxygenase (LOX), cyclooxygenases (COX-1 and COX-2), renin and angiotensin converting enzyme (ACE) inhibition assays. Additionally, in-vivo rat model of high-fat-high-carbohydrate diet (HFD)-induced MetS was established, where metformin (MT) (200 mg/kg) was used as a reference drug and GSE was given at 100 and 200 mg/kg by oral gavage. GSE was standardized using HPLC analysis for the major reported compound; catechin which should be ≥ 160.76 ± 5.52 μg/mL. Total phenolic content of GSE was 21.12±0.61 µg gallic acid equivalent/1 mg extract and total flavonoid content was 23.81±0.64 µg rutin equivalent/1 mg extract. In-vitro assays revealed the potential of GSE to manage the metabolic syndrome, besides its strong antioxidant capacity. Treatment with GSE (100 mg/kg and 200 mg/kg) markedly (P < 0.05) controlled the weight gain, improved the metabolic pathways (total glucose, cholesterol, triglycerides, AST, and ALT), oxidative stress parameters (MDA, GSH, and catalase) and inflammatory biomarkers in HFD fed rats. GSE downregulated the expression of insulin resistance gene (IR) and some inflammatory related genes (TNF-α and NF-κB), additionally it improved the pathological features of metabolic conditions and upgraded the expression of Nrf2 compared to HFD group. The superior effects were owned to the high dose of GSE, 200 mg/kg b.wt. (P < 0.05, P < 0.001). All results sustenance the beneficial effects of the standardized GSE in the management of metabolic syndrome.

Protocolo diagnóstico y terapéutico de la esteatosis hepática asociada a disfunción metabólica

Metabolic dysfunction-associated steatotic liver disease (MASLD) refers to a broad spectrum of liver manifestations that range from simple steatosis, with a generally benign course, to forms with a higher risk of progression, such as hepatic steatosis or advanced liver disease phenotypes like cirrhosis or hepatocellular carcinoma. The global prevalence of MASLD is increasing in parallel to that of the metabolic syndrome, with the main groups at risk for the disease being patients with cardiometabolic comorbidity. Advances in non-invasive diagnostic techniques allow for identifying cases with a higher risk of progression and clinical events in these at-risk populations. The management of patients with MASLD is based on lifestyle modification. There are currently no drugs with an approved indication for the management of MASLD. Therefore, it is crucial to optimize the therapeutic management of metabolic syndrome and cardiovascular risk in these patients.

Biological activities, Molecular mechanisms, and Clinical application of Naringin in Metabolic syndrome

Metabolic syndrome has become major health problems in recent decades, and natural compounds receive considerable attention in the management of metabolic syndrome. Among them, naringin is abundant in citrus fruits and tomatoes. Many studies have investigated the therapeutic effects of naringin in metabolic syndrome. This review discusses in vitro and in vivo studies on naringin and implications for clinical trials on metabolic syndrome such as diabetes mellitus, obesity, nonalcoholic fatty liver disease, dyslipidemia, and hypertension over the past decades, overviews the molecular mechanisms by which naringin targets metabolic syndrome, and analyzes possible correlations between the different mechanisms. This review provides a theoretical basis for the further application of naringin in the treatment of metabolic syndrome.

Health Behavior Adherence in a Metropolitan-Based Metabolic Syndrome Management Program during the COVID-19 Pandemic.

The COVID-19 pandemic increased the worldwide prevalence of metabolic syndrome. The purpose of this study was to assess health behavior adherence during the pandemic in adults who had engaged in a metabolic syndrome management program for at least six months. This assessment included an evaluation of health behavior changes, factors influencing adherence, and clinical parameters. The city-wide program was operated by the Seoul Metropolitan Government. Baseline and follow-up data were compared in 116 participants who engaged in the program for at least 6 months prior to the pandemic. Health behaviors and clinical parameters were examined. Generalized estimating equation analysis was used to identify sociodemographic variables influencing health behavior adherence over time. Systolic blood pressure, waist circumference, and blood glucose improved (all P<0.05), and risk factors decreased (P<0.001) from baseline to follow-up (mean±standard deviation, 1.13±0.91 years). All six health behaviors, physical activity and weight control, eating habits, alcohol consumption and smoking, stress management, sleep and rest, and medication compliance and medical examination improved (all P<0.001) from baseline to follow-up (2.37±1.05 years). Smoking and employment negatively influenced adherence to health behaviors (P<0.05). Participants felt the most beneficial part of the program was receiving sequential medical examination results with follow-up consultations by public health professionals without charge. Our study demonstrated the durability of the impact of the Seoul Program on all six targeted health behaviors as well as clinical parameters. Findings encourage participation in such broad-based programs and development of novel approaches to facilitate success for smokers and employed participants.

Metabolic effects of aldosterone

Currently, increasing evidence shows the mutual influence of aldosterone and adipose tissue. Aldosterone excess has been reported in patients with obesity and metabolic syndrome. Aldosterone has a direct effect on adipose tissue increasing anabolic activity and expression of mineralocorticoid receptors. In turn, excessive activation of MCR leads to stimulation of adipogenesis and an increase in the volume of adipose tissue. Aldosterone excess can be considered an independent cardiovascular risk factor that affects such processes as cardiac fibrosis, nephrosclerosis, and arteriosclerosis. There is convincing evidence of higher prevalence and severity of impaired glucose homeostasis and lipid metabolism disorders among patients with primary hyperaldosteronism. Similar pathological changes are also observed in patients with obesity and metabolic syndrome. This review presents scientific data on the metabolic effects of aldosterone, in particular its effect on adipose tissue function, glucose and lipid metabolism. Treatment with mineralocorticoid receptor antagonists may provide substantial benefit in the management of metabolic syndrome, contribute to the stabilisation of glucose and lipid metabolism, improve clinical status of patients with cardiovascular diseases and reduce the risk of complications. However, available evidence from the conducted studies is not sufficient to justify introduction of such therapy into clinical practice.

Natural Products in the Clinical Management of Metabolic Syndrome.

Metabolic syndrome (MetS) is a prevalent health condition that requires significant attention and intervention due to its multifaceted nature. It encompasses a variety of ailments such as diabetes mellitus, hypertension, obesity, and dyslipidemia. Despite extensive research, the underlying pathophysiology of MetS is not entirely understood, and current synthetic drugs used to treat it have adverse effects and can be expensive. Therefore, natural products are being investigated as a potential alternative treatment for MetS. This chapter provides an overview of studies on natural products as a treatment for MetS. The available evidence suggests that bioactive phytochemicals and herbal medicines, such as curcumin, resveratrol, Nigella sativa, Hibiscus sabdariffa, and Theobroma cacao, have the potential to treat MetS effectively. Furthermore, natural products can be explored as a novel drug discovery approach for MetS. However, it is imperative to conduct well-designed randomized controlled trials with large sample sizes to confirm these findings. Based on our review, we conclude that natural products could be a promising alternative for treating MetS. Further research is warranted to explore this potential fully. The use of natural products for MetS treatment could reduce the reliance on synthetic drugs, many of which have harmful side effects and are costly. The development of natural products as a treatment for MetS could have significant implications for public health, and we encourage further research in this area.

Insights Into Geriatric Care and Healthy Ageing

The global population of older adults is expanding rapidly. According to the United Nations world social report (2023), 1 in 10 people worldwide were aged 65 or above in 2021. In 2050, this age group is projected to account for 1 in 6 people globally. In 2019, 9.6% of the Lebanese population were above 65 years of age according to statistics of the Ministry of Health. Geriatric medicine plays a vital role in enhancing the quality of life for older adults, as it drives health promotion and disease prevention and treatment. The last two decades have witnessed a lot of progress in this field due to advancement on personalized care driven by genomic analysis, comprehensive geriatric assessment, polypharmacy management, assessment of frailty to prevent cognitive decline and nutrition and exercise interventions to maintain muscle and bone health and cognitive function. Yet, a lot of aspects need to be explored, as complex multimorbidity in this age group requires coordinated care across specialties. In addition, evidence-based studies that include older adults are limited. To tackle the different aspects of geriatric care, Beirut Arab University-Tripoli branch hosted the conference entitled “Insights into Geriatric Care and Healthy Ageing” which featured a series of keynote speeches, sessions, and discussions led by esteemed experts in the fields of Ageing and healthcare. The conference was organized in collaboration with the Middle East Academy for Medicine of Ageing (MEAMA) and the International Institute on Ageing (INIA). The first session held by Dr. Abdul Razzak Abyad and Dr. Nabil Kronfol addressed the medical and social transformation of ageing, the major challenges faced by older people and proposed a comprehensive program to improve the health and well-being of older people. A session entitled “Update on Geriatric Medicine” reflected a comprehensive approach to understanding and managing common health challenges associated with Ageing and offered the latest medical protocols and treatment to improve patient outcomes. The topics included the management of Metabolic Syndrome and Parkinson’s Disease, clinical presentation and management of depression in older adults, prevention and control of urinary tract infections in elderly, medication management to prevent polypharmacy, in addition to bone healthcare to prevent osteoporosis and fracture. A session specified for dementia and delirium covered the latest update on diagnosis and management of dementia, the progress in the process of using genetic markers for diagnosis of Alzheimer’s Disease, and nursing care tools used in the screening of delirium. Another session focused on prevention, assessment, and nursing care management protocols of pressure injuries in addition to surgical treatment. The concept of “healthy ageing” and the maintenance of physical health was highlighted during the conference through a talk about frailty prevention and management, which extensively covered the different types of exercise recommended in older age, their benefits, and the conditions of each. In addition, another talk linked the different dietary patterns to the risk of frailty and cognitive decline in older adults according to a Lebanese national study. The last session of the conference was dedicated to policies and programs of elderly healthcare. Dr. Samar El Feky, Regional Focal Person for Health of Older People from the Eastern Mediterranean Regional Office of the World Health Organization, introduced the WHO guidelines for integrated care for older people (ICOPE) program implemented in several countries in the region. On the other hand, Dr. Saadallah Sabouneh presented the elderly care policies and programs in Lebanon, on behalf of the Minister of Health, Dr. Firas Abyad. The president of the order of nurses, Dr. Rima Sassine Kazan, presented the challenges of Nursing care for the elderly in Lebanon. The conference was concluded by the organizers who emphasized the significance of “healthy ageing”, the process of maintaining functional ability as people grow older to enable their continued participation in society.

Tocopherol Vs Tocotrienol (Vitamin E) in the Management of Metabolic Syndrome

Metabolic syndrome (Met-S) reflects a congregate of metabolic derangements including central obesity, hypertension, insulin resistance, dyslipidemia leading to enhanced risk of developing cardiovascular disease and diabetes. Both tocopherol (TCP) and tocotrienol (T3) have significant role in Met-S. However, it is still unclear regarding better clinical efficacy of either one in management of Met-S. This review compares clinical efficacy of different isomers of tocopherol with tocotrienol in stewardship of Met-S by search of human clinical studies only. Literature search was conducted till 20th May 2023 on PubMed, google scholar, open google search, pak- medinet and Cochrane data-bases. So far evidence revealed that Tocotrienol have been found safer and more beneficial as compared to tocopherol, having great potential in improving diabetes, hypertension and hyperlipidemia in Met-S patients and robust candidate for further future research regarding ameliorating obesity in metabolic syndrome. Keywords: Metabolic Syndrome, Tocopherol, Tocotrienol, Obesity, Diabetes, Dyslipidemias. How to Cite This: Rafique S, Khan DA, Farhat K, Noor M, Khan MA, Sharif M. Tocopherol Vs Tocotrienol (Vitamin E) in the Management of Metabolic Syndrome. Isra Med J. 2023; 15(2): 74-77.DOI: https://doi.org/10.55282/imj.ra52

Ginkgolic Acid Derivatives from Ginkgo biloba Show Inhibitory Activity against Protein Tyrosine Phosphatases Associated with Insulin Resistance

Ginkgo biloba L. (Ginkgoacea) contains an abundance of beneficial compounds and has demonstrated positive clinical effects in the management of metabolic syndrome. Recent studies have emphasized its efficacy against type 2 diabetes mellitus (T2DM), including improvements in diabetic nephropathy and retinopathy. Particularly noteworthy are ginkgolic acid analogs, which have shown potential in combating T2DM by inhibiting protein tyrosine phosphatases (PTPs), facilitating glucose uptake, and influencing signaling pathways. In this study, we isolated six derivatives of ginkgolic acid from the MeOH extract of G. biloba leaves with the guidance of liquid chromatography–mass spectrometry (LC/MS). We determined the chemical structures of these isolated compounds as 2-hydroxy-6-(10′-hydroxypentadec-11′(E)-en-1-yl) benzoic acid (1), 2-hydroxy-6-(11′-hydroxypentadec-9′(E)-en-1-yl) benzoic acid (2), 2-hydroxy-6-tridecylbenzoic acid (3), 2-hydroxy-6-pentadecylbenzoic acid (4), 2-hydroxy-6-(12′-hydroxyheptadec-13′(E)-en-1-yl) benzoic acid (5), and 2-hydroxy-6-(11-hydroxyundecyl) benzoic acid (6) using NMR spectroscopic data and LC/MS analysis. To assess their potential for addressing T2DM, we subjected the isolated compounds (1–6) to tests measuring their inhibitory activity against six PTPs: PTPN11, PTPN2, PTP1B, DUSP9, PTPRS, and PTPN9. Among these compounds, compounds 3–5 displayed enzyme inhibition exceeding 90% against all six PTPs. In conclusion, ginkgolic acid derivatives, acting as PTP inhibitors relevant to insulin resistance, hold promise as potential therapeutic candidates for the prevention and treatment of T2DM.

Elemental evaluation, nutritional analysis, GC-MS analysis and ameliorative effects of Artocarpus communis J.R.Forst. & G.Forst. seeds’ phytoconstituents on metabolic syndrome via in silico approach

The nutritional as well as beneficial effects of the Artocarpus communis seed on metabolic syndrome complications have not been studied. In this research, the aim was to investigate the nutritional composition and beneficial effects of Artocarpus communis seeds’ phytoconstituents on the p53 core, fat mass and obesity-associated (FTO) protein and cytochrome P450 CYP11A1 domains. The elements and phytochemicals in the seed were determined through atomic absorption spectroscopy assay and gas chromatography–mass spectrometry (GC-MS) analysis, respectively. Also, the compounds detected were docked to the p53 core, FTO protein and cytochrome P450 CYP11A1 domains protein. Artocarpus communis seed contains sodium (7.824 ± 0.0134 ppm), magnesium (10.187 ± 0.0239 ppm) and iron (1.924 ± 0.0017), while zinc and cadmium were undetected. Phenolics and flavonoids were the most abundant phytochemicals in the seed. Phytoconstituents, such as pentadecanoic acid, hexadecanoic acid and methyl ester, possessing different therapeutic effects were identified via GC-MS analysis. In A. communis seed, 3-methyl-4-nitro-5-(1-pyrazolyl) pyrazole and phenanthrene were able to bind more peculiarly and specifically to the p53 core, FTO protein and cytochrome P450 CYP11A1 domains. One of the important processes that were hypothesized for the recovery of metabolic syndrome in affected victims is shown by the molecular dynamics analysis, which shows that the binding of these chemicals to the targeted structure stabilized the proteins. Therefore, Artocarpus communis seeds could be a new strategy for the management of metabolic syndrome. Communicated by Ramaswamy H. Sarma

Metabolic effects of colour- and odour-induced sweetness enhancement

Can the mere expectation of drinking a sweeter beverage induce changes in taste perception and blood metabolism? Recent evidence has shown that sweetness perception can be altered by other senses, such as vision, audition, and olfaction. However, it is still unclear whether such crossmodal influences have a physiological basis. The present study examined how subjective mental states, such as the expectation of drinking a sweeter beverage due to colour and odour associations, may influence taste perception and metabolism. Twenty-seven healthy participants consumed two beverages containing identical sucrose and citric acid concentrations but altered in colour and aroma, namely a green, lemon-flavoured beverage and a red, strawberry-flavoured beverage. On average, the strawberry manipulation resulted in significantly higher sweetness ratings and lower sourness ratings compared to the lemon manipulation, although there were clear individual differences in the direction of sweetness enhancement. Blood glucose and insulin levels measured at −15, 0, 10, 20, 30, 45, 60 and 90 min after consumption showed no direct difference between the two beverage conditions. However, we found a significant indirect effect of perceived sweetness on insulin release, whereby consuming the beverage perceived to be sweeter resulted in higher overall levels of insulin release compared to the beverage that was less sweet. These results show a partial role of subjective sweetness perception influencing metabolism in accordance with an anticipatory budging model, suggesting that psychological intervention programs may be important for diabetes and metabolic syndrome management.